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Copyright of Médecine et Santé Tropicales is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mali Médical is the property of Mali Medical, Faculte de Medecine, de Pharmacie et d'Odonto-stomatologie and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Médecine et Santé Tropicales is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Diagnosing a non-epileptic seizure is difficult in the absence of a video electroencephalogram. The expert commission of the international league against epilepsy proposes a diagnostic approach allowing the diagnosis to be made according to a degree of certainty with or in the absence of a video electroencephalogram. Our objective was to determine the hospital frequency of psychogenic non-epileptic seizures in the absence of video-electroencephalogram. Using the outpatient registry, we identified patients followed for epilepsy with two normal interictal electroencephalographies, between January 2020 and October 2021. A review of the patients' medical records and an assessment of the validity of the diagnosis were carried out. Out of 64 patients evaluated with normal interictal electroencephalogram, 19 were included as suffering from psychogenic non-epileptic seizures, i.e. 26.68%. The average age was 23.94 +/- 9.4 years. Women represented 68.4%. Patients followed in neurology represented 84%. A history of childhood trauma was found in (47.4%). The first crisis was preceded by stressful events in 47.36%. Post-traumatic stress disorder was the most represented with 73.7% of cases. The average age was 20.95 +/- 9.8 years for the first crisis and the average duration of evolution of the crises was 3 years +/- 2 years. This study illustrates the possibility of making a presumptive diagnosis of psychogenic non-epileptic seizure in the absence of video-electroencephalogram., Competing Interests: Les auteurs ne déclarent aucun conflit d'intérêts., (Copyright: Gaoussou Keita et al.)

Leptospirosis is presumably an important cause of non-malarial fever in West Africa. In this study, outpatients consulting in primary care clinics during the rainy season were tested for leptospirosis, and clinical characteristics associated with leptospirosis cases were explored. Patients with fever ≥ 39°C were recruited in nine primary health care centers in Bobo Dioulasso (Burkina Faso). Diagnosis of malaria was ruled out using a rapid diagnostic test (RDT; SD Bioline Malaria®). Leptospirosis cases were defined as patients who tested positive for Leptospira IgM (Leptocheck-WB RDT and Leptospira IgM ELISA assay, Panbio) or DNA in plasma (LipL32 polymerase chain reaction [PCR]). Among 350 patients, 202 tested positive for malaria and were excluded, and 148 met the eligibility criteria and were included. Among these, 26 subjects were considered to be leptospirosis cases: 23 tested positive for Leptospira IgM (15.5%) and three tested positive by PCR (2.2%). Headaches, abdominal symptoms, and myalgia were frequently reported without any difference between leptospirosis cases and negative cases. Cough was more frequently observed among subjects testing positive for leptospirosis (P = 0.02). Water exposure, presence of a skin injury, and walking barefoot were associated with a Leptospira-positive test. All leptospirosis cases recovered without sequelae. A significant portion of outpatients with non-malarial febrile illness during the rainy season in Burkina Faso had epidemiological factors associated with leptospirosis and tested positive for Leptospira. The favorable outcome of leptospirosis cases was reassuring; this could be due in particular to the young age of the patients.

