MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'The Lancet Infectious Diseases' source. Wed, 08 Feb 2012 18:15:53 +0100 http://www.medworm.com/index.php?rid=5630026&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970244-4%2Fabstract%3Frss%3Dyes We present the case of a 26-year-old HIV-seronegative patient with XDR pulmonary tuberculosis refractory to medical therapy. Surgical resection of the patient's solitary cavitary lesion was done as adjunctive treatment, and a successful outcome with a combination of surgery and drug therapy was achieved. We review the history of surgical therapy for tuberculosis and reports of its role in treatment of MDR and XDR tuberculosis. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5630026 Thu, 26 Jan 2012 23:05:13 +0100 5630026 http://www.medworm.com/index.php?rid=5630025&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970287-0%2Fabstract%3Frss%3Dyes Crowds are a feature of large cities, occurring not only at mass gatherings but also at routine events such as the journey to work. To address extreme crowding, various computer models for crowd movement have been developed in the past decade, and we review these and show how they can be used to identify health and safety issues. State-of-the-art models that simulate the spread of epidemics operate on a population level, but the collection of fine-scale data might enable the development of models for epidemics that operate on a microscopic scale, similar to models for crowd movement. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5630025 Thu, 26 Jan 2012 23:05:13 +0100 5630025 http://www.medworm.com/index.php?rid=5630024&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970293-6%2Fabstract%3Frss%3Dyes Mass gatherings (MGs) have been associated with high rates of morbidity and mortality from non-communicable diseases, accidents, and terrorist attacks, thus posing complex public health challenges. We assessed the health risks and public health responses to MGs to identify an evidence-based framework for public health interventions. Human stampedes and heat-related illnesses are the leading causes of mortality. Minor traumatic injuries and medical complaints are the main contributors to morbidity and, particularly, the need for onsite medical care. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5630024 Thu, 26 Jan 2012 23:05:13 +0100 5630024 http://www.medworm.com/index.php?rid=5630023&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970253-5%2Fabstract%3Frss%3Dyes Introduction of effective and available rotavirus vaccines could substantially affect worldwide deaths attributable to diarrhoea. Our new estimates can be used to advocate for rotavirus vaccine introduction and to monitor the effect of vaccination on mortality once introduced. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5630023 Thu, 26 Jan 2012 23:05:13 +0100 5630023 http://www.medworm.com/index.php?rid=5630022&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970190-6%2Fabstract%3Frss%3Dyes Supplemental mOPV1 resulted in almost total seroprevalence against poliovirus type 1, which is consistent with recent absence of poliomyelitis cases; whereas seroprevalence against types 2 and 3 was expected for routine vaccination histories. The immunogenicity of IPV produced in India (Panacea) was similar to that of an internationally manufactured IPV (GSK). Intradermal IPV was less immunogenic. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5630022 Thu, 26 Jan 2012 23:05:13 +0100 5630022 http://www.medworm.com/index.php?rid=5630021&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970248-1%2Fabstract%3Frss%3Dyes A substantial improvement in viral load suppression and accompanying decrease in the rates of AIDS in people after extensive failure to drugs from the three original antiretroviral classes during 2000–09 was probably mainly driven by availability of newer drugs with better tolerability and ease of use and small cross-resistance profiles, suggesting the public health benefit of the introduction of new drugs. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5630021 Thu, 26 Jan 2012 23:05:13 +0100 5630021 http://www.medworm.com/index.php?rid=5630020&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970290-0%2Fabstract%3Frss%3Dyes Dolutegravir was effective when given once daily without a pharmacokinetic booster and was well tolerated at all assessed doses. Our findings support the assessment of once daily 50 mg dolutegravir in phase 3 trials. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5630020 Thu, 26 Jan 2012 23:05:13 +0100 5630020 http://www.medworm.com/index.php?rid=5630019&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2812%2970027-0%2Ffulltext%3Frss%3Dyes We are introduced to a postsurgery ward in an American hospital, to which a healthy young female student has been admitted after an appendectomy. She acquires an intravenous-line-associated infection caused by meticillin-resistant Staphylococcus aureus (MRSA) and dies. The video then retraces the choices and actions of five individuals on the ward who collectively and unwittingly facilitated this outcome. These people include a family member of another patient with MRSA, the physician manager of the ward responsible for implementing and leading safety initiatives, the infection control practitioner providing support for the ward, a third-year medical student, and a registered nurse. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5630019 Thu, 26 Jan 2012 23:05:13 +0100 5630019 http://www.medworm.com/index.php?rid=5630018&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2812%2970026-9%2Ffulltext%3Frss%3Dyes Vaccines based on human adenovirus 5 (Ad5) induce protective immune responses against several pathogens in animal models, but the neutralising antibodies to Ad5 that most people make are likely to impair the immunological potency of such vaccines. To circumvent this potential problem, researchers have isolated more than 1000 chimpanzee adenovirus strains. Vaccine vectors derived from some of these viruses induce potent cellular immunity in mice. Moreover, in a phase 1 clinical trial, a chimpanzee adenovirus-based vector expressing non-structural hepatitis C virus (HCV) proteins induced broad, sustained T-cell responses to HCV. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5630018 Thu, 26 Jan 2012 23:05:13 +0100 5630018 http://www.medworm.com/index.php?rid=5630017&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2812%2970025-7%2Ffulltext%3Frss%3Dyes Health officials in the Philippines have reported 128 confirmed and 200 suspected cases of leptospirosis. Many of the infections are likely to have arisen through contact with flood waters after heavy rains brought by tropical storm Washi in mid-December. The areas most affected by the leptospirosis outbreak, Iligan and Cagayan de Oro in the south of the country, were also the areas hardest hit by the floods. The outbreak has claimed the lives of four people so far. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5630017 Thu, 26 Jan 2012 23:05:13 +0100 5630017 http://www.medworm.com/index.php?rid=5630016&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2812%2970024-5%2Ffulltext%3Frss%3Dyes In a deal struck with WHO, Gilead Sciences have agreed to donate 445 000 vials of liposomal amphotericin B—used to treat visceral leishmaniasis and marketed under the brand name AmBisome—over the next 5 years. The donation is expected to reach some 50 000 patients during this time. “This initiative will greatly enhance access to AmBisome”, commented WHO's Jorge Alvar. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5630016 Thu, 26 Jan 2012 23:05:13 +0100 5630016 http://www.medworm.com/index.php?rid=5630015&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2812%2970023-3%2Ffulltext%3Frss%3Dyes As part of a drive to increase transparency across Australian hospitals, the Australian Federal Government, on October 27, 2011, announced rates of Staphylococcus aureus bacteraemia (SAB) to the public for the first time. Nicola Roxon, then Minister for Health and Ageing, said that “the publication of infection rates caused by these potentially deadly bacteria will drive improved hospital performance”. The announcement covered 450 hospitals, including all public hospitals and any private hospitals that elected to be included. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5630015 Thu, 26 Jan 2012 23:05:13 +0100 5630015 http://www.medworm.com/index.php?rid=5630014&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970356-5%2Ffulltext%3Frss%3Dyes In response to yearly increases in Escherichia coli bacteraemia, the UK Department of Health recently launched mandatory E coli bacteraemia surveillance. Before starting this programme, the Department of Health should have reviewed historical data and contacted units, such as the Barking, Havering & Redbridge University Hospitals NHS Trust (BHRUT), that undertake bacteraemia surveillance. We have, therefore, pre-empted the surveillance findings and estimated the proportion of preventable E coli bacteraemias. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5630014 Thu, 26 Jan 2012 23:05:13 +0100 5630014 http://www.medworm.com/index.php?rid=5630013&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970352-8%2Ffulltext%3Frss%3Dyes We were intrigued by Edoardo Tartaglia and colleagues' use of a small sample of human papillomavirus (HPV) typing data of unknown representativeness to scrutinise the decline in genital warts reported in Australia after HPV vaccination. They suggest that the decline could be less than anticipated by international data because genital warts in Australia might be caused predominantly by non-HPV vaccine types, implying that the cause of genital warts in Australia could be different to that in every other country studied. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5630013 Thu, 26 Jan 2012 23:05:13 +0100 5630013 http://www.medworm.com/index.php?rid=5630012&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970369-3%2Ffulltext%3Frss%3Dyes Martina Bielaszewska and colleagues characterised the Shiga-toxin-producing Escherichia coli (STEC) O104:H4 outbreak strain, which has been reported to cause gastroenteritis and haemolytic uraemic syndrome. They used a diagnostic protocol recommended by the Robert Koch Institute. Broth enrichment of faecal samples was followed by Shiga-toxin immunoassay or PCR to detect the genes encoding Shiga toxin (Stx) and other virulence factors, and microbiological culture was used as the gold standard. In our laboratory, we processed 754 faecal samples from 481 patients that were sent from affiliated hospitals and private practices in Bremen and Lower Saxony during the outbreak from May 23, to June 10, 2011. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5630012 Thu, 26 Jan 2012 23:05:13 +0100 5630012 http://www.medworm.com/index.php?rid=5630011&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970372-3%2Ffulltext%3Frss%3Dyes We thank the three correspondents for their responses to our Article. Badrul Hasan and colleagues identified extended-spectrum β-lactamases (ESBLs) in faecal samples from wild birds; although the samples were negative for blaNDM-1, the gene might have been missed because the forward NDM-1 primer at position 123 is in fact a reverse primer at position 691–673 and the reverse primer is a forward primer at position 533–549, resulting in a PCR product of only 150 base pairs. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5630011 Thu, 26 Jan 2012 23:05:13 +0100 5630011 http://www.medworm.com/index.php?rid=5630010&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970334-6%2Ffulltext%3Frss%3Dyes I read the Article by Timothy Walsh and colleagues regarding environmental dissemination of NDM-1 in New Delhi with interest. In the research in context panel of the Article, the researchers state that none of the studies of carbapenemases that they found had examined waste material or drinking water. However, Quinteira and Peixe reported isolation of blaVIM-2 from sewage (24 isolates), rivers (17 isolates), pig faeces (seven isolates), ambulatory patients (seven isolates), and a healthy person from Portugal, and emphasised the importance of surveying environmental strains that might act as a source or reservoir of resistance genes with clinical relevance. