Deworming and Development: Asking the Right Questions, Asking the Questions Right

Two billion people are infected with intestinal worms. In many areas, the majority of schoolchildren are infected, and the World Health Organization (WHO) has called for school-based mass deworming. The key area for debate is not whether deworming medicine works—in fact, the medical literature finds that treatment is highly effective, and thus the standard of care calls for treating any patient known to harbor an infection. As the authors of the Cochrane systematic review point out, a critical issue in evaluating current soil-transmitted helminth policies is whether the benefits of deworming exceed the costs or whether it would be more prudent to use the money for other purposes. While in general we think the Cochrane approach is very valuable, we argue below that many of the underlying studies of deworming suffer from three critical methodological problems: treatment externalities in dynamic infection systems, inadequate measurement of cognitive outcomes and school attendance, and sample attrition. We then argue that the currently available evidence from studies that address these issues is consistent with the consensus view expressed by other reviews and by policymakers that deworming is a very cost-effective way to increase school participation and has a high benefit to cost ratio.Economic

Connecting massive galaxies to dark matter halos in BOSS - I. Is galaxy color a stochastic process in high-mass halos?

We use subhalo abundance matching (SHAM) to model the stellar mass function (SMF) and clustering of the Baryon Oscillation Spectroscopic Survey (BOSS) "CMASS" sample at $z\sim0.5$. We introduce a novel method which accounts for the stellar mass incompleteness of CMASS as a function of redshift, and produce CMASS mock catalogs which include selection effects, reproduce the overall SMF, the projected two-point correlation function $w_{\rm p}$, the CMASS $dn/dz$, and are made publicly available. We study the effects of assembly bias above collapse mass in the context of "age matching" and show that these effects are markedly different compared to the ones explored by Hearin et al. (2013) at lower stellar masses. We construct two models, one in which galaxy color is stochastic ("AbM" model) as well as a model which contains assembly bias effects ("AgM" model). By confronting the redshift dependent clustering of CMASS with the predictions from our model, we argue that that galaxy colors are not a stochastic process in high-mass halos. Our results suggest that the colors of galaxies in high-mass halos are determined by other halo properties besides halo peak velocity and that assembly bias effects play an important role in determining the clustering properties of this sample.Comment: 22 pages. Appendix. B added. Matches the version accepted by MNRAS. Mock galaxy catalog and HOD table are available at http://www.massivegalaxies.co

Mass deworming programmes in middle childhood and adolescence

Soil-transmitted helminthes (STH) deworming programs remain among the largest public health programs in low- and lower-middle-income countries as measured by coverage. The actual scale of these programs remains unknown but substantial, with more than 1 billion donated doses of medicines effective against STHs delivered by formal programs and supplemented by widespread self-treatment and unprogrammed activities. STH infection declines worldwide likely reflect the influence of improved hygiene and sanitation associated with global declines in poverty, but it also reflects control efforts during the twentieth century that have largely eliminated STHs as a public health problem in previously endemic areas of North America (Mexico and the United States), Japan, Korea, and upper- middle-income countries throughout southern and eastern Asia. Much of the treatment targets delivery through schools and targets school-age children. STH infection associates with clinical and developmental outcomes that prove largely reversible by treatment. Both historical and contemporary trials of targeted treatment of infected individuals have also demonstrated benefit from treatment

