Religion and HIV in Tanzania: Influence of Religious Beliefs on HIV stigma, Disclosure, and Treatment Attitudes.

Religion shapes everyday beliefs and activities, but few studies have examined its associations with attitudes about HIV. This exploratory study in Tanzania probed associations between religious beliefs and HIV stigma, disclosure, and attitudes toward antiretroviral (ARV) treatment. A self-administered survey was distributed to a convenience sample of parishioners (n = 438) attending Catholic, Lutheran, and Pentecostal churches in both urban and rural areas. The survey included questions about religious beliefs, opinions about HIV, and knowledge and attitudes about ARVs. Multivariate logistic regression analysis was performed to assess how religion was associated with perceptions about HIV, HIV treatment, and people living with HIV/AIDS. Results indicate that shame-related HIV stigma is strongly associated with religious beliefs such as the belief that HIV is a punishment from God (p < 0.01) or that people living with HIV/AIDS (PLWHA) have not followed the Word of God (p < 0.001). Most participants (84.2%) said that they would disclose their HIV status to their pastor or congregation if they became infected. Although the majority of respondents (80.8%) believed that prayer could cure HIV, almost all (93.7%) said that they would begin ARV treatment if they became HIV-infected. The multivariate analysis found that respondents' hypothetical willingness to begin ARV treatme was not significantly associated with the belief that prayer could cure HIV or with other religious factors. Refusal of ARV treatment was instead correlated with lack of secondary schooling and lack of knowledge about ARVs. The decision to start ARVs hinged primarily on education-level and knowledge about ARVs rather than on religious factors. Research results highlight the influence of religious beliefs on HIV-related stigma and willingness to disclose, and should help to inform HIV-education outreach for religious groups

Urban malaria and associated risk factors in Jimma town, south-west Ethiopia

<p>Abstract</p> <p>Background</p> <p>Malaria kills millions around the world. Until recently it was believed to be a disease of rural areas, since the <it>Anopheles </it>mosquito, which transmits <it>Plasmodium </it>species breeds in rural areas. Urban malaria is emerging as a potential, but "avertable" crisis, in Africa. In view of the rapidly growing number of small and medium-sized towns in Ethiopia there is a pressing need to improve the understanding of the epidemiology of malaria. Therefore, the aim of this study was to determine malaria prevalence and associated risk factors in Jimma town.</p> <p>Methods</p> <p>A cross-sectional study was carried out in Jimma town from April 1 to May 28, 2010. 804 study participants were included from 291 households for microscopic examination of malaria parasites. Socio-demography data and risk factors were collected using structured questionnaires. Logistic regression analysis was done using SPSS 15.0 statistical software.</p> <p>Results</p> <p>From a total of 804 study participants in current survey only 42 (5.2%) were positive for malaria parasites. <it>Plasmodium vivax, Plasmodium falciparum </it>and mixed infection accounted 71.4%, 26.2% and 2.4%, respectively. Higher malaria prevalence rate was observed among under-five children (11%). Those who do not use insecticide-treated bed nets (ITN) were more likely to be infected with malaria (OR = 13.6; 95% CI 4.9-37.2, p < 0.001) compared with those who use the ITN. Living in areas where stagnant water existed (OR = 2.1; 95% CI 1.00-4.2, p = 0.047) and its distance of existence <1 km from the house(OR = 2.1; 95% CI 2.0-15.8, p = 0.001) were more likely to be infected with malaria parasite compared with those who live away from stagnant at a distance greater than 1 km.</p> <p>Conclusion</p> <p>Malaria is a major health problem with <it>P. vivax </it>becoming a predominant species in the town. The prevalence was strongly associated with proximity of residence to potential mosquito breeding sites. Malaria is affecting significant proportions of the urban settlers and human activities nevertheless play an important role in bringing the mosquito breeding sites closer to residences.</p

Cost-effectiveness of intermittent preventive treatment of malaria in infants (IPTi) for averting anaemia in Gabon: a comparison between intention to treat and according to protocol analyses

