Showing papers by "Makerere University published in 1999"
TL;DR: Nevirapine lowered the risk of HIV-1 transmission during the first 14-16 weeks of life by nearly 50% in a breastfeeding population, suggesting this simple and inexpensive regimen could decrease mother-to-child HIV- 1 transmission in less-developed countries.
1,766 citations
TL;DR: In the Rakai population, a substantial proportion of HIV-1 acquisition appears to occur independently of treatable STD cofactors, and in pregnant women, the follow-up prevalences of trichomoniasis, bacterial vaginosis, gonorrhoea, and chlamydia infection were significantly lower in the intervention group than in the control group.
784 citations
TL;DR: The data indicate that the immunosuppression of TB is not only immediate and apparently dependent (at least in part) on Immunosuppressive cytokines early during the course of Mycobacterium TB infection but is also long lasting, presumably relating to a primary abnormality in T-cell function.
Abstract: Immunological and clinical profiles were evaluated in 2 groups: human immunodeficiency virus (HIV)-uninfected and HIV-infected patients, with newly diagnosed pulmonary tuberculosis (TB), and tuberculin-skin-test-reactive healthy control subjects. HIV-uninfected patients with TB were also followed up longitudinally during and after chemotherapy. At the time of diagnosis, purified protein derivative (PPD)-stimulated production of interferon (IFN)-gamma by peripheral blood mononuclear cells from TB patients was depressed, compared with that of healthy control subjects, whereas levels of transforming growth factor (TGF)-beta and interleukin (IL)-10 were increased. In longitudinal studies, PPD stimulated production of IL-10 and TGF-beta returned to baseline by 3 months, whereas IFN-gamma production remained depressed for at least 12 months. These data indicate that the immunosuppression of TB is not only immediate and apparently dependent (at least in part) on immunosuppressive cytokines early during the course of Mycobacterium TB infection but is also long lasting, presumably relating to a primary abnormality in T-cell function.
313 citations
TL;DR: The cost effectiveness of HIVNET 012 was robust under a wide range of parameters in the sensitivity analysis, and in lower seroprevalence areas, when multidose regimens are not cost effective, nevirapine therapy could have a major public-health impact at a reasonable cost.
286 citations
TL;DR: The administration of a single dose of nevirapine to women during labor and to their newborns at 72 h was well tolerated and showed potent antiretroviral activity in the women at 1 week after dosing without rebound above baseline 6 weeks after a single doses.
Abstract: The transmission of HIV-1 infection from an infected mother to her infant is estimated to be 15-40% with more than half of transmission probably occurring late in pregnancy or during labor and delivery. Nevirapine a non-nucleoside reverse transcriptase inhibitor is an excellent candidate for a single-dose antiretroviral intervention administered during labor. Findings are presented from a study assessing the safety pharmacokinetics tolerance antiretroviral activity and infant HIV infection status following the administration of 1 dose of nevirapine to HIV-1-infected pregnant women during labor and their newborns during the first week of life. 200 mg of nevirapine were given as a single dose during labor to 21 HIV-1-infected pregnant women in Kampala Uganda. 8 of their infants did not receive the drug while 13 infants received 1 dose of nevirapine at 2 mg/kg at 72 hours of age. Nevirapine was well tolerated by both the women and infants with no serious adverse events related to the drug observed. Median nevirapine concentration in breast milk 1 week after delivery was 103 ng/ml. Plasma nevirapine concentrations remained above 100 ng/ml in all infants from both cohorts tested at age 7 days. Maternal HIV-1 RNA levels decreased by a median of 1.3 logs at 1 week postpartum and returned to baseline by 6 weeks postpartum. Detectable plasma HIV-1 RNA was observed in 1 of 22 (4.5%) infants at birth 3/21 (14%) at 6 weeks and 4/21 (19%) at 6 months of age. This regimen has promise as a prophylaxis against intrapartum and early breast milk HIV transmission in a breast-feeding population.
227 citations
TL;DR: Tolerance was of the phenotypic type, although increased tolerance appeared to emerge after prolonged drug exposure in vivo, suggesting that drug tolerance may be an important determinant of the outcome of therapy for tuberculosis.
