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Sample records for asia hiv observational

  1. HIV and aging: insights from the Asia Pacific HIV Observational Database (APHOD)

    PubMed Central

    Han, N; Wright, ST; O'Connor, CC; Hoy, J; Ponnampalavanar, S; Grotowski, M; Zhao, HX; Kamarulzaman, A

    2016-01-01

    Background The proportion of people living with HIV/AIDS in the ageing population (>50 years) is increasing. We aim to explore the relationship between older age and treatment outcomes in HIV-positive persons from the Asia-Pacific region. Methods Patients from the Australian HIV Observational Database (AHOD) and the TREAT Asia HIV Observational Database (TAHOD) were included in the analysis. We used survival methods to assess the association between older age and all-cause mortality, as well as time-to treatment modification. We used regression analyses to evaluate changes in CD4 counts after combination antiretroviral therapy (cART) initiation and determined the odds of detectable viral load, up to 24 months of treatment. Results A total of 7142 patients were included in these analyses (60% TAHOD, 40% AHOD), of which, 25% were >50 years old. In multivariable analyses those aged >50 were at least twice as likely to die as those aged 30-39 years [HR (50-59 years): 2.27, 95% CI: 1.34-3.83; HR (>60years) 4.28, 95% CI: 2.42-7.55]. The effect of older age on CD4 count changes was insignificant (p-trend=0.06). The odds of detectable viral load after cART initiation decreased with age (p-trend=<0.0001). The effect of older age on time-to first treatment modification was insignificant (p-trend=0.21). We found no statistically significant differences in outcomes between AHOD and TAHOD participants for all endpoints examined. Conclusion The associations between older age and typical patient outcomes in HIV-positive patients from the Asia-Pacific region are similar in AHOD and TAHOD. Our data indicate that ‘age-effects’ traverse the resource-rich and resource-limited divide and indicate that future ageing-related findings might be applicable to each setting. PMID:25407085

  2. A Decade of Combination Antiretroviral Treatment in Asia: The TREAT Asia HIV Observational Database Cohort.

    PubMed

    2016-08-01

    Asian countries have seen the expansion of combination antiretroviral therapy (cART) over the past decade. The TREAT Asia HIV Observational Database (TAHOD) was established in 2003 comprising 23 urban referral sites in 13 countries across the region. We examined trends in treatment outcomes in patients who initiated cART between 2003 and 2013. Time of cART initiation was grouped into three periods: 2003-2005, 2006-2009, and 2010-2013. We analyzed trends in undetectable viral load (VL; defined as VL <400 copies/ml), CD4 changes from pre-cART levels, and overall survival. Of 6,521 patients included, the overall median CD4 count at cART initiation was 120 cells/μl (interquartile range: 38-218). Despite an increase over time, pre-cART CD4 counts remained <200 cells/μl. Adjusted analyses showed undetectable VL was more likely when starting cART in later years [2006-2009: odds ratio (OR) = 1.76, 95% confidence interval (CI) (1.45, 2.15); and 2010-2013: OR = 3.04, 95% CI (2.33, 3.97), all p < .001, compared to 2003-2005], and survival was improved [2006-2009: subdistribution hazard ratio (SHR) = 0.41, 95% CI (0.27, 0.61), 2010-2013: SHR = 0.29, 95% CI (0.17, 0.49), all p < .001, compared to 2003-2005]. No differences in CD4 response was observed over time. Age and CD4 levels prior to cART initiation were associated with all three treatment outcomes, with older age and higher CD4 counts being associated with undetectable VL. Survival and VL response on cART have improved over the past decade in TAHOD, although CD4 count at cART initiation remained low. Greater effort should be made to facilitate earlier HIV diagnosis and linkage to care and treatment, to achieve greater improvements in treatment outcomes. PMID:27030657

  3. Impact of Antiretroviral Therapy on Opportunistic Infections of HIV-Infected Children in the TREAT Asia Pediatric HIV Observational Database

    PubMed Central

    Prasitsuebsai, Wasana; Kariminia, Azar; Puthanakit, Thanyawee; Lumbiganon, Pagakrong; Hansudewechakul, Rawiwan; Moy, Fong Siew; Law, Matthew; Kumarasamy, Nagalingeswaran; Razali, Kamarul; Sirisanthana, Virat; Sohn, Annette H.; Chokephaibulkit, Kulkanya

    2014-01-01

    Background There are limited data on opportunistic infections (OI) and factors associated with their occurrence after highly active antiretroviral therapy (HAART) in Asian children. The use of HAART in Asia started much later than in developed countries and therefore reported findings may not be fully applicable to the pediatric HIV epidemic in Asia. Methods Retrospective and prospectively collected data from the TREAT Asia Pediatric HIV Observational Database cohort study from March 1993 to March 2009 were analyzed. OIs were defined according to WHO clinical staging criteria, and incidence rates calculated. Factors associated with the incidence of severe OIs were analyzed using random effects Poisson regression modeling. Results Of 2280 children in the cohort, 1752 were ever reported to have received ART, of whom 1480 (84%) started on HAART. Before commencing any ART, OIs occurred at a rate of 89.5 per 100 person-years. The incidence rate was 28.8 infections per 100 person-years during mono- or dual-therapy, and 10.5 infections per 100 person-years during HAART. The most common OIs both before and after ART initiation were recurrent upper respiratory tract infections, persistent oral candidiasis, and pulmonary tuberculosis. The incidence rates of WHO clinical stage 3 or 4 OIs after HAART were highest among children <18 months of age and those with low weight-for-age z scores, CD4 cell percentage <15%, and WHO stage 3 at HAART initiation. Conclusions Despite dramatic declines in their incidence, OIs remained important causes of morbidity after HAART initiation in this regional cohort of HIV-infected children in Asia. PMID:24378942

  4. Efficacy of second-line antiretroviral therapy among people living with HIV/AIDS in Asia: Results from the TREAT Asia HIV Observational Database

    PubMed Central

    BOETTIGER, David C; NGUYEN, Van Kinh; DURIER, Nicolas; BUI, Huy Vu; SIM, Benedict Lim Heng; AZWA, Iskandar; LAW, Matthew; RUXRUNGTHAM, Kiat

    2014-01-01

    Background Roughly 4% of the 1.25 million patients on antiretroviral therapy (ART) in Asia are using second-line therapy. To maximize patient benefit and regional resources it is important to optimize the timing of second-line ART initiation and use the most effective compounds available. Methods HIV positive patients enrolled in the TREAT Asia HIV Observational Database who had used second-line ART for ≥6 months were included. ART use and rates and predictors of second-line treatment failure were evaluated. Results There were 302 eligible patients. Most were male (76.5%) and exposed to HIV via heterosexual contact (71.5%). Median age at second-line initiation was 39.2 years, median CD4 cell count was 146 cells/mm3, and median HIV viral load was 16,224 copies/mL. Patients started second-line ART before 2007 (n=105), 2007-2010 (n=147) and after 2010 (n=50). Ritonavir-boosted lopinavir and atazanavir accounted for the majority of protease inhibitor use after 2006. Median follow-up time on second-line was 2.3 years. The rates of treatment failure and mortality per 100 patient/years were 8.8 (95%CI 7.1 to 10.9) and 1.1 (95%CI 0.6 to 1.9), respectively. Older age, high baseline viral load and use of a protease inhibitor other than lopinavir or atazanavir were associated with a significantly shorter time to second-line failure. Conclusions Increased access to viral load monitoring to facilitate early detection of first-line ART failure and subsequent treatment switch is important for maximizing the durability of second-line therapy in Asia. Although second-line ART is highly effective in the region, the reported rate of failure emphasizes the need for third-line ART in a small portion of patients. PMID:25590271

  5. Trends in First-Line Antiretroviral Therapy in Asia: Results from the TREAT Asia HIV Observational Database

    PubMed Central

    Boettiger, David Charles; Kerr, Stephen; Ditangco, Rossana; Merati, Tuti Parwati; Pham, Thuy Thi Thanh; Chaiwarith, Romanee; Kiertiburanakul, Sasisopin; Li, Chung Ki Patrick; Kumarasamy, Nagalingeswaran; Vonthanak, Saphonn; Lee, Christopher; Van Kinh, Nguyen; Pujari, Sanjay; Wong, Wing Wai; Kamarulzaman, Adeeba; Zhang, Fujie; Yunihastuti, Evy; Choi, Jun Yong; Oka, Shinichi; Ng, Oon Tek; Kantipong, Pacharee; Mustafa, Mahiran; Ratanasuwan, Winai; Sohn, Annette; Law, Matthew

    2014-01-01

    Background Antiretroviral therapy (ART) has evolved rapidly since its beginnings. This analysis describes trends in first-line ART use in Asia and their impact on treatment outcomes. Methods Patients in the TREAT Asia HIV Observational Database receiving first-line ART for ≥6 months were included. Predictors of treatment failure and treatment modification were assessed. Results Data from 4662 eligible patients was analysed. Patients started ART in 2003–2006 (n = 1419), 2007–2010 (n = 2690) and 2011–2013 (n = 553). During the observation period, tenofovir, zidovudine and abacavir use largely replaced stavudine. Stavudine was prescribed to 5.8% of ART starters in 2012/13. Efavirenz use increased at the expense of nevirapine, although both continue to be used extensively (47.5% and 34.5% of patients in 2012/13, respectively). Protease inhibitor use dropped after 2004. The rate of treatment failure or modification declined over time (22.1 [95%CI 20.7–23.5] events per 100 patient/years in 2003–2006, 15.8 [14.9–16.8] in 2007–2010, and 11.6 [9.4–14.2] in 2011–2013). Adjustment for ART regimen had little impact on the temporal decline in treatment failure rates but substantially attenuated the temporal decline in rates of modification due to adverse event. In the final multivariate model, treatment modification due to adverse event was significantly predicted by earlier period of ART initiation (hazard ratio 0.52 [95%CI 0.33–0.81], p = 0.004 for 2011–2013 versus 2003–2006), older age (1.56 [1.19–2.04], p = 0.001 for ≥50 years versus <30years), female sex (1.29 [1.11–1.50], p = 0.001 versus male), positive hepatitis C status (1.33 [1.06–1.66], p = 0.013 versus negative), and ART regimen (11.36 [6.28–20.54], p<0.001 for stavudine-based regimens versus tenofovir-based). Conclusions The observed trends in first-line ART use in Asia reflect changes in drug availability, global treatment recommendations and

  6. Hepatitis B and C Co-Infection in HIV Patients from the TREAT Asia HIV Observational Database: Analysis of Risk Factors and Survival

    PubMed Central

    Chen, Marcelo; Wong, Wing-Wai; Law, Matthew G.; Kiertiburanakul, Sasisopin; Yunihastuti, Evy; Merati, Tuti Parwati; Lim, Poh Lian; Chaiwarith, Romanee; Phanuphak, Praphan; Lee, Man Po; Kumarasamy, Nagalingeswaran; Saphonn, Vonthanak; Ditangco, Rossana; Sim, Benedict L. H.; Nguyen, Kinh Van; Pujari, Sanjay; Kamarulzaman, Adeeba; Zhang, Fujie; Pham, Thuy Thanh; Choi, Jun Yong; Oka, Shinichi; Kantipong, Pacharee; Mustafa, Mahiran; Ratanasuwan, Winai; Durier, Nicolas; Chen, Yi-Ming Arthur

    2016-01-01

    Background We assessed the effects of hepatitis B (HBV) or hepatitis C (HCV) co-infection on outcomes of antiretroviral therapy (ART) in HIV-infected patients enrolled in the TREAT Asia HIV Observational Database (TAHOD), a multi-center cohort of HIV-infected patients in the Asia-Pacific region. Methods Patients testing HBs antigen (Ag) or HCV antibody (Ab) positive within enrollment into TAHOD were considered HBV or HCV co-infected. Factors associated with HBV and/or HCV co-infection were assessed by logistic regression models. Factors associated with post-ART HIV immunological response (CD4 change after six months) and virological response (HIV RNA <400 copies/ml after 12 months) were also determined. Survival was assessed by the Kaplan-Meier method and log rank test. Results A total of 7,455 subjects were recruited by December 2012. Of patients tested, 591/5656 (10.4%) were HBsAg positive, 794/5215 (15.2%) were HCVAb positive, and 88/4966 (1.8%) were positive for both markers. In multivariate analysis, HCV co-infection, age, route of HIV infection, baseline CD4 count, baseline HIV RNA, and HIV-1 subtype were associated with immunological recovery. Age, route of HIV infection, baseline CD4 count, baseline HIV RNA, ART regimen, prior ART and HIV-1 subtype, but not HBV or HCV co-infection, affected HIV RNA suppression. Risk factors affecting mortality included HCV co-infection, age, CDC stage, baseline CD4 count, baseline HIV RNA and prior mono/dual ART. Shortest survival was seen in subjects who were both HBV- and HCV-positive. Conclusion In this Asian cohort of HIV-infected patients, HCV co-infection, but not HBV co-infection, was associated with lower CD4 cell recovery after ART and increased mortality. PMID:26933963

  7. HIV in Southeast Asia.

    PubMed

    Abrams, S

    1998-01-01

    This article explores the HIV/AIDS epidemic in Southeast Asia. Prostitution and injecting drug use are two major factors in the appearance of HIV/AIDS in a country. But, it is the correct social network that assures its transmission to epidemic proportions. Heterosexual transmission in Cambodia, Myanmar, and Thailand is linked with prevalence among female sex workers and their clients. In Malaysia, the Ministry of Health responded immediately, but the number of new infections continued to increase. The failures suggest the need for more effective, intensive health education programs, outreach by nongovernmental organizations, and peer education at the grassroots level and in remote areas. Public health officials need to promote political change. International agencies could play an important role, if countries such as Myanmar, Cambodia, and Viet Nam were open to international exchanges. In Myanmar, political unrest has a priority over the need for aggressive health interventions. In Indonesia, the Islamic influence prevents recognition of the country's significant sex industry or the existence of a homosexual community. In Cambodia, health officials warned about the high number of sexual partners, high mobility rate, and low condom use, but HIV spread rapidly in the 1990s. Thailand initiated a 100% condom campaign to combat HIV prevalence in the 1990s, and HIV prevalence declined among sex workers and military recruits. Risk factors for rapid transmission include mobility, the number of sexual partners/sex worker, the proportion engaging in commercial sex, and the rate of regular condom use among sex workers. PMID:12294443

  8. Prevalence, Characteristics, Management, and Outcome of Pulmonary Tuberculosis in HIV-Infected Children in the TREAT Asia Pediatric HIV Observational Database (TApHOD)

    PubMed Central

    Sudjaritruk, Tavitiya; Maleesatharn, Alan; Prasitsuebsai, Wasana; Fong, Siew Moy; Le, Ngoc Oanh; Le, Thanh Thuy Thi; Lumbiganon, Pagakrong; Kumarasamy, Nagalingeswaran; Kurniati, Nia; Hansudewechakul, Rawiwan; Yusoff, Nik Khairulddin Nik; Razali, Kamarul Azahar Mohd; Kariminia, Azar; Sohn, Annette H.

    2013-01-01

    Abstract A multicenter, retrospective, observational study was conducted to determine prevalence, characteristics, management, and outcome of pulmonary tuberculosis (PTB) in Asian HIV-infected children in the TREAT Asia Pediatric HIV Observational Database (TApHOD). Data on PTB episodes diagnosed during the period between 12 months before antiretroviral therapy (ART) initiation and December 31, 2009 were extracted. A total of 2678 HIV-infected children were included in TApHOD over a 13-year period; 457 developed PTB, giving a period prevalence of 17.1% (range 5.7–33.0% per country). There were a total of 484 PTB episodes; 27 children had 2 episodes each. There were 21 deaths (4.3%). One third of episodes (n=175/484) occurred after ART initiation at a median of 14.1 months (interquartile range [IQR] 2.5–28.8 months). The median (IQR) CD4+ values were 9.0% (3.0–16.0%) and 183.5 (37.8–525.0) cells/mm3 when PTB was diagnosed. Most episodes (n=424/436, 97.3%) had abnormal radiographic findings compatible with PTB, whereas half (n=267/484, 55.2%) presented with clinical characteristics of PTB. One third of those tested (n=42/122, 34.4%) had bacteriological evidence of PTB. Of the 156 episodes (32.2%) that were accompanied with extrapulmonary TB, pleuritis was the most common manifestation (81.4%). After treatment completion, most episodes (n=396/484, 81.9%) were recorded as having positive outcomes (cured, treatment completed and child well, and improvement). The prevalence of PTB among Asian HIV-infected children in our cohort was high. Children with persistent immunosuppression remain vulnerable to PTB even after ART initiation. PMID:24206012

  9. Contextual factors influencing HIV risk behavior in Central Asia

    PubMed Central

    Smolak, Alex

    2010-01-01

    Central Asia has experienced a rapid increase in HIV. HIV interventions and prevention programmes are needed that adequately appreciate and account for the ways that ongoing cultural, political, and economic changes in this region affect HIV risk reduction efforts. Drawing on relevant literature, this paper provides a contextual foundation to better understand the impact of context on HIV risk behaviour in the countries of Central Asia and to begin the conversation on the contextual factors of Islam and polygamy. PMID:20301020

  10. Asia: fighting HIV / AIDS makes business sense.

    PubMed

    1999-11-15

    Three Asian companies are investing in HIV/AIDS education and prevention schemes because they are starting to feel the effects of the HIV/AIDS pandemic on their workforces. A total of 17 companies from the region signed a document in the Fifth International Congress on AIDS in Asia and the Pacific committing to the fight against AIDS. The group said that effective workplace programs can prevent an increase in absenteeism, health care costs and labor turnover, a decrease in productivity, loss of experienced personnel and the need for increased resources to hire and retrain replacements. American International Assurance in Thailand accredits companies with effective HIV/AIDS campaigns in the workplace and gives them a 5-10% discount on premiums on group life insurance policies. At Freeport Mining in Indonesia, an HIV/AIDS campaign markedly improved condom usage rates and decreased incidence of sexually transmitted diseases (STDs) among workers. Meanwhile, India's Tata Tea Limited expanded its health services to include surveys, training, education, and counseling on HIV/AIDS and STDs. PMID:12295521

  11. Measures of site resourcing predict virologic suppression, immunologic response and HIV disease progression following highly active antiretroviral therapy (HAART) in the TREAT Asia HIV Observational Database (TAHOD)

    PubMed Central

    Oyomopito, R; Lee, MP; Phanuphak, P; Lim, PL; Ditangco, R; Zhou, J; Sirisanthana, T; Chen, YMA; Pujari, S; Kumarasamy, N; Sungkanuparph, S; Lee, CKC; Kamarulzaman, A; Oka, S; Zhang, FJ; Mean, CV; Merati, T; Tau, G; Smith, J; Li, PCK

    2010-01-01

    Objectives Surrogate markers of HIV disease progression are HIV RNA in plasma viral load (VL) and CD4 cell count (immune function). Despite improved international access to antiretrovirals, surrogate marker diagnostics are not routinely available in resource-limited settings. Therefore, the objective was to assess effects of economic and diagnostic resourcing on patient treatment outcomes. Methods Analyses were based on 2333 patients initiating highly active antiretroviral therapy (HAART) from 2000 onwards. Sites were categorized by World Bank country income criteria (high/low) and annual frequency of VL (≥ 3, 1–2 or <1) or CD4 (≥ 3 or <3) testing. Endpoints were time to AIDS/death and change in CD4 cell count and VL suppression (<400 HIV-1 RNA copies/mL) at 12 months. Demographics, Centers for Disease Control and Prevention (CDC) classification, baseline VL/CD4 cell counts, hepatitis B/C coinfections and HAART regimen were covariates. Time to AIDS/death was analysed by proportional hazards models. CD4 and VL endpoints were analysed using linear and logistic regression, respectively. Results Increased disease progression was associated with site-reported VL testing less than once per year [hazard ratio (HR)=1.4; P=0.032], severely symptomatic HIV infection (HR=1.4; P=0.003) and hepatitis C virus coinfection (HR=1.8; P=0.011). A total of 1120 patients (48.2%) had change in CD4 cell count data. Smaller increases were associated with older age (P<0.001) and `Other' HIV source exposures, including injecting drug use and blood products (P=0.043). A total of 785 patients (33.7%) contributed to the VL suppression analyses. Patients from sites with VL testing less than once per year [odds ratio (OR)=0.30; P<0.001] and reporting `Other' HIV exposures experienced reduced suppression (OR=0.28; P<0.001). Conclusion Low measures of site resourcing were associated with less favourable patient outcomes, including a 35% increase in disease progression in patients from sites

  12. Know your epidemic, know your response: targeting HIV in Asia.

    PubMed

    Lazarus, Jeffrey V; Curth, Nadja; Bridge, Jamie; Atun, Rifat

    2010-09-01

    This article provides an overview of the HIV epidemic in Asia, the context within which the epidemic is evolving, and the key actions to address the challenges faced by countries and risk groups. HIV epidemics across Asia are predominantly concentrated among most-at-risk populations. Although there have been many successes in the HIV response in Asia over the past decade, great challenges clearly remain - especially when addressing most-at-risk populations, who are often criminalized, marginalized, and discriminated against. These groups face significant legal and social barriers to accessing HIV prevention and treatment services. In order to reach the Millennium Development Goal of halting and reversing the spread of HIV by 2015 and to achieve universal access to HIV treatment, these barriers must be overcome across Asia. High-impact programs must be targeted at those in need, with continuous and predictable funding for a sustainable response that incorporates prevention and treatment scale-up. Strong political leadership and the involvement of affected communities are key to developing a systematic and comprehensive response. The potential consequences of inaction in Asia are enormous: even small increases in the HIV prevalence levels in the region will translate into vast numbers of new HIV infections due to the sheer size of the population. PMID:20926934

  13. The funding landscape for HIV in Asia and the Pacific

    PubMed Central

    Stuart, Robyn M; Lief, Eric; Donald, Braedon; Wilson, David; Wilson, David P

    2015-01-01

    Introduction Despite recent and robust economic growth across the Asia-Pacific region, the majority of low- and middle-income countries in the region remain dependent on some donor support for HIV programmes. We describe the availability of bilateral and multilateral official development assistance (ODA) for HIV programmes in the region. Methods The donor countries considered in this analysis are Australia, Canada, Denmark, France, Germany, Netherlands, Norway, Sweden, the United Kingdom and the United States. To estimate bilateral and multilateral ODA financing for HIV programmes in the Asia-Pacific region between 2004 and 2013, we obtained funding data from the Organisation for Economic Co-operation and Development Creditor Reporting System database. Where possible, we checked these amounts against the funding data available from government aid agencies. Estimates of multilateral ODA financing for HIV/AIDS were based on the country allocations announcement by the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) for the period 2014 to 2016. Results Countries in the Asia-Pacific region receive the largest share of aid for HIV from the Global Fund. Bilateral funding for HIV in the region has been relatively stable over the last decade and is projected to remain below 10% of the worldwide response to the epidemic. Bilateral donors continue to prioritize ODA for HIV to other regions, particularly sub-Saharan Africa; Australia is an exception in prioritizing the Asia-Pacific region, but the United States is the bilateral donor providing the greatest amount of assistance in the region. Funding from the Global Fund has increased consistently since 2005, reaching a total of US$1.2 billion for the Asia-Pacific region from 2014 to 2016. Conclusions Even with Global Fund allocations, countries in the Asia-Pacific region will not have enough resources to meet their epidemiological targets. Prevention funding is particularly vulnerable and requires greater

  14. HIV surveillance systems in the Asia Pacific region.

    PubMed

    Loo, Virginia; Saidel, Tobi; Reddy, Amala; Htin, Khin Cho Win; Shwe, Ye Yu; Verbruggen, Bob

    2012-07-01

    In 2011, the United Nations Joint Programme on HIV/AIDS (UNAIDS) Regional Support Team for Asia-Pacific conducted a stock-taking process of available strategic information in the Asia Pacific region. This paper summarizes the progress of HIV surveillance for 20 countries in the region, covering population size estimates of key populations at higher risk, HIV case reporting, HIV sentinel surveillance and probability surveys of behavioural and biological markers. Information on surveillance activities was obtained from publically available surveillance reports and protocols, supplemented by personal communication with the UNAIDS monitoring and evaluation advisers and surveillance experts in country. Key findings include substantial efforts in broadening the number and types of HIV surveillance components included in national HIV surveillance systems and adopting approaches to make surveillance more cost-efficient, such as integrating routine programme monitoring data and passive surveillance case reporting systems. More investment in regularly analysing and applying surveillance data to programme strengthening at the subnational level is needed but will require additional capacity-building and resources. The ability to triangulate multiple sources of surveillance data into a more comprehensive view of the HIV epidemic will be enhanced if more investment is made in better documentation and dissemination of surveillance activities and findings. PMID:23908915

  15. HIV surveillance systems in the Asia Pacific region

    PubMed Central

    Loo, Virginia; Reddy, Amala; Htin, Khin Cho Win; Shwe, Ye Yu; Verbruggen, Bob

    2012-01-01

    In 2011, the United Nations Joint Programme on HIV/AIDS (UNAIDS) Regional Support Team for Asia-Pacific conducted a stock-taking process of available strategic information in the Asia Pacific region. This paper summarizes the progress of HIV surveillance for 20 countries in the region, covering population size estimates of key populations at higher risk, HIV case reporting, HIV sentinel surveillance and probability surveys of behavioural and biological markers. Information on surveillance activities was obtained from publically available surveillance reports and protocols, supplemented by personal communication with the UNAIDS monitoring and evaluation advisers and surveillance experts in country. Key findings include substantial efforts in broadening the number and types of HIV surveillance components included in national HIV surveillance systems and adopting approaches to make surveillance more cost-efficient, such as integrating routine programme monitoring data and passive surveillance case reporting systems. More investment in regularly analysing and applying surveillance data to programme strengthening at the subnational level is needed but will require additional capacity-building and resources. The ability to triangulate multiple sources of surveillance data into a more comprehensive view of the HIV epidemic will be enhanced if more investment is made in better documentation and dissemination of surveillance activities and findings. PMID:23908915

