ABSTRACT Avian species are recognized as reservoirs of bacteria with potential human health risks, highlighting the need for further research into their role in spreading these pathogens, and the associated public health concerns. This study aimed to investigate the prevalence and antibiotic resistance patterns of Campylobacter jejuni and Escherichia coli among various farmed avian species. A total of 5 avian species from different farms in the district of Kasur were sampled, and fecal samples (n=250) were collected for analysis. The samples were processed using standard microbiological techniques to isolate and identify C. jejuni and E. coli. Antibiotic susceptibility testing was performed to determine the resistance patterns of these bacteria against commonly used antibiotics. The results revealed a significant prevalence of C. jejuni (56%) and E. coli (87%) among the avian species tested. Regarding antibiotic resistance, both C. jejuni and E. coli strains showed varying levels of resistance to the tested antibiotics (ciprofloxacin, tetracycline, erythromycin and amoxicillin). The findings suggest that avian species may harbor C. jejuni and E. coli, underscoring the need for surveillance, control, and effective management of antibiotic use. It was concluded that avian species are significant reservoirs for Campylobacter jejuni and Escherichia coli, which exhibited notable antibiotic resistance and multidrug-resistant strains. risks pathogens concerns sampled n=250 n250 n 250 (n=250 analysis C E 56% 56 (56% 87% 87 (87% ciprofloxacin, ciprofloxacin (ciprofloxacin tetracycline amoxicillin. amoxicillin . amoxicillin) surveillance control use multidrugresistant multidrug resistant n=25 n25 25 (n=25 (56 8 (87 n=2 n2 2 (n=2 (5 (8 n= (n= ( (n

ABSTRACT The present study intended to identify the effects of the Saccharomyces cerevisiae yeast on production performance and parameters related to the quality of layers’ eggs. Effects of yeast on immune titers after routine vaccinations against Newcastle disease and infectious bronchitis were also studied. Fayoumi chicken (n=288) were divided in four groups (72 in each), and Black Australorp (n=288) in four groups (72 in each). Both had 12 weeks of age and were kept in 08 groups (3 replicates per treatment). Hens were fed a controlled diet along with the addition of 0.5g, 1.0 g, and 1.5 g of S. cerevisiae per kg of feed, till 25 weeks of age. Feed intake and egg production were measured on a daily basis, while body weight gain and egg weight were measured weekly. Egg quality parameters were evaluated by picking 5 eggs from every group weekly. Birds were vaccinated for Newcastle disease (ND) and infectious bronchitis (IB) at the 18th week. Subsequently, 10 days after vaccination, antibody titers were determined by Hemagglutination Inhibition and Enzyme Linked Immunosorbent Assay for both diseases. Results showed no significant effect of S. cerevisiae on layers’ weight gain and feed intake. However, egg production was increased in the experimental group. Moreover, yeast supplementation impacted positively on birds’ immune system. In conclusion, probiotic supplementation improved birds’ egg production and immunity. layers studied n=288 n288 n 288 (n=288 72 (7 each, each , each) each. . 1 0 3 ( treatment. treatment treatment) 05g 5g 0.5g 1. 15 S 2 basis weekly ND (ND IB (IB th week Subsequently vaccination diseases However Moreover birds system conclusion immunity n=28 n28 28 (n=28 7 n=2 n2 (n=2 n= (n= (n