ABSTRACT: BACKGROUND: In Gabon, the impact of intermittent preventive treatment of malaria in infants (IPTi) was not statistically significant on malaria reduction, but the impact on moderate anaemia was, with some differences between the intention to treat (ITT) and the according to protocol (ATP) trial analyses. Specifically, ATP was statistically significant, while ITT analysis was borderline. The main reason for the difference between ITT and ATP populations was migration. METHODS: This study estimates the cost-effectiveness of IPTi on the reduction of anaemia in Gabon, comparing results of the ITT and the ATP clinical trial analyses. Threshold analysis was conducted to identify when the intervention costs and protective efficacy of IPTi for the ATP cohort equalled the ITT cost-effectiveness ratio. RESULTS: Based on IPTi intervention costs, the cost per episode of moderate anaemia averted was US$12.88 (CI 95$11.30 (CI 95% 4.56, 26.66) using the ATP analysis. In order for the ATP results to equal the cost-effectiveness of ITT, total ATP intervention costs should rise from US$118.38 to US$134 or the protective efficacy should fall from 27% to 18.1%. The uncertainty surrounding the cost-effectiveness ratio using ITT trial results was higher than using the ATP results. CONCLUSIONS: Migration implies great challenges in the organization of health interventions that require repeat visits in Gabon. This was apparent in the study as the cost-effectiveness of IPTp-SP worsened when drop out from the prevention was taken into account. Despite such challenges, IPTi was both inexpensive and efficacious in averting cases of moderate anaemia in infant

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

Growth acceleration, behaviour and otolith check marks\ud associated with sex change in the wrasse Halichoeres miniatus

In protogynous sex-changing fishes, females are expected to compete for the opportunity to change sex following the loss of a dominant male and may exhibit growth and behavioural traits that help them maintain their dominant status after sex change. A male removal experiment was used to examine changes in female growth and behaviour associated with sex change in the haremic wrasse Halichoeres miniatus and to test whether any changes in growth associated with sex change were recorded in otolith microstructure. Dominant females began displaying male-characteristic behaviour almost immediately after the harem male was removed. The frequency of interactions between females increased following male removal. In contrast, feeding frequency of females decreased. The largest one to three females in each social group changed sex following male removal and exhibited an increase in growth associated with sex change. Sex changers grew more than twice as fast as non-sex changers during the experimental period. This growth acceleration may enable new sex-changed males to rapidly reach a size where they can defend the remaining harem from other males. An optical discontinuity (check mark) was present in the otoliths of sex-changed fish, and otolith accretion rate increased significantly after the check mark, corresponding with the increased growth rate of sex-changing females. Wild caught males, but not females, exhibited an analogous check mark in their otoliths and similar increases in otolith increment widths after the check. This indicates that an increase in growth rate is a regular feature of sex-change dynamics of H. miniatus

Relative size-at-sex-change in parrotfishes across the Caribbean: is there variance in a supposed life-history invariant?

Invariant life-history theory has been used to identify parallels in life histories across diverse taxa. One important invariant life-history model predicts that, given simple assumptions and conditions, size-at-sex-change relative to maximum attainable body size (relative size-at-sex-change, RSSC) will be invariant across populations and species in sequential hermaphrodites. Even if there are broad pecies-wide limits to RSSC, populations could fine-tune RSSC to local conditions and, onsequently, exhibit subtle but important differences in timing of sex change. Previous analyses of the invariant sexchange model have not explicitly considered the potential for meaningful differences in RSSC within the confines of a broader ‘invariance’. Furthermore, these tests differ in their geographical and taxonomic scope, which could account for their conflicting conclusions. We test the model using several populations of three female-first ex-changing Caribbean parrotfish species. We first test for species-wide invariance using traditional log–log regressions and randomisation analyses of population-specific point estimates of RSSC

Mating opportunities, paternity, and sexual conflict: Paternal care in northern and southern temperate house wrens

Males are generally predicted to care less for their young when they have more additional mating opportunities, lower paternity, or when their mates care more. We tested these predictions using male provisioning as a proxy for paternal care in two temperate populations of house wrens (Troglodytes aedon) with divergent life histories. Males in the migratory, occasionally socially polygynous New York, USA (northern) population provisioned less when more local females were fertile. A similar relationship was only weakly supported in the resident, socially monogamous Buenos Aires Province, Argentina (southern) population, possibly due to the higher density of house wrens there. A relationship between male provisioning and level of paternity within the brood was supported in both populations, but in opposite directions: while males in the southern population provisioned less at broods containing more extra-pair young, males in the northern population provisioned such broods more, contradicting predictions. Males provisioned less when their mates provisioned more in both populations, in agreement with sexual conflict theory. Additionally, the populations both exhibited a positive relationship between male provisioning and nestling age, but differed in the direction of the relationships of male provisioning with date and brood size. Our results suggest that even within a species, life history differences may be accompanied by differences in the determinants of behavior such as paternal care.Fil: LaBarbera, Katie. Cornell Lab Of Ornithology; Estados Unidos. University of California at Berkeley; Estados UnidosFil: Lovette, Irby Jhon. Cornell University; Estados UnidosFil: Llambias, Paulo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; Argentin