  16. Migrant workers spreading HIV in Southeast Asia.

    PubMed

    1996-10-21

    Interruption of the spread of human immunodeficiency virus (HIV) across southeast Asian borders by legal and illegal migrant laborers is a major concern of the Association of Southeast Asian Nations (ASEAN). ASEAN intends to move immediately to implement regional projects focused on education, information sharing, and improved surveillance. HIV transmission from laborers from poorer countries in search of jobs in economically booming regions underscores the global nature of the AIDS problem. Malaysia, for example, has over 1 million illegal workers. Moreover, many legal guest workers who enter Malaysia with letters from a physician stating they are not HIV-infected have falsified documents. PMID:12320478

  17. Prognostic significance of the intervals between the initiation of antiretroviral therapy and anti-tuberculosis treatment in HIV-tuberculosis co-infected patients: Results from the TREAT Asia HIV Observational Database

    PubMed Central

    Han, Sang Hoon; Zhou, Jialun; Lee, Man Po; Zhao, Hongxin; Chen, Yi-Ming Arthur; Kumarasamy, Nagalingeswaran; Pujari, Sanjay; Lee, Christopher; Faridah Syed Omar, Sharifah; Ditangco, Rossana; Phanuphak, Nittaya; Kiertiburanakul, Sasisopin; Chaiwarith, Romanee; Merati, Tuti Parwati; Yunihastuti, Evy; Tanuma, Junko; Saphonn, Vonthanak; Sohn, Annette H.; Choi, Jun Yong

    2013-01-01

    Objectives We evaluated the effect of time intervals between the initiation of antiretroviral therapy (ART) and tuberculosis (TB) treatment on clinical outcomes in HIV-TB co-infected patients in an Asian regional cohort. Methods Adult HIV-TB co-infected patients in an observational HIV cohort database who had a known date of ART initiation and history of TB treatment were eligible for study inclusion. The time intervals between the initiation of ART and TB treatment were categorized as follows: TB diagnosed while on ART, early ART (<90 days after TB treatment), delayed ART (>90 days after TB treatment), and ART not started. Outcomes were assessed using survival analyses. Results A total of 768 HIV-TB co-infected patients were included in this study. Median CD4 T-cell count at TB diagnosis was 100 (IQR 40–208) cells/µL. The treatment outcomes between early ART and delayed ART initiation were not significantly different. Kaplan-Meier analysis indicated that mortality was highest for those diagnosed with TB while on ART (3.77 deaths per 100 person-years), and the prognoses of other groups were not different (in deaths per 100 person-years: 2.12 early ART, 1.46 delayed ART, and 2.94 ART not started). In a multivariate model, the interval between ART initiation and TB therapy did not significantly impact all-cause mortality. Conclusions The negative impact of delayed ART in patients co-infected with TB was not observed in this observational cohort of moderately to severely immunosuppressed patients. The broader impact of earlier ART in actual clinical practice should be monitored more closely. PMID:23980589

  18. Australia to fund HIV / AIDS projects in Southeast Asia.

    PubMed

    1994-12-19

    Australia will fund 23 new HIV-AIDS projects in Southeast Asian countries, the government announced. "Asia is predicted to be the major growth area for human immunodeficiency virus (HIV) infections over the next decade, " Minister for Development Cooperation Gordon Bilney said. "These projects, worth some $4.35 million over three years, will help meet the challenge of preventing the spread of the disease in the region." The projects--in Thailand, Vietnam, the Philippines, Indonesia, Malaysia and Cambodia--emphasize education and prevention activities as well as programs which focus on the care and support of people living with HIV, Bilney said. He also said a variety of Australian and overseas organizations will implement the projects, many of which will feature the significant involvement of communities at risk and people with HIV. "It is in keeping with the fundamental spirit of the aid program that we should seek to share this expertise with our neighbors in the region." Bilney said one Australian success story--the creative "Streetwize comics" (publications in Australia which help street kids and under privileged kids understand HIV/AIDS problems)--will be piloted in Vietnam in conjunction with the Vietnam Youth Federation. He said Vietnamese staff will be trained in the production of a series of bilingual mini-comics on HIV-AIDS prevention for youth. "This project will receive funding of $187,500 over three years," Bilney said. Bilney said the projects would help minimize the individual and social impact of the epidemic in the targeted countries. PMID:12288268

  19. HIV incidence in Asia: a review of available data and assessment of the epidemic.

    PubMed

    Dokubo, E Kainne; Kim, Andrea A; Le, Linh-Vi; Nadol, Patrick J; Prybylski, Dimitri; Wolfe, Mitchell I

    2013-01-01

    Rates of new HIV infections in Asia are poorly characterized, likely resulting in knowledge gaps about infection trends and the most important areas to target for interventions. We conducted a systematic review of peer-reviewed English language publications and conference abstracts on HIV incidence in thirteen countries - Bangladesh, Cambodia, China, India, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Taiwan, Thailand, and Vietnam. We obtained data on HIV incidence rate, incidence estimation method, population, and risk factors for incident infection. Our search yielded 338 unique incidence estimates from 70 published articles and 41 conference abstracts for eight countries. A total of 138 (41%) were obtained from prospective cohort studies and 106 (31%) were from antibody-based tests for recent infection. High HIV incidence rates were observed among commercial sex workers (0.4-27.8 per 100 person-years), people who inject drugs (0.0-43.6 per 100 person-years) and men who have sex with men (0.7-15.0 per 100 person-years). Risk factors for incident HIV infection include brothel-based sex work and cervicitis among commercial sex workers; young age, frequent injection use and sharing needles or syringes among people who inject drugs; multiple male sexual partners, receptive anal intercourse and syphilis infection among men who have sex with men. In the countries with available data, incidence rates were highest in key populations and varied widely by incidence estimation method. Established surveillance systems that routinely monitor trends in HIV incidence are needed to inform prevention planning, prioritize resources, measure impact, and improve the HIV response in Asia. PMID:23681434

  20. Oral manifestations of HIV/AIDS in Asia: Systematic review and future research guidelines

    PubMed Central

    Oberoi, Sukhvinder-Singh; Vohra, Puneeta; Nagpal, Archna

    2015-01-01

    Objectives The authors have conducted a systematic review of oral manifestations of HIV from studies conducted in Asia to establish the characteristics and prevalence of individual oral manifestations in Asia, and to assess the direction of future research studies on oral manifestations of HIV in Asia. Material and Methods The electronic retrieval systems and databases searched for relevant articles were PubMed [MEDLINE], EBSCO, and EMBASE. The search was for limited articles published in English or with an English abstract and articles published during the period January 1995 to August 2014. The authors reached a final overall sample of 39 studies that were conducted in Asia. Results The median population size among all studies was 312.7 patients. Oral candidiasis [OC] was the most common oral manifestation [37.7%] in studies conducted in Asia. The overall prevalence of oral hairy leukoplakia and melanotic hyperpigmentation was computed to be 10.1% and 22.8% respectively. Thailand and India are primarily countries with maximum research on oral manifestations. Conclusions The research on oral manifestations of HIV in Asia has to upgrade to more interventional and therapeutic studies rather than the contemporary cross- sectional epidemiological descriptive studies. The authors have given suggestions and future directions for the implementation of clinical research of oral manifestations in HIV patients. Key words:Oral manifestations, HIV/AIDS, Asia, Systematic review. PMID:26330942

  1. [Asia: front-line country in the HIV epidemic].

    PubMed

    1993-01-19

    More than 1.8 million HIV cases can be found in Thailand and India, the front-line states in the war against the spread of AIDS. Asia's booming sex industry, lax regulation, and unabated migration of people are some of the causes of the spread of AIDS. In India about 500,000 people are infected with the virus and about the same number in Thailand, however, there the official figure is much lower. According to a Thai official of the health service, nearly 2.4 million men, women, and children will be infected by the end of this century. It is estimated that 1400 Thais become infected every day. With 1 million pregnant women in Thailand, 10,000 future mothers will be infected with AIDS every year. Much of the blame is placed on the lucrative sex industry, but an aggressive AIDS awareness campaign has started including the handing out of condoms in brothels. Sex boutiques have been recruiting young girls from Burma, Laos, and Yunan province of South China with false promises of well-paying factory jobs in Thailand who ended up in prostitution. Burmese girls were preferred because they were thought to be AIDS-free, but this is no longer the case. Malaysian authorities are hunting for mobile brothels or vans packed with Thai prostitutes who are on the run to avoid being caught by police. The Malaysian health minister states that they are aware of the prostitutes' numerous clients and forewarn them about AIDS. More than 3700 Malaysians are HIV positive, most of whom are iv drug users who use infected syringes. Muslim Malaysians frown at prevention and condoms, and health authorities seem too weak to combat prostitution. PMID:8466793

  2. Global vegetation dynamics - Satellite observations over Asia

    NASA Technical Reports Server (NTRS)

    Malingreau, J.-P.

    1986-01-01

    The weekly global vegetation index (GVI) derived from the NOAA AVHRR instrument has been analyzed for the 1982-1985 period over a wide range of vegetation formations of Asia. Temporal development curves of the index are presented for environments ranging from the desert of central Asia to the tropical forest of Borneo. The paper shows that, despite the coarse resolution of the GVI product, a large set of useful information on ecosystem dynamics and cropping practices can be consistently derived from time series of such data. In addition, it is shown that the impact of the 1982-1983 El Nino Southern Oscillation-related drought can be detected in the GVI data through an analysis of anomalies in the development of selected vegetation formations. The relevance of such analysis for global vegetation monitoring and change detection is then underlined.

  3. HIV Epidemic in Asia: Implications for HIV Vaccine and Other Prevention Trials.

    PubMed

    Phanuphak, Nittaya; Lo, Ying-Ru; Shao, Yiming; Solomon, Sunil Suhas; O'Connell, Robert J; Tovanabutra, Sodsai; Chang, David; Kim, Jerome H; Excler, Jean Louis

    2015-11-01

    An overall decrease of HIV prevalence is now observed in several key Asian countries due to effective prevention programs. The decrease in HIV prevalence and incidence may further improve with the scale-up of combination prevention interventions. The implementation of future prevention trials then faces important challenges. The opportunity to identify heterosexual populations at high risk such as female sex workers may rapidly wane. With unabating HIV epidemics among men who have sex with men (MSM) and transgender (TG) populations, an effective vaccine would likely be the only option to turn the epidemic. It is more likely that efficacy trials will occur among MSM and TG because their higher HIV incidence permits smaller and less costly trials. The constantly evolving patterns of HIV-1 diversity in the region suggest close monitoring of the molecular HIV epidemic in potential target populations for HIV vaccine efficacy trials. CRF01_AE remains predominant in southeast Asian countries and MSM populations in China. This relatively steady pattern is conducive to regional efficacy trials, and as efficacy warrants, to regional licensure. While vaccines inducing nonneutralizing antibodies have promise against HIV acquisition, vaccines designed to induce broadly neutralizing antibodies and cell-mediated immune responses of greater breadth and depth in the mucosal compartments should be considered for testing in MSM and TG. The rationale and design of efficacy trials of combination prevention modalities such as HIV vaccine and preexposure prophylaxis (PrEP) remain hypothetical, require high adherence to PrEP, are more costly, and present new regulatory challenges. The prioritization of prevention interventions should be driven by the HIV epidemic and decided by the country-specific health and regulatory authorities. Modeling the impact and cost-benefit may help this decision process. PMID:26107771

  4. The emerging epidemic of HIV infection and AIDS in Asia and the Pacific.

    PubMed

    Kaldor, J M; Sittitrai, W; John, T J; Kitamura, T

    1994-01-01

    The countries of Asia in 1988 did not seem to be at great risk of sharing in the virtually global HIV/AIDS epidemic. HIV transmission was not occurring on a large scale in those countries and no dominant pattern of transmission had been established. That situation has, however, dramatically changed such that Asia and the Pacific are now fully part and parcel of the global pandemic. Indeed, Australia and New Zealand were among the first developed countries to record high rates of AIDS incidence during the early 1980s, while Thailand had documented alarming increases in HIV seroprevalence by 1988. In New Zealand and Australia, sex between men was quickly established as the dominant route of transmission, with IV drug use remaining a rare mode. IV drug use appears to have been the major transmission route in southern China, northern Malaysia, and northern Myanmar, while heterosexual transmission dominates in the majority of Asian and Pacific countries. Tuberculosis is the major opportunistic infection in the countries of Asia and a fungal pathogen of increasing importance in the region, Penicillium marneffei, had not been associated with HIV infection until the virus reached Asia. Some governments have been slow to respond, yet others including Australia and Thailand have implemented comprehensive national strategies. Many community level prevention activities are ongoing. Despite these activities and some important successes, HIV infection and its related social, economic, and political consequences continue to threaten Asia and the Pacific. PMID:7857551

  5. Explosive HIV-1 subtype B' epidemics in Asia driven by geographic and risk group founder events.

    PubMed

    Li, Yue; Uenishi, Rie; Hase, Saiki; Liao, Huanan; Li, Xiao-Jie; Tsuchiura, Takayo; Tee, Kok Keng; Pybus, Oliver G; Takebe, Yutaka

    2010-07-01

    We explored the timescale, spatial spread, and risk group population structure of HIV-1 subtype B', the cause of explosive blood-borne HIV-1 epidemics among injecting drug users (IDUs) and former plasma donors (FPDs) in Asia. Sequences from FPDs in China formed a distinct monophyletic cluster within subtype B'. Further analysis revealed that subtype B' was founded by a single lineage of pandemic subtype B around 1985. Subsequently, the FPD cluster appears to have derived from a single subtype B' lineage around 1991, corroborating the hypothesis that FPD outbreaks stemmed from the preceding epidemic among IDUs in Southeast Asia, most likely from the Golden-Triangle region. PMID:20435329

  6. HIV/AIDS in Asia: Human Rights and the Education Sector. Discussion Paper No. II

    ERIC Educational Resources Information Center

    Wijngaarden, Jan; Shaeffer, Sheldon

    2005-01-01

    An evaluation is presented on the impact of HIV/AIDS on the education sector in the Asia Pacific region. Its focus is how human rights in relation to education have been upset by the epidemic. The education sector is urged to develop more initiatives to educate about the epidemic, and to build measures that deal with both immediate and long-term…

  7. Current status of HIV treatment in Asia and the Pacific region.

    PubMed

    Phuphuakrat, Angsana; Kiertiburanakul, Sasisopin; Sungkanuparph, Somnuek

    2014-07-01

    Asia and the Pacific represent a diverse group of nations facing HIV epidemic profiles of differing severity. Compared to other parts of the world, the burden of HIV disease is high in this region because of its large populations. At the end of 2011, 5million people were living with HIV in Asia and the Pacific. This accounted for 15% of people living with HIV worldwide. The prevalence of people living with HIV, as well as access to HIV treatment and care, varies widely between countries. Differences between high-income economies and the rest of the continent are remarkable. Many high-income countries provide antiretroviral therapy (ART) to their citizens. Middle- and low-income countries have rapid ART scale-up and are dependent on international funding. This may compromise the sustainability of ART availability. In addition, lack of access to second- and third-line therapy remains a problem in many countries. The global goal of achieving universal access to ART by 2015 requires mainly low- and middle-income countries to be targeted. Regional policy should be developed in order to identify new infections in key populations, to start earlier treatment, to retain patients in care and to maintain funding. PMID:24433878

  8. Confronting the HIV, Tuberculosis, Addiction, and Incarceration Syndemic in Southeast Asia: Lessons Learned from Malaysia.

    PubMed

    Culbert, Gabriel J; Pillai, Veena; Bick, Joseph; Al-Darraji, Haider A; Wickersham, Jeffrey A; Wegman, Martin P; Bazazi, Alexander R; Ferro, Enrico; Copenhaver, Michael; Kamarulzaman, Adeeba; Altice, Frederick L

    2016-09-01

    Throughout Southeast Asia, repressive drug laws have resulted in high rates of imprisonment in people who inject drugs (PWID) and people living with HIV (PLH), greatly magnifying the harm associated with HIV, tuberculosis, and addiction. We review findings from Malaysia's largest prison to describe the negative synergistic effects of HIV, tuberculosis, addiction, and incarceration that contribute to a 'perfect storm' of events challenging public and personal health and offer insights into innovative strategies to control these converging epidemics. The majority of PLH who are imprisoned in Malaysia are opioid dependent PWID. Although promoted by official policy, evidence-based addiction treatment is largely unavailable, contributing to rapid relapse and/or overdose after release. Similarly, HIV treatment in prisons and compulsory drug treatment centers is sometimes inadequate or absent. The prevalence of active tuberculosis is high, particularly in PLH, and over 80 % of prisoners and prison personnel are latently infected. Mandatory HIV testing and subsequent segregation of HIV-infected prisoners increases the likelihood of tuberculosis acquisition and progression to active disease, amplifying the reservoir of infection for other prisoners. We discuss strategies to control these intersecting epidemics including screening linked to standardized treatment protocols for all three conditions, and effective transitional programs for released prisoners. For example, recently introduced evidence-based interventions in prisons like antiretroviral therapy (ART) to treat HIV, isoniazid preventive therapy to treat latent tuberculosis infection, and methadone maintenance to treat opioid dependence, have markedly improved clinical care and reduced morbidity and mortality. Since introduction of these interventions in September 2012, all-cause and HIV-related mortality have decreased by 50.0 % and 75.7 %, respectively. We discuss the further deployment of these

  9. CD4+ T cell recovery during suppression of HIV replication: an international comparison of the immunological efficacy of antiretroviral therapy in North America, Asia and Africa

    PubMed Central

    Geng, Elvin H; Neilands, Torsten B; Thièbaut, Rodolphe; Bosco Bwana, Mwebesa; Nash, Denis; Moore, Richard D; Wood, Robin; Marcel Zannou, Djimon; Althoff, Keri N; Lian Lim, Poh; Nachega, Jean B; Easterbrook, Philippa J; Kambugu, Andrew; Little, Francesca; Nakigozi, Gertrude; Nakanjako, Damalie; Kiggundu, Valerian; Chung Ki Li, Patrick; Bangsberg, David R; Fox, Matthew P; Prozesky, Hans W; Hunt, Peter W; Davies, Mary-Ann; Reynolds, Steven J; Egger, Matthias; Yiannoutsos, Constantin T; Vittinghoff, Eric V; Deeks, Steven G; Martin, Jeffrey N

    2015-01-01

    Background: Even among HIV-infected patients who fully suppress plasma HIV RNA replication on antiretroviral therapy, genetic (e.g. CCL3L1 copy number), viral (e.g. tropism) and environmental (e.g. chronic exposure to microbial antigens) factors influence CD4 recovery. These factors differ markedly around the world and therefore the expected CD4 recovery during HIV RNA suppression may differ globally. Methods: We evaluated HIV-infected adults from North America, West Africa, East Africa, Southern Africa and Asia starting non-nucleoside reverse transcriptase inhibitor-based regimens containing efavirenz or nevirapine, who achieved at least one HIV RNA level <500/µl in the first year of therapy and observed CD4 changes during HIV RNA suppression. We used a piecewise linear regression to estimate the influence of region of residence on CD4 recovery, adjusting for socio-demographic and clinical characteristics. We observed 28 217 patients from 105 cohorts over 37 825 person-years. Results: After adjustment, patients from East Africa showed diminished CD4 recovery as compared with other regions. Three years after antiretroviral therapy initiation, the mean CD4 count for a prototypical patient with a pre-therapy CD4 count of 150/µl was 529/µl [95% confidence interval (CI): 517–541] in North America, 494/µl (95% CI: 429–559) in West Africa, 515/µl (95% CI: 508–522) in Southern Africa, 503/µl (95% CI: 478–528) in Asia and 437/µl (95% CI: 425–449) in East Africa. Conclusions: CD4 recovery during HIV RNA suppression is diminished in East Africa as compared with other regions of the world, and observed differences are large enough to potentially influence clinical outcomes. Epidemiological analyses on a global scale can identify macroscopic effects unobservable at the clinical, national or individual regional level. PMID:25859596

  10. Precipitation over Monsoon Asia: a comparison of reanalyses and observations

    NASA Astrophysics Data System (ADS)

    Toreti, Andrea; Ceglar, Andrej; Balsamo, Gianpaolo; Kobayashi, Shinya

    2016-04-01

    Daily precipitation is essential in many impact modelling exercises and several global/regional products exist. Here, we focus on Monsoon Asia and we compare four different reanalyses with a rain-gauge gridded dataset and with a rain-gauge/satellite dataset. Differences in seasonality and distributional differences during the monsoon season are assessed by applying recently proposed approaches. Drought events during the monsoon season are compared as well. Results show remarkable differences in the seasonality of the two observational datasets as well as in the reanalyses. Distributional differences during the monsoon season are also significant almost over the whole region for all reanalyses. Finally, remarkable temporal non-stationarity characterises some of the analysed reanalyses.

  11. Challenges of cross-cultural research: Lessons from a U.S.-Asia HIV collaboration

    PubMed Central

    Chen, Wei-Ti; Shiu, Cheng-Shi; Simoni, Jane M.; Chuang, Peing; Zhao, Hongxin; Bao, Meijuan; Lu, Hongzhou

    2013-01-01

    Many Asian countries have scaled up their research to combat human immunodeficiency virus (HIV). HIV experts from the West have teamed up with these countries to assist in designing research protocols and providing necessary training. In this paper, we document the formation and maintenance of international and interdisciplinary HIV research collaboration among cross-disciplinary researchers working in the United States, Taiwan, and China. We conducted international social-behavioral HIV studies in several major metropolitan areas in Asia. Culturally sensitive issues that could be attributed to social and disciplinary differences have emerged throughout the collaboration process, including questions of who should be the research leader, where should resources be allocated, how should tasks be shared, which topics are valuable for investigation, and what survey questions are allowable. There is now a window of opportunity for greater international and interdisciplinary collaboration; however, for such collaboration to flourish, team dynamics in international research collaboration should be carefully identified and managed before studies are begun. PMID:23419838

  12. Hidden Drug Resistant HIV to Emerge in the Era of Universal Treatment Access in Southeast Asia

    PubMed Central

    Hoare, Alexander; Kerr, Stephen J.; Ruxrungtham, Kiat; Ananworanich, Jintanat; Law, Matthew G.; Cooper, David A.; Phanuphak, Praphan; Wilson, David P.

    2010-01-01

    Background Universal access to first-line antiretroviral therapy (ART) for HIV infection is becoming more of a reality in most low and middle income countries in Asia. However, second-line therapies are relatively scarce. Methods and Findings We developed a mathematical model of an HIV epidemic in a Southeast Asian setting and used it to forecast the impact of treatment plans, without second-line options, on the potential degree of acquisition and transmission of drug resistant HIV strains. We show that after 10 years of universal treatment access, up to 20% of treatment-naïve individuals with HIV may have drug-resistant strains but it depends on the relative fitness of viral strains. Conclusions If viral load testing of people on ART is carried out on a yearly basis and virological failure leads to effective second-line therapy, then transmitted drug resistance could be reduced by 80%. Greater efforts are required for minimizing first-line failure, to detect virological failure earlier, and to procure access to second-line therapies. PMID:20544022

  13. HIV-1 Drug Resistance Mutations Among Antiretroviral-Naïve HIV-1–Infected Patients in Asia: Results From the TREAT Asia Studies to Evaluate Resistance-Monitoring Study

    PubMed Central

    Oyomopito, Rebecca; Sirivichayakul, Sunee; Sirisanthana, Thira; Kantipong, Pacharee; Lee, Christopher K. C.; Kamarulzaman, Adeeba; Messerschmidt, Liesl; Law, Matthew G.; Phanuphak, Praphan

    2011-01-01

    (See editorial commentary by Jordan on pages 1058–1060.) Of 682 antiretroviral-naïve patients initiating antiretroviral therapy in a prospective, multicenter human immunodeficiency virus type 1 (HIV-1) drug resistance monitoring study involving 8 sites in Hong Kong, Malaysia, and Thailand, the prevalence of patients with ≥1 drug resistance mutation was 13.8%. Primary HIV drug resistance is emerging after rapid scaling-up of antiretroviral therapy use in Asia. PMID:21460324

  14. Characteristics of body wave microseism observed at northern continental Asia

    NASA Astrophysics Data System (ADS)

    Sheen, D. H.; Jung, S.

    2014-12-01

    It has been understood that most of microseism observed at land is generated at coastal region by the ocean wave activity and propagates into the continent as the Rayleigh wave. However, it has also been reported that microseism could be generated at mid ocean and propagate as the body waves, such as P, PP and PKP phases. In this study, we analyzed microseisms with seismic records from seismic stations that are located at northern continental Asia. These included seismic arrays and a local dense network at South Korea, Kazakhstan, and China. First, we computed seismic noise spectra in the frequency band between 0.01 and 0.4 Hz. Second, the back-azimuth and the phase velocity of the microseism were measured from the frequency-wavenumber (FK) analysis. Although each data set was recorded at different time periods, the results show similar patterns. Non-transient microseism peak around the 0.2 Hz frequency was observed coherently at all data of winter season. The FK analysis shows that this microseism propagated with the phase velocities of around 12, 11, and 21 km/s at South Korea, China, and Kazakhstan, respectively. The back-projection of the FK result shows that these body wave microseisms were mostly generated at the northern part of the Pacific.

