| 1. |
- Askling, Helena H, et al.
(författare)
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Serologic Analysis of Returned Travelers with Fever, Sweden
- 2009
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Ingår i: Emerging Infectious Diseases. - Atlanta, GA, USA : U.S. Department of Health and Human Services * Centers for Disease Control and Prevention. - 1080-6040 .- 1080-6059. ; 15:11, s. 1805-1808
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Tidskriftsartikel (refereegranskat)abstract
- We studied 1,432 febrile travelers from Sweden who had returned from malaria-endemic areas during March 2005-March 2008. In 383 patients, paired serum samples were blindly analyzed for influenza and 7 other agents. For 21% of 115 patients with fever of unknown origin, serologic analysis showed that influenza was the major cause.
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| 2. |
- Hommel, Ami, et al.
(författare)
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Influence of optimised treatment of people with hip fracture on time to operation, length of hospital stay, reoperations and mortality within 1 year
- 2008
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Ingår i: Injury. - : Elsevier. - 0020-1383 .- 1879-0267. ; 39:10, s. 1164-1174
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Tidskriftsartikel (refereegranskat)abstract
- Hip fractures are a major cause of hospital stay among the elderly, and result in increased disability and mortality. In this study from 1 April 2003 to 31 March 2004, the influence of optimised treatment of hip fracture on time to operation, length of hospital stay, reoperations and mortality within 1 year were investigated. Comparisons were made between the first 210 patients in the period and the last 210 patients, who followed the new clinical pathway introduced at the University Hospital in Lund, Sweden. Early surgery, within 24h, was not associated with reduced mortality, but was significantly associated with reduced length of stay (p<0.001). Significantly more cases of osteosynthesis for femoral neck fracture were reoperated compared with all other types of surgery (p<0.001) when reoperations with extraction of the hook pins in healed fractures were excluded. Mortality was significantly higher among men than women at 4 (p=0.025) and 12 (p=0.001) months after fracture and among medically fit patients with administrative delay to surgery compared with patients with no delay (p<0.001).
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| 3. |
- Hultberg, Tove, et al.
(författare)
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The late-Holocene decline of Tilia in relation to climate and human activities - pollen evidence from 42 sites in southern Sweden
- 2017
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Ingår i: Journal of Biogeography. - : Wiley. - 0305-0270 .- 1365-2699. ; 44:10, s. 2398-2409
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The dominant role of Tilia in primeval forests of Scandinavia has long been recognized, but the timing and mechanisms for its decline have not been completely unravelled. A particular uncertainty involves the balance between climate and human activities as the drivers of the change. One reason for the uncertainty is the challenge in evaluating the past cover of the genus owing to its poorly dispersed pollen; another is that a multi-site study would be required to trace subregional differences. To overcome these obstacles, we here apply two different analytical methods to pollen data from 42 sites in two distinct vegetation zones of Sweden. Location: Temperate and hemi-boreal vegetation zones of southern Sweden. Methods: Generalized additive mixed models (GAMM) were used to model the development of Tilia and cereal pollen percentages over time. Twelve sites were used for reconstruction of local cover of Tilia using the landscape reconstruction algorithm (LRA). Results: Before 4000 cal. bp the Tilia mean pollen percentages were similar in the two vegetation zones. Thereafter, values in the hemi-boreal zone declined, with less Tilia since around 3000 cal. bp. In contrast, Tilia did not decrease in the temperate zone until this past millennium. The LRA application revealed that in some forests a large cover of Tilia remained considerably longer than has traditionally been estimated by pollen percentages alone. Main conclusions: By using a large coherent dataset we found significant differences in how the abundance and distribution of Tilia changed through time between two adjacent vegetation zones. We interpret the initial decline in the northern hemi-boreal zone to be driven by cooling climate, and the later decline in the southern temperate zone to be driven more by human land-use.
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| 4. |
- Källberg, Eva, et al.
