Effects of the Zanzibar School-Based Deworming Program on Iron Status of Children.

We evaluated the effects of the Zanzibar school-based deworming program on the iron status of primary school children. Parasitologic and nutritional assessments were carried out at baseline, 6 mo, and 12 mo in 4 nonprogram schools (n = 1002), 4 schools in which students received twice-yearly deworming (n = 952), and 4 schools in which students received thrice-yearly deworming (n = 970) with 500 mg generic mebendazole. Schools were randomly selected for evaluation and allocated to program groups. Relative to no treatment, thrice-yearly deworming caused significant decreases in protoporphyrin concentrations and both deworming regimens caused marginally significant increases in serum ferritin concentrations. The average annual changes in protoporphyrin concentrations were -5.9 and -23.5 micromol/mol heme in the control and thrice-yearly deworming groups, respectively (P < 0.001). The average changes in ferritin concentration were 2.8 and 4.5 microg/L, respectively (P = 0.07). Deworming had no effect on annual hemoglobin change or prevalence of anemia. However, the relative risk of severe anemia (hemoglobin < 70 g/L) was 0.77 (95% confidence limits: 0.39, 1.51) in the twice-yearly deworming group and 0.45 (0.19, 1.08) in the thrice-yearly deworming group. The effects on prevalence of high protoporphyrin values and incidence of moderate-to-severe anemia (hemoglobin < 90 g/L) were significantly greater in children with > 2000 hookworm eggs/g feces at baseline. We estimate that this deworming program prevented 1260 cases of moderate-to-severe anemia and 276 cases of severe anemia in a population of 30,000 schoolchildren in 1 y. Where hookworm is heavily endemic, deworming programs can improve iron status and prevent moderate and severe anemia, but deworming may be needed at least twice yearly

Interpretación automática de ensayos de flujo bifásico en medios porosos. Comparación de técnicas de optimización

Se aplica una técnica de regresión automática para obtener las curvas de permeabilidades relativas y de presión capilar a partir de datos de caudales medidos durante un ensayo transitorio de desplazamiento de petróleo por agua a través de un testigo de roca. Estas curvas desconocidas están descritas por funciones potenciales, cada una de ellas conteniendo dos parámetros como máximo. Los parámetros se encuentran minimizando una función objetivo que es la suma pesada de los cuadrados de las diferencias entre los datos de caudales medidos experimentalmente y los simulados numéricamente. La minimización se realiza aplicando tres técnicas de optimización: Levenberg Marquardt (en dos versiones diferentes, LM1 y LM2) y Aproximaciones Quasi- Newton para el problema de mínimos cuadrados (AQN). El propósito principal de esta publicación es comparar el comportamiento de dichas técnicas. AQS es siempre convergente a la solución óptima a costa de una importante inversión de tiempo de máquina. LM1 es más rápida pero a veces se estanca siendo incapaz de encontrar el óptimo. El problema se debe a la forma en que esta técnica aproxima la matriz hessiana de la función objetivo. LM2, si bien converge al óptimo en la mayoría de los casos, consume un tiempo de CPU análogo (y aún mayor en los casos más complejos) que el de AQN, lo que la hace desventajosa frente a los otros dos algoritmos. Además, al incorporar la curva de presión capilar, se observan mejores ajustes con los datos experimentales que cuando los términos capilares son ignorados.Peer Reviewe

Interpretación automática de ensayos de flujo bifásico en medios porosos. Comparación de técnicas de optimización

Se aplica una técnica de regresión automática para obtener las curvas de permeabilidades relativas y de presión capilar a partir de datos de caudales medidos durante un ensayo transitorio de desplazamiento de petróleo por agua a través de un testigo de roca. Estas curvas desconocidas están descritas por funciones potenciales, cada una de ellas conteniendo dos parámetros como máximo. Los parámetros se encuentran minimizando una función objetivo que es la suma pesada de los cuadrados de las diferencias entre los datos de caudales medidos experimentalmente y los simulados numéricamente. La minimización se realiza aplicando tres técnicas de optimización: Levenberg Marquardt (en dos versiones diferentes, LM1 y LM2) y Aproximaciones Quasi- Newton para el problema de mínimos cuadrados (AQN). El propósito principal de esta publicación es comparar el comportamiento de dichas técnicas. AQS es siempre convergente a la solución óptima a costa de una importante inversión de tiempo de máquina. LM1 es más rápida pero a veces se estanca siendo incapaz de encontrar el óptimo. El problema se debe a la forma en que esta técnica aproxima la matriz hessiana de la función objetivo. LM2, si bien converge al óptimo en la mayoría de los casos, consume un tiempo de CPU análogo (y aún mayor en los casos más complejos) que el de AQN, lo que la hace desventajosa frente a los otros dos algoritmos. Además, al incorporar la curva de presión capilar, se observan mejores ajustes con los datos experimentales que cuando los términos capilares son ignorados.Peer Reviewe

School-Based Deworming Program Yields Small Improvement in Growth of Zanzibari School Children After one Year.