  15. TES Observations of Enhanced Ammonia & Methanol Over Northeast Asia

    NASA Astrophysics Data System (ADS)

    Beer, R.; Bowman, K.; Clough, S. A.; Eldering, A.; Fisher, B.; Kulawik, S. S.; Kuo, M.; Osterman, G.; Sander, S. P.; Shephard, M.; Worden, J.

    2007-12-01

    The Tropospheric Emission Spectrometer (TES) on the EOS Aura satellite makes global measurements of infrared radiances that are used to derive profiles of species such as O3, CO, H2O and CH4 as routine standard products. In addition, TES has a variety of special modes that provide denser spatial mapping at the expense of reduced coverage. One of these modes (called "transect") has now been used to detect additional molecules indicative of regional air pollution. On July 10 2007 at about 05:37 UTC (13:24 LMST) TES conducted such a transect observation over northeast Asia between latitudes +37.988 & +41.998, east longitudes 117.014 & 115.746 (some 460 km long). Examination of the spectral residuals (observed - calculated) following the retrieval of the TES standard products revealed surprisingly strong features attributable to enhanced concentrations of ammonia (NH3) and methanol (CH3OH), well above the normal background levels. This is the first time that these molecules have been detected in nadir viewing measurements that penetrate into the lower atmosphere. The paper will discuss the concentration and distribution of these species over this area and offer suggestions as to their origin. This work was carried out, in part, at the Jet Propulsion Laboratory, California Institute of Technology, Pasadena, under contract with the National Aeronautics and Space Administration.

  16. HIV Disclosure and Sexual Transmission Behaviors among an Internet Sample of HIV-positive Men Who Have Sex with Men in Asia: Implications for Prevention with Positives

    PubMed Central

    Wei, Chongyi; Lim, Sin How; Guadamuz, Thomas E.; Koe, Stuart

    2012-01-01

    The relationship between HIV disclosure and sexual transmission behaviors, and factors that influence disclosure are unknown among HIV-positive men who have sex with men (MSM) in Asia. We describe disclosure practices and sexual transmission behaviors, and correlates of disclosure among this group of MSM in Asia. A cross-sectional multi-country online survey was conducted among 416 HIV-positive MSM. Data on disclosure status, HIV-related risk behaviors, disease status, and other characteristics were collected. Multivariable logistic regression was used to identify significant correlates of disclosure. Only 7.0% reported having disclosed their HIV status to all partners while 67.3% did not disclose to any. The majority (86.5%) of non-disclosing participants had multiple partners and unprotected insertive or receptive anal intercourse with their partners (67.5%). Non-disclosure was significantly associated with non-disclosure from partners (AOR = 37.13, 95% CI: 17.22, 80.07), having casual partners only (AOR = 1.91, 95% CI: 1.03, 3.53), drug use before sex on a weekly basis (AOR: 6.48, 95% CI: 0.99, 42.50), being diagnosed with HIV between 1–5 years ago (AOR = 2.23, 95% CI: 1.05, 4.74), and not knowing one’s viral load (AOR = 2.80, 95% CI: 1.00, 7.83). Given the high HIV prevalence and incidence among MSM in Asia, it is imperative to include Prevention with Positives for MSM. Interventions on disclosure should not solely focus on HIV-positive men but also need to include their sexual partners and HIV-negative men. PMID:22198313

  17. Predawn plasma bubble cluster observed in Southeast Asia

    NASA Astrophysics Data System (ADS)

    Watthanasangmechai, Kornyanat; Yamamoto, Mamoru; Saito, Akinori; Tsunoda, Roland; Yokoyama, Tatsuhiro; Supnithi, Pornchai; Ishii, Mamoru; Yatini, Clara

    2016-06-01

    Predawn plasma bubble was detected as deep plasma depletion by GNU Radio Beacon Receiver (GRBR) network and in situ measurement onboard Defense Meteorological Satellite Program F15 (DMSPF15) satellite and was confirmed by sparse GPS network in Southeast Asia. In addition to the deep depletion, the GPS network revealed the coexisting submesoscale irregularities. A deep depletion is regarded as a primary bubble. Submesoscale irregularities are regarded as secondary bubbles. Primary bubble and secondary bubbles appeared together as a cluster with zonal wavelength of 50 km. An altitude of secondary bubbles happened to be lower than that of the primary bubble in the same cluster. The observed pattern of plasma bubble cluster is consistent with the simulation result of the recent high-resolution bubble (HIRB) model. This event is only a single event out of 76 satellite passes at nighttime during 3-25 March 2012 that significantly shows plasma depletion at plasma bubble wall. The inside structure of the primary bubble was clearly revealed from the in situ density data of DMSPF15 satellite and the ground-based GRBR total electron content.

  18. Confronting the HIV epidemic in Asia and the Pacific: developing successful strategies to minimize the spread of HIV infection.

    PubMed

    Moodie, R; Aboagye-Kwarteng, T

    1993-12-01

    In Asia, the cumulative total of HIV-infected adults will reach 1.22 million by 1995, and, by 2000, the number is estimated to reach 11-45 million. The modes of transmission vary from country to country and include injecting drug users, commercial sex workers and their clients, commercial blood donors, hemophiliacs, and homosexuals. Social, cultural, and health factors also affect transmission, such as rites of passage to adulthood, lack of female autonomy, multiple sex partners, wars and civil unrest, and availability of drugs. The HIV epidemic has economic ramifications and causes, e.g., migrant worker camps, the sex industry, and rapid urbanization luring Burmese girls to Thailand. Governments must create an environment for behavior-change through financial, political, and legislative measures. Community organizations also play a role in prevention, as in programs initiated by a squatter settlement in Bangkok, where 36% of IV drug users were found to be HIV-positive. In Maharashtra State, India, peer-based prevention programs were developed for sex workers. Successful behavior change of individuals is based on redefinition of peer norms, understanding the danger and vulnerability to infection, and building confidence to change behavior. Successful programs require placing priority on HIV issues on the political agenda, negotiation and consensus-building skills, and competent program management. For instance, in Zimbabwe a project enlisted 380,000 people in 4500 education sessions within 2 years, and distributed 2.5 million condoms. Among sex workers, condom use increased from 5% to 50%. Implementation strategies include the provision of information and interpersonal education. In Zaire, mass media and social marketing efforts boosted condom sales from less than half a million in 1987 to over 20 million in 1991. The means to change behavior requires the availability of good quality condoms, disinfectants, and syringes. Furthermore, clinical management of

  19. Light-absorption properties of aerosols observed in East and South Asia

    NASA Astrophysics Data System (ADS)

    Kim, S.; Yoon, S.; Lee, H.

    2011-12-01

    We compared light-absorption properties of aerosols observed in East and South Asia from black carbon (BC) mass concentration, aerosol scattering and absorption coefficients measurements at four sites: Korea Climate Observatory-Gosan (KCO-G), Korea Climate Observatory-Anmyeon (KCO-A), Maldives Climate Observatory-Hanimaadhoo (MCO-H) and Nepal Climate Observatory-Pyramid (NCO-P). No significant seasonal variations of BC mass concentration, aerosol scattering and absorption coefficients, except for summer due to wet scavenging by rainfall, were observed in East Asia, whereas dramatic changes of light-absorbing aerosol properties were observed in South Asia between dry and wet monsoon periods. Although BC mass concentration in East Asia is generally higher than that observed in South Asia, BC mass concentration at MCO-H during winter dry monsoon is similar to that of East Asia. The observed solar absorption efficiency (absorption coefficient/extinction coefficient) at 550 nm at KCO-G and KCO-A is higher than that in MCO-H due to large portions of BC emission from fossil fuel combustion. Interestingly, solar absorption efficiency at NCO-P is 0.14, which is two times great than that in MCO-H and is about 40% higher than that in East Asia, though BC mass concentration at NCO-P is the lowest among four sites. Consistently, the highest elemental carbon to sulfate ratio is found at NCO-P.

  20. Pollution patterns in the upper troposphere over Europe and Asia observed by CARIBIC

    NASA Astrophysics Data System (ADS)

    Baker, Angela K.; Traud, Sebastian; Brenninkmeijer, Carl A. M.; Hoor, Peter; Neumaier, Marco; Oram, David E.; Rauthe-Schöch, Armin; Sprung, Detlev; Schloegl, Sebastian; Slemr, Franz; van Velthoven, Peter F. J.; Wernli, Heini; Zahn, Andreas; Ziereis, Helmut

    2014-10-01

    Between May 2005 and March 2008 the CARIBIC (Civil Aircraft for the Regular Investigation of the atmosphere Based on an Instrument Container) observatory was deployed to make atmospheric observations on 42 flights between Frankfurt, Germany and Manila, the Philippines. This nearly 3 year flight series provides information about atmospheric composition in the upper troposphere over Europe and Asia during all seasons and was used to investigate seasonal and regional differences in trace gas distributions and the influence of long range transport and local convection on composition. The flight route was separated into three different regions having characteristic differences in transport and composition; these were Europe and Western Asia (5°E-60°E), Central Asia (60°E-100°E) and Southeast Asia (100°E-125°E). The region over Europe and Western Asia was strongly influenced by air masses from North America, while the region over Southeast Asia was mostly influenced by local emissions, particularly from biomass/biofuel burning as indicated by high levels of acetonitrile and carbon monoxide. Air masses over Central Asia were found to be influenced by both recent convection from the Indian subcontinent and mid-range transport from Europe, Western Asia and the Middle East. Elevated levels of propane and other non-methane hydrocarbons, both with and without concomitant elevations in other trace gases (i.e. carbon monoxide, acetonitrile) was a persistent feature over Central Asia in all seasons except summer, and were particularly prominent in fall. Influences on composition over Central Asia were investigated in detail for a case study from a series of flights in October 2006, where elevated levels of pollutants were found to be the result of convective transport of both biomass/biofuel burning and urban emissions from South Asia and fossil fuel related emissions from Eastern Europe.

  1. Global Health Donor Presence, Variations in HIV/AIDS Prevalence, and External Resources for Health in Developing Countries in Africa and Asia

    PubMed Central

    Azuine, Romuladus Emeka; Singh, Gopal K.; Ekejiuba, Sussan E.; Ashu, Eta; Azuine, Magnus A.

    2014-01-01

    Objective: The presence of multiple global health aid organizations in donor recipient countries at any point in time has led to arguments for and against aid coordination and aid pluralism. Little data, however, exist to empirically demonstrate the relationship between donor presence and longitudinal disease outcomes in donor-recipient countries. We examined the association between global health donor presence and changes in HIV/AIDS prevalence in 14 developing countries: 12 in Africa (Ethiopia, Kenya, Tanzania, Malawi, Zimbabwe, Mozambique, Rwanda, South Africa, Uganda, Zambia, Burkina Faso and Mali) and compared them with two developing countries in Asia (India and Vietnam). Methods: To conduct our analyses, we conceptualized a framework for examining global health donor presence and disease outcomes. Donor presence data were derived from Mapping the Donor Landscape in Global Health: HIV/AIDS, a report published by the Kaiser Family Foundation, Washington, DC, USA. HIV/AIDS prevalence data were obtained and analyzed from the World Health Statistics and the Demographic and Health Surveys. Percent changes in national HIV/AIDS prevalence between 2009 and 2011 in the 14 developing countries were computed and correlation coefficients between donor presence and prevalence changes were calculated. Results: Between 2009 and 2011, HIV/AIDS prevalence decreased in all but one of the 14 developing countries with the presence of 21 or more global health donors. There was about 40% overall reduction in HIV/AIDS prevalence across the 14 countries in our analyses. South Africa recorded the most reduction in HIV/AIDS prevalence (-6.7%) followed by Zambia (-6.3, %), and Mozambique (-5.7%). Ethiopia was the only country without a reduction in HIV/AIDS prevalence (+0.1%). A correlation coefficient of 0.43 implied greater reductions in HIV/AIDS prevalence associated with increased donor presence. Conclusions and Public Health Implications: Our study shows a correlation between

  2. The Potential Role of Circuit Parties in the Spread of HIV among Men Who Have Sex with Men in Asia: A Call for Targeted Prevention

    PubMed Central

    Cheung, Doug H.; Lim, Sin How; Guadamuz, Thomas E.; Koe, Stuart; Wei, Chongyi

    2014-01-01

    We postulated that the growing popularity of circuit parties may play a role in the escalating HIV prevalence among men who have sex with men (MSM) in Asia. The present study is the first to characterize the sociodemographic and HIV-related behavioral factors of circuit party attendees living in Asia. We analyzed a subset of data from the Asia Internet MSM Sex Survey conducted from January 1 to February 28, 2010. Inclusion criteria included: being biologically male, aged 18 years or above, self-reported sex with another man, and reported international travel in the past 6 months (N = 6,094). From our multivariable logistic regression model, participants’ resident country with low HIV prevalence (among MSM) (AOR: 1.59, 95% CI: 1.27–2.00) and country of destination with high HIV prevalence were independently associated with higher odds of circuit party attendance (AOR: 1.32, 95% CI: 1.14–1.53) during international travel. Statistical interaction indicated circuit party attendees were likely to have traveled from low HIV prevalence (among MSM) countries to high HIV prevalence countries (AOR: 1.40, 95% CI: 1.20–1.64). Other independent correlates included unprotected anal sex with a male casual sex partner and recreational drug use during travel. HIV and STI prevention focusing on circuit party attendees may have a pivotal role on the spread of the HIV epidemics among MSM in Asia. PMID:25104105

  3. The Impact of HIV/AIDS on Children and Young People: Reviewing Research Conducted and Distilling Implications for the Education Sector in Asia. Discussion Paper No. I

    ERIC Educational Resources Information Center

    Wijngaarden, Jan; Shaeffer, Sheldon

    2005-01-01

    This discussion paper evaluates the impact of HIV/AIDS on the education sector in the Asia Pacific region. It looks at the impact of the epidemic on children (aged 0-18) focusing on how the presence of HIV/AIDS in the household affects the education sector. Examples are summarized from research papers from inter-governmental agencies including…

  4. Characterizing HIV Manifestations and Treatment Outcomes of Perinatally Infected Adolescents in Asia

    PubMed Central

    Chokephaibulkit, Kulkanya; Kariminia, Azar; Oberdorfer, Peninnah; Nallusamy, Revathy; Bunupuradah, Torsak; Hansudewechakul, Rawiwan; Dung, Khu Thi Khanh; Saphonn, Vonthanak; Kumarasamy, Nagalingeswaran; Lumbiganon, Pagakrong; Viet, Do Chau; Kurniati, Nia; Yusoff, Nik Khairuddin Nik; Razali, Kamarul; Fong, Siew Moy; Khanh, Truong Huu; Wati, Dewi Kumara; Sohn, Annette H.

    2013-01-01

    Background More perinatally HIV-infected children in Asia are reaching adolescence. Methods We analyzed data from July 1991 to March 2011 reported by 18 clinics in six countries of children age >12 years. Results Of 1,254 adolescents, 33 (2.6%) died, and 52 (4.2%) were lost to follow-up within 2.4-year (3566 person-years) median follow-up period. Of 1,061 adolescents under active follow-up, 485 (46%) were male, median (IQR) age was 14.7 (13.3-16.4) years, 73% had lost a parent(s), 93% attended school, and 62% were aware of their HIV status. At the most recent evaluation, 93% were receiving highly active antiretroviral therapy (ART), 71% (N=737/1035) had CD4 >500 cells/mm3 and 86% (N=718/830) had viral load (VL) <400 copies/mL. Current CD4 >200 cells/mm3, no previous WHO stage 3 or 4, and being on a first-line regimen were independently associated with recent VL <400 copies/mL. Current age <15 years, VL <400 copies/ml, CD4 15-24% (vs. <10%) at ART initiation, no previous WHO stage 3 or 4, and ART duration of >1 year were associated with recent CD4 >500 cells/mm3.Primary causes of death after age 12 were opportunistic infections (N=15/33) and other AIDS- or treatment-related conditions (N=9/33). Those at age 12 with CD4 <200 vs. >500 cells/mm3 and those with VL >10,000 vs. <10,000 copies/mL were 17.4 and 4.76 times more likely to die in adolescence, respectively. Conclusion Adolescents in this cohort have been successfully maintained in HIV care. Initiating treatment at earlier stages of disease was associated with immune recovery and virologic suppression during adolescence. PMID:23942457

  5. Aerosol Optical Properties in Southeast Asia From AERONET Observations

    NASA Astrophysics Data System (ADS)

    Eck, T. F.; Holben, B. N.; Boonjawat, J.; Le, H. V.; Schafer, J. S.; Reid, J. S.; Dubovik, O.; Smirnov, A.

    2003-12-01

    There is little published data available on measured optical properties of aerosols in the Southeast Asian region. The AERONET project and collaborators commenced monitoring of aerosol optical properties in February 2003 at four sites in Thailand and two sites in Viet Nam to measure the primarily anthropogenic aerosols generated by biomass burning and fossil fuel combustion/ industrial emissions. Automatic sun/sky radiometers at each site measured spectral aerosol optical depth in 7 wavelengths from 340 to 1020 nm and combined with directional radiances in the almucantar, retrievals were made of spectral single scattering albedo and aerosol size distributions. Angstrom exponents, size distributions and spectral single scattering albedo of primarily biomass burning aerosols at rural sites are compared to measurements made at AERONET sites in other major biomass burning regions in tropical southern Africa, South America, and in boreal forest regions. Additionally, the aerosol single scattering albedo and size distributions measured in Bangkok, Thailand are compared with those measured at other urban sites globally. The influences of aerosols originating from other regions outside of Southeast Asia are analyzed using trajectory analyses. Specifically, cases of aerosol transport and mixing from Southern China and from India are presented.

  6. Characteristics of Overshooting Convections over Asia Observed from TRMM Satellite

    NASA Astrophysics Data System (ADS)

    Yuan, T.; Li, X.

    2014-12-01

    The spatial-temporal distribution and intensity of Overshooting Convections (OCs) over Asian have been investigated by using the multi-sensor data based on the Tropical Rainfall Measuring Mission (TRMM) satellite from 1998 to 2011, and the corresponding meteorological fields also have been analyzed from the European Centre for Medium-Range Weather Forecasts (ECMWF) reanalysis data (i.e. ERA-Interim). The results show that OCs Only account for 2.6% of total cold cloud systems (cloud top IR brightness temperature less than 235 K) over Asian, and are mainly distributed to the south of 15°N, and nearly 50% of OCs occur in summer. The number of OCs over the ocean is higher than that over the land almost in every month, and the volumetric precipitation rate and area of OCs over the ocean are also higher than that over the land. It can be seen that OCs is obviously stronger than Non-Overshooting Convections (NOCs), and the OCs over the land are stronger than that over the ocean from lightning frequency, microwave brightness temperature and radar echo top. Strong OCs are mainly concentrated in the south slope of the Himalayas, eastern China and Southeast Asia, where the probability of OCs occurrence is also higher. It can be found that there are similar patterns of spatial distribution between OCs and thermodynamic and humidity parameters. The CAPE and specific humidity in the tropics are higher than that in the subtropics, which provides a favorable environmental condition for OCs occurrence. In summer, the same scenario also can be seen in the south slope of the Himalayas and the eastern-central China.

  7. Redressing the Epidemics of Opioid Overdose and HIV among People who Inject Drugs in Central Asia: The Need for a Syndemic Approach

    PubMed Central

    Gilbert, Louisa; Primbetova, Sholpan; Nikitin, Danil; Hunt, Timothy; Terlikbayeva, Assel; Momenghalibaf, Azzi; Ruziev, Murodali; El-Bassel, Nabila

    2013-01-01

    Background Accumulating evidence suggests that opioid overdose and HIV infection are burgeoning intertwined epidemics among people who inject drugs (PWID) in Central Asia. To date, however, research on overdose and its associations with HIV risks among PWID in Central Asia remains virtually absent. This paper aims to provide a regional overview of the hidden epidemic of overdose and how it is linked to HIV among PWID in Central Asia, using a syndemic framework that is guided by risk environment research. Methods We conducted a comprehensive literature search of peer-reviewed publications and grey literature on opioid overdose and its associations with HIV in five countries of Central Asia (Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan) as well as on policies and programs that address these co-occurring epidemics. Results Regional data indicate high rates of fatal and non-fatal overdose among PWID. Evidence suggests mortality rates from overdose exceed HIV/AIDS as the leading cause of death among PWID. The syndemic framework suggests multiple macro-level and micro-level environmental risk factors that drive the co-occurring epidemics of HIV and overdose. This framework identifies several interacting biological and behavioral risks that result in additive effects for HIV and overdose. Conclusion The high rates of overdose and its associations with HIV underscore the need for a syndemic approach that considers overdose on parity with HIV. Such an approach should focus on the biological, behavioral and structural interactions between these epidemics to reduce social suffering, morbidity and mortality among PWID in Central Asia. PMID:23954070

  8. HIV among people who inject drugs in Central and Eastern Europe and Central Asia: a systematic review with implications for policy

    PubMed Central

    Jolley, Emma; Rhodes, Tim; Platt, Lucy; Hope, Vivian; Latypov, Alisher; Donoghoe, Martin; Wilson, David

    2012-01-01

    Background and objectives HIV among people who inject drugs (PWID) is a major public health concern in Eastern and Central Europe and Central Asia. HIV transmission in this group is growing and over 27 000 HIV cases were diagnosed among PWID in 2010 alone. The objective of this systematic review was to examine risk factors associated with HIV prevalence among PWID in Central and Eastern Europe and Central Asia and to describe the response to HIV in this population and the policy environments in which they live. Design A systematic review of peer-reviewed and grey literature addressing HIV prevalence and risk factors for HIV prevalence among PWID and a synthesis of key resources describing the response to HIV in this population. We used a comprehensive search strategy across multiple electronic databases to collect original research papers addressing HIV prevalence and risk factors among PWID since 2005. We summarised the extent of key harm reduction interventions, and using a simple index of ‘enabling’ environment described the policy environments in which they are implemented. Studies reviewed Of the 5644 research papers identified from electronic databases and 40 documents collected from our grey literature search, 70 documents provided unique estimates of HIV and 14 provided multivariate risk factors for HIV among PWID. Results HIV prevalence varies widely, with generally low or medium (<5%) prevalence in Central Europe and high (>10%) prevalence in Eastern Europe. We found evidence for a number of structural factors associated with HIV including gender, socio-economic position and contact with law enforcement agencies. Conclusions The HIV epidemic among PWID in the region is varied, with the greatest burden generally in Eastern Europe. Data suggest that the current response to HIV among PWID is insufficient, and hindered by multiple environmental barriers including restricted access to services and unsupportive policy or social environments. PMID:23087014

  9. Access to HIV counseling and testing among people who inject drugs in Central Asia: Strategies for improving access and linkages to treatment and care

    PubMed Central

    Terlikbayeva, Assel; Zhussupov, Baurzhan; Primbetova, Sholpan; Gilbert, Louisa; Atabekov, Nurmat; Giyasova, Gusal; Ruziev, Murodali; Soliev, Alijon; Saliev, Daniiar; El-Bassel, Nabila

    2013-01-01

    Introduction As a population profoundly affected by the HIV epidemic and in critical need of linkages to HIV treatment and care, PWID in Central Asia remain largely underserved. This paper provides an overview of the current state of HIV testing and counseling in Central Asia for PWID, identifies main barriers leading to gaps in service delivery, and discusses implications for improving strategies that promote HIV testing for PWID. Methods We reviewed a number of sources for this paper including unpublished government reports, published papers, and Ministries of Health of Kazakhstan, Kyrgyzstan, Tajikistan, and Uzbekistan country progress reports to the UN General Assembly Special Session on HIV/AIDS (UNGASS) for 2012. Results Between 29 to 65% of PLWH in some Central Asian countries have been tested for HIV in the last 12 months. The rates have been increasing in the recent years but still are relatively low. Stigma, discrimination, human rights violations, and repressive legislation are barriers to HTC for people who inject drugs (PWID). Conclusion The use of innovative evidence-based HTC models, such as community mobile-vans, self-testing at home, and rapid HIV testing among PWID in Central Asia are discussed and recommendations given regarding amendments in legislation and scaling up of existing community-based pilot projects to support HIV testing among PWID in CA. PMID:23916319

  10. The Japanese Air Pollusion Observation Missions, GMAP-Asia and APOLLO.

    NASA Astrophysics Data System (ADS)

    Kasai, Y.; Kita, K.; Kanaya, Y.; Gmap-Asia; Apollo Mission Team

    2011-12-01

    There are two mission concepts in Japan for air quality observation, GMAP-Asia (Geostationary mission for Meteorology and Air Pollution) from geostationary orbit and APOLLO (Atmospheric pollution observation) from Japanese Experiment Module (JEM) of International Space Station (ISS). The mission's purpose is to identify human versus natural sources of ozone and its precursors, aerosols, and intercontinental air pollution transport, and understand the dynamics of coastal ecosystems. The scientific targets are: 1. Understanding of global air quality status. 2. Air pollution and human health. 3. Impact of air pollution on climate change. GMAP-Asia passed the Mission Definition Review in Japanese space agency in December 2009, and continue the investigation of the instrument. Science working groups are developing and prioritizing the requirements for atmospheric composition, and aerosols for for APOLLO mission. In this talk we will summarize the current status of GMAP-Asia and APOLLO mission study activities.