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5630010 Thu, 26 Jan 2012 23:05:13 +0100 5630010 http://www.medworm.com/index.php?rid=5630007&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2812%2970022-1%2Ffulltext%3Frss%3Dyes Heffron R, Donnell D, Rees H, et al. Use of hormonal contraceptives and risk of HIV-1 transmission: a prospective cohort study. Lancet Infect Dis 2012; 12: 19–26—In table 5, the odds ratio (95% CI) and p value for detection of any genital HIV-1 RNA in HIV-1 positive women taking injectable contraceptives should have been 1·38 (1·05 to 1·81) and 0·05 and for those taking oral contraceptives 0·98 (0·63 to 1·52) and 0·43. This correction has been made to the online version as of Jan 23, 2012. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5630007 Thu, 26 Jan 2012 23:05:13 +0100 5630007 http://www.medworm.com/index.php?rid=5630005&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970354-1%2Ffulltext%3Frss%3Dyes We are entering a new phase in the strategic use of antiretroviral drugs. In addition to dramatically reducing HIV/AIDS-related morbidity and mortality, these drugs have recently shown an important effect in reducing HIV incidence and transmission. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5630005 Thu, 26 Jan 2012 23:05:12 +0100 5630005 http://www.medworm.com/index.php?rid=5630004&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970349-8%2Ffulltext%3Frss%3Dyes The field of infection control is devoted to reducing the spread of pathogens. Over the years, this endeavour has developed along two distinct lines. In resource-limited communities, as shown by Curtis and colleagues in their recent Review, simple hygienic measures can have a remarkable effect on decreasing transmission, although their implementation may be inconsistent. By contrast, modern high-tech hospitals, which occupy the opposite end of the resource spectrum, are ceaselessly haunted by a different set of transmissible pathogens, those that cause health-care-associated infection (HAI). (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5630004 Thu, 26 Jan 2012 23:05:12 +0100 5630004 http://www.medworm.com/index.php?rid=5630003&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970288-2%2Ffulltext%3Frss%3Dyes In The Lancet Infectious Diseases, Jacqueline Tate and colleagues assess more than 40 reports published between 2008 and 2011 and recent data from WHO-coordinated Global Surveillance Networks, which established the rate of rotavirus-associated acute gastroenteritis in children younger than 5 years who were admitted to hospital in various parts of the world. From these rates and the actual numbers of childhood deaths in different countries related to all causes of diarrhoea, Tate and colleagues obtained estimates of deaths associated with rotavirus disease. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5630003 Thu, 26 Jan 2012 23:05:12 +0100 5630003 http://www.medworm.com/index.php?rid=5630002&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970312-7%2Ffulltext%3Frss%3Dyes 2012 will mark the 24th year of WHO's Global Poliomyelitis Eradication Initiative. Eradication has proven more difficult than originally envisioned because of geopolitical events, such as war, social disruption, and political indifference; social and cultural issues, such as distrust of poliovirus vaccines and vaccinators; and the unanticipated emergence of virulent vaccine-derived polioviruses in many locations. Few of these obstacles have bewildered the scientific community as much as the low efficacy of the major weapon in the arsenal, trivalent oral polio vaccine (OPV) in regions with dense populations, high birthrates, and poor sanitation resulting from diarrhoea due to enteric pathogens, particularly rotaviruses, and perhaps nutritional deficiencies and other factors. (Source: The La... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5630002 Thu, 26 Jan 2012 23:05:12 +0100 5630002 http://www.medworm.com/index.php?rid=5630001&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970278-X%2Ffulltext%3Frss%3Dyes Antiretroviral therapy (ART) inhibits viral replication, allows for recovery of normal immune function, and prevents progression to AIDS in millions of people with HIV. However, if inhibition of viral replication is incomplete, the residual antiviral pressure will select for drug-resistant virus Although drug regimens are designed to prevent these outcomes, some people initiating ART since 1998 have acquired extensively drug-resistant HIV since the treatment's introduction 14 years ago. are reported from the Pursuing Later Treatment Options II (PLATO II) collaboration; this group analyses data from European cohorts to assess outcomes in people with HIV infection with a history of failure of drugs from the three main classes. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5630001 Thu, 26 Jan 2012 23:05:12 +0100 5630001 http://www.medworm.com/index.php?rid=5630000&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970291-2%2Ffulltext%3Frss%3Dyes Combination antiretroviral therapy (cART) has transformed the lives of people living with HIV. Studies suggest that treatment with cART might lead to the normal to near-normal life expectancy. Over the past decade our understanding of the toxic effects of cART has improved and new, convenient, seemingly less toxic, and more tolerable antiretroviral drugs in old and new classes have become available. Once or twice daily regimens—in particular fixed-dose once-daily combinations of two or three drugs—have simplified cART and made lifelong prescription far more acceptable. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5630000 Thu, 26 Jan 2012 23:05:12 +0100 5630000 http://www.medworm.com/index.php?rid=5629999&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2812%2970020-8%2Ffulltext%3Frss%3Dyes On Oct 25, 2011, Eli Lilly announced the voluntarily withdrawal from the market of drotrecogin alfa (activated), marketed as Xigris, a drug licensed for the treatment of severe sepsis. Drotrecogin alfa, a recombinant form of human activated protein C with anticoagulant and anti-inflammatory activity, was the only pharmaceutical available designed specifically to treat sepsis. Its withdrawal marks the end of another chapter in the inglorious history of the search for a specific treatment for sepsis. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5629999 Thu, 26 Jan 2012 23:05:11 +0100 5629999 http://www.medworm.com/index.php?rid=5526375&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970315-2%2Fabstract%3Frss%3Dyes SummaryMost pregnant women at risk of for infection with Plasmodium vivax live in the Asia-Pacific region. However, malaria in pregnancy is not recognised as a priority by many governments, policy makers, and donors in this region. Robust data for the true burden of malaria throughout pregnancy are scarce. Nevertheless, when women have little immunity, each infection is potentially fatal to the mother, fetus, or both. WHO recommendations for the control of malaria in pregnancy are largely based on the situation in Africa, but strategies in the Asia-Pacific region are complicated by heterogeneous transmission settings, coexistence of multidrug-resistant Plasmodium falciparum and Plasmodium vivax parasites, and different vectors. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5526375 Thu, 22 Dec 2011 11:07:41 +0100 5526375 http://www.medworm.com/index.php?rid=5526374&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970246-8%2Fabstract%3Frss%3Dyes SummaryWe assess risks of communicable diseases that are associated with mass gatherings (MGs), outline approaches to risk assessment and mitigation, and draw attention to some key challenges encountered by organisers and participants. Crowding and lack of sanitation at MGs can lead to the emergence of infectious diseases, and rapid population movement can spread them across the world. Many infections pose huge challenges to planners of MGs; however, these events also provide an opportunity to engage in public health action that will benefit host communities and the countries from which participants originate. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5526374 Thu, 22 Dec 2011 11:07:41 +0100 5526374 http://www.medworm.com/index.php?rid=5526373&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970337-1%2Fabstract%3Frss%3Dyes SummaryAlthough definitions of mass gatherings (MG) vary greatly, they consist of large numbers of people attending an event at a specific site for a finite time. Examples of MGs include World Youth Day, the summer and winter Olympics, rock concerts, and political rallies. Some of the largest MGs are spiritual in nature. Among all MGs, the public health issues, associated with the Hajj (an annual pilgrimage to Mecca, Saudi Arabia) is clearly the best reported—probably because of its international or even intercontinental implications in terms of the spread of infectious disease. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5526373 Thu, 22 Dec 2011 11:07:41 +0100 5526373 http://www.medworm.com/index.php?rid=5526372&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970210-9%2Fabstract%3Frss%3Dyes SummaryBackgroundWe aimed to assess whether interferon-γ release assays (IGRAs) can predict the development of active tuberculosis and whether the predictive ability of these tests is better than that of the tuberculin skin test (TST).MethodsLongitudinal studies of the predictive value for active tuberculosis of in-house or commercial IGRAs were identified through searches of PubMed, Embase, Biosis, and Web of Science and complementary manual searches up to June 30, 2011. Eligible studies included adults or children, with or without HIV, who were free of active tuberculosis at study baseline. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5526372 Thu, 22 Dec 2011 11:07:41 +0100 5526372 http://www.medworm.com/index.php?rid=5526371&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970295-X%2Fabstract%3Frss%3Dyes SummaryBackgroundNo published meta-analyses have assessed efficacy and effectiveness of licensed influenza vaccines in the USA with sensitive and highly specific diagnostic tests to confirm influenza.MethodsWe searched Medline for randomised controlled trials assessing a relative reduction in influenza risk of all circulating influenza viruses during individual seasons after vaccination (efficacy) and observational studies meeting inclusion criteria (effectiveness). Eligible articles were published between Jan 1, 1967, and Feb 15, 2011, and used RT-PCR or culture for confirmation of influenza. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5526371 Thu, 22 Dec 2011 11:07:41 +0100 5526371 http://www.medworm.com/index.php?rid=5526370&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970249-3%2Fabstract%3Frss%3Dyes SummaryBackgroundElvitegravir is a once daily inhibitor of HIV-1 integrase boosted by ritonavir. We aimed to compare the efficacy and safety of elvitegravir with raltegravir, another HIV-1 integrase inhibitor, in patients in whom previous antiretroviral treatment failed.MethodsWe conducted a randomised, double-blind, double-dummy, phase 3 study at 234 sites in 13 countries. Eligible patients had plasma HIV RNA of 1000 copies per mL or greater, any CD4 cell count, and resistance to or 6 months' experience with at least two classes of antiretroviral drugs. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5526370 Thu, 22 Dec 2011 11:07:41 +0100 5526370 http://www.medworm.com/index.php?rid=5526369&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970247-X%2Fabstract%3Frss%3Dyes SummaryBackgroundHormonal contraceptives are used widely but their effects on HIV-1 risk are unclear. We aimed to assess the association between hormonal contraceptive use and risk of HIV-1 acquisition by women and HIV-1 transmission from HIV-1-infected women to their male partners.MethodsIn this prospective study, we followed up 3790 heterosexual HIV-1-serodiscordant couples participating in two longitudinal studies of HIV-1 incidence in seven African countries. Among injectable and oral hormonal contraceptive users and non-users, we compared rates of HIV-1 acquisition by women and HIV-1 transmission from women to men. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5526369 Thu, 22 Dec 2011 11:07:41 +0100 5526369 http://www.medworm.com/index.php?rid=5526368&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970365-6%2Ffulltext%3Frss%3Dyes (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5526368 Thu, 22 Dec 2011 11:07:41 +0100 5526368 http://www.medworm.com/index.php?rid=5526367&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970364-4%2Ffulltext%3Frss%3Dyes To date, no effective vaccines against HIV have been developed and, although some people produce broadly neutralising antibodies in response to HIV infection, whether conventional vaccination can elicit the production of similar antibodies is unclear. Now a study describes an alternative approach to HIV prophylaxis—vectored immunoprophylaxis (VIP). VIP uses an adeno-associated virus vector to engineer the secretion of existing broadly neutralising antibodies into the circulation. Intramuscular VIP injection protects humanised mice from challenge with high doses of replication competent HIV. