The rate of CD4 decline as a determinant of progression to AIDS independent of the most recent CD4 count

The data of two cohort studies of HIV-infected individuals were used to examine whether the rate of CD4 decline is a determinant of HIV progression, independent of the most recent CD4 count. Time from seroconversion to clinical AIDS was the main outcome measure. Rates of CD4 decline were estimated using the ordinary least squares regression method. AIDS incidences were compared in individuals who had previously experienced either a steeper or a less steep rate of CD4 decline. Cox proportional hazards model including a time-dependent covariate for the rate of CD4 decline was performed. The rate of prior CD4 decline was significantly associated with the risk of developing AIDS independently from the most recent CD4 count, with a 2 % increase in hazard of AIDS (P < 0.01) for a difference of 10 cells/mm(3) in the estimated yearly drop in CD4 count. This finding gives scientific credit to the belief that individuals with a prior steeper CD4 decline consistently have a higher subsequent risk of developing AIDS than those with a less steep prior decline

Probable autochthonous introduced malaria cases in Italy in 2009-2011 and the risk of local vector-borne transmission.

We describe two cases of probable autochthonous introduced Plasmodium vivax malaria that occurred in 2009 and 2011 in two sites of South-Central Italy. Although the sources of the infections were not detected, local transmission could not be disproved and therefore the cases were classified as autochthonous. Sporadic P. vivax cases transmitted by indigenous vectors may be considered possible in some areas of the country where vector abundance and environmental conditions are favourable to malaria transmission

Reply: Probable imported rather than autochthonous Plasmodium vivax cases in Italy

To the editor: Dr Nicastri argues that cryptic sporadic cases may not be considered as autochthonous unless other cases have been identified in a specific geographical area. This is a rigid and not scientifically corroborated assumption that, in our opinion, cannot be generalised. In fact, there is no reason to assume that secondary cases should necessarily occur [1,2], since the generation of a chain of transmission depends strictly on the basic reproductive number R0, which is influenced by a series of factors [3] ranging from prevalence of infection among mosquitoes (likely to be very low when autochthonous introduced cases occur, as demonstrated by the lack of detection of plasmodia among mosquitoes in recent outbreaks in Greece) and probability of exposure of humans to mosquito bites. Dr Nicastri's latter two points pertain to only one of the two cases and have been critically discussed in our article. However, it should be mentioned that the patient who visited Santo Domingo did not report febrile episodes after their return and that the likelihood of very late relapse is very low; thus, we think this patient should be considered as a cryptic case. In conclusion, we do not feel Dr Nicastri's criticism is sufficiently supported by the arguments raised. Reference

Fungsi dan Mitos Upacara Adat Nyangku di Desa Panjalu Kecamatan Panjalu Kabupaten Ciamis

Konservasi Budaya Lokal Mikanyaah Munding sebagai Landasan Village Breeding Center Kerbau adalah penelitian yang dilaksanakan oleh kami terkait dengan bentuk penangkaran kerbau berbasis budaya tradisional, yang dilaksanakan di Desa Cikeusal-Tasikmalaya. Di dalam budaya “Mikanyaah Munding” juga ternyata terdapat pelestarian berbagai seni tradisi Sunda, diantaranya adalah Seni Terbang Gebes. Dalam tulisan ini digunakan metode penelitian kualitatif dengan kajian etnografi, sedangkan teknik pengumpulan data digunakan teknik wawancara. Dari pembahasan hasil penelitian diperoleh antara lain; sistem penangkaran kerbau berbasis budaya lokal Mikanyaah Munding, yang di dalamnya terdapat; kebiasaan masyarakat setempat di dalam memperlakukan ternak kerbau, kosa kata khusus terkait dengan peternakan kerbau, hajat lembur yang ada hubungannya dengan peternakan kerbau, dan berbagai bentuk kesenian tradisional Sunda yang dilaksanakan dalam rangka budaya Mikanyaah Munding. Dalam artikel ini akan dibahas salah satu kesenian terkait, yaitu Seni Terbang Gebes

