Spatial priorities for conserving the most intact biodiverse forests within Central Africa

The forests of Central Africa contain some of Earth's few remaining intact forests. These forests are increasingly threatened by infrastructure development, agriculture, and unsustainable extraction of natural resources (e.g. minerals, bushmeat, and timber), all of which is leading to deforestation and forest degradation, particularly defaunation, and hence causing declines in biodiversity and a significant increase in carbon emissions. Given the pervasive nature of these threats, the global importance of Central African forests for biodiversity conservation, and the limited resources for conservation and sustainable management, there is a need to identify where the most important areas are to orientate conservation efforts. We developed a novel approach for identifying spatial priorities where conservation efforts can maximize biodiversity benefits within Central Africa's most intact forest areas. We found that the Democratic Republic of Congo has the largest amount of priority areas in the region, containing more than half, followed by Gabon, the Republic of Congo and Cameroon. We compared our approach to one that solely prioritizes forest intactness and one that aims to achieve only biodiversity representation objectives. We found that when priorities are only based on forest intactness (without considering biodiversity representation), there are significantly fewer biodiversity benefits and vice versa. We therefore recommend multi-objective planning that includes biodiversity representation and forest intactness to ensure that both objectives are maximized. These results can inform various types of conservation strategies needed within the region, including land-use planning, jurisdictional REDD + initiatives, and performance related carbon payments, protected area expansion, community forest management, and forest concession plans

Development and Validation of a Risk Score for Chronic Kidney Disease in HIV Infection Using Prospective Cohort Data from the D:A:D Study

Ristola M. on työryhmien DAD Study Grp ; Royal Free Hosp Clin Cohort ; INSIGHT Study Grp ; SMART Study Grp ; ESPRIT Study Grp jäsen.Background Chronic kidney disease (CKD) is a major health issue for HIV-positive individuals, associated with increased morbidity and mortality. Development and implementation of a risk score model for CKD would allow comparison of the risks and benefits of adding potentially nephrotoxic antiretrovirals to a treatment regimen and would identify those at greatest risk of CKD. The aims of this study were to develop a simple, externally validated, and widely applicable long-term risk score model for CKD in HIV-positive individuals that can guide decision making in clinical practice. Methods and Findings A total of 17,954 HIV-positive individuals from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study with >= 3 estimated glomerular filtration rate (eGFR) values after 1 January 2004 were included. Baseline was defined as the first eGFR > 60 ml/min/1.73 m2 after 1 January 2004; individuals with exposure to tenofovir, atazanavir, atazanavir/ritonavir, lopinavir/ritonavir, other boosted protease inhibitors before baseline were excluded. CKD was defined as confirmed (>3 mo apart) eGFR In the D:A:D study, 641 individuals developed CKD during 103,185 person-years of follow-up (PYFU; incidence 6.2/1,000 PYFU, 95% CI 5.7-6.7; median follow-up 6.1 y, range 0.3-9.1 y). Older age, intravenous drug use, hepatitis C coinfection, lower baseline eGFR, female gender, lower CD4 count nadir, hypertension, diabetes, and cardiovascular disease (CVD) predicted CKD. The adjusted incidence rate ratios of these nine categorical variables were scaled and summed to create the risk score. The median risk score at baseline was -2 (interquartile range -4 to 2). There was a 1: 393 chance of developing CKD in the next 5 y in the low risk group (risk score = 5, 505 events), respectively. Number needed to harm (NNTH) at 5 y when starting unboosted atazanavir or lopinavir/ritonavir among those with a low risk score was 1,702 (95% CI 1,166-3,367); NNTH was 202 (95% CI 159-278) and 21 (95% CI 19-23), respectively, for those with a medium and high risk score. NNTH was 739 (95% CI 506-1462), 88 (95% CI 69-121), and 9 (95% CI 8-10) for those with a low, medium, and high risk score, respectively, starting tenofovir, atazanavir/ritonavir, or another boosted protease inhibitor. The Royal Free Hospital Clinic Cohort included 2,548 individuals, of whom 94 individuals developed CKD (3.7%) during 18,376 PYFU (median follow-up 7.4 y, range 0.3-12.7 y). Of 2,013 individuals included from the SMART/ESPRIT control arms, 32 individuals developed CKD (1.6%) during 8,452 PYFU (median follow-up 4.1 y, range 0.6-8.1 y). External validation showed that the risk score predicted well in these cohorts. Limitations of this study included limited data on race and no information on proteinuria. Conclusions Both traditional and HIV-related risk factors were predictive of CKD. These factors were used to develop a risk score for CKD in HIV infection, externally validated, that has direct clinical relevance for patients and clinicians to weigh the benefits of certain antiretrovirals against the risk of CKD and to identify those at greatest risk of CKD.Peer reviewe

What explains wildlife value orientations? A study among central African forest dwellers