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5526367 Thu, 22 Dec 2011 11:07:41 +0100 5526367 http://www.medworm.com/index.php?rid=5526366&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970363-2%2Ffulltext%3Frss%3Dyes Over 200 villagers, many of them children aged younger than 10 years, have been infected with hepatitis C virus in Anhui and Henan provinces in eastern China. Between Nov 17, and Dec 1, 2011, 105 people from the Dancheng township, Anhui, and 104 from the neighbouring Maqiao township, Henan, tested positive for antibodies to the virus on screening by local health authorities, with several clinical cases reported in both areas. A privately run village clinic in Maqiao suspected of reusing unsterilised needles is a possible source for the outbreak. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5526366 Thu, 22 Dec 2011 11:07:41 +0100 5526366 http://www.medworm.com/index.php?rid=5526365&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970362-0%2Ffulltext%3Frss%3Dyes In mid-November 2011, the GAVI Alliance invited eligible countries to apply for support in rolling out a vaccine against rubella. The decision to expand its activities to include a rubella vaccine was taken in 2008. June's successful pledging conference left GAVI in a position to act on these intentions. By 2015, GAVI aims to have vaccinated 300 million children in 30 countries. If it all goes according to plan, the rubella virus might not survive the 21st century. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5526365 Thu, 22 Dec 2011 11:07:41 +0100 5526365 http://www.medworm.com/index.php?rid=5526364&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970361-9%2Ffulltext%3Frss%3Dyes The world has achieved enormous progress over the past decade in the global fight against the HIV/AIDS epidemic, spearheaded by advances in prevention, treatment, and care interventions, but the momentum is at risk because of a widening gap in funding, warn two status reports by UN agencies. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5526364 Thu, 22 Dec 2011 11:07:41 +0100 5526364 http://www.medworm.com/index.php?rid=5526363&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970338-3%2Ffulltext%3Frss%3Dyes The third sentence of the Editorial in the November issue of The Lancet Infectious Diseases—“That planet Earth now supports more people than have lived in all of human history is cause for reflection on how we got here, and what might be done to produce a stable population with an acceptable quality of life”—is not correct. In fact, although the 7 billion people alive today are indeed more than have lived at any one time, an estimated 83 billion people have lived in all of human history. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5526363 Thu, 22 Dec 2011 11:07:41 +0100 5526363 http://www.medworm.com/index.php?rid=5526362&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970360-7%2Ffulltext%3Frss%3Dyes The recent outbreak of a non-O157 Shiga-toxin-producing Escherichia coli (STEC) did not surprise me. In 2007, I noted the widespread nature of non-O157 STEC: most ruminants carry them in their intestinal flora, and improved methods of isolation suggest that the serotype could be present in almost all ruminants; whereas O157 STEC are the minority, if found at all. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5526362 Thu, 22 Dec 2011 11:07:41 +0100 5526362 http://www.medworm.com/index.php?rid=5526361&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970336-X%2Ffulltext%3Frss%3Dyes We read with great interest Laura Rodrigues and Diana Lockwood's Review of leprosy around the world. The Review included information about the epidemiology, transmission, clinical features, treatment, diagnosis, and prevention of leprosy, and will be very helpful for future studies and control of the disease. However, we wonder why the authors included so little information about leprosy in China. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5526361 Thu, 22 Dec 2011 11:07:41 +0100 5526361 http://www.medworm.com/index.php?rid=5526360&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970343-7%2Ffulltext%3Frss%3Dyes Michael Sweat and colleagues recently reported that the provision of community-based voluntary counselling and testing (CBVCT) led to a significantly higher uptake of HIV testing in Tanzania, Zimbabwe, and Thailand than did routine voluntary counselling. This finding clearly shows that the transfer of medical services from large cities to communities and villages in developing countries improves uptake rates. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5526360 Thu, 22 Dec 2011 11:07:41 +0100 5526360 http://www.medworm.com/index.php?rid=5526359&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970319-X%2Ffulltext%3Frss%3Dyes Between the eighth and 12th days of Dhu al-Hajjah, the 12th month of the Islamic calendar, Saudi Arabia welcomed 3 million people to Mecca for the annual Hajj pilgrimage. As Hajj ended in mid-November, the country had many reasons to be grateful. Risk of injury and death during the pilgrimage has fallen since 2007, with redesigned venues and modern crowd-control strategies. Medical treatment for injuries, infections, and various chronic diseases will have been provided to thousands. Despite intense crowding and the diversity of ethnic groups and nationalities in attendance, around 2 million visitors from more than 183 countries will return home, having participated in this singularly rigorous and peaceful event. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5526359 Thu, 22 Dec 2011 11:07:41 +0100 5526359 http://www.medworm.com/index.php?rid=5526358&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970359-0%2Ffulltext%3Frss%3Dyes The new cover artist for the The Lancet Infectious diseases for 2012 is David Mack, who replaces Andrew Selby. We thank Andrew for the insightful and thought-provoking covers throughout 2011. David comes originally from Belgium and currently lives in Sussex, UK. David holds a degree in engineering from Southampton University. After having spent few years in the city working as a management consultant he decided to move towards the more creative world of computer animation. He later branched out on his own and set up a company, Skyline Imaging, that specialises in health-care animations and still imagery. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5526358 Thu, 22 Dec 2011 11:07:41 +0100 5526358 http://www.medworm.com/index.php?rid=5526357&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970358-9%2Ffulltext%3Frss%3Dyes In this issue we publish the first two in a Series of six articles on mass gatherings health. The remaining articles will be published online, before appearing in print in the February and March, 2012, issues of the journal. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5526357 Thu, 22 Dec 2011 11:07:41 +0100 5526357 http://www.medworm.com/index.php?rid=5526356&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970215-8%2Ffulltext%3Frss%3Dyes In The Lancet Infectious Diseases, Molebogeng Rangaka and colleagues present findings from their systematic review and meta-analysis, showing that existing diagnostic devices for latent tuberculosis infection cannot accurately predict the development of active tuberculosis. They also show that interferon-γ release assays (IGRAs), like the tuberculin skin test (TST), have only a moderate predictive value. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5526356 Thu, 22 Dec 2011 11:07:41 +0100 5526356 http://www.medworm.com/index.php?rid=5526355&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970289-4%2Ffulltext%3Frss%3Dyes In The Lancet Infectious Diseases, Michael Osterholm and colleagues report a meta-analysis on the efficacy and effectiveness of influenza vaccines licensed in the USA. Although not confined to country of licensure, similar analyses have been published by the Cochrane collaboration. However, this new study differs in several ways from the Cochrane analyses. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5526355 Thu, 22 Dec 2011 11:07:41 +0100 5526355 http://www.medworm.com/index.php?rid=5526354&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970277-8%2Ffulltext%3Frss%3Dyes Combination antiretroviral treatment has transformed HIV infection from a deadly disease to a chronic one. Long-term suppression of viraemia requires patients' commitment to take antiretroviral drugs on a daily basis for the rest of their lives. Although more than 25 antiretroviral drugs have been approved for clinical use, novel and better treatment options are needed for individuals in whom existing regimens fail because of antiviral resistance or side-effects. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5526354 Thu, 22 Dec 2011 11:07:41 +0100 5526354 http://www.medworm.com/index.php?rid=5526353&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970254-7%2Ffulltext%3Frss%3Dyes Most of the 16 million women currently living with HIV are in sub-Saharan Africa, where 60% of HIV infections occur in women. A high proportion of women in this region also use hormonal contraception, especially injectable depot-medroxyprogesterone acetate (DMPA). Since the first report of increased HIV acquisition in women taking oral contraceptives, whether hormonal contraception increases the risk of HIV acquisition remains a crucial unanswered question. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5526353 Thu, 22 Dec 2011 11:07:41 +0100 5526353 http://www.medworm.com/index.php?rid=5526352&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970357-7%2Ffulltext%3Frss%3Dyes Ahead of World AIDS Day on Dec 1, 2011, WHO, UNICEF, and UNAIDS launched the Global HIV/AIDS Response 2011 progress report on Nov 30. The report is the fifth such annual report published since 2006. As John Zarocostas reports in this month's Newsdesk, the latest edition contains much good news on treatment and prevention, but the gains made by past efforts are jeapardised by the ongoing global financial crisis and dwindling funds. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5526352 Thu, 22 Dec 2011 11:07:41 +0100 5526352 http://www.medworm.com/index.php?rid=5432535&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970311-5%2Ffulltext%3Frss%3Dyes (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5432535 Tue, 22 Nov 2011 11:05:03 +0100 5432535 http://www.medworm.com/index.php?rid=5432534&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970274-2%2Fabstract%3Frss%3Dyes SummaryWHO has declared obesity to be a global epidemic. Obesity management strategies mainly target behavioural components of the disorder, but are only marginally effective. A comprehensive understanding of the causative factors of obesity might provide more effective management approaches. Several microbes are causatively and correlatively linked with obesity in animals and human beings. If infections contribute to human obesity, then entirely different prevention and treatment strategies and public health policies could be needed to address this subtype of the disorder. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5432534 Tue, 22 Nov 2011 11:05:03 +0100 5432534 http://www.medworm.com/index.php?rid=5432533&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970281-X%2Fabstract%3Frss%3Dyes SummaryStaphylococcus aureus decolonisation—treatment to eradicate staphylococcal carriage—is often considered as a measure to prevent S aureus infection. The most common approach to decolonisation has been intranasal application of mupirocin either alone or in combination with antiseptic soaps or systemic antimicrobial agents. Some data support the use of decolonisation in surgical patients colonised with S aureus, particularly in those undergoing cardiothoracic procedures. Although this intervention has been associated with low rates of postoperative S aureus infection, whether overall rates of infection are also decreased is unclear. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5432533 Tue, 22 Nov 2011 11:05:03 +0100 5432533 http://www.medworm.com/index.php?rid=5432532&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970181-5%2Fabstract%3Frss%3Dyes SummaryThe success of potent antiretroviral treatment for HIV infection is primarily determined by adherence. We systematically review the evidence of effectiveness of interventions to increase adherence to antiretroviral treatment in sub-Saharan Africa. We identified 27 relevant reports from 26 studies of behavioural, cognitive, biological, structural, and combination interventions done between 2003 and 2010. Despite study diversity and limitations, evidence suggests that treatment supporters, directly observed therapy, mobile-phone text messages, diary cards, and food rations can effectively increase adherence in sub-Saharan Africa. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5432532 Tue, 22 Nov 2011 11:05:03 +0100 5432532 http://www.medworm.com/index.php?rid=5432531&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970245-6%2Fabstract%3Frss%3Dyes SummaryBackgroundCryptococcal disease remains an important cause of morbidity and mortality in HIV-infected individuals in sub-Saharan Africa, despite the introduction of antiretroviral therapy. We studied fluconazole as primary prophylaxis against cryptococcal disease in patients awaiting or starting antiretroviral therapy in Uganda.MethodsIn this prospective, double-blind randomised controlled trial, we enrolled HIV-positive adults with CD4 counts less than 200 cells per μL, cryptococcal antigen (CrAg)-negative, naive for antiretroviral therapy, and coming from five local AIDS organisations in Masaka district, Uganda. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5432531 Tue, 22 Nov 2011 11:05:03 +0100 5432531 http://www.medworm.com/index.php?rid=5432530&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970194-3%2Fabstract%3Frss%3Dyes SummaryBackgroundSubstantial reductions in malaria have been reported in several African countries after distribution of insecticide-treated bednets and the use of artemisinin-based combination therapies (ACTs). Our aim was to assess the effect of these policies on malaria morbidity, mosquito populations, and asymptomatic infections in a west African rural population.MethodsWe did a longitudinal study of inhabitants of Dielmo village, Senegal, between January, 2007, and December, 2010. We monitored the inhabitants for fever during this period and we treated malaria attacks with artesunate plus amodiaquine. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5432530 Tue, 22 Nov 2011 11:05:03 +0100 5432530 http://www.medworm.com/index.php?rid=5432529&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970240-7%2Fabstract%3Frss%3Dyes SummaryBackgroundBecause the general population is largely naive to H5N1 influenza, antibodies generated to H5 allow analysis of novel influenza vaccines independent of background immunity from previous infection. We assessed the safety and immunogenicity of DNA encoding H5 as a priming vaccine to improve antibody responses to inactivated influenza vaccination.MethodsIn VRC 306 and VRC 310, two sequentially enrolled phase 1, open-label, randomised clinical trials, healthy adults (age 18–60 years) were randomly assigned to receive intramuscular H5 DNA (4 mg) at day 0 or twice, at day 0 and week 4, followed by H5N1 monovalent inactivated vaccine (MIV; 90 μg) at 4 or 24 weeks, and compared with a two-dose regimen of H5N1 MIV with either a 4 or 24 week interval. (Source: The Lancet Infectio... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5432529 Tue, 22 Nov 2011 11:05:03 +0100 5432529 http://www.medworm.com/index.php?rid=5432528&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970196-7%2Fabstract%3Frss%3Dyes SummaryBackgroundTwice-daily raltegravir with once-daily tenofovir-emtricitabine is an effective initial antiretroviral regimen for patients with HIV-1. On the basis of pharmacokinetic data suggesting efficacy of once-daily raltegravir and because adherence is often improved with once-daily dosing, we aimed to compare these dosing schedules.MethodsIn our international, double-blind, randomised, phase 3 non-inferiority study, we enrolled antiretroviral-naive patients with HIV RNA loads of more than 5000 copies per mL and no baseline resistance to tenofovir or emtricitabine at 83 centres worldwide. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5432528 Tue, 22 Nov 2011 11:05:03 +0100 5432528 http://www.medworm.com/index.php?rid=5432527&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970332-2%2Ffulltext%3Frss%3Dyes (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5432527 Tue, 22 Nov 2011 11:05:03 +0100 5432527 http://www.medworm.com/index.php?rid=5432526&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970331-0%2Ffulltext%3Frss%3Dyes (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5432526 Tue, 22 Nov 2011 11:05:03 +0100 5432526 http://www.medworm.com/index.php?rid=5432525&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970330-9%2Ffulltext%3Frss%3Dyes More than 80% of the US population is infected with herpes simplex virus type 1, the virus that causes cold sores. Some infected individuals rarely develop cold sores whereas others are plagued by monthly or more frequent outbreaks of lesions. In 2008, a 3-megabase region on human chromosome 21 containing six candidate genes was linked to cold sore susceptibility. Now, researchers using single nucleotide polymorphism genotyping, linkage analysis, and transmission disequilibrium testing have identified C21orf91, which encodes a cytosolic protein of unknown function, as a potential cold sore susceptibility gene. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5432525 Tue, 22 Nov 2011 11:05:03 +0100 5432525 http://www.medworm.com/index.php?rid=5432524&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970329-2%2Ffulltext%3Frss%3Dyes The 49th annual meeting of the Infectious Diseases Society of America (IDSA) in Boston (MA, USA) on Oct 20–23 brought together physicians and infectious disease professionals involved in research, care, prevention, and education. The meeting was arranged in four tracks: adult, investigative, and paediatric infectious diseases, and HIV. Public health issues, including attitudes to vaccination and antibiotic stewardship, were among the hot topics of this year's meeting. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5432524 Tue, 22 Nov 2011 11:05:03 +0100 5432524 http://www.medworm.com/index.php?rid=5432523&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970328-0%2Ffulltext%3Frss%3Dyes Two cases of tularaemia, a rare zoonotic infectious disease caused by the Gram-negative bacterium Francisella tularensis, have been confirmed in the Australian island state of Tasmania. The two women contracted the disease after being bitten and scratched by infected possums in the western part of the state, and have been treated for persistent skin infections. These are thought to be the first known cases of tularaemia in the southern hemisphere. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5432523 Tue, 22 Nov 2011 11:05:03 +0100 5432523 http://www.medworm.com/index.php?rid=5432522&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970327-9%2Ffulltext%3Frss%3Dyes A shortage of benznidazole, the first-line drug for treating Chagas disease in most endemic countries, will result in thousands of patients going untreated in the coming months, according to Médicins Sans Frontières (MSF). (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5432522 Tue, 22 Nov 2011 11:05:03 +0100 5432522 http://www.medworm.com/index.php?rid=5432521&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970326-7%2Ffulltext%3Frss%3Dyes When the words “Europe” and “contagion” crop up in the same sentence these days, the chances are that the writer is alluding to the parlous state of the continent's finances. But a recent PLoS Medicine paper has focused attention on another, more traditional type of contagion, which continues to be a cause for European concern: the burdens of mortality, morbidity, and economic costs brought about by antibiotic-resistant hospital-associated infections (HAIs). (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5432521 Tue, 22 Nov 2011 11:05:03 +0100 5432521 http://www.medworm.com/index.php?rid=5432520&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970325-5%2Ffulltext%3Frss%3Dyes The Article by Katherine Ajdukiewicz and colleagues rightly investigated whether oral glycerol, which our group reported effectively protected children with bacterial meningitis from serious neurological sequelae in Latin America, would have the same efficacy in adult patients in Malawi. Unfortunately, glycerol was not effective at the dose used in this study. Two major issues with the trial suggest that patients' safety was jeopardised. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5432520 Tue, 22 Nov 2011 11:05:03 +0100 5432520 http://www.medworm.com/index.php?rid=5432519&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970310-3%2Ffulltext%3Frss%3Dyes Johannes Bogaards' and Johannes Berkhof's suggested method of analysis is perfectly valid. However, they have used the data for all heterosexual men (table 1 and figure 2C in our Article) rather than for younger heterosexual men (12–26 years old; figure 2D). This younger age group was the only group that seemed to have benefited from a herd effect, and in this group the prevalence of genital warts did not seem to be decreasing before vaccination began. Before we submitted our original report we asked several colleagues about the best way to analyse our data, and no two statisticians suggested the same method. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5432519 Tue, 22 Nov 2011 11:05:03 +0100 5432519 http://www.medworm.com/index.php?rid=5432518&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970324-3%2Ffulltext%3Frss%3Dyes We read with interest the Article by Basil Donovan and colleagues, who presented early evidence of reduced morbidity of genital warts after the introduction of quadrivalent human papillomavirus (HPV) vaccination. Their pooled analysis of sentinel surveillance data from eight sexual health service clinics across Australia suggested a stable incidence of genital warts in the prevaccination period followed by a highly significant downwards trend (p<0·0001) since mid-2007, when the quadrivalent vaccine became available to young Australian women at no cost. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5432518 Tue, 22 Nov 2011 11:05:03 +0100 5432518 http://www.medworm.com/index.php?rid=5432517&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970286-9%2Ffulltext%3Frss%3Dyes Eron JJ Jr, Rockstroh JK, Reynes J, et al, for the QDMRK Investigators. Raltegravir once daily or twice daily in previously untreated patients with HIV-1: a randomised, active-controlled, phase 3 non-inferiority trial. Lancet Infect Dis 2011; published online Sept 19. DOI:10.1016/S1473-3099(11)70196-7—In the Summary on page 1 and in the Randomisation and masking section on page 2, the correct dose of emtricitabine should have been 200 mg. The online version has been corrected as of Oct 10, 2011. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5432517 Tue, 22 Nov 2011 11:05:03 +0100 5432517 http://www.medworm.com/index.php?rid=5432515&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970292-4%2Ffulltext%3Frss%3Dyes In an investigation of individuals who died during the plague in London in 1348–50, Schuenemann and colleagues recently reported that they detected Yersinia pestis-specific sequences, thus confirming data we published 13 years ago.Y pestis-specific DNA sequences have now been recorded in samples from 23 burial sites scattered across six European countries (, ). Furthermore, the Y pestis-specific F1 antigen has been detected in samples from eight of these sites and from three other sites. These observations, which were made independently by different research teams studying different sites, leave no doubt that Y pestis caused the two historical plague pandemics in Europe. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5432515 Tue, 22 Nov 2011 11:05:03 +0100 5432515 http://www.medworm.com/index.php?rid=5432514&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970252-3%2Ffulltext%3Frss%3Dyes Although the incidence of cryptococcosis has substantially decreased in the developed world, it remains a very common opportunistic infection in the southern hemisphere despite expansion of programmes of antiretroviral therapy. The combination of high incidence and difficulties with treatment mean cryptococcosis is a common cause of death in patients with AIDS, The CDC analysis estimated that cryptococcal disease is associated with more than 500 000 deaths per year in sub-Saharan Africa alone. