Low-cost adaptation options to support green growth in agriculture, water resources, and coastal zones.

The regional climate as it is now and in the future will put pressure on investments in sub-Saharan Africa in water resource management, fisheries, and other crop and livestock production systems. Changes in oceanic characteristics across the Atlantic Ocean will result in remarkable vulnerability of coastal ecology, littorals, and mangroves in the middle of the twenty-first century and beyond. In line with the countries' objectives of creating a green economy that allows reduced greenhouse gas emissions, improved resource efficiency, and prevention of biodiversity loss, we identify the most pressing needs for adaptation and the best adaptation choices that are also clean and affordable. According to empirical data from the field and customized model simulation designs, the cost of these adaptation measures will likely decrease and benefit sustainable green growth in agriculture, water resource management, and coastal ecosystems, as hydroclimatic hazards such as pluviometric and thermal extremes become more common in West Africa. Most of these adaptation options are local and need to be scaled up and operationalized for sustainable development. Governmental sovereign wealth funds, investments from the private sector, and funding from global climate funds can be used to operationalize these adaptation measures. Effective legislation, knowledge transfer, and pertinent collaborations are necessary for their success.

[Multifocal tuberculosis associated with cerebral toxoplasmosis in an African immigrant immunocompromised patient due to HIV-infection at the Hospital Centre in Soissons, France]. / Tuberculose multifocale associée à une toxoplasmose cérébrale sur terrain immunodéprimé à VIH chez un patient immigré africain au Centre Hospitalier de Soissons, France.

In the industrialized countries and, in particular, in France, given the means of prevention, early screening and treatment of HIV infection, there is almost no evidence of opportunistic infections among immigrants and in some disadvantaged socio-professional groups. We here report the case of a 42-year old African immigrant HIV1 positive man with impaired general condition hospitalized for infectious syndrome. He had received antiretroviral therapy for 2 years and stopped it four months before admission. He had had pulmonary tuberculosis treated and declared cured in February 2017. Clinical examination showed slow ideation, a temperature of 39.6°C and weight loss. The patient had nadir CD4 cell counts 12/mm3 and HIV viral load log value 5.80. Thoracoabdominal CT scan and brain MRI showed intra-abdominal and thoracic lesions as well as brain lesions before diagnostic confirmation of tuberculosis and toxoplasmosis. The patient underwent triple antiretroviral therapy on day 15 of antituberculosis treatment. Then he underwent toxoplasmosis treatment with favorable outcome.