Global Burden of Invasive Nontyphoidal Salmonella Disease, 2010

Nontyphoidal Salmonella is a major cause of bloodstream infections worldwide, and HIV-infected persons and malaria-infected and malnourished children are at increased risk for the disease. We conducted a systematic literature review to obtain age group–specific, population-based invasive nontyphoidal Salmonella (iNTS) incidence data. Data were categorized by HIV and malaria prevalence and then extrapolated by using 2010 population data. The case-fatality ratio (CFR) was determined by expert opinion consensus. We estimated that 3.4 (range 2.1–6.5) million cases of iNTS disease occur annually (overall incidence 49 cases [range 30–94] per 100,000 population). Africa, where infants, young children, and young adults are most affected, had the highest incidence (227 cases [range 152–341] per 100,000 population) and number of cases (1.9 [range 1.3–2.9] million cases). An iNTS CFR of 20% yielded 681,316 (range 415,164–1,301,520) deaths annually. iNTS disease is a major cause of illness and death globally, particularly in Africa. Improved understanding of the epidemiology of iNTS is needed

Low-Cost National Media-Based Surveillance System for Public Health Events, Bangladesh.

We assessed a media-based public health surveillance system in Bangladesh during 2010-2011. The system is a highly effective, low-cost, locally appropriate, and sustainable outbreak detection tool that could be used in other low-income, resource-poor settings to meet the capacity for surveillance outlined in the International Health Regulations 2005

Data for: "Immune activation in the female genital tract: Expression profiles of soluble proteins in women at high risk for HIV infection"

An anonymised dataset containing details of a sub-study of 100 HIV-negative women in 2009. This sub-study was part of a microbicide feasibility study in North-West Tanzania that was carried out between 2008-2010. It contains information on sexual behaviour, vaginal practices, current contraception, STI symptoms, as well as results of a clinical and colposcopic examinatio

Prevalence of nonsuppressed viral load and associated factors among HIV-positive adults receiving antiretroviral therapy in Eswatini, Lesotho, Malawi, Zambia and Zimbabwe (2015 to 2017): results from population-based nationally representative surveys.

INTRODUCTION The global target for 2020 is that ≥90% of people living with HIV (PLHIV) receiving antiretroviral therapy (ART) will achieve viral load suppression (VLS). We examined VLS and its determinants among adults receiving ART for at least four months. METHODS We analysed data from the population-based HIV impact assessment (PHIA) surveys in Eswatini, Lesotho, Malawi, Zambia and Zimbabwe (2015 to 2017). PHIA surveys are nationally representative, cross-sectional household surveys. Data collection included structured interviews, home-based HIV testing and laboratory testing. Blood samples from PLHIV were analysed for HIV RNA, CD4 counts and recent exposure to antiretroviral drugs (ARVs). We calculated representative estimates for the prevalence of VLS (viral load <1000 copies/mL), nonsuppressed viral load (NVL; viral load ≥1000 copies/mL), virologic failure (VF; ARVs present and viral load ≥1000 copies/mL), interrupted ART (ARVs absent and viral load ≥1000 copies/mL) and rates of switching to second-line ART (protease inhibitors present) among PLHIV aged 15 to 59 years who participated in the PHIA surveys in Eswatini, Lesotho, Malawi, Zambia and Zimbabwe, initiated ART at least four months before the survey and were receiving ART at the time of the survey (according to self-report or ARV testing). We calculated odds ratios and incidence rate ratios for factors associated with NVL, VF, interrupted ART, and switching to second-line ART. RESULTS We included 9200 adults receiving ART of whom 88.8% had VLS and 11.2% had NVL including 8.2% who experienced VF and 3.0% who interrupted ART. Younger age, male sex, less education, suboptimal adherence, receiving nevirapine, HIV non-disclosure, never having married and residing in Zimbabwe, Lesotho or Zambia were associated with higher odds of NVL. Among people with NVL, marriage, female sex, shorter ART duration, higher CD4 count and alcohol use were associated with lower odds for VF and higher odds for interrupted ART. Many people with VF (44.8%) had CD4 counts <200 cells/µL, but few (0.31% per year) switched to second-line ART. CONCLUSIONS Countries are approaching global VLS targets for adults. Treatment support, in particular for younger adults, and people with higher CD4 counts, and switching of people to protease inhibitor- or integrase inhibitor-based regimens may further reduce NVL prevalence

Trends in Prevalence of Advanced HIV Disease at Antiretroviral Therapy Enrollment - 10 Countries, 2004-2015.