Abstract: Although Mycobacterium tuberculosis is eradicated rapidly during therapy in some patients with pulmonary tuberculosis, it can persist for many months in others. This study examined the relationship between mycobacterial drug tolerance (delayed killing in vitro), persistence, and relapse. It was performed with 39 fully drug-susceptible isolates from a prospective trial of standard short-course antituberculous therapy with sputum smear-positive, human immunodeficiency virus-uninfected subjects with pulmonary tuberculosis in Brazil and Uganda. The rate of killing in vitro was determined by monitoring the growth index (GI) in BACTEC 12B medium after addition of drug to established cultures and was measured as the number of days required for 99% sterilization. Drugs differed significantly in bactericidal activity, in the following order from greatest to least, rifampin > isoniazid-ethambutol > ethambutol (P < 0.001). Isolates from subjects who had relapses (n = 2) or in whom persistence was prolonged (n = 1) were significantly more tolerant of isoniazid-ethambutol and rifampin than isolates from other subjects (P < 0.01). More generally, the duration of persistence during therapy was predicted by strain tolerance to isoniazid and rifampin (P = 0.012 and 0.026, respectively). Tolerance to isoniazid-ethambutol and tolerance to rifampin were highly correlated (P < 0.001). Tolerant isolates did not differ from others with respect to the MIC of isoniazid; the rate of killing of a tolerant isolate by isoniazid-ethambutol was not increased at higher drug concentrations. These observations suggest that tolerance may not be due to drug-specific mechanisms. Tolerance was of the phenotypic type, although increased tolerance appeared to emerge after prolonged drug exposure in vivo. This study suggests that drug tolerance may be an important determinant of the outcome of therapy for tuberculosis.
136 citations
TL;DR: In this mature, generalized HIV epidemic setting, most HIV seroconversion occurs without recognized STD symptoms or curable STD detected by screening, and syndromic management or other strategies of STD treatment are unlikely to substantially reduce HIV incidence in this population.
Abstract: The objective was to assess the linkage of sexually transmitted disease (STD) symptoms and treatable STD to HIV incidence. An analysis was done of a randomized trial of STD control for HIV prevention Rakai Uganda. Consenting adults 15-59 years of age were seen at 10-monthly home visits interviewed regarding STD symptoms and asked to provide samples for HIV and STD diagnoses. HIV incidence was determined in 8089 HIV-negative subjects over 10457 person-years. Adjusted rate ratios (RR) and 95% confidence intervals (CI) of HIV acquisition associated with genital ulcer disease (GUD) and discharge/dysuria were used to estimate the population attributable fraction (PAF) of HIV acquisition. HIV transmission risks associated with STD symptoms in HIV-positive partners of 167 HIV discordant couples and the numbers of sexual partners reported by HIV-positive subjects were used to estimate the PAF of HIV transmission attributable to STD. HIV prevalence was 16%. The risk of HIV acquisition was increased with GUD (RR 3.14; CI 1.98-4.98) and in males with discharge/dysuria (RR 2.44; CI 1.17-5.12) but not in females with discharge/dysuria. The PAF of HIV acquisition was 9.5% (CI 2.8-15.8%) with any of the three STD symptoms. The PAF for GUD was 8.8% (3.7-13.8) but only 8.2% of reported GUD was caused by treatable syphilis or chancroid. The PAF for discharge/dysuria in males was 6.7% (CI 1.1-13.8) but only 25% of symptomatic males had concurrent gonorrhea or chlamydial infection. No significant differences were seen in PAF between study treatment arms. The PAF of HIV transmission associated with STD symptoms in HIV-positive persons was indirectly estimated to be 10.4%. In this mature generalized HIV epidemic setting most HIV seroconversion occurs without recognized STD symptoms or curable STD detected by screening. Therefore syndromic management or other strategies of STD treatment are unlikely to substantially reduce HIV incidence in this population. However STD is associated with significant HIV risk at the individual level and STD management is needed to protect individuals. (authors)
128 citations
TL;DR: Prepubertal circumcision is associated with reduced HIV risk, whereas circumcision after age 20 years is not significantly protective against HIV-1 infection.
Abstract: This cross-sectional study aims to assess whether circumcision performed on postpubertal men affords the same level of protection from HIV-1 acquisition as circumcisions performed earlier in childhood. The study was conducted in Rakai district in rural Uganda and included 6821 men aged 15-49 years. Venous blood samples were drawn from these men and tested for HIV-1 and syphilis. Age at circumcision was dichotomized into men who were circumcised before or at age 12 (prepubertal) and men circumcised after age 12 (postpubertal). Postpubertally circumcised men were also subdivided into those reporting circumcision at age 13-20 and 21 years and above. Results revealed that the prevalence of HIV-1 in uncircumcised males was 14.1% compared with 16.2% for men circumcised at age 21 and above 10.0% for men circumcised between the ages of 13 and 20 years and 6.9% in men circumcised before age 12. On bivariate analysis lower prevalence of HIV-1 associated with prepubertal circumcision was observed in all of the age education ethnic and religious groups. Multivariate adjusted odds ratio of prevalent HIV-1 infection associated with prepubertal circumcision was 0.39. In the postpubertal group the adjusted odds ratio for men circumcised at ages 13-20 was 0.46 (0.28-0.77); it was 0.78 (0.43-1.43) for men circumcised after age 20. This study concludes that prepubertal circumcision is associated with reduced HIV risk whereas circumcision after age 20 years is not significantly protective against HIV-1 infection.