  11. Accelerating harm reduction interventions to confront the HIV epidemic in the Western Pacific and Asia: the role of WHO (WPRO)

    PubMed Central

    Mesquita, Fabio; Jacka, David; Ricard, Dominique; Shaw, Graham; Tieru, Han; Yifei, Hu; Poundstone, Katharine; Salva, Madeline; Fujita, Masami; Singh, Nirmal

    2008-01-01

    The epidemic of HIV/AIDS linked to injecting drug usage is one of the most explosive in recent years. After a historical epicentre in Europe, South and North America, at present it is clearly the main cause of dissemination of the epidemic in Eastern Europe and some key Asian countries. Recently, 10 African countries reported the spread of HIV through people who inject drugs (PWID), breaking one of the final geographical barriers to the globalization of the epidemic of HIV among and from PWID. Several countries of the Asia and Pacific Region have HIV epidemics that are driven by injecting drug usage. Harm reduction interventions have been implemented in many countries and potential barriers to implementation are being overcome. Harm reduction is no longer a marginal approach in the Region; instead, it is the core tool for responding to the HIV/AIDS epidemic among PWID. The development of a comprehensive response in the Region has been remarkable, including scaling up of needle and syringe programmes (NSPs), methadone maintenance treatment (MMT), and care, support and treatment for PWID. This development is being followed up by strong ongoing changes in policies and legislations. The main issue now is to enhance interventions to a level that can impact the epidemic. The World Health Organization (WHO) is one of the leading UN agencies promoting harm reduction. Since the establishment of the Global Programme on AIDS, WHO has been working towards an effective response to the HIV epidemic among PWID. WHO's work is organized into a number of components: establishing an evidence base; advocacy; development of normative standards, tools and guidelines; providing technical support to countries; ensuring access to essential medicines, diagnostics and commodities; and mobilizing resources. In this paper, we trace the course of development of the HIV/AIDS epidemic among and from PWID in the Western Pacific and Asia Region (WPRO) as well as WHO's role in supporting the

  12. Regional scale modeling of atmospheric CO2 over East Asia and comparison with satellite observations

    NASA Astrophysics Data System (ADS)

    Shim, C.

    2012-12-01

    East Asia is now the most important regions in terms of CO2 emissions and the analyzing accurate CO2 budget is critical issue for low-carbon policy. He we show the simulated regional scale CO2 distribution. The regional scale chemical transport model (WRF-Chem) was used with 50km x 50km resolution. The lateral boundary conditions were from GEOS-Chem CO2 simulations (with 2x2.5 degree resolution) where the chemical CO2 production and 3-D emissions from aviation were included. It is clear that the seasonal changes in north-south gradient of CO2 concentration over East Asia is shown by the model. In spring, the westerly transport of CO2 from north-east China is dominant, which increases the higher CO2 concentration in northern part of East Asia in the lower troposphere (< 2km). In contrast, the strong CO2 sink of vegetation from northern part of Asia and Siberia reduces CO2 concentration significantly in northern part of East Asia. The modeling results represent that the seasonal CO2 changes in the spatial distribution are affected by both the Chinese CO2 emissions and CO2 sinks from the vegetation. The modeling results are compared with the recent GOSAT CO2 column observations and stationary data. The regional CO2 modeling study will help the global low carbon policy for responding to recent climate change.

  13. Prevalence of sexually transmitted infections in HIV positive and HIV negative females, in a tertiary care hospital - An observational study

    PubMed Central

    Chopra, Dimple; Sandhu, Ivy; Bahl, RK; Bhatia, Ruby; Goyal, Anupama

    2015-01-01

    The presentation and course of Sexually transmitted diseases(STI) may be altered by presence of coexisting HIV status. Aim of the study was to study the prevalence of STI in 50 females with HIV infection and 50 females without HIV infection and to study the pap smear of patients to look for any cellular changes (dysplasia) due to sexually transmitted infections. Material and methods: The present study was an observational study, which was undertaken on 100 females with STIs (50 females with coexistent HIV infection and 50 females without HIV infection), in the age group 15-49 years attending Skin and VD OPD of Rajindra hospital, Patiala. Results: In our study, the commonest presenting complaint in case of both HIV positive (66%) and HIV negative (80%) women was vaginal discharge. PAP smear abnormalities were present in 28 (56%) HIV positive women and 11 (22%) HIV negative women. In case of HIV positive women, the inflammation was trichomonal in 4 (8%), bacterial in 2 (4%), fungal in 2 (4%) and non-specific in 20 (40%) patients. In HIV negative women, the inflammation was trichomonal in 2 (4%) patients, bacterial in 2 (4%) patients and non-specific in 7 (14%) patients. The difference in abnormality seen in PAP smear between HIV positive and HIV negative women is statistically significant only in case of non-specific inflammation which is more common in case of HIV positive women. Conclusion: From the present study, it was concluded vaginal discharge was the commonest presenting complaint in both HIV positive and HIV negative women, though the commonest cause of vaginal discharge was candidiasis in HIV positive females and bacterial vaginosis in HIV negative females. Also, PAP smear abnormalities were significantly higher in HIV positive women than HIV negative women. So it is important that HIV positive women should have complete gynecological evaluation including a PAP smear with aggressive screening of STIs. PMID:26392656

  14. AEROSOL Characterization in SW Asia from long-term AERONET Observations

    NASA Astrophysics Data System (ADS)

    Holben, B. N.

    2005-12-01

    The Arabian Gulf is a focus of aerosol sources and transport in Southwest Asia owing to arid landscapes modified by land degradation, a highly developed fossil fuel industry and the unique meteorology of the region. The aerosol properties were well characterized in the gulf during the UAE2 campaign but their impact on the greater South and Southwest Asia aerosol environment is not well known. The AERONET program has a well established network in the gulf region with a growing distribution in SW Asia including India, Israel, Chad, and SE Africa and Indian Ocean island sites. This presentation will compare the UAE2 campaign and longer term gulf region aerosol characterizations from AERONET to the wider subcontinental and oceanic aerosol properties measured by AERONET over the last decade. These long-term point observations will be supported by backtrajectories and selected MODIS and MISR data since 2001.

  15. Comparison of predicted susceptibility between genotype and virtual phenotype HIV drug resistance interpretation systems among treatment-naive HIV-infected patients in Asia: TASER-M cohort analysis

    PubMed Central

    2012-01-01

    Background Accurate interpretation of HIV drug resistance (HIVDR) testing is challenging, yet important for patient care. We compared genotyping interpretation, based on the Stanford University HIV Drug Resistance Database (Stanford HIVdb), and virtual phenotyping, based on the Janssen Diagnostics BVBA’s vircoTYPE™ HIV-1, and investigated their level of agreement in antiretroviral (ARV) naive patients in Asia, where non-B subtypes predominate. Methods Sequences from 1301 ARV-naive patients enrolled in the TREAT Asia Studies to Evaluate Resistance – Monitoring Study (TASER-M) were analysed by both interpreting systems. Interpretations from both Stanford HIVdb and vircoTYPE™ HIV-1 were initially grouped into 2 levels: susceptible and non-susceptible. Discrepancy was defined as a discordant result between the susceptible and non-susceptible interpretations from the two systems for the same ARV. Further analysis was performed when interpretations from both systems were categorised into 3 levels: susceptible, intermediate and resistant; whereby discrepancies could be categorised as major discrepancies and minor discrepancies. Major discrepancy was defined as having a susceptible result from one system and resistant from the other. Minor discrepancy corresponded to having an intermediate interpretation in one system, with a susceptible or resistant result in the other. The level of agreement was analysed using the prevalence adjusted bias adjusted kappa (PABAK). Results Overall, the agreement was high, with each ARV being in “almost perfect agreement”, using Landis and Koch’s categorisation. Highest discordance was observed for efavirenz (75/1301, 5.8%), all arising from susceptible Stanford HIVdb versus non-susceptible vircoTYPE™ HIV-1 predictions. Protease Inhibitors had highest level of concordance with PABAKs all above 0.99, followed by Nucleoside Reverse Transcriptase Inhibitors with PABAKs above 0.97 and non-NRTIs with the lowest PABAK of 0.88. The

  16. Observed Holiday Aerosol Reduction and Temperature Cooling over East Asia

    SciTech Connect

    Gong, Daoyi; Wang, Wenshan; Qian, Yun; Bai, Wenbing; Guo, Yuanxi; Mao, Rui

    2014-06-16

    The Spring Festival air pollution in China was investigated using the long-term observations from 2001-2012 over 323 stations. During the Spring Festival with nearly half of urban population leaving the cities for holidays, the particulate matter (PM10) concentration is about 24.5μgm-3 (23%) lower than normal days. Associated with the national-wide burning of firework, the PM10 concentration sharply increases to 123.8μgm-3 at Chinese New Year Day (increment of 35%). Similar to PM10, the SO2 and NO2 decrease from high values in normal days to a holiday minimum with reduction of 23.3% and 30.6%, respectively. The NO2 has no peak in New Year Day because of the different emission source. The night mean and minimum temperature co-vary with PM10. Both nighttime mean and minimum temperature decrease by about 2.1°C during the holidays. And in association with the pollution jump at New Year Day the night temperature simultaneously increase by about 0.89°C. The in-phase co-variations between PM10 and night temperature suggest an overall warming effect of holiday aerosol during winter in China.

  17. Observed holiday aerosol reduction and temperature cooling over East Asia

    NASA Astrophysics Data System (ADS)

    Gong, Dao-Yi; Wang, Wenshan; Qian, Yun; Bai, Wenbing; Guo, Yuanxi; Mao, Rui

    2014-06-01

    The air pollution in Chinese Spring Festival (CSF) period over eastern China was investigated using the long-term observations from 2001 to 2012 over 323 stations. The dominant feature of the pollutants around the CSF holidays is the significant reduction of concentration. During the 10day period around the CSF (but excluding the Lunar New Year's Day, LNYD), PM10 experiences a reduction of -9.24%. In association with the aerosol reduction, temperature significantly drops over eastern China. From the third day before the LNYD to the second day after, the daily mean temperature anomaly is -0.81°C, and for no-rain days the anomaly is -0.85°C. The simultaneous anomalies of the daily maximum and minimum temperatures are -0.79°C and -0.82°C, respectively. From the third day to seventh day after the LNYD, the significant negative temperature anomalies move out of China, extending to a broad area from the South China Sea to the western North Pacific. Between the 8th and the 12th days, the significant temperature anomalies can still be found over 140°E-160°E and 15°N-25°N. The reduced downward longwave flux might play an important role in holiday cooling. The possible atmospheric feedback is discernable. The thermal and circulation configuration accompanying the cooling favors baroclinic interaction between upper and lower troposphere for the midlatitude cyclone. The anomalous cyclone becomes mature during the third to the seventh day after the LNYD and disappears 12 days later. The anomalous northern winds in association with the cyclone decrease the temperature and also help disperse the holiday aerosols over eastern China.

  18. Capacity building and predictors of success for HIV-1 drug resistance testing in the Asia-Pacific region and Africa

    PubMed Central

    Land, Sally; Zhou, Julian; Cunningham, Philip; Sohn, Annette H; Singtoroj, Thida; Katzenstein, David; Mann, Marita; Sayer, David; Kantor, Rami

    2013-01-01

    Background The TREAT Asia Quality Assessment Scheme (TAQAS) was developed as a quality assessment programme through expert education and training, for laboratories in the Asia-Pacific and Africa that perform HIV drug-resistance (HIVDR) genotyping. We evaluated the programme performance and factors associated with high-quality HIVDR genotyping. Methods Laboratories used their standard protocols to test panels of human immunodeficiency virus (HIV)-positive plasma samples or electropherograms. Protocols were documented and performance was evaluated according to a newly developed scoring system, agreement with panel-specific consensus sequence, and detection of drug-resistance mutations (DRMs) and mixtures of wild-type and resistant virus (mixtures). High-quality performance was defined as detection of ≥95% DRMs. Results Over 4.5 years, 23 participating laboratories in 13 countries tested 45 samples (30 HIV-1 subtype B; 15 non-B subtypes) in nine panels. Median detection of DRMs was 88–98% in plasma panels and 90–97% in electropherogram panels. Laboratories were supported to amend and improve their test outcomes as appropriate. Three laboratories that detected <80% DRMs in early panels demonstrated subsequent improvement. Sample complexity factors – number of DRMs (p<0.001) and number of DRMs as mixtures (p<0.001); and laboratory performance factors – detection of mixtures (p<0.001) and agreement with consensus sequence (p<0.001), were associated with high performance; sample format (plasma or electropherogram), subtype and genotyping protocol were not. Conclusion High-quality HIVDR genotyping was achieved in the TAQAS collaborative laboratory network. Sample complexity and detection of mixtures were associated with performance quality. Laboratories conducting HIVDR genotyping are encouraged to participate in quality assessment programmes. PMID:23845227

  19. Comparisons of anemia, thrombocytopenia, and neutropenia at initiation of HIV antiretroviral therapy in Africa, Asia, and the Americas

    PubMed Central

    Firnhaber, Cynthia; Smeaton, Laura; Saukila, Nasinuku; Flanigan, Timothy; Gangakhedkar, Raman; Kumwenda, Johnstone; La Rosa, Alberto; Kumarasamy, Nagalingeswaran; De Gruttola, Victor; Hakim, James Gita; Campbell, Thomas B.

    2010-01-01

    Summary Background Hematological abnormalities are common manifestations of advanced HIV-1 infection that could affect the outcomes of highly-active antiretroviral therapy (HAART). Although most HIV-1-infected individuals live in resource-constrained countries, there is little information about the frequency of hematological abnormalities such as anemia, neutropenia, and thrombocytopenia among individuals with advanced HIV-1 disease. Methods This study compared the prevalence of pre-antiretroviral therapy hematological abnormalities among 1571 participants in a randomized trial of antiretroviral efficacy in Africa, Asia, South America, the Caribbean, and the USA. Potential covariates for anemia, neutropenia, and thrombocytopenia were identified in univariate analyses and evaluated in separate multivariable models for each hematological condition. Results The frequencies of neutropenia (absolute neutrophil count ≤ 1.3 × 109/l), anemia (hemoglobin ≤ 10 g/dl), and thrombocytopenia (platelets ≤ 125 × 109/l) at initiation of antiretroviral therapy were 14%, 12%, and 7%, respectively, and varied by country (p < 0.0001 for each). In multivariable models, anemia was associated with gender, platelet count, and country; neutropenia was associated with CD4+ lymphocyte and platelet counts; and thrombocytopenia was associated with country, gender, and chronic hepatitis B infection. Conclusions Differences in the frequency of pretreatment hematological abnormalities could have important implications for the choice of antiretroviral regimen in resource-constrained settings. PMID:20961784

  20. Observations of Light-Absorbing Carbonaceous Aerosols in East and South Asia

    NASA Astrophysics Data System (ADS)

    Yoon, S.; Kim, S.; Choi, W.

    2013-05-01

    Light-absorbing aerosols, such as black carbon (BC), brown carbon and mineral dust, typically constitute a small fraction of ambient particle mass but can contribute to solar radiative forcing through absorption of solar radiation and heating of the absorbing aerosol layer. Besides the direct radiative effect, the heating can evaporate clouds and change the atmospheric dynamics. In this study, we investigate the optical and radiative properties of light-absorbing aerosols from ground-based and aircraft measurements in East and South Asia within the framework of UNEP Atmospheric Brown Cloud-Asia (ABC-Asia) project and Sustainable Atmosphere for the Kathmandu Valley (SusKat) campaign (December 2012 ~ February 2013). BC mass concentration, aerosol scattering and absorption coefficients measurements and radiative forcing calculations were performed at four sites: Gosan (Korea), Anmyeon (Korea), Hanimaadhoo (Maldives) and Pyramid (Nepal). No significant seasonal variations of aerosol properties, except for summer due to wet scavenging by rainfall, were observed in East Asia, whereas dramatic changes of light-absorbing aerosol properties were observed in South Asia between dry and wet monsoon periods. Although BC mass concentration in East Asia is generally higher than that observed in South Asia, BC mass concentration at Hanimaadhoo during winter dry monsoon is similar to that of East Asia. The observed solar absorption efficiency (absorption coefficient/extinction coefficient) at 550 nm at Gosan and Anmyeon is higher than that in Hanimaadhoo due to large portions of BC emission from fossil fuel combustion. Interestingly, solar absorption efficiency at Pyramid is 0.14, which is two times great than that in Hanimaadhoo and is about 40% higher than that in East Asia, though BC mass concentration at Pyramid is the lowest among four sites. Throughout the unmanned aerial vehicle experiment in Jeju, Korea during August-September 2008, long-range transport of aerosols from

  1. Partnering with law enforcement to deliver good public health: the experience of the HIV/AIDS Asia regional program

    PubMed Central

    2012-01-01

    In the South-East Asia region, the drug control and supply reduction agenda is of high political importance. A multitude of law enforcement agencies are engaged in this work. Nationwide campaigns such as the “Strike- Hard” campaign in China or the “war on drugs” in Thailand dominate the landscape. Viet Nam’s response to drug use has historically focused on deterrence through punishment and supply-side measures. This policy environment is further complicated by lack of evidence-based drug dependence treatment in several settings. The public health consequences of this approach have been extremely serious, with some of the highest documented prevalence of preventable blood-borne viral infections, including HIV, and hepatitis B and C. The wider socioeconomic consequences of this have been borne by families, communities and the governments themselves. The HIV/AIDS Asia Regional Program (HAARP) aims to stop the spread of HIV associated with drug use in South-East Asia and parts of southern China. HAARP works across five countries (Cambodia, China Burma, Laos, Viet Nam) chiefly through the Ministries of Health and Social Affairs, National Drug Control Agencies, and Public Security sectors, including prisons. HAARP has also engaged with UN agencies and a wide range of civil society organisations, including organisations of people who use drugs, to ensure their meaningful involvement in matters that directly affect them. We describe the experience of HAARP in implementing a large-scale harm reduction programme in the Sub-Mekong Region. HAARP chose to direct its efforts in three main areas: supporting an enabling environment for effective harm reduction policies, building core capacity among national health and law enforcement agencies, and supporting “universal access” goals by making effective, high-coverage services available to injecting drug users and their partners. The activities supported by HAARP are humble yet important steps. However, a much higher

  2. Partnering with law enforcement to deliver good public health: the experience of the HIV/AIDS Asia regional program.

    PubMed

    Sharma, Mukta; Chatterjee, Anindya

    2012-01-01

    In the South-East Asia region, the drug control and supply reduction agenda is of high political importance. A multitude of law enforcement agencies are engaged in this work. Nationwide campaigns such as the "Strike- Hard" campaign in China or the "war on drugs" in Thailand dominate the landscape. Viet Nam's response to drug use has historically focused on deterrence through punishment and supply-side measures. This policy environment is further complicated by lack of evidence-based drug dependence treatment in several settings. The public health consequences of this approach have been extremely serious, with some of the highest documented prevalence of preventable blood-borne viral infections, including HIV, and hepatitis B and C. The wider socioeconomic consequences of this have been borne by families, communities and the governments themselves.The HIV/AIDS Asia Regional Program (HAARP) aims to stop the spread of HIV associated with drug use in South-East Asia and parts of southern China. HAARP works across five countries (Cambodia, China Burma, Laos, Viet Nam) chiefly through the Ministries of Health and Social Affairs, National Drug Control Agencies, and Public Security sectors, including prisons. HAARP has also engaged with UN agencies and a wide range of civil society organisations, including organisations of people who use drugs, to ensure their meaningful involvement in matters that directly affect them. We describe the experience of HAARP in implementing a large-scale harm reduction programme in the Sub-Mekong Region. HAARP chose to direct its efforts in three main areas: supporting an enabling environment for effective harm reduction policies, building core capacity among national health and law enforcement agencies, and supporting "universal access" goals by making effective, high-coverage services available to injecting drug users and their partners.The activities supported by HAARP are humble yet important steps. However, a much higher political

  3. Contrasting aerosol trends over South Asia during the last decade based on MODIS observations

    NASA Astrophysics Data System (ADS)

    Kaskaoutis, D. G.; Kharol, S. K.; Sinha, P. R.; Singh, R. P.; Badarinath, K. V. S.; Mehdi, W.; Sharma, M.

    2011-08-01

    Atmospheric aerosols over south Asia constitute a major environmental and climate issue. Thus, extensive land and cruise campaigns have been conducted over the area focusing on investigating the aerosol properties and climate implications. Except from the ground-based instrumentation, several studies dealt with analyzing the aerosol properties from space, focusing mainly on the spatial distribution of the aerosol optical depth (AOD) and possible feedbacks of aerosols on the monsoon system. However, except from some works using ground-based instrumentation or satellite observations over a specific region, there is lack of studies dealing with monitoring of the aerosol trend over south Asia. The present work analyzes the variations and trends in aerosol load over south Asia using Terra-MODIS AOD550 data in the period 2000-2009. Overall, an increasing trend of 10.17 % in AOD is found over whole south Asia, which exhibits large spatio-temporal variation. More specifically, the AOD550 increasing trend is more pronounced in winter, and especially over northern India. The present study shows an evidence of a decreasing AOD550 trend over the densely-populated Indo-Gangetic Plains (IGP) during the period April-September, which has never been reported before. This decreasing trend is not statistically significant and leads to an AOD change of -0.01 per year in June, when the dust activity is at its maximum. The AOD decrease seems to be attributed to weakness of dust activity in the northwest of India, closely associated with expansion of the vegetated areas and increase in precipitation over the Thar desert. Similarly, GOCART simulations over south Asia show a pronounced decreasing trend in dust AOD in accordance with MODIS. However, much more analysis and longer dataset are required for establishing this evidence.

  4. Late Presentation into Care of HIV Disease and Its Associated Factors in Asia: Results of TAHOD.

    PubMed

    Jeong, Su Jin; Italiano, Claire; Chaiwarith, Romanee; Ng, Oon Tek; Vanar, Sasheela; Jiamsakul, Awachana; Saphonn, Vonthanak; Nguyen, Kinh Van; Kiertiburanakul, Sasisopin; Lee, Man Po; Merati, Tuti Parwati; Pham, Thuy Thanh; Yunihastuti, Evy; Ditangco, Rossana; Kumarasamy, Nagalingeswaran; Zhang, Fujie; Wong, Wingwai; Sim, Benedict L H; Pujari, Sanjay; Kantipong, Pacharee; Phanuphak, Praphan; Ratanasuwan, Winai; Oka, Shinichi; Mustafa, Mahiran; Durier, Nicolas; Choi, Jun Yong

    2016-03-01

    Many HIV-infected individuals do not enter health care until late in the infection course. Despite encouraging earlier testing, this situation has continued for several years. We investigated the prevalence of late presenters and factors associated with late presentation among HIV-infected patients in an Asian regional cohort. This cohort study included HIV-infected patients with their first positive HIV test during 2003-2012 and CD4 count and clinical status data within 3 months of that test. Factors associated with late presentation into care (CD4 count <200 cells/μl or an AIDS-defining event within ±3 months of first positive HIV test) were analyzed in a random effects logistic regression model. Among 3,744 patients, 2,681 (72%) were late presenters. In the multivariable model, older patients were more likely to be late presenters than younger (≤30 years) patients [31-40, 41-50, and ≥51 years: odds ratio (OR) = 1.57, 95% confidence interval (CI) 1.31-1.88; OR = 2.01, 95% CI 1.58-2.56; and OR = 1.69, 95% CI 1.23-2.31, respectively; all p ≤ 0.001]. Injecting drug users (IDU) were more likely (OR = 2.15, 95% CI 1.42-3.27, p < 0.001) and those with homosexual HIV exposure were less likely (OR = 0.45, 95% CI 0.35-0.58, p < 0.001) to be late presenters compared to those with heterosexual HIV exposure. Females were less likely to be late presenters (OR = 0.44, 95% CI 0.36-0.53, p < 0.001). The year of first positive HIV test was not associated with late presentation. Efforts to reduce the patients who first seek HIV care at the late stage are needed. The identified risk factors associated with late presentation should be utilized in formulating targeted public health intervention to improve earlier entry into HIV care. PMID:26414065

  5. Observationally-constrained estimates of aerosol optical depths (AODs) over East Asia via data assimilation techniques

    NASA Astrophysics Data System (ADS)

    Lee, K.; Lee, S.; Song, C. H.

    2015-12-01

    Not only aerosol's direct effect on climate by scattering and absorbing the incident solar radiation, but also they indirectly perturbs the radiation budget by influencing microphysics and dynamics of clouds. Aerosols also have a significant adverse impact on human health. With an importance of aerosols in climate, considerable research efforts have been made to quantify the amount of aerosols in the form of the aerosol optical depth (AOD). AOD is provided with ground-based aerosol networks such as the Aerosol Robotic NETwork (AERONET), and is derived from satellite measurements. However, these observational datasets have a limited areal and temporal coverage. To compensate for the data gaps, there have been several studies to provide AOD without data gaps by assimilating observational data and model outputs. In this study, AODs over East Asia simulated with the Community Multi-scale Air Quality (CMAQ) model and derived from the Geostationary Ocean Color Imager (GOCI) observation are interpolated via different data assimilation (DA) techniques such as Cressman's method, Optimal Interpolation (OI), and Kriging for the period of the Distributed Regional Aerosol Gridded Observation Networks (DRAGON) Campaign (March - May 2012). Here, the interpolated results using the three DA techniques are validated intensively by comparing with AERONET AODs to examine the optimal DA method providing the most reliable AODs over East Asia.