Efficacy trials of antihelminthic therapies conducted in Africa have reported improvements in children's growth, but nutritional evaluations of large-scale deworming programs are lacking. We evaluated the first-year effect on growth of a school-based deworming program in Zanzibar, where growth retardation occurs in school children. Children in four primary schools were given thrice-yearly mebendazole (500 mg) and compared with children in four schools that received twice-yearly mebendazole and children in four non-program schools. Evaluation schools were randomly selected and allocated to control, twice-yearly or thrice-yearly deworming. Approximately 1000 children in each program group completed the 1-y follow-up. Children <10 y old gained 0.27 kg more weight (P < 0.05) and 0.13 cm more height (P = 0.20) in the twice-yearly group, and 0. 20 kg more weight (P = 0.07) and 0.30 cm more height (P < 0.01) in the thrice-yearly group, compared with the control group. Children <10 y old with higher heights-for-age at baseline had higher weight and height gains in response to deworming. In children >/=10 y old, overall program effects on height or weight gains were not significant. But in this age range, younger boys had significant improvements in height gain with thrice-yearly deworming, and children with higher heights-for-age had greater improvements in weight gain with deworming. We conclude that the deworming program improved the growth of school children, especially children who were younger and less stunted, but the improvements were small. More effective antihelminthic regimens or additional dietary or disease control interventions may be needed to substantially improve the growth of school children in areas such as Zanzibar

How Much Can We Trust Major Element Quantification in Bioapatite Investigation?

Bioapatite is probably the key factor in the unreplicated success of vertebrates. Chemical data on bioapatite composition can be achieved on a solid sample by using different analytical tools such as spectroscopic and spectrometric methods. As analytical outputs can be affected by the physical-chemical characteristics of the sample matrix, an internal standard is usually required to correct and validate the results. Bioapatite lattice can accommodate iso- and heterovalent substitutions during life or diagenesis varying its chemical composition through (geological) time. If on the one hand, this makes bioapatite a unique archive of physical and chemical information for both the living cycle and the events occurring after death, on the other, it excludes the identification of a sole internal standard. Here, we propose a method to measure major element concentration with specific care for P, Ca, Mg, Na, K, Si, Al, and Fe, which are the main substituent atoms in bioapatite, through homemade matrix-matched external calibration standards for laser ablation inductively coupled plasma mass spectrometry (LA-ICPMS). We tested the method on living and fossil shark teeth, critically comparing the results obtained using other analytical techniques and certified external standards. We demonstrated that matrix-matched calibration in LA-ICPMS is mandatory for obtaining a reliable chemical characterization even if factors such as matrix aggregation variability, diverse presence of volatile compounds, the fossilization footprint, and the instrumental variability can represent further variability parameters

Influencia de la permeabilidad vertical en el flujo de petróleo hacia un pozo productor

Se describe el flujo bidimensional de petróleo a través de un reservorio heterogéneo mediante una ecuación parabólica en derivadas parciales, que es una extensión de la denominada ecuación de difusividad. Este modelo tiene interés práctico en ingeniería de reservorios: se utiliza para predecir la producción de un pozo de petróleo y también en la interpretación de ensayos de presión en pozos. La solución numérica de dicha ecuación se obtiene mediante una familia de esquemas de diferencias finitas que dependen de un parámetro 8, O 5 8 5 1. Una técnica basada en la expansión en serie de Taylor de funciones matriciales (TSMF) es usada para resolver el sistema de ecuaciones lineales resultante. El simulador numérico descrito se aplica para estudiar el comportamiento de reservorios de dos capas con valores típicos de permeabilidad vertical iguales o menores que los de permeabilidad horizontal. Específicamente, para un pozo de petróleo que produce a caudal constante, se analiza la influencia de la permeabilidad vertical en las respuestas de presión y caudal de cada capa. Se concluye que la permeabilidad vertical influye en las respuestas de presión y caudal a tiempos cortos e intermedios, por lo que debería ser tenida en cuenta tanto en el diseño como en la interpretación de los ensayos de presión en pozos.Peer Reviewe