(författare)
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S100A9 Interaction with TLR4 Promotes Tumor Growth
- 2012
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Ingår i: PLOS ONE. - San Francisco : Public Library of Science. - 1932-6203. ; 7:3, s. e34207-
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Tidskriftsartikel (refereegranskat)abstract
- By breeding TRAMP mice with S100A9 knock-out (S100A9(-/-)) animals and scoring the appearance of palpable tumors we observed a delayed tumor growth in animals devoid of S100A9 expression. CD11b(+) S100A9 expressing cells were not observed in normal prostate tissue from control C57BL/6 mice but were readily detected in TRAMP prostate tumors. Also, S100A9 expression was observed in association with CD68(+) macrophages in biopsies from human prostate tumors. Delayed growth of TRAMP tumors was also observed in mice lacking the S100A9 ligand TLR4. In the EL-4 lymphoma model tumor growth inhibition was observed in S100A9(-/-) and TLR4(-/-), but not in RAGE(-/-) animals lacking an alternative S100A9 receptor. When expression of immune-regulating genes was analyzed using RT-PCR the only common change observed in mice lacking S100A9 and TLR4 was a down-regulation of TGF beta expression in splenic CD11b(+) cells. Lastly, treatment of mice with a small molecule (ABR-215050) that inhibits S100A9 binding to TLR4 inhibited EL4 tumor growth. Thus, S100A9 and TLR4 appear to be involved in promoting tumor growth in two different tumor models and pharmacological inhibition of S100A9-TLR4 interactions is a novel and promising target for anti-tumor therapies.
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| 5. |
- Reepalu, Anton, et al.
(författare)
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Development of an algorithm for determination of the likelihood of virological failure in HIV-positive adults receiving antiretroviral therapy in decentralized care
- 2017
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Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 10:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Early identification of virological failure (VF) limits occurrence and spread of drug-resistant viruses in patients receiving antiretroviral treatment (ART). Viral load (VL) monitoring is therefore recommended, but capacities to comply with this are insufficient in many low-income countries. Clinical algorithms might identify persons at higher likelihood of VF to allocate VL resources. Objectives: We aimed to construct a VF algorithm (the Viral Load Testing Criteria; VLTC) and compare its performance to the 2013 WHO treatment failure criteria. Methods: Subjects with VL results available 1 year after ART start (n = 494) were identified from a cohort of ART-naïve adults (n = 812), prospectively recruited and followed 2011-2015 at Ethiopian health centres. VF was defined as VL≥1000 copies/mL. Variables recorded at the time of sampling, with potential association with VF, were used to construct the algorithm based on multivariate logistic regression. Results: Fifty-seven individuals (12%) had VF, which was independently associated with CD4 count <350 cells/mm3, previous ART interruption, and short mid-upper arm circumference (<24cm and <23cm, for men and women, respectively). These variables were included in the VLTC. In derivation, the VLTC identified 52/57 with VF; sensitivity 91%, specificity 43%, positive predictive value (PPV) 17%, negative predictive value (NPV) 97%. In comparison, the WHO criteria identified 38/57 with VF (sensitivity 67%, specificity 74%, PPV 25%, NPV 94%). Conclusions: The VLTC identified subjects at greater likelihood of VF, with higher sensitivity and NPV than the WHO criteria. If external validation confirms this performance, these criteria could be used to allocate limited VL resources. Due to its limited specificity, it cannot be used to determine treatment failure in the absence of a confirmatory viral load.
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| 6. |
- Tesfaye, Fregenet, et al.