  6. Observed Increase of TTL Temperature and Water Vapor in Polluted Couds over Asia

    SciTech Connect

    Su, Hui; Jiang, Jonathan; Liu, Xiaohong; Penner, J.; Read, William G.; Massie, Steven T.; Schoeberl, Mark R.; Colarco, Peter; Livesey, Nathaniel J.; Santee, Michelle L.

    2011-06-01

    Aerosols can affect cloud particle size and lifetime, which impacts precipitation, radiation and climate. Previous studies1-4 suggested that reduced ice cloud particle size and fall speed due to the influence of aerosols may increase evaporation of ice crystals and/or cloud radiative heating in the tropical tropopause layer (TTL), leading to higher water vapor abundance in air entering the stratosphere. Observational substantiation of such processes is still lacking. Here, we analyze new observations from multiple NASA satellites to show the imprint of pollution influence on stratospheric water vapor. We focus our analysis on the highly-polluted South and East Asia region during boreal summer. We find that "polluted" ice clouds have smaller ice effective radius than "clean" clouds. In the TTL, the polluted clouds are associated with warmer temperature and higher specific humidity than the clean clouds. The water vapor difference between the polluted and clean clouds cannot be explained by other meteorological factors, such as updraft and detrainment strength. Therefore, the observed higher water vapor entry value into the stratosphere in the polluted clouds than in the clean clouds is likely a manifestation of aerosol pollution influence on stratospheric water vapor. Given the radiative and chemical importance of stratospheric water vapor, the increasing emission of aerosols over Asia may have profound impacts on stratospheric chemistry and global energy balance and water cycle.

  7. Structured Observations Reveal Slow HIV-1 CTL Escape

    PubMed Central

    Roberts, Hannah E.; Hurst, Jacob; Robinson, Nicola; Brown, Helen; Flanagan, Peter; Vass, Laura; Fidler, Sarah; Weber, Jonathan; Babiker, Abdel; Phillips, Rodney E.; McLean, Angela R.; Frater, John

    2015-01-01

    The existence of viral variants that escape from the selection pressures imposed by cytotoxic T-lymphocytes (CTLs) in HIV-1 infection is well documented, but it is unclear when they arise, with reported measures of the time to escape in individuals ranging from days to years. A study of participants enrolled in the SPARTAC (Short Pulse Anti-Retroviral Therapy at HIV Seroconversion) clinical trial allowed direct observation of the evolution of CTL escape variants in 125 adults with primary HIV-1 infection observed for up to three years. Patient HLA-type, longitudinal CD8+ T-cell responses measured by IFN-γ ELISpot and longitudinal HIV-1 gag, pol, and nef sequence data were used to study the timing and prevalence of CTL escape in the participants whilst untreated. Results showed that sequence variation within CTL epitopes at the first time point (within six months of the estimated date of seroconversion) was consistent with most mutations being transmitted in the infecting viral strain rather than with escape arising within the first few weeks of infection. Escape arose throughout the first three years of infection, but slowly and steadily. Approximately one third of patients did not drive any new escape in an HLA-restricted epitope in just under two years. Patients driving several escape mutations during these two years were rare and the median and modal numbers of new escape events in each patient were one and zero respectively. Survival analysis of time to escape found that possession of a protective HLA type significantly reduced time to first escape in a patient (p = 0.01), and epitopes escaped faster in the face of a measurable CD8+ ELISpot response (p = 0.001). However, even in an HLA matched host who mounted a measurable, specific, CD8+ response the average time before the targeted epitope evolved an escape mutation was longer than two years. PMID:25642847

  8. Promoting Global Health - Prevention and Treatment of Substance Abuse and HIV in Asia.

    PubMed

    Li, Ming D; Hser, Yih-Ing; Chen, Zhiwei; Chang, Linda

    2016-09-01

    This special issue contains 20 papers including 3 Perspectives, 1 Brief Report, 6 Invited Reviews, and 10 Original Articles, which highlight the work by presenters at the second meeting of the biennial Conference Series to Promote Global Health held on April 22-24, 2015 in Hangzhou, Zhejiang, China. These papers focused on the prevalent substance misuse of amphetamine-type-stimulants and opioids, and the increasing prevalence of HIV-infection in Asian countries. The Conference Series is sponsored by the National Institute on Drug Abuse of the U.S. National Institutes of Health, with the goal of exchanging knowledge and ideas related to, and promoting international collaborative work on, the prevention and treatment of substance use disorders and HIV-infection, in order to promote health in Asian and Pacific Islanders and other populations. PMID:27484319

  9. Large XCH4 anomaly in summer 2013 over northeast Asia observed by GOSAT

    NASA Astrophysics Data System (ADS)

    Ishizawa, Misa; Uchino, Osamu; Morino, Isamu; Inoue, Makoto; Yoshida, Yukio; Mabuchi, Kazuo; Shirai, Tomoko; Tohjima, Yasunori; Maksyutov, Shamil; Ohyama, Hirofumi; Kawakami, Shuji; Takizawa, Atsushi; Belikov, Dmitry

    2016-07-01

    Extremely high levels of column-averaged dry-air mole fractions of atmospheric methane (XCH4) were detected in August and September 2013 over northeast Asia (˜ 20 ppb above the averaged summertime XCH4 over 2009-2012, after removing a long-term trend), as being retrieved from the Short-Wavelength InfraRed (SWIR) spectral data observed with the Thermal And Near-infrared Sensor for carbon Observation - Fourier Transform Spectrometer (TANSO-FTS) onboard Greenhouse Gases Observing Satellite (GOSAT). Similar enhancements of XCH4 were also observed by the ground-based measurements at two Total Carbon Column Observing Network (TCCON) sites in Japan. The analysis of surface CH4 concentrations observed at three monitoring sites around the Japan archipelago suggest that the extreme increase of XCH4 has occurred in a limited area. The model analysis was conducted to investigate this anomalously high XCH4 event, using an atmospheric transport model. The results indicate that the extreme increase of XCH4 is attributed to the anomalous atmospheric pressure pattern over East Asia during the summer of 2013, which effectively transported the CH4-rich air to Japan from the strong CH4 source areas in east China. The two Japanese TCCON sites, ˜ 1000 km east-west apart each other, coincidentally located along the substantially CH4-rich air flow from east China. This analysis demonstrates the capability of GOSAT to monitor an XCH4 event on a synoptic scale. We anticipate that the synoptic information of XCH4 from GOSAT data contributes to improve our understanding of regional carbon cycle and the regional flux estimation.

  10. Renal Dysfunction during Tenofovir Use in a Regional Cohort of HIV-Infected Individuals in the Asia-Pacific

    PubMed Central

    Tanuma, Junko; Jiamsakul, Awachana; Makane, Abhimanyu; Avihingsanon, Anchalee; Ng, Oon Tek; Kiertiburanakul, Sasisopin; Chaiwarith, Romanee; Kumarasamy, Nagalingeswaran; Nguyen, Kinh Van; Pham, Thuy Thanh; Lee, Man Po; Ditangco, Rossana; Merati, Tuti Parwati; Choi, Jun Yong; Wong, Wing Wai; Kamarulzaman, Adeeba; Yunihastuti, Evy; Sim, Benedict LH; Ratanasuwan, Winai; Kantipong, Pacharee; Zhang, Fujie; Mustafa, Mahiran; Saphonn, Vonthanak; Pujari, Sanjay; Sohn, Annette H.

    2016-01-01

    Background In resource-limited settings, routine monitoring of renal function during antiretroviral therapy (ART) has not been recommended. However, concerns for tenofovir disoproxil fumarate (TDF)-related nephrotoxicity persist with increased use. Methods We investigated serum creatinine (S-Cr) monitoring rates before and during ART and the incidence and prevalence of renal dysfunction after starting TDF by using data from a regional cohort of HIV-infected individuals in the Asia-Pacific. Time to renal dysfunction was defined as time from TDF initiation to the decline in estimated glomerular filtration rate (eGFR) to <60 ml/min/1.73m2 with >30% reduction from baseline using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation or the decision to stop TDF for reported TDF-nephrotoxicity. Predictors of S-Cr monitoring rates were assessed by Poisson regression and risk factors for developing renal dysfunction were assessed by Cox regression. Results Among 2,425 patients who received TDF, S-Cr monitoring rates increased from 1.01 to 1.84 per person per year after starting TDF (incidence rate ratio 1.68, 95%CI 1.62–1.74, p <0.001). Renal dysfunction on TDF occurred in 103 patients over 5,368 person-years of TDF use (4.2%; incidence 1.75 per 100 person-years). Risk factors for developing renal dysfunction included older age (>50 vs. ≤30, hazard ratio [HR] 5.39, 95%CI 2.52–11.50, p <0.001; and using PI-based regimen (HR 1.93, 95%CI 1.22–3.07, p = 0.005). Having an eGFR prior to TDF (pre-TDF eGFR) of ≥60 ml/min/1.73m2 showed a protective effect (HR 0.38, 95%CI, 0.17–0.85, p = 0.018). Conclusions Renal dysfunction on commencing TDF use was not common, however, older age, lower baseline eGFR and PI-based ART were associated with higher risk of renal dysfunction during TDF use in adult HIV-infected individuals in the Asia-Pacific region. PMID:27560968

  11. STS-57 Earth observation of the Eastern Mediterranean, Nile River, Asia Minor

    NASA Technical Reports Server (NTRS)

    1993-01-01

    STS-57 Earth observation of the Eastern Mediterranean. From a high vantage point over the Nile River, this north-looking view shows the eastern Mediterranean and the entire landmass of Asia Minor, with the Black Sea dimly visible at the horizon. Many of the Greek islands can be seen in the Aegean Sea (top left), off the coast of Asia Minor. Cyprus is visible under atmospheric dust in the northeastern corner of the Mediterranean. The dust cloud covers the east end of the Mediterranean, its western edge demarcated by a line that cuts the center of the Nile Delta. This dust cloud originated far to the west, in Algeria, and moved northeast. A gyre of clouds in the southeast corner of the Mediterranean indicates a complementary counterclockwise (cyclonic) circulation of air. The Euphrates River appears as a thin green line (upper right) in the yellow Syrian desert just south of the mountains of Turkey. The Dead Sea (lower right) lies in a rift valley which extends north into Turkey and sout

  12. Bringing new HIV infections to zero - opportunities and challenges offered by antiretroviral-based prevention in Asia, the Pacific and beyond: An overview of this special issue.

    PubMed

    Zablotska, Iryna B; Whittaker, Bill; de Wit, John; Kamarulzaman, Adeeba; Ananworanich, Jintanat; Wright, Edwina; Poynten, Isobel Mary; Mayer, Kenneth

    2014-07-01

    This editorial to the special issue of Sexual Health on antiretroviral-based prevention of HIV infection is dedicated to showcasing research and practice in this area. It aims to promote debate regarding the potential of new antiretroviral-based prevention approaches and the challenges encountered in moving prevention innovations into the community. This special issue covers the breadth of innovative HIV prevention research, including that undertaken in the fields of epidemiology, clinical research, social and behavioural science, public health and policy analysis, and with special emphasis on Asia and the Pacific region. Most importantly, it provides an indication of how the region is progressing towards embracing new prevention approaches to combat HIV epidemics across the region. PMID:25017549

  13. Legislative and policy analysis of HIV prevention, treatment and care for people who use drugs and incarcerated people in Central Asia and Azerbaijan.

    PubMed

    Cozac, David; Elliott, Richard

    2011-04-01

    In January 2011, the Regional Office for Central Asia of the UN Office on Drugs and Crime (UNODC) and the Canadian HIV/AIDS Legal Network released an extensive report assessing the legislative and policy environment affecting the response to HIV in six countries of the Commonwealth of Independent States (CIS). The report, which draws in part upon the work of a national expert group in each country, puts forward dozens of recommendations for legislative and policy reform, including recommendations for specific reform tailored to the situation in each of the participating countries, with a particular focus on addressing the fast-growing HIV epidemic linked to injection drug use and in prisons. PMID:21688698

  14. Virtual versus physical spaces: which facilitates greater HIV risk taking among men who have sex with men in East and South-East Asia?

    PubMed

    Wei, Chongyi; Lim, Sin How; Guadamuz, Thomas E; Koe, Stuart

    2014-08-01

    Increasing use of the Internet to seek sex partners is accompanied by rising HIV infections among men who have sex with men (MSM) in East and South-East Asia. We examined whether the Internet facilitates greater HIV risk taking among MSM in the region. A cross-sectional sample of 9,367 MSM was recruited via the Internet in 2010. We compared socio-demographic and HIV-related behavioral characteristics among MSM who met sex partners on the Internet only, who met sex partners offline only, and who met sex partners through both. Multinomial logistic regression was used to identify independent correlates that were associated with differences in where participants met their male sex partners. Compared to MSM who met partners offline only, those who met partners online only were less likely to have multiple male sex partners, have paid for sex, have consumed recreational drugs, and have used alcohol before sex. MSM who met partners both online and offline appeared to be the riskiest group that they were more likely to have multiple male sex partners, have engaged in UIAI, and have consumed alcohol before sex. These findings suggest that social networking websites alone do not facilitate greater HIV risk taking among MSM. Rather, they provide additional venues for MSM who already engage in HIV-related high risk behaviors to seek sex partners. The Internet offers incredible opportunities to reach large numbers of MSM in East and South-East Asia for HIV prevention and research. Web-based outreach and prevention activities are needed to reach these men. In addition, mobile and application-based interventions should also be developed and disseminated. PMID:24077974

  15. Virtual vs. physical spaces: which facilitates greater HIV risk taking among men who have sex with men in East and South-East Asia?

    PubMed Central

    Wei, Chongyi; Lim, Sin How; Guadamuz, Thomas E.; Koe, Stuart

    2013-01-01

    Increasing use of the Internet to seek sex partners is accompanied by rising HIV infections among men who have sex with men (MSM) in East and South-East Asia. We examined whether the Internet facilitates greater HIV risk taking among MSM in the region. A cross-sectional sample of 9,367 MSM was recruited via the Internet in 2010. We compared socio-demographic and HIV-related behavioral characteristics among MSM who met sex partners on the Internet only, who met sex partners offline only, and who met sex partners through both. Multinomial logistic regression was used to identify independent correlates that were associated with differences in where participants met their male sex partners. Compared to MSM who met partners offline only, those who met partners online only were less likely to have multiple male sex partners, have paid for sex, have consumed recreational drugs, and have used alcohol before sex. MSM who met partners both online and offline appeared to be the riskiest group that they were more likely to have multiple male sex partners, have engaged in UIAI, and have consumed alcohol before sex. These findings suggest that social networking websites alone do not facilitate greater HIV risk taking among MSM. Rather, they provide additional venues for MSM who already engage in HIV-related high risk behaviors to seek sex partners. The Internet offers incredible opportunities to reach large numbers of MSM in East and South-East Asia for HIV prevention and research. Web-based outreach and prevention activities are needed to reach these men. In addition, mobile and application-based interventions should also be developed and disseminated. PMID:24077974

  16. Influence of Madden-Julian Oscillation on Southeast Asia rainfall extremes: Observations and predictability

    NASA Astrophysics Data System (ADS)

    Xavier, Prince; Rahmat, Raizan; Cheong, Wee Kiong; Wallace, Emily

    2014-06-01

    The influence of Madden-Julian Oscillation (MJO) on the rainfall distribution of Southeast Asia is studied using TRMM satellite-derived rainfall and rain gauge data. It is shown that convectively active (suppressed) phases of MJO can increase (decrease) the probability of extreme rain events over the land regions by about 30-50% (20-25%) during November-March season. The influence of MJO on localized rainfall extremes are also observed both in rainfall intensity and duration. The Met Office Global Seasonal forecasting system seasonal forecasting system is shown to reproduce the MJO influence on rainfall distribution well despite the model biases over land. Skills scores for forecasting 90th percentile extreme rainfall shows significant skills for convective phases. This study demonstrates the feasibility of deriving probabilistic forecasts of extreme rainfall at medium range.

  17. The non-migrating Tides in the Middle Atmosphere over East Asia Observed by HRDI/UARS Data Set

    NASA Astrophysics Data System (ADS)

    Yonggang, P.; Zeyu, C.; Hongbin, C.; Zhenhui, W.

    In this paper the long term mean characteristics of the zonal winds in the middle atmosphere over East Asia were studied by using the HRDI UARS measurements The investigation revealed the presence of considerable regional scale disturbances in the whole of the middle to upper atmosphere over East Asia except the situations in mid-latitudes in summer In mid-latitudes very few zonal fluctuation can bee seen in the zonal winds from 55km to 115 km altitude range in the summer season however the winter mesospheric and lower thermospheric zonal winds are disturbed prominently in the zonal Furthermore in winter the tropical lower thermospheric zonal winds fluctuate significantly in zonal direction and this kind of the zonal disturbances extend downward to 55 km altitude the lower limit of the observation mode of the satellite instrument in summer According the correlative study results there is significant non-migrating tides in the thermosphere over East Asia LSo that non-migrating tides controlled the disturbances in midlle and upper atmosphere over tropical region observed by the HRDI UARS data set and HRDI UARS data set have observed that these is significant non-migrating tides in midlle atmosphere over tropical region in East Asia Key words Middle atmosphere East Asia Zonal winds HRDI UARS

  18. Bridging borders in Southeast Asia: the politics of HIV prevention for women.

    PubMed

    Hartwig, K

    1995-11-01

    Participants in a workshop on "Women, Family, and Acquired Immunodeficiency Syndrome (AIDS) Prevention," held in Chiang Mai, Thailand, in July 1995, developed a cross-border strategy for stemming the spread of the epidemic across Southeast Asia. Regional economic growth, new trade initiatives, and growing openness between countries are facilitating increased population movement among the neighboring countries of Thailand, Laos, Cambodia, Viet Nam, and China's Yunnan Province. Workshop participants, representing all of these countries, agreed that AIDS prevention projects for Southeast Asian women work best in family and community settings. Although representatives from neighboring countries were impressed with Thailand's programs created for or initiated by commercial sex workers, they were pessimistic about the potential for replication in settings where prostitution is outlawed. Also remarkable to participants was the collective strength of Thai AIDS victims, who have implemented their own support strategies. Policy advocacy, including building intergovernmental relationships that foster collaboration, was considered an essential step to slowing the AIDS epidemic in the region. Creation of a health care workers' network within and between countries and formation of cross-border committees were also proposed. PMID:12347558

  19. Using geophysical observations to constrain dynamic models of large-scale continental deformation in Asia

    NASA Astrophysics Data System (ADS)

    Flesch, L. M.; Holt, W. E.; Haines, A. J.

    2003-04-01

    The deformation of continental lithosphere is controlled by a variety of factors, including (1) body forces, (2) basal tractions, (3) boundary forces, and (4) rheology. Obtaining unique solutions that describe the dynamics of continental lithosphere is extremely challenging. Limitations are associated with inadequate observations that can uniquely constrain the dynamics as well as inadequate numerical methods. However, the compilation of space geodetic, seismic, and geologic data over the past 10-15 years have made it possible to make significant strides toward understanding the dynamics of large-scale continental deformation. The first step in making inferences about continental dynamics involves a quantification of the kinematics of active deformation (measurement of the velocity gradient tensor field). We interpolate both GPS velocity vectors and Quaternary strain rates with continuous spline functions (bi-cubic Bessel interpolation) to define a model velocity gradient tensor field solution (strain rates, rotation rates, and relative motions). In our methodology grid areas can be defined to be small enough such that fault zones are narrow and regions between faults (crustal blocks) possess rigid behavior. Our dynamic models are solutions to equations for a thin sheet, accounting for body forces associated with horizontal density variations and edge forces associated with accommodation of relative plate motion. The formalism can also include basal tractions associated with coupling between lithosphere and deeper mantle circulation. These dynamic models allow for lateral variations of viscosity and they allow for different power-law rheologies with power law exponents ranging from n = 1-9. Thus our dynamic models account for possible block-like behavior (high effective viscosity) as well as concentrated strain within shear zones. Kinematic results to date for central Asia show block-like behavior for large regions such as South China, Tarim Basin, Amurian block

  20. Regional occurrence characteristics of ESF backscatter plumes observed with the VHF radar in Southeast Asia

    NASA Astrophysics Data System (ADS)

    Ning, Baiqi; Li, Guozhu

    The development of the equatorial spread-F (ESF) plumes can be well recorded by steerable backscatter radars operated at and off the magnetic equator due to the fact that the vertically extended plume structures are tracers of magnetically north-south aligned larger scale structures. In this study, the temporal and spatial evolutions of ESF plasma plumes and their smaller scale longitudinal differences in Southeast Asia are investigated using the beam steering capability of the two radars, the Equatorial Atmosphere Radar (EAR) (0.2ºS, 100.3ºE; dip lat 10.4ºS) and the Sanya VHF radar (18.4ºN, 109.6ºE; dip lat 12.8ºN) separated in longitude by ~1000 km. In the beam steering mode of operation, the scanned area at a height of 300 km covers approximately 360 km and 280 km in east-west direction for the EAR and the Sanya radar, respectively. Thus the beam steering measurements by the two radars provide a good spatial coverage, and can be used to study the occurrence and dynamics of equatorial plasma plumes in Southeast Asia and possible short longitude scale differences in their characteristics. We present observations of periodic backscatter plume structures with the EAR and Sanya radar during geomagnetic quiet days and examine the mechanism responsible for the generation of these structures. A tracing analysis on the onset locations of plasma plumes reveals spatially well-separated backscatter plumes, with a maximum east-west wavelength of about 1000 km, periodically generated in longitudes of Southeast Asia. The post-sunset backscatter plumes seen by the Sanya VHF radar are found to be due to the passage of sunset plumes initiated around the longitude of EAR. On the other hand, the EAR measurements show multiple plume structures that developed successively in the radar scanned area with east-west separation of ~50 km, with however, no sunset plasma plume over Sanya at times. This could indicate that the small scale waves, unlike the large scale wave structure

  1. Atmospheric observations of carbon monoxide and fossil fuel CO2 emissions from East Asia

    NASA Astrophysics Data System (ADS)

    Turnbull, Jocelyn C.; Tans, Pieter P.; Lehman, Scott J.; Baker, David; Conway, Thomas J.; Chung, Y. S.; Gregg, Jay; Miller, John B.; Southon, John R.; Zhou, Ling-Xi

    2011-12-01

    Flask samples from two sites in East Asia, Tae-Ahn Peninsula, Korea (TAP), and Shangdianzi, China (SDZ), were measured for trace gases including CO2, CO and fossil fuel CO2 (CO2ff, derived from Δ14CO2observations). The five-year TAP record shows high CO2ff when local air comes from the Korean Peninsula. Most samples, however, reflect air masses from Northeastern China with lower CO2ff. Our small set of SDZ samples from winter 2009/2010 have strongly elevated CO2ff. Biospheric CO2 contributes substantially to total CO2variability at both sites, even in winter when non-fossil CO2 sources (including photosynthesis, respiration, biomass burning and biofuel use) contribute 20-30% of the total CO2 enhancement. Carbon monoxide (CO) correlates strongly with CO2ff. The SDZ and TAP far-field (China influenced) samples have CO: CO2ff ratios (RCO:CO2ff) of 47 ± 2 and 44 ± 3 ppb/ppm respectively, consistent with recent bottom-up inventory estimates and other observational studies. Locally influenced TAP samples fall into two distinct data sets, ascribed to air sourced from South Korea and North Korea. The South Korea samples have low RCO:CO2ffof 13 ± 3 ppb/ppm, slightly higher than bottom-up inventories, but consistent with emission ratios for other developed nations. We compare our CO2ff observations with modeled CO2ff using the FLEXPART Lagrangian particle dispersion model convolved with a bottom-up CO2ff emission inventories. The modeled annual mean CO2ff mole fractions are consistent with our observations when the model inventory includes the reported 63% increase in Chinese emissions from 2004 to 2010, whereas a model version which holds Chinese emissions flat is unable to replicate the observations.

  2. Direct and Semi-direct Radiative Responses to Observation-Constrained Aerosol Absorption over S Asia

    NASA Astrophysics Data System (ADS)

    Feng, Y.; Kotamarthi, V. R.; Manoharan, V.

