Practices and Obstacles to Provider-Initiated HIV Testing and Counseling (PITC) Among Healthcare Providers in Côte d’Ivoire

Practices of Provider-Initiated HIV Testing and Counseling (PITC) remains suboptimal in Côte d'Ivoire. The aim of this survey was to identify the practices and obstacles to PITC among healthcare professionals in Côte d'Ivoire. A nationally representative cross-sectional survey was conducted in 2018 by telephone among three separate samples of midwives, nurses and physicians practicing in Côte d'Ivoire. The number of HIV tests proposed during consultation in the month preceding the survey was collected for each professional. Factors associated with the number of proposed tests were identified through ordinal logistic regression models. A total of 298 midwives, 308 nurses and 289 physicians were interviewed. Midwives proposed the test more frequently, followed by nurses and physicians. Among midwives, a higher number of proposed tests was associated with the perception that HIV testing does not require specific consent compared to other diseases (aOR 4.00 [95% CI 1.37-14.29]). Among nurses, having received HIV training and the presence of community HIV counselors were associated with a higher number of proposed tests (aOR 2.01 [1.31-3.09] and aOR 1.75 [1.14-2.70], respectively). For physicians, the presence of a voluntary testing center was associated with a higher number of proposed tests (aOR 1.69 [1.01-2.86]). PITC practices and barriers differed across professions. Beyond improving environmental opportunities such as dedicated staff or services, strengthening the motivations and capabilities of healthcare professionals to propose testing could improve PITC coverage

Even-parity autoionizing states in the extreme-ultraviolet photoabsorption spectra of Mg, Al⁺, and Si²⁺

The dual-laser-produced plasma (DLP) photoabsorption technique has been used to study 2p→3s excitations in the isoelectronic species Mg, Al+, and Si2+ prepared in the excited configuration 2p63s3p. The autoionizing upper states belong to the 2p53s23p even-parity configuration. The versatility of the technique is demonstrated through a careful combination of space- and time-resolved photoabsorption scans. Plasma conditions optimized for the observation of the inaccessible parity regime were successfully reproduced along the isoelectronic sequence of interest. All the observed transitions were interpreted with the help of multiconfigurational atomic structure calculations. In the case of magnesium, the photoabsorption data are compared with the ejected-electron spectra excited by low-energy electron impact of Pejcev et al. [J. Phys. B 10, 2389 (1977)]

Action to protect the independence and integrity of global health research

Storeng KT, Abimbola S, Balabanova D, et al. Action to protect the independence and integrity of global health research. BMJ GLOBAL HEALTH. 2019;4(3): e001746

Permanence et invisibilité des paiements directs pour le VIH en République Démocratique du Congo

Bien que la gratuité des soins dans le contexte du VIH figure comme l'un des succès de la lutte contre le sida, les paiements directs imputés aux personnes vivant avec le VIH (PVVIH) perdurent dans certains contextes. Ce chapitre vise, à partir d'une revue documentaire, à mettre en évidence les connaissances existantes dans la littérature grise sur la présence des paiements directs au sein des interventions de lutte contre le VIH en République Démocratique du Congo ainsi que leurs conséquences et conditions de mise en oeuvre. Cette revue documentaire montre la persistance et l'ampleur des paiements directs imputés aux PVVIH pour les soins associés au VIH en RDC ainsi que leurs effets délétères et - paradoxalement - le manque de visibilité de la question dans les écrits. Elle permet de dégager des besoins en connaissances dans le contexte de la RDC

Effect of organizational models of provider-initiated testing and counseling (PITC) in health facilities on adult HIV testing coverage in sub-Saharan Africa