Monitoring prevalence of advanced human immunodeficiency virus (HIV) disease (i.e., CD4+ T-cell count <200 cells/μL) among persons starting antiretroviral therapy (ART) is important to understand ART program outcomes, inform HIV prevention strategy, and forecast need for adjunctive therapies.*,†,§ To assess trends in prevalence of advanced disease at ART initiation in 10 high-burden countries during 2004-2015, records of 694,138 ART enrollees aged ≥15 years from 797 ART facilities were analyzed. Availability of national electronic medical record systems allowed up-to-date evaluation of trends in Haiti (2004-2015), Mozambique (2004-2014), and Namibia (2004-2012), where prevalence of advanced disease at ART initiation declined from 75% to 34% (p<0.001), 73% to 37% (p<0.001), and 80% to 41% (p<0.001), respectively. Significant declines in prevalence of advanced disease during 2004-2011 were observed in Nigeria, Swaziland, Uganda, Vietnam, and Zimbabwe. The encouraging declines in prevalence of advanced disease at ART enrollment are likely due to scale-up of testing and treatment services and ART-eligibility guidelines encouraging earlier ART initiation. However, in 2015, approximately a third of new ART patients still initiated ART with advanced HIV disease. To reduce prevalence of advanced disease at ART initiation, adoption of World Health Organization (WHO)-recommended "treat-all" guidelines and strategies to facilitate earlier HIV testing and treatment are needed to reduce HIV-related mortality and HIV incidence

Vaginal practices among women at high risk of HIV infection in Uganda and Tanzania: recorded behaviour from a daily pictorial diary.

BACKGROUND: Intravaginal practices (IVP) are highly prevalent in sub-Saharan African and have been implicated as risk factors for HIV acquisition. However, types of IVP vary between populations, and detailed information on IVP among women at risk for HIV in different populations is needed. We investigated IVP among women who practice transactional sex in two populations: semi-urban, facility workers in Tanzania who engage in opportunistic sex work; and urban, self-identified sex workers and bar workers in Uganda. The aim of the study was to describe and compare IVP using a daily pictorial diary. METHODOLOGY/PRINCIPAL FINDINGS: Two hundred women were recruited from a HIV prevention intervention feasibility study in Kampala, Uganda and in North-West Tanzania. Women were given diaries to record IVP daily for six weeks. Baseline data showed that Ugandan participants had more lifetime partners and transactional sex than Tanzanian participants. Results from the diary showed that 96% of Tanzanian participants and 100% of Ugandan participants reported intravaginal cleansing during the six week study period. The most common types of cleansing were with water only or water and soap. In both countries, intravaginal insertion (e.g. with herbs) was less common than cleansing, but insertion was practiced by more participants in Uganda (46%) than in Tanzania (10%). In Uganda, participants also reported more frequent sex, and more insertion related to sex. In both populations, cleansing was more often reported on days with reported sex and during menstruation, and in Uganda, when participants experienced vaginal discomfort. Participants were more likely to cleanse after sex if they reported no condom use. CONCLUSIONS: While intravaginal cleansing was commonly practiced in both cohorts, there was higher frequency of cleansing and insertion in Uganda. Differences in IVP were likely to reflect differences in sexual behaviour between populations, and may warrant different approaches to interventions targeting IVP. Vaginal practices among women at high risk in Uganda and Tanzania: recorded behaviour from a daily pictorial diary

Entwicklung von Membranen fuer Direktmethanol-Brennstoffzellen Abschlussbericht

Membrane characteristics are to be modified for higher power densities and higher fuel gas concentrations. In particular, the permeability to methanol is to be reduced significantly. The membranes and electrodes will be combined into a 500 W demonstration system for a gaseous DMFC.Ziel des Projektes ist es, die Membraneigenschaften so einzustellen, dass hoehere Leistungsdichten erzielt werden koennen und mit hoeheren Brenngaskonzentrationen gearbeitet werden kann. Es soll vor allem die Permeabilitaet der Membranen gegenueber Methanol entscheidend verringert werden. Durch Kombination der so erhaltenen Membranen und Elektroden soll dann ein Demonstrationssystem fuer eine gasfoermige DMFC mit 500 Watt aufgebaut werden, in dem alle notwendigen Komponenten enthalten sind. (orig.)SIGLEAvailable from TIB Hannover: F02B199 / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekBundesministerium fuer Bildung und Forschung, Berlin (Germany)DEGerman

Human immunodeficiency virus type 1 among bar and hotel workers in northern Tanzania: the role of alcohol, sexual behavior, and herpes simplex virus type 2.