    2013-12-01

    Climate impacts of aerosols over S. Asia have been studied extensively in both models and observations. However, discrepancies between observed and modeled aerosol concentrations and optical properties have hindered our understanding of the aerosol influences on the regional monsoon circulation and rainfall. We present an in-depth examination of direct and semi-direct radiative responses due to aerosols on the latitudinal heating gradient and cloud distribution, with observational constraints on solar absorption by aerosols. Regional distributions of aerosol concentration are simulated with a 12-km regional climate model (WRF-Chem) driven by the NCEP analysis data from August 2011 to March 2012. During this time period, the ground-based measurements of aerosols and clouds, surface radiation, water vapor, and temperature were taken at Nainital (29.38°N, 79.45°E) during the DOE Ganges Valley Experiment (GVAX). This data set, which is available at high temporal resolution (hourly), is used to evaluate and constrain the simulated wavelength dependence of aerosol absorption and the correlation with changes in surface radiation, cloud base height and liquid water content for the entire post-monsoon period. The analysis is extended to a regional scale by comparing with satellite observation of absorbing aerosol optical depth (OMI) and cloud properties (MODIS). Preliminary results show good agreement in monthly variations of simulated and observed aerosol optical depth (AOD) except during periods of high observed AOD. Initial analysis indicates a possible local origin for the aerosols that is not captured in the model at present. Furthermore, analysis of the spectrally resolved aerosol absorption measurements indicates that these local aerosols exhibit strong absorption in near-UV and visible wavelengths. A large fraction of increased absorption during October and November (local fall harvest season) is attributable to the super-micron sized aerosol particles. In

  3. Antiretroviral Treatment Interruption and Loss to Follow-Up in Two HIV Cohorts in Australia and Asia: Implications for ‘Test and Treat’ Prevention Strategy

    PubMed Central

    Wand, Handan; McManus, Hamish; Vonthanak, Saphonn; Woolley, Ian; Honda, Miwako; Read, Tim; Sirisanthana, Thira; Zhou, Julian; Carr, on behalf of Australia HIV Observational Database (AHOD) and Treat Asia HIV Observation Database (TAHOD), Andrew

    2013-01-01

    Abstract Both antiretroviral treatment interruption (TI) and cessation have been strongly discouraged since 2006. We describe the incidence, duration, and risk factors for TI and loss-to-follow-up (LTFU) rates across 13 countries. All 4689 adults (76% men) in two large HIV cohorts in Australia and Asia commencing combination antiretroviral therapy (ART) to March 2010 were included. TI was defined by ART cessation >30 days, then recommencement, and loss to follow-up (LTFU) by no visit since 31 March 2009 and no record of death. Survival analysis and Poisson regression methods were used. With median follow-up of 4.4 years [interquartile range (IQR):2.1–6.5], TI incidence was 6.7 per 100 person years (PY) (95% CI:6.1–7.3) pre-2006, falling to 2.0 (95% CI:1.7–2.2) from 2006 (p<0.01). LTFU incidence was 3.5 per 100 PY (95% CI:3.1–3.9) pre-2006, and 4.1 (95% CI:3.5–4.9) from 2006 (p=0.22). TIs accounted for 6.4% of potential time on ART pre-2006 and 1.2% from 2006 (p<0.01), and LTFU 4.7% of potential time on ART pre-2006 and 6.6% from 2006 (p<0.01). Median TI duration was 163 (IQR: 75–391) days pre-2006 and 118 (IQR: 67–270) days from 2006 (p<0.01). Independent risk factors for the first TI were: Australia HIV Observational Database participation; ART initiation pre-2006; ART regimens including stavudine and didanosine; three nucleoside analogue reverse transcriptase inhibitors; ≥7 pills per day; and ART with food restrictions (fasting or with food). In conclusion, since 2006, 7.8% of patients had significant time off treatment, which has the potential to compromise any ‘test and treat’ policy as during the interruption viral load will rebound and increase the risk of transmission. PMID:24320013

  4. Antiretroviral treatment interruption and loss to follow-up in two HIV cohorts in Australia and Asia: implications for 'test and treat' prevention strategy.

    PubMed

    Guy, Rebecca; Wand, Handan; McManus, Hamish; Vonthanak, Saphonn; Woolley, Ian; Honda, Miwako; Read, Tim; Sirisanthana, Thira; Zhou, Julian; Carr, Andrew

    2013-12-01

    Both antiretroviral treatment interruption (TI) and cessation have been strongly discouraged since 2006. We describe the incidence, duration, and risk factors for TI and loss-to-follow-up (LTFU) rates across 13 countries. All 4689 adults (76% men) in two large HIV cohorts in Australia and Asia commencing combination antiretroviral therapy (ART) to March 2010 were included. TI was defined by ART cessation >30 days, then recommencement, and loss to follow-up (LTFU) by no visit since 31 March 2009 and no record of death. Survival analysis and Poisson regression methods were used. With median follow-up of 4.4 years [interquartile range (IQR):2.1-6.5], TI incidence was 6.7 per 100 person years (PY) (95% CI:6.1-7.3) pre-2006, falling to 2.0 (95% CI:1.7-2.2) from 2006 (p<0.01). LTFU incidence was 3.5 per 100 PY (95% CI:3.1-3.9) pre-2006, and 4.1 (95% CI:3.5-4.9) from 2006 (p=0.22). TIs accounted for 6.4% of potential time on ART pre-2006 and 1.2% from 2006 (p<0.01), and LTFU 4.7% of potential time on ART pre-2006 and 6.6% from 2006 (p<0.01). Median TI duration was 163 (IQR: 75-391) days pre-2006 and 118 (IQR: 67-270) days from 2006 (p<0.01). Independent risk factors for the first TI were: Australia HIV Observational Database participation; ART initiation pre-2006; ART regimens including stavudine and didanosine; three nucleoside analogue reverse transcriptase inhibitors; ≥7 pills per day; and ART with food restrictions (fasting or with food). In conclusion, since 2006, 7.8% of patients had significant time off treatment, which has the potential to compromise any 'test and treat' policy as during the interruption viral load will rebound and increase the risk of transmission. PMID:24320013

  5. Source identification and apportionment of halogenated compounds observed at a remote site in East Asia.

    PubMed

    Li, Shanlan; Kim, Jooil; Park, Sunyoung; Kim, Seung-Kyu; Park, Mi-Kyung; Mühle, Jens; Lee, Gangwoong; Lee, Meehye; Jo, Chun Ok; Kim, Kyung-Ryul

    2014-01-01

    The sources of halogenated compounds in East Asia associated with stratospheric ozone depletion and climate change are relatively poorly understood. High-precision in situ measurements of 18 halogenated compounds and carbonyl sulfide (COS) made at Gosan, Jeju Island, Korea, from November 2007 to December 2011 were analyzed by a positive matrix factorization (PMF). Seven major industrial sources were identified from the enhanced concentrations of halogenated compounds observed at Gosan and corresponding concentration-based source contributions were also suggested: primary aluminum production explaining 37% of total concentration enhancements, solvent usage of which source apportionment is 25%, fugitive emissions from HCFC/HFC production with 11%, refrigerant replacements (9%), semiconductor/electronics industry (9%), foam blowing agents (6%), and fumigation (3%). Statistical trajectory analysis was applied to specify the potential emission regions for seven sources using back trajectories. Primary aluminum production, solvent usage and fugitive emission sources were mainly contributed by China. Semiconductor/electronics sources were dominantly located in Korea. Refrigerant replacement, fumigation and foam blowing agent sources were spread throughout East Asian countries. The specified potential source regions are consistent with country-based consumptions and emission patterns, verifying the PMF analysis results. The industry-based emission sources of halogenated compounds identified in this study help improve our understanding of the East Asian countries' industrial contributions to halogenated compound emissions. PMID:24298975

  6. Age and climate contribution to observed forest carbon sinks in East Asia

    NASA Astrophysics Data System (ADS)

    Gao, Shan; Zhou, Tao; Zhao, Xiang; Wu, Donghai; Li, Zheng; Wu, Hao; Du, Ling; Luo, Hui

    2016-03-01

    The observed forest carbon sink, i.e. positive net ecosystem productivity (NEP), in East Asia reported by the eddy covariance flux tower network is an integrated result of forests themselves (e.g. age) and abiotic factors such as climate. However the relative contribution of climate alone to that sink is highly uncertain and has been in debate. In this study we de-trended a primary effect of forest age on carbon sinks by a statistical regression model between NEP and forest ages. Then, modeled residual NEP was regressed against climate factors again so that its relative contribution could be evaluated appropriately in the region. The analysis for data from the 2000s showed that forest age appeared to be the primary impact factor on the carbon sink of the region (R 2 = 0.347), and the mean annual temperature (MAT) was the second (R 2 = 0.23), while the mean annual precipitation effect might not be as apparent as MAT. Particularly for forests in China, climate might contribute to about 31.7% of the total NEP of 0.540 Pg C yr-1. Given that forests in China are relatively young under current climate conditions, we predicted that they would be capable of atmospheric carbon sequestration in the near future.

  7. Regional nitrogen oxides emission trends in East Asia observed from space

    NASA Astrophysics Data System (ADS)

    Mijling, B.; van der A, R. J.; Zhang, Q.

    2013-07-01

    Due to changing economic activity, emissions of air pollutants in East Asia change rapidly in space and time. Monthly emission estimates of nitrogen oxides derived from satellite observations provide valuable insight in the evolution of anthropogenic activity on a regional scale. We present the first results of a new emission estimation algorithm, specifically designed to use daily satellite observations of column concentrations for fast updates of emissions of short-lived atmospheric constituents on a~mesoscopic scale (~ 0.25° × 0.25°). The algorithm is used to construct a monthly NOx emission time series for 2007-2011 from tropospheric NO2 observations of GOME-2 for East Chinese provinces and surrounding countries. The new emission estimates correspond well with the bottom-up inventory of EDGAR v4.2, but are smaller than the inventories of INTEX-B and MEIC. They reveal a strong positive trend during 2007-2011 for almost all Chinese provinces, related to the country's economic development. We find a 41% increment of NOx emissions in East China during this period, which shows the need to update emission inventories in this region on a regular basis. Negative emission trends are found in Japan and South Korea, which can be attributed to a combined effect of local environmental policy and global economic crises. Analysis of seasonal variation distinguishes between regions with dominant anthropogenic or biogenic emissions. For regions with a mixed anthropogenic and biogenic signature, the opposite seasonality can be used for an estimation of the separate emission contributions. Finally, the non-local concentration/emission relationships calculated by the algorithm are used to quantify the direct effect of regional NOx emissions on tropospheric NO2 concentrations outside the region. For regions such as North Korea and Beijing province, a substantial part of the tropospheric NO2 originates from emissions elsewhere.

  8. Regional nitrogen oxides emission trends in East Asia observed from space

    NASA Astrophysics Data System (ADS)

    Mijling, B.; van der A, R. J.; Zhang, Q.

    2013-12-01

    Due to changing economic activity, emissions of air pollutants in East Asia are changing rapidly in space and time. Monthly emission estimates of nitrogen oxides derived from satellite observations provide valuable insight into the evolution of anthropogenic activity on a regional scale. We present the first results of a new emission estimation algorithm, specifically designed to use daily satellite observations of column concentrations for fast updates of emissions of short-lived atmospheric constituents on a mesoscopic scale (~ 0.25° × 0.25°). The algorithm is used to construct a monthly NOx emission time series for the period 2007-2011 from tropospheric NO2 observations of GOME-2 for East Chinese provinces and surrounding countries. The new emission estimates correspond well with the bottom-up inventory of EDGAR v4.2, but are smaller than the inventories of INTEX-B and MEIC. They reveal a strong positive trend during 2007-2011 for almost all Chinese provinces, related to the country's economic development. We find a 41% increment of NOx emissions in East China during this period, which shows the need to update emission inventories in this region on a regular basis. Negative emission trends are found in Japan and South Korea, which can be attributed to a combined effect of local environmental policy and global economic crises. Analysis of seasonal variation distinguishes between regions with dominant anthropogenic or biogenic emissions. For regions with a mixed anthropogenic and biogenic signature, the opposite seasonality can be used for an estimation of the separate emission contributions. Finally, the non-local concentration/emission relationships calculated by the algorithm are used to quantify the direct effect of regional NOx emissions on tropospheric NO2 concentrations outside the region. For regions such as North Korea and the Beijing municipality, a substantial part of the tropospheric NO2 originates from emissions elsewhere.

  9. Spending of HIV resources in Asia and Eastern Europe: systematic review reveals the need to shift funding allocations towards priority populations

    PubMed Central

    Craig, Andrew P; Thein, Hla-Hla; Zhang, Lei; Gray, Richard T; Henderson, Klara; Wilson, David; Gorgens, Marelize; Wilson, David P

    2014-01-01

    Introduction It is increasingly important to prioritize the most cost-effective HIV interventions. We sought to summarize the evidence on which types of interventions provide the best value for money in regions with concentrated HIV epidemics. Methods We conducted a systematic review of peer-reviewed and grey literature reporting measurements of cost-effectiveness or cost-benefit for HIV/AIDS interventions in Asia and Eastern Europe. We also collated HIV/AIDS spending assessment data from case-study countries in the region. Results We identified 91 studies for inclusion, 47 of which were from peer-reviewed journals. Generally, in concentrated settings, prevention of mother-to-child transmission programmes and prevention programmes targeting people who inject drugs and sex workers had lower incremental cost-effectiveness ratios than programmes aimed at the general population. The few studies evaluating programmes targeting men who have sex with men indicate moderate cost-effectiveness. Collation of prevention programme spending data from 12 countries in the region (none of which had generalized epidemics) indicated that resources for the general population/non-targeted was greater than 30% for eight countries and greater than 50% for five countries. Conclusions There is a misalignment between national spending on HIV/AIDS responses and the most affected populations across the region. In concentrated epidemics, scarce funding should be directed more towards most-at-risk populations. Reaching consensus on general principles of cost-effectiveness of programmes by epidemic settings is difficult due to inconsistent evaluation approaches. Adopting a standard costing, impact evaluation, benefits calculation, analysis and reporting framework would enable cross comparisons and improve HIV resource prioritization and allocation. PMID:24572053

  10. Halting and reversing HIV epidemics in Asia by interrupting transmission in sex work: experience and outcomes from ten countries.

    PubMed

    Steen, Richard; Zhao, Pengfei; Wi, Teodora E; Punchihewa, Neelamanie; Abeyewickreme, Iyanthi; Lo, Ying-Ru

    2013-10-01

    HIV epidemics spread rapidly through Asian sex work networks two decades ago under conditions of high vulnerability, low condom use, intact male foreskins and ulcerative STIs. Experiences implementing interventions to prevent transmission in sex work in ten Asian countries were reviewed. All report increasing condom use trends in sex work. In the seven countries where condom use exceeds 80%, surveillance and other data indicate declining HIV trends or low and stable HIV prevalence with declining STI trends. All four countries with national-level HIV declines among sex workers have also documented significant HIV declines in the general population. While all interventions in sex work included outreach, condom programing and STI services, the largest declines were found in countries that implemented structural interventions on a large scale. Thailand and Cambodia, having controlled transmission early, are closest to providing universal access to HIV care, support and treatment and are exploring HIV elimination strategies. PMID:24124797

  11. Impact of synoptic patterns on East Asia pollutant transport pathways observed from satellites

    NASA Astrophysics Data System (ADS)

    Kim, H. C.; Lee, P.; Kim, S.; Ngan, F.; Bae, C.; Kim, B. U.; Kim, E.

    2014-12-01

    This study presents that wintertime pollutant transport patterns in East Asia are visible from multiple satellite observations when inspected with corresponding synoptic weather analysis. Transport pathways of pollutants and anthropogenic emissions are investigated using satellite images, surface weather chart, and chemical transport model simulation in the context of conceptual categorization of synoptic weather pattern. We combined daily distributions of MODIS AOD and CMAQ simulated PM to represent aerosol distribution; and GOME-2 and OMI NO2 column density as a proxy for fresh anthropogenic emission flux; and Korean Meteorological Administration surface weather analysis chart to understand synoptic weather pattern using GIS geo-referencing technique. We identified a periodic extension of the Siberian high to south China and its associated migratory systems are important to understand transport patterns in this region. Based on the relative location and strength of high pressure system over south China, we classified three types of synoptic patterns that might affect high surface PM events: (1) Expansion of Siberian high as a result of cold surge, (2) Cold front passage associated with migratory northern low pressure system, and (3) Stagnant high pressure system near Yellow Sea. In all cases, the development of high pressure system in south China is essential for development of pollutant event. We demonstrate that observed and simulated surface PM show good agreement, not only with MODIS AOD but also with NO2 column density, implying the possible contributions of transported anthropogenic emissions. We also demonstrate many of these PM plumes are originated from northeastern China, pushed southward by cold front passage, generating unique narrow-band-shape PM plumes. All 3 types of transport patterns are shown to be important, in terms of intensity, frequency, and vertical lifting. These transport pathways are crucial to understand not only local pollutant events

  12. Synergy of Satellite-Surface Observations for Studying the Properties of Absorbing Aerosols in Asia

    NASA Technical Reports Server (NTRS)

    Tsay, Si-Chee

    2010-01-01

    , in major international research projects such as the Joint Aerosol Monsoon Experiment (JAM EX), a core element of the Asian Monsoon Years (AMY, 2008-2012). SMART-COMMIT deployments during 2008 AMY/JAMEX were conducted in northwestern China to characterize the properties of dust-laden aerosols and in the vicinity of Beijing for mega-city aerosols. In 2009, SMART-COMMIT also participated in the JAMEX/RAJO-MEGHA (Radiation, Aerosol Joint Observations-Monsoon Experiment in the Gangetic-Himalayan Area; Sanskrit for Dust-Cloud) to study the aerosol properties, solar absorption and the associated atmospheric warming, and the climatic impact of elevated aerosols during the pre-monsoon season in South Asia. We will show results from these field experiments, as well as discuss a new initiative of 7-SEAS (7 South East Asian Studies) to study the interaction of anthropogenic aerosols with regional meteorology, particularly with clouds.

  13. Observations of Aerosol Optical Properties over 15 AERONET Sites in Southeast Asia

    NASA Astrophysics Data System (ADS)

    Chan, J. D.; Lagrosas, N.; Uy, S. N.; Holben, B. N.; Dorado, S.; Tobias, V., Jr.; Anh, N. X.; Po-Hsiung, L.; Janjai, S.; Salinas Cortijo, S. V.; Liew, S. C.; Lim, H. S.; Lestari, P.

    2014-12-01

    Mean column-integrated optical properties from ground sun photometers of the Aerosol Robotic Network (AERONET) are studied to provide an overview of the characteristics of aerosols over the region as part of the 7 Southeast Asian Studies (7-SEAS) mission. The 15 AERONET sites with the most available level 2 data products are selected from Thailand (Chiang Mai, Mukdahan, Songkhla and Silpakorn University), Malaysia (University Sains Malaysia), Laos (Vientiane), Vietnam (Bac Giang, Bac Lieu and Nha Trang), Taiwan (National Cheng Kung University and Central Weather Bureau Taipei), Singapore, Indonesia (Bandung) and the Philippines (Manila Observatory and Notre Dame of Marbel University). For all 15 sites, high angstrom exponent values (α>1) have been observed. Chiang Mai and USM have the highest mean Angstrom exponent indicating the dominance of fine particles that can be ascribed to biomass burning and urbanization. Sites with the lowest Angstrom exponent values include Bac Lieu (α=1.047) and Manila Observatory (α=1.021). From the average lognormal size distribution curves, Songkhla and NDMU show the smallest annual variation in the fine mode region, indicating the observed fine aerosols are local to the sites. The rest of the sites show high variation which could be due to large scale forcings (e.g., monsoons and biomass burnings) that affect aerosol properties in these sites. Both high and low single scattering albedo at 440 nm (ω0440) values are found in sites located in major urban areas. Silpakorn University, Manila Observatory and Vientiane have all mean ω0440 < 0.90. Singapore and CWB Taipei have ω0440 > 0.94. The discrepancy in ω0 suggests different types of major emission sources present in urban areas. The absorptivity of urban aerosols can vary depending on the strength of traffic emissions, types of fuel combusted and automobile engines used, and the effect of biomass burning aerosols during the dry season. High aerosol optical depth values (τa550

  14. Carbon Flux Estimation in Southeast Asia using a Eulerian-Lagrangian Coupled Inversion System and Observational Data from Multiple Platforms

    NASA Astrophysics Data System (ADS)

    Ishizawa, M.; Shirai, T.; Terao, Y.; Mukai, H.; Nomura, S.; Mohamad, M.; Jahaya, M. F.; Inoue, M.; Morino, I.; Yoshida, Y.; Uchino, O.; Zhuravlev, R.; Ganshin, A.; Maksyutov, S. S.

    2015-12-01

    Southeast Asia is rich in tropical forest and biodiversity. Previous inversion studies show large inter-annual variability in the biosphere-atmosphere carbon exchange attributable to climate anomalies. However, the magnitudes of estimated fluxes are significantly different among the inversions. On the other hand, land-use change has been accelerating the anthropogenic emissions. For the sustainable development in Southeast Asia under the on-going climate change, it is important to understand the biosphere-atmosphere carbon exchange and access the regional emissions. One of the reasons for the large uncertainty in flux estimate is a limited coverage of atmospheric observation against the large variety of ecosystems and the geographical complexity. Recently, the number of measurements has been increasing, including ground-based and satellite-based measurements. We estimated the regional CO2fluxes using a Eulerian-Lagrangian inverse modeling system and examined the characteristics of observational constraints and their impacts on the flux estimate in Southeast Asia. The results show that the temporal variations and source/sink strength of estimated regional fluxes are sensitive to the observational constraints. As a control run, we used the Observational Package (ObsPack) data product since 2001 as a global dataset of atmospheric CO2 measurement. In the addition to Bukit, Sumatra Island (BKT) in ObsPack, we included a stationary CO2 data at Danum Valley in Borneo Island (DMV) since late 2009. Compared to BKT, DMV shows a clear seasonal cycle. The inversion including DMV tends to increase the regional carbon sink in the second half of year. Remotely the aircraft measurements over Rarotonga (RTA) in the tropical Pacific Ocean see the signals from Southeast Asia through an atmospheric convection. The sensitivity test shows RTA impacts on the inter-annual variations of estimated flux, which might be associated with ENSO events. Since June 2009, Greenhouse gases Observing

  15. Observation-constrained Estimation of Aerosol Climate Impacts over S Asia

    NASA Astrophysics Data System (ADS)

    Feng, Y.; Kotamarthi, V. R.; Jefferson, A.; Wilcox, E. M.; Bender, F.; Pistone, K.; Praveen, P. S.; Thomas, R. M.; Ramanathan, V.

    2012-12-01

    Climate impacts of elevated aerosols over S. Asia have been studied extensively. Despite different methods employed and uncertainties, one clear message is that these aerosols have a large impact on the regional energy balance. However, uncertainty in the elevated aerosol absorption, as well as poor fidelity in model representations of aerosol-cloud interactions contribute to the discrepancies in quantifying the aerosol influences on monsoon circulation and rainfall. The main goal of this study is to examine the latitudinal heating gradient and the aerosol impact on the hydrological cycle during the pre-monsoon, with observational constraints on the aerosol vertical distribution. We run a 12-km regional climate model (WRF-Chem) driven by the NCEP analysis data from August 2011 to March 2012. During this time period, the ground-based profiling of aerosol extinction, cloud liquid water, water vapor, and temperature were taken at Nainital (29.38°N, 79.45°E) as part of the Ganges Valley Experiment (GVAX). It is the first time that such vertical profiling data sets are available in the northern Indian subcontinent for such a long period. In the pre-monsoon season (Feb-Mar), the regional model simulations show good agreement in the aerosol optical depth (AOD; 0.1~0.2) and black carbon (BC; ~0.8 ug/m3) concentrations compared with the surface observations at Nainital. The observed diurnal variation in BC concentration, peaking in the afternoon and lowering at night, is also captured by the model as a result of the thermal convection from the polluted valley. The simulated OC/BC ratio is about 2~4 near the surface, which is lower than observations, implying that we may underestimate the secondary organic formation from the biomass burning or biogenic sources. Spectral measurements of aerosol absorption will be used to investigate the absorption of OC in the UV and visible bands. During this time, surface and in situ profiling of aerosols and clouds were also made during

  16. Earlier anal sexarche and co-occurring sexual risk are associated with current HIV-related risk behaviors among an online sample of men who have sex with men in Asia

    PubMed Central

    Cheung, Doug H.; Suharlim, Christian; Guadamuz, Thomas E.; Lim, Sin How; Koe, Stuart; Wei, Chongyi

    2014-01-01

    Studies of heterosexual populations across the globe and men who have sex with men (MSM) in a few developed countries showed that earlier sexual debut (sexarche) was associated with higher levels of co-occurring and subsequent HIV risk behaviors. We examined the relationships between earlier anal sexarche, unprotected earlier anal sexarche and current HIV risks among MSM from Asia. A cross-sectional online survey was conducted among MSM (N = 10,826) in Asia in 2010. Bivariate and multivariable logistic regressions were used to identify co-occurring (i.e., sexual experiences during sexarche) and current HIV-related risk factors (i.e., past six months) associated with earlier anal sexarche (before the age of 18) and unprotected earlier anal sexarche, respectively. Earlier anal sexarche was significantly associated with lack of condom use, being anal receptive or both receptive and insertive, and having a partner who were older during sexarche. It was also associated with current HIV-related risk behaviors including having multiple male sexual partners, having been paid for sex, and increased frequencies of recreational drug use. Unprotected earlier anal sexarche was significantly associated with inconsistent condom use in the past the six months. Improved and culturally sensitive sex education at schools should be included in national and regional HIV/AIDS prevention programming and policies in Asia. Such sex education programs should incorporate curriculum that address sexuality, sexual orientation, and sexual behaviors beyond those related to reproductive health. PMID:24920344

  17. Spatial and Temporal Analysis of Winter Fog Episodes over South Asia by exploiting ground-based and satellite observations

    NASA Astrophysics Data System (ADS)

    Fahim Khokhar, Muhammad; Yasmin, Naila; Zaib, Naila; Murtaza, Rabia; Noreen, Asma; Ishtiaq, Hira; Khayyam, Junaid; Panday, Arnico