105 citations
TL;DR: The higher prevalence and intensity of HPV infection in HIV-positive women could facilitate HPV transmission in this population of women, and self-collected vaginal swabs could be used in population-based screening to identify women at high risk of cervical neoplasia.
Abstract: A random sample of 960 women aged 15-59 years enrolled in a population-based study in rural Uganda were asked to provide self-collected vaginal swabs for human papillomavirus (HPV) testing by hybrid capture assay. The intensity of HPV infection was assessed by the relative light unit (RLU) ratio in the specimen-to-positive control (PC) ratio. In total, 898 women (93%) provided a swab and 737 provided serum for human immunodeficiency virus type 1 (HIV-1) determination. HPV prevalence was 16.7% and was highest in younger women. HIV-1 prevalence was 17.8%. HPV prevalence was 44.3% in HIV-positive and 10.2% in HIV-negative women (rate ratio, 5.36; 95% confidence interval, 3.81-7.54). The intensity of HPV infection was significantly greater among HIV-positive than HIV-negative women (54.4 vs. 11.1 RLU/PC; P = .026); intensity of infection was highest in women aged <30 years. The higher prevalence and intensity of HPV infection in HIV-positive women could facilitate HPV transmission in this population. Self-collected vaginal swabs could be used in population-based screening to identify women at high risk of cervical neoplasia.
100 citations
TL;DR: Oocysts in the gorilla stools were morphologically, morphometrically, and immunologically undistinguishable from a bovine isolate of Cryptosporidium parvum oocysts, and there was no apparent relationship between oocyst concentration and gorilla age, sex, or habituation status.
Abstract: For conservation purposes and because of growing ecotourism, some mountain gorilla (Gorilla gorilla beringei) populations have been habituated to humans. Fecal specimens (n = 100) of nonhabituated and human-habituated gorillas (5 populations; 6 age classes) were tested for Cryptosporidium sp. oocysts and Giardia sp. cysts by conventional staining and immunofluorescent antibody (IFA). Cryptosporidium sp. infections (prevalence 11%) were not restricted to very young gorillas but were observed in 3-yr-old to >12-yr-old gorillas; most of the infections (73%) occurred in human-habituated gorillas. The prevalence of Giardia sp. infections was 2%; 1 nonhabituated gorilla was concomitantly infected. Oocysts of Cryptosporidium sp. in the gorilla stools were morphologically, morphometrically, and immunologically undistinguishable from a bovine isolate of Cryptosporidium parvum oocysts. Mean concentration of Cryptosporidium sp. oocysts and Giardia sp. cysts in gorilla stools was 9.39x10(4)/g, and 2.49x10(4)/g, respectively. There was no apparent relationship between oocyst concentration and gorilla age, sex, or habituation status. Most Cryptosporidium sp. infections found in gorillas with closest proximity to people may be a result of the habituation process and ecotourism. This study constitutes the first report of Cryptosporidium sp. infections in the family Pongidae, in the free-ranging great apes, and in the species of gorilla.
98 citations
TL;DR: TGF-β1 and IL-10 together potentiate the downmodulatory effect on M. tuberculosis-induced T-cell production of IFN-γ, and TGF- β1 alone enhances IL-11 production, which may be conducive to the suppression of mononuclear cell functions.
Abstract: Mycobacterium tuberculosis is associated with the activation of cytokine circuits both at sites of active tuberculosis in vivo and in cultures of mononuclear cells stimulated by M. tuberculosis or its components in vitro. Interactive stimulatory and/or inhibitory pathways are established between cytokines, which may result in potentiation or attenuation of the effects of each molecule on T-cell responses. Here we examined the interaction of transforming growth factor β1 (TGF-β1) and interleukin-10 (IL-10) in purified protein derivative (PPD)-stimulated human mononuclear cell cultures in vitro. TGF-β1 induced monocyte IL-10 (but not tumor necrosis factor alpha) production (by 70-fold, P < 0.02) and mRNA expression in the absence but not in the presence of PPD. Both exogenous recombinant (r) IL-10 and rTGF-β1 independently suppressed the production of PPD-induced gamma interferon (IFN-γ) in mononuclear cells from PPD skin test-positive individuals. Synergistic suppression of IFN-γ in cultures containing both rTGF-β1 and rIL-10 was only seen when the responder cell population were peripheral blood mononuclear cells (PBMC) and not monocyte-depleted mononuclear cells and when PBMC were pretreated with rTGF-β1 but not with rIL-10. Suppression of PPD-induced IFN-γ in PBMC containing both rTGF-β1 (1 ng/ml) and rIL-10 (100 pg/ml) was 1.5-fold higher (P < 0.05) than cultures containing TGF-β1 alone and 5.7-fold higher (P < 0.004) than cultures containing IL-10 alone. Also, neutralization of endogenous TGF-β1 and IL-10 together enhanced PPD-induced IFN-γ in PBMC in a synergistic manner. Thus, TGF-β1 and IL-10 together potentiate the downmodulatory effect on M. tuberculosis-induced T-cell production of IFN-γ, and TGF-β1 alone enhances IL-10 production. At sites of active M. tuberculosis infection, these interactions may be conducive to the suppression of mononuclear cell functions.
