Challenges with using estimates when calculating ART need among adults in South Africa

Background. The Foundation for Professional Development (FPD) collects information annually on HIV/AIDS service provision and estimates service needs in the City of Tshwane Metropolitan Municipality (CTMM). Methods. Antiretroviral therapy (ART) data from the Department of Health and Statistics South Africa (SSA) mid-year population estimates were used to approximate the ART need among adults in the CTMM. Results. According to SSA data, ART need decreased dramatically from 2010 to 2011 and was lower than the number of adults receiving ART. Although the noted difference was probably due to changes in the calculations by SSA, no detailed or confirmed explanation could be offered. Conclusions. We provide a constructive contribution to the discussion regarding the use of model-derived estimates of ART need

Provision and need of HIV/AIDS services in the City of Tshwane Metropolitan Municipality, 2010

Objectives. To determine the need for HIV/AIDS service provision in the City of Tshwane Metropolitan Municipality (CTMM), especially in municipal areas. Methods. The Foundation for Professional Development initiated the Compass Project. Using a questionnaire, data were collected during May - June 2010 from organisations providing HIV/AIDS services in the CTMM (organisational information and types of HIV/AIDS services). The need for HIV counselling and testing (HCT), antiretroviral treatment (ART), prevention of mother-tochild transmission (PMTCT), and care for orphans and vulnerable children (OVC) was estimated using data from various sources. Results. A total of 447 service providers was included in the study: 72.3% non-governmental organisations (NGOs); 18.1% in the public sector; 5.1% in the private sector; and 4.5% faithbased organisations. The majority of the prevention- (70.2%) and support-related services (77.4%) were provided by NGOs, while the majority of treatment-related services originated from the public sector (57.3%). Service need estimates included: HCT – 1 435 438 adults aged 15 - 49 years (11 127/service provider); total ART – 75 211 adults aged 15+ years (1 213/service provider); ART initiation – 30 713 adults aged 15+ years (495/service provider); PMTCTHCT – 30 092 pregnant women (510/service provider); PMTCTART – 7 734 HIV+ pregnant women (221/service provider); and OVC care – 54 590 children (258/service provider). Conclusions. Service gaps remain in the provision of HCT, PMTCT-ART and OVC care. ART provision must be increased, in light of new treatment guidelines from the Department of Health.S Afr Med J 2012;102:44-4

Anthropogenic influence on sediment transport in the Whittard Canyon, NE Atlantic

Unusual peaks in turbidity were detected in two branches of the Whittard Canyon in June 2013. Enhanced nepheloid layers (ENLs) were defined as layers with concentrations of suspended particulate matter exceeding those of nepheloid layers typically observed in a given region. Here, ENLs had peaks in turbidity and elevated suspended particulate matter concentrations exceeding ~1 mg L−1 with the largest ENLs measuring between ~2–8mg L−1. The ENLs measured ~100–260m in vertical height and were detected inwater depths of between 640 and 2880 m. Vessel Monitoring System data showed that high spatial and temporal activity of potential bottom trawling vessels coincided with the occurrence of the ENLs. Molar C/N ratios of the suspended organic material from the ENLs showed a high degree of degradation. Regular occurrences of such events are likely to have implications for increased sediment fluxes, burial of organic carbon and alteration of benthic and canyon ecosystems

Enabling meta-analysis in systematic reviews on carpal tunnel syndrome

Possible solutions to the problems of clinical heterogeneity of outcome measures and inadequate reporting of results for randomized controlled trials (RCTs) on carpal tunnel syndrome (CTS) are presented. Meta-analysis was impeded by these problems in 2 systematic reviews concerning conservative and surgical treatment options for CTS. A solution to the problem of inadequate data presentation is to add explicit information on minimal requirements with regard to data presentation to guidelines for the reporting of studies. To resolve the problem of clinical heterogeneity of the outcomes there should be consensus on the (validated) outcomes that should be used in RCTs. For CTS there is little evidence available on the reliability, validity, and responsiveness to change of the commonly used outcomes in RCTs. Resolving both problems will increase the comparability of RCTs, enabling the calculation of a pooled estimate of effect in a meta-analysi