(författare)
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Alternative biomarkers for classification of latent tuberculosis infection status in pregnant women with borderline Quantiferon plus results
- 2020
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Ingår i: Tuberculosis. - : Elsevier BV. - 1472-9792. ; 124
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Tidskriftsartikel (refereegranskat)abstract
- Borderline interferon-gamma (IFN-γ) results (near the cut-off level 0.35 IU/ml) occur in QuantiFERON (QFT) assays. We investigated the performance of alternative biomarkers for classification of latent tuberculosis infection (LTBI) status in pregnant women with borderline QFT IFN-γ responses. Pregnant women (n = 96) were identified from a cohort study in Ethiopia, based on QFT-Plus IFN-γ results (QFT-low: <0.20 IU/ml, n = 33; QFT-borderline: 0.20–0.70 IU/ml, n = 31; QFT-high: >0.70 IU/ml, n = 32), including 12 HIV-positive individuals in each group and with 20 HIV-negative non-pregnant women from the same cohort with QFT IFN-γ <0.20 IU/ml as controls. Concentrations of 8 markers (IL-1ra, IL-6, IL-8, IP-10, MCP-1, MCP-2, osteopontin and resistin) were measured in whole blood QFT supernatants, stimulated separately with TB1 and TB2 antigens. K-nearest neighbor analysis (KNN) was used to classify participants with regard to likelihood of LTBI. Concentrations of MCP-2, IP-10 and IL-1ra were higher in QFT-borderline compared to QFT-low participants in both antigen stimulations (p < 0.001). KNN classification indicated high likelihood of LTBI in 13/31 (42%) women with QFT-borderline IFN-γ results. MCP-2, IP-10 and IL-1ra expressed in whole blood after TB antigen stimulation may be considered as alternative biomarkers for classification of LTBI status in pregnant women with borderline QFT IFN-γ results.
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| 7. |
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31 recommendations for increased profit - reducing waste
- 2010
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Those companies and organizations that wish to ensure long-term profitability must successively decrease resource use in both product development and in product usage. Primarily, it is waste that must be reduced, i.e. the consumption of resources that do not add to customer value or to the organization. Waste is widespread in all operations. Even in well-functioning processes, more than half of the resource consumption can be classified as waste. One obstacle to waste elimination is that most waste is hidden. Thus, executives, middle management and specialists must prioritize efforts to uncover the waste in their operations.Building and construction activities consist of a complex system of decisions, components, organizations and processes that must be coordinated. There are therefore many explanations as to why waste arises, or does not. Based on a series of discussions with experienced builders, consultants, contractors and materials providers, five main groups of factors that characterize effective operations were found. In this report these factors are illustrated in the form of a “value pyramid”. A holistic view of long-term customer benefits is the apex of the pyramid. Structure, competence, leadership and culture act as the driving forces at each corner of the pyramid’s foundation. Should one of the corners gives way, then the pyramid risks toppling over.With the value pyramid as support, 31 recommendations for what should be done to reduce waste are presented. These are aimed at standardizing the product from an overall perspective (five recommendations), defining and standardizing processes (ten recommendations), developing the organization and its competence (seven recommendations), disciplining management (five recommendations), and driving continuous improvement work (four recommendations). Reducing uncertainties and increasing effective time utilization are the red threads, as the Swedes would say, that run through all the recommendations.Everyone who uses resources has a responsibility to reduce waste. By systematically monitoring one’s own use of time, one can gain insights that will help improve one’s work situation. However, the burden of initiating and driving improvements overall obviously lies with management. How this should be done depends on the nature and purpose of the activities as well as on the organization’s capabilities. It is to manage this progress and achieve profitability that managers are appointed. It is in the interest of all enterprises and organizations to develop the ability and an interest to detect and understand what work/task is value adding what is not. This ability will provide possibilities to develop new competitive advantages and new business concepts.