Resumo Salmo trutta fario é a espécie de peixe mais importante da família dos salmonídeos, inibida em águas frias em todo o mundo, incluindo as partes do noroeste do Paquistão. Este estudo teve como objetivo conhecer a seleção de presas e os hábitos alimentares da espécie. Cento e oitenta e cinco Salmo trutta fario foram capturados de março de 2016 a abril de 2017. Intensidade de alimentação representada por um índice de plenitude (FI), mudando com vários grupos de comprimento e estação. De 185 trutas, 24 estômagos de peixes foram encontrados vazios. Os itens alimentares mais importantes e comuns da truta marrom foram brachycentridae, blepharocera, hydropsychidae, ephemerellaspp. O teste H de Kruskal Wallis foi aplicado em grupos de intensidade de alimentação consistindo de um grupo de três meses. A estatística de teste para o teste KW-H foi (H = 8,13 com df = 3) teve um valor de p de 0,043 <(alfa = 0,05 indica favor da hipótese alternativa de pelo menos uma diferença entre os grupos de intensidade de alimentação. relação de N com o índice de importância relativa e% IRI denotado pela linha de regressão do mínimo quadrado (N = 35,2 + 22,1% IRI), mostra que para 22 presas há 1% de mudança no IRI. A relação entre comprimento total (mm) e peixes o peso corporal (gm) é expresso pelo coeficiente de correlação de Pearson (r = 0,976), mostrou que o comprimento total (mm) e o peso corporal dos peixes (gm.) são altamente correlacionados. Estatísticas descritivas são usadas para a plenitude do estômago, o que mostra que a intensidade da alimentação foi registrado mais alto de março a maio. Um total de 2.289 presas foi registrado, incluindo os mais comuns foram; trichoptera, hydropsychidae, brachycentridae, diptera, blepharocera, efemérala, chironomida, abelhas, funil de grama, gafanhoto, ovo de truta, trocânter, tecido vegetal, pedras foram retiradas do intestino conteúdo de truta marrom. De acordo com o índice de importância relativa IRI%, quatro presas representam os principais componentes da dieta. O maior IRI% foi registrado em brachycentridae (39,38%), seguido por blepharocera (13,23%), hydropsychidae (10,76%) e ephemerellaspp (8,28%). A relação entre IRI e FO é (r = 0,556) está moderadamente correlacionada com o coeficiente de determinação (r2 = 0,31). Este estudo auxiliará no desenvolvimento de uma dieta artificial para a espécie para melhor desempenho de crescimento em cativeiro.

Abstract Salmo trutta fario is the most important fish species of family Salmonidae inhibited in cool waters all over the world including the nortern parts of Pakistan. This study was aimed to find out the prey selection and feeding habits of the species. One hundred and eighty five Salmo trutta fario were captured from March 2016 to April 2017. Feeding intensity as represented by a fullness index (FI), changing with various length groups and season. Out of 185 Brown trout 24 fish stomaches were found empty. The most important and common food items of brown trout were Brachycentridae, Blepharocera, Hydropsychidae, ephemerella spp. Kruskal Wallis H-test were applied on feeding intensity groups consisting of three month group. The test statistic for K.W-H-test were (H=8.13 with df =3) had a p-value of 0.043 < (alpha=0.05 indicates favor of the alternative hypothesis of at least one difference among the feeding intensity groups. The linear relationship of N with index of relative importance and %IRI denoted by least square regression line (N = 35.2 + 22.1%IRI), shows that for 22 prey there is 1% change in IRI. The relationship between total length (mm) and fish body weight (gm) is expressed by Pearson correlation coefficient (r = 0.976), showed that total length (mm) and fish body weight (gm.) is highly correlated. Descriptive statistics are used for the stomach fullness, which shows that feeding intensity was recorded higher from March to May. A total of 2289 preys was recorded including the most common were; Trichoptera, Hydropsychidae, Brachycentridae, diptera, blepharocera, ephemerala, chironomida, honey bees, grass hopper, locust, trout egg, trochanter, plant tissue, stones were retrieved from the gut contents of brown trout. According to index of relative importance IRI% four preys represents major components of the diet. The highest IRI% was recorded in Brachycentridae (39.38%), followed by blepharocera (13.23%), Hydropsychidae (10.76%) and ephemerella spp (8.28%). The relationship between IRI and FO is (r =0.556) is moderately correlated with coefficient of determination (r2=0.31). This study will help in the development of an artificial diet for the species for better growth performance in captivity.

