Does the national program of prevention of mother to child transmission of HIV (PMTCT) reach its target in Ouagadougou, Burkina Faso?

Background: In the context of universal access to prevention, treatment, care and support, each country has to ensure that 80% of women and children in need have access to PMTCT interventions.Objective: To assess the PMTCT program achievement in Ouagadougou, the capital city of Burkina Faso.Methods: Between August and October 2008, a cross sectional study was carried out in the five health districts of the Centre Health Region. We reviewed weekly statistics from all health care centres (HCC) to compute the coverage of PMTCT program. In 38 HCC with functional PMTCT program, we extracted data of interest from HCC registers and made direct observations of PMTCT services.Results: The PMTCT program was implemented in 49% of HCC (target for the national program: 70%). Fifteen to 31% of these centers were often in shortage for PMTCT consumables. Patients’ privacy was not observed in 67% of Voluntary Counselling & HIV Testing wards. Care providers were not qualified enough to deliver PMTCT services. Vitamin A supplementation was not implemented. None of the facilities offered the whole package of PMTCT program interventions. HCC providing HIV testing in labour or in postnatal ward were consistently lacking. Only 86% of antenatal care new attendants benefited from pre-test counselling; 2.4% of pretested women were HIV-positive and 39% of positive mothers received antiretroviral prophylaxis.Conclusion: Coverage and quality of PMTCT programme in the Centre Health Region in Burkina Faso are still limited. Particular support is needed for training, supervision and infrastructures upgrading.Key words: vertical transmission, HIV infection, program, implementation

La grille au service du développement médical en Afrique

PCSV, présenté par F. Jacq, pas de proceedingsObjectives: Telemedicine networks allow to train local physicians and to improve diagnosis by exchanging medical data. But the set-up of multipoint dynamic telemedicine requires moving towards GRID technologies. The objective is to develop telemedicine services for physicians from Burkina Faso and France with the perspective of setting up a grid infrastructure between the participating medical sites. Methods: A web site to exchange diagnosis on diabetic retinopathy was developed in PHP. Another application using web services was developed to exchange patient information on ophthalmology between two databases. Results: The main difficulty comes from limited resources in developing countries including staff skills, bandwidth and funding. But the collaboration with dispensaries opened a door to enhanced collaboration between physicians of France and Burkina Faso Conclusions: These applications are designed with the aim of their use on grids which opens the perspective of multipoint dynamic telemedicine. We are developing a new generation of telemedicine service using experience acquired in the last two years

Five Grade 7 learners\u27 understanding of comprehension skills at a quintile 5 school in South Africa

Background: Research into language and reading scores show that South African learners struggle to read for meaning. Many local researchers report on the inadequate teaching training programmes. Teachers cannot teach basic comprehenion skills. Objectives: This research identifies a gap in the research and records an intervention programme designed to engage learners and develop their higher-order comprehension abilities. This research analyses responses from five learners who engaged in a variety of literacy activities to extend their zones of literacy abilities to become independent critical thinkers. Method: An interpretivist paradigm, within a qualitative approach, using a case study design was devised and implemented. Five struggling Grade 7 learners were purposively selected to participate in a 10-week intervention programme. Data were collected using pre-tests and post-tests and the learners\u27 own exercise books to assess their academic performance in written comprehensions, their daily comments on their motivation charts, information from two interviews and the researchers\u27 participant observation scheduled notes. Results: During the time of the intervention, all five Grade 7 learners gradually learned and began to use higher-order thinking skills. Conclusion: This small research project indicates that when a teacher explicitly planned and used a variety of literacy strategies to teach comprehension skills, not only did the learners enjoy the respectful discussions but this experience developed them into independent higher-order thinkers

Improving resolution-sensitivity trade off in sub-shot noise quantum imaging

One of the challenges of quantum technologies is realizing the quantum advantage, predicted for ideal systems, in real applications, which have to cope with decoherence and inefficiencies. In quantum metrology, sub-shot-noise quantum imaging (SSNQI) and sensing methods can provide genuine quantum enhancement in realistic situations. However, wide-field SSNQI schemes realized so far suffer a trade-off between the resolution and the sensitivity gain over a classical counterpart: small pixels or integrating area are necessary to achieve high imaging resolution, but larger pixels allow a better detection efficiency of quantum correlations, which means a larger quantum advantage. Here, we show how the SSNQI protocol can be optimized to significantly improve the resolution without giving up the quantum advantage in sensitivity. We show a linear resolution improvement (up to a factor 3) with respect to the simple protocol used in previous demonstrations

