Modeling and Solving Alternative Financial Solutions Seeking

International audienceIn this paper we build a method to optimize Multi-Year Prospective Budgets. First we present a systemic model of Local Community Finances. Then, from two acceptable Multi-Year Prospective Budgets the method implements a Genetic Algorithm to generate a collection of admissible Multi-Year Prospective Budgets among which Decision-Makers can choose. The method is tested on simplified cases and on in operational situation and gives satisfactory results

Effects of larval growth condition and water availability on desiccation resistance and its physiological basis in adult Anopheles gambiae sensu stricto

<p>Abstract</p> <p>Background</p> <p>Natural populations of the malaria mosquito <it>Anopheles gambiae </it>s.s. are exposed to large seasonal and daily fluctuations in relative humidity and temperature, which makes coping with drought a crucial aspect of their ecology.</p> <p>Methods</p> <p>To better understand natural variation in desiccation resistance in this species, the effects of variation in larval food availability and access to water as an adult on subsequent phenotypic quality and desiccation resistance of adult females of the Mopti chromosomal form were tested experimentally.</p> <p>Results</p> <p>It was found that, under normal conditions, larval food availability and adult access to water had only small direct effects on female wet mass, dry mass, and water, glycogen and body lipid contents corrected for body size. In contrast, when females subsequently faced a strong desiccation challenge, larval food availability and adult access to water had strong carry-over effects on most measured physiological and metabolic parameters, and affected female survival. Glycogen and water content were the most used physiological reserves in relative terms, but their usage significantly depended on female phenotypic quality. Adult access to water significantly influenced the use of water and body lipid reserves, which subsequently affected desiccation resistance.</p> <p>Conclusions</p> <p>These results demonstrate the importance of growth conditions and water availability on adult physiological status and subsequent resistance to desiccation.</p

Public sector services for the prevention of mother-to-child transmission of HIV infection: a micro-costing survey in Namibia and Rwanda

OBJECTIVE: To assess the costs associated with the provision of services for the prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus in two African countries. METHODS: In 2009, the costs to health-care providers of providing comprehensive PMTCT services were assessed in 20 public health facilities in Namibia and Rwanda. Information on prices and on the total amount of each service provided was collected at the national level. The costs of maternal testing and counselling, male partner testing, CD4+ T-lymphocyte (CD4+ cell) counts, antiretroviral prophylaxis and treatment, community-based activities, contraception for 2 years postpartum and early infant diagnosis were estimated in United States dollars (US$). FINDINGS: The estimated costs to the providers of PMTCT, for each mother-infant pair, were US$ 202.75-1029.55 in Namibia and US$94.14-342.35 in Rwanda. These costs varied with the drug regimen employed. At 2009 coverage levels, the maximal estimates of the national costs of PMTCT were US$ 3.15 million in Namibia and US$7.04 million in Rwanda (or < US$ 0.75 per capita in both countries). Adult testing and counselling accounted for the highest proportions of the national costs (37% and 74% in Namibia and Rwanda, respectively), followed by management and supervision. Treatment and prophylaxis accounted for less than 20% of the costs of PMTCT in both study countries. CONCLUSION: The costs involved in the PMTCT of HIV varied widely between study countries and in accordance with the protocols used. However, since per-capita costs were relatively low, the scaling up of PMTCT services in Namibia and Rwanda should be possible

Prevalence of Intestinal Coccidiosis Among Patients Living with the Human Immunodeficiency Virus in Abidjan (Côte d'Ivoire)

International audienceBackground and Objective: Intestinal coccidia is one of the main causes of diarrheal infections among people living with HIV (PLHIV). The occurrence of diarrhoea in PLHIV affects their health status. The purpose of this study was to determine the prevalence of intestinal coccidia in patients with HIV/AIDS and to investigate a possible correlation between these parasites and the CD4 count in patients. Materials and Methods: This was a cross-sectional study carried out in three health care centres of PLHIV in Abidjan. Socio-demographic, clinical and biological data were collected using a questionnaire. Stool and blood samples were collected. Parasitic coprology analysis included the direct microscopic examinations, the concentration techniques (Ritchie and kato-katz) and Ziehl Neelsen. The last one allowed the detection of the oocysts of the coccidia. Results: A total of 363 faecal samples were collected from 03 health care centres. The stool samples collected consisted of 47.65% of diarrhoea. The results of the microscopic analysis revealed 03 intestinal coccidia's namely Cryptosporidium spp. (3.86%), Isospora spp. (1.65%) and Cyclospora spp. (0.83%). The highest microscopic prevalence was recorded in Cryptosporidium spp. (3.86%). Intestinal coccidia was more common in females infected with type 1 of HIV. CD4 count was a significant factor in the occurrence of Cryptosporidium spp. (χ2 = 29.968, p-value = 0.0001) with a correlation coefficient of -0.2438. Conclusion: This study assessed the microscopic prevalence rates of intestinal coccidia, which are responsible for diarrheal disease among PLHIV. The current study also showed that the presence of these intestinal coccidia's could affect the immune system of PLHIV when the CD4 cell count is below 200 cells mm–3