The 2014-2016 West Africa Ebola Virus Disease (EVD) Epidemic devastated Guinea's health system and constituted a public health emergency of international concern. Following the crisis, Guinea invested in the establishment of basic health system reforms and crucial legal instruments for strengthening national health security in line with the WHO's recommendations for ensuring better preparedness for (and, therefore, a response to) health emergencies. The investments included the scaling up of Integrated Disease Surveillance and Response; Joint External Evaluation of International Health Regulation capacities; National Action Plan for Health Security; Simulation Exercises; One Health platforms; creation of decentralised structures such as regional and prefectural Emergency Operation Centres; Risk assessment and hazard identification; Expanding human resources capacity; Early Warning Alert System and community preparedness. These investments were tested in the subsequent 2021 EVD outbreak and other epidemics. In this case, there was a timely declaration and response to the 2021 EVD epidemic, a lower-case burden and mortality rate, a shorter duration of the epidemic and a significant reduction in the cost of the response. Similarly, there was timely detection, response and containment of other epidemics including Lassa fever and Marburg virus disease. Findings suggest the utility of the preparedness activities for the early detection and efficient containment of outbreaks, which, therefore, underlines the need for all countries at risk of infectious disease epidemics to invest in similar reforms. Doing so promises to be not only cost-effective but also lifesaving., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: During simulation training, the confederate is a member of the pedagogical team. Its role is to facilitate the interaction between participants and the environment, and is thought to increase realism and immersion. Its influence on participants' performance in full-scale simulation remains however unknown. The purpose of this study was to observe the effect of the presence of confederates on the participants' performance during full-scale simulation of crisis medical situations., Methods: This was a prospective, randomized study comparing 2 parallel groups. Participants were emergency medicine residents engaging in a simulation session, with or without confederates. Participants were then evaluated on their Crisis Resource Management performance (CRM). The overall performance score on the Ottawa Global Rating Scale was assessed as primary outcome and the 5 non-technical CRM skills as secondary outcomes., Results: A total of 63 simulation sessions, including 63 residents, were included for statistical analysis (n = 32 for Control group and 31 for Confederate group). The mean Overall Performance score was 3.9 ± 0.8 in the Control group and 4.0 ± 1.1 in the Confederate group, 95% confidence interval of the difference [-0.6; 0.4], p = 0.60. No significant differences between the two groups were observed on each CRM items (leadership, situational awareness, communication, problem solving, resource utilization) CONCLUSION: In this randomized and controlled study, the presence of confederates during full-scale simulated practice of crisis medical situations does not seem to influence the CRM skills performance of Emergency medicine residents., Trial Registration: This study does not need to be registered on Clintrial as it does not report a health care intervention on human participants., (© 2022. The Author(s).)

Background: Schizophrenia is a relatively common disease worldwide with a point prevalence of around 5/1000 in the population. The aim of this present work was to assess the demographic, clinical, familial, and environmental factors associated with schizophrenia in Mali., Methods: This was a prospective descriptive study on a series of 164 patients aged at least 12 years who came for a follow-up consultation at the psychiatry department of the University Hospital Center (CHU) Point G in Mali between February 2019 and January 2020 for schizophrenia spectrum disorder as defined by DSM-5 diagnostic criteria., Results: Our results revealed that the male sex was predominant (80.5%). The 25-34 age group was more represented with 44.5%. The place of birth for the majority of our patients was the urban area (52.4%), which also represented the place of the first year of life for the majority of our patients (56.1%). We noted that the unemployed and single people accounted for 56.1 and 61% respectively. More than half of our patients 58.5% reported having reached secondary school level. With the exception of education level, there was a statistically significant difference in the distribution of demographic parameters. Familial schizophrenia cases accounted for 51.7% versus 49.3% for non-familial cases. The different clinical forms were represented by the paranoid form, followed by the undifferentiated form, and the hebephrenic form with respectively 34, 28 and 17.1%. We noted that almost half (48.8%) of patients were born during the cold season. Cannabis use history was not observed in 68.7% of the patients. The proportions of patients with an out-of-school father or an out-of-school mother were 51.2 and 64.2%, respectively., Conclusion: The onset of schizophrenia in the Malian population has been associated with socio-demographic, clinical, genetic and environmental characteristics., (© 2021. The Author(s).)

Introduction: Mental health is a state of equilibrium and well-being, any alteration of which leads to the appearance of a state of distress and/or mental disorder., Objective: The objective of this work was to study familial and environmental factors associated with mental disorders., Materials and Methods: A cross-sectional study was conducted in the Psychiatry Department of the Point G University Hospital Center from April 1, 2016 to March 31, 2017 among outpatients with a psychiatric disorder in whom factors associated with psychiatric disorders were studied., Results: We included 288 patients. The median age was 33.0 years. The sex ratio was 1.88 in favor of males. Married patients accounted for 45.5%. First born uterine siblings accounted for 26.7%. Patients born of an inbreeding alliance accounted for 25.7%. Cases with a family history of a psychiatric disorder represented 59.0% and those who spent their childhood with their parents accounted for 64.2%. Cases of psychoactive substance use prior to the onset of the mental disorder accounted for 42.7%. The main psychosocial stress factors that preceded the onset of the mental disorder were grief (46.2%) and family conflict (22.6%). Psychotic disorders accounted for 77.8%., Conclusion: Our results show an association of mental disorders with family history of psychiatric disorder among patients followed in psychiatry. Further studies, such as genetic association may prove useful., Competing Interests: Conflit d’intérêt : Les auteurs ne déclarent aucun conflit d’intérêt.