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| 8. |
- Adman, Per, 1970-
(författare)
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Arbetslöshet, arbetsplatsdemokrati och politiskt deltagande
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The purpose of this thesis is to test two hypotheses about how work affects political participation. The first concerns unemployment, and states that unemployment has strong and negative effects on political activity. The second hypothesis is found in theories of participatory democracy, and claims that more democratic workplaces lead to more political participation. Existing empirical evidence on both of the hypotheses is not conclusive. Furthermore, studies have mainly been carried out using data collected in the United States. Here empirical tests of the hypotheses are undertaken using a Swedish survey.The results confirm the first hypothesis; unemployment has negative effects on political participation. The reasons for these negative effects are that the unemployed become less active in organisational life, fall outside of the recruitment networks where people are being asked to participate in politics, and experience a decrease in income. The second hypothesis is not supported. Workplace participation does not affect political participation, according to the analyses. The results are surprising for both hypotheses, and contradict previous empirical findings. The differences in results are likely due to differences in research design and differences in approaches to analysing political participation. Previous studies are inadequate in these perspectives, it is maintained.The thesis ends with a discussion of the results from the perspective of normative democratic theory. It is argued that the lack of political equality is particularly acute when the low participation among the unemployed is considered.
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| 9. |
- Ahlgren, Bengt, et al.
(författare)
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Integrated layer processing can be hazardous to your performance
- 1997. - 1
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Konferensbidrag (refereegranskat)abstract
- Integrated Layer Processing (ILP) has been presented as an implementation technique to improve communication protocol performance by reducing the number of memory references. Previous research has however not pointed out that in some circumstances ILP can significantly increase the number of memory references, resulting in lower communication throughput. We explore the performance effects of applying ILP to data manipulation functions with varying characteristics. The functions are generated from a set of parameters including input and output block size, state size and number of instructions. We present experimental data for varying function state sizes, number of integrated functions and instruction counts. The results clearly show that the aggregated state of the functions must fit in registers for ILP to be competitive.
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| 10. |
- Ahlgren, Bengt, et al.
(författare)
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The applicability of integrated layer processing
- 1998. - 4
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Ingår i: IEEE Journal on Selected Areas in Communications. ; 16:3, s. 317-331
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Tidskriftsartikel (refereegranskat)abstract
- In this paper we review previous work on the applicability and performance of Integrated Layer Processing (ILP). ILP has been shown to clearly improve computer communication performance when integrating simple data manipulation functions, but the situation has been less clear for more complex functions and complete systems. We discuss complications when applying ILP to protocol stacks, the requirements of ILP on the communication subsystem, caching aspects, the importance of the processor registers, and a model for predicting the performance of data manipulation functions. We conclude that the main drawback of ILP is its limited aplicability to complex data manipulation functions. The performance to expect from an ILP implementation also depends heavily on the protocol architecture and the host system architecture.
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| 11. |
- Ahlgren, Bengt, et al.
(författare)
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The applicability of integrated layer processing
- 1998
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Ingår i: IEEE Journal on Selected Areas in Communications. - : Institute of Electrical and Electronics Engineers (IEEE). - 0733-8716 .- 1558-0008. ; 16:3, s. 317-331
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Tidskriftsartikel (refereegranskat)abstract
- In this paper, we review previous work on the applicability and performance of integrated layer processing (ILP). ILP has been shown to clearly improve computer communication performance when integrating simple data manipulation functions, but the situati
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| 12. |
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| 13. |
- Ahlgren, Bengt, et al.
(författare)
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Towards predictable ILP performance-controlling communication buffer cache effects
- 1996. - 4
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Ingår i: The Australian Computer Journal. ; 28, s. 66-71
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Tidskriftsartikel (refereegranskat)abstract
- Cache memory behavior is becoming more and more important as the speed of CPUs is increasing faster than the speed of memories. The operation of caches are statistical which means that the system level performance becomes unpredictable. In this paper we investigate the worst case behavior of cache line conflicts in the context of communication protocols implemented using Integrated Layer Processing. The goal of our work is to control the cache by placing communication buffers and code in non-conflicting positions in the cache. The result would be higher and more predictable performance. Our first results indicate that the worst case behavior can be up to almost four times slower than the best case.
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| 14. |
- Ahlgren, Bengt, et al.
