Retinal Microvasculopathy Is Common in HIV/AIDS Patients: A Cross-Sectional Study at the Cape Coast Teaching Hospital, Ghana
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Auteurs : Emmanuel Kwasi Abu [Ghana] ; Samuel Abokyi [Ghana] ; Dorcas Obiri-Yeboah [Ghana] ; Richard Kobina Dadzie Ephraim [Ghana] ; Daniel Afedo [Ghana] ; Lawrence Duah Agyeman [Ghana] ; Samuel Bert Boadi-Kusi [Ghana]Source :
- Journal of Ophthalmology [ 2090-004X ] ; 2016.
Abstract
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DOI: 10.1155/2016/8614095
PubMed: 28127467
PubMed Central: 5227161
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Retinal Microvasculopathy Is Common in HIV/AIDS Patients: A Cross-Sectional Study at the Cape Coast Teaching Hospital, Ghana</title><author><name sortKey="Abu, Emmanuel Kwasi" sort="Abu, Emmanuel Kwasi" uniqKey="Abu E" first="Emmanuel Kwasi" last="Abu">Emmanuel Kwasi Abu</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Optometry, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Optometry, School of Allied Health Sciences, University of Cape Coast, Cape Coast</wicri:regionArea></affiliation></author><author><name sortKey="Abokyi, Samuel" sort="Abokyi, Samuel" uniqKey="Abokyi S" first="Samuel" last="Abokyi">Samuel Abokyi</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Optometry, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Optometry, School of Allied Health Sciences, University of Cape Coast, Cape Coast</wicri:regionArea></affiliation></author><author><name sortKey="Obiri Yeboah, Dorcas" sort="Obiri Yeboah, Dorcas" uniqKey="Obiri Yeboah D" first="Dorcas" last="Obiri-Yeboah">Dorcas Obiri-Yeboah</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Cape Coast</wicri:regionArea></affiliation></author><author><name sortKey="Ephraim, Richard Kobina Dadzie" sort="Ephraim, Richard Kobina Dadzie" uniqKey="Ephraim R" first="Richard Kobina Dadzie" last="Ephraim">Richard Kobina Dadzie Ephraim</name><affiliation wicri:level="1"><nlm:aff id="I3">Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast</wicri:regionArea></affiliation></author><author><name sortKey="Afedo, Daniel" sort="Afedo, Daniel" uniqKey="Afedo D" first="Daniel" last="Afedo">Daniel Afedo</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Optometry, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Optometry, School of Allied Health Sciences, University of Cape Coast, Cape Coast</wicri:regionArea></affiliation></author><author><name sortKey="Agyeman, Lawrence Duah" sort="Agyeman, Lawrence Duah" uniqKey="Agyeman L" first="Lawrence Duah" last="Agyeman">Lawrence Duah Agyeman</name><affiliation wicri:level="1"><nlm:aff id="I3">Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast</wicri:regionArea></affiliation></author><author><name sortKey="Boadi Kusi, Samuel Bert" sort="Boadi Kusi, Samuel Bert" uniqKey="Boadi Kusi S" first="Samuel Bert" last="Boadi-Kusi">Samuel Bert Boadi-Kusi</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Optometry, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Optometry, School of Allied Health Sciences, University of Cape Coast, Cape Coast</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">28127467</idno><idno type="pmc">5227161</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5227161</idno><idno type="RBID">PMC:5227161</idno><idno type="doi">10.1155/2016/8614095</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000462</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000462</idno><idno type="wicri:Area/Pmc/Curation">000461</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000461</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Retinal Microvasculopathy Is Common in HIV/AIDS Patients: A Cross-Sectional Study at the Cape Coast Teaching Hospital, Ghana</title><author><name sortKey="Abu, Emmanuel Kwasi" sort="Abu, Emmanuel Kwasi" uniqKey="Abu E" first="Emmanuel Kwasi" last="Abu">Emmanuel Kwasi Abu</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Optometry, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Optometry, School of Allied Health Sciences, University of Cape Coast, Cape Coast</wicri:regionArea></affiliation></author><author><name sortKey="Abokyi, Samuel" sort="Abokyi, Samuel" uniqKey="Abokyi S" first="Samuel" last="Abokyi">Samuel Abokyi</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Optometry, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Optometry, School of Allied Health Sciences, University of Cape Coast, Cape Coast</wicri:regionArea></affiliation></author><author><name sortKey="Obiri Yeboah, Dorcas" sort="Obiri Yeboah, Dorcas" uniqKey="Obiri Yeboah D" first="Dorcas" last="Obiri-Yeboah">Dorcas Obiri-Yeboah</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Cape