Risk factors of visceral leishmaniasis in East Africa: a case-control study in Pokot territory of Kenya and Uganda

BACKGROUND: In East Africa, visceral leishmaniasis (VL) is endemic in parts of Sudan, Ethiopia, Somalia, Kenya and Uganda. It is caused by Leishmania donovani and transmitted by the sandfly vector Phlebotomus martini. In the Pokot focus, reaching from western Kenya into eastern Uganda, formulation of a prevention strategy has been hindered by the lack of knowledge on VL risk factors as well as by lack of support from health sector donors. The present study was conducted to establish the necessary evidence-base and to stimulate interest in supporting the control of this neglected tropical disease in Uganda and Kenya. METHODS: A case-control study was carried out from June to December 2006. Cases were recruited at Amudat hospital, Nakapiripirit district, Uganda, after clinical and parasitological confirmation of symptomatic VL infection. Controls were individuals that tested negative using a rK39 antigen-based dipstick, which were recruited at random from the same communities as the cases. Data were analysed using conditional logistic regression. RESULTS: Ninety-three cases and 226 controls were recruited into the study. Multivariate analysis identified low socio-economic status and treating livestock with insecticide as risk factors for VL. Sleeping near animals, owning a mosquito net and knowing about VL symptoms were associated with a reduced risk of VL. CONCLUSIONS: VL affects the poorest of the poor of the Pokot tribe. Distribution of insecticide-treated mosquito nets combined with dissemination of culturally appropriate behaviour-change education is likely to be an effective prevention strategy

Advanced video anomaly detection using 2D CNN and stacked LSTM with deep active learning-based model

Around the world, the video surveillance system has gained wide acceptance and astonishing growth due to its broad applications. The surveillance system has become a paramount tool and benchmark for analyzing the harmony and safety of society. Anomaly detection and its associated applications play a key role in the integrity of the system. The aim of anomaly detection is to find rare and sparse occurrences of events from videos. Developing an accurate and time-efficient system is still remains challenging due to the dynamic nature of anomalies. An active learning-based end-to-end system with full use of both spatial and temporal features from the input videos is proposed. The model combines the use of 2DCNN and Stacked LSTM to extract frame-level features through an improved anisotropic Gunnar Farneback Optical Flow algorithm. The system is evaluated on the benchmarked datasets namely UCSD Ped1 UCSD Ped2 and achieves an AUC of 95% and 94% respectively. The experimental results indicate that the proposed method is superior to state-of-the-art algorithms

Cost-Effectiveness Analysis of Combination Therapies for Visceral Leishmaniasis in the Indian Subcontinent

Visceral leishmaniasis (VL) is a serious health problem in the Indian subcontinent affecting the rural poor. It has a significant economic impact on concerned households. The development of drug resistance is a major problem and threatens control efforts under the VL elimination initiative. With an unprecedented choice of antileishmanial drugs (but no newer compound in clinical development), policies that protect these drugs against the emergence of resistance are required. A possible strategy that has been successfully used for malaria and tuberculosis is the use of combination therapies. This study is the first comprehensive assessment of the cost-effectiveness of all possible mono- and combination therapies for the treatment of visceral leishmaniasis in the Indian subcontinent. The analysis was done from the societal perspective, including both health provider and household costs. The present work shows that combination treatments are a cost-effective alternative to current monotherapy for VL. Given their expected impact on emergence of drug resistance, the use of combination therapy should be considered in the context of the VL elimination programme in the Indian subcontinent

Geographical Variation in the Response of Visceral Leishmaniasis to Paromomycin in East Africa: A Multicentre, Open-Label, Randomized Trial

Visceral leishmaniasis (VL) is a fatal parasitic disease with 500,000 new cases each year according to WHO estimates. New and better treatment options are urgently needed in disease endemic areas due to the long courses, toxicity and development of resistance to current treatments. Recently, the antibiotic paromomycin was tested and registered in India to treat this disease. The current study describes a clinical trial to test the effectiveness of injectable paromomycin, either alone or in combination with the standard drug sodium stibogluconate in three East African countries—Sudan, Kenya and Ethiopia. The study showed that at the same paromomycin dose that was successfully used and registered in India, a far poorer outcome was obtained, particularly in Sudan, suggesting that there are either differences in the patients ability to respond to the drug or in the susceptibility of parasites in East Africa compared with those in India. However, no major safety concerns were noted with the treatment. Further research was initiated to see if a higher dose of paromomycin would perform better, especially in Sudan. The results of this and the performance of the combination arm will be reported later. Our study highlights the importance of considering geographical differences to treatment responses

Safety and efficacy of single dose versus multiple doses of AmBisome for treatment of visceral leishmaniasis in eastern Africa: a randomised trial.