(författare)
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Towards predictable ILP performance controlling communication buffer cache effects
- 1996
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Ingår i: Australian Computer Journal. - 0004-8917. ; 28:2, s. 66-71
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Tidskriftsartikel (refereegranskat)abstract
- Cache memory behaviour is becoming more and more important as the speed of CPUs is increasing faster than the speed of memories. The operation of caches are statistical which means that the system level performance becomes unpredictable. In this paper we
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| 15. |
- ALANKO BLOMÉ, MARIANNE, et al.
(författare)
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Minimal transmission of HIV despite persistently high transmission of hepatitis C virus in a Swedish needle exchange program.
- 2011
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Ingår i: Journal of Viral Hepatitis. - : Wiley. - 1365-2893 .- 1352-0504. ; 18, s. 831-839
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Tidskriftsartikel (refereegranskat)abstract
- Summary. The aim of this study was to examine the prevalence and incidence of HIV and hepatitis B and C (HBV and HCV) among injecting drug users in a Swedish needle exchange programme (NEP) and to identify risk factors for blood-borne transmission. A series of serum samples from NEP participants enrolled from 1997 to 2005 were tested for markers of HIV, HBV and HCV (including retrospective testing for HCV RNA in the last anti-HCV-negative sample from each anti-HCV seroconverter). Prevalence and incidence were correlated with self-reported baseline characteristics. Among 831 participants available for follow-up, one was HIV positive at baseline and two seroconverted to anti-HIV during the follow-up of 2433 HIV-negative person-years [incidence 0.08 per 100 person-years at risk (pyr); compared to 0.0 in a previous assessment of the same NEP covering 1990-1993]. The corresponding values for HBV were 3.4/100 pyr (1990-1993: 11.7) and for HCV 38.3/100 pyr (1990-1993: 27.3). HCV seroconversions occurred mostly during the first year after NEP enrolment. Of the 332 cases testing anti-HCV negative at enrolment, 37 were positive for HCV RNA in the same baseline sample (adjusted HCV incidence 31.5/100 pyr). HCV seroconversion during follow-up was significantly associated with mixed injection use of amphetamine and heroin, and a history of incarceration at baseline. In this NEP setting, HIV prevalence and incidence remained low and HBV incidence declined because of vaccination, but transmission of HCV was persistently high. HCV RNA testing in anti-HCV-negative NEP participants led to more accurate identification of timepoints for transmission.
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| 16. |
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| 17. |
- Alaridah, Nader, et al.
(författare)
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Impaired CXCR1-dependent oxidative defence in active tuberculosis patients.
- 2015
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Ingår i: Tuberculosis. - : Elsevier BV. - 1873-281X .- 1472-9792. ; 95:6, s. 744-750
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Tidskriftsartikel (refereegranskat)abstract
- Much of the pronounced host inflammatory response that occurs in tuberculosis (TB) is related to failed immunity against the invading pathogen. The G-protein coupled receptors CXCR1 and CXCR2 are implicated in important signal transduction pathways in lung inflammatory responses. We investigated the expression and function of these receptors in a simple whole blood model from 24 patients with pulmonary TB and in subjects with latent TB infection (LTBI). Healthy controls were recruited from close contacts to the pulmonary index patients. We found that pulmonary TB patients had significantly increased CXCR1 expression on blood cells compared to LTBI subjects and controls (p < 0.001). In contrast, LTBI subjects had a significant increase in CXCR2 expression compared to pulmonary TB patients (p < 0.001) and controls (p < 0.01). Leukocyte function, measured as oxidative capacity, was decreased in pulmonary TB patients compared to LTBI and controls (p < 0.001) and correlated with the increased CXCR1 expression. Leukocyte recruitment, measured as the expression of microRNA-223 was increased in pulmonary TB patients compared to LTBI (p < 0.05). We found that variations in receptor expression are linked to disease progression and affect the immune response against Mycobacterium tuberculosis (Mtb).
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| 18. |
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| 19. |
- Arimide, Dawit Assefa, et al.