This study of values placed on wildlife by Bantu and Yaka Pygmy forest dwellers (n = 200) in Northern Congo identified and analyzed two wildlife value orientations - “anthropocentric” and “biocentric.” The former, strongly displayed across all segments of both societies, was likely motivated by heavy reliance on bushmeat and human–wildlife conflicts, and was linked to attitudes approving the killing of animals for human benefit. The “biocentric” orientation was more common among formally educated male respondents who do not hunt and positively linked to attitudes favoring conservation. Wildlife management strategies should consider including 1) sustainable local wildlife exploitation, 2) livelihood projects that provide a real alternative to hunting, and 3) human–wildlife conflict mitigation. (Résumé d'auteur

Forest condition in the Congo Basin for the assessment of ecosystem conservation status

Quantifying ecological condition, notably the extent of forest degradation is important for understanding and designing measures to protect biodiversity and enhancing the capacity of forests to deliver ecosystem services. Conservation planning, particularly the prioritization of management interventions for forests, is often lacking spatial data on forest degradation, and it is often overlooked within decision-making processes. We develop a continuous metric termed Forest Condition (FC) which aims to measure the degree of forest degradation on a scale from 0 to 100, incorporating the temporal history of forest change over any spatial extent. We parameterize this metric based on estimated changes in above ground biomass in the context of forest fragmentation over time to estimate a continuous measure of forest degradation for Congo Basin countries. We estimate that just <70% of Congo Basin forests remain fully intact, a decrease from 78% in the year 2000. FC was validated by direct remote sensing measurements from Landsat imagery for DRC. Results showed that FC was significantly positively correlated with forest canopy cover, gap area per hectare, and magnitude of temporal change in Normalized Burn Ratio. We tested the ability of FC to distinguish primary and secondary degradation and deforestation and found significant differences in gap area and spectral anomalies to validate our theoretical model. We apply the IUCN Red List of Ecosystems criteria to demonstrate the integration of forest condition to assess the risk of ecosystem collapse. Based on this assessment, we found that without including FC in the assessment of biotic disruption, 12 ecosystems representing over 11% of forested area in 2015 would not have been assigned a threat status, and an additional 9 ecosystems would have a lower threat status. Our overall assessment of ecosystems found about half of all Congo Basin ecosystem types, accounting for 20% of all forest area are threatened to some degree, including 4 ecosystems (<1% of total area) which are critically engendered. FC is a transferrable and scalable assessment to support forest monitoring, planning, and management

Understanding deforestation and forest fragmentation from a livelihood perspective

Worldwide, forests provide a wide variety of resources to rural inhabitants, and especially to the poor. In Madagascar, forest resources make important contributions to the livelihoods of the rural population living at the edges of these forests. Although people benefit from forest resources, forests are continuously cleared and converted into arable land. Despite long-term efforts on the part of researchers, development cooperation projects and government, Madagascar has not been able to achieve a fundamental decrease in deforestation. The question of why deforestation continues in spite of such efforts remains. To answer this question, we aimed at understanding deforestation and forest fragmentation from the perspective of rural households in the Manompana corridor on the east coast. Applying a sustainable livelihood approach, we explored local social-ecological systems to understand: (i) how livelihood strategies leading to deforestation evolve and (ii) how the decrease of forest impacts on households' strategies. Results highlight the complexity of the environmental, cultural and political context in which households’ decision-making takes place. Further, we found crucial impacts of deforestation and forest fragmentation on livelihood systems, but also recognized that people have been able to adapt to the changing landscapes without major impacts on their welfare

All cause mortality in the Swiss HIV cohort study from 1990 to 2001 in comparison with the Swiss population

Methods: Standardized mortality ratios (SMR) and life tables were calculated for strata defined by combinations of gender and HIV transmission group. The effect of dropouts was investigated with a sensitivity analysis and by analysing CD4 cell counts before dropout. Results: During the study period 10 977 individuals had at least one cohort visit with a median observation time of 46 months. A total of 3630 patients died and 2290 dropped out. SMR decreased from 79.3 [95% confidence interval (CI), 77.2-81.5] before the introduction of highly active antiretroviral treatment (HAART) in 1996 to 15.3 (95% CI, 14.2-16.4) thereafter. For persons who acquired HIV infection by injecting drug use (IDUs), the SMR decreased from 98.2 (95% CI, 94.9-103.5) to 40.9 (95% CI, 37.0-44.8) after 1996; for all other HIV transmission groups the SMR decreased from 69.2 (95% CI, 66.9-71.6) to 9.4 (95% CI, 8.5-10.4). Thus, IDUs had significantly lower survival in comparison with other patient groups after 1996. Patients who had started HAART during the time period in which this treatment was available, had even lower SMRs. Conclusions: Although overall survival has improved considerably since the introduction of HAART, cohort life expectancy remains below that of the Swiss population. We noted, however, substantial differences in mortality among subgroups, and the results indicate that the additional risk related to injection drug use before 1996 had been masked by HIV-associated mortality

Adverse events to antiretrovirals in the Swiss HIV Cohort Study: effect on mortality and treatment modification

Antiretroviral therapy (ART) decreases morbidity and mortality in HIV-infected patients but is associated with considerable adverse events (AEs