Study and implementation of urogenital schistosomiasis elimination in Zanzibar (Unguja and Pemba islands) using an integrated multidisciplinary approach

ABSTRACT: BACKGROUND: Schistosomiasis is a parasitic infection that continues to be a major public health problem in many developing countries being responsible for an estimated burden of at least 1.4 million disability-adjusted life years (DALYs) in Africa alone. However, morbidity due to schistosomiasis has been greatly reduced in some parts of the world, including Zanzibar. The Zanzibar government is now committed to eliminate urogenital schistosomiasis. Over the next 3--5 years, the whole at-risk population will be administered praziquantel (40 mg/kg) biannually. Additionally, snail control and behaviour change interventions will be implemented in selected communities and the impact measured in a randomized intervention trial. METHODS: In this 5-year research study, on both Unguja and Pemba islands, urogenital schistosomiasis will be assessed in 45 communities with urine filtration and reagent strips in 4,500 schoolchildren aged 9--12 years annually, and in 4,500 first-year schoolchildren and 2,250 adults in years 1 and 5. Additionally, from first-year schoolchildren, a finger-prick blood sample will be collected and examined for Schistosoma haematobium infection biomarkers. Changes in prevalence and infection intensity will be assessed annually. Among the 45 communities, 15 were randomized for biannual snail control with niclosamide, in concordance with preventive chemotherapy campaigns. The reduction of Bulinus globosus snail populations and S. haematobium-infected snails will be investigated. In 15 other communities, interventions triggering behaviour change have been designed and will be implemented in collaboration with the community. A change in knowledge, attitudes and practices will be assessed annually through focus group discussions and in-depth interviews with schoolchildren, teachers, parents and community leaders. In all 45 communities, changes in the health system, water and sanitation infrastructure will be annually tracked by standardized questionnaire-interviews with community leaders. Additional issues potentially impacting on study outcomes and all incurring costs will be monitored and recorded. DISCUSSION: Elimination of schistosomiasis has become a priority on the agenda of the Zanzibar government and the international community. Our study will contribute to identifying what, in addition to preventive chemotherapy, needs to be done to prevent, control, and ultimately eliminate schistosomiasis, and to draw lessons for current and future schistosomiasis elimination programmes in Africa and elsewhere.Trial registrationISRCTN4883768

Elimination of Schistosomiasis Transmission in Zanzibar: Baseline Findings before the Onset of a Randomized Intervention Trial.

Gaining and sustaining control of schistosomiasis and, whenever feasible, achieving local elimination are the year 2020 targets set by the World Health Organization. In Zanzibar, various institutions and stakeholders have joined forces to eliminate urogenital schistosomiasis within 5 years. We report baseline findings before the onset of a randomized intervention trial designed to assess the differential impact of community-based praziquantel administration, snail control, and behavior change interventions. In early 2012, a baseline parasitological survey was conducted in ∼20,000 people from 90 communities in Unguja and Pemba. Risk factors for schistosomiasis were assessed by administering a questionnaire to adults. In selected communities, local knowledge about schistosomiasis transmission and prevention was determined in focus group discussions and in-depths interviews. Intermediate host snails were collected and examined for shedding of cercariae. The baseline Schistosoma haematobium prevalence in school children and adults was 4.3% (range: 0-19.7%) and 2.7% (range: 0-26.5%) in Unguja, and 8.9% (range: 0-31.8%) and 5.5% (range: 0-23.4%) in Pemba, respectively. Heavy infections were detected in 15.1% and 35.6% of the positive school children in Unguja and Pemba, respectively. Males were at higher risk than females (odds ratio (OR): 1.45; 95% confidence interval (CI): 1.03-2.03). Decreasing adult age (OR: 1.04; CI: 1.02-1.06), being born in Pemba (OR: 1.48; CI: 1.02-2.13) or Tanzania (OR: 2.36; CI: 1.16-4.78), and use of freshwater (OR: 2.15; CI: 1.53-3.03) showed higher odds of infection. Community knowledge about schistosomiasis was low. Only few infected Bulinus snails were found. The relatively low S. haematobium prevalence in Zanzibar is a promising starting point for elimination. However, there is a need to improve community knowledge about disease transmission and prevention. Control measures tailored to the local context, placing particular attention to hot-spot areas, high-risk groups, and individuals, will be necessary if elimination is to be achieved