Spatial heterogeneity in projected leprosy trends in India

Background: Leprosy is caused by infection with Mycobacterium leprae and is characterized by peripheral nerve damage and skin lesions. The disease is classified into paucibacillary (PB) and multibacillary (MB) leprosy. The 2012 London Declaration formulated the following targets for leprosy control: (1) global interruption of transmission or elimination by 2020, and (2) reduction of grade-2 disabilities in newly detected cases to below 1 per million population at a global level by 2020. Leprosy is treatable, but diagnosis, access to treatment and treatment adherence (all necessary to curtail transmission) represent major challenges. Globally, new case detection rates for leprosy have remained fairly stable in the past decade, with India responsible for more than half of cases reported annually. Methods: We analyzed publicly available data from the Indian Ministry of Health and Family Welfare, and fit linear mixed-effects regression models to leprosy case detection trends reported at the district level. We assessed correlation of the new district-level case detection rate for leprosy with several state-level regressors: TB incidence, BCG coverage, fraction of cases exhibiting grade 2 disability at diagnosis, fraction of cases in children, and fraction multibacillary. Results: Our analyses suggest an endemic disease in very slow decline, with substantial spatial heterogeneity at both district and state levels. Enhanced active case finding was associated with a higher case detection rate. Conclusions: Trend analysis of reported new detection rates from India does not support a thesis of rapid progress in leprosy control

Cost-Effectiveness of Rotavirus Vaccination in France-Accounting for Indirect Protection.

BACKGROUND: Vaccination against rotavirus has shown great potential for reducing the primary cause of severe childhood gastroenteritis. Previous economic evaluations of rotavirus vaccination in France have not modeled the potential impact of vaccines on disease burden via reduced transmission. OBJECTIVE: To determine the cost-effectiveness of the introduction of pentavalent rotavirus vaccination into the French infant vaccination schedule. METHODS: We developed an age-structured model of rotavirus transmission calibrated to 6 years of French gastroenteritis incidence and vaccine clinical trial data. We evaluated the cost-effectiveness of pentavalent rotavirus vaccination considering that 75% of infants would receive the three-dose vaccine course. RESULTS: Our model predicts that rotavirus vaccination will decrease rotavirus gastroenteritis incidence and associated clinical outcomes in vaccinated and unvaccinated individuals, delay the seasonal peak of infection, and increase the age of infection. From the societal perspective, our base-case scenario predicts that vaccination coverage would be cost-effective at €115 or €135 per vaccine course at €28,500 and €39,500/quality-adjusted life-year (QALY) gained, respectively, and suggests that almost 95% of the financial benefits will be recouped within the first 5 years following vaccination implementation. From the third-party payer perspective, incremental cost-effectiveness ratios ranged from €12,500 to €20,000/QALY, respectively. Our uncertainty analysis suggests that findings were sensitive to various assumptions including the number of hospitalizations, outpatient visits, and the extent of QALY losses per rotavirus episode. CONCLUSIONS: Introducing pentavalent rotavirus vaccination into the French infant vaccination schedule would significantly reduce the burden of rotavirus disease in children, and could be cost-effective under plausible conditions

Composição florística e fauna associada das ilhas flutuantes livres, Rio Paraguai, Corumbá, MS.

As ilhas flutuantes livres englobam várias espécies vegetais tais como camalotes e gramíneas. Nas folhas e raízes destas plantas encontra-se uma diversidade de organismos. Este trabalho teve como objetivo fazer o levantamento das espécies vegetais componentes das ilhas flutuantes livres e conhecer os organismos associados e seus hábitos alimentares. Free floating islands include several species such as water hyacinth and grasses. In leaves and roots of these plants there are a diversity of organisms. This study aimed to survey the plant species of these free floating islands and recognize the associated organisms and its food habits

Aplicação localizada de herbicidas para controle de alecrim-do-campo (Vernonia nudiflora) em pastagem natural.

Resumo: Para avaliar o controle de alecrim-do-campo (Vernonia nudiflora) com aplicação de herbicidas de contato, foi conduzido durante 353 dias, um experimento com delineamento de parcelas subdivididas, dispostas em blocos ao acaso, com três repetições em um arranjo fatorial (5x3)+1, sendo cinco herbicidas em três doses mais a testemunha. As parcelas corresponderam aos herbicidas, com doses de 1,5; 3,0 e 4,5 L ha-1 de Tordon, Aminol 806, Garlon, Grazon e Plenum. A abundância de V. nudiflora foi avaliada antes da aplicação e 60 e 353 dias após. A aplicação foi feita com ?roçadeira química? tratorizada, consistindo em uma plataforma com bandejas com altura regulável, que entra em contato somente com as plantas alvo. Os herbicidas não diferiram quanto à redução na abundância do alecrim e todos reduziram significativamente mais que a testemunha. Os tratamentos não interferiram na frequência na composição de espécies desejáveis no campo nativo. O uso do aplicador químico é eficaz para o controle, mesmo com baixas concentrações de herbicidas, tendo eficácia na redução do alecrim-do-campo e preservando as espécies desejáveis para a produção animal. [Located herbicide application to control alecrim-do-campo (Vernonia nudiflora) in natural grassland]. Abstract: To evaluate the control of alecrim-do-campo (Vernonia nudiflora) with contact herbicides, an experiment was conducted during 353 days, following a split plot block design, with three replicates in a (5x3)+1 factorial arrangement, being five herbicides in three doses and the control. The plots corresponded to the herbicides, with doses of 1.5, 3.0 and 4.5 L ha-1 of Tordon, Aminol 806, Garlon, Grazon e Plenum. The presence of V. nudiflora was evaluated prior to application and 60 and 353 days after. The application was made using a chemical applicator, which consists of a platform of adjustable height that contacts only the target plant. The herbicides did not differ in reducing the abundance of V. nudiflora and all of them reduced significantly more than the control. The chemical applicator was effective to control alecrim-do-campo, even with low herbicide concentrations, reducing the Vernonia abundance and not being harmful to the native desirable species