The Morphology of Galaxies in the Baryon Oscillation Spectroscopic Survey

We study the morphology of luminous and massive galaxies at 0.3<z<0.7 targeted in the Baryon Oscillation Spectroscopic Survey (BOSS) using publicly available Hubble Space Telescope imaging from COSMOS. Our sample (240 objects) provides a unique opportunity to check the visual morphology of these galaxies which were targeted based solely on stellar population modelling. We find that the majority (74+/-6%) possess an early-type morphology (elliptical or S0), while the remainder have a late-type morphology. This is as expected from the goals of the BOSS target selection which aimed to predominantly select slowly evolving galaxies, for use as cosmological probes, while still obtaining a fair fraction of actively star forming galaxies for galaxy evolution studies. We show that a colour cut of (g-i)>2.35 selects a sub-sample of BOSS galaxies with 90% early-type morphology - more comparable to the earlier Luminous Red Galaxy (LRG) samples of SDSS-I/II. The remaining 10% of galaxies above this cut have a late-type morphology and may be analogous to the "passive spirals" found at lower redshift. We find that 23+/-4% of the early-type galaxies are unresolved multiple systems in the SDSS imaging. We estimate that at least 50% of these are real associations (not projection effects) and may represent a significant "dry merger" fraction. We study the SDSS pipeline sizes of BOSS galaxies which we find to be systematically larger (by 40%) than those measured from HST images, and provide a statistical correction for the difference. These details of the BOSS galaxies will help users of the data fine-tune their selection criteria, dependent on their science applications. For example, the main goal of BOSS is to measure the cosmic distance scale and expansion rate of the Universe to percent-level precision - a point where systematic effects due to the details of target selection may become important.Comment: 18 pages, 11 figures; v2 as accepted by MNRA

Which New Approaches to Tackling Neglected Tropical Diseases Show Promise?

This PLoS Medicine Debate examines the different approaches that can be taken to tackle neglected tropical diseases (NTDs). Some commentators, like Jerry Spiegel and colleagues from the University of British Columbia, feel there has been too much focus on the biomedical mechanisms and drug development for NTDs, at the expense of attention to the social determinants of disease. Burton Singer argues that this represents another example of the inappropriate “overmedicalization” of contemporary tropical disease control. Peter Hotez and colleagues, in contrast, argue that the best return on investment will continue to be mass drug administration for NTDs

Hookworm-Related Anaemia among Pregnant Women: A Systematic Review

Anaemia affects large numbers of pregnant women in developing countries and increases their risk of dying during pregnancy and delivering low birth weight babies, who in turn are at increased risk of dying. Human hookworm infection has long been recognized among the major causes of anaemia in poor communities, but understanding of the benefits of the management of hookworm infection in pregnancy has lagged behind the other major causes of maternal anaemia. Low coverage of anthelmintic treatment in maternal health programmes in many countries has been the result. After systematically reviewing the available literature we observed that increasing hookworm infection intensity is associated with lower haemoglobin levels in pregnant women. We also estimate that between a quarter and a third of pregnant women in sub-Saharan Africa are infected with hookworm and at risk of preventable hookworm-related anaemia. However, all identified intervention studies showed a benefit of deworming for maternal or child health and we argue that increased efforts should be made to increase the coverage of anthelmintic treatment among pregnant women

Stellar masses of SDSS-III/BOSS galaxies at z ~ 0.5 and constraints to galaxy formation models

We calculate stellar masses for ∼400 000 massive luminous galaxies at redshift ∼0.2–0.7 using the first two years of data from the Baryon Oscillation Spectroscopic Survey (BOSS). Stellar masses are obtained by fitting model spectral energy distributions to u, g, r, i, z magnitudes, and simulations with mock galaxies are used to understand how well the templates recover the stellar mass. Accurate BOSS spectroscopic redshifts are used to constrain the fits. We find that the distribution of stellar masses in BOSS is narrow (Δlog M ∼ 0.5 dex) and peaks at about log M/M⊙ ∼ 11.3 (for a Kroupa initial stellar mass function), and that the mass sampling is uniform over the redshift range 0.2–0.6, in agreement with the intended BOSS target selection. The galaxy masses probed by BOSS extend over ∼1012 M⊙, providing unprecedented measurements of the high-mass end of the galaxy mass function. We find that the galaxy number density above ∼2.5 × 1011 M⊙ agrees with previous determinations. We perform a comparison with semi-analytic galaxy formation models tailored to the BOSS target selection and volume, in order to contain incompleteness. The abundance of massive galaxies in the models compare fairly well with the BOSS data, but the models lack galaxies at the massive end. Moreover, no evolution with redshift is detected from ∼0.6 to 0.4 in the data, whereas the abundance of massive galaxies in the models increases to redshift zero. Additionally, BOSS data display colour–magnitude (mass) relations similar to those found in the local Universe, where the most massive galaxies are the reddest. On the other hand, the model colours do not display a dependence on stellar mass, span a narrower range and are typically bluer than the observations. We argue that the lack of a colour–mass relation for massive galaxies in the models is mostly due to metallicity, which is too low in the models