TL;DR: Seven flavonols including the novel 3-(2″-acetylrhamnosides) of myricetin and quercetin are isolated from blue flowers of the African water lily Nymphaea caerulea and their structures were elucidated by a combination of chromatography and homo- and heteronuclear two-dimensional NMR techniques.
TL;DR: Stratified multivariate analyses by place of residence indicated that the association between education and HIV prevalence was statistically significant in the rural villages, but not in the main road trading centres and intermediate trading villages.
Abstract: We examined the association between education and prevalent HIV-1 infection in the Rakai district, rural Uganda based on a cross-sectional analysis of a population-based cohort. In 1990, 1397 men and 1705 women aged 13 years and older, were enrolled in 31 randomly selected communities. Strata were comprised of main road trading centres, secondary road trading villages and rural villages. Sociodemographic and behavioural data were obtained by interview and serum for HIV serostatus were obtained in the home. The analysis examines the association between sex-specific prevalent HIV infection and educational attainment, categorized as secondary, primary or none. The odds ratios (ORs) and 95% confidence intervals (95% CIs) of HIV infection were estimated, using no education as the referent group. Higher levels of education were associated with a higher HIV seroprevalence in bivariate analyses (OR 2.7 for primary and 4.1 for secondary education, relative to no education). The strength of the association was diminished but remained statistically significant after multivariate adjustment for sociodemographic and behavioural variables (adjusted OR of HIV infection 1.6 (95% CI: 1.2-2.1)) for primary education and 1.5 (95% CI: 1.0-2.2) for secondary education. Stratified multivariate analyses by place of residence indicated that the association between education and HIV prevalence was statistically significant in the rural villages, but not in the main road trading centres and intermediate trading villages. Educational attainment is a significant predictor of HIV risk in rural Uganda, in part because of risk behaviours and other characteristics among better educated individuals. Preventive interventions need to focus on better educated adults and on school-aged populations.
TL;DR: Overall the study indicates that placental membrane inflammation increases the risk of vertical transmission of HIV.
Abstract: This prospective study was conducted to examine the association between placental membrane inflammation and risks of maternal-to-child (vertical) transmission of HIV-1 in Uganda. The cohort study consisted of 172 HIV-infected pregnant women over 15 years old who presented for antenatal care and intended to deliver at Mulago Hospital and their infants. Data on maternal immune status (CD4 counts or clinical AIDS) and concurrent infections with sexually transmitted diseases were obtained. Infants were followed-up for possible HIV infection using polymerase chain reaction for those below 15 months and enzyme immunoassay/Western blot for infants older than 15 months. Placental membrane inflammation and placental villous inflammation were determined by histopathology. Women without any placental pathology were used as reference group to assess vertical transmission rates. Among the 172 mother-infant pairs 40 infants showed evidence of HIV infection giving an overall transmission rate of 23.3%. Women without any placental pathology or immune suppression had an 11.3% transmission rate compared with 25.5% in women with placental inflammation and nonimmunocompromised. Women with immunosuppression had a 37.0% transmission rate. Inflammation of placental villous and artificial membrane rupture did not improve transmission rates and delivery through cesarean section and was associated with nonsignificant risk reduction. Overall the study indicates that placental membrane inflammation increases the risk of vertical transmission of HIV.
TL;DR: During 1996-1997, south-central Uganda experienced the second ONN fever epidemic ever recognized, and the combination of fever, arthralgia, and lymphadenopathy had a specificity of 83% and a sensitivity of 61% in the identification of cases and thus could be useful for surveillance purposes.
Abstract: O'nyong-nyong (ONN) fever, caused by infection with a mosquito-borne central African alphavirus, is an acute, nonfatal illness characterized by polyarthralgia. During 1996-1997, south-central Uganda experienced the second ONN fever epidemic ever recognized. Among 391 persons interviewed and sampled, 40 cases of confirmed and 21 of presumptive, well-characterized acute, recent, or previous ONN fever were identified through active case-finding efforts or during a household serosurvey and by the application of clinical and laboratory criteria. Among confirmed cases, the knees and ankles were the joints most commonly affected. The median duration of arthralgia was 6 days (range, 2-21 days) and of immobilization was 4 days (range, 1-14 days). In the majority, generalized skin rash was reported, and nearly half had lymphadenopathy, mainly of the cervical region. Viremia was documented in 16 cases, primarily during the first 3 days of illness, and in some of these, body temperature was normal. During this epidemic, the combination of fever, arthralgia, and lymphadenopathy had a specificity of 83% and a sensitivity of 61% in the identification of cases of ONN fever and thus could be useful for surveillance purposes.
