Strengthening the evidence base for nutrition and cancer in low and middle income countries

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Quest Volume 4 Number 2

Contents: IYPE Out of Africa - South African National Committee for the International Year of Planet Earth - The world celebrates and the Earth sciences get down to business Features: African landscapes from remote sensing - Clear views in 3D: Climate: past changes & future uncertainties - Reading the rock record helps: Megacities - Coping with urbanization: Viewpoint Mineral resources - wealth at a frightening price People and planet pay up: Earth: gigantic recycling machine: How the planet sustains life Africa Array - Seismic stations and geoscientists Ocean crossroad at the tip of Africa: Where the waters move and meet DNA clocks for dating landforms - Animals and landscapes evolve together: Groundwater: managing dwindling reserves - Finding and caring for precious water Geohazards: the risks beneath our feet - Staying safe: Nurturing soil - It's payback time: Healthy foods from Mother Earth - Pioneering dietary guidelines: Art and map-making - Seeing the world in different ways: Africa Alive Corridors - Our continent - our heritage: Fact files - Urban facts -What is soil? - Malnutrition in South Africa: Your questions answered - Why does oceanography matter? What makes oceans salty?: The S&T tourist Water in the iSimangaliso - Wetland Park: Careers Work in geology:The Department of Science and Innovation: Academy of Science of South Afric

Quest Volume 4 Number 3

Contents: Discovering the deep African past at Wonderwerk Cave - Archaeological dating points to the birth of human technology and culture right here in southern Africa: Storing and restoring plant-life from seeds - How to store genetic material once considered unstorable: Nutrition - you are what you eat: Diet and lifestyle for good health - From molecules to society: Micronutrients for healthy living -Eating and exercise: How blood clots form and disintegrate: Treating children with HIV/AIDS: Careers: Why maths counts Opening the door to a future in science, technology, and engineering - Getting back to basics: Girls doing science (maths is the key) Conditioning - Notes from TIMSS-R Girls and boys on a par: Reading, maths, and gender equality: Maths and environmental science - Out of the classroom, into the field - The why (and how) of biomaths: Viewpoint - How bad is 'child labour'? - What's really best for the children?: Watching whale-tusks grow - Measuring the amazing tusk of the Arctic narwhal - Diamond and mammography screening: Improved measurement of X-ray doses: The drinking habits of sunbirds - A taste for sugary nectars: Drug-resistant TB in South Africa The struggle continues: Fact files - More on the Arctic narwhal Bird nectars in flowers - TB facts and stats - Science news - Spider webs for hungry times; Brain food -Energy options: How smoke affects cloud cover and climate; Fact and fiction - The case for early antiretroviral therapy for HIV/AIDS: Your questions answered Life on planet Earth? - Reducing greenhouse gases: Boiling water: The S&T tourist Not just elephants at Addo: QUEST the first four years; Wind power; People on the move; On teaching evolution:The Department of Science and Innovation: Academy of Science of South Afric

Association of HIV and ART with cardiometabolic traits in sub-Saharan Africa: a systematic review and meta-analysis.

BACKGROUND: Sub-Saharan Africa (SSA) has the highest burden of HIV in the world and a rising prevalence of cardiometabolic disease; however, the interrelationship between HIV, antiretroviral therapy (ART) and cardiometabolic traits is not well described in SSA populations. METHODS: We conducted a systematic review and meta-analysis through MEDLINE and EMBASE (up to January 2012), as well as direct author contact. Eligible studies provided summary or individual-level data on one or more of the following traits in HIV+ and HIV-, or ART+ and ART- subgroups in SSA: body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TGs) and fasting blood glucose (FBG) or glycated hemoglobin (HbA1c). Information was synthesized under a random-effects model and the primary outcomes were the standardized mean differences (SMD) of the specified traits between subgroups of participants. RESULTS: Data were obtained from 49 published and 3 unpublished studies which reported on 29 755 individuals. HIV infection was associated with higher TGs [SMD, 0.26; 95% confidence interval (CI), 0.08 to 0.44] and lower HDL (SMD, -0.59; 95% CI, -0.86 to -0.31), BMI (SMD, -0.32; 95% CI, -0.45 to -0.18), SBP (SMD, -0.40; 95% CI, -0.55 to -0.25) and DBP (SMD, -0.34; 95% CI, -0.51 to -0.17). Among HIV+ individuals, ART use was associated with higher LDL (SMD, 0.43; 95% CI, 0.14 to 0.72) and HDL (SMD, 0.39; 95% CI, 0.11 to 0.66), and lower HbA1c (SMD, -0.34; 95% CI, -0.62 to -0.06). Fully adjusted estimates from analyses of individual participant data were consistent with meta-analysis of summary estimates for most traits. CONCLUSIONS: Broadly consistent with results from populations of European descent, these results suggest differences in cardiometabolic traits between HIV-infected and uninfected individuals in SSA, which might be modified by ART use. In a region with the highest burden of HIV, it will be important to clarify these findings to reliably assess the need for monitoring and managing cardiometabolic risk in HIV-infected populations in SSA

HIV treatment is associated with a two-fold higher probability of raised triglycerides: Pooled Analyses in 21 023 individuals in sub-Saharan Africa.

Anti-retroviral therapy (ART) regimes for HIV are associated with raised levels of circulating triglycerides (TG) in western populations. However, there are limited data on the impact of ART on cardiometabolic risk in sub-Saharan African (SSA) populations. Pooled analyses of 14 studies comprising 21 023 individuals, on whom relevant cardiometabolic risk factors (including TG), HIV and ART status were assessed between 2003 and 2014, in SSA. The association between ART and raised TG (>2.3 mmol/L) was analysed using regression models. Among 10 615 individuals, ART was associated with a two-fold higher probability of raised TG (RR 2.05, 95% CI 1.51-2.77, I2=45.2%). The associations between ART and raised blood pressure, glucose, HbA1c, and other lipids were inconsistent across studies. Evidence from this study confirms the association of ART with raised TG in SSA populations. Given the possible causal effect of raised TG on cardiovascular disease (CVD), the evidence highlights the need for prospective studies to clarify the impact of long term ART on CVD outcomes in SSA