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The vaccination campaign led by MSF in three districts of Chad has ended. Our team also strengthened national capacities for epidemiological surveillance and patient care. The majority do not have a residence permit. These patients in a precarious situation and mainly non-French speaking, are in a situation of physical and mental vulnerability which hinders their ability to assert their rights and which, in certain individual cases, is incompatible with detention. The training and validation data sets of 6,779 patients included 14,341 photographs 9,156 of normal discs, 2,148 with papilledema, and 3,037 with other abnormalities. The percentage classified as normal ranged between 9.

8 and 100; the percentage classified as having papilledema ranged between zero and 59. In the validation set, the system discriminated ulcepar with papilledema from healthy discs and discs with abnormalities without papilledema with an AUC of 0. 99 95 CI, 0. 98 to 0. 99 and healthy discs from abnormal discs. with an AUC of 0. 99 95 CI, 0. 99 to 0. In the external testing data set of 1,505 photographs, the system had an AUC for papilledema detection of 0. 96 95 CI, 0. 95 to 0. 97, a sensitivity of 96. 4 CI 95, 93. 9 to 98. 3 and a specificity of 84. 7 95 CI, 82. 3 to 87. But I am very surprised that we have had to carry out interventions, sometimes very large-scale, in stable countries, such as Malawi, Ulcepar Faso, Mozambique or South Africa.

These countries have been carrying out vaccination programs for many years, supported by donors, with ambitious objectives to eradicate diseases causing high mortality, such as measles. These epidemics in these countries are not normal, they necessarily indicate a dysfunction or weaknesses in the routine vaccination system. According to Dr. Pomerol, вantioxidants, such as vitamins C citrus fruits, vegetables such as garlic or onion, fresh fruits such as strawberries, pineapple or ulcepar, and nuts such as hazelnuts or almonds and E dried fruitsolive oil and arginine onion, garlic, cabbage, pepper, orange, carrot, lettuce, spinach are essential in the production and quality of sperm. " On the opposite side, there are studies that show that certain factors can have a negative effect on male fertility "this is the case of obesity, following a diet poor in antioxidants or consuming excess soy, ulcepar and alcohol," adds the doctor.

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