Objectives: the purpose of this work was to describe the epidemiological, clinical, paraclinical and therapeutic aspect of surgical treatment of chronic osteomyilitis of limbs., Patients Methods: it was a retrospective study over a period of 12 years, from January 2003 to December 2014. It covered all cases of chronic osteomyelitis osteonecrosis treated our service., Results: The authors report the results of the surgical treatment of a series 56 patients operated on for chronic limb osteomyelitis. The mean age was 20.7 years with extremes of 6 months and 56 years. The tibia and femur were the most affected segments. Staphylococcus aureus was the most frequently found germ, 80% of the cases. We obtained complete healing with total cure in 68% of cases and recurrence of suppuration in 32% of cases., Conclusion: Chronic osteomyelitis of limbs is a frequent pathology in Africa. Staphylococcus aureus was the most frequently found germ. Surgery in a time seems a good alternative. The rate of recurrence of the suppuration remains high., (Le comité de rédaction se réserve le droit de renvoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de conserver un exemplaire du manuscrit, des figures et des tableaux.)

Introduction: The objective of this work was to determine the frequency of mental disorders among female inmates of the C.S.D.R.F "Bollé"., Method: This was a descriptive, cross-cutting, prospective study that took place from August to September 2016 at (C.S.D.R.F) "Bollé" in Bamako. It concerned all female inmates present during the study period. The data were collected from pre-established fact sheets, the administration of the Mental Health Screening Questionnaire (MSQ) and clinical variables according to ICD10 criteria., Results: In total, 85 of inmates, or 74% (N-115) agreed to participate in the study. The 14-24 age group accounted for 61.0%. Singles accounted for 56.5% and 95.3% of female inmates had no previous prison history. Seventy-four percent were in pre-trial detention 12.6% had psychotic disorders. Personality disorders were observed in 11.8%. An inmate was on the committee. Thyme disorders were present in 4.7% of female inmates. Drug abuse was observed in 2.4% of female inmates., Conclusion: Detention can trigger, promote or aggravate a mental disorder., (Le comité de rédaction se réserve le droit de renvoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de conserver un exemplaire du manuscrit, des figures et des tableaux.)

Patients in Burkina Faso who sought medical attention for febrile jaundice were tested for leptospirosis. We confirmed leptospirosis in 27 (3.46%) of 781 patients: 23 (2.94%) tested positive using serologic assays and 4 (0.51%) using LipL32 PCR. We further presumed leptospirosis in 16 (2.82%) IgM-positive specimens.

Esthetic and functional surgeries in the periocular region fall into the domain of oculoplastic, or plastic and reconstructive surgery and otorhinolaryngology. Oculoplasty is the largest surgical spectrum in ophthalmology including eyelids, orbits and the lacrimal system. Our purpose was to study the frequency of eyelid, lacrimal and orbital (oculoplastic) surgery at the CHU IOTA., Material and Methods: Retrospective medical chart review of all the patients who underwent oculoplastic surgery was conducted from October 2015 to September 2016., Results: A total of 233 patients were included with 52% female and 48% male. Patients were 37 years old on average. In total, the surgery was performed on the eyelids in83 cases (35.6%), the orbits in 113 cases (48.5%) and the lachrymal system in 37 cases (15.9%).Eyelid surgery commonly resulted from eye trauma (43,3%), followed by malpositions (30,2%). Mutilating surgery accounted for 92% of the orbital surgery. External dacryocystorhinostomy was the main lacrimal surgery (42%) followed by canalicular lacerations 25%., Conclusion: Oculoplasticsurgeryoccupies an important place in the surgical activities of the ophthalmologic University hospital despite a larger volume for cataractsurgery. Our studydoesn't highlight the outcome of the surgery itself but the epidemiology to help decision makers in their eye health policy including the reduction of mutilating surgery and oculoplastic training., (Le comitée de rédaction se réserve le droit de revoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de sonserver un examplaire du manuscrit, des figures et des tableaux.)