    2016-04-01

    The South Asian region in general and the Indo-Gangetic Plains (IGP) in particular hold about 1/6th of the world's population and is considered as one of the major hotspots with increasing air pollution. Due to growing population and globalization, South Asia is experiencing high transformations in the urban and industrial sectors. Fog is one of the meteorological/environmental phenomena which can generate significant social and economic problems especially havoc to air and road traffic. Meteorological stations provide information about the fog episodes only on the basis of point observation. Continuous monitoring as well as a spatially coherent picture of fog distribution can only be possible through the use of satellite imagery. Current study focus on winter fog episodes over South Asian region using Moderate Resolution Image Spectrometer (MODIS) Level 2 Terra Product and other MODIS Aerosol Product in addition to ground-based sampling and AERONET measurements. MODIS Corrected Reflectance RGBs are used to analyse the spatial extent of fog over study area. MOD04 level 2 Collection 6 data is used to study aerosol load and distribution which are further characterised by using aerosol type land product of MODIS. In order to study the variation of ground based observations from satellite data MODIS, AERONET and high volume air Sampler were used. Main objective of this study was to explore the spatial extent of fog, its causes and to analyse the Aerosol Optical Depth (AOD) over South Asia with particular focus over Indo-Gangetic Plains (IGP). Current studies show a descent increase in AOD from past few decades over South Asia and is contributing to poor air quality in the region due to growing population, urbanization, and industrialization. Smoke and absorbing aerosol are major constituent of fog over South Asia. Furthermore, winter 2014-15 extended span of Fog was also observed over South Asia. A significant correlation between MODIS (AOD) and AERONET Station (AOD

  18. Combined observational and modeling efforts of aerosol-cloud-precipitation interactions over Southeast Asia

    NASA Astrophysics Data System (ADS)

    Loftus, Adrian; Tsay, Si-Chee; Nguyen, Xuan Anh

    2016-04-01

    Low-level stratocumulus (Sc) clouds cover more of the Earth's surface than any other cloud type rendering them critical for Earth's energy balance, primarily via reflection of solar radiation, as well as their role in the global hydrological cycle. Stratocumuli are particularly sensitive to changes in aerosol loading on both microphysical and macrophysical scales, yet the complex feedbacks involved in aerosol-cloud-precipitation interactions remain poorly understood. Moreover, research on these clouds has largely been confined to marine environments, with far fewer studies over land where major sources of anthropogenic aerosols exist. The aerosol burden over Southeast Asia (SEA) in boreal spring, attributed to biomass burning (BB), exhibits highly consistent spatiotemporal distribution patterns, with major variability due to changes in aerosol loading mediated by processes ranging from large-scale climate factors to diurnal meteorological events. Downwind from source regions, the transported BB aerosols often overlap with low-level Sc cloud decks associated with the development of the region's pre-monsoon system, providing a unique, natural laboratory for further exploring their complex micro- and macro-scale relationships. Compared to other locations worldwide, studies of springtime biomass-burning aerosols and the predominately Sc cloud systems over SEA and their ensuing interactions are underrepresented in scientific literature. Measurements of aerosol and cloud properties, whether ground-based or from satellites, generally lack information on microphysical processes; thus cloud-resolving models are often employed to simulate the underlying physical processes in aerosol-cloud-precipitation interactions. The Goddard Cumulus Ensemble (GCE) cloud model has recently been enhanced with a triple-moment (3M) bulk microphysics scheme as well as the Regional Atmospheric Modeling System (RAMS) version 6 aerosol module. Because the aerosol burden not only affects cloud

  19. Invasive Non-typhoidal Salmonella Infections in Asia: Clinical Observations, Disease Outcome and Dominant Serovars from an Infectious Disease Hospital in Vietnam

    PubMed Central

    Phu Huong Lan, Nguyen; Le Thi Phuong, Tu; Nguyen Huu, Hien; Thuy, Le; Mather, Alison E.; Park, Se Eun; Marks, Florian; Thwaites, Guy E.; Van Vinh Chau, Nguyen; Thompson, Corinne N.; Baker, Stephen

    2016-01-01

    Invasive non-typhoidal Salmonella (iNTS) infections are now a well-described cause of morbidity and mortality in children and HIV-infected adults in sub-Saharan Africa. In contrast, the epidemiology and clinical manifestations of iNTS disease in Asia are not well documented. We retrospectively identified >100 cases of iNTS infections in an infectious disease hospital in Southern Vietnam between 2008 and 2013. Clinical records were accessed to evaluate demographic and clinical factors associated with iNTS infection and to identify risk factors associated with death. Multi-locus sequence typing and antimicrobial susceptibility testing was performed on all organisms. Of 102 iNTS patients, 71% were HIV-infected, >90% were adults, 71% were male and 33% reported intravenous drug use. Twenty-six/92 (28%) patients with a known outcome died; HIV infection was significantly associated with death (p = 0.039). S. Enteritidis (Sequence Types (ST)11) (48%, 43/89) and S. Typhimurium (ST19, 34 and 1544) (26%, 23/89) were the most commonly identified serovars; S. Typhimurium was significantly more common in HIV-infected individuals (p = 0.003). Isolates from HIV-infected patients were more likely to exhibit reduced susceptibility against trimethoprim-sulfamethoxazole than HIV-negative patients (p = 0.037). We conclude that iNTS disease is a severe infection in Vietnam with a high mortality rate. As in sub-Saharan Africa, HIV infection was a risk factor for death, with the majority of the burden in this population found in HIV-infected adult men. PMID:27513951

  20. Invasive Non-typhoidal Salmonella Infections in Asia: Clinical Observations, Disease Outcome and Dominant Serovars from an Infectious Disease Hospital in Vietnam.

    PubMed

    Phu Huong Lan, Nguyen; Le Thi Phuong, Tu; Nguyen Huu, Hien; Thuy, Le; Mather, Alison E; Park, Se Eun; Marks, Florian; Thwaites, Guy E; Van Vinh Chau, Nguyen; Thompson, Corinne N; Baker, Stephen

    2016-08-01

    Invasive non-typhoidal Salmonella (iNTS) infections are now a well-described cause of morbidity and mortality in children and HIV-infected adults in sub-Saharan Africa. In contrast, the epidemiology and clinical manifestations of iNTS disease in Asia are not well documented. We retrospectively identified >100 cases of iNTS infections in an infectious disease hospital in Southern Vietnam between 2008 and 2013. Clinical records were accessed to evaluate demographic and clinical factors associated with iNTS infection and to identify risk factors associated with death. Multi-locus sequence typing and antimicrobial susceptibility testing was performed on all organisms. Of 102 iNTS patients, 71% were HIV-infected, >90% were adults, 71% were male and 33% reported intravenous drug use. Twenty-six/92 (28%) patients with a known outcome died; HIV infection was significantly associated with death (p = 0.039). S. Enteritidis (Sequence Types (ST)11) (48%, 43/89) and S. Typhimurium (ST19, 34 and 1544) (26%, 23/89) were the most commonly identified serovars; S. Typhimurium was significantly more common in HIV-infected individuals (p = 0.003). Isolates from HIV-infected patients were more likely to exhibit reduced susceptibility against trimethoprim-sulfamethoxazole than HIV-negative patients (p = 0.037). We conclude that iNTS disease is a severe infection in Vietnam with a high mortality rate. As in sub-Saharan Africa, HIV infection was a risk factor for death, with the majority of the burden in this population found in HIV-infected adult men. PMID:27513951

  1. Astronomical Observations in Asia from Delisle's Manuscripts Preserved in the Paris Observatory Library

    NASA Astrophysics Data System (ADS)

    Débarbat, S.

    Delisle, born in 1688 April 4, is well known as a collector of astronomical data from all over the world. Part of his manuscripts are preserved in the Paris Observatory library. He is said to have collected all available astronomical data at the time he was in activity in France and in Russia where he spent more than twenty years. He had more correspondents and among them, in Asia father Gaubil, of which more than one hundred letters are in the Paris Observatory archives, providing priceless informations to astronomical researchers, historians and others.

  2. Correlation slopes of GEM / CO, GEM / CO2, and GEM / CH4 and estimated mercury emissions in China, South Asia, the Indochinese Peninsula, and Central Asia derived from observations in northwestern and southwestern China

    NASA Astrophysics Data System (ADS)

    Fu, X. W.; Zhang, H.; Lin, C.-J.; Feng, X. B.; Zhou, L. X.; Fang, S. X.

    2015-01-01

    Correlation analyses between atmospheric mercury (Hg) and other trace gases are useful for identification of sources and constraining regional Hg emissions. Emissions of Hg in Asia contribute significantly to the global budget of atmospheric Hg. However, due to the lack of reliable data on the source strength, large uncertainties remain in the emission inventories of Hg in Asia. In the present study, we calculated the correlation slopes of GEM / CO, GEM / CO2, and GEM / CH4 for mainland China, South Asia, the Indochinese Peninsula, and Central Asia using the ground-based observations at three remote sites in northwestern and southwestern China, and applied these values to estimate GEM emissions in the four source regions. The geometric mean GEM / CO correlation slopes for mainland China, South Asia, the Indochinese Peninsula, and Central Asia were 7.3 ± 4.3, 7.8 ± 6.4, 7.8 ± 5.0, and 13.4 ± 9.5 pg m-3 ppb-1, respectively, and values in the same source regions were 33.3 ± 30.4, 27.4 ± 31.0, 23.5 ± 15.3, and 20.5 ± 10.0 pg m-3 ppb-1 for the GEM / CH4 correlation slopes, respectively. The geometric means of GEM / CO2 correlation slopes for mainland China, South Asia, and Central Asia were 240 ± 119, 278 ± 164, 315 ± 289 pg m-3 ppm-1, respectively. These values were the first reported correlation slopes of GEM / CO, GEM / CO2, and GEM / CH4 in four important source regions of Asia, not including the GEM / CO ratios in mainland China. The correlation slopes of GEM / CO, GEM / CO2, and GEM / CH4 in Asia were relatively higher than those observed in Europe, North America, and South Africa, which may highlight GEM emissions from non-ferrous smelting, large-scale and artisanal mercury and gold production, natural sources, and historically deposited mercury (re-emission) in Asia. Using the observed GEM / CO and GEM / CO2 slopes, and the recently reported emission inventories of CO and CO2, the annual GEM emissions in mainland China, South Asia, the Indochinese

  3. Evaluation of VIIRS, GOCI, and MODIS Collection 6 AOD retrievals against ground sunphotometer observations over East Asia

    NASA Astrophysics Data System (ADS)

    Xiao, Q.; Zhang, H.; Choi, M.; Li, S.; Kondragunta, S.; Kim, J.; Holben, B.; Levy, R. C.; Liu, Y.

    2016-02-01

    Persistent high aerosol loadings together with extremely high population densities have raised serious air quality and public health concerns in many urban centers in East Asia. However, ground-based air quality monitoring is relatively limited in this area. Recently, satellite-retrieved Aerosol Optical Depth (AOD) at high resolution has become a powerful tool to characterize aerosol patterns in space and time. Using ground AOD observations from the Aerosol Robotic Network (AERONET) and the Distributed Regional Aerosol Gridded Observation Networks (DRAGON)-Asia Campaign, as well as from handheld sunphotometers, we evaluated emerging aerosol products from the Visible Infrared Imaging Radiometer Suite (VIIRS) aboard the Suomi National Polar-orbiting Partnership (S-NPP), the Geostationary Ocean Color Imager (GOCI) aboard the Communication, Ocean, and Meteorology Satellite (COMS), and Terra and Aqua Moderate Resolution Imaging Spectroradiometer (MODIS) (Collection 6) in East Asia in 2012 and 2013. In the case study in Beijing, when compared with AOD observations from handheld sunphotometers, 51 % of VIIRS Environmental Data Record (EDR) AOD, 37 % of GOCI AOD, 33 % of VIIRS Intermediate Product (IP) AOD, 26 % of Terra MODIS C6 3 km AOD, and 16 % of Aqua MODIS C6 3 km AOD fell within the reference expected error (EE) envelope (±0.05 ± 0.15 AOD). Comparing against AERONET AOD over the Japan-South Korea region, 64 % of EDR, 37 % of IP, 61 % of GOCI, 39 % of Terra MODIS, and 56 % of Aqua MODIS C6 3 km AOD fell within the EE. In general, satellite aerosol products performed better in tracking the day-to-day variability than tracking the spatial variability at high resolutions. The VIIRS EDR and GOCI products provided the most accurate AOD retrievals, while VIIRS IP and MODIS C6 3 km products had positive biases.

  4. Decreasing emissions of NOx relative to CO2 in East Asia inferred from satellite observations

    NASA Astrophysics Data System (ADS)

    Reuter, M.; Buchwitz, M.; Hilboll, A.; Richter, A.; Schneising, O.; Hilker, M.; Heymann, J.; Bovensmann, H.; Burrows, J. P.

    2014-11-01

    At present, global CO2 emission inventories are mainly based on bottom-up estimates that rely, for example, on reported fossil fuel consumptions and fuel types. The associated uncertainties propagate into the CO2-to-NOx emission ratios that are used in pollution prediction and monitoring, as well as into biospheric carbon fluxes derived by inverse models. Here we analyse simultaneous and co-located satellite retrievals from SCIAMACHY (ref. ; SCanning Imaging Absorption SpectroMeter for Atmospheric CHartographY) of the column-average dry-air mole fraction of CO2 (refs , ) and NO2 (refs , , ) for the years 2003-2011 to provide a top-down estimate of trends in emissions and in the ratio between CO2 and NOx emissions. Our analysis shows that the CO2-to-NOx emission ratio has increased by 4.2 +/- 1.7% yr-1 in East Asia. In this region, we find a large positive trend of CO2 emissions (9.8 +/- 1.7% yr-1), which we largely attribute to the growing Chinese economy. This trend exceeds the positive trend of NOx emissions (5.8 +/- 0.9% yr-1). Our findings suggest that the recently installed and renewed technology in East Asia, such as power plants, transportation and so on, is cleaner in terms of NOx emissions than the old infrastructure, and roughly matches relative emission levels in North America and Europe.

  5. How does sex trafficking increase the risk of HIV Infection? An observational study from Southern India.

    PubMed

    Wirth, Kathleen E; Tchetgen Tchetgen, Eric J; Silverman, Jay G; Murray, Megan B

    2013-02-01

    Studies have documented the substantial risk of human immunodeficiency virus (HIV) infection endured by sex-trafficked women, but it remains unclear how exposure to trafficking puts its victims at risk. We assessed whether the association between sex trafficking and HIV could be explained by self-reported forced prostitution or young age at entry into prostitution using cross-sectional data collected from 1,814 adult female sex workers in Karnataka, India, between August 2005 and August 2006. Marginal structural logistic regression was used to estimate adjusted odds ratios for HIV infection. Overall, 372 (21%) women met 1 or both criteria used to define sex trafficking: 278 (16%) began sex work before age 18 years, and 107 (5%) reported being forcibly prostituted. Thirteen (0.7%) met both criteria. Forcibly prostituted women were more likely to be HIV-infected than were women who joined the industry voluntarily, independent of age at entering prostitution (odds ratio = 2.30, 95% confidence interval: 1.08, 4.90). Conversely, after adjustment for forced prostitution and other confounders, no association between age at entry into prostitution and HIV was observed. The association between forced prostitution and HIV infection became stronger in the presence of sexual violence (odds ratio = 11.13, 95% confidence interval: 2.41, 51.40). These findings indicate that forced prostitution coupled with sexual violence probably explains the association between sex trafficking and HIV. PMID:23324332

  6. Factors associated with presenting late or with advanced HIV disease in the Netherlands, 1996–2014: results from a national observational cohort

    PubMed Central

    Op de Coul, Eline L M; van Sighem, Ard; Brinkman, Kees; van Benthem, Birgit H; van der Ende, Marchina E; Geerlings, Suzanne; Reiss, Peter

    2016-01-01

    Objectives Early testing for HIV and entry into care are crucial to optimise treatment outcomes of HIV-infected patients and to prevent spread of HIV. We examined risk factors for presentation with late or advanced disease in HIV-infected patients in the Netherlands. Methods HIV-infected patients registered in care between January 1996 and June 2014 were selected from the ATHENA national observational HIV cohort. Risk factors for late presentation and advanced disease were analysed by multivariable logistic regression. Furthermore, geographical differences and time trends were examined. Results Of 20 965 patients, 53% presented with late-stage HIV infection, and 35% had advanced disease. Late presentation decreased from 62% (1996) to 42% (2013), while advanced disease decreased from 46% to 26%. Late presentation only declined significantly among men having sex with men (MSM; p <0.001), but not among heterosexual males (p=0.08) and females (p=0.73). Factors associated with late presentation were: heterosexual male (adjusted OR (aOR), 1.59; 95% CI 1.44 to 1.75 vs MSM), injecting drug use (2.00; CI 1.69 to 2.38), age ≥50 years (1.46; CI 1.33 to 1.60 vs 30–49 years), region of origin (South-East Asia 2.14; 1.80 to 2.54, sub-Saharan Africa 2.11; 1.88 to 2.36, Surinam 1.59; 1.37 to 1.84, Caribbean 1.31; 1.13 to 1.53, Latin America 1.23; 1.04 to 1.46 vs the Netherlands), and location of HIV diagnosis (hospital 3.27; 2.94 to 3.63, general practitioner 1.66; 1.50 to 1.83, antenatal screening 1.76; 1.38 to 2.34 vs sexually transmitted infection clinic). No association was found for socioeconomic status or level of urbanisation. Compared with Amsterdam, 2 regions had higher adjusted odds and 2 regions had lower odds of late presentation. Results were highly similar for advanced disease. Conclusions Although the overall rate of late presentation is declining in the Netherlands, targeted programmes to reduce late HIV diagnoses remain needed for all risk groups, but

  7. Effects of experimental protocol on global vegetation model accuracy: a comparison of simulated and observed vegetation patterns for Asia

    USGS Publications Warehouse

    Tang, Guoping; Shafer, Sarah L.; Barlein, Patrick J.; Holman, Justin O.

    2009-01-01

    Prognostic vegetation models have been widely used to study the interactions between environmental change and biological systems. This study examines the sensitivity of vegetation model simulations to: (i) the selection of input climatologies representing different time periods and their associated atmospheric CO2 concentrations, (ii) the choice of observed vegetation data for evaluating the model results, and (iii) the methods used to compare simulated and observed vegetation. We use vegetation simulated for Asia by the equilibrium vegetation model BIOME4 as a typical example of vegetation model output. BIOME4 was run using 19 different climatologies and their associated atmospheric CO2 concentrations. The Kappa statistic, Fuzzy Kappa statistic and a newly developed map-comparison method, the Nomad index, were used to quantify the agreement between the biomes simulated under each scenario and the observed vegetation from three different global land- and tree-cover data sets: the global Potential Natural Vegetation data set (PNV), the Global Land Cover Characteristics data set (GLCC), and the Global Land Cover Facility data set (GLCF). The results indicate that the 30-year mean climatology (and its associated atmospheric CO2 concentration) for the time period immediately preceding the collection date of the observed vegetation data produce the most accurate vegetation simulations when compared with all three observed vegetation data sets. The study also indicates that the BIOME4-simulated vegetation for Asia more closely matches the PNV data than the other two observed vegetation data sets. Given the same observed data, the accuracy assessments of the BIOME4 simulations made using the Kappa, Fuzzy Kappa and Nomad index map-comparison methods agree well when the compared vegetation types consist of a large number of spatially continuous grid cells. The results of this analysis can assist model users in designing experimental protocols for simulating vegetation.

  8. Neutralization of soil aerosol and its impact on the distribution of acid rain over east Asia: Observations and model results

    NASA Astrophysics Data System (ADS)

    Wang, Zifa; Akimoto, Hajime; Uno, Itsushi

    2002-10-01

    A comprehensive Air Quality Prediction Modeling System is applied to simulate the pH values in precipitation and to investigate neutralization by soil aerosols and their influence on the distribution of acid rain over east Asia. A modified deflation module is designed to provide explicit information on the soil aerosol loading. Numerical simulation was performed for 1 year, from 15 December 1998 to 31 December 1999. Wet deposition monitoring data at 17 sites of the Acid Deposition Monitoring Network in east Asia in addition to State Environmental Protection Agency data were used to evaluate the model, and a reasonable agreement was obtained. Observed evidence clearly shows that in northern China acid deposition is heavily influenced and buffered by natural soil dust from desert and semiarid areas. The observed mean rainwater pH value in northern China is the highest, between 6.0 and 7.2, while in southern China, where many areas severely impacted by acid precipitation are located, the pH value is much lower, between 3.5 and 5. In Japan the mean pH value is 4.7, significantly higher than that in southern China, while in South Korea the pH value is intermediate between those in northern China and Japan. The model is capable of reproducing this geographical distribution of rainwater pH over east Asia. The simulation results for 1999 demonstrated strong neutralization of precipitation by soil aerosols over northeast Asia, and the distribution pattern of acid rain was also altered. The annual mean pH values in northern China and Korea show a remarkable increase of 0.8-2.5, while the increase in mean pH values over southern China and Japan are less than 0.1. The neutralization effects vary by season, with the greatest influence in spring, when pH values increased by 0.1-0.4 in Japan, 0.5-1.5 in Korea, and more than 2 in northern China.

  9. Correlation slopes of GEM / CO, GEM / CO2, and GEM / CH4 and estimated mercury emissions in China, South Asia, Indochinese Peninsula, and Central Asia derived from observations in northwest and southwest China

    NASA Astrophysics Data System (ADS)

    Fu, X. W.; Zhang, H.; Lin, C.-J.; Feng, X.; Zhou, L. X.; Fang, S. X.

    2014-09-01

    Correlation analysis between atmospheric mercury (Hg) and other trace gases are useful for identification of sources and constraining regional estimated Hg emissions. Emissions of Hg in Asia contribute significantly to the global budget of atmospheric Hg. However, due to the lack of reliable data on the source strength, large uncertainties remain in the emission inventories of Hg in Asia. In the present study, we calculated the correlation slopes of GEM / CO, GEM / CO2, and GEM / CH4 for mainland China, South Asia, Indochinese Peninsula, and Central Asia using the ground-based observations at three remote sites in northwest and southwest China, and applied the values to estimate GEM emissions in the four source regions. The geometric mean of the GEM / CO correlation slopes for mainland China, South Asia, Indochinese Peninsula, and Central Asia were 7.3 ± 4.3, 7.8 ± 6.4, 7.8 ± 5.0, and 13.4 ± 9.5 pg m-3 ppb-1, respectively. The values in the same source regions were 240 ± 119, 278 ± 164, 315 ± 289 pg m-3 ppm-1 for the GEM / CO2 correlation slopes; and 33.3 ± 30.4, 27.4 ± 31.0, 23.5 ± 15.3, and 20.5 ± 10.0 pg m-3 ppb-1 for the GEM / CH4 correlation slopes, respectively. These values were the first reported correlation slopes of GEM / CO, GEM / CO2, and GEM / CH4 in four important source regions of Asia except the GEM / CO ratios in mainland China. The correlation slopes of GEM / CO, GEM / CO2 and GEM / CH4 in Asia were relatively higher than those observed in Europe, North America and South Africa, which may highlight GEM emissions from non-ferrous smelting, mercury mining, natural sources and historical deposited mercury (re-emission) in Asia. Using the observed GEM / CO and GEM / CO2 slopes, and the recently reported emission inventories of CO and CO2, the annual GEM emissions in mainland China, South Asia, Indochinese Peninsula, and Central Asia were estimated to be in the ranges of 1071-1187 t, 340-470 t, 125 t, and 54-90 t, respectively. The estimate

  10. Spatial and diurnal variation of precipitation systems over Asia observed by the TRMM Precipitation Radar

    NASA Astrophysics Data System (ADS)

    Hirose, Masafumi; Nakamura, Kenji

    2005-03-01

    The spatial and diurnal variation of rainfall over Asia was investigated using the spaceborne radar data for four seasons during 1998-2003. The regional variation of the prevailing precipitation systems most closely associated with the maximum hourly rainfall was shown by examining the fine spatial distribution of rainfall amount and scale-based precipitation systems. Small precipitation systems (<102 km2) occurred most frequently around early afternoon over most land. The south facing slopes of the Himalayas, especially south of Mount Everest and the upper portion of the Brahmaputra valley, is the most obvious region of the daytime genesis of the convective systems over the Asian landmass. Over the Tibetan Plateau the occurrence of the small systems was larger than over inland India and the foothills. Large systems (>104 km2) developed mostly in the evening over nearly flat landmasses. Wide-spread systems with intense rain pixels developed over the foothills of the Himalayas in late night-early morning period, which was distinct from the daytime convection. Over ocean, in addition to the morning signature, spatially inhomogeneous and systematic characteristics were evident over the offshore region, for example, around the maritime continent. Large systems, which are strongly associated with terrain, have a great influence on the total number of rain pixels and the total amount of rainfall. For 86% of the region where large system is dominant the time of maximum rainfall is within 3 hours of the time of maximum rainfall for large systems.

  11. CARIBIC observations of short-lived halocarbons and carbonyl sulphide over Asia

    NASA Astrophysics Data System (ADS)

    Leedham, E.; Wisher, A.; Oram, D.; Baker, A. K.; Brenninkmeijer, C. A.

    2013-12-01

    The CARIBIC project (Civil Aircraft for the Regular Investigation of the atmosphere Based on an Instrument Container, www.caribic-atmospheric.com) aims to investigate the spatial and temporal distribution of a wide-range of compounds, including those of marine origin/influence, via ~monthly flights to collect in situ data and whole air samples aboard a commercial Lufthansa aircraft. CARIBIC measures up to an altitude of 12 km, allowing the influence of marine compounds on the upper troposphere/lower stratosphere (UTLS) to be explored. In particular, CARIBIC is a useful tool for exploring the impact of very short lived halocarbons (e.g. CH2Br2, CHBr3), whose impact on stratospheric ozone is dependent on convective uplift to the UTLS, a process which is not yet fully quantified. As part of the suite of CARIBIC measurements, whole air samples are analysed at the University of East Anglia (UEA) via gas chromatography mass spectrometry for carbonyl sulphide (OCS) and up to 40 halocarbons (accounting for virtually 100% of organic chlorine, bromine and iodine in the UTLS). Here we present an overview of short-lived halocarbons and OCS measured by CARIBIC. We focus on two regions of particular interest. (1) measurements made in 2012 over the tropical west Pacific to link with UEA measurements made during the SHIVA campaign. (2) measurements made during a collection of flights over India in 2008. Flights over India investigated the impact of monsoon circulation on the distribution of these compounds; for example, elevated concentrations of OCS were seen in CARIBIC samples taken over India during the summer monsoon (July - September). These flights, along with a wider range of flights over Asia (from Frankfurt to Guangzhou, Manila, Bangkok and Kuala Lumpur) can provide unique information on the influence of tropical convection and monsoon circulation on halocarbon and OCS transport within this region.