TL;DR: In a study from October, 1996 to March, 1997, 34 pigeons in three different locations were studied for parasites, revealing that Pseudolynchia canariensis (the 'pigeon fly') was the most prevalent parasite (100%).
Abstract: In a study from October, 1996 to March, 1997, 34 pigeons in three different locations were studied for parasites. The majority of birds in Nakulabye appeared clinically sick, while those within Makerere University and Wandegeya were apparently healthy. Biometric data were taken for each bird and, during the process, ectoparasites were collected. Faecal and blood samples were obtained. The study of ectoparasites revealed that Pseudolynchia canariensis (the 'pigeon fly') was the most prevalent parasite (100%). The louse Columbicola columbae was next in prevalence (94.1%). It is postulated that the pigeon fly transports this parasite. Three lice of economic importance were found: Menopon gallinae, Menacanthus stramineus and Chelopistes meleagridis. Cestodes were the only helminths found, occurring in 23.5% of the birds. Identification of the cestodes was not possible. Haemoparasites were mainly of two genera, Haemoproteus and Plasmodium. Haemaproteus was the most prevalent (76.5%). This was possibly due to t...
TL;DR: Amongst samples of the sweet potato chlorotic stunt crinivirus (SPCSV) obtained from crops of sweet potato in Uganda, two serotypes were distinguished using a panel of monoclonal antibodies to a Kenyan isolate of SPCSV whereas SEA2 has not previously been reported.
Abstract: Amongst samples of the sweet potato chlorotic stunt crinivirus (SPCSV) obtained from crops of sweet potato in Uganda, two serotypes (SEA1 and SEA2) were distinguished using a panel of monoclonal antibodies (Mabs) to a Kenyan isolate of SPCSV. SEA1 serologically resembled the Kenyan isolate of SPCSV whereas SEA2 has not previously been reported. SEA1 was predominant in eastern Uganda whereas SEA2 was predominant in southern and western Uganda. SEA2 tended to occur in more severely diseased sweet potato plants than SEA1. RNA was extracted from eight plants and replicate clones representing the heat shock protein 70 (HSP70) homologue and coat protein (CP) genes were generated by reverse transcription and PCR. Sequence analyses revealed substitutions at two nucleotide positions in the HSP70 homologue gene, although neither affected deduced amino-acid sequences. Nucleotide substitutions in the CP gene region, which led to 11 amino-acid substitutions, revealed two major groupings plus other minor variants. The EMBL accession numbers of the sequences reported in this paper are AJ010754 through to AJ01769 (coat protein sequences) and AJ010914 through to AJ010929 (partial HSP70 homologue gene sequences).
TL;DR: Data indicate that relative poverty and environmental factors triggering eosinophilia appear to act in a geographically restricted region of Uganda in the aetiology of EMF.
Abstract: OBJECTIVE To determine the relative risks of socio-demographic, dietary, and environmental factors for endomyocardial fibrosis (EMF) in Uganda. METHOD Unmatched case control study in Mulago Hospital, Kampala. Cases (n = 61) were sequential patients hospitalized with an echocardiographic diagnosis of EMF from June 1995 to March 1996. Controls (n = 120) were concurrent patients with other forms of heart disease (heart controls, n = 59) and subjects admitted for trauma or elective surgery (hospital controls, n = 61). All consenting subjects answered a structured questionnaire administered by trained interviewers. Complete blood counts, malaria films and stool examination for ova and parasites were performed. Questionnaires elicited information on home address, economic circumstances, variables concerned with environmental exposures and usual diet before becoming ill. RESULTS After adjustment for age and sex, cases were significantly more likely than controls to have Rwanda/Burundi ethnic origins (P = 0.008). Compared with controls, cases had a lower level of education (P < 0.001 for heart controls and P = 0.07 for hospital controls), were more likely to be peasants (P < 0.001), and to come from Luwero or Mukono Districts (P = 0.003). After further adjustment for peasant occupation, cases were more likely than controls to walk barefoot (P = 0.015), consume cassava as their staple food (P < 0.001) and to lack fish or meat in dietary sauces (P = 0.02). Cases were more likely to exhibit absolute eosinophilia (P = 0.006). The effect of cassava diet was more marked in the younger age group, while the effect of eosinophilia was greater in adults. Socio-economic disadvantage is a risk for EMF. Absolute eosinophilia is a putative cause of EMF, a finding not explained by parasitism. CONCLUSION Data indicate that relative poverty and environmental factors triggering eosinophilia appear to act in a geographically restricted region of Uganda in the aetiology of EME.
