Virological profile of pregnant HIV positive women with high levels of CD4 count in low income settings: Can viral load help as eligibility criteria for maternal triple ARV prophylaxis (WHO 2010 option B)?

INTRODUCTION: The objective of the study was to determine HIV-1 RNA load profile during pregnancy and assess the eligibility for the maternal triple antiretroviral prophylaxis. It was an observational cohort of pregnant HIV positive women ignorant of antiretroviral therapy with CD4 cell count of > 350/mm(3) METHODS: Routine CD4 cell count assessment in HIV positive pregnant women completed by non exclusive measurement of the viral load by PCR /ARN in those with CD4 cell count > 350/mm(3). Exclusion criteria: highly active antiretroviral therapy prior to pregnancy. RESULTS: Between January and December 2010, CD4 cell count was systematically performed in all pregnant women diagnosed as HIV-infected (n=266) in a referral center of 25 antenatal clinics. 63% (N=170) had CD4 cell count > 350/mm(3), median: 528 (IQR: 421-625). 145 underwent measurement of viral load by PCR/RNA at a median gestational of 23 weeks of pregnancy (IQR: 19-28). Median viral load 4.4 log(10)/ml, IQR (3.5-4.9).19/145(13%) had an undetectable viral load of = 1.8 log(10)/ml. 89/145(61%) had a viral load of = 4 log(10)/ml and were eligible for maternal triple ARV prophylaxis. CONCLUSION: More than 6 in 10 pregnant HIV positive women with CD4 cell count of > 350/mm(3) may require triple antiretroviral for prophylaxis of MTCT. Regardless of cost, such results are conclusive and may be considered in HIV high burden countries for universal access to triple antiretroviral prophylaxis in order to move towards virtual elimination of HIV MTCT

A CAPTCHA model based on visual psychophysics: Using the brain to distinguish between human users and automated computer bots

Demand for the use of online services such as free emails, social networks, and online polling is increasing at an exponential rate. Due to this, online service providers and retailers feel pressurised to satisfy the multitude of end-user expectations. Meanwhile, automated computer robots (known as “bots”) are targeting online retailers and service providers by acting as human users and providing false information in order to abuse their service provisioning. CAPTCHA is a set of challenge/response protocol, which was introduced to protect online retailers and service providers from misuse and automated computer attacks. Text-based CAPTCHAs are the most popular form, and are used by most online service providers to differentiate between the human users and bots. However, the vast majority of text-based CAPTCHAs have been broken using the Optical Character Recognition (OCR) techniques and thus, reinforces the need for developing a secure and robust CAPTCHA model. Security and usability are the two fundamental issues that pose a trade-off in the design of a CAPTCHA; a hard CAPTCHA model could also be difficult for human users to resolve, which affects its usability, and vice versa. The model developed in this study uses the unsurpassed abilities of the Human Visual System (HVS) to superimpose and integrate complex information presented in individual frames, using the mechanism of trans-saccadic memory. In this context, the model integrates in its design the concept of persistence of vision, which enables humans to see the world in a continuous fashion. Preliminary results from the proposed model based on this technique are encouraging. To ensure the usability of the proposed CAPTCHA model, we set the threshold for the ORO parameter at 40%. This ensured that our CAPTCHA strings would be recognised by human observers at a rate of over 99% (or as close to 100% as is realistic). In turn, when examining the robustness of our VICAP model to computer programme attacks, we can observe that for the traditional case of OCR recognition, based on a single-frame scenario, the Computer Recognition Success Rate (CRSR) was about 0%, while in the case of a multi-frame scenario, the CRSR could increase to up to 50%

Feasibility of Early Infant Diagnosis of HIV in Resource-Limited Settings: The ANRS 12140-PEDIACAM Study in Cameroon