The aim of this work was to evaluate the public transport drivers' visual driving ability in Bamako. We carried out a descriptive cross-sectional study from May 15 to July 15, 2013. The probabilistic method was used. 385 drivers were examined at the University Hospital of the Institute of Tropical Ophthalmology of Africa (IOTA). The average age was 44.69 years. 296 drivers (76.9%) were able to drive public transport vehicles. Among drivers over 50 years old, 42.5% are unfit for driving. Color vision was normal in 98.7 % of cases. Ametropia, cataract and neuropathies accounted for 48.5%, 25.1% and 17.5% respectively, of the causes of impaired vision of drivers. According to European legislation, official transport drivers must be subject to periodic eye examinations. In the absence of such measures in Malian legislation, 42.5% of drivers over 50 years old are unfit to drive. The improvement of road safety requires the renewal and application of the texts for the delivery and renewal of the driver's license of public transport drivers.

Papilledema is a fluid and/or axonal swelling of the optic nerve head due to a blockage of axoplasmic flow at the level of the cribriform plate. We report the case of a 17-year old adolescent girl with bilateral papilledema secondary to idiopathic intracranial hypertension., Competing Interests: Les auteurs ne déclarent aucun conflit d’intérêts.

Juvenile retinoschisis is an inherited macular dystrophy that is transmitted in the chromosome X-linked recessive mode. Clinical signs include a macular star, with or without peripheral retinoschisis, responsible for decreased visual acuity. We report the case of a 12-year-old boy received for a visual acuity decline (VAD). His visual acuity after the best correction is 10/100 on the right and 20/100 on the left. The anterior segment examination shows no peculiarities. In funduscopy, macular striations and macular hole are observed respectivelly on the right and on the left, with inferotemporal schisis in the middle periphery. The electrophysiological assessment shows a major dysfunction of the electroretinogram. The evolution is aggravated by the occurrence of vitreous hemorrhage and retinal detachment., (Le comitée de rédaction se réserve le droit de revoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de sonserver un examplaire du manuscrit, des figures et des tableaux.)

Introduction: The treatment of cataract blindness is surgical, allowing restored vision. The purpose of this study was to evaluate the functional results of cataract surgery in adults in a tertiary care referral center., Patients and Methods: Prospective study of 2012 eyes operated for adult cataract from September 1, 2009 to August 31, 2010 (12 months). The results were analyzed by the Monitoring Cataract Surgical Outcomes software (MCSO). The postoperative functional data and the causes of poor outcomes were identified., Results: A total of 1044 women (51.9%) and 968 men (48.1%) underwent cataract surgery. Mean age was 65 years. Extracapsular cataract extraction (ECCE), and manual sutureless small incision cataract surgery (SICS) with posterior chamber IOL implantation in 98%, were the main surgical techniques. Functional results indicated that 45.5% of our patients had good visual acuity (≥3/10) with current spectacles, 33% had limited visual acuity (1/10-2/10), and 21.6% had poor visual acuity (<1/10). The proportion of patients with good results improved with best spectacle correction to 63%, vs. 22.9% with limited visual acuity and 14.1% with poor outcomes. The causes of poor outcomes were mainly related to surgical complications (42.1%) and refractive errors (34.8%)., Discussion: These results are inferior to WHO standards, which recommend a rate greater than or equal to 80% for good outcomes and a rate below 5% for bad outcomes., Conclusion: The identification of the causes of poor outcomes underscores the importance of improving surgical skills and the need for postoperative refraction., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