TL;DR: In this article, principal component analysis (PCA) was used to delineate the Raingauge network of Tanzania into homogeneous groups, and the spatial patterns of the rotated PCA dominant modes delineated Tanzania's RA network into 15 homogeneous regions.
Abstract: In this paper, principal component analysis (PCA) was used to delineate the raingauge network of Tanzania into homogeneous groups. The monthly rainfall records for the years 1961–1990 inclusive at 150 raingauge stations used in the study were extracted from the records at the Directorate of Meteorology, Tanzania. The spatial patterns of the rotated PCA dominant modes delineated Tanzania's raingauge network into 15 homogeneous groups. Statistical tests, climatological information, topographic features and other data supported the physical reality of the 15 delineated groups. The delimited rainfall regions may be useful for Tanzania in agricultural planning, the assessment of water resources potential, delineation of drought or flood risk zones and as a basis of ensuring collection of climatologically representative rainfall data by the inclusion of a station(s) from each homogeneous rainfall region. Copyright © 1999 Royal Meteorological Society
TL;DR: HIV-infected infants of non-drug-using mothers with abnormal neurologic exams had lower motor and mental test scores and lower rates of motor Bayley Scales scores than their HIV- Infected counterparts with normal Neurologic exams.
Abstract: Neurodevelopmental outcomes of human immunodeficiency virus Type 1 (HIV-1)-infected infants of non-drug-using mothers were assessed in a controlled, prospective study from birth to 24 months with 3 groups: 61 infants of HIV-infected mothers, 234 uninfected infants of HIV-infected mothers (seroreverters), and 115 uninfected infants of uninfected mothers Compared with seroreverters and uninfected infants, HIV-infected infants demonstrated lower mental and motor development on the Bayley Scales and greater deceleration in their rate of motor development HIV-infected infants with abnormal neurologic exams had lower motor and mental test scores and lower rates of motor Bayley Scales scores than their HIV-infected counterparts with normal neurologic exams Contrary to prediction, no group differences in mean performance or growth rates were found on visual information processing on the Fagan Test of Infant Intelligence
Journal Article•
TL;DR: BCG vaccination at birth had no important effect on the interpretation of the tuberculin skin test reactivity in this group of Ugandan children, and the tuberculosis skin test remains a valuable tool for the evaluation of household contacts and suspected cases of tuberculosis in BCG-vaccinated children.
Abstract: CADRE: En Ouganda, la couverture vaccinale par le BCG a la naissance se situe entre 82 et 84%. OBJECTIF: Evaluer l'effet de la vaccination neonatale au BCG sur la positivite du test cutane a la tuberculine chez les enfants d'Ouganda exposes a des cas infectieux. SCHEMA : Au sein d'une etude de prevalence actuellement en cours chez les contacts familiaux de nouveaux cas de tuberculosis, l'on a examine 365 enfants pour determiner dans quelle mesure la vaccination par le BCG a la naissance avait un impact sur le test tuberculinique cutane. Les enfants ont ete classifies comme contacts (179) et non-contacts (186) selon qu'il y avait presence ou non d'un cas de tuberculosis a bacilloscopie positive chez un adulte de la famille. RESULTATS: Quelle que soit la vaccination anterieure par le BCG, les enfants exposes a un adulte a bacilloscopie positive etaient plus susceptibles d'avoir un test cutane positif (PPD > 5 mm, 68% versus 36%, P < 0,01). Les enfants vaccines au BCG avant l'âge d'un an et sans contact connu au sein de la famille avec un cas de tuberculosis active, ont une frequence de reactions cutanees a la tuberculine inferieure (29%) a celle observee chez leurs contreparties des familles contact (65%, P = 0,031). CONCLUSION: La vaccination par le BCG a la naissance n'a pas d'effet important sur l'interpretation de la reactivite cutanee a la tuberculine dans ce groupe d'enfants en Ouganda. Le test tuberculinique reste un outil valable pour l'evaluation des contacts familiaux et des cas suspects de tuberculosis meme chez les enfants vaccines par le BCG.
TL;DR: In this article, perch fillets stored at −13 and −27°C were monitored to determine changes in protein functionality [expressible moisture (EM), water uptake ability (WUA), soluble protein (SP), changes in lipids [free fatty acids (FFA) and malonaldehyde accumulation] and changes in sensory properties.
TL;DR: This epidemic was focused near lakes and swamps, where it was associated with high infection and attack rates, for an apparent:inapparent infection ratio of nearly 2 in affected areas.