Coast</wicri:regionArea></affiliation></author><author><name sortKey="Ephraim, Richard Kobina Dadzie" sort="Ephraim, Richard Kobina Dadzie" uniqKey="Ephraim R" first="Richard Kobina Dadzie" last="Ephraim">Richard Kobina Dadzie Ephraim</name><affiliation wicri:level="1"><nlm:aff id="I3">Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast</wicri:regionArea></affiliation></author><author><name sortKey="Afedo, Daniel" sort="Afedo, Daniel" uniqKey="Afedo D" first="Daniel" last="Afedo">Daniel Afedo</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Optometry, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Optometry, School of Allied Health Sciences, University of Cape Coast, Cape Coast</wicri:regionArea></affiliation></author><author><name sortKey="Agyeman, Lawrence Duah" sort="Agyeman, Lawrence Duah" uniqKey="Agyeman L" first="Lawrence Duah" last="Agyeman">Lawrence Duah Agyeman</name><affiliation wicri:level="1"><nlm:aff id="I3">Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast</wicri:regionArea></affiliation></author><author><name sortKey="Boadi Kusi, Samuel Bert" sort="Boadi Kusi, Samuel Bert" uniqKey="Boadi Kusi S" first="Samuel Bert" last="Boadi-Kusi">Samuel Bert Boadi-Kusi</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Optometry, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Optometry, School of Allied Health Sciences, University of Cape Coast, Cape Coast</wicri:regionArea></affiliation></author></analytic><series><title level="j">Journal of Ophthalmology</title><idno type="ISSN">2090-004X</idno><idno type="eISSN">2090-0058</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><italic>Purpose</italic>. The purpose of this study was to evaluate the ocular disorders in HIV positive patients attending the Cape Coast Teaching Hospital, Ghana.<italic> Methods</italic>. A cross-sectional study using systematic random sampling was conducted on 295 HIV positive patients. Data collection consisted of semistructured questionnaires, laboratory investigation, medical profile, and ophthalmic examination. Statistical association tests including <italic>χ</italic><sup>2</sup>, independent <italic>t</italic>-test, and ANOVA were done. A <italic>p</italic> value ≤ 0.05 was considered statistically significant.<italic> Results</italic>. Of the 295 participants, 205 (69.5%) were on antiretroviral therapy while 90 (30.3%) were not on therapy. Majority of the participants (162, 54.9%) were in clinical stage two, followed by stages three (68, 23.1%), one (62, 21%), and four (3, 1%), respectively. The overall prevalence of ocular disorders was 5.8%. The most common HIV related ocular disorder was HIV retinal microvasculopathy (58.8%), followed by herpes zoster ophthalmicus and<italic> Toxoplasma</italic> retinochoroiditis, both representing 11.8% of ocular disorders seen. Cytomegalovirus retinitis, Bell's palsy, and optic neuritis were the least common (5.9%). CMV retinitis recorded the highest viral load of 1,474,676 copies/mL and mean CD4 count of 136 cells/mm<sup>3</sup>. The mean CD4 count for participants with HIV related ocular disorders was significantly lower compared to participants without disorders (<italic>t</italic> = 2.5, <italic>p</italic> = 0.012). Participants with ocular disorders also recorded significantly higher mean viral loads than those who did not have ocular disorders (<italic>t</italic> = 2.8, <italic>p</italic> = 0.006).<italic> Conclusion</italic>. Lower CD4 counts and high viral load copies were associated with the manifestation of HIV related ocular disorders.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Douek, D C" uniqKey="Douek D">D. C. Douek</name></author><author><name sortKey="Roederer, M" uniqKey="Roederer M">M. Roederer</name></author><author><name sortKey="Koup, R A" uniqKey="Koup R">R. A. Koup</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lucas, S" uniqKey="Lucas S">S. Lucas</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chan, C C" uniqKey="Chan C">C.-C. Chan</name></author><author><name sortKey="Zhang, M" uniqKey="Zhang M">M. Zhang</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Holland, G N" uniqKey="Holland G">G. N. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">J Ophthalmol</journal-id><journal-id journal-id-type="iso-abbrev">J Ophthalmol</journal-id><journal-id journal-id-type="publisher-id">JOPH</journal-id><journal-title-group><journal-title>Journal of Ophthalmology</journal-title></journal-title-group><issn pub-type="ppub">2090-004X</issn><issn pub-type="epub">2090-0058</issn><publisher><publisher-name>Hindawi Publishing Corporation</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">28127467</article-id><article-id pub-id-type="pmc">5227161</article-id><article-id pub-id-type="doi">10.1155/2016/8614095</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>Retinal Microvasculopathy Is Common in HIV/AIDS Patients: A Cross-Sectional Study at the Cape Coast Teaching Hospital, Ghana</article-title></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0003-2354-9170</contrib-id><name><surname>Abu</surname><given-names>Emmanuel Kwasi</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib><contrib contrib-type="author"><name><surname>Abokyi</surname><given-names>Samuel</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Obiri-Yeboah</surname><given-names>Dorcas</given-names></name><xref ref-type="aff" rid="I2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0001-5572-9059</contrib-id><name><surname>Ephraim</surname><given-names>Richard Kobina Dadzie</given-names></name><xref ref-type="aff" rid="I3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Afedo</surname><given-names>Daniel</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Agyeman</surname><given-names>Lawrence Duah</given-names></name><xref ref-type="aff" rid="I3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Boadi-Kusi</surname><given-names>Samuel Bert</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref></contrib></contrib-group><aff id="I1"><sup>1</sup>Department of Optometry, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana</aff><aff id="I2"><sup>2</sup>Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana</aff><aff id="I3"><sup>3</sup>Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana</aff><author-notes><corresp id="cor1">*Emmanuel Kwasi Abu: <email>eabu@ucc.edu.gh</email></corresp><fn fn-type="other"><p>Academic Editor: Jesús Pintor</p></fn></author-notes><pub-date pub-type="ppub"><year>2016</year></pub-date><pub-date pub-type="epub"><day>29</day><month>12</month><year>2016</year></pub-date><volume>2016</volume><elocation-id>8614095</elocation-id><history><date date-type="received"><day>27</day><month>9</month><year>2016</year></date><date date-type="accepted"><day>6</day><month>12</month><year>2016</year></date></history><permissions><copyright-statement>Copyright © 2016 Emmanuel Kwasi Abu et al.</copyright-statement><copyright-year>2016</copyright-year><license xlink:href="https://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p><italic>Purpose</italic>. The purpose of this study was to evaluate the ocular disorders in HIV positive patients attending the Cape Coast Teaching Hospital, Ghana.<italic> Methods</italic>. A cross-sectional study using systematic random sampling was conducted on 295 HIV positive patients. Data collection consisted of semistructured questionnaires, laboratory investigation, medical profile, and ophthalmic examination. Statistical association tests including <italic>χ</italic><sup>2</sup>, independent <italic>t</italic>-test, and ANOVA were done. A <italic>p</italic> value ≤ 0.05 was considered statistically significant.<italic> Results</italic>. Of the 295 participants, 205 (69.5%) were on antiretroviral therapy while 90 (30.3%) were not on therapy. Majority of the participants (162, 54.9%) were in clinical stage two, followed by stages three (68, 23.1%), one (62, 21%), and four (3, 1%), respectively. The overall prevalence of ocular disorders was 5.8%. The most common HIV related ocular disorder was HIV retinal microvasculopathy (58.8%), followed by herpes zoster ophthalmicus and<italic> Toxoplasma</italic> retinochoroiditis, both representing 11.8% of ocular disorders seen. Cytomegalovirus retinitis, Bell's palsy, and optic neuritis were the least common (5.9%). CMV retinitis recorded the highest viral load of 1,474,676 copies/mL and mean CD4 count of 136 cells/mm<sup>3</sup>. The mean CD4 count for participants with HIV related ocular disorders was significantly lower compared to participants without disorders (<italic>t</italic> = 2.5, <italic>p</italic> = 0.012). Participants with ocular disorders also recorded significantly higher mean viral loads than those who did not have ocular disorders (<italic>t</italic> = 2.8, <italic>p</italic> = 0.006).<italic> Conclusion</italic>. Lower CD4 counts and high viral load copies were associated with the manifestation of HIV related ocular disorders.</p></abstract></article-meta></front><floats-group><table-wrap id="tab1" orientation="portrait" position="float"><label>Table 1</label><caption><p>Ocular disorders among participants.