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Provider initiated HIV testing and counceling in Uganda: assessment of feasibility, approaches and outcomes of implementation
No full textMolecular investigation on the dynamics of Plasmodium vivax infection in Peru and Vietnam
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Alternative foods for the multicoloured Asian lady beetle Harmonia axyridis (Coleoptera: Coccinellidae)
No full textThe multicoloured Asian lady beetle Harmonia axyridis (Coleoptera: Coccinellidae) may potentially exploit a range of "alternative" food sources. The nutritional value of three common non-prey food groups, i.e. fruit, fungi and pollen, is examined in this study. Development, reproduction and survival of the species were assessed in the laboratory on diets of apple, pear and raspberries and the fungi Oidium lycopersicum, Botrytis cinerea, Sclerotinia sclerotiorum and Rhizoctonia solani. When fed exclusively on these foods this ladybird failed to complete its development or reproduce. However, larval and adult survival was prolonged by 4 to 8 days and 55 to 67 days, respectively, when fruit was offered compared with only water. During a field study H. axyridis adults were collected monthly from March to October at two locations near Ghent, Belgium. Gut analysis demonstrated that, despite the continued presence of aphids, over 90% of all the adults collected contained pollen throughout the year. The pollen belonged to 53 different pollen types. Monthly average numbers of pollen grains in the gut varied from 5 to 233 grains. In contrast, there were about 35,000 grains in the guts of H. axyridis females that successfully developed and reproduced in the laboratory on diet that consisted of only pollen. This suggests that in the field in the majority of cases pollinivory mainly only provided complementary nutrients for this coccinellid. The use of alternative non-prey foods like pollen and fruit may play a role in sustaining populations of this coccinellid at times when the optimal prey is absent
Assessment of mucosal immunity to HIV-1
No full textA key gap in the development and evaluation of HIV-1 vaccines is insufficient knowledge with regard to sampling techniques and assessment of mucosal immune responses required for early prevention and inhibition of viral dissemination. In an attempt to start bridging this gap, the EUROPRISE network of scientists working on HIV-1 vaccine and microbicide research organized a workshop with the aim to review the types of mucosal responses/biomarkers currently measured in mucosal immunology and to define how the mucosal responses/biomarkers are measured and/or the assays and sampling methods used. The Workshop addressed two critical questions: first whether, with current knowledge, it would be possible to define a consensus set of mucosal sampling methods to facilitate cross-species comparisons and ensure standardized implementation in clinical trials; second to determine the remaining challenges (technical and logistical) and their possible solutions for assessing mucosal responses to HIV-1 vaccines
Crowding out: are relations between international health aid and government health funding too complex to be captured in averages only?
No full textDevelopment and evaluation of different PCR-based typing methods for discrimination of Leishmania donovani isolates from Nepal
No full textINTRODUCTION: Leishmania donovani, the causative agent of visceral leishmaniasis in the Indian subcontinent, has been reported to be genetically homogeneous. In order to support ongoing initiatives to eliminate the disease, highly discriminative tools are required for documenting the parasite population and dynamics. METHODS: Thirty-four clinical isolates of L. donovani from Nepal were analysed on the basis of size and restriction endonuclease polymorphisms of PCR amplicons from kinetoplast minicircle DNA, 5 nuclear microsatellites, and nuclear loci encoding glycoprotein 63, cysteine proteinase B, and hydrophilic acylated surface protein B. We present and validate a procedure allowing standardized analysis of kDNA fingerprint patterns. RESULTS: Our results show that parasites are best discriminated on the basis of kinetoplast minicircle DNA (14 genotypes) and 1 microsatellite defining 7 genotypes, while the remaining markers discriminated 2 groups or were monomorphic. Combination of all nuclear markers revealed 8 genotypes, while extension with kDNA data yielded 18 genotypes. CONCLUSION: We present tools that allow discrimination of closely related L. donovani strains circulating in the Terai region of Nepal. These can be used to study the micro-epidemiology of parasite populations, determine the geographical origin of infections, distinguish relapses from re-infection, and monitor the spread of particular variants
Public hospital management in times of crisis: lessons learned from Cienfuegos, Cuba (1996-2008)
No full textCuba's public health system is well known for its integrated first line services based on family medicine. Less publicized is the country's experience in public hospital management. After a harsh economic crisis in the first half of the 1990s had brought the Cienfuegos hospital near to collapse, from 1996 onwards the hospital management team took advantage of the incipient economic recovery to launch an ambitious recovery process. This article reconstructs this endeavor, based on annual hospital reports, scientific publications by the hospital staff, and interviews with key decision-makers. First the endless waiting list for elective surgery was tackled through a more efficient use of the surgery department, and an increase of ambulatory surgery. Next, overall hospital efficiency was improved in the aim to drastically reduce the average length of stay, reaching a decrease from an average stay of 12 days to a little more than 6 days in 1999. Also the emergency department was reorganized, setting up a triage system based on a color code, linked to specific emergency protocols. Attention for improving the clinical efficiency for AMI and stroke coincided with a drop in their intrahospital lethality. Clinical guidelines for the most important diagnoses were collectively developed, adapting international evidence to the local setting. An individual and collective performance evaluation system was elaborated in a participatory way, and further evolved into a 'total quality management' process. This experience of Cienfuegos hospital provides an interesting example on how a public hospital - embedded in a well developed national public health system - can be effective and efficient, even in circumstances of limited resource