Abstract: O'nyong-nyong (ONN) fever, an acute, nonfatal illness characterized by polyarthralgia, is caused by infection with a mosquito-borne central African alphavirus. During 1996-1997, south-central Uganda experienced the second ONN fever epidemic ever recognized. During January and early February 1997, active case-finding and a household cluster serosurvey were conducted in two affected and two comparison areas. A confirmed case was defined as an acute febrile illness with polyarthralgia occurring within the previous 9 months plus serologic confirmation or isolation of ONN virus from blood. In affected (n = 129) and comparison (n = 115) areas, the estimated infection rates were 45% and 3%, respectively, and the estimated attack rates were 29% and 0%, respectively, for an apparent : inapparent infection ratio of nearly 2 in affected areas. In villages sampled near Lake Kijanebalola, Rakai District, the estimated infection and attack rates were 68% and 41%, respectively, and 55% of sampled households had ≥1 case of ONN fever. In conclusion, this epidemic was focused near lakes and swamps, where it was associated with high infection and attack rates.
TL;DR: It is concluded that African countries need to develop procedures for testing pesticides in Africa in order to arrive at the correct conclusions concerning adverse side effects from pesticide use.
TL;DR: It was concluded that gliricidia forage is better utilized when fed with an energy source such as maize bran.
TL;DR: It is concluded that PCR coupled with DNA probe hybridization provides a highly sensitive tool for the assessment of therapeutic efficiency and disease progression intrypanosome infections, especially in chronic infections when the level of parasitemia is low or when trypanosomes are sequestered at cryptic sites.
Abstract: Four of eight Ankole longhorn cattle experimentally infected with Trypanosoma brucei were treated with 7 mg/kg diminazene aceturate (Berenil, Hoechst AG, Germany) at day 71 postinfection. The trypanocidal activity was monitored using polymerase chain reaction (PCR) and DNA probe hybridization. When extracted parasite DNA (without host DNA) was used, as little as 1 fg per reaction, which is equivalent to about 1-10% of the DNA in a single trypanosome, produced a specific product that was visible as a 177-bp band in an agarose gel. In infected cattle, specific PCR products could be amplified at as early as 1 day postinfection. PCR signals remained positive during infection, except in one sample, although aparasitemic phases occurred. In cases where treatment resulted in a significant clinical improvement, PCR signals disappeared at 3-4 days after the administration of the drug. By contrast, in cattle that showed clinical signs of CNS involvement after treatment, although aparasitemic, and died before the termination of the experiment, specific products could be amplified on several occasions following treatment. The PCR signals generated after treatment could be further enhanced by subsequent slot-blot hybridization with a T. brucei-specific DNA probe. We conclude that PCR coupled with DNA probe hybridization provides a highly sensitive tool for the assessment of therapeutic efficiency and disease progression in trypanosome infections, especially in chronic infections when the level of parasitemia is low or when trypanosomes are sequestered at cryptic sites.
TL;DR: In this paper, the issues involved in constructing feminisms in a global context, while recognising women's diverse cultural backgrounds and local priorities are discussed, and it is concluded that international feminist links need to be built in order to influence public policy makers internationally, nationally and locally to embrace the principle of women's rights as human rights.
Abstract: This article discusses the issues involved in constructing feminisms in a global context, while recognising women's diverse cultural backgrounds and local priorities. The issues raised here include whether there exists something which can be identified as “African feminism”; whether such a concept could be said to span all African countries; whether there is a truly “African feminism” as distinct form “western feminism”; and what lessons might be learnt from each other. Focusing on the Ugandan context, the relationships between feminisms at local, national, and international levels are explored. Although feminist concerns cannot be generalised, fundamental commonalities can be found by looking beyond political rhetoric and focusing on the reality of women's lived experiences. It is concluded that international feminist links need to be built in order to influence public policy makers internationally, nationally, and locally to embrace the principle of “women's rights as human rights”.
TL;DR: Four- to 5-year-old females nursed fewer juveniles than did older or younger females in their groups and were thus less likely to be donors, suggesting a better co-ordination between mother and offspring.
Abstract: This paper examines the distribution of non-offspring nursing or ‘allosuckling’ in warthogs Phacochoerus africanus Of the 16 breeding groups studied, 11 contained two or more nursing females Allosuckling occurred in six of these groups (55%) The number of juveniles per nursing female was lower for groups with allosuckling, although juvenile mortality was not measurably affected by either allosuckling, group size or the number of females in a group Time spent drinking was longer for juveniles in smaller litters but was not influenced by allosuckling or juvenile age Longer intervals between the females' nursing bouts resulted in longer drinking bouts for the juveniles, but there was no correlation with inter-meal intervals The proportion of successful sucking bouts increased with juvenile age This success rate was greater in groups without allosuckling, suggesting a better co-ordination between mother and offspring Females appeared able to distinguish between juveniles and to nurse selectively Four- to 5-year-old females nursed fewer juveniles than did older or younger females in their groups and were thus less likely to be donors
TL;DR: The presence of diverse HIV-1 subtypes in Uganda increases the potential for dual infection, and V3 cDNAs from Ugandan women and infants analyzed for subtype analysis provided a unique opportunity to study dual transmission.