BACKGROUND: Anti-leishmanial drug regimens that include a single dose AmBisome could be suitable for eastern African patients with symptomatic visceral leishmaniasis (VL) but the appropriate single dose is unknown. METHODOLOGY: A multi-centre, open-label, non-inferiority, randomized controlled trial with an adaptive design, was conducted to compare the efficacy and safety of a single dose and multiple doses of AmBisome for the treatment of VL in eastern Africa. The primary efficacy endpoint was definitive cure (DC) at 6 months. Symptomatic patients with parasitologically-confirmed, non-severe VL, received a single dose of AmBisome 7.5 mg/kg body weight or multiple doses, 7 times 3 mg/kg on days 1-5, 14, and 21. If interim analyses, evaluated 30 days after the start of treatment following 40 or 80 patients, showed the single dose gave significantly poorer parasite clearance than multiple doses at the 5% significance level, the single dose was increased by 2·5 mg/kg. In a sub-set of patients, parasite clearance was measured by quantitative reverse transcriptase (qRT) PCR. PRINCIPAL FINDINGS: The trial was terminated after the third interim analysis because of low efficacy of both regimens. Based on the intention-to-treat population, DC was 85% (95%CI 73-93%), 40% (95%CI 19-64%), and 58% (95%CI 41-73%) in patients treated with multiple doses (n = 63), and single doses of 7·5 (n = 21) or 10 mg/kg (n = 40), respectively. qRT-PCR suggested superior parasite clearance with multiple doses as early as day 3. Safety data accorded with the drug label. CONCLUSIONS: The tested AmBisome regimens would not be suitable for VL treatment across eastern Africa. An optimal single dose regimen was not identified. TRIALS REGISTRATION: www.clinicaltrials.govNCT00832208

Advanced video anomaly detection using 2D CNN and stacked LSTM with deep active learning-based model

Around the world, the video surveillance system has gained wide acceptance and astonishing growth due to its broad applications. The surveillance system has become a paramount tool and benchmark for analyzing the harmony and safety of society. Anomaly detection and its associated applications play a key role in the integrity of the system. The aim of anomaly detection is to find rare and sparse occurrences of events from videos. Developing an accurate and time-efficient system i s s till remains c hallenging due to t he dynamic nature of a nomalies. The deep learning-based end-to-end system with full use of both spatial and temporal features from the input videos is proposed. The model combines the use of 2DCNN and Stacked LSTM to extract frame-level features through an anisotropic Gunnar Farneback Optical Flow algorithm. The system is evaluated on the benchmarked datasets namely UCSD Ped1 and UCSD Ped2, and it achieves an AUC of 95% and 94% respectively. The experimental results indicate that the proposed method is superior to state-of-the-art algorithms.</jats:p

Comparative phytosociological assessment of three terrestrial ecosystems of Wayanad Wildlife Sanctuary, Kerala, India

Phytosociological studies were conducted in three vegetation types in the WS II area of Wayanad Wildlife Sanctuary.  In each vegetation type, 85 quadrats (10 x 10 m) were laid to quantify the vegetation.  Natural forest showed comparatively higher species richness than plantation and vayal (swamps/low lying grassland).  In natural forest 96 plant species were present while it was 70 and 66 respectively in plantation and vayal.  Fabaceae was the dominant family in all the three vegetation types.  The natural forest was dominated by Chromolaena odorata, followed by Lantana camara, Mimosa pudica, Terminalia elliptica, Glycosmis pentaphylla.  In the plantations, Chromolaena odorata, Tectona grandis, Mimosa pudica and Glycosmis pentaphylla showed dominance.  The vayal was dominated by Arundinella leptochloa.  The second most dominant species in the vayal was Chromolaena odorata.  Other dominant species were Kyllinga nemoralis and Sporobolus tenuissimus.  Among the three, vayal recorded the highest Simpson Diversity Index.  The highest Berger-Parker Dominance Index value in plantation indicates the presence of dominant species. Natural forests recorded highest Margalef Richness Index and the least was in vayal.  The highest Pielou’s Wiener Equitability Index in vayal indicated all species are evenly distributed.&#x0D;  </jats:p

Competition and innovation: allies or foes? A case study of Indian manufacturing sector

Presented at the GLOBELICS 6th International Conference 2008 22-24 September, Mexico City, Mexico.The fundamental building block of the economic theory of competition is that the most ideal condition of competition is represented by perfect competition. It refers to a situation in which the market is characterized by the presence of a large number of sellers selling homogenous products. Economists held the view that perfect competition was the best possible market structure in which an optimal resource allocation could be achieved (Cohen and Levin, 1989). Also, this interpretation of competition suited the static view of competition of the early periods of the evolution of the concept of competition. However, this view was severely shaken in 1942 when Schumpeter opined that, “ the atomistic firm operating in a competitive market may be a perfectly suitable vehicle for static resource allocation, but the large firm operating in a concentrated market was the most powerful engine of progress and….long run expansion of output.” The major aspect of this view was that it marked a major shift from the static to dynamic conceptualization of competition. In a dynamic setting, competition needn’t necessarily be characterized by a large number of players. Instead, competition is characterized by the presence of players who have the potential to innovate and keep their rivals up on their toes. In this scenario, players who have the ability to innovate find that their production costs fall resulting in them able to capture a greater market share. Meanwhile, the players who are unable to innovate fail to survive in the market resulting in them leaving the market. The result in innovation plays a key role in reducing the number of market players in a particular good resulting in the creation of a concentrated market structure. To the proponents of a static competition framework, this would indicate a sure sign of a fall in competition. However, the dynamic competition theorists opine that a concentrated market structure can indicate a substantial degree of competition among the few players in operation. The emergence of greater competition in concentrated market structure resulting in innovation which plays a crucial role in a country’s long term economic growth was a direct challenge to the antitrust orthodoxy prevalent during that tim