resumo Uma série de acetamidas 2-{[5-(1H-indol-3-ilmetil)-1,3,4-oxadiazol-2-il]sulfanila} N-substituídas (8a-w) foi sintetizada em três fases. A primeira etapa envolveu a conversão sequencial de ácido 2-(1H-indol-3-il)acético (1) a éster (2), seguido por hidrazida (3) e, finalmente, a e ciclização na presença de CS2 e KOH alcoólico produziu 5-(1H-indol-3-il- metil)-1,3,4-oxadiazole-2-tiol (4). Na segunda etapa, aminas arílicas/aralquílicas(5a-w) reagiram com brometo de 2-bromoacetila (6), em meio básico, para se obter acetamidas 2-bromo-N-substituídas (7a-w). Na terceira etapa, estes eletrófilos (7a- w) reagiram com 4, para se obter os compostos alvo (8a-w). A elucidação estrutural de todos os derivados sintetizados foi realizada por 1H-NMR, IR e técnicas de espectrometria de EI-MS. Além disso, eles foram submetidos a triagem de atividade antibacteriana e hemolítica. Análise da inibição enzimática foi bem apoiada pelos resultados de docking molecular. Por exemplo, o composto 8q exibiu melhor potencial inibitório contra α-glicosidase, e os compostos 8g e 8b exibiram, comparativamente, melhor inibição contra butirilcolinesterase (BChE) elipoxigenase (LOX), respectivamente. Do mesmo modo os compostos 8b e 8c mostraram excelente potencial antibacteriano contra SalmonellaTyphi, semelhante ao do ciprofloxacino, antibiótico padrão usado neste estudo. Os compostos 8c e 8l também mostraram excelente potencial antibacteriano contra Staphylococcus aureus . Quase todos os compostos mostraram pequena atividade hemolítica, sendo que o composto 8p apresentou menor atividade. Assim, as moléculas sintetizadas podem ter a sua utilidade como agentes terapêuticos adequados.

abstract A series of N-substituted 2-{[5-(1H-indol-3-ylmethyl)-1,3,4-oxadiazol-2-yl]sulfanyl}acetamides (8a-w) was synthesized in three steps. The first step involved the sequential conversion of 2-(1H-indol-3-yl)acetic acid (1) to ester (2) followed by hydrazide (3) formation and finally cyclization in the presence of CS2 and alcoholic KOH yielded 5-(1H-indole-3-yl-methyl)-1,3,4-oxadiazole-2-thiol (4). In the second step, aryl/aralkyl amines (5a-w) were reacted with 2-bromoacetyl bromide (6) in basic medium to yield 2-bromo-N-substituted acetamides (7a-w). In the third step, these electrophiles (7a-w) were reacted with 4 to afford the target compounds (8a-w). Structural elucidation of all the synthesized derivatives was done by 1H-NMR, IR and EI-MS spectral techniques. Moreover, they were screened for antibacterial and hemolytic activity. Enzyme inhibition activity was well supported by molecular docking results, for example, compound 8q exhibited better inhibitory potential against α-glucosidase, while 8g and 8b exhibited comparatively better inhibition against butyrylcholinesterase and lipoxygenase, respectively. Similarly, compounds 8b and 8c showed very good antibacterial activity against Salmonella typhi, which was very close to that of ciprofloxacin, a standard antibiotic used in this study. 8c and 8l also showed very good antibacterial activity against Staphylococcus aureus as well. Almost all compounds showed very slight hemolytic activity, where 8p exhibited the least. Therefore, the molecules synthesized may have utility as suitable therapeutic agents.