BACKGROUND: Early infant diagnosis (EID) of HIV is a key-point for the implementation of early HAART, associated with lower mortality in HIV-infected infants. We evaluated the EID process of HIV according to national recommendations, in urban areas of Cameroon. METHODS/FINDINGS: The ANRS12140-PEDIACAM study is a multisite cohort in which infants born to HIV-infected mothers were included before the 8(th) day of life and followed. Collection of samples for HIV DNA/RNA-PCR was planned at 6 weeks together with routine vaccination. The HIV test result was expected to be available at 10 weeks. A positive or indeterminate test result was confirmed by a second test on a different sample. Systematic HAART was offered to HIV-infected infants identified. The EID process was considered complete if infants were tested and HIV results provided to mothers/family before 7 months of age. During 2007-2009, 1587 mother-infant pairs were included in three referral hospitals; most infants (n = 1423, 89.7%) were tested for HIV, at a median age of 1.5 months (IQR, 1.4-1.6). Among them, 51 (3.6%) were HIV-infected. Overall, 1331 (83.9%) completed the process by returning for the result before 7 months (median age: 2.5 months (IQR, 2.4-3.0)). Incomplete process, that is test not performed, or result of test not provided or provided late to the family, was independently associated with late HIV diagnosis during pregnancy (adjusted odds ratio (aOR) = 1.8, 95%CI: 1.1 to 2.9, p = 0.01), absence of PMTCT prophylaxis (aOR = 2.4, 95%CI: 1.4 to 4.3, p = 0.002), and emergency caesarean section (aOR = 2.5, 95%CI: 1.5 to 4.3, p = 0.001). CONCLUSIONS: In urban areas of Cameroon, HIV-infected women diagnosed sufficiently early during pregnancy opt to benefit from EID whatever their socio-economic, marital or disclosure status. Reduction of non optimal diagnosis process should focus on women with late HIV diagnosis during pregnancy especially if they did not receive any PMTCT, or if complications occurred at delivery

Nyama yonsi uninkha amakho (You gave all the meat to your mother)

This group had no drums so they brought three tins (beer mugs) along as substitutes. The Nyau dance is performed with the head covered with feathers and with masks. In Nyau dance songs the young men often sing in feigned voices, no doubt on account of the fact that in the actual dance itself, and not for the purpose of this recording, they would be wearing grass and wickerwork masks and would wish to hide their identity. Nyau dance song with (tins used as drums

Waselo waselo (Jumping, jumping)

A husband complained that his wife was unfaithful to him and worried about his son by this woman, as she would have to leave him if she did not mend her ways. The translation given for Waselo as 'jumping' may indeed be literally incorrect, but it is intended to convey promiscuity in going about with several men. Dance song for Chintala women dance

Iyaya lero (Bad today)

It is bad today. How will I sleep today. May I sleep outside? Even when I have a child, may I sleep outside. Pounding song with pestle and mortar

Mmali nkono boy (I want a son)

'I want to have a son. He (the husband) is still at the other house, he has not yet come. What shall I do?" Note that uneven beat of the pestles to match the rhythm, one beat being slightly faster and out of the usual strict tempo. The singer indicates that she wants a baby but that the husband is impotent and unable to giver her one. What is more he is not slepping in her hut but in the other wife's hut. So what can she do to get her child?. Pounding song with pestle and mortar

Apa mkuti

"When you say it is a dog, it is a dog, Mama. My childis a dog, Mama. Bugs! Bugs! Yaya-hole! They bite my child in the hut, Mama. Dori I am tired." Pounding song with pestle and mortar

Mungabvale

"Even though you put on long trousers, small at the ankles and white, I still would not like you. I prefer a man who wears shorts." Chewa women it seems have a definite taste in the clothes their men would wear. Chintali dance for women with brass drum

Alaina n'kuphika nkhwani (Alaina cooked vegetables)

This kind of dance they say was first introduced into the district by Yao people about 15 years ago in 1940 when it was originally sung in the Yao language from the Fort Johnstone district. But the Chewa girls liked the dance and made up their own words for it. They reflect a young girls growing sense of responsibility towards her domestic duties. "Alaina cooked vegetables, what shall I do for vegetables myself? My mother cooked vegetables, what shall I do for vegetables myself?" Mjiri dance song. Girls evening dances with clapping