Répercussions du Maintien Sexuel sur l'Intimité et l'Adaptation des Militaires Amputés à l'Hôpital Militaire d'Abidjan

Cet article scientifique examine les dimensions psychologiques et relationnelles de l'expérience des militaires ayant subi une amputation de la jambe à l'Hôpital militaire d'Abidjan. À l'aide d'une méthodologie qualitative impliquant 21 participants militaires, l'étude explore les processus d'adaptation, les stratégies d'ajustement et les ressources mobilisées par ces individus face aux défis psychologiques résultant de l'amputation. En s'appuyant sur les théories du stress post-traumatique et de l'adaptation, les résultats mettent en évidence l'interaction complexe entre la dimension sexuelle et les facteurs psychologiques, ainsi que l'impact sur les relations interpersonnelles et la dynamique du couple. Ces résultats suggèrent la prise en compte de la dimension sexuelle dans la réhabilitation psychologique, en intégrant les mécanismes de stress post-traumatique et d'adaptation dans les approches cliniques.   This scientific article examines the psychological and relational dimensions of the experience of military personnel who have had leg amputations at the Military Hospital of Abidjan. Using a qualitative methodology involving 21 military participants, the study explores the processes of adaptation, adjustment strategies, and resources mobilized by these individuals in the face of psychological challenges resulting from amputation. Drawing upon theories of post-traumatic stress and adaptation, the results highlight the complex interplay between the sexual dimension and psychological factors, as well as the impact on interpersonal relationships and couple dynamics. These findings suggest the consideration of the sexual dimension in psychological rehabilitation, incorporating post-traumatic stress and adaptation mechanisms into clinical approaches

Répercussions du Maintien Sexuel sur l'Intimité et l'Adaptation des Militaires Amputés à l'Hôpital Militaire d'Abidjan

Cet article scientifique examine les dimensions psychologiques et relationnelles de l'expérience des militaires ayant subi une amputation de la jambe à l'Hôpital militaire d'Abidjan. À l'aide d'une méthodologie qualitative impliquant 21 participants militaires, l'étude explore les processus d'adaptation, les stratégies d'ajustement et les ressources mobilisées par ces individus face aux défis psychologiques résultant de l'amputation. En s'appuyant sur les théories du stress post-traumatique et de l'adaptation, les résultats mettent en évidence l'interaction complexe entre la dimension sexuelle et les facteurs psychologiques, ainsi que l'impact sur les relations interpersonnelles et la dynamique du couple. Ces résultats suggèrent la prise en compte de la dimension sexuelle dans la réhabilitation psychologique, en intégrant les mécanismes de stress post-traumatique et d'adaptation dans les approches cliniques.   This scientific article examines the psychological and relational dimensions of the experience of military personnel who have had leg amputations at the Military Hospital of Abidjan. Using a qualitative methodology involving 21 military participants, the study explores the processes of adaptation, adjustment strategies, and resources mobilized by these individuals in the face of psychological challenges resulting from amputation. Drawing upon theories of post-traumatic stress and adaptation, the results highlight the complex interplay between the sexual dimension and psychological factors, as well as the impact on interpersonal relationships and couple dynamics. These findings suggest the consideration of the sexual dimension in psychological rehabilitation, incorporating post-traumatic stress and adaptation mechanisms into clinical approaches

Repercussions du Maintien de l’Activité Sexuelle sur l'Intimité et l'Adaptation des Militaires Amputés à l'Hôpital Militaire d'Abidjan

Cet article scientifique vise à décrire les dimensions psychologiques et relationnelles de l'expérience sexuelle des militaires ayant subi une amputation de la jambe à l'Hôpital militaire d'Abidjan. À l'aide d'une méthodologie qualitative fondée sur des entretiens semi-directifs réalisés avec 21 participants militaires, l'étude explore les processus d'adaptation, les stratégies d'ajustement et les ressources mobilisées par ces individus face aux défis psychologiques résultant de l'amputation. En s'appuyant sur les théories du stress post-traumatique et de l'adaptation, les résultats mettent en évidence une configuration complexe de la dimension sexuelle liée aux facteurs affectifs, cognitifs et la dynamique du couple. Ces résultats suggèrent la prise en compte de la dimension sexuelle dans la réhabilitation psychologique, en intégrant les mécanismes de stress post-traumatique et d'adaptation dans les approches cliniques.   This scientific article aims to describe the psychological and relational dimensions of the sexual experience of military personnel who have undergone leg amputation at the Abidjan Military Hospital. Using a qualitative methodology based on semi-structured interviews with 21 military participants, the study explores the coping processes, adjustment strategies and resources mobilized by these individuals in the face of the psychological challenges resulting from amputation. Drawing on post-traumatic stress and coping theories, the results highlight a complex configuration of the sexual dimension linked to affective, cognitive and couple dynamics. These results suggest that the sexual dimension should be taken into account in psychological rehabilitation, by integrating post-traumatic stress and coping mechanisms into clinical approaches

Case Report Multifocal Buruli Ulcer Associated with Secondary Infection in HIV Positive Patient