Maintenance of high bacterial population in the rhizosphere improves the efficiency of these organisms. This high bacterial population can be maintained by the application of enriched compost which supports their growth and activities. Thus integrated use of Rhizobium, plant growth promoting rhizobacteria (PGPR) containing 1-aminocyclopropane-1-carboxylate deaminase (ACC-deaminase) and P-enriched compost (PEC) could be highly effective for promoting growth, nodulation, and yield of lentil (Lens culinaris Medik.). A field study was conducted to evaluate the potential of Rhizobium, PGPR containing ACC-deaminase and PEC for promoting growth of lentil. For this study, the soil type was sandy clay loam soil having pH 7.6; EC (electrical conductivity) 2.8 dS m-1; organic matter (OM) 0.59%; total N 0.032%; available P 7.9 mg kg-1, and extractable K 129 mg kg-1. Treatments were replicated thrice, using randomized complete block (RCB) design. Results showed that the integrated use of R. leguminosarum with Pseudomonas spp. containing ACC-deaminase along with PEC was highly effective and caused up to 73.5, 73.9, 74.4, 67.5, 73.3, 65.8, 40.5, and 52.5% increase in fresh biomass, grain yield, straw yield, pods plant-1, nodule plant-1, nodule dry weight plant-1, 1000-grain weight, and N content in grain of lentil, respectively, as compared to respective control. It is concluded that integrated use of R. leguminosarum with Pseudomonas spp. having trait ACC-deaminase plus PEC would be an effective approach for better nodulation which consequently improved yield of lentil under natural conditions.

La mantención de una alta población bacteriana en la rizósfera mejora la eficiencia de estos organismos. Esta población bacteriana puede ser mantenida por la aplicación de compost enriquecido que mantiene su crecimiento y actividades. Por lo tanto, el uso integrado de Rhizobium, rhizobacterias promotoras de crecimiento vegetal (PGPR) conteniendo 1-aminociclopropano-1-carboxilato desaminasa (ACC-desaminasa) y compost enriquecido con P (PEC) podría ser altamente efectivo en la promoción de crecimiento, nodulación, y producción de lenteja (Lens culinaris Medik.). Un estudio de campo se condujo para evaluar el potencial de Rhizobium, PGPR conteniendo ACC-desaminasa y PEC para promover el crecimiento de lenteja. Para este estudio, el tipo de suelo fue franco-arcillo arenoso con pH 7,6; conductividad eléctrica 2,8 dS m-1; materia orgánica 0,59%; N total 0,032%; P disponible 7,9 mg kg-1, y K extraíble 129 mg kg-1. Los tratamientos se repitieron tres veces, usando diseno de bloques completos al azar. Los resultados mostraron que el uso integrado de R. leguminosarum con Pseudomonas spp. conteniendo ACC-desaminasa junto con PEC fue altamente efectivo y causaron hasta 73.5, 73.9, 74.4, 67.5, 73.3, 65.8, 40.5, y 52.5% de aumento en biomasa fresca, producción de grano, producción de paja, vainas planta-1, peso seco de nódulo por planta, peso de 1000 granos, y contenido de N en grano de lenteja, respectivamente, comparado con el respectivo control. Se concluyó que el uso integrado de R. leguminosarum con Pseudomonas spp. portando el rasgo de ACC-desaminasa más PEC podría ser un apronte efectivo para mejor nodulación que consecuentemente mejoró producción de lenteja bajo condiciones naturales.

Finding more efficient ways to fertilize crops will reduce N losses and increase nutrient uptake. A field experiment was conducted at the Agronomic Research Farm, University of Agriculture, Faisalabad, Pakistan, during 2006 and repeated in 2007. The crop was planted in three different geometrical arrangements, viz. flat sowing (rows spaced 75 cm), ridge sowing (ridges spaced 75 cm), and strip planting (double row strips spaced 120 cm with 30 cm between rows in a strip); NPK was applied in four different combinations (0-0-0 control, 200-100-100 low dose,250-125-125 medium dose, and 300-150-150 high dose kg ha-1). Both fertilizer use efficiency (FUE) and N use efficiency (NUE) were significantly lower with the high fertilizer dose (300-150-150 kg NPK ha-1) than with the low or medium doses. The highest nitrogen uptake efficiency was with the medium fertilizer dose and proved to be a good indicator of grain yield. Among planting methods, ridge plantation resulted in higher FUE, NUE, and N uptake efficiency. The highest grain yield, net income, and benefit cost ratio were recorded when a crop was planted on ridges with the medium fertilizer dose. Sowing methods did not significantly affect grain quality parameters. Seed oil, protein, and starch contents were the lowest in the control. Thereafter, seed oil contents continued to decrease, while seed protein and seed starch increased with each NPK fertilizer increment.

