Caractéristiques cliniques de la dégénérescence maculaire chez les personnes vivant avec le VIH / Clinical characteristics of macular degeneration in people living with HIV

Objectif : Décrire les caractéristiques cliniques de la dégénérescence maculaire (DM) chez les personnes vivant avec le VIH (PVVIH).Patients et méthodes : Il s'agissait d'une étude observationnelle menée dans le service d'infectiologie du CHU de Libreville. Il était inclus les adultes âgés de plus de 17 ans, vivant avec le VIH (PVVIH) type 1 et ayant le même protocole thérapeutique antirétroviral. Les paramètres recueillis étaient l'âge, le sexe, le taux de CD4, l'ancienneté de l'infection au VIH, le délai de mise sous traitement antirétroviral et les lésions rétiniennes en rapport avec la DM. Les paramètres des PVVIH sans DM (DM-) étaient comparés à ceux avec DM (DM+) (p < 0,05). Résultats : L'enquête avait concerné 772 personnes vivant avec le VIH (PVVIH) dont 30 avaient présenté une DM+, soit une fréquence de 4%. La moyenne d'âge des DM+ était de 50,3 ± 12,8 ans et celle des DM- de 44,9 ± 10,8 ans (0,0083).Le sex-ratio était de 0,3 chez les DM+ et de 0,24 chez les DM- (p = 0,5950). Parmi les DM+, 28 avaient une forme intermédiaire et 2 une forme tardive. Il n'existait pas de différence significative entre l'ancienneté de l'infection à VIH (p = 0,1599), le taux de CD4 (p = 0,8666) et le délai de mise sous traitement antirétroviral (p = 0,9040) entre les deux groupes (DM+, DM- ).Conclusion : Ce travail permet de constater que la dégénérescence maculaire chez les PVVIH est fréquente et précoce,avec une prédominance de la forme intermédiaire

Objective: To describe the clinicals characteristics of macular degeneration (MD) in people living with HIV.Patients and methods: This was an observational study carried out in the infectious disease department of the University Hospital of Libreville. It was included adults over the age of 17, living with type 1 HIV (PLHIV) and having the same antiretroviral therapy protocol. The parameters collected were age, gender, CD4 count, age of HIV infection, time to antiretroviral treatment, and retinal lesions related to MD. The PLHIV were divided into two groups, those without MD (MD-) and those with MD (MD+ ) (p <0.05).Results: The survey concerned 772 people living with HIV (PLHIV), of whom 30 presented with MD+, either a frequency of 4%. The mean age of DM+ was 50.3 ± 12.8 years and that of MD- 44.9 ± 10.8 years (0.0083). The sex ratio was 0.3 in DM+ and 0.24 in DM- (p = 0.5950). Of the MD+, 28 had an intermediate form and 2 had a late form. There was no significant difference between the age of HIV infection (p = 0.1599), CD4 count (p = 0.8666) and time to antiretroviral treatment (p = 0.9040) between the two groups (MD+, MD-).Conclusion: This work has shown that macular degeneration in PLHIV is frequent and early, with a predominance of theintermediate form

Scoring Clinical Competencies of Learners: A Quantitative Descriptive Study

This article reports the correlation between different clinical assessors' scoring of learners' clinical competencies in order to exclude any possible extraneous variables with regard to reasons for poor clinical competencies of learners. A university in Gauteng; South Africa provides a learning programme that equips learners with clinical knowledge; skills and values in the assessment; diagnosis; treatment and care of patients presenting at primary health care (PHC) facilities. The researcher observed that; despite additional clinical teaching and guidance; learners still obtained low scores in clinical assessments at completion of the programme. This study sought to determine possible reason(s) for this observation. The objectives were to explore and describe the demographic profile of learners and the correlation between different clinical assessors' scoring of learners. A purposive convenience sample consisted of learners (n = 34) and clinical assessors (n = 6). Data were collected from learners using a self-administered questionnaire and analysed using a nominal and ordinal scale measurement. Data from clinical assessors were collected using a checklist; which was statistically analysed using a software package. The variables were correlated to determine the nature of the relationship between the different clinical assessors' scores on the checklist to ensure inter-rater reliability. Findings showed that there was no significant difference in the mean of the scoring of marks between clinical assessors after correlation (p 0.05). Thus; scoring of marks did not contribute to poor clinical competencies exhibited by learners

Personality Profile and Coping Resources of Family Medicine Vocational Trainees at the University of Limpopo; South Africa

Background: Doctors are exposed to various stress factors in their personal and family lives; as well as in the workplace. Stress inherent to the responsibilities and challenges of the medical field may become a health hazard and threaten the well-being of the medical practitioner. Methods: The aim of this study was to investigate the personality traits and coping resources that contribute to the wellbeing of medical practitioners. A cross-sectional study of 44 out of 45 (98response rate) family medicine vocational trainees at the Medical University of Southern Africa (now known as the University of Limpopo) was conducted. A biographic questionnaire was utilised to obtain specific information regarding the participants. The principal researcher used the Coping Resources Inventory (CRI) questionnaire to assess coping resources; and the 16PF personality analysis (16PF) to establish a personality profile of the participants. Results: The majority of participants (81.8) indicated that they mainly experienced work-related stress. Thirty-two participants (72.72) self-medicated. Fourteen participants (31.81) claimed to experience burn-out and twenty (45.45) reported fatigue. In terms of their coping resources; 24 male participants (54.54) did not cope socially (p . 0.008) and eight (18.18) also did not cope physically (p . 0.024). Conclusions: The medical practitioners had a universal personality profile. They lacked insight regarding the symptoms they were experiencing that warranted management; e.g. depression and anxiety. The medical practitioners in this study did not utilise their social and physical coping resources optimally and reported poor help-seeking behaviour