The discovery of unilateral exophthalmia requires multidisciplinary care made all the more difficult in the case of a 14-year-old girl living in a tropical environment. The child, C.A., resident of the town of Djenné in Mali, was examined for nonpulsate, nonretractile, left lateral unilateral exophthalmia, painful upon palpation of a left upper-external mass under the orbital rim. The initial examination highlighted the existence of an intraorbital tumor with a moderate effect on visual function. In view of the slow and progressive development over 2 years, and with the assistance of an association, the child was transferred to a specialized medical structure where the tumorous nature was confirmed after surgical exeresis. The diagnosis was cylindroma, or adenoid cystic carcinoma. Neither chemotherapy nor radiation were used. At 15 months after surgery, the child showed no clinical sign of recurrence. Intraorbital tumors in children present diagnostic and therapeutic problems in countries with limited medical resources. Cylindromas or adenoid cystic carcinomas of the lachrymal gland are the second most common cause of epithelial tumors in this gland, which are characterized by a high degree of malignancy, a very high rate of recurrence, and a low survival rate at 5 years. In a tropical environment, diagnostic and therapeutic difficulties are compounded by limits to comprehensive care for the child.

The purpose of this prospective observational study was to evaluate the extent of visual impairment in a socially and professionally active population attending the Tropical Ophthalmology Institute of Africa (IOTA). Thanks to high recruitment rate at the IOTA, which is the third reference eye centre, a total of 828 patients ranging from 18 and 50 years of age and consulting for the first time were included between February 1 and May 4, 2003. Each patient underwent a thorough ocular examination. Data were recorded using a dedicated study form. Most patients (40%) consulted for reduced visual acuity. Diagnosis determined organic disease in 75.6% of cases (626 patients) and ametropia (including presbyopia) in 18.5% (153 patients). In the remaining 6% of cases (49 patients), ophthalmic examination was normal. Bilateral blindness was observed in 5.8% of cases (48 patients). The main cause of bilateral blindness was cataract (19.2%). The third most common cause (14.6%) was ocular manifestations of HIV infection, confirming that the epidemiology of blindness is changing and that HIV/AIDS should be taken into account. Unilateral blindness accounted for 11.5% of cases (95 patients). The main causes of unilateral blindness were trauma (50.5%), infection (26%) and degenerative disease (18%). Low vision accounted for 8.5% of cases (70 patients). The main cause of low vision was ametropia. This is one of the few hospital-based studies on causes of blindness in West Africa. The major finding is the high prevalence of blinding ocular complications of HIV infection. Another important finding is the high incidence of low vision that is often disregarded in West Africa.

The purpose of this prospective study was to evaluate retinal damage in patients with sickle cell disease and its links with the different genotypic forms of the disease in patients consulting at the African Tropical Ophthalmology Institute (IOTA). A total of 38 patients with the HbS gene were included over a 12-month study period. Retinal damage was assessed by a computerised angiofluorography in 31 patients. Of the 38 patients studied, 71% had sickle cell disease (SC), 21% had sickle cell trait (AS) and 8% had sickle cell anemia (SS). Sixty-eight percent of patients (n = 21) presented sickle cell retinopathy. The age group with the highest prevalence of proliferative neovascularisation was between 26 and 35 years. Retinopathy was more frequent in SC patients than AS patients: 90% (n = 19) versus 10% (n = 2). None of the 3 SS patients presented retinopathy. Retinal neovascularisation was the most common finding in the 27 affected eyes. This study confirms the frequency and severity of retinal damage in patients with the HbS haemoglobin, particularly among young people with double heterozygous disease (SC) in the tropical African environment. Treatment of this disorder is largely unavailable to patients in sub-Saharan Africa except at the major eye care centres. An early screening and management programme for retinal damage related to SC would reduce ocular complications and optimise visual efficiency in these young active patients.