(författare)
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High Level of HIV Drug Resistance and Virologic Nonsuppression among Female Sex Workers in Ethiopia : A Nationwide Cross-Sectional Study
- 2022
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Ingår i: Journal of Acquired Immune Deficiency Syndromes. - 1525-4135. ; 89:5, s. 566-574
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Tidskriftsartikel (refereegranskat)abstract
- Objective:To determine viral load (VL) nonsuppression (VLN) rates, HIV drug resistance (HIVDR) prevalence, and associated factors among female sex workers (FSWs) in Ethiopia.Methods:A cross-sectional biobehavioral survey was conducted among FSWs in 11 cities in Ethiopia in 2014. Whole blood was collected, and HIVDR genotyping was performed. Logistic regression analysis was performed to identify factors associated with VLN and HIVDR.Results:Among 4900 participants, 1172 (23.9%) were HIV-positive and 1154 (98.5%) had a VL result. Participants were categorized into antiretroviral therapy (ART) (n = 239) and ART-naive (n = 915) groups based on self-report. From the 521 specimens (ART, 59; ART-naive, 462) with VL ≥1000 copies/mL, genotyping was successful for 420 (80.6%) and 92 (21.9%) had drug resistance mutations (DRMs). Pretreatment drug resistance (PDR) was detected in 16.5% (63/381) of the ART-naive participants. Nucleoside reverse transcriptase inhibitor (NRTI), non-NRTIs (NNRTIs), and dual-class DRMs were detected in 40 (10.5%), 55 (14.4%), and 35 (9.2%) of the participants, respectively. Among 239 participants on ART, 59 (24.7%) had VLN. Genotyping was successfully performed for 39 (66.1%). DRMs were detected in 29 (74.4%). All 29 had NNRTI, 23 (79.3%) had NRTI or dual-class DRMs. VLN was associated with age 35 years or older, CD4+T-cell count <350 cells/mm3, and being forced into selling sex. PDR and acquired drug resistance were associated with CD4+T-cell count <350 cells/mm3(P < 0.001).Conclusions:The high VLN and HIVDR rates among FSWs underscore the need for targeted interventions to improve ART access and virologic monitoring to maximize the benefit of ART and limit the spread of HIV and HIVDR.
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| 20. |
- Arimide, Dawit Assefa, et al.
(författare)
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HIV-genetic diversity and drug resistance transmission clusters in Gondar, Northern Ethiopia, 2003-2013
- 2018
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 13:10
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Tidskriftsartikel (refereegranskat)abstract
- Background The HIV-1 epidemic in Ethiopia has been shown to be dominated by two phylogenetically distinct subtype C clades, the Ethiopian (C'-ET) and East African (C-EA) clades, however, little is known about the temporal dynamics of the HIV epidemic with respect to subtypes and distinct clades. Moreover, there is only limited information concerning transmission of HIV-1 drug resistance (TDR) in the country. Methods A cross-sectional survey was conducted among young antiretroviral therapy (ART)-naïve individuals recently diagnosed with HIV infection, in Gondar, Ethiopia, 2011-2013 using the WHO recommended threshold survey. A total of 84 study participants with a median age of 22 years were enrolled. HIV-1 genotyping was performed and investigated for drug resistance in 67 individuals. Phylogenetic analyses were performed on all available HIV sequences obtained from Gondar (n = 301) which were used to define subtype C clades, temporal trends and local transmission clusters. Dating of transmission clusters was performed using BEAST. Result Four of 67 individuals (6.0%) carried a HIV drug resistance mutation strain, all associated with non-nucleoside reverse transcriptase inhibitors (NNRTI). Strains of the C-EA clade were most prevalent as we found no evidence of temporal changes during this time period. However, strains of the C-SA clade, prevalent in Southern Africa, have been introduced in Ethiopia, and became more abundant during the study period. The oldest Gondar transmission clusters dated back to 1980 (C-EA), 1983 (C-SA) and 1990 (C'-ET) indicating the presence of strains of different subtype C clades at about the same time point in Gondar. Moreover, some of the larger clusters dated back to the 1980s but transmissions within clusters have been ongoing up till end of the study period. Besides being associated with more sequences and larger clusters, the C-EA clade sequences were also associated with clustering of HIVDR sequences. One cluster was associated with the G190A mutation and showed onward transmissions at high rate. Conclusion TDR was detected in 6.0% of the sequenced samples and confirmed pervious reports that the two subtype C clades, C-EA and C'-ET, are common in Ethiopia. Moreover, the findings indicated an increased diversity in the epidemic as well as differences in transmission clusters sizes of the different clades and association with resistance mutations. These findings provide epidemiological insights not directly available using standard surveillance and may inform the adjustment of public health strategies in HIV prevention in Ethiopia.
