Intracellular survival of Streptococcus pneumoniae in human alveolar macrophages is augmented with HIV infection

People Living with HIV (PLHIV) are at an increased risk of pneumococcal pneumonia than HIV-uninfected adults, but the reasons for this are still not well understood. We investigated whether alveolar macrophages (AM) mediated control of pneumococcal infection is impaired in PLHIV compared to HIV-uninfected adults. We assessed anti-bactericidal activity against Streptococcus pneumoniae of primary human AM obtained from PLHIV and HIV-uninfected adults. We found that pneumococcus survived intracellularly in AMs at least 24 hours post ex vivo infection, and this was more frequent in PLHIV than HIV-uninfected adults. Corroborating these findings, in vivo evidence showed that PLHIV had a higher propensity for harboring S. pneumoniae within their AMs than HIV-uninfected adults. Moreover, bacterial intracellular survival in AMs was associated with extracellular propagation of pneumococcal infection. Our data suggest that failure of AMs to eliminate S. pneumoniae intracellularly could contribute to the increased risk of pneumococcal pneumonia in PLHIV

Transport and mobility constraints in an aging population: health and livelihood implications in rural Tanzania

This paper offers a rare examination of older people’s mobility in a developing country context. It presents findings from a recent mixed-methods study of the transport and mobility constraints faced by older people in 10 settlements in Kibaha district Tanzania and is concerned, in particular, with the interconnections between transport, health and livelihoods. The study demonstrates the diverse ways in which older people’s health, livelihoods and access to transport are interconnected, the growing importance of motorcycle–taxi services for rural connectivity, and how the relationality between older people and younger generations contributes to the shaping of mobility patterns