Encontrando maneras más eficientes para fertilizar los cultivos se reducirán las pérdidas de N y aumentará la absorción de nutrientes. Un experimento de campo se llevó a cabo en la Granja de Investigación Agronómica de la Universidad de Agricultura, Faisalabad, Pakistán, durante 2006 y 2007. El cultivo fue sembrado en tres modalidades geométricas diferentes: siembra plana (filas separadas 75 cm), siembra en camellones (camellones separados 75 cm), y plantación en hileras (franjas de doble hilera separadas por 120 cm con espacio de 30 cm entre las hileras de una franja) y cuatro combinaciones de NPK (control 0-0-0; dosis baja 200-100-100; dosis media 250-125-125, y dosis alta 300-150-150 kg ha-1). La eficiencia de uso de fertilizantes (FUE), así como la eficiencia del uso del N (NUE) fue significativamente menor con la dosis más alta de fertilizante (300-150-150) que con las dosis baja o media. Eficiencia de absorción de N fue mayor con la dosis fertilizante media y demostró ser un buen indicador del rendimiento de grano. Entre los métodos de siembra, plantación en camellones resultó en una mayor extracción de unidades foliculares, NUE, y la eficiencia de absorción de N. El mayor rendimiento de grano, la utilidad neta y la relación costo-beneficio se registraron en el cultivo sembrado en camellones con dosis media de fertilizante. Métodos de siembra no afectaron significativamente los parámetros de calidad del grano. Contenido de aceite de semillas, proteína y almidón fueron los más bajos con el control. A partir de entonces, el contenido de aceite de semilla continuó disminuyendo, mientras que la proteína y el almidón de semillas aumentaron con cada incremento de fertilizantes NPK.

Our aim in this study is to give a broad overview of the main ethical and legal challenges of pharmaceutical marketing. The purpose of this study was also to investigate unethical pharmaceutical marketing, the effect on physicians of receiving gifts, the influences of perceptions regarding the importance of ethics and social responsibility on ethical intentions of marketing professionals. It also investigates the effect of unethical marketing on ultimate consumer (patient). Questionnaire based survey study was conducted from two main categories: (i) physicians/consultants and (ii) pharmaceutical companies. In Pakistan, there is no mechanism to monitor the drug promotional campaign by pharmaceutical industry despite the fact that there is enough evidence that irrational pharmacotherapy is increasingly encountered even in the developed countries due to unethical practices of pharmaceutical promotion. Medical practitioners and the pharmaceutical industry serve interests that sometimes overlap and sometimes conflict. There is strong evidence that associations between industry and physicians influence the behaviour of the latter in relation to both clinical decision making and ethical promotion of drugs. The basic principles underlying the conduct of physicians with respect to pharmaceutical companies should be openness and transparency.

Nuestro objetivo es dar una amplia visión de los principales desafíos éticos y legales del mercado farmacéutico. El propósito de este estudio fue investigar faltas éticas en el mercado farmacéutico, el efecto de la recepción de regalos por parte de los medicos y la influencia de las percepciones respecto de la importancia de la ética y la responsabilidad social en las intenciones éticas de los profesionales del mercado. También se investigó el efecto de las faltas éticas sobre el consumidor último (el paciente). Se realizó un estudio, mediante una encuesta cuestionario, con dos categorías principales: (i) médicos/consultores y (ii) empresas farmacéuticas. En Pakistán no existe un mecanismo para monitorear la campaña promocional de medicamentos realizada por la industria farmacéutica, a pesar de existir bastante evidencia de que ha aumentado la farmacoterapia irracional, incluso en países en desarrollo, debido a prácticas contrarias a la ética de la promoción farmacéutica. Los médicos practicantes y la industria farmacéutica sirven a intereses que algunas veces se superponen y otras entran en conflicto. Existe fuerte evidencia de que las asociaciones entre la industria y los médicos influyen el comportamiento de los últimos, tanto en relación con la toma de decisiones clínicas como en la promoción contraria a la ética de medicamentos. La apertura y transparencia debieran ser los principios básicos que fundamenten la conducta de los médicos respecto de las empresas farmacéuticas.