GOALS: We assessed baseline prevalence of human immunodeficiency virus type 1 (HIV-1) and other STDs, as well as behavioral and biologic risk factors for HIV-1 in a population of female bar/hotel workers in Moshi, Tanzania. STUDY DESIGN: Between 2002 and 2003, we enrolled 1042 female bar/hotel workers in an ongoing prospective cohort study. We analyzed data collected at baseline to assess the associations between alcohol, sexual behavior, STDs, and HIV-1 infection. RESULTS: The prevalence of HIV-1 infection was 19.0% (95% confidence interval [CI] = 16.6%-21.4%). Consistent condom use was low (11.1%). HIV-1 was associated with genital ulcers on examination (adjusted odds ratio [AOR] = 2.08, 95% CI = 1.16-3.74), herpes simplex virus type 2 (HSV-2) (AOR = 3.80, 95% CI = 2.42-5.97), and problem drinking (AOR = 1.92, 95% CI = 1.06-3.47). Other independent predictors of HIV-1 were increasing age, number of sex partners, cohabitating, formerly married, location of employment, and having a husband with another wife. CONCLUSIONS: These findings suggest that programs designed to control HSV-2, reduce the number of sexual partners and alcohol use, and promote condom use could be effective in reducing transmission of HIV-1 in this population

Prevalence of syndromes diagnosed, by visit month, in a cohort of women at increased risk for HIV acquisition in northwestern Tanzania.

<p>Values shown at the top of the bars are the prevalence (%). PID = pelvic inflammatory disease, VDS = vaginal discharge syndrome.</p

Associations of <i>C. trachomatis</i>, <i>N. gonorrhoeae</i>, <i>T. vaginalis</i> and active syphilis (high-titre) with sociodemographic, behavioural and biological factors in a cohort of women at increased risk for HIV acquisition in northwestern Tanzania.

<p>Note: <i>C. trachomatis</i>, <i>N. gonorrhoeae</i> and <i>T. vaginalis</i> data from all visits were used in the analysis. For active syphilis (high-titre), data only from the enrolment visit were used since there were very few incident infections. “1” denotes the reference category throughout.</p><p><a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0101221#pone.0101221-Celum1" target="_blank">[1]</a> ORs for sociodemographic variables adjusted for visit month, town, age and duration working in facility type; ORs for behavioural variables adjusted for these sociodemographic variables, number of lifetime partners and contraception; ORs for biological variables adjusted for these sociodemographic and behavioural variables, ever pregnant and gonorrhoea status (the results for these variables are shown in bold). Full results from each level shown in Table S1 in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0101221#pone.0101221.s001" target="_blank">File S1</a>.</p><p><a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0101221#pone.0101221-Schmid1" target="_blank">[2]</a> ORs for sociodemographic variables adjusted for visit month, town and age; ORs for behavioural variables adjusted for these sociodemographic variables and AUDIT; ORs for biological variables adjusted for these sociodemographic and behavioural variables, ever pregnant and chlamydia status (the results for these variables are shown in bold). Full results from each level shown in Table S2 in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0101221#pone.0101221.s001" target="_blank">File S1</a>.</p><p><a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0101221#pone.0101221-Tobian1" target="_blank">[3]</a> ORs for sociodemographic variables adjusted for visit month, town, age, education and marital status; ORs for behavioural variables adjusted for these sociodemographic variables (no behavioural variables included); ORs for biological variables adjusted for these sociodemographic and behavioural variables and current vaginal microbiota assessed by Nugent score (the results for these variables are shown in bold). Full results from each level shown in Table S3 in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0101221#pone.0101221.s001" target="_blank">File S1</a>.</p><p><a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0101221#pone.0101221-Moodley1" target="_blank">[4]</a> ORs for sociodemographic variables adjusted for visit month, town, age and education; ORs for behavioural variables adjusted for these sociodemographic variables and whether had concurrent partners in the last 3 months; ORs for biological variables adjusted for these sociodemographic and behavioural variables and <i>T. vaginalis</i> status (the results for these variables are shown in bold). Full results from each level shown in Table S4 in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0101221#pone.0101221.s001" target="_blank">File S1</a>.</p><p><a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0101221#pone.0101221-Fleming1" target="_blank">[5]</a> Combined complete primary and secondary since only two women who attended secondary school had active syphilis (high-titre) at enrolment.</p><p><a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0101221#pone.0101221-Rours1" target="_blank">[6]</a> Based on responses to ten AUDIT questions. Scores based on responses to each question: 0–7 = non-drinker or low-risk; ≥8 harmful or hazardous drinking.</p><p><a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0101221#pone.0101221-WatsonJones1" target="_blank">[7]</a> Combined positive (from baseline) and positive (seroconverted during follow-up).</p><p><a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0101221#pone.0101221-Johnson1" target="_blank">[8]</a> Current syphilis status is defined as follows: RPR negative/RPR positive and TPPA negative = never infected (includes biological false positives); RPR negative and TPPA positive = previous infection; RPR positive and TPPA positive = active infection.</p><p><a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0101221#pone.0101221-Kapiga1" target="_blank">[9]</a> All women HIV-negative at enrolment as per eligibility criteria.</p