Assays to Detect β-Tubulin Codon 200 Polymorphism in Trichuris trichiura and Ascaris lumbricoides

The soil-transmitted helminths Ascaris lumbricoides and Trichuris trichiura are gastrointestinal nematodes causing many disabilities in tropical parts of the developing world. Control programs, such as “The Focussing Resources on Effective School Health” (FRESH) Partnership, have been implemented to remove human soil-transmitted nematodes through large-scale use of benzimidazole anthelmintic drugs for school-aged children in developing countries. The benzimidazole drugs albendazole and mebendazole are commonly used as a single annual treatment in areas where the burden is high. In veterinary nematodes, repeated use of these anthelmintics has selected for resistant populations. Resistance to benzimidazoles is commonly associated with a single amino acid substitution from phenylalanine to tyrosine in the β-tubulin gene at position 200. In this study, we have developed pyrosequencing assays for codon 200 in A. lumbricoides and T. trichiura to screen for this single nucleotide polymorphism (SNP) in β-tubulin. The 200Tyr SNP was detected at low frequency in T. trichiura from non-treated people from Kenya and at high frequency in T. trichiura from treated people from Panama. The presence of the resistance-associated SNP may play a role in the sometimes low and variable efficacy of benzimidazole anthelmintics against T. trichiura

Long-Term Impact of Malaria Chemoprophylaxis on Cognitive Abilities and Educational Attainment: Follow-Up of a Controlled Trial

OBJECTIVES: We investigated the long-term impact of early childhood malaria prophylaxis on cognitive and educational outcomes. DESIGN: This was a household-based cluster-controlled intervention trial. SETTING: The study was conducted in 15 villages situated between 32 km to the east and 22 km to the west of the town of Farafenni, the Gambia, on the north bank of the River Gambia. PARTICIPANTS: A total of 1,190 children aged 3–59 mo took part in the trial. We traced 579 trial participants (291 in the prophylaxis group and 288 in the placebo group) in 2001, when their median age was 17 y 1 mo (range 14 y 9 mo to 19 y 6 mo). INTERVENTIONS: Participants received malaria chemoprophylaxis (dapsone/pyrimethamine) or placebo for between one and three malaria transmission seasons from 1985 to 1987 during the controlled trial. At the end of the trial, prophylaxis was provided for all children under 5 y of age living in the study villages. OUTCOME MEASURES: The outcome measures were cognitive abilities, school enrolment, and educational attainment (highest grade reached at school). RESULTS: There was no significant overall intervention effect on cognitive abilities, but there was a significant interaction between intervention group and the duration of post-trial prophylaxis (p = 0.034), with cognitive ability somewhat higher in the intervention group among children who received no post-trial prophylaxis (treatment effect = 0.2 standard deviations [SD], 95% confidence interval [CI] −0.03 to 0.5) and among children who received less than 1 y of post-trial prophylaxis (treatment effect = 0.4 SD, 95% CI 0.1 to 0.8). The intervention group had higher educational attainment by 0.52 grades (95% CI = −0.041 to 1.089; p = 0.069). School enrolment was similar in the two groups. CONCLUSIONS: The results are suggestive of a long-term effect of malaria prophylaxis on cognitive function and educational attainment, but confirmatory studies are needed