Use of rapid diagnostic tests in malaria school surveys in Kenya: does their under-performance matter for planning malaria control?

Malaria rapid diagnostic tests (RDTs) are known to yield false-positive results, and their use in epidemiologic surveys will overestimate infection prevalence and potentially hinder efficient targeting of interventions. To examine the consequences of using RDTs in school surveys, we compared three RDT brands used during a nationwide school survey in Kenya with expert microscopy and investigated the cost implications of using alternative diagnostic approaches in identifying localities with differing levels of infection. Overall, RDT sensitivity was 96.1% and specificity was 70.8%. In terms of classifying districts and schools according to prevalence categories, RDTs were most reliable for the 40% categories and least reliable in the 1-4.9% category. In low-prevalence settings, microscopy was the most expensive approach, and RDT results corrected by either microscopy or polymerase chain reaction were the cheapest. Use of polymerase chain reaction-corrected RDT results is recommended in school malaria surveys, especially in settings with low-to-moderate malaria transmission

Factors associated with the performance and cost-effectiveness of using lymphatic filariasis transmission assessment surveys for monitoring soil-transmitted helminths: a case study in Kenya.

Transmission assessment surveys (TAS) for lymphatic filariasis have been proposed as a platform to assess the impact of mass drug administration (MDA) on soil-transmitted helminths (STHs). This study used computer simulation and field data from pre- and post-MDA settings across Kenya to evaluate the performance and cost-effectiveness of the TAS design for STH assessment compared with alternative survey designs. Variations in the TAS design and different sample sizes and diagnostic methods were also evaluated. The district-level TAS design correctly classified more districts compared with standard STH designs in pre-MDA settings. Aggregating districts into larger evaluation units in a TAS design decreased performance, whereas age group sampled and sample size had minimal impact. The low diagnostic sensitivity of Kato-Katz and mini-FLOTAC methods was found to increase misclassification. We recommend using a district-level TAS among children 8-10 years of age to assess STH but suggest that key consideration is given to evaluation unit size

Relativistic theory of tidal Love numbers

In Newtonian gravitational theory, a tidal Love number relates the mass multipole moment created by tidal forces on a spherical body to the applied tidal field. The Love number is dimensionless, and it encodes information about the body's internal structure. We present a relativistic theory of Love numbers, which applies to compact bodies with strong internal gravities; the theory extends and completes a recent work by Flanagan and Hinderer, which revealed that the tidal Love number of a neutron star can be measured by Earth-based gravitational-wave detectors. We consider a spherical body deformed by an external tidal field, and provide precise and meaningful definitions for electric-type and magnetic-type Love numbers; and these are computed for polytropic equations of state. The theory applies to black holes as well, and we find that the relativistic Love numbers of a nonrotating black hole are all zero.Comment: 25 pages, 8 figures, many tables; final version to be published in Physical Review

Geographical inequalities in use of improved drinking water supply and sanitation across Sub-Saharan Africa: mapping and spatial analysis of cross-sectional survey data.

BACKGROUND: Understanding geographic inequalities in coverage of drinking-water supply and sanitation (WSS) will help track progress towards universal coverage of water and sanitation by identifying marginalized populations, thus helping to control a large number of infectious diseases. This paper uses household survey data to develop comprehensive maps of WSS coverage at high spatial resolution for sub-Saharan Africa (SSA). Analysis is extended to investigate geographic heterogeneity and relative geographic inequality within countries. METHODS AND FINDINGS: Cluster-level data on household reported use of improved drinking-water supply, sanitation, and open defecation were abstracted from 138 national surveys undertaken from 1991-2012 in 41 countries. Spatially explicit logistic regression models were developed and fitted within a Bayesian framework, and used to predict coverage at the second administrative level (admin2, e.g., district) across SSA for 2012. Results reveal substantial geographical inequalities in predicted use of water and sanitation that exceed urban-rural disparities. The average range in coverage seen between admin2 within countries was 55% for improved drinking water, 54% for use of improved sanitation, and 59% for dependence upon open defecation. There was also some evidence that countries with higher levels of inequality relative to coverage in use of an improved drinking-water source also experienced higher levels of inequality in use of improved sanitation (rural populations r = 0.47, p = 0.002; urban populations r = 0.39, p = 0.01). Results are limited by the quantity of WSS data available, which varies considerably by country, and by the reliability and utility of available indicators. CONCLUSIONS: This study identifies important geographic inequalities in use of WSS previously hidden within national statistics, confirming the necessity for targeted policies and metrics that reach the most marginalized populations. The presented maps and analysis approach can provide a mechanism for monitoring future reductions in inequality within countries, reflecting priorities of the post-2015 development agenda. Please see later in the article for the Editors' Summary

Low-Temperature Spin Diffusion in a Spin-Polarized Fermi Gas

We present a finite temperature calculation of the transverse spin-diffusion coefficient, $D_\bot$, in a dilute degenerate Fermi gas in the presence of a small external magnetic field, $H$. While the longitudinal diffusion coefficient displays the conventional low-temperature Fermi-liquid behavior, $D_\parallel \propto T^{-2}$, the corresponding results for $D_\bot$ show three separate regimes: (a) $D_\bot \sim H^{-2}$ for $T \ll H$; (b) $D_\bot \sim T^{-2}$, $D_\bot /D_\parallel \neq 1$ for $T \gg H$ and large spin-rotation parameter $\xi \gg 1$, and (c) $D_\bot = D_\parallel \propto T^{-2}$ for $T \gg H$ and $\xi \ll 1$. Our results are qualitatively consistent with the available experimental data in weakly spin-polarized $^3{\rm He}$ and $^3{\rm He} - ^4{\rm He}$ mixtures.Comment: 13 pages, REVTEX, 3 figures available upon request, RU-94-4

Plasmodium–Helminth Coinfection and Its Sources of Heterogeneity Across East Africa

Background. Plasmodium–helminth coinfection can have a number of consequences for infected hosts, yet our knowledge of the epidemiology of coinfection across multiple settings is limited. This study investigates the distribution and heterogeneity of coinfection with Plasmodium falciparum and 3 major helminth species across East Africa

Anisotropic Susceptibility of La_2-xSr_xCoO_4 related to the Spin States of Cobalt

We present a study of the magnetic susceptibility of La_2-xSr_xCoO_4 single crystals in a doping range 0.3<=x<=0.8. Our data shows a pronounced magnetic anisotropy for all compounds. This anisotropy is in agreement with a low-spin ground state (S=0) of Co^3+ for x>=0.4 and a high-spin ground state (S=3/2) of Co^2+. We compare our data with a crystal-field model calculation assuming local moments and find a good description of the magnetic behavior for x>=0.5. This includes the pronounced kinks observed in the inverse magnetic susceptibility, which result from the anisotropy and low-energy excited states of Co^2+ and are not related to magnetic ordering or temperature-dependent spin-state transitions