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Ocular disorder</th><th align="center" rowspan="1" colspan="1"><italic>n</italic> (%)</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Cytomegalovirus retinitis</td><td align="center" rowspan="1" colspan="1">1 (5.9)</td></tr><tr><td align="left" rowspan="1" colspan="1">Herpes zoster ophthalmicus</td><td align="center" rowspan="1" colspan="1">2 (11.8)</td></tr><tr><td align="left" rowspan="1" colspan="1">HIV retinal microvasculopathy</td><td align="center" rowspan="1" colspan="1">10 (58.8)</td></tr><tr><td align="left" rowspan="1" colspan="1"><italic>Toxoplasma</italic> retinochoroiditis</td><td align="center" rowspan="1" colspan="1">2 (11.8)</td></tr><tr><td align="left" rowspan="1" colspan="1">Bell's (hemifacial) palsy</td><td align="center" rowspan="1" colspan="1">1 (5.9)</td></tr><tr><td align="left" rowspan="1" colspan="1">Optic neuritis</td><td align="center" rowspan="1" colspan="1">1 (5.9)</td></tr><tr><td align="left" rowspan="1" colspan="1"><italic>Total</italic></td><td align="center" rowspan="1" colspan="1"><italic>17 (100)</italic></td></tr></tbody></table></table-wrap><table-wrap id="tab2" orientation="portrait" position="float"><label>Table 2</label><caption><p>Comparing mean CD4 counts/viral loads between various ocular disorders manifested.</p></caption><table frame="hsides" rules="groups"><thead><tr><th rowspan="2" align="left" colspan="1">HIV biomarker</th><th colspan="6" align="center" rowspan="1">Mean count</th><th rowspan="2" align="center" colspan="1"><italic>F</italic></th><th rowspan="2" align="center" colspan="1"><italic>p</italic> value</th></tr><tr><th align="center" rowspan="1" colspan="1">CMV R</th><th align="center" rowspan="1" colspan="1">HZO</th><th align="center" rowspan="1" colspan="1">HIV RM</th><th align="center" rowspan="1" colspan="1">TR</th><th align="center" rowspan="1" colspan="1">ON</th><th align="center" rowspan="1" colspan="1">BP</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Nadir CD4 (cells/mm<sup>3</sup>)</td><td align="center" rowspan="1" colspan="1">136</td><td align="center" rowspan="1" colspan="1">269</td><td align="center" rowspan="1" colspan="1">142</td><td align="center" rowspan="1" colspan="1">342</td><td align="center" rowspan="1" colspan="1">278</td><td align="center" rowspan="1" colspan="1">148</td><td align="center" rowspan="1" colspan="1">2.5</td><td align="center" rowspan="1" colspan="1">0.20</td></tr><tr><td align="left" rowspan="1" colspan="1">Viral load (copies/mL)</td><td align="center" rowspan="1" colspan="1">1,474,676</td><td align="center" rowspan="1" colspan="1">38,090</td><td align="center" rowspan="1" colspan="1">20,308</td><td align="center" rowspan="1" colspan="1">146</td><td align="center" rowspan="1" colspan="1">18,060</td><td align="center" rowspan="1" colspan="1">41,120</td><td align="center" rowspan="1" colspan="1">362.7</td><td align="center" rowspan="1" colspan="1"><0.001</td></tr></tbody></table><table-wrap-foot><fn><p>CMV R: cytomegalovirus retinitis; HZO: herpes zoster ophthalmicus; HIV RM: HIV retinal microvasculopathy; TR: <italic>Toxoplasma</italic> retinochoroiditis; ON: optic neuritis; BP: Bell's palsy.</p></fn></table-wrap-foot></table-wrap><table-wrap id="tab3" orientation="portrait" position="float"><label>Table 3</label><caption><p>Comparing mean CD4 counts/viral loads between patients who manifested ocular disorders and those who did not.</p></caption><table frame="hsides" rules="groups"><thead><tr><th rowspan="2" align="left" colspan="1">HIV biomarker</th><th colspan="2" align="center" rowspan="1">Mean count (CI)</th><th rowspan="2" align="center" colspan="1"><italic>t</italic></th><th rowspan="2" align="center" colspan="1"><italic>p</italic> value</th></tr><tr><th align="center" rowspan="1" colspan="1">Participants with ocular disorders</th><th align="center" rowspan="1" colspan="1">Participants without ocular disorders</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Nadir CD4 count (cells/mm<sup>3</sup>)</td><td align="center" rowspan="1" colspan="1">172 (92.2–251.6)</td><td align="center" rowspan="1" colspan="1">309 (279.9–339.1)</td><td align="center" rowspan="1" colspan="1">2.5</td><td align="center" rowspan="1" colspan="1">0.012</td></tr><tr><td align="left" rowspan="1" colspan="1">Current CD4 count (cells/mm<sup>3</sup>)</td><td align="center" rowspan="1" colspan="1">660 (438.8–880.2)</td><td align="center" rowspan="1" colspan="1">807 (764.1–849.6)</td><td align="center" rowspan="1" colspan="1">1.7</td><td align="center" rowspan="1" colspan="1">0.10</td></tr><tr><td align="left" rowspan="1" colspan="1">Viral load (copies/mL)</td><td align="center" rowspan="1" colspan="1">165,270 (164883.1–495420.3)</td><td align="center" rowspan="1" colspan="1">31,992 (15919.2–48065.2)</td><td align="center" rowspan="1" colspan="1">2.8</td><td align="center" rowspan="1" colspan="1">0.006</td></tr></tbody></table></table-wrap></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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