An HIV epidemic is ready to emerge in the Philippines

<p>Abstract</p> <p>Background</p> <p>The state of the HIV epidemic in the Philippines has been described as "low and slow", which is in stark contrast to many other countries in the region. A review of the conditions for HIV spread in the Philippines is necessary.</p> <p>Methods</p> <p>We evaluated the current epidemiology, trends in behaviour and public health response in the Philippines to identify factors that could account for the current HIV epidemic, as well as to review conditions that may be of concern for facilitating an emerging epidemic.</p> <p>Results</p> <p>The past control of HIV in the Philippines cannot be attributed to any single factor, nor is it necessarily a result of the actions of the Filipino government or other stakeholders. Likely reasons for the epidemic's slow development include: the country's geography is complicated; injecting drug use is relatively uncommon; a culture of sexual conservatism exists; sex workers tend to have few clients; anal sex is relatively uncommon; and circumcision rates are relatively high.</p> <p>In contrast, there are numerous factors suggesting that HIV is increasing and ready to emerge at high rates, including: the lowest documented rates of condom use in Asia; increasing casual sexual activity; returning overseas Filipino workers from high-prevalence settings; widespread misconceptions about HIV/AIDS; and high needle-sharing rates among injecting drug users.</p> <p>There was a three-fold increase in the rate of HIV diagnoses in the Philippines between 2003 and 2008, and this has continued over the past year. HIV diagnoses rates have noticeably increased among men, particularly among bisexual and homosexual men (114% and 214% respective increases over 2003-2008). The average age of diagnosis has also significantly decreased, from approximately 36 to 29 years.</p> <p>Conclusions</p> <p>Young adults, men who have sex with men, commercial sex workers, injecting drug users, overseas Filipino workers, and the sexual partners of people in these groups are particularly vulnerable to HIV infection. There is no guarantee that a large HIV epidemic will be avoided in the near future. Indeed, an expanding HIV epidemic is likely to be only a matter of time as the components for such an epidemic are already present in the Philippines.</p

Embracing different approaches to estimating HIV incidence, prevalence and mortality

Background: Joint United Nations Programme on HIV/AIDS (UNAIDS) and Murray et al. have both produced sets of estimates for worldwide HIV incidence, prevalence and mortality. Understanding differences in these estimates can strengthen the interpretation of each

Impact of inhaled corticosteroids on growth in children with asthma: systematic review and meta-analysis

Background: Long-term inhaled corticosteroids (ICS) may reduce growth velocity and final height of children with asthma. We aimed to evaluate the association between ICS use of >12 months and growth. Methods: We initially searched MEDLINE and EMBASE in July 2013, followed by a PubMed search updated to December 2014. We selected RCTs and controlled observational studies of ICS use in patients with asthma. We conducted random effects meta-analysis of mean differences in growth velocity (cm/year) or final height (cm) between groups. Heterogeneity was assessed using the I2 statistic. Results: We found 23 relevant studies (twenty RCTs and three observational studies) after screening 1882 hits. Meta-analysis of 16 RCTs showed that ICS use significantly reduced growth velocity at one year follow-up (mean difference -0.48 cm/year (95% CI -0.66 to -0.29)). There was evidence of a dose-response effect in three RCTs. Final adult height showed a mean reduction of -1.20 cm (95% CI -1.90 cm to -0.50 cm) with budesonide versus placebo in a high quality RCT. Meta-analysis of two lower quality observational studies revealed uncertainty in the association between ICS use and final adult height, pooled mean difference -0.85 cm (95% CI -3.35 to 1.65). Conclusion: Use of ICS for >12 months in children with asthma has a limited impact on annual growth velocity. In ICS users, there is a slight reduction of about a centimeter in final adult height, which when interpreted in the context of average adult height in England (175 cm for men and 161 cm for women), represents a 0.7% reduction compared to non-ICS users

Action cameras: Bringing aquatic and fisheries research into view

Digital action cameras (ACs) are increasingly being utilized for aquatic research purposes due to their cost effectiveness, versatility, high-resolution imagery, and durability. Here we review the advantages of AC technology in research, with particular emphases on (a) research videography (both in the field and the laboratory), (b) animal-borne studies, and (c) outreach and education purposes. We also review some of the limitations of this technology as represented by environmental factors (e.g., depth, turbidity) and deployment considerations (e.g., lens choices, imaging settings, battery life). As AC technologies evolve in response to growing public interest in their application versatility, researchers are indirectly reaping the rewards, with technological advances that are innovative, cost-effective, and can withstand frequent use in dynamic and rugged field conditions. With such a diversity of options available, future usefulness of ACs in research will only be limited by the creativity of the scientists using them

