ABSTRACT
PURPOSE: To evaluate the results of anti-VGEF with trabeculectomy in the treatment of neovascular glaucoma, a severe complication of retinal vein occlusion (RVO). PATIENTS AND METHODS: This is a prospective case series of consecutive patients with neovascular glaucoma secondary to retinal vein occlusion. All patients underwent panretinal photocoagulation and a mean of 3 anti-VEGF injections prior to trabeculectomy. Ophthalmic parameters were recorded pre- and postoperatively: visual acuity (VA), intraocular pressure (IOP), iris examination, gonioscopy and fundus examination, and as necessary, fluorescein angiography. Minimum follow-up was 9 months. RESULTS: Twenty-one eyes of 21 patients were included. The mean preoperative intraocular pressure was 38mmHg (31-45mmHg). Postoperatively, the mean IOP was 15mmHg (13-19mmHg). IOP reduction was observed in all eyes after surgery and stayed finally stabilized in nineteen eyes (90.5 %). The rubeosis had definitively disappeared an average of two weeks after injection, but VA decreased in all patients. Nineteen patients (90.5 %) maintained preservation of their eyes. Two eyes underwent evisceration. CONCLUSION: In most cases, trabeculectomy with anti-VGEF halted anterior segment neovascularization. It allowed for surgery on a quiet, normotensive eye, with good postoperative results. While functional rehabilitation was not achieved, the globe was able to be preserved in 90.5 % of cases.
Subject(s)
Angiogenesis Inhibitors/therapeutic use , Bevacizumab/therapeutic use , Glaucoma, Neovascular/drug therapy , Glaucoma, Neovascular/surgery , Retinal Vein Occlusion/drug therapy , Retinal Vein Occlusion/surgery , Trabeculectomy , Aged , Angiogenesis Inhibitors/administration & dosage , Antibodies, Monoclonal, Humanized/administration & dosage , Antibodies, Monoclonal, Humanized/therapeutic use , Bevacizumab/administration & dosage , Combined Modality Therapy , Female , Glaucoma, Neovascular/etiology , Humans , Intravitreal Injections , Laser Coagulation/methods , Male , Middle Aged , Retinal Vein Occlusion/complications , Rwanda , Treatment Outcome , Vascular Endothelial Growth Factor A/antagonists & inhibitors , Vascular Endothelial Growth Factor A/immunologyABSTRACT
BACKGROUND: The prevalence of HIV-serodiscordant couples is increasing. In these couples, one member is infected with HIV and the other one is not, so HIV testing for both members of the couple remains one of the significant challenges in the prevention of sexual transmission of HIV within the couple. The aim of this study was to analyze couples' attitudes toward HIV testing after prenatal HIV testing offered to pregnant women and analyze the males' behavior with regard to their own HIV testing. METHODS: One hundred and forty-three pregnant women and their partners were interviewed in the Lubumbashi health district in the Democratic Republic of the Congo. The usual descriptive statistics were applied. RESULTS: Seventy-one percent of the couples declared that they accepted the HIV testing proposed to the woman and approximately 64% of the couples said they had discussed the HIV testing proposed in prenatal healthcare clinics. However, this dialogue seemed to have a poor impact on the HIV testing of the male partner: no male partner was tested in spite of the high proportion of men encouraged to do so. Nearly 30% and 50% of the couples disagreed on systematic condom use and the need for the husband's permission to undergo HIV testing, respectively. Twenty-nine percent of the couples did not wish to have the male sexual partner present at the prenatal consultation. CONCLUSION: The majority of men considered that their wife's HIV testing gives them information about their own HIV status and this makes HIV testing difficult for both members of the couple. Better management of the couple in HIV screening and prevention programs therefore seems necessary.
Subject(s)
AIDS Serodiagnosis , Attitude to Health , HIV Infections/diagnosis , Parents , Prenatal Diagnosis , Adult , Counseling , Democratic Republic of the Congo , Female , Humans , Male , Pregnancy , Sex FactorsABSTRACT
BACKGROUND: HIV-1 testing and counselling are essential activities that must be integrated into mother-to-child HIV transmission prevention programs (PMTCT) in order to identify women who can benefit from the treatment, immediately or later and from interventions that can prevent HIV in their infants. The aim of this study was to describe how women's attitudes influence acceptance of HIV-1 testing in the context of antenatal care. METHODS: Four hundred and thirty-nine women attending antenatal care clinics offering HIV-1 testing in the health district of Lubumbashi in Democratic Republic of Congo were included in the study. Data were collected through interviewer-administered questionnaire. Women were asked to give their consent for a home visit and interview of their partners; 143 agreed to participate. Statistical analyses were carried out using Chi-square test and logistic regression. RESULTS: The proportion of pregnant women who declared that they would accept HIV testing was 76.5%. Non-married women (p=0.046), women who had never carried out a former HIV test (p<0.001), who had mentioned that they would wish to share the results of the test with their partner or would wish to be accompanied at least once by their partner at the antenatal clinic (p<0.001), those whose partner agreed to participate in the study (p=0.010) and those who knew at least one mode of HIV transmission (p=0.025) were more likely to accept the HIV testing. CONCLUSION: Improving counselling and a policy of HIV counselling and testing integrating a couple components could help to overcome obstacles to the integration of the women within PMTCT programs and help improve acceptance of HIV testing.
Subject(s)
AIDS Serodiagnosis , HIV Infections/prevention & control , HIV Infections/transmission , HIV-1 , Infectious Disease Transmission, Vertical/prevention & control , Patient Acceptance of Health Care/statistics & numerical data , Adolescent , Adult , Democratic Republic of the Congo , Female , HIV Infections/diagnosis , Humans , Pregnancy , Young AdultABSTRACT
Contexte : L'etat nutritionnel des enfants est un indicateur mondial de son bien-etre et indirectement celui de sa communaute. Les objectifs de ce travail consistent a evaluer l'etat nutritionnel des enfants ages de moins de cinq ans du quartier Bongonga de Lubumbashi; en RD Congo; et ses determinants. Methodes : Une enquete transversale a ete menee; dans des menages; aupres de 1963 enfants. Outre les variables anthropometriques; les conditions de vie ont egalement ete relevees. Une regression logistique a ete appliquee. Resultats : Les prevalences etaient de 33;5de retard de croissance et 3;8d'emaciation. En regression logistique; le niveau d'etude de la mere (moins de 7 ans); l'absence d'un robinet d'eau potable dans la parcelle; l'age superieur a 11 mois et la duree de sejour de l'enfant dans le quartier inferieure a 3 mois etaient significativement associes a un risque accru de retard de croissance. Le niveau bas d'etude de la mere et l'age de l'enfant (12 mois ou plus) etaient significativement associes du retard de croissance severe. Par ailleurs; l'anorexie; la diarrhee; la souffrance et l'age de l'enfant (moins de 12 mois) etaient les determinants significatifs d'une emaciation. Conclusion : Comparee a la classification de l'Organisation Mondiale de la Sante; la prevalence du retard de croissance est elevee et celle de l'emaciation basse. Afin de reduire la mortalite; la morbidite et contribuer au bien-etre de la population; il faut integrer ces facteurs dans toute intervention