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5432514 Tue, 22 Nov 2011 11:05:03 +0100 5432514 http://www.medworm.com/index.php?rid=5432513&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970212-2%2Ffulltext%3Frss%3Dyes Long-lasting insecticide-treated nets (LLINs) are highly effective at reducing malaria transmission and subsequent malaria morbidity and mortality. In combination with new rapid diagnostics and highly effective artemisinin-based combination therapy (ACT), there has been an unprecedented level of investment over the past decade to scale up LLINs across Africa. Several countries have already achieved success in decreasing the malaria burden with a combination of these interventions. Research investigating shifts in clinical malaria epidemiology and insecticide resistance after malaria control scale-up are both timely and relevant. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5432513 Tue, 22 Nov 2011 11:05:03 +0100 5432513 http://www.medworm.com/index.php?rid=5432512&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970256-0%2Ffulltext%3Frss%3Dyes In The Lancet Infectious Diseases, Julie Ledgerwood and colleagues reported on results from a phase 1 clinical trial showing that initial immunisation of individuals with a DNA vaccine expressing the haemagglutinin antigen of an avian source H5 subtype influenza virus, greatly improved the protective antibody responses elicited by a subsequent immunisation with the conventional inactivated influenza vaccine. By contrast, administration of two doses of the same inactivated influenza vaccine had much lower antibody responses than did the vaccine preceded by the DNA prime. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5432512 Tue, 22 Nov 2011 11:05:03 +0100 5432512 http://www.medworm.com/index.php?rid=5432511&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970250-X%2Ffulltext%3Frss%3Dyes In The Lancet Infectious Diseases, Eron and colleagues report an important clinical trial assessing whether the HIV-1 integrase inhibitor raltegravir can be given once daily (800 mg) along with tenofovir and emtricitabine for the initial treatment of HIV-1 infection. Since raltegravir's introduction in 2007, it has assumed an important role in HIV-1 treatment because of its efficacy, small number of toxic effects, and activity against viruses that are resistant to reverse transcriptase and protease inhibitors. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5432511 Tue, 22 Nov 2011 11:05:03 +0100 5432511 http://www.medworm.com/index.php?rid=5432510&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970322-X%2Ffulltext%3Frss%3Dyes On Oct 14, 2010, WHO launched the report Working to Overcome the Global Impact of Neglected Tropical Diseases, which was accompanied by pledges from governments of some of the 149 countries affected by neglected tropical diseases and from pharmaceutical companies to commit themselves to prevention and control programmes. To maintain focus, WHO recently marked the first anniversary of the report with an update on the status of these 17 infectious diseases. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5432510 Tue, 22 Nov 2011 11:05:03 +0100 5432510 http://www.medworm.com/index.php?rid=5362934&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970142-6%2Fabstract%3Frss%3Dyes SummaryThe importance of different routes of influenza transmission (including the role of bioaerosols) and the ability of masks and hand hygiene to prevent transmission remain poorly understood. Interest in transmission of influenza has grown as the effectiveness of prevention measures implemented during the 2009 H1N1 pandemic are questioned and as plans to better prepare for the next pandemic are debated. Recent studies of naturally infected patients have encountered difficulties and have fallen short of providing definitive answers. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5362934 Tue, 01 Nov 2011 04:00:00 +0100 5362934 http://www.medworm.com/index.php?rid=5362933&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970241-9%2Fabstract%3Frss%3Dyes SummaryInfections frequently contain multiple strains (genotypes) of the same pathogen, yet they are still usually treated as uniform entities. In this Review, we discuss problems with inconsistent definition of the term “strain” and review the prevalence and implications of multiple-strain infections. Up to now, multiple-strain infections have been shown unambiguously in 51 human pathogens (and 21 non-human ones) and are likely to arise in most pathogen species. In human pathogens, multiple-strain infections usually reach considerable frequencies (median 11·3%, mean 21·7% of infections), which are certainly underestimated in many cases because of technical limitations of detection. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5362933 Tue, 01 Nov 2011 04:00:00 +0100 5362933 http://www.medworm.com/index.php?rid=5362932&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970145-1%2Fabstract%3Frss%3Dyes SummaryTuberculosis is a major cause of morbidity and mortality in people with HIV and about a quarter of HIV-related deaths are attributed to tuberculosis. In this Review we identify and synthesise published evidence for the effectiveness and cost-effectiveness of eight integrated strategies recommended by WHO that represent coordinated delivery of HIV and tuberculosis services. Evidence supports concurrent screening for tuberculosis and HIV, and provision of either co-trimoxazole during routine tuberculosis care or isoniazid during routine HIV care and at voluntary counselling and testing centres. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5362932 Tue, 01 Nov 2011 04:00:00 +0100 5362932 http://www.medworm.com/index.php?rid=5362931&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970127-X%2Fabstract%3Frss%3Dyes SummaryBackgroundWe did a systematic review and random effects meta-analysis of randomised trials to assess the effect of oral care with chlorhexidine or povidone-iodine on the prevalence of ventilator-associated pneumonia versus oral care without these antiseptics in adults.MethodsStudies were identified through PubMed, CINAHL, Web of Science, CENTRAL, and complementary manual searches. Eligible studies were randomised trials of mechanically ventilated adult patients receiving oral care with chlorhexidine or povidone-iodine. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5362931 Tue, 01 Nov 2011 04:00:00 +0100 5362931 http://www.medworm.com/index.php?rid=5362930&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970177-3%2Fabstract%3Frss%3Dyes SummaryBackgroundMultidrug resistance among bacteria increases the need for new antimicrobial drugs with high potency and stability. Tigecycline is one candidate drug, and a previous meta-analysis of only published randomised controlled trials suggested that it might as effective as comparator treatments; we did a meta-analysis to include new and unpublished trials to assess its efficacy for the treatment of adult patients with serious bacterial infection.MethodsWe searched PubMed, Cochrane Central Register, and Embase up to March 30, 2011, to identify published studies, and we searched clinical trial registries to identify completed unpublished studies, the results of which were obtained through the manufacturer. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5362930 Tue, 01 Nov 2011 04:00:00 +0100 5362930 http://www.medworm.com/index.php?rid=5362929&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970168-2%2Fabstract%3Frss%3Dyes SummaryBackgroundScaling up of antiretroviral therapy in low-resource countries is done on the basis of decentralised, integrated HIV care in rural facilities; however, laboratory monitoring is generally unavailable. We aimed to assess the effectiveness and safety of clinical monitoring alone (CLIN) in terms of non-inferiority to laboratory and clinical monitoring (LAB).MethodsWe did a randomised, open-label, non-inferiority trial in nine rural district hospitals in Cameroon. Eligible participants were adults (≥18 years) infected with HIV-1 group M (WHO disease stage 3–4) who had not previously received antiretroviral therapy, and were followed-up for 2 years by health-care workers in routine activities. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5362929 Tue, 01 Nov 2011 04:00:00 +0100 5362929 http://www.medworm.com/index.php?rid=5362928&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970167-0%2Fabstract%3Frss%3Dyes SummaryBackgroundWHO recommends that Xpert MTB/RIF replaces smear microscopy for initial diagnosis of suspected HIV-associated tuberculosis or multidrug-resistant pulmonary tuberculosis, but no data exist for its use in children. We aimed to assess the accuracy of the test for the diagnosis of pulmonary tuberculosis in children in an area with high tuberculosis and HIV prevalences.MethodsIn this prospective, descriptive study, we enrolled children aged 15 years or younger who had been admitted to one of two hospitals in Cape Town, South Africa, with suspected pulmonary tuberculosis between Feb 19, 2009, and Nov 30, 2010. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5362928 Tue, 01 Nov 2011 04:00:00 +0100 5362928 http://www.medworm.com/index.php?rid=5362927&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970308-5%2Ffulltext%3Frss%3Dyes (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5362927 Tue, 01 Nov 2011 04:00:00 +0100 5362927 http://www.medworm.com/index.php?rid=5362926&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970307-3%2Ffulltext%3Frss%3Dyes To date, efforts to raise broadly neutralising antibodies against HIV-1 through vaccination have been unsuccessful. However, a new study that shows how the immune system recognises and responds to retroviruses might facilitate the production of effective HIV-1 vaccines. The study uses mouse genetics to show that Toll-like receptor 7 (TLR7), a component of the innate immune system, recognises retroviruses and regulates the development of germinal centre B cells. Manipulation of TLR7 and its signalling pathway in B cells might, therefore, provide a way to enhance the effectiveness of HIV-1 vaccines. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5362926 Tue, 01 Nov 2011 04:00:00 +0100 5362926 http://www.medworm.com/index.php?rid=5362925&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970306-1%2Ffulltext%3Frss%3Dyes Emerging antibiotic resistance figured large at this year's Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) held in Chicago (IL, USA), Sept 17–20. David Livermore (Health Protection Agency [HPA], London, UK) gave the opening keynote address about Gram-negative multidrug-resistant organisms, such as those carrying the NDM-1 carbapenemase. Livermore warned that unless development of new antibiotics is reinvigorated, the antibiotic revolution of the 20th century will end with Gram-negative resistance. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5362925 Tue, 01 Nov 2011 04:00:00 +0100 5362925 http://www.medworm.com/index.php?rid=5362924&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970305-X%2Ffulltext%3Frss%3Dyes Officials from the US Centers for Disease Control and Prevention (CDC) continue to advise people not to eat cantaloupe melons produced by Jensen Farms in Colorado, USA, as the death toll from an outbreak of listeriosis linked to the fruits had risen to 23 by Oct 10. Four outbreak-associated strains of Listeria monocytogenes have been the cause of 109 reported infections in 24 states, with the CDC expecting more cases in coming weeks due to the incubation period before symptoms present. Meanwhile the US Food and Drug Administration (FDA) has issued a recall notice on romaine lettuce produced by True Leaf Farms of Salinas, CA, due to potential L monocytogenes contamination discovered during an FDA research programme. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5362924 Tue, 01 Nov 2011 04:00:00 +0100 5362924 http://www.medworm.com/index.php?rid=5362923&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970304-8%2Ffulltext%3Frss%3Dyes When used consistently, condoms can prevent almost 100% of HIV infections, but the many challenges associated with condom use mean they cannot be relied on for 100% prevention. For HIV prevention, an effective vaccine remains the “holy grail”, according to Barton Haynes (Duke Human Vaccine Institute, Durham, NC, USA) as he addressed the AIDS Vaccine Conference, Bangkok, Thailand, Sept 12–15, 2011. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5362923 Tue, 01 Nov 2011 04:00:00 +0100 5362923 http://www.medworm.com/index.php?rid=5362922&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970303-6%2Ffulltext%3Frss%3Dyes Former US President Jimmy Carter and WHO Director General Margaret Chan joined Stephen O'Brien, UK Parliamentary Under-Secretary of State for International Development, on Oct 5 to call for financial support for the final push for eradication of dracunculiasis. The Carter Center and WHO hope that the campaign can raise US$70 million to stop transmission of Guinea worm by 2015. The UK Government has pledged £20 million (estimated to be about a third of the required amount), if other donors can be found to put forward the remainder. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5362922 Tue, 01 Nov 2011 04:00:00 +0100 5362922 http://www.medworm.com/index.php?rid=5362921&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970302-4%2Ffulltext%3Frss%3Dyes The beautiful region of Tuscany in Italy, home of poets and scholars, has also inspired vaccinologist Rino Rappuoli, who grew up in Radicofani, located in the natural park of Valdorcia about 40 miles southeast of Siena. This small rustic village perched on a hill between the Mount Amiata and Mount Cetonia feels light years away from the high-tech environment with which Rappuoli has surrounded himself. When he was a young boy studying classics, lost in the magic of Greek, Latin, and Italian literature, he would dream of doing something more practical that could change the world. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5362921 Tue, 01 Nov 2011 04:00:00 +0100 5362921 http://www.medworm.com/index.php?rid=5362920&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970301-2%2Ffulltext%3Frss%3Dyes When stocks of HIV drugs and supplies run out, unplanned treatment interruptions lead to increased risk of HIV drug resistance, treatment failure, and death. In the early days of antiretroviral therapy (ART) programmes, management of HIV supplies outside of national systems was considered acceptable by governments to facilitate scale-up, but this approach is proving difficult to sustain. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5362920 Tue, 01 Nov 2011 04:00:00 +0100 5362920 http://www.medworm.com/index.php?rid=5362919&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970300-0%2Ffulltext%3Frss%3Dyes As a physician with an MBBS from India, working as a professor of infectious diseases for more than 25 years at a US medical school, and as one deeply interested in Indian medical education, I wish to bring to the readers' attention the long unfulfilled need for a formal training programme in infectious diseases in India. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5362919 Tue, 01 Nov 2011 04:00:00 +0100 5362919 http://www.medworm.com/index.php?rid=5362918&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970299-7%2Ffulltext%3Frss%3Dyes Multidrug-resistant (MDR) Salmonella enterica (serotypes typhi and paratyphi A) has become an emerging problem in endemic countries. In 2002, after giving a presentation at the annual convention of the Society of Internal Medicine of Nepal, a Nepalese physician asked me what they could use to treat multidrug-resistant typhoid. The resistance of S enterica to oral antibiotics including ampicillin, chloramphenicol, co-trimoxazole (trimethoprim-sulfamethoxazole), ofloxacin, and ciprofloxacin was increasing across all endemic areas. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5362918 Tue, 01 Nov 2011 04:00:00 +0100 5362918 http://www.medworm.com/index.php?rid=5362917&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970298-5%2Ffulltext%3Frss%3Dyes Proponents of the one-health initiative have recognised the need to move the concept from vision to implementation. The paper by Richard Coker and colleagues admirably draws attention to the importance of, and possible mechanisms for, incorporation of a systemic perspective into one-health discussions about changes in human, livestock, and wildlife populations and their effect on infectious diseases. We welcome the development of a conceptual framework for informing these discussions and acknowledge its usefulness in unifying perspectives from animal, wildlife, and human sectors to guide assessments of specific sets of one-health interventions. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5362917 Tue, 01 Nov 2011 04:00:00 +0100 5362917 http://www.medworm.com/index.php?rid=5362916&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970297-3%2Ffulltext%3Frss%3Dyes Mariani-Kurkdjian P, Bingen E, Gault G, Jourdan-Da Silva N, Weill FX. Escherichia coli O104:H4 south-west France, June 2011. Lancet Infect Dis 2011; 11: 732–33—The webappendix of this letter has been corrected as of Oct 24, 2011. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5362916 Tue, 01 Nov 2011 04:00:00 +0100 5362916 http://www.medworm.com/index.php?rid=5362915&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970188-8%2Ffulltext%3Frss%3Dyes Patients in intensive care units are at high risk for nosocomial infections because they are the most critically ill, might be receiving immunosuppressive drugs, and are often monitored invasively with tube insertion. Mortality, morbidity, and cost are increased with ventilator-associated pneumonia. Findings from studies of both single and combination interventions for preventing ventilator-associated pneumonia have shown a reduction in disease incidence. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5362915 Tue, 01 Nov 2011 04:00:00 +0100 5362915 http://www.medworm.com/index.php?rid=5362914&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970183-9%2Ffulltext%3Frss%3Dyes “Antimicrobial resistance: no action today, no cure tomorrow”, the theme for World Health Day 2011, shows the helplessness of the human predicament. Thus, any new antibiotics effective against strains resistant to existing drugs would gain worldwide attention. Tigecycline is one such antibiotic, with efficacy against many multidrug-resistant pathogens widely reported. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5362914 Tue, 01 Nov 2011 04:00:00 +0100 5362914 http://www.medworm.com/index.php?rid=5362913&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970185-2%2Ffulltext%3Frss%3Dyes In The Lancet Infectious Diseases, Laurent and colleagues report the results of a randomised non-inferiority trial in adults in Cameroon with HIV infection receiving antiretroviral therapy (ART). The trial compares the effectiveness and safety of two monitoring strategies: clinical monitoring alone and clinical monitoring plus laboratory monitoring of CD4 cell counts and viral loads. Participants in the laboratory group had increases in CD4 cell counts of more than the 25% threshold in the first 2 years of treatment and therefore non-inferiority of clinical monitoring alone was not shown. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5362913 Tue, 01 Nov 2011 04:00:00 +0100 5362913 http://www.medworm.com/index.php?rid=5362912&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970187-6%2Ffulltext%3Frss%3Dyes Tuberculosis is a leading cause of mortality in HIV populations worldwide with almost 2 million deaths every year; however, laboratory diagnostic techniques for tuberculosis have many well described limitations. In developing countries, smear microscopy is the most used technique but has variable sensitivity (30–80%) in adult populations. Culture methods are slow, complex, need specific infrastructure, and are not available in all developing countries. In children, diagnosis is even more difficult. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5362912 Tue, 01 Nov 2011 04:00:00 +0100 5362912 http://www.medworm.com/index.php?rid=5362911&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970296-1%2Ffulltext%3Frss%3Dyes On Oct 31, 2011, the human population will likely reach 7 billion. The event has special resonance for the author of this editorial, who is expecting to become the father of a child who will contribute to our passing this milestone. That planet Earth now supports more people than have lived in all of human history is cause for reflection on how we got here, and what might be done to produce a stable population with an acceptable quality of life. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5362911 Tue, 01 Nov 2011 04:00:00 +0100 5362911 http://www.medworm.com/index.php?rid=5261978&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2810%2970121-3%2Ffulltext%3Frss%3Dyes (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5261978 Thu, 29 Sep 2011 11:39:45 +0100 5261978 http://www.medworm.com/index.php?rid=5261977&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970151-7%2Fabstract%3Frss%3Dyes SummaryIn 1918, two waves of epidemic influenza arose with very different clinical phenotypes. During the first wave, infection rates were high but mortality was low. During the second wave, high numbers of deaths occurred and mortality differed 30–100 times among seemingly similar groups of affected adults, but the reason for this variation is unclear. In 1918, the crews of most warships and some island populations were affected by influenza during both waves of infection and had no or very few deaths during the second wave. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5261977 Thu, 29 Sep 2011 11:39:45 +0100 5261977 http://www.medworm.com/index.php?rid=5261976&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970217-1%2Fabstract%3Frss%3Dyes SummarySome mendelian (monogenic) disorders directly conferring increased susceptibility are associated with diverse infectious organisms, whereas others are restricted in scope to specific genera or even to one species. So far, most investigations of primary immunodeficiency disorders have focused on those conferring susceptibility to viral, bacterial, or mycobacterial infections, providing powerful insight into human determinants of host resistance to these microbes. Monogenic disorders that increase susceptibility to fungal infections are increasingly being recognised. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5261976 Thu, 29 Sep 2011 11:39:45 +0100 5261976 http://www.medworm.com/index.php?rid=5261975&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970141-4%2Fabstract%3Frss%3Dyes SummaryHIV-positive children are at high risk of drug resistance, which is of particular concern in settings where antiretroviral options are limited. In this Review we explore resistance rates and patterns among children in developing countries in whom antiretroviral treatment has failed. We did a systematic search of online databases and conference abstracts and included studies reporting HIV-1 drug resistance after failure of first-line paediatric regimens in children (<18 years) in resource-poor regions (Latin America, Africa, and Asia). (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5261975 Thu, 29 Sep 2011 11:39:45 +0100 5261975 http://www.medworm.com/index.php?rid=5261974&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970090-1%2Fabstract%3Frss%3Dyes SummaryBackgroundThe seven-valent pneumococcal conjugate vaccine (PCV7) has reduced vaccine-type (VT) invasive pneumococcal disease but increases in non-vaccine-type (NVT) disease have varied between countries. We assess the effect of the PCV7 vaccination on VT and NVT disease in England and Wales.MethodsThe study cohort was the population of England and Wales from July, 2000, to June, 2010. We calculated incidence rate ratios (IRRs) to compare incidences of VT and NVT disease before (2000–06) and after (2009–10) the introduction of PCV7. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5261974 Thu, 29 Sep 2011 11:39:45 +0100 5261974 http://www.medworm.com/index.php?rid=5261973&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970149-9%2Fabstract%3Frss%3Dyes SummaryBackgroundThere are few data on the epidemiology of primary HIV-1 drug resistance after the roll-out of antiretroviral treatment (ART) in sub-Saharan Africa. We aimed to assess the prevalence of primary resistance in six African countries after ART roll-out and if wider use of ART in sub-Saharan Africa is associated with rising prevalence of drug resistance.MethodsWe did a cross-sectional study in antiretroviral-naive adults infected with HIV-1 who had not started first-line ART, recruited between 2007 and 2009 from 11 regions in Kenya, Nigeria, South Africa, Uganda, Zambia, and Zimbabwe. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5261973 Thu, 29 Sep 2011 11:39:45 +0100 5261973 http://www.medworm.com/index.php?rid=5261972&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970100-1%2Fabstract%3Frss%3Dyes We report extended follow-up to 19 months, including efficacy results.MethodsWe did a randomised, open-label, phase 2 trial of safety and efficacy of the RTS,S/AS01E candidate malaria vaccine given with EPI vaccines between April 30, 2007, and Oct 7, 2009, in Ghana, Tanzania, and Gabon. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5261972 Thu, 29 Sep 2011 11:39:45 +0100 5261972 http://www.medworm.com/index.php?rid=5261971&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970273-0%2Ffulltext%3Frss%3Dyes (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5261971 Thu, 29 Sep 2011 11:39:45 +0100 5261971 http://www.medworm.com/index.php?rid=5261970&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970272-9%2Ffulltext%3Frss%3Dyes (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5261970 Thu, 29 Sep 2011 11:39:45 +0100 5261970 http://www.medworm.com/index.php?rid=5261969&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970271-7%2Ffulltext%3Frss%3Dyes (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5261969 Thu, 29 Sep 2011 11:39:45 +0100 5261969 http://www.medworm.com/index.php?rid=5261968&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970270-5%2Ffulltext%3Frss%3Dyes An ideal HIV-1 vaccine would induce broadly neutralising antibodies but such antibodies are rarely induced. Could “holes” in the naive B-cell repertoire account for the lack of antibodies that bind conserved, broadly neutralising epitopes in the HIV-1 envelope? New research does not support this possibility but shows instead that sugars on HIV-1 envelope proteins prevent them binding to the unmutated ancestor antibodies of existing broadly neutralising antibodies to the HIV-1 envelope. Moreover, immunisation of rhesus macaques with deglycosylated HIV-1 gp140 envelope protein enhances the induction of antibodies to a broadly neutralising gp41 epitope. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5261968 Thu, 29 Sep 2011 11:39:45 +0100 5261968 http://www.medworm.com/index.php?rid=5261967&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970269-9%2Ffulltext%3Frss%3Dyes More than 4000 cases of dengue fever have been reported in the Punjab region of east Pakistan over a 2 month period—a substantial increase over previous years. Regional capital, Lahore, is particularly badly affected, with authorities in the city ordering the closure of all state-run and private schools for 12 days in an attempt to control the spread of the virus, transmitted by Aedes spp mosquitoes. 438 patients are receiving treatment in hospitals across the region, and at least eight people have died. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5261967 Thu, 29 Sep 2011 11:39:45 +0100 5261967 http://www.medworm.com/index.php?rid=5261966&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970268-7%2Ffulltext%3Frss%3Dyes Developments in technology, new evidence, and fresh policy thinking from WHO and other partners are finally bringing changes to tuberculosis diagnosis. Vital steps are stopping use of inadequate tests and determining niches for newer diagnostics. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5261966 Thu, 29 Sep 2011 11:39:45 +0100 5261966 http://www.medworm.com/index.php?rid=5261965&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970267-5%2Ffulltext%3Frss%3Dyes 76 countries worldwide maintain legislation criminalising same-sex relationships, but statutes and penalties vary. In Guyana, Kenya, and Sierra Leone, homosexuality among men, but not women, is punishable. In Angola, the penal code, which dates back to the country's time as a Portuguese colony, allows for homosexuals to be put to work in labour camps. In Botswana, offenders can be imprisoned for up to 7 years. Other countries allow for fines, some mandate flogging. And in a handful of places—including Saudi Arabia, Iran, and some states in Nigeria—homosexuality is a capital crime. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5261965 Thu, 29 Sep 2011 11:39:45 +0100 5261965 http://www.medworm.com/index.php?rid=5261964&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970266-3%2Ffulltext%3Frss%3Dyes We present microbiological data from the outbreak of bloody diarrhoea and haemolytic-uraemic syndrome associated with consumption of sprouts that occurred in June–July, 2011, in the Bordeaux area, south-west France. From June 8, 2011, to July 11, 2011, 12 confirmed cases of Shiga-toxin-producing E coli infection (nine haemolytic-uraemic syndrome, one bloody diarrhoea, two simple diarrhoea) were reported. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5261964 Thu, 29 Sep 2011 11:39:45 +0100 5261964 http://www.medworm.com/index.php?rid=5261963&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970265-1%2Ffulltext%3Frss%3Dyes Michael Niederman and colleagues raise concerns regarding our multicentre effort to implement American Thoracic Society (ATS) and Infectious Diseases Society of America (IDSA) guidelines for treatment of health-care-associated, hospital-acquired, and ventilator-associated pneumonias. Specifically, in patients at risk for multidrug-resistant pathogens, we reported that empirical antibiotic therapy conforming to guidelines was associated with increased mortality unexplained by patients' acuity or chronic conditions. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5261963 Thu, 29 Sep 2011 11:39:45 +0100 5261963 http://www.medworm.com/index.php?rid=5261962&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970264-X%2Ffulltext%3Frss%3Dyes Daniel Kett and colleagues' finding that the empirical antibiotic treatments recommended by the American Thoracic Society and the Infectious Diseases Society of America for hospital-acquired pneumonias were not associated with a decrease in mortality might be partly explained by two other factors not referred to in their Article. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5261962 Thu, 29 Sep 2011 11:39:45 +0100 5261962 http://www.medworm.com/index.php?rid=5261957&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970213-4%2Ffulltext%3Frss%3Dyes Asante KP, Abdulla S, Agnandji S, et al. Safety and efficacy of the RTS,S/AS01Ecandidate malaria vaccine given with expanded-programme-on-immunisation vaccines: 19 month follow-up of a randomised, open-label, phase 2 trial. Lancet Infect Dis 2011; published online July 21. DOI:10.1016/S1473-3099(11)70100-1—In figure 3 of this Article, the blue and green lines for the control group and RTS,S/AS01E 0, 1, 2 months group were incorrect. We have corrected the online version as of August 5, 2011, and the printed Article will be correct. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5261957 Thu, 29 Sep 2011 11:39:45 +0100 5261957 http://www.medworm.com/index.php?rid=5261955&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970242-0%2Ffulltext%3Frss%3Dyes As part of our celebrations of 10 years of The Lancet Infectious Diseases, we asked readers to vote—via thelancet.com—for the ten most influential papers published by the journal. Voters made their choice among 25 papers chosen by the journal's editors from across our 10 years of publication. The 25 were mostly chosen for their high number of citations, but included some papers published too recently to have garnered many citations. Participants in the vote were asked to rank papers from most influential to tenth most influential. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5261955 Thu, 29 Sep 2011 11:39:45 +0100 5261955 http://www.medworm.com/index.php?rid=5261954&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970143-8%2Ffulltext%3Frss%3Dyes Since 2000, more than 70 countries have introduced pneumococcal conjugate vaccines. Ecological studies—ie, studies that track disease trends over time in relation to the timing of interventions such as introduction of pneumococcal vaccines—have documented reductions in invasive pneumococcal disease, otitis media, and pneumococcal pneumonia after initiation of routine vaccination of infants with a seven-valent pneumococcal conjugate vaccine (PCV7) in the USA and elsewhere. Such studies allow both short-term and long-term assessment of vaccine performance in a general population. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5261954 Thu, 29 Sep 2011 11:39:45 +0100 5261954 http://www.medworm.com/index.php?rid=5261953&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970216-X%2Ffulltext%3Frss%3Dyes The development of effective antiretroviral treatments has resulted in substantial reductions in mother-to-child transmission of HIV as well as AIDS-related morbidity and mortality in infected individuals. However, drug resistance commonly emerges with suboptimal antiretroviral adherence or exposure to inadequately potent (eg, single or two drug) antiretroviral therapy. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5261953 Thu, 29 Sep 2011 11:39:45 +0100 5261953 http://www.medworm.com/index.php?rid=5261952&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970186-4%2Ffulltext%3Frss%3Dyes Despite widespread use of effective drugs and vector control with insecticide-treated bednets (ITNs) and indoor residual spraying, hundreds of millions of people have malaria and nearly a million die every year. Children aged less than 5 years living in sub-Saharan Africa are disproportionally affected; accounting for 80% of malaria deaths worldwide. The disease is an important constraint to the development of sub-Saharan Africa. Severe malaria caused by Plasmodium falciparum is the most common form of the disease in this region. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5261952 Thu, 29 Sep 2011 11:39:45 +0100 5261952 http://www.medworm.com/index.php?rid=5261951&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970258-4%2Ffulltext%3Frss%3Dyes In 2010, WHO's Director General, Margaret Chan, formed an independent monitoring board to assess progress towards achievment of the milestones of the Global Polio Eradication Initiative strategic plan 2010–12. The board's report in April this year showed that the number of poliomyelitis cases has decreased from 350 000 in 1988 to 1294 in 2010. Endemic transmission of wild poliovirus types 1 and 3 continued only in Afghanistan, India, Nigeria, and Pakistan, the four countries in which poliovirus transmission has never been stopped. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5261951 Thu, 29 Sep 2011 11:39:45 +0100 5261951 http://www.medworm.com/index.php?rid=5163743&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2810%2970254-1%2Ffulltext%3Frss%3Dyes A 24-year-old man, with no remarkable medical history, was admitted to hospital with buttock and flank masses. 2 months earlier the patient had progressive left buttock pain after a skiing weekend and influenza-like symptoms were present during the previous days. During the next 2 months symptoms included high-spiking fever, substantial weight loss, and severe buttock pain with left sciatic and crural neuropathy. A rapidly growing and painful left buttock mass developed 5 days before the patient was admitted to hospital. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5163743 Sat, 27 Aug 2011 16:35:11 +0100 5163743 http://www.medworm.com/index.php?rid=5163742&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970034-2%2Fabstract%3Frss%3Dyes SummaryAdvocacy for Lyme disease has become an increasingly important part of an antiscience movement that denies both the viral cause of AIDS and the benefits of vaccines and that supports unproven (sometimes dangerous) alternative medical treatments. Some activists portray Lyme disease, a geographically limited tick-borne infection, as a disease that is insidious, ubiquitous, difficult to diagnose, and almost incurable; they also propose that the disease causes mainly non-specific symptoms that can be treated only with long-term antibiotics and other unorthodox and unvalidated treatments. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5163742 Sat, 27 Aug 2011 16:35:10 +0100 5163742 http://www.medworm.com/index.php?rid=5163741&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970099-8%2Fabstract%3Frss%3Dyes SummaryToll-like receptors (TLRs) recognise highly conserved molecular structures, collectively known as pathogen-associated molecular patterns. In the past two decades, development and clinical implementation of TLR ligands—ie, chemically modified synthetic derivatives of naturally occurring ligands and fully synthetic small molecules—have been topics of intense research. Targeted manipulation of TLR signalling has been applied clinically to boost vaccine effectiveness, promote a robust T helper 1-predominant immune response against viral infection, or dampen the exaggerated inflammatory response to bacterial infection. