ABSTRACT
OBJECTIVE: To demonstrate the feasibility, from the public health standpoint, of preventing mother-to-child transmission of human immunodeficiency virus type 1 (HIV-1) in Africa. METHODS: Voluntary counselling and HIV serotesting were routinely provided in four health centres in Abidjan, Côte d'Ivoire, for six months in 1998-99. Peripartum treatment with zidovudine and alternatives to breastfeeding were provided free to HIV-infected women. FINDINGS: Of the 4309 pregnant women in the study who attended their first antenatal care visit, 3756 benefited from individual counselling and pretesting (87.2%), and 3452 (80.1%) agreed to undergo HIV serotesting. Overall HIV prevalence was (12.89%) and 5% for women aged under 18 years. Among the 2998 HIV-negative women, 71% returned for their test result, whereas only 60% of the 445 HIV-positive women did so. A total of 124 HIV-positive women were informed of their serostatus and the possibility of preventing mother-to-child transmission of HIV; 100 started treatment and 80 completed zidovudine prophylaxis. At 6 weeks of age, 36 of the 78 liveborn children were being breastfed (46%), two were being mixed-fed and 41 (52%) were being artificially fed. CONCLUSIONS: In Abidjan, voluntary counselling and HIV testing with a view to preventing mother-to-child transmission was feasible in antenatal care units and was well accepted by pregnant women. An insufficient proportion of women returned to obtain their test results. This was especially so among HIV-positive women, the target group for preventing mother-to-child transmission of HIV. Additional staff were required in order to offer voluntary counselling and HIV testing to the study women. Close supervision and strong commitment of health workers were essential. Alternatives to breastfeeding were effectively proposed to HIV-positive women, with active follow-up of children and clinical, nutritional and social support.
Subject(s)
HIV Infections/transmission , Infectious Disease Transmission, Vertical/prevention & control , Pregnancy Complications, Infectious , AIDS Serodiagnosis , Anti-HIV Agents/therapeutic use , Breast Feeding/adverse effects , Cote d'Ivoire/epidemiology , Counseling , Female , HIV Infections/diagnosis , HIV Infections/epidemiology , HIV Infections/prevention & control , HIV Seroprevalence , HIV-1 , Humans , Pregnancy , Pregnancy Complications, Infectious/drug therapy , Program Evaluation , Reverse Transcriptase Inhibitors/therapeutic use , Truth Disclosure , Zidovudine/therapeutic useABSTRACT
All patients exhibiting the various types of abnormal head postures of ocular origin that were seen during the last two years are presented in order to determine the relative frequency of the different causes of these postures, and the purposes they serve. The treatment modality and results are also discussed. This manuscript is divided into four parts: Parts I, II, and III concern head postures in incomitant strabismus. In Part IV, head postures in Ciancia's syndrome, restrictions, and refractive errors are described.
Subject(s)
Head/physiopathology , Adolescent , Adult , Aged , Child , Child, Preschool , Eye Movements , Facial Muscles/physiopathology , Female , Fixation, Ocular , Humans , Infant , Kinesis , Male , Middle Aged , Muscular Diseases/physiopathology , Nystagmus, Pathologic/etiology , Nystagmus, Pathologic/physiopathology , Nystagmus, Pathologic/surgery , Postoperative Complications/physiopathology , Posture , Refractive Errors/physiopathology , Strabismus/physiopathology , SyndromeABSTRACT
All patients exhibiting the various types of abnormal head postures of ocular origin that were seen during the last two years are presented in order to determine the relative frequency of the different causes of these postures, and the purposes they serve. The treatment modality and results are also discussed. The manuscript is divided into four parts: Parts I, II, and III concern head postures in incomitant strabismus. In Part IV, head postures in Ciancia's syndrome, restrictions, and refractive errors are described.
Subject(s)
Fixation, Ocular , Ophthalmoplegia/diagnosis , Posture , Humans , Strabismus/diagnosisABSTRACT
All patients exhibiting the various types of abnormal head postures of ocular origin that were seen during the last two years are presented in order to determine the relative frequency of the different causes of these postures, and the purposes they serve. The treatment modality and results are also discussed. The manuscript is divided into four parts: Parts I, II, and III concern head postures in incomitant strabismus. In Part IV, head postures in Ciancia's syndrome, restrictions, and refractive errors are described.
Subject(s)
Duane Retraction Syndrome/physiopathology , Head , Ophthalmoplegia/physiopathology , Posture , Duane Retraction Syndrome/surgery , Esotropia/physiopathology , Esotropia/surgery , Humans , Methods , Oculomotor Muscles/surgeryABSTRACT
All patients exhibiting the various types of abnormal head postures of ocular origin that were seen during the last two years are presented in order to determine the relative frequency of the different causes of these postures, and the purposes they serve. The treatment modality and results are also discussed. The manuscript is divided into four parts: Part I, II, and III concern head postures in incomitant strabismus. In Part IV, head postures in Ciancia's syndrome, restrictions, and refractive errors are described.
Subject(s)
Posture , Vision Disorders/diagnosis , Child , Esotropia/diagnosis , Humans , Ophthalmoplegia/diagnosis , Refractive Errors/diagnosis , Strabismus/diagnosisABSTRACT
Thirty-two eyes with uveal neovascularization at the ora serrata and pars plana were studied histopathologically. Chronic retinal detachment of various etiologies was the most frequently associated feature, present in 65% of the patients. In three eyes, the neovascularization took the form of an angiomatous lesion, whereas in the others, capillaries, arterioles, and venules were present. A history of glaucoma was found in 60% of the patients. Other associated findings included choroidal rupture, vitreous hemorrhage, and a history of cryotherapy. Uveal neovascularization at the ora serrata should be considered in the differential diagnosis of retinal angiomas, retinal telangiectasia, malignant melanoma, adult Coats's disease, peripheral proliferative retinopathies, and vitreous hemorrhage.
Subject(s)
Ciliary Body/blood supply , Neovascularization, Pathologic/pathology , Uvea/blood supply , Adult , Aged , Child, Preschool , Ciliary Body/pathology , Female , Glaucoma/pathology , Humans , Male , Middle Aged , Retina/pathology , Retinal Detachment/pathology , Uveal Diseases/pathologyABSTRACT
Corneal endothelialization of the anterior chamber angle was observed in three cases of iris neovascularization and one case of post-contusion deformity. Scanning electron microscopy in two cases revealed a sheet composed of confluent fusiform cells forming a regular mosaic, growing in a tissue culture-like fashion, and extending over the anterior iris surface. Electron microscopy revealed an endothelial lining continuous with the corneal endothelium extending over the fibrovascular membrane which covered the anterior iris surface in the cases of iris neovascularization and partially extended over the trabecular meshwork in an eye with post-contusion deformity. These endothelial cells possess junctional complexes, apical villi, and prominent basement membrane. In addition, myoblastic differentiation with intracytoplasmic microfilaments, measuring 5 to 6 nm in diameter and often marginally located with fusiform densities, were observed. The presence of myoblastic features may play a role in the ability of corneal endothelial cells to migrate and participate in production of peripheral anterior synechia and ectropion of the iris.