Biphoton compression in standard optical fiber: exact numerical calculation

Generation of two-photon wavepackets, produced by spontaneous parametric down conversion in crystals with linearly chirped quasi-phase matching grating, is analyzed. Although being spectrally broad, two-photon wavepackets produced this way are not Fourier transform limited. In the paper we discuss the temporal compression of the wavepackets, exploiting the insertion of a standard optical fiber in the path of one of the two photons. The effect is analyzed by means of full numerical calculation and the exact dispersion dependencies in both the crystal and the fiber are considered. The study opens the way to the practical realization of this idea.Comment: 10 pages, 16 figure

Nonbreast-fed, HIV-1-exposed Burkinabe infants have low energy intake between 6 and 11 months of age despite free access to infant food aid

In a WHO coordinated, mother-to-child HIV transmission (MTCT) prevention trial in Burkina Faso, HIV-1 nfected mothers were adv sed to either stop breast-feeding oy 6 mo or totally avoid it. Participants were prov ded with cereal-based, infant fortified mix (IFM) from 6 to 12 mo postpartum along with infant feeding counseling. Our objective was to describe ronbreast-fed infants food consumption and adecuacy of nutrient intake. A 1-d weighed food record and one 24 h dietary recall were performed in 68 nonbreast-fed, non-HIV infected 6- to 11-mo-old infants. Mean food enemy density and feeding frequency were satisfactory n 6-8 mo ods [0.8 +/- 0.2 kcal/g (3.3 +/- 0.9 kJ/g) and 7.2 +/- 1.6 times/c] and n 9-11 moods [0.9 +/- 0.2 kcal/lg (3.6 +/- 0.8 kJ/g) and 7.7 +/- 2 1 times/d]. Median energy intake was 523 Kcal [range 82-1053 (2187 kJ, range: 345-4401)] in 6-8- and 811 kcal [range: 34-1543 (3392 kJ, range: 144-6452)] n 9-11-mo-old infants, respectively. Approximately 75% of their energy intake was provided by subsidized foods (milk that mothers obta ned from support networks and IFM). One-has of the infants had intakes < 80 kcal/kg (<334 kJ/kg) on the day of the survey, mainly because IFM and milk were consumed in amounts that were too low. Thus, coverage of energy needs required a diet with sufficient amounts of both IFM and milk in these vulnerable infants. These findings argue for the development of adequate, sustainable infant fort fed foods and their rapid integration into MTCT prevent on services They also lend support to the recent revision of WHO infant feeding guidance for future MTCT prevention programming that recommends breast-feeding up to 12 me postpartum (under cover of antiretroviral prophylaxis) as the safest feeding option for infants of HIV-infected mothers. J. Nutr. 141: 674-679, 2011

Hepatic ER&#945; accounts for sex differences in the ability to cope with an excess of dietary lipids

Objective: Among obesity-associated metabolic diseases, non-alcoholic fatty liver disease (NAFLD) represents an increasing public health issue due to its emerging association with atherogenic dyslipidemia and cardiovascular diseases (CVDs). The lower prevalence of NAFLD in pre-menopausal women compared with men or post-menopausal women led us to hypothesize that the female-inherent ability to counteract this pathology might strongly rely on estrogen signaling. In female mammals, estrogen receptor alpha (ER\u3b1) is highly expressed in the liver, where it acts as a sensor of the nutritional status and adapts the metabolism to the reproductive needs. As in the male liver this receptor is little expressed, we here hypothesize that hepatic ER\u3b1 might account for sex differences in the ability of males and females to cope with an excess of dietary lipids and counteract the accumulation of lipids in the liver. Methods: Through liver metabolomics and transcriptomics we analyzed the relevance of hepatic ER\u3b1 in the metabolic response of males and females to a diet highly enriched in fats (HFD) as a model of diet-induced obesity. Results: The study shows that the hepatic ER\u3b1 strongly contributes to the sex-specific response to an HFD and its action accounts for opposite consequences for hepatic health in males and females. Conclusion: This study identified hepatic ER\u3b1 as a novel target for the design of sex-specific therapies against fatty liver and its cardio-metabolic consequences

Acceptability of interventions to reduce mother-to-child transmission of HIV-1 in West Africa

Would HIV-1-positive African women use interventions of AIDS testing, medication (oral and vaginal), and vaginal disinfection to reduce the likelihood of HIV-1 transmission to their child ? In this pilot study in two west African cities (Abidjan, Côte d'Ivoire, and Bobo-Dioulasso, Burkina Faso), social workers gave a native-language questionnaire to 607 pregnant women at four Maternal and Child Health Centers. The women were asked about their perception of the HIV test ; consequences of testing and counseling ; choice of medical intervention to protect the future child ; and feelings about being in a randomized, placebo-controlled, clinical trial. Most accepted the principle of an AIDS test, said they wanted the agreement of their regular partner before being tested, and would use interventions to reduce the risk of vertical transmission. The researchers concluded that although concepts of informed consent, randomization, and placebo are difficult to understand, the study results are promising and encourage the evaluation of clinical trials to reduce mother-to-child transmission. (Résumé d'auteur