Controle de espécies indesejáveis e preservação de leguminosas de campo nativo com aplicação localizada de herbicidas.

Resumo: Para avaliar o efeito da aplicação localizada de herbicidas por contato, em Desmodium incanum, foi conduzido este estudo pelo período de 353 dias. O delineamento experimental foi de parcelas subdivididas, dispostas em blocos ao acaso, com três repetições em um arranjo fatorial [(5x3)+1], sendo cinco herbicidas mais a testemunha e três épocas de avaliação. As parcelas corresponderam aos herbicidas, locados na dose de 1,5 L ha-1 de Tordon, Aminol 806, Garlon, Grazon e Plenum, sendo compostas por oito quadros dispostos sobre uma transecta fixa. Realizou-se um levantamento prévio ao experimento, e dois levantamentos subseqüentes aos 60 e 365 dias apos a aplicação. A planta indesejável mais frequente era Vernonia nudiflora. Para aplicação dos herbicidas utilizou-se uma 'roçadeira química' tratorizada, consistindo em uma plataforma com bandejas com altura regulável, que entra em contato somente com as plantas alvo. O uso do aplicador químico foi eficaz para o controle de espécies indesejáveis além de não interferir na frequência do Desmodium incanum, sendo interessante a limpeza seletiva e preservação da flora nativa. [Weed control and preservation of native legumes species in natural grassland by herbicide localized application] Abstract: To evaluate the effect of localized application of herbicides by contact, in Desmodium incanum, this trial was conducted during a period of 353 days. The experimental design was a split plot arranged in a randomized block design with three replications in a factorial arrangement [(5x3) +1], five herbicides plus the control and three evaluation periods. The plots corresponded to herbicides, doses were locate: 1.5, 3.0 and 4.5 L ha -1 of Tordon, Aminol 806, Garlon, Grazon e Plenum, being composed by 8 tables arranged on a fixed line. Prior to application, was made a survey, another in 60 and 353 days after application. For the herbicides application, was used a chemical applicator, which consists in an adjustable height platform, and it is contact is only with the target plant. The use of chemical applicator was effective for controlling undesirable species besides not interfere on Desmodium incanum frequency besides being interesting for selective cleaning and preservation of the native vegetation

Direct and indirect effects of rotavirus vaccination: Comparing predictions from transmission dynamic models

Early observations from countries that have introduced rotavirus vaccination suggest that there may be indirect protection for unvaccinated individuals, but it is unclear whether these benefits will extend to the long term. Transmission dynamic models have attempted to quantify the indirect protection that might be expected from rotavirus vaccination in developed countries, but results have varied. To better understand the magnitude and sources of variability in model projections, we undertook a comparative analysis of transmission dynamic models for rotavirus. We fit five models to reported rotavirus gastroenteritis (RVGE) data from England and Wales, and evaluated outcomes for short- and long-term vaccination effects. All of our models reproduced the important features of rotavirus epidemics in England and Wales. Models predicted that during the initial year after vaccine introduction, incidence of severe RVGE would be reduced 1.8-2.9 times more than expected from the direct effects of the vaccine alone (28-50% at 90% coverage), but over a 5-year period following vaccine introduction severe RVGE would be reduced only by 1.1-1.7 times more than expected from the direct effects (54-90% at 90% coverage). Projections for the long-term reduction of severe RVGE ranged from a 55% reduction at full coverage to elimination with at least 80% coverage. Our models predicted short-term reductions in the incidence of RVGE that exceeded estimates of the direct effects, consistent with observations from the United States and other countries. Some of the models predicted that the short-term indirect benefits may be offset by a partial shifting of the burden of RVGE to older unvaccinated individuals. Nonetheless, even when such a shift occurs, the overall reduction in severe RVGE is considerable. Discrepancies among model predictions reflect uncertainties about age variation in the risk and reporting of RVGE, and the duration of natural and vaccine-induced immunity, highlighting important questions for future research