Retinopathy Revealing Cerebral Venous Thrombosis in Sickle Cell Disease in Niger

Cerebral venous thrombosis (CVT) in sickle cell disease has been rarely described in the literature. Some authors consider sickle cell disease as a risk factor for CVT. We report the case of a 20-year-old boy, known as sickle cell, followed at the National Reference Center for Sickle Cell Disease in Niger. Admitted in consultation for a decrease of acuity with the right eye with perception of a black spot evolving since about three (3) days, ophthalmological examination revealed sickle cell retinopathy associated with cerebral venous thrombosis on MRI. The rest of the balance showed normochromic anemia, ionic disturbance and a D-dimer at 1500 μg/l. Rehydration, strict rest, antibiotic therapy and analgesics were started with an internal medicine opinion for further treatment. There was an improvement in visual acuity of 6/10 in 48 hours with disappearance of black spot perception, after three weeks, an ad integrum recovery of retinal lesions to control imaging. Despite the ocular complications of sickle cell disease involving visual prognosis, cerebral venous thrombosis is another complication to be investigated in any sickle cell retinopathy.

Patient-Reported Factors Facilitating Participation in Prevention of Mother to Child Transmission of HIV Programs in Kara, Togo, West Africa

Background: Despite efforts to expand prevention of mother-to-child transmission (PMTCT) of HIV in resource-limited settings, only 53% of women in sub-Saharan Africa receive adequate PMTCT services. Understanding factors that enable successful program completion are crucial to improving adherence rates to PMTCT programs in these settings. Using a positive deviance approach, we explored patient and provider’s perspectives on factors enabling women to successfully access and adhere to PMTCT services to identify areas of program improvement and further reduce HIV transmission. Methods: Semi-structured interviews were conducted with 11 health care workers (HCWs) at two health centers in Kara, Togo and 34 women who had successfully completed the PMTCT program at those facilities. Women were identified using purposive sampling and content theme analysis was used to analyze the data. Results: Knowledge and belief in the potential to give birth to an HIV-negative child, supported by facilitating factors on the individual and community levels, was the cornerstone to women’s PMTCT program success. Effective program education and peer-to-peer interactions fostered the participants’ knowledge and belief in PMTCT, with the resulting internal motivation driving continued participation and adherence. The welcoming environment, availability of peer support groups and financial assistance from the health facility, further facilitated success, with women using this facility-based community to seek advice and support from HCWs and peers. Financial, physical, and emotional support from relatives was also important in ensuring unhindered access. Finally, the faith-based communities’ acceptance and support for HIV-positive women further encouraged participants to adhere to the program. Conclusion: Understanding and believing in the ability to have an HIV-negative baby was the most important facilitator for PMTCT program adherence. This led to internal motivation that was continually reinforced through facility and community supportive environments focused on addressing barriers. Efforts to improve PMTCT success should focus on all of these factors through a patient-centered approach.

Identification of Empirical Models for the Prediction of the Plasticity Index:Case of the KhôDepression in South Benin

The plasticity index is an essential design parameter used as a standard input in fine-grained soil investigation programs.It is used to estimate the plasticity and physical properties of soils,and indirectly their strength properties.This index is determined from the Atterberg limit tests,starting from the limits of liquidity and plasticity.However,the realization of the test considered as basic and simple,is not so much.The effects of the operator,the calibration of the apparatus and the environmental aspects during the tests affect the reliability and accuracy of the results.In this paper,the objective is to overcome these difficulties by evaluating the plasticity index of clay and loam soils by considering only the values of the liquid limit.Soil samples were collected from 0 to 5 m depth in the localities of the Khôdepression in Benin.On these samples,Atterberg limit tests were performed in the laboratory.Using MATLAB’s Curve Fitting Toolbox,linear,exponential and power prediction models were analyzed.The results showed that there is indeed a good correlation between the plasticity index and the liquid limit of the soils.For the linear model,it was observed R2 equal to 0.9891.For the exponential model,R2 is 0.98871 and for the power model 0.9802.A study of the residual plot validated the models found,as well as comparisons with well-known literature sources.Through the equations obtained,it is now possible to study the plasticity of soils in the Khôdepression only from the liquid limit,without determining the plasticity limit.