Analisis Program Pembangunan Desa Wisata Wonolopo Di Kota Semarang

DEVELOPMENT PROGRAM ANALYSIS OF WONOLOPO TOURIST VILLAGE IN SEMARANG CITYREZZA ABDY PRADANA(GOVERNMENT SCIENCE, FISIP UNDIP, SEMARANG)ABSTRACTIONThis research was motivated by the Tourism Village Wonolopo in Semarang who can not develop like other tourist village in the city of Semarang. So the tourist village in the Village program Wonolopo threatened not to proceed. Wonolopo Tourism Village Development Program should be maintained to create a prosperous society and independent evenly according to the Indonesian government program that people want mensejahterkan evenly from the Central State to the people in the village and prepare people to face the free market in ASEAN. To maintain Wonolopo Tourism Village, Semarang city government should be able to develop tourism village Wonolopo. Semarang city government should establish cooperation with Tourism Awareness Group Wonolopo and Tourism Village community in managing the program Wonolopo tourist village in Sub Wonolopo.This type of research is descriptive analysis with qualitative approach. Sources of data derived from primary data through interviews with key informants or person with semistructure interview techniques. Secondary data derived from the data of documents, archives and other sources related to the research. Data collection techniques in this study using interviews, observation and documentation. While the analytical techniques used in this research by analyzing qualitative data analysis in the form of a description or notes, depictions and conclusion on the symptoms studied.The results of this study found that the program is not developed tourist villages in the Village Wonolopo there are problems that are diinternal Wonolopo Travel Awareness Group itself. The problems started with the improper management of funds acquired through PNPM assistance of the Central Government by one group of people in the Travel Awareness Group. Additionally, adannya supervision less than Department of Culture and Tourism of Semarang on Wonolopo Travel Awareness Group. Moreover, the lack of attention from the local government of Semarang look at the lack of supporting facilities for running programs Wonolopo Tourism Village. Road infrastructure is still a lot of damage and there are no signposts direction. So that the revamping of the base is necessary for Rural Development Program in Semarang Tourism Wonolopo could run better than befor

Does the Japanese encephalitis virus (JEV) represent a threat for human health in Europe? Detection of JEV RNA sequences in birds collected in Italy.

To the editor: Autochthonous cases of Japanese encephalitis (JE) have never been reported in Europe, where there is virtually no circulation of the virus [1]. However, in the issue of Eurosurveillance published on 12 July 2012, Ravanini et al. [2] reported the detection of an RNA sequence of the Japanese encephalitis virus (JEV) NS5 gene in one pool of Culex pipiens mosquitoes collected in north-eastern Italy during the summer of 2010. Unfortunately, the sequence was relatively short (167 bp), and attempts to amplify longer sequences using primers targeted to E, NS5 and NS3 genes and to isolate the virus on cell cultures failed

Non-B HIV type 1 subtypes among men who have sex with men in Rome, Italy

An increase in the circulation of HIV-1 non-B subtypes has been observed in recent years in Western European countries. Due to the lack of data on the circulation of HIV-1 non-B subtypes among European HIV-1-infected men who have sex with men (MSM), a biomolecular study was conducted in Rome, Italy. HIV-1 partial pol gene sequences from 111 MSM individuals (76 drug naive and 35 drug experienced) were collected during the years 2004-2006. All these sequences were analyzed using the REGA HIV-1 Subtyping Tool, and aligned using CLUSTAL X followed by manual editing using the Bioedit software. A BLAST search for non-B subtype sequences was also performed. Twenty-six (23.4%) MSM were not Italians. Eight individuals (7.2%) were diagnosed as HIV infected before 1991, 20 (18.0%) between 1991 and 1999, and 83 (74.8%) from 2000 to 2006. Fifteen (15/111, 13.5%) individuals were infected with the non-B subtype. The percentage of infection with HIV-1 non-B subtypes was 8.2% (7/85) among Italian MSM and 30.8% (8/26) among the non-Italians (OR = 4.95 95% IC: 1.40-17.87). Individuals infected with the non-B subtype were significantly younger than those infected with the HIV-1 B subtype (28 years vs. 34 years, p = 0.003). The CRFs were more prevalent (8.1%) than pure subtypes (5.4%), which were distributed as follows: subtype C (2.6%), subtype A1 (1.7%), and subtype F1 (0.9%). Major mutations conferring resistance to antiretroviral drugs (ARV) were not found among HIV-1 non-B subtype drug-naive patients but were found in two ARV-experienced individuals. The data show that viral diversity is likely increasing in a population group that had been previously characterized by the circulation of HIV-1 subtype B. © Copyright 2009, Mary Ann Liebert, Inc

