Lymphatic Filariasis Control in Tanzania: Effect of Six Rounds of Mass Drug Administration with Ivermectin and Albendazole on Infection and Transmission.

Control of lymphatic filariasis (LF) in most countries of sub-Saharan Africa is based on annual mass drug administration (MDA) with a combination of ivermectin and albendazole, in order to interrupt transmission. We present findings from a detailed study on the effect of six rounds of MDA with this drug combination as implemented by the National Lymphatic Filariasis Elimination Programme (NLFEP) in a highly endemic rural area of north-eastern Tanzania.\ud The effect of treatment on transmission and human infection was monitored in a community- and a school-based study during an 8-year period (one pre-intervention and 7 post-intervention years) from 2003 to 2011. Before intervention, 24.5% of the community population had microfilariae (mf) in the blood, 53.3% had circulating filarial antigens (CFA) and 78.9% had specific antibodies to the recombinant filarial antigen Bm14. One year after the sixth MDA, these values had decreased considerably to 2.7%, 19.6% and 27.5%, respectively. During the same period, the CFA prevalence among new intakes of Standard 1 pupils in 10 primary schools decreased from 25.2% to 5.6%. In line with this, transmission by the three vectors (Anopheles gambiae, An. funestus and Culex quinquefasciatus) as determined by dissection declined sharply (overall vector infectivity rate by 99.3% and mean monthly transmission potential by 99.2% between pre-intervention and fifth post-intervention period). A major shift in vector species composition, from predominantly anopheline to almost exclusively culicine was observed over the years. This may be largely unrelated to the MDAs but may have important implications for the epidemiology of LF in the area. Six MDAs caused considerable decrease in all the measured indices for transmission and human infection. In spite of this, indices were still relatively high in the late period of the study, and it may take a long time to reach the recommended cut-off levels for interruption of transmission unless extra efforts are made. These should include increased engagement of the target population in the control activities, to ensure higher treatment coverage. It is expected that the recent initiative to distribute insecticide impregnated bed nets to every household in the area will also contribute towards reaching the goal of successful LF elimination

Urban Lymphatic Filariasis in the Metropolis of\ud Dar es Salaam, Tanzania

The last decades have seen a considerable increase in urbanization in Sub-Saharan Africa, and it is estimated that over 50% of the population will live in urban areas by 2040. Rapid growth of cities combined with limited economic resources often result in informal settlements and slums with favorable conditions for proliferation of vectors of lymphatic filariasis (LF). In Dar es Salaam, which has grown more than 30 times in population during the past 55 years (4.4 million inhabitants in 2012), previous surveys have indicated high prevalences of LF. This study investigated epidemiological aspects of LF in Dar es Salaam, as a background for planning and implementation of control. Six sites with varying distance from the city center (3–30 km) and covering different population densities, socioeconomic characteristics, and water, sewerage and sanitary facilities were selected for the study. Pupils from one public primary school at each site were screened for circulating filarial antigen (CFA; marker of adult worm infection) and antibodies to Bm14 (marker of exposure to transmission). Community members were examined for CFA, microfilariae and chronic manifestations. Structured questionnaires were administered to pupils and heads of community households, and vector surveys were carried out in selected households. The study indicated that a tremendous decrease in the burden of LF infection had occurred, despite haphazard urbanisation. Contributing factors may be urban malaria control targeting Anopheles vectors, short survival time of the numerous Culex quinquefasciatus vectors in the urban environment, widespread use of bed nets and other mosquito proofing measures, and mass drug administration (MDA) in 2006 and 2007. Although the level of ongoing transmission was low, the burden of chronic LF disease was still high. The development has so far been promising, but continued efforts are necessary to ensure elimination of LF as a public health problem. These will include improving the awareness of people about the role of mosquitoes in transmission of LF, more thorough implementation of environmental sanitation to reduce Cx. Quinquefasciatus breeding, continued MDA to high-risk areas, and set-up of programmes for management of chronic LF disease

Multi-mode photonic crystal fibers for VCSEL based data transmission

Quasi error-free 10 Gbit/s data transmission is demonstrated over a novel type of 50 micron core diameter photonic crystal fiber with as much as 100 m length. Combined with 850$ nm VCSEL sources, this fiber is an attractive alternative to graded-index multi-mode fibers for datacom applications. A comparison to numerical simulations suggests that the high bit-rate may be partly explained by inter-modal diffusion.Comment: Accepted for Optics Expres

Synchronization Model for Stock Market Asymmetry

The waiting time needed for a stock market index to undergo a given percentage change in its value is found to have an up-down asymmetry, which, surprisingly, is not observed for the individual stocks composing that index. To explain this, we introduce a market model consisting of randomly fluctuating stocks that occasionally synchronize their short term draw-downs. These synchronous events are parameterized by a ``fear factor'', that reflects the occurrence of dramatic external events which affect the financial market.Comment: 4 pages, 4 figure