Nosso objetivo é dar uma ampla visão dos principais desafios éticos e legais do mercado farmacêutico. O propósito deste estudo foi investigar faltas éticas no mercado farmacêutico, o efeito da recepção de brindes por parte dos médicos e a influência das percepções a respeito da importância da ética e da responsabilidade social nas intenções éticas dos profissionais do mercado. Também se investigou o efeito das faltas éticas sobre o consumidor último (o paciente). Foi realizado um estudo, mediante um questionário, com duas categorias principais: (i) médicos/consultores e (ii) empresas farmacêuticas. No Paquistão não existe um mecanismo para monitorar a campanha promocional de medicamentos realizada pela indústria farmacêutica, apesar de existir bastante evidência de que tem aumentado a farmacoterapia irracional, inclusive em países em desenvolvimento, devido a práticas contrárias à ética da promoção farmacêutica. Os médicos praticantes e a indústria farmacêutica servem a interesses que algumas vezes se superpõem e em outras entram em conflito. Existe forte evidência de que as associações entre a indústria e os médicos influenciam o comportamento destes últimos, tanto em relação à tomada de decisões clínicas quanto na promoção contrária à ética dos medicamentos. A abertura e transparência deveriam ser os princípios básicos que fundamentam a conduta dos médicos a respeito das empresas farmacêuticas.

OBJECTIVE: To explore use-inequity in maternal health-care services in home-based skilled-birth-attendant (SBA) programme areas in Bangladesh. METHODS: Data from a community survey, conducted from February to May 2006, were analysed to examine inequities in use of SBAs, caesarean sections for deliveries and postnatal care services according to key socioeconomic factors. FINDINGS: Of 2164 deliveries, 35% had an SBA, 22.8% were in health facilities and 10.8% were by caesarean section. Rates of uptake of antenatal and postnatal care were 93% and 28%, respectively. There were substantial use-inequities in maternal health by asset quintiles, distance, and area of residence, and education of both the woman and her husband. However, not all inequities were the same. After adjusting for other determinants, the differences in the use of maternal health-care services for poor and rich people remained substantial [adjusted odds ratio (OR) 2.51 (95% confidence interval, CI: 1.68-3.76) for skilled attendance; OR 2.58 (95% CI: 1.28-5.19) for use of caesarean sections and OR 1.53 (95% CI: 1.05-2.25) for use of postnatal care services]. Complications during pregnancy influenced use of SBAs, caesarean-section delivery and postnatal care services. The number of antenatal carevisits was a significant predictor for use of SBAs and postnatal care, but not for caesarean sections. CONCLUSION: Use of maternity care services was higher in the study areas than national averages, but a tremendous use-inequity persists. Interventions to overcome financial barriers are recommended to address inequity in maternal health. A greater focus is needed on the implementation and evaluation of maternal-health interventions for poor people.