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| 21. |
- Arimide, Dawit Assefa, et al.
(författare)
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Molecular Epidemiology and Transmission Dynamics of the HIV-1 Epidemic in Ethiopia : Epidemic Decline Coincided With Behavioral Interventions Before ART Scale-Up
- 2022
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Ingår i: Frontiers in Microbiology. - : Frontiers Media SA. - 1664-302X. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Background: Ethiopia is one of the sub-Saharan countries hit hard by the HIV epidemic. Previous studies have shown that subtype C dominates the Ethiopian HIV-1 epidemic, but the evolutionary and temporal dynamics of HIV-1 in Ethiopia have not been closely scrutinized. Understanding the evolutionary and epidemiological pattern of HIV is vital to monitor the spread, evaluate and implement HIV prevention strategies. Methods: We analyzed 1,276 Ethiopian HIV-1 subtype C polymerase (pol sequences), including 144 newly generated sequences, collected from different parts of the country from 1986 to 2017. We employed state-of-art maximum likelihood and Bayesian phylodynamic analyses to comprehensively describe the evolutionary dynamics of the HIV-1 epidemic in Ethiopia. We used Bayesian phylodynamic models to estimate the dynamics of the effective population size (Ne) and reproductive numbers (Re) through time for the HIV epidemic in Ethiopia. Results: Our analysis revealed that the Ethiopian HIV-1 epidemic originated from two independent introductions at the beginning of the 1970s and 1980s from eastern and southern African countries, respectively, followed by epidemic growth reaching its maximum in the early 1990s. We identified three large clusters with a majority of Ethiopian sequences. Phylodynamic analyses revealed that all three clusters were characterized by high transmission rates during the early epidemic, followed by a decline in HIV-1 transmissions after 1990. Re was high (4–6) during the earlier time of the epidemic but dropped significantly and remained low (Re < 1) after the mid-1990. Similarly, with an expected shift in time, the effective population size (Ne) steadily increased until the beginning of 2000, followed by a decline and stabilization until recent years. The phylodynamic analyses corroborated the modeled UNAIDS incidence and prevalence estimates. Conclusion: The rapid decline in the HIV epidemic took place a decade before introducing antiretroviral therapy in Ethiopia and coincided with early behavioral, preventive, and awareness interventions implemented in the country. Our findings highlight the importance of behavioral interventions and antiretroviral therapy scale-up to halt and maintain HIV transmissions at low levels (Re < 1). The phylodynamic analyses provide epidemiological insights not directly available using standard surveillance and may inform the adjustment of public health strategies in HIV prevention in Ethiopia.
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| 22. |
- Arimide, Dawit Assefa, et al.