Unlabelled: The objective of this study was to determine the different groups of ocular disorders causing low vision or blindness among working-age patients consulting at the African Institute of Tropical Ophthalmology (IOTA) in Bamako, Mali., Methods: This prospective study took place from 1 February through 8 April, 2003, at IOTA. It included all new patients aged between 18 and 50 years, regardless of whether they worked, but excluding students., Results: 828 patients were recruited: 384 men (46.4%) and 444 women (53.6%). The average age was 35.7 years. The rate of bilateral blindness was 5.8%, of low vision 8.5%, and of blindness in one eye 11.5%. Men and women did not differ significantly in rates of bilateral blindness (p = 0.77) or low vision (p = 0.24), but blindness in a single eye affected men (67.4%) more often than women (32.6%, p = 0.01). While the frequency of bilateral blindness and low vision increased with age, blindness in one eye affected all ages. We observed no significant differences according to ethnic group in the prevalence of bilateral blindness and low vision, both observed most frequently among housewives, farmers and low-income workers, most illiterate. The major causes of bilateral blindness were cataracts 29.2%, glaucoma 22.9%, trachoma 14.6%, ocular manifestations linked to HIV/AIDS 8.3%, and non-glaucomatous optical neuropathies 8.3%. Half the cases (50.5%) of blindness in one eye resulted from ocular trauma, and five cases from HIV/AIDS (5.3%). Low vision resulted from impaired refraction 22.9%, cataract 17.2%, trachoma 15.7%, glaucoma 10% and corneal opacities 5.7%., Discussions: The high rate of blindness and low vision are associated with the study site: a reference center whose population was composed completely of patients with vision problems. The causes of blindness and low vision have not changed over time except for the ocular manifestations of HIV/AIDS, which is among the most important current causes of blindness, because of the lack of antiretroviral treatments in sub-Saharan Africa. If nothing stops this pandemic, it will soon modify epidemiological data about blindness., Conclusion: Blindness and visual deficiencies, already a public health problem, will become an important socioeconomic burden in sub-Saharan Africa and may even stop progress among low-income countries.

Gaucher's disease is a recessive autosomal disorder caused by an inherited deficiency of betaglucocerebrosidase. We report here the case of an 8 month old child, fourth in a family of four children, who presents the neuropathic form of the disease. The dosages of betaglucosidase activity using C (14 ) techniques have confirmed the diagnosis, and allowed the detection of the disease in the elder brother. Both parents were considered as responsible for the transmission of this disease to their progeny. The type 2 Gaucher's disease is rare in black population, and may be associated with phenotypes heterogeneity.

The major causes of blindness in the OCCCMED states are cataracts, trachoma, glaucoma and oncocercosis. The prevalence of blindness is about 1.2% and there are about 880,000 blind individuals and 2,500,000 people with impaired vision. Cataracts were the cause of blindness in 440,000 people and the cause of visual impairment in 1,320,000 individuals. About 1,500,000 people were found to have oncocercosis, and about 24,000 were blind. The true rate of trachoma is unknown. Thirteen thousand cataracts are surgically removed in the region each year, the CSR (cataract surgery rate) being 210. In the last few years, national programs have been set up to combat blindness and equipment and training have been established. With a ratio of 1 ophthalmologist per 523,000 people, the WHO's objectives are becoming attainable.

The African Institute of Tropical Ophthalmology (AITO) was founded in Bamako in 1953. It is part of a regional structure, The Organization for Cooperation and Coordination in the Control of Major Endemic Diseases (OCCCMED). AITO is a WHO collaborating center for the prevention of blindness and has four aims: the provision of eye care, training (ophthalmologists, cataract surgeons, specialist nurses, spectacle manufacturers), research (epidemiology, clinical and surgical) and assessment of public eye care as a function of the needs of the member states of OCCCMED. The European Regional Program for the Prevention of Blindness and an International Sight First Program Center are located at AITO. AITO is at the heart of a network dedicated to fighting blindness, and its activities extend beyond the borders of the OCCCMED.

Six ophthalmologists and 24 specialist ophthalmology nurses from French-speaking African countries graduate from AITO each year. Their training focuses on the skills they will need to participate in the national programs to combat blindness. All the ophthalmologists (10) and specialist ophthalmology nurses (42) from Mali, Niger, Burkina Faso and Senegal, who graduated from AITO within the last ten years were interviewed. Eight of the ten ophthalmologists and all of the specialist nurses are currently working in national programs to combat blindness. The specialist nurses knew more about public eye health issues than about optics. The training given is appropriate for ophthalmology professionals working in these countries. The chief demand of both ophthalmologists and specialist nurses was that they should have continuous training and supervision.