OBJETIVO: Estudiar la inequidad en el uso de los servicios de atención materna en las zonas con programas de parteras calificadas (PC) de atención domiciliaria en Bangladesh. MÉTODOS: Se analizaron los datos de una encuesta comunitaria llevada a cabo entre febrero y mayo de 2006 para analizar las inequidades en el uso de las PC, la práctica de cesáreas y los servicios de atención posnatal en función de factores socioeconómicos clave. RESULTADOS: De un total de 2164 partos, el 35% tuvieron lugar con la asistencia de una PC, el 22,8% se produjeron en establecimientos de salud, y un 10,8% se hicieron mediante cesárea. Las tasas de uso de los servicios de atención prenatal y posnatal fueron del 93% y el 28%, respectivamente. Se observaron inequidades sustanciales en el uso de los servicios de salud materna en función de los quintiles de riqueza, la distancia y la zona de residencia y el nivel de instrucción tanto de la mujer como del cónyuge, pero el grado de inequidad difería. Después de ajustar para otros determinantes, las diferencias de uso de los servicios de atención materna entre las personas ricas y las pobres siguieron siendo sustanciales [razón de posibilidades (OR) ajustada de 2,51 (intervalo de confianza del 95%: 1,68-3,76) para la asistencia por personal cualificado; 2,58 (IC95%: 1,28-5,19) para la práctica de cesáreas, y 1,53 (IC95%: 1,05-2,25) para el uso de servicios de atención posnatal]. Las complicaciones durante el embarazo influyeron en el uso de las PC, el parto por cesárea y los servicios de atención posnatal. El número de visitas de atención prenatal fue un factor predictivo importante de la intervención de PC y del recurso a los servicios de atención posnatal, pero no de las cesáreas. CONCLUSIÓN: La utilización de los servicios de maternidad en las zonas estudiadas fue mayor que la media nacional, pero sigue habiendo grandes inequidades en lo tocante al uso de esos servicios. Se recomienda emprender intervenciones para superar los obstáculos económicos y corregir las inequidades en salud materna, y hay que hacer más hincapié en la aplicación y evaluación de las intervenciones de salud materna en la población pobre.

OBJECTIF: Etudier l'inéquité dans le recours aux services de soins maternels dans les zones desservies par des programmes d'assistance à domicile des naissances par du personnel qualifié (SBA) au Bangladesh. MÉTHODES: Les données fournies par une enquête en communauté, réalisée de février à mai 2006, ont été analysées pour étudier, en fonction de facteurs socioéconomiques clés, les inéquités dans le recours aux SBA, à une césarienne pour l'accouchement et aux services de soins postnatals. RÉSULTATS: Sur 2164 accouchements, 35 % ont bénéficié d'un SBA, 22,8 % se sont déroulés dans un établissement de soins et 10,8 % se sont effectués par césarienne. Les taux d'utilisation des soins anténatals et postnatals étaient respectivement de 93 et 28 %. Il existait des inéquités sanitaires substantielles entre les mères selon le quintile de richesse, l'éloignement et la zone de résidence et le niveau d'éducation maternel et paternel. Cependant, ces inéquités étaient d'une ampleur variable. Après ajustement pour d'autres déterminants, les écarts entres riches et pauvres pour le recours aux services de soins maternels restaient importants : odds ratio ajusté (OR) = 2,51 (intervalle de confiance à 95 %, IC = 1,68-3,76) pour l'assistance par du personnel qualifié à la naissance ; OR = 2,58 (IC à 95 % = 1,28-5,19)] pour l'accouchement par césarienne et 0R = 1,53 (IC à 95 % = 1,05-2,25 pour les services de soins postnatals. La survenue de complications pendant la grossesse influait sur le recours aux SBA, à l'accouchement par césarienne et aux services de soins postnatals. Le nombre de visites anténatales était un paramètre prédictif important pour le recours aux SBA et aux soins postnatals, mais pas pour le recours à une césarienne. CONCLUSION: Les services de soins maternels étaient plus utilisés dans les zones étudiées qu'en moyenne dans le pays. Une très forte inéquité persiste cependant dans le recours à ces soins. Des interventions visant à surmonter les obstacles financiers sont recommandées pour faire face à cette inéquité en matière de santé maternelle. Il faut se concentrer davantage sur la mise en œuvre et l'évaluation des interventions en faveur de la santé maternelle visant des personnes défavorisées.