Buruli ulcer is a chronic and infectious skin disease, caused by Mycobacterium ulcerans. It leads to large skin ulceration and sometimes bone infection which is responsible for deformities. Here, we report a case of multifocal form of Buruli ulcer associated with secondary infection in a 46-year-old human immunodeficiency virus (HIV) positive woman. The antimycobacterial drugs combined to surgery allowed curing this multifocal case and rose up two relevant issues: the susceptibility of immune reconstitution inflammatory syndrome (IRIS) occurrence and Mycobacterium dissemination. The deep immune depression, the underline biological, and clinical disorders of the patient might contribute to IRIS occurrence and Buruli ulcer dissemination. Future investigations have to be conducted on the mechanism of IRIS on set and on Mycobacterium ulcerans dissemination after ARV drugs initiation and the patient related underline clinical or biological disorders

Multifocal Buruli Ulcer Associated with Secondary Infection in HIV Positive Patient

Buruli ulcer is a chronic and infectious skin disease, caused by Mycobacterium ulcerans. It leads to large skin ulceration and sometimes bone infection which is responsible for deformities. Here, we report a case of multifocal form of Buruli ulcer associated with secondary infection in a 46-year-old human immunodeficiency virus (HIV) positive woman. The antimycobacterial drugs combined to surgery allowed curing this multifocal case and rose up two relevant issues: the susceptibility of immune reconstitution inflammatory syndrome (IRIS) occurrence and Mycobacterium dissemination. The deep immune depression, the underline biological, and clinical disorders of the patient might contribute to IRIS occurrence and Buruli ulcer dissemination. Future investigations have to be conducted on the mechanism of IRIS on set and on Mycobacterium ulcerans dissemination after ARV drugs initiation and the patient related underline clinical or biological disorders

Sentinel surveillance of influenza-like illness in the Central African Republic, 2010–2015

Abstract Background Influenza-like illness (ILI) is an important public health problem worldwide. In the Central African Republic, acute infectious diseases are the commonest reason for consultation. The Institut Pasteur of Bangui set up a surveillance network in 2008 to monitor the circulation of influenza viruses. We report the results of use of this surveillance system during the period 2010–2015. Methods The first surveillance centre covered Bangui, the capital of the country, and neighbouring areas and epidemiological data on syndromes similar to ILI. Throat and nasopharyngeal swab samples are transmitted weekly to the Institut Pasteur of Bangui, where real-time and multiplex reverse transcription polymerase chain reaction are used to detect and subtype influenza A (H1N1 and H3N2) and B viruses. The demographic characteristics of all patients and of positive cases according to age and the seasonal patterns of influenza virus circulation were analysed. Results Between January 2010 and December 2015, 5385 throat swabs were collected; 454 (8.4%) of the samples were positive. Of these, 450 yielded at least one influenza virus and four showed co-infections. Children under the age of 5 years were the most frequently infected (257/450, 57.1%), with irregular peaks of ILI. Influenza B predominated (56.2%; n = 201), with 39.0% H3N2 and 16.7%H1N1pdm09. Influenza viruses were detected mainly in the rainy season (July–December). Conclusion The sentinel surveillance site is yielding important information about the seasonality and age pattern of circulating influenza virus. Nationwide distribution of sentinel sites is warranted

Effect of isoniazid preventive therapy on risk of death in west African, HIV-infected adults with high CD4 cell counts: long-term follow-up of the Temprano ANRS 12136 trial

International audienc

Effect of isoniazid preventive therapy on risk of death in west African, HIV-infected adults with high CD4 cell counts: long-term follow-up of the Temprano ANRS 12136 trial

Background: Temprano ANRS 12136 was a factorial 2 × 2 trial that assessed the benefits of early antiretroviral therapy (ART; ie, in patients who had not reached the CD4 cell count threshold used to recommend starting ART, as per the WHO guidelines that were the standard during the study period) and 6-month isoniazid preventive therapy (IPT) in HIV-infected adults in Côte d'Ivoire. Early ART and IPT were shown to independently reduce the risk of severe morbidity at 30 months. Here, we present the efficacy of IPT in reducing mortality from the long-term follow-up of Temprano. Methods: For Temprano, participants were randomly assigned to four groups (deferred ART, deferred ART plus IPT, early ART, or early ART plus IPT). Participants who completed the trial follow-up were invited to participate in a post-trial phase. The primary post-trial phase endpoint was death, as analysed by the intention-to-treat principle. We used Cox proportional models to compare all-cause mortality between the IPT and no IPT strategies from inclusion in Temprano to the end of the follow-up period. Findings: Between March 18, 2008, and Jan 5, 2015, 2056 patients (mean baseline CD4 count 477 cells per μL) were followed up for 9404 patient-years (Temprano 4757; post-trial phase 4647). The median follow-up time was 4·9 years (IQR 3·3–5·8). 86 deaths were recorded (Temprano 47 deaths; post-trial phase 39 deaths), of which 34 were in patients randomly assigned IPT (6-year probability 4·1%, 95% CI 2·9–5·7) and 52 were in those randomly assigned no IPT (6·9%, 5·1–9·2). The hazard ratio of death in patients who had IPT compared with those who did not have IPT was 0·63 (95% CI, 0·41 to 0·97) after adjusting for the ART strategy (early vs deferred), and 0·61 (0·39–0·94) after adjustment for the ART strategy, baseline CD4 cell count, and other key characteristics. There was no evidence for statistical interaction between IPT and ART (pinteraction=0·77) or between IPT and time (pinteraction=0·94) on mortality. Interpretation: In Côte d'Ivoire, where the incidence of tuberculosis was last reported as 159 per 100 000 people, 6 months of IPT has a durable protective effect in reducing mortality in HIV-infected people, even in people with high CD4 cell counts and who have started ART. Funding: National Research Agency on AIDS and Viral Hepatitis (ANRS)