Meningococcal C conjugate vaccine effectiveness before and during an outbreak of invasive meningococcal disease due to Neisseria meningitidis serogroup C/cc11, Tuscany, Italy

Introduction: In Tuscany, Italy, where a universal immunization program with monovalent meningococcal C conjugate vaccine (MCC) was introduced in 2005, an outbreak of invasive meningococcal disease (IMD) due to the hypervirulent strain of Neisseria meningitidis C/cc11 occurred in 2015–2016, leading to an immunization reactive campaign using either the tetravalent (ACWY) meningococcal conjugate or the MCC vaccine. During the outbreak, IMD serogroup C (MenC) cases were also reported among vaccinated individuals. This study aimed to characterize meningococcal C conjugate vaccines (MenC-vaccines) failures and to estimate their effectiveness since the introduction (2005–2016) and during the outbreak (2015–2016). Methods: MenC cases and related vaccine-failures were drawn from the National Surveillance System of Invasive Bacterial Disease (IBD) for the period 2006–2016. A retrospective cohort-study, including the Tuscany' population of the birth-cohorts 1994–2014, was carried out. Based on annual reports of vaccination, person-years of MenC-vaccines exposed and unexposed individuals were calculated by calendar-year, birth-cohort, and local health unit. Adjusted (by birth-cohort, local health unit, and calendar-year) risk-ratios (ARR) of MenC invasive disease for vaccinated vs unvaccinated were estimated by the Poisson model. Vaccine-effectiveness (VE) was estimated as: VE = 1-ARR. Results: In the period 2006–2016, 85 MenC-invasive disease cases were reported; 61 (71.8%) from 2015 to 2016. Twelve vaccine failures occurred, all of them during the outbreak. The time-interval from immunization to IMD onset was 20 days in one case, from 9 months to 3 years in six cases, and ≥7 years in five cases. VE was, 100% (95%CI not estimable, p = 0.03) before the outbreak (2006–2014) and 77% (95%CI 36–92, p &lt; 0.01) during the outbreak; VE was 80% (95%CI 54–92, p &lt; 0.01) during the overall period. Conclusions: In Tuscany, MenC-vaccine failures occurred exclusively during the 2015–2016 outbreak. Most of them occurred several years after vaccination. VE during the outbreak-period was rather high supporting an effective protection induced by MenC-vaccines

Molecular and phylogenetic analysis of HIV-1 variants circulating among injecting drug users in Mashhad-Iran

Genetic and phylogenetic information on the HIV-1 epidemic in Middle-East Countries, and in particular in Iran, are extremely limited. By March 2004, the Iranian Ministry of Health officially reported a cumulative number of 6'532 HIV positive individuals and 214 AIDS cases in the Iranian HIV-1 epidemic. The intra-venous drug users (IDUs) represent the group at highest risk for HIV-1 infection in Iran, accounting for almost 63% of all HIV-infected population. In this regards, a molecular phylogenetic study has been performed on a sentinel cohort of HIV-1 seropositive IDUs enrolled at the end of 2005 at the University of Mashhad, the largest city North East of Tehran. The study has been performed on both gag and env subgenomic regions amplified by Polymerase Chain Reaction (PCR) from peripheral blood mononuclear cells (PBMCs) and characterized by direct DNA sequence analysis. The results reported here show that the HIV-1 subtype A is circulating in this IDUs sentinel cohort. Moreover, the single phylogenetic cluster as well as the intra-group low nucleotide divergence is indicative of a recent outbreak. Unexpectedly, the Iranian samples appear to be phylogenetically derived from African Sub-Saharan subtype A viruses, raising stirring speculations on HIV-1 introduction into the IDUs epidemic in Mashhad. This sentinel study could represent the starting point for a wider molecular survey of the HIV-1 epidemics in Iran to evaluate in detail the distribution of genetic subtypes and possible natural drug-resistant variants, which are extremely helpful information to design diagnostic and therapeutic strategies