(författare)
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Pre-Treatment Integrase Inhibitor Resistance and Natural Polymorphisms among HIV-1 Subtype C Infected Patients in Ethiopia
- 2022
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Ingår i: Viruses. - : MDPI AG. - 1999-4915. ; 14:4
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Tidskriftsartikel (refereegranskat)abstract
- Dolutegravir-based antiretroviral therapy (ART) has been scaled up in many developing countries, including Ethiopia. However, subtype-dependent polymorphic differences might influence the occurrence of HIV-drug-resistance mutations (HIVDRMs). We analyzed the prevalence of pre-treatment integrase strand transfer inhibitor (INSTI) HIVDRMs and naturally occurring polymorphisms (NOPs) of the integrase gene, using plasma samples collected as part of the national HIVDR survey in Ethiopia in 2017. We included a total of 460 HIV-1 integrase gene sequences from INSTI-naïve (n = 373 ART-naïve and n = 87 ART-experienced) patients. No dolutegravir-associated HIVDRMs were detected, regardless of previous exposure to ART. However, we found E92G in one ART-naïve patient specimen and accessory mutations in 20/460 (4.3%) of the specimens. Moreover, among the 288 integrase amino acid positions of the subtype C, 187/288 (64.9%) were conserved (<1.0% variability). Analysis of the genetic barrier showed that the Q148H/K/R dolutegravir resistance pathway was less selected in subtype C. Docking analysis of the dolutegravir showed that protease-and reverse-transcriptase-associated HIVDRMs did not affect the native structure of the HIV-1 integrase. Our results support the implementation of a wide scale-up of dolutegravir-based regimes. However, the detection of polymorphisms contributing to INSTI warrants the continuous surveillance of INSTI resistance.
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| 23. |
- Artin, Ingrid, et al.
(författare)
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First case of type E wound botulism diagnosed using real-time PCR.
- 2007
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Ingår i: Journal of Clinical Microbiology. - 1098-660X. ; 45:11, s. 3589-3594
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Tidskriftsartikel (refereegranskat)abstract
- Wound botulism is a growing problem among injecting drug users. The condition is often difficult to diagnose, with laboratory confirmation in only 50% of the cases. Here we present a real-time PCR-based method for the diagnosis of wound botulism caused by Clostridium botulinum. The assay includes an internal amplification control which is amplified simultaneously with the genes encoding neurotoxin types A, B, and E. This method was used to detect the first case of wound botulism in an injecting drug user in Sweden. In addition, to the best of our knowledge, this is the first reported case of wound botulism caused by C. botulinum type E.
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| 24. |
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| 25. |
- Balcha, Taye, et al.
(författare)
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Detection of lipoarabinomannan in urine for identification of active tuberculosis among HIV-positive adults in Ethiopian health centres
- 2014
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Ingår i: Tropical medicine & international health. - : Wiley. - 1360-2276 .- 1365-3156. ; 19:6, s. 734-742
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo assess the diagnostic performance of urine lipoarabinomannan (LAM) detection for TB screening in HIV-positive adults in Ethiopia. MethodsTesting for LAM was performed using the Determine TB-LAM lateral flow assay on urine samples from participants in a prospective cohort with baseline bacteriological categorisation for active TB in sputum. Characteristics of TB patients with regard to LAM status were determined. Participants were followed for 6months to evaluate survival, retention in care and incident TB. ResultsPositive LAM results were found in 78/757 participants. Among 128 subjects with definite (confirmed by culture and/or Xpert MTB/RIF) TB, 33 were LAM-positive (25.8%); the respective figure for clinically diagnosed cases was 2/20 (10%). Five of the remaining 43 LAM-positive individuals had died during the 6-month follow-up period, whereas 38 remained in care without clinical signs of TB. The overall sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 25.8%, 92.9%, 42.3% and 86.0%, respectively. Among TB patients, LAM positivity was associated with higher WHO clinical stage, lower body mass index (BMI), CD4 cell and haemoglobin levels, and with increased mortality. A combination algorithm of urine LAM testing and sputum smear microscopy detected 49 (38.2%) of definite TB cases; among those with CD4 count 100cells/mm(3), this proportion was 66.7%. ConclusionsThe performance of urine LAM testing for TB detection was poor in this population. However, this was improved among subjects with CD4 count 100cells/mm(3). In combination with sputum microscopy urine, LAM could be considered for targeted TB screening in this subgroup.
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