Population uptake of antiretroviral treatment through primary care in rural South Africa

<p>Abstract</p> <p>Background</p> <p>KwaZulu-Natal is the South African province worst affected by HIV and the focus of early modeling studies investigating strategies of antiretroviral treatment (ART) delivery. The reality of antiretroviral roll-out through primary care has differed from that anticipated and real world data are needed to inform the planning of further scaling up of services. We investigated the factors associated with uptake of antiretroviral treatment through a primary healthcare system in rural South Africa.</p> <p>Methods</p> <p>Detailed demographic, HIV surveillance and geographic information system (GIS) data were used to estimate the proportion of HIV positive adults accessing antiretroviral treatment within northern KwaZulu-Natal, South Africa in the period from initiation of antiretroviral roll-out until the end of 2008. Demographic, spatial and socioeconomic factors influencing the likelihood of individuals accessing antiretroviral treatment were explored using multivariable analysis.</p> <p>Results</p> <p>Mean uptake of ART among HIV positive resident adults was 21.0% (95%CI 20.1-21.9). Uptake among HIV positive men (19.2%) was slightly lower than women (21.8%, P = 0.011). An individual's likelihood of accessing ART was not associated with level of education, household assets or urban/rural locale. ART uptake was strongly negatively associated with distance from the nearest primary healthcare facility (aOR = 0.728 per square-root transformed km, 95%CI 0.658-0.963, <it>P </it>= 0.002).</p> <p>Conclusions</p> <p>Despite concerns about the equitable nature of antiretroviral treatment rollout, we find very few differences in ART uptake across a range of socio-demographic variables in a rural South African population. However, even when socio-demographic factors were taken into account, individuals living further away from primary healthcare clinics were still significantly less likely to be accessing ART</p

PB.23: Effect of detector type on cancer detection in digital mammography

This work measured the effect that image quality associated with different detectors has on cancer detection in mammography using a novel method for changing the appearance of images.\ud \ud A set of 270 mammography cases (one view, both breasts) was acquired using five Hologic Selenias and two Hologic Dimensions X-ray units: 80 normal, 80 with simulated inserted subtle calcification clusters, 80 with subtle real noncalcification malignant lesions and 30 with benign lesions (biopsy proven). These 270 cases (Arm 1) were converted to appear as if they had been acquired on two other imaging systems: needle image plate computed radiography (CR) (Arm 2) and powder phosphor CR (Arm 3). Three experienced mammography readers marked the location of suspected cancers in the images and classified whether each lesion would require further investigation and the confidence in that decision. Performance was calculated as the area under curve (AUC) of the alternative free-response receiver operating characteristic curv

Classifying the posture and activity of ewes and lambs using accelerometers and machine learning on a commercial flock

This is the final version. Available on open access from Elsevier via the DOI in this recordData Availability: A censored version of the data is available upon request.Early decision making in commercial livestock systems is key to maximising animal welfare and production. Detailed information on an animal’s phenotype is needed to facilitate this, but can be difficult to obtain in a commercial setting. Research into the use of bio-logging on sheep to continuously monitor individual behaviour and indirectly inform health and production has seen rapid growth in recent years. Much of this research, however, has been conducted on small numbers of animals in an experimental setting and over limited time periods. Previous studies have also focused on ewes and there has been little research on the potential of bio-logging for collecting behavioural data on lambs, despite clear potential relevance for production. The present study aimed to test the feasibility of deploying accelerometers on a commercial sheep flock at a key point in the annual production cycle (lambing), to validate the viability of automated monitoring of sheep behaviour in a commercial setting. Also, we aimed to develop robust machine learning algorithms that can classify both the posture and physical activity of adult sheep and lambs. We used a Random Forest machine learning algorithm to predict: two mutually exclusive postures in ewes and lambs (standing and lying), achieving average accuracies of 83.7% and 85.9% respectively; four mutually exclusive activities in ewes (grazing, ruminating, inactive and walking), achieving an average accuracy of 70.9%; and three mutually exclusive activities in lambs (inactive, suckling, walking), achieving an average accuracy of 80.8%. These performance accuracies on large numbers of individuals afford the opportunity to provide a detailed understanding of the daily activity budget of ewes and lambs. Monitoring changes in daily patterns across the annual production cycle while capturing changes in environmental conditions such as weather, day length, terrain and management could reveal key indicator metrics that may inform production and health and provide early warning systems for key issues in commercial flocks.Biotechnology & Biological Sciences Research Council (BBSRC