Low-loss photonic crystal fibers for transmission systems and their dispersion properties

We report on a single-mode photonic crystal fiber with attenuation and effective area at 1550 nm of 0.48 dB/km and 130 square-micron, respectively. This is, to our knowledge, the lowest loss reported for a PCF not made from VAD prepared silica and at the same time the largest effective area for a low-loss (< 1 dB/km) PCF. We briefly discuss the future applications of PCFs for data transmission and show for the first time, both numerically and experimentally, how the group velocity dispersion is related to the mode field diameterComment: 5 pages including 3 figures + 1 table. Accepted for Opt. Expres

Photonic crystal fiber with a hybrid honeycomb cladding

We consider an air-silica honeycomb lattice and demonstrate a new approach to the formation of a core defect. Typically, a high or low-index core is formed by adding a high-index region or an additional air-hole (or other low-index material) to the lattice, but here we discuss how a core defect can be formed by manipulating the cladding region rather than the core region itself. Germanium-doping of the honeycomb lattice has recently been suggested for the formation of a photonic band-gap guiding silica-core and here we experimentally demonstrate how an index-guiding silica-core can be formed by fluorine-doping of the honeycomb lattice.Comment: 5 pages including 3 figures. Accepted for Optics Expres

The Scattering of Electromagnetic Waves from Two-Dimensional Randomly Rough Penetrable Surfaces

An accurate and efficient numerical simulation approach to electromagnetic wave scattering from two-dimensional, randomly rough, penetrable surfaces is presented. The use of the M\"uller equations and an impedance boundary condition for a two-dimensional rough surface yields a pair of coupled two-dimensional integral equations for the sources on the surface in terms of which the scattered field is expressed through the Franz formulas. By this approach, we calculate the full angular intensity distribution of the scattered field that is due to a finite incident beam of $p$-polarized light. We specifically check the energy conservation (unitarity) of our simulations (for the non-absorbing case). Only after a detailed numerical treatment of {\em both} diagonal and close-to-diagonal matrix elements is the unitarity condition found to be well-satisfied for the non-absorbing case (${\mathcal U}>0.995$), a result that testifies to the accuracy of our approach.Comment: Revtex, 4 pages, 2 figure

Selective Transparence of Single-Mode Waveguides with Surface Scattering

A random surface scattering in a one-mode waveguide is studied in the case when the surface profile has long-range correlations along the waveguide. Analytical treatment of this problem shows that with a proper choice of the surface, one can arrange any desired combination of transparent and non-transparent frequency windows. We suggest a method to find such profiles, and demonstrate its effectiveness by making use of direct numerical simulations.Comment: RevTex, 3 pages including 2 ps-figure

Spillover Effects of Early-Life Medical Interventions

We investigate the spillover effects of early-life medical treatments on the siblings of treated children. We use a regression discontinuity design that exploits changes in medical treatments across the very low birth weight (VLBW) cutoff. Using administrative data from Denmark, we first confirm the findings in the previous literature that children who are slightly below the VLBW cutoff have better short- and long-term health, and higher math test scores in 9th grade. We next investigate spillover effects on siblings and find no evidence of an impact on their health outcomes. However, we find substantial positive spillovers on all our measures of academic achievement. Our estimates suggest that siblings of focal children who were slightly below the VLBW cutoff have higher 9th grade language and math test scores, as well as higher probability of enrolling in a high school by age 19. Our results suggest that improved interactions within the family may be an important pathway behind the observed spillover effects

Enzyme prodrug therapy achieves site-specific, personalized physiological responses to the locally produced nitric oxide

Nitric oxide (NO) is a highly potent but short-lived endogenous radical with a wide spectrum of physiological activities. In this work, we developed an enzymatic approach to the site-specific synthesis of NO mediated by biocatalytic surface coatings. Multilayered polyelectrolyte films were optimized as host compartments for the immobilized β-galactosidase (β-Gal) enzyme through a screen of eight polycations and eight polyanions. The lead composition was used to achieve localized production of NO through the addition of β-Gal–NONOate, a prodrug that releases NO following enzymatic bioconversion. The resulting coatings afforded physiologically relevant flux of NO matching that of the healthy human endothelium. The antiproliferative effect due to the synthesized NO in cell culture was site-specific: within a multiwell dish with freely shared media and nutrients, a 10-fold inhibition of cell growth was achieved on top of the biocatalytic coatings compared to the immediately adjacent enzyme-free microwells. The physiological effect of NO produced via the enzyme prodrug therapy was validated ex vivo in isolated arteries through the measurement of vasodilation. Biocatalytic coatings were deposited on wires produced using alloys used in clinical practice and successfully mediated a NONOate concentration-dependent vasodilation in the small arteries of rats. The results of this study present an exciting opportunity to manufacture implantable biomaterials with physiological responses controlled to the desired level for personalized treatment