Abstract: 217 GROUP M HIV-1 VIRUSES have been categorized into subtypes A±J based on phylogenetic reconstruction using DNA sequences. Sequence variation between these subtypes generally ranges from 25 to 35% within the env gene. In most cases of HIV-1 infection, viruses of a single subtype are detected. While the identification of recombinant viruses derived from different subtypes suggests the occurrence of dual infection, there are relatively few reports in which HIV-1 viruses of two different M group subtypes were detected in a single individual. In most cases, it is not possible to determine the timing of infection with viruses of different subtypes or whether both subtypes originated from the same source. The setting of vertical (mother-to-infant) HIV-1 transmission provides a unique opportunity to study dual transmission. In this setting, the time available for transmission is relatively limited and the mother is usually the only potential source of infection. There is little known about dual HIV-1 infection in the setting of vertical transmission. In one study, subtype A and C viruses were detected in a Rwandan woman; however, only subtype A was detected in her infant. In a second study, subtype B and C viruses were detected in a Brazilian woman and in her infant. To examine the potential transmission of HIV-1 viruses of different subtypes, we analyzed V3 cDNAs from Ugandan women and infants. The presence of diverse HIV-1 subtypes in Uganda increases the potential for dual infection. HIV-1 subtypes found in Uganda include A, B, C, D, and G; subtypes A and D account for the majority of infections. Plasma samples were collected from a Ugandan woman and her infant at the time of delivery. An additional sample was collected from the infant at 6 weeks of age. These samples were collected in 1993 as part of a natural history study of vertical HIV-1 transmission in Kampala, Uganda. Plasma was shipped to the United States for analysis. HIV-1 RNA was extracted from 200 m l of plasma using the Amplicor HIV-1 Monitor test kit (Roche Diagnostic Systems, Branchburg, NJ) according to manufacturer instructions. RNA extracts were resuspended in a final volume of 400 m l. Twenty-five microliters of each RNA extract was used for reverse transcription (RT) with Moloney murine leukemia virus reverse transcriptase. Each 25-m l aliquot contained at least 50 copies of HIV-1 RNA. To minimize the potential for bias due to primer binding, random hexamer oligonucleotide primers [pd(N)6; Pharmacia, Piscataway, NJ] were used in the RT reactions. The V3 region of the env gene was amplified in a nested polymerase chain reaction (PCR) using primers that correspond to highly conserved regions of the env gene.23 To reduce the potential for sample contamination, each step of the RT-PCR amplification was assembled in a separate, enclosed workstation using aerosol-resistant pipette tips and dedicated equipment. Equipment in each workstation was ultraviolet (UV) irradiated after each experiment. Negative controls without template were included for each RT and PCR reaction. Each step of the analysis (including RT, PCR, cloning, and plasmid analysis) was performed on a separate day for each sample. Comparison of V3 cDNA sequences obtained from these plasma samples and from unrelated samples analyzed in our laboratory showed no evidence of contamination. PCR products were purified using a spin column technique and cloned into the pCR2.1 vector, using the TA cloning kit (Invitrogen, Carlsbad, CA). The resulting plasmids were isolated and sequenced using the 2 21 M13 forward primer and the BigDye terminator cycle sequencing ready reaction kit (Perkin-Elmer Applied Biosystems, Foster City, CA). At least 10 cDNAs from each sample were analyzed by DNA sequencing and the predicted amino acid sequences were determined (Fig. 1). V3 sequences were used for subtype analysis. Sequences were aligned manually in the program VisEd (provided by Dr. Ken Peters). For regions of high variability, the alignment was based primarily on the most conservative amino acid substitutions. The full sequence alignment contained 18 unique Ugan-
TL;DR: The most consistent and strongest difference between the groups was the Ugandans' belief that supernatural factors influenced their health to a limited extent, while the British believed this factor to be irrelevant to current and future health status.
Abstract: Two groups of student participants one from Great Britain, the other Uganda completed a four-pan questionnaire on lay perceptions of current and future health, the causes of illness, and the nature of recovery. Demographic differences between the two groups, totalling 335 subjects in all, were co-varied out statistically. As predicted the most consistent and strongest difference between the groups was the Ugandans' belief that supernatural factors influenced their health to a limited extent, while the British believed this factor to be irrelevant to current and future health status. The other major difference between the groups indicated that the Ugandans, more than the British, rated the importance of Western medicine as a contributor to their current and future health. The results could be explained by the main causes of mortality and the health services available in the two countries. Limitations of studies such as this are discussed.