International audienceThe purpose of this paper is to identify which Provider-Initiated HIV Testing and Counseling (PITC) organizational models are the most efficient to maximize testing coverage. We conducted a systematic literature review to identify published articles that evaluated routine PITC programs implemented in adult health facilities in Sub-Saharan Africa. We considered only articles measuring PITC offer, PITC acceptability and PITC coverage. Adjusted meta-regression models were performed to measure the association between PITC offer, acceptability and coverage with PITC organizational model. A total of 30 articles were included in the meta-analysis. Overall, 85.4% [95%CI: 77.2-93.5] of patients were offered a test, and 87.1% [82.4-91.7] accepted the test resulting in a PITC coverage of 74.3% [66-82.6]. Four types of PITC organizational models were identified: PITC initiated and performed during the consultation (model A), PITC initiated before consultation (model B), PITC referred on-site (model C) and PITC referred off-site (model D). Compared to model A, model B had a similar coverage (aOR: 1.02 [0.82-1.26]). However, coverage was lower for model C (aOR: 0.81 [0.68-0.97]) and model D (aOR: 0.58 [0.44-0.77]). Initiating the testing process before or during medical consultation is recommended for maximizing testing coverage among patients

Synchrotron Radiation µCT : A Reference Tool for the Characterization of Bone Samples

International audienceTomographic techniques are attractive for the analysis of bone micro-architecture since they are non-destructive and may provide images of bone samples in three dimensions. Currently, two modalities are available: x-ray µCT (Micro-Computerized Tomography) and MRI (Magnetic Resonance Imaging). Due to the typical dimensions of trabeculae, specific µCT or MRI devices had to be developed.1,2Whereas both types of devices may deliver 3D images of bone architecture, the characteristics of these images differ 3D images of bone architecture, the characteristics of these images differ meaningfully. First, the parameter that is imaged is related to the corresponding phenomenon, either the x-rays absorption coefficient in /lCT, or the protons’ magnetization in MRI. Second, the two modalities do not offer the same spatial resolution and image quality. For in vivo imaging, an inslice spatial resolution around 100-150µlm. with a generally larger slice thickness, is typically achievable with both modalities.3, 4However, the use of x-ray µlCT is restricted to peripheral sites, such as the forearm, and this typical spatial resolution might not be significantly improved considering the problem of dose delivery. For in vitro imaging, much higher spatial resolutions are attainable at this time. In µlMRI (Micro-MRI), images of bone samples with isotropic spatial resolution of 50 µlm have been reported.5In x-ray µlCT, images with voxel sizes up to 28 µlm are available.6, 7Furthermore, the use of x-rays generated from synchrotron sources permits a spatial resolution of 1µlm

Sequential pumping in Ne-like iron. Multiple irradiation of X-ray lasers

We study a X-ray laser (XRL) pumped by two 140 ps pulses frorn an IR laser beam. With the aim to regenerate the plasma gain with the second pulse, and then realise a double pass, we separate the two pulses by 800 ps. First experimental results obtained at LULI with Ne-like iron were very encouraging. In single pass mode, two saturated X-ray laser emissions have been observed with reproducible way. The gain values were respectively 15 cm-1 and 12 cm-1. This result qualitatively agrees with EHYBRID and Maxwell-Bloch modelling. We present the first far field pattern obtained in Ne-like iron and we deduce the two different positions of each XRL beam by subtracting images

Wavefront measurements in the soft X-ray range

In this article we report a new wavefront sensor, developed at the Laboratoire de Spectroscopie Atomique et Ionique, for a full characterization of soft X-ray beams. The Shack-Hartmann sensor has a theoretical accuracy in the order of $\lambda/100$ at a wavelength around 13 nm. A cartography of the wave-vectors pointing of laser-pumped soft X-ray laser has been achieved. It has shown the presence of many ripples probably coming from plasma instabilities. Capillary discharge soft X-ray laser has been also investigated. For all the pumping configurations, the wavefront is spherical, divergent with a radius of about 6.5 m at 2.5 m from the plasma end. The best wavefront exhibits an error to a perfect wave of 3λ rms. Assuming to focus the beam with a f = 50 mm diffraction-limited mirror, a theoretical focal spot size of 0.5 μm in diameter have been estimated containing 70% of the incident energy. In that case an intensity of 4 × 1013 W cm−2 should be achieved