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5163741 Sat, 27 Aug 2011 16:35:10 +0100 5163741 http://www.medworm.com/index.php?rid=5163740&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970054-8%2Fabstract%3Frss%3Dyes SummaryIn much of the world antimicrobial drugs are sold without prescription or oversight by health-care professionals. The scale and effect of this practice is unknown. We systematically reviewed published works about non-prescription antimicrobials from 1970–2009, identifying 117 relevant articles. 35 community surveys from five continents showed that non-prescription use occurred worldwide and accounted for 19–100% of antimicrobial use outside of northern Europe and North America. Safety issues associated with non-prescription use included adverse drug reactions and masking of underlying infectious processes. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5163740 Sat, 27 Aug 2011 16:35:10 +0100 5163740 http://www.medworm.com/index.php?rid=5163739&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970104-9%2Fabstract%3Frss%3Dyes The objectives of this study were to review the literature systematically to determine the effectiveness of screening interventions to prevent congenital syphilis and other adverse pregnancy outcomes.MethodsWe searched four electronic databases and selected studies to examine evidence for effectiveness of interventions on three outcomes: increased uptake of syphilis testing, increased treatment rates, and reduction in adverse pregnancy outcomes. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5163739 Sat, 27 Aug 2011 16:35:10 +0100 5163739 http://www.medworm.com/index.php?rid=5163738&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970065-2%2Fabstract%3Frss%3Dyes SummaryBackgroundChloroquine has in-vitro activity against influenza and could be an ideal candidate for worldwide prevention of influenza in the period between onset of a pandemic with a virulent influenza strain and the development and widespread dissemination of an effective vaccine. We aimed to assess the efficacy of such an intervention.MethodsIn this randomised, double-blind, placebo-controlled trial done at a single centre in Singapore, we randomly assigned (1:1) healthy adults to receive chloroquine phosphate (500 mg/day for 1 week, then once a week to complete 12 weeks) or matching placebo by use of a computer-generated randomisation list. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5163738 Sat, 27 Aug 2011 16:35:10 +0100 5163738 http://www.medworm.com/index.php?rid=5163737&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970165-7%2Fabstract%3Frss%3Dyes SummaryBackgroundIn an ongoing outbreak of haemolytic uraemic syndrome and bloody diarrhoea caused by a virulent Escherichia coli strain O104:H4 in Germany (with some cases elsewhere in Europe and North America), 810 cases of the syndrome and 39 deaths have occurred since the beginning of May, 2011. We analysed virulence profiles and relevant phenotypes of outbreak isolates recovered in our laboratory.MethodsWe analysed stool samples from 80 patients that had been submitted to the National Consulting Laboratory for Haemolytic Uraemic Syndrome in Münster, Germany, between May 23 and June 2, 2011. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5163737 Sat, 27 Aug 2011 16:35:10 +0100 5163737 http://www.medworm.com/index.php?rid=5163736&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970234-1%2Ffulltext%3Frss%3Dyes Antibiotic Resistance provides a comprehensive assessment of a key topic. The authors are experts in their topic, with impressive lists of previous publications related to antibiotic treatment and resistance. The book is well written and easy to read, and benefits from having just two authors so that the style is fluent throughout. The book can either be read from cover to cover as there is a clear progression from one chapter to the next, or individual chapters can be delved into if specific aspects of resistance are of interest; for example, individual chapters neatly describe the mechanisms of action of the major groups of antibiotics and the ways in which resistance can develop. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5163736 Sat, 27 Aug 2011 16:35:10 +0100 5163736 http://www.medworm.com/index.php?rid=5163735&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970233-X%2Ffulltext%3Frss%3Dyes “A young man might be wearing only a loincloth because he didn't want anything touching his face or limbs, which were covered in lesions. His legs were bloody. He was trying not to move, grimacing in pain when he did. Any touch caused the lesions to bleed. His face was contorted in pain; he wanted only to die.” (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5163735 Sat, 27 Aug 2011 16:35:09 +0100 5163735 http://www.medworm.com/index.php?rid=5163734&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970232-8%2Ffulltext%3Frss%3Dyes Broadly neutralising antibodies against influenza A viruses would be useful for passive immunisation and vaccine design but, because haemagglutinin (the major target of neutralising antibodies) exists as 16 rapidly evolving subtypes that form two groups, such antibodies have been hard to find. Now, by using a single-cell culture method to screen large numbers of human plasma cells, researchers have isolated a monoclonal antibody that recognises all 16 haemagglutinin subtypes and that neutralises group 1 and group 2 influenza A viruses. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5163734 Sat, 27 Aug 2011 16:35:09 +0100 5163734 http://www.medworm.com/index.php?rid=5163733&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970231-6%2Ffulltext%3Frss%3Dyes The the Auditorium Parco della Musica, Rome, Italy was the grand setting for the sixth International AIDS Society Meeting on HIV Pathogenesis, Treatment, and Prevention July 17–20, 2011. The conference, which is hosted in alternate years to the politicised, campaigning International AIDS Conference aims to promote the most innovative science across four research tracks: basic sciences, clinical sciences, prevention science, and operations and implementation research. The operations and implementation research track was first introduced at the 2009 meeting in Cape Town as operational research, but has since expanded to in recognition of the importance of acting on results of operational research to deliver care. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5163733 Sat, 27 Aug 2011 16:35:09 +0100 5163733 http://www.medworm.com/index.php?rid=5163732&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970230-4%2Ffulltext%3Frss%3Dyes 13 new cases of infection with Japanese encephalitis—a mosquito-borne viral disease originating in pigs and birds—were detected at Baba Raghav Das Medical College Hospital in Uttar Pradesh state in India on Aug 5 and Aug 6, bringing the number of patients undergoing treatment to 124 in this hospital alone. Some 731 cases of Japanese encephalitis have been reported in eastern Uttar Pradesh in 2011, and up to 128 individuals have died. The districts of Gorakhpur and Kushinagar are worst affected. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5163732 Sat, 27 Aug 2011 16:35:09 +0100 5163732 http://www.medworm.com/index.php?rid=5163731&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970229-8%2Ffulltext%3Frss%3Dyes According to the latest report from the Independent Monitoring Board (IMB) of the Global Polio Eradication Initiative (GPEI), continued transmission of polio is a “global health emergency”, and plans to interrupt transmission by the end of 2012 are “at risk”. With a US$590 million funding gap and weak political leadership in some countries, the engagement of communities to plan and implement local approaches is paramount. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5163731 Sat, 27 Aug 2011 16:35:09 +0100 5163731 http://www.medworm.com/index.php?rid=5163730&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970228-6%2Ffulltext%3Frss%3Dyes In the mid-19th century, colloquial names for tuberculosis, such as the white plague, with reference to the pallor common in patients with tuberculosis, and consumption, reflecting the atrophy of an infected body, engendered fear of the disease and those with it. This fear often led to stigmatisation; although the disease is now much better understood, fear and stigma remain and create barriers to effective management. The importance of stigma in relation to tuberculosis control has been emphasised in recent months, with non-governmental organisations, such as Via Libre in Peru, raising awareness of this issue in public health campaigns. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5163730 Sat, 27 Aug 2011 16:35:08 +0100 5163730 http://www.medworm.com/index.php?rid=5163729&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970227-4%2Ffulltext%3Frss%3Dyes We reported a case of pulmonary MDR tuberculosis in a 41-year-old man with diabetes from the West Bank, Palestine. The bacteria belonged to the Beijing family, which is highly virulent and easily disseminated. The patient withdrew from treatment after 2 years while still sputum-positive. Despite persistent efforts of the tuberculosis directly observed treatment programme, he disappeared and cannot be located. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5163729 Sat, 27 Aug 2011 16:35:08 +0100 5163729 http://www.medworm.com/index.php?rid=5163728&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970191-8%2Ffulltext%3Frss%3Dyes In response to Gyanshankar Mishra, we used the best available published data to place the fluoroquinolones ahead of the injectables in our priority listing, because the former have been associated with better treatment outcomes in most studies of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis. First, we agree that the scant information in which a cure rate of 87·9% was achieved with a 9 month regimen including gatifloxacin at a high dose (800 mg per day). (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5163728 Sat, 27 Aug 2011 16:35:08 +0100 5163728 http://www.medworm.com/index.php?rid=5163727&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970226-2%2Ffulltext%3Frss%3Dyes We read with interest the Review by José Caminero and colleagues, which described various mutations that confer resistance to antituberculosis treatment and the manner in which effective therapy can be devised without actually testing for each mutation. However, this clinical approach might not work well if variation exists in the pattern and prevalence of mutations worldwide. We wish to point out the differences in mutations that we recorded at our tertiary care centre, which could have implications for devising therapy. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5163727 Sat, 27 Aug 2011 16:35:08 +0100 5163727 http://www.medworm.com/index.php?rid=5163725&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970195-5%2Ffulltext%3Frss%3Dyes Over the past decade, the idea that iatrogenic infection is a major driver of HIV infection in Africa has been pursued on the basis of little data by a handful of scientists, some of whom have an insufficient understanding of basic epidemiological principles. The notion has received respectful attention from high-level authorities in the past, including advisory panels at WHO and the US Senate, and it has been thoroughly dismissed. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5163725 Sat, 27 Aug 2011 16:35:08 +0100 5163725 http://www.medworm.com/index.php?rid=5163724&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473-3099%2811%2970175-X%2Ffulltext%3Frss%3Dyes A report by Oghenowede Eyawo and colleagues draws attention to millions of HIV-positive women in Africa who have HIV-negative partners. Such discordance is also seen in other countries with generalised HIV epidemics. Data for HIV prevalence in couples is available from national surveys in 12 of the 16 countries in Africa and Asia with the largest number of HIV infections (). In these 12 countries, the median proportion of HIV-positive women aged between 20 and 29 years who live with HIV-negative partners is 54%, and for women aged between 30 and 39 years it is 49%. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=5163724 Sat, 27 Aug 2011 16:35:08 +0100 5163724