  12. The Silk Road Health Project: How Mobility and Migration Status Influence HIV Risks among Male Migrant Workers in Central Asia

    PubMed Central

    El-Bassel, Nabila; Gilbert, Louisa; Shaw, Stacey A.; Mergenova, Gaukhar; Terlikbayeva, Assel; Primbetova, Sholpan; Ma, Xin; Chang, Mingway; Ismayilova, Leyla; Hunt, Tim; West, Brooke; Wu, Elwin; Beyrer, Chris

    2016-01-01

    Objectives We examined whether mobility, migrant status, and risk environments are associated with sexually transmitted infections (STIs) and HIV risk behaviors (e.g. sex trading, multiple partners, and unprotected sex). Methods We used Respondent Driven Sampling (RDS) to recruit external male migrant market vendors from Kyrgyzstan, Uzbekistan, and Tajikistan as well internal migrant and non-migrant market vendors from Kazakhstan. We conducted multivariate logistic regressions to examine the effects of mobility combined with the interaction between mobility and migration status on STIs and sexual risk behaviors, when controlling for risk environment characteristics. Results Mobility was associated with increased risk for biologically-confirmed STIs, sex trading, and unprotected sex among non-migrants, but not among internal or external migrants. Condom use rates were low among all three groups, particularly external migrants. Risk environment factors of low-income status, debt, homelessness, and limited access to medical care were associated with unprotected sex among external migrants. Conclusion Study findings underscore the role mobility and risk environments play in shaping HIV/STI risks. They highlight the need to consider mobility in the context of migration status and other risk environment factors in developing effective prevention strategies for this population. PMID:26967159

  13. An offline constrained data assimilation technique for aerosols: Improving GCM simulations over South Asia using observations from two satellite sensors

    NASA Astrophysics Data System (ADS)

    Baraskar, Ankit; Bhushan, Mani; Venkataraman, Chandra; Cherian, Ribu

    2016-05-01

    Aerosol properties simulated by general circulation models (GCMs) exhibit large uncertainties due to biases in model processes and inaccuracies in aerosol emission inputs. In this work, we propose an offline, constrained optimization based procedure to improve these simulations by assimilating them with observational data. The proposed approach explicitly incorporates the non-negativity constraint on the aerosol optical depth (AOD) which is a key metric to quantify aerosol distributions. The resulting optimization problem is quadratic programming in nature and can be easily solved by available optimization routines. The utility of the approach is demonstrated by performing offline assimilation of GCM simulated aerosol optical properties and radiative forcing over South Asia (40-120 E, 5-40 N), with satellite AOD measurements from two sensors, namely Moderate Resolution Imaging SpectroRadiometer (MODIS) and Multi-Angle Imaging SpectroRadiometer (MISR). Uncertainty in observational data used in the assimilation is computed by developing different error bands around regional AOD observations, based on their quality assurance flags. The assimilation, evaluated on monthly and daily scales, compares well with Aerosol Robotic Network (AERONET) observations as determined by goodness of fit statistics. Assimilation increased both model predicted atmospheric absorption and clear sky radiative forcing by factors consistent with recent estimates in literature. Thus, the constrained assimilation algorithm helps in systematically reducing uncertainties in aerosol simulations.

  14. Characterization of aerosols in East Asia with the Asian Dust and Aerosol Lidar Observation Network (AD-Net)

    NASA Astrophysics Data System (ADS)

    Sugimoto, Nobuo; Nishizawa, Tomoaki; Shimizu, Atsushi; Matsui, Ichiro; Jin, Yoshitaka

    2014-11-01

    Continuous observations of aerosols are being conducted with the Asian Dust and aerosol lidar observation Network (AD-Net). Currently, two-wavelength (1064 nm and 532 nm) polarization-sensitive (532 nm) lidars are operated at 20 stations in East Asia. At the primary stations (6 stations), nitrogen vibrational Raman scattering is also measured to obtain the extinction coefficient at 532 nm. Recently, continuous observations with a three-wavelength (1064 nm, 532 nm and 355 nm) lidar having a high-spectral-resolution receiver at 532 nm and a Raman receiver at 355 nm and polarization-sensitive receivers at 532 nm and 355 nm) was started in Tsukuba. Also, continuous observations with multi-wavelength Raman lidars are being prepared in Fukuoka, Okinawa Hedo, and Toyama. A data analysis method for deriving distributions of aerosol components (weak absorption fine (such as sulfate), weak absorption coarse (sea salt), strong absorption fine (black carbon), non-spherical (dust)) has been developed for these multi-parameter lidars. Major subjects of the current studies with AD-Net include data assimilation of multi-parameter lidars, mixing states of Asian dust with air pollution particulate matter, and validation of EarthCARE ATLID based on the aerosol component analysis method.

  15. Investigation of Ionospheric Disturbances Using Radio and Optical Observations in South-East Asia -- The Initial Results of the ASI and FPI Observations in Chiang Mai, Thailand

    NASA Astrophysics Data System (ADS)

    Kubota, M.; Nagatsuma, T.; Otsuka, Y.; Shiokawa, K.; Komonjinda, S.; Komolmis, T.; Somboon, E.; Tsugawa, T.; Maruyama, T.; Murata, K. T.

    2010-12-01

    For the purpose of monitoring and forecasting equatorial ionospheric disturbances, SEALION (SouthEast Asia Low-latitude IOnospheric Network) has been developed since 2003 as a cooperation project by National Institute of Information and Communications Technology (NICT), King Mongkut's Institute of Technology Ladkrabang (KMITL) in Thailand, Chiang Mai University (CMU) in Thailand, National Institute of Aeronautics and Space (LAPAN) in Indonesia, Hanoi Institute of Geophysics (HIG), Vietnamese Academy of Science and Technology in Vietnam, Center for Space Science and Applied Research (CSSAR), Chinese Academy of Sciences in China, Kyoto University in Japan, and Solar-Terrestrial Environment Laboratory (STEL), Nagoya University in Japan. SEALION consists of five ionosondes, four GPS receivers, two GPS scintillation monitors, and a magnetometer. As a part of this project, we newly installed an all-sky imager (ASI) and a Fabry-Perot Interferometer (FPI) at Sirindhorn observatory in Chiang Mai (18.8N, 98.9E, Dip lat. 13.1), Thailand. This site is located near conjugate to EAR site in Kototabang, Indonesia. One of main targets of the ASI observation is the large-scale wave structure (LSWS) with wavelengths of 100-1000 km. The LSWS is thought to be connected to the generation mechanism of equatorial plasma bubbles (EPB). The optical observations in Chiang Mai started in February 2010, and we have detected several ionospheric disturbance events with these instruments In this paper, we will show the initial results of the optical observations from Sirindhorn observatory, and discuss the features of ionospheric disturbances in Southeast Asia.

  16. Observational Research on NCDs in HIV-Positive Populations: Conceptual and Methodological Considerations

    PubMed Central

    Petersen, Maya; Yiannoutsos, Constantin T.; Justice, Amy; Egger, Matthias

    2015-01-01

    Noncommunicable diseases (NCDs) account for a growing burden of morbidity and mortality among people living with HIV in low- and middle-income countries (LMICs). HIV infection and antiretroviral therapy interact with NCD risk factors in complex ways, and research into this “web of causation” has so far been largely based on data from high-income countries. However, improving the understanding, treatment, and prevention of NCDs in LMICs requires region-specific evidence. Priority research areas include: (1) defining the burden of NCDs among people living with HIV, (2) understanding the impact of modifiable risk factors, (3) evaluating effective and efficient care strategies at individual and health systems levels, and (4) evaluating cost-effective prevention strategies. Meeting these needs will require observational data, both to inform the design of randomized trials and to replace trials that would be unethical or infeasible. Focusing on Sub-Saharan Africa, we discuss data resources currently available to inform this effort and consider key limitations and methodological challenges. Existing data resources often lack population-based samples; HIV-negative, HIV-positive, and antiretroviral therapy–naive comparison groups; and measurements of key NCD risk factors and outcomes. Other challenges include loss to follow-up, competing risk of death, incomplete outcome ascertainment and measurement of factors affecting clinical decision making, and the need to control for (time-dependent) confounding. We review these challenges and discuss strategies for overcoming them through augmented data collection and appropriate analysis. We conclude with recommendations to improve the quality of data and analyses available to inform the response to HIV and NCD comorbidity in LMICs. PMID:25117964

  17. HIV

    PubMed Central

    Chawla, Sumit; Sahoo, Soumya Swaroop; Jain, Rambilas; Khanna, Pardeep; Mehta, Bharti; Singh, Inderjeet

    2014-01-01

    Getting to zero: zero new HIV infections, zero deaths from AIDS-related illness, zero discrimination is the theme of World AIDS Day 2012. Given the spread of the epidemic today, getting to zero may sound difficult, but significant progress is underway. The total annual loss for the entire country due to HIV is 7% of GDP, which exceeds India’s annual health expenditure in 2004. The additional loss due to loss of labor income and increased medical expenditure as measured by the external transfers, account for 5% of the country’s health expenditure and 0.23% of GDP. Given that the HIV incidence rate is only 0.27% in India, these losses are quite staggering. Despite the remarkable achievements in development of anti-retroviral therapies against HIV and the recent advances in new prevention technologies, the rate of new HIV infections continue to outpace efforts on HIV prevention and control. Thus, the development of a safe and effective vaccine for prevention and control of AIDS remains a global public health priority and the greatest opportunity to eventually end the AIDS pandemic. PMID:24056755

  18. A 12-Month Prospective, Observational Study of Treatment Regimen and Quality of Life Associated with ADHD in Central and Eastern Europe and Eastern Asia

    ERIC Educational Resources Information Center

    Goetz, Michal; Yeh, Chin-Bin; Ondrejka, Igor; Akay, Aynur; Herczeg, Ilona; Dobrescu, Iuliana; Kim, Boong Nyun; Jin, Xingming; Riley, Anne W.; Martenyi, Ferenc; Harrison, Gavan; Treuer, Tamas

    2012-01-01

    Objectives: This prospective, observational, non-randomized study aimed to describe the relationship between treatment regimen prescribed and the quality of life (QoL) of ADHD patients in countries of Central and Eastern Europe (CEE) and Eastern Asia over 12 months. Methods: 977 Male and female patients aged 6-17 years seeking treatment for…

  19. Key operational characteristics in emergency department observation units: a comparative study between sites in the United States and Asia

    PubMed Central

    2014-01-01

    Background To improve efficiency, emergency departments (EDs) use dedicated observation units (OUs) to manage patients who are unable to be discharged home, yet do not clearly require inpatient hospitalization. However, operational metrics and their ideal targets have not been created for this setting and patient population. Variation in these metrics across different countries has not previously been reported. This study aims to define and compare key operational characteristics between three ED OUs in the United States (US) and three ED OUs in Asia. Methods This is a descriptive study of six tertiary-care hospitals, all of which are level 1 trauma centers and have OUs managed by ED staff. We collected data via various methods, including a standardized survey, direct observation, and interviews with unit leadership, and compared these data across continents. Results We define multiple key operational characteristics to compare between sites, including OU length of stay (LOS), OU discharge rate, and bed turnover rate. OU LOS in the US and Asian sites averaged 12.9 hours (95% CI, 8.3 to 17.5) and 20.5 hours (95% CI, -49.4 to 90.4), respectively (P = 0.39). OU discharge rates in the US and Asia averaged 84.3% (95% CI, 81.5 to 87.2) and 88.7% (95% CI, 81.5 to 95.8), respectively (P = 0.11), and the bed turnover rates in the US and Asian sites averaged 1.6 patients/bed/day (95% CI, -0.1 to 3.3) and 0.9 patient/bed/day (95% CI, -0.6 to 2.4), respectively (P = 0.27). Conclusions Prior research has shown that the OU is a resource that can mitigate many of problems in the ED and hospital, while simultaneously improving patient care and satisfaction. We describe key operational characteristics that are relevant to all OUs, regardless of geography or healthcare system to monitor and maximize efficiency. Although measures of LOS and bed turnover varied widely between US and Asian sites, we did not find a statistically significant difference. Use of these metrics

  20. New Particle Formation in Anthropogenic Plumes Advecting from Asia Observed During TRACE-P

    NASA Technical Reports Server (NTRS)

    Weber, R. J.; Lee, S.; Chen, G.; Wang, B.; Kapustin, V.; Moore, K.; Clarke, A. D.; Mauldin, L.; Kosciuch, E.; Cantrell, C.

    2003-01-01

    The characteristics and sources of what are believed to be newly formed 3 to 4 nm particles in anthropogenic plumes advecting from Asian are reported. Airborne measurements were made from March to April 2001 as part of the NASA TRACE-P experiment at latitudes ranging from North of the Philippines to Northern Japan (20 to 45 deg. N). In the more polluted plumes, high concentrations of 3 to 4 nm diameter particles (less than 100/qu cm) were observed both within and along the upper outer edges of plumes that were identified by enhanced carbon monoxide and fine particulate sulfate concentrations. The results from two research flights are investigated in detail. Three to four-nm particle concentrations are generally correlated with gas phase sulfuric acid and found in regions of low surface areas relative to the immediate surroundings or where there are steep transitions to lower surface areas. Sulfuric acid and surface area concentrations in the most polluted plume reached 6 x l0(exp 7) and 750 micro sq m/qu cm, respectively, in regions of particle formation. In contrast to these anthropogenic plumes, few 3 to 4 nm particles were observed in the clean background and few were detected within a volcanic plume where the studies highest H2SO4 concentrations (less than lO(exp 8)/qu cm) were recorded. Enhanced SO2 concentrations in the range of approximately 2 to 7 ppb, in conjunction with other unidentified, possibly coemitted species, appear to be the driving factor for nucleation. (0345, 4801); 0322 Atmospheric Composition and Structure: Constituent sources and sinks; 0345 Atmospheric Composition and Structure: Pollution-urban and regional (0305); 4801 Oceanography: Biological and Chemical: Aerosols (0305).

  1. Aerial observations of air masses transported from East Asia to the Western Pacific: Vertical structure of polluted air masses

    NASA Astrophysics Data System (ADS)

    Hatakeyama, Shiro; Ikeda, Keisuke; Hanaoka, Sayuri; Watanabe, Izumi; Arakaki, Takemitsu; Bandow, Hiroshi; Sadanaga, Yasuhiro; Kato, Shungo; Kajii, Yoshizumi; Zhang, Daizhou; Okuyama, Kikuo; Ogi, Takashi; Fujimoto, Toshiyuki; Seto, Takafumi; Shimizu, Atsushi; Sugimoto, Nobuo; Takami, Akinori

    2014-11-01

    There has been only limited information about the vertical chemical structure of the atmosphere, so far. We conducted aerial observations on 11, 12, and 14 December 2010 over the northern part of the East China Sea to analyze the spatial distribution of atmospheric pollutants from East Asia and to elucidate transformation processes of air pollutants during the long-range transport. On 11 December, a day on which Asian dust created hazy conditions, the average PM10 concentration was 40.69 μg m-3, and we observed high concentrations of chemical components such as Ca2+, NO3-, SO42-, Al, Ca, Fe, and Zn. The height of the boundary layer was about 1200 m, and most species of pollutants (except for dust particles and SO2) had accumulated within the boundary layer. In contrast, concentrations of pollutants were low in the boundary layer (up to 1000 m) on 12 December because clean Pacific air from the southeast had diluted the haze. However, we observed natural chemical components (Na+, Cl-, Al, Ca, and Fe) at 3000 m, the indication being that dust particles, including halite, were present in the lower free troposphere. On 14 December, peak concentrations of SO2 and black carbon were measured within the boundary layer (up to 700 m) and at 2300 m. The concentrations of anthropogenic chemical components such as NO3-, NH4+, and Zn were highest at 500 m, and concentrations of both anthropogenic and natural chemical components (SO42-, Pb, Ca2+, Ca, Al, and Fe) were highest at 2000 m. Thus, it was clearly indicated that the air above the East China Sea had a well-defined, layered structure below 3000 m.

  2. Observations and modeling of the ionospheric behaviors over the east Asia zone during the 22 July 2009 solar eclipse

    NASA Astrophysics Data System (ADS)

    Le, Huijun; Liu, Libo; Ding, Feng; Ren, Zhipeng; Chen, Yiding; Wan, Weixing; Ning, Baiqi; Xu, Guirong; Wang, Min; Li, Guozhu; Xiong, Bo; Hu, Lianhuan

    2010-10-01

    The longest total solar eclipse during the 21st century with a maximum duration of 6 min and 39 s occurred in South and East Asia on 22 July 2009. The TEC data from four GPS stations in the total eclipse region (around 30°N) from 105°E to 135°E are used to study the variation in TEC. Height profiles of electron density from Formosa3/Cosmic satellites are used to study the height dependence of the electron density response. We also modeled the eclipse effects on the ionosphere by an ionospheric model. Both the observations from F3/C and the modeled results show that there is an overall decrease in the electron density below F2 region, with the largest relative decrease occurring at F1 region. The TEC observations show the delay time of the largest TEC decrease at the total eclipse region with regard to the maximum obscuration is less than five minutes and smaller than what is estimated from the time constant of the plasma loss rate at the F2 peak altitude although main contribution to TEC comes from the plasma density in the F2 region. The modeling study shows that, due to the large plasma flux from topside ionosphere to F2 layer, the TEC response around 30°N is mainly due to the electron density response at low altitudes (E and F1 region, 200 km below) where the time delay of electron density response is very short (less than 4 min). Thus the time delay of TEC response would also be short as observed by GPS TEC.

  3. HIV multi-drug resistance at first-line antiretroviral failure and subsequent virological response in Asia

    PubMed Central

    Jiamsakul, Awachana; Sungkanuparph, Somnuek; Law, Matthew; Kantor, Rami; Praparattanapan, Jutarat; Li, Patrick CK; Phanuphak, Praphan; Merati, Tuti; Ratanasuwan, Winai; Lee, Christopher KC; Ditangco, Rossana; Mustafa, Mahiran; Singtoroj, Thida; Kiertiburanakul, Sasisopin

    2014-01-01

    Introduction First-line antiretroviral therapy (ART) failure often results from the development of resistance-associated mutations (RAMs). Three patterns, including thymidine analogue mutations (TAMs), 69 Insertion (69Ins) and the Q151M complex, are associated with resistance to multiple-nucleoside reverse transcriptase inhibitors (NRTIs) and may compromise treatment options for second-line ART. Methods We investigated patterns and factors associated with multi-NRTI RAMs at first-line failure in patients from The TREAT Asia Studies to Evaluate Resistance – Monitoring study (TASER-M), and evaluated their impact on virological responses at 12 months after switching to second-line ART. RAMs were compared with the IAS-USA 2013 mutations list. We defined multi-NRTI RAMs as the presence of either Q151M; 69Ins; ≥2 TAMs; or M184V+≥1 TAM. Virological suppression was defined as viral load (VL) <400 copies/ml at 12 months from switch to second-line. Logistic regression was used to analyze (1) factors associated with multi-NRTI RAMs at first-line failure and (2) factors associated with virological suppression after 12 months on second-line. Results A total of 105 patients from 10 sites in Thailand, Hong Kong, Indonesia, Malaysia and Philippines were included. There were 97/105 (92%) patients harbouring ≥1 RAMs at first-line failure, 39/105 with multi-NRTI RAMs: six with Q151M; 24 with ≥2 TAMs; and 32 with M184V+≥1 TAM. Factors associated with multi-NRTI RAMs were CD4 ≤200 cells/µL at genotyping (OR=4.43, 95% CI [1.59–12.37], p=0.004) and ART duration >2 years (OR=6.25, 95% CI [2.39–16.36], p<0.001). Among 87/105 patients with available VL at 12 months after switch to second-line ART, virological suppression was achieved in 85%. The median genotypic susceptibility score (GSS) for the second-line regimen was 2.00. Patients with ART adherence ≥95% were more likely to be virologically suppressed (OR=9.33, 95% CI (2.43–35.81), p=0.001). Measures of patient

  4. A novel approach to directly observed therapy for tuberculosis in an HIV-endemic area.

    PubMed Central

    Desvarieux, M; Hyppolite, P R; Johnson, W D; Pape, J W

    2001-01-01

    OBJECTIVES: This study evaluated a novel approach to the delivery of directly observed therapy (DOT) for tuberculosis in Haiti. METHODS: A total of 194 patients (152 HIV seropositive, 42 HIV seronegative) received daily unsupervised triple-drug therapy for 4 to 8 weeks, followed by twice-weekly 2-drug therapy for the remainder of the 6-month period. DOT was deferred until initiation of the twice-weekly phase. RESULTS: A total of 169 of 194 patients (87.1%) completed the 6-month course. The program of deferred DOT had an effectiveness of 85%. Overall cost was reduced by approximately 40%. CONCLUSIONS: Flexible approaches to DOT, integrating behavioral knowledge, cost considerations, and practicality may improve completion rates and program effectiveness. PMID:11189809

  5. An effective tool for identifying HIV-1 subtypes B, C, CRF01_AE, their recombinant forms, and dual infections in Southeast Asia by the multi-region subtype specific PCR (MSSP) assay.

    PubMed

    Sakkhachornphop, Supachai; Kijak, Gustavo H; Beyrer, Chris; Razak, Myat Htoo; Sanders-Buell, Eric; Jittiwutikarn, Jaroon; Suriyanon, Vinai; Robb, Merlin L; Kim, Jerome H; Celentano, David D; McCutchan, Francine E; Tovanabutra, Sodsai

    2015-06-01

    The RV144 Thai vaccine trial has been the only vaccine study to show efficacy in preventing HIV infection. Ongoing molecular surveillance of HIV-1 in Southeast Asia is vital for vaccine development and evaluation. In this study a novel tool, the multi-region subtype specific PCR (MSSP) assay, that was able to identify subtypes B, C, CRF01_AE for Thailand, other Southeast Asian countries, India and China is described. The MSSP assay is based on a nested PCR strategy and amplifies eight short regions distributed along the HIV-1 genome using subtype-specific primers. A panel of 41 clinical DNA samples obtained primarily from opiate users in northern Thailand was used to test the assay performance. The MSSP assay provided 73-100% sensitivity and 100% specificity for the three subtypes in each genome region. The assay was then field-tested on 337 sera from HIV infected northern Thai drug users collected between 1999 and 2002. Subtype distribution was CRF01_AE 77.4% (n=261), subtype B 3.3% (n=11), CRF01_AE/B recombinant 12.2% (n=41), CRF01_AE/C recombinant 0.6% (n=2), and non-typeable 6.5% (n=22). The MSSP assay is a simple, cost-effective, and accurate genotyping tool for laboratory settings with limited resources and is sensitive enough to capture the recombinant genomes and dual infections. PMID:25725414

  6. An observational study of comorbidity and healthcare utilisation among HIV-positive patients aged 50 years and over.

    PubMed

    Patel, Roshani; Moore, Thomas; Cooper, Vanessa; McArdle, Conor; Perry, Nicky; Cheek, Elizabeth; Gainsborough, Nicola; Fisher, Martin

    2016-07-01

    The number of HIV-positive people aged ≥50 years is rising each year. We measured the prevalence of non-infectious illnesses and their risk factors and described healthcare use in this UK population. A cross-sectional, observational study was conducted at an outpatient HIV specialist clinic in south east England. Patients age ≥50 years were invited to complete questionnaires measuring demographics, non-infectious illnesses, medication use, lifestyle and healthcare utilisation. The response rate was 67%. Of 299 participants, 84% reported ≥1 comorbid condition and 61% reported ≥2 (multimorbidity). Most commonly reported were high cholesterol, sexual dysfunction, hypertension and depression. In multivariate analyses, age, number of years HIV-positive and duration of antiretroviral therapy remained significant predictors of comorbidity when controlling for lifestyle factors (exercise, smoking and use of recreational drugs and alcohol). Use of non-HIV healthcare services was associated with increasing comorbidity, a longer duration of HIV and recreational drug use. The majority of HIV-patients aged ≥50 years reported multiple comorbidities and this was associated with polypharmacy and increased use of non-HIV services. Further research examining the quality, safety and patient experience of healthcare is needed to inform development of services to optimally meet the needs of older HIV-positive patients. PMID:26068965

  7. Characteristics and comprehensiveness of adult HIV care and treatment programmes in Asia-Pacific, sub-Saharan Africa and the Americas: results of a site assessment conducted by the International epidemiologic Databases to Evaluate AIDS (IeDEA) Collaboration

    PubMed Central

    Duda, Stephany N; Farr, Amanda M; Lindegren, Mary Lou; Blevins, Meridith; Wester, C William; Wools-Kaloustian, Kara; Ekouevi, Didier K; Egger, Matthias; Hemingway-Foday, Jennifer; Cooper, David A; Moore, Richard D; McGowan, Catherine C; Nash, Denis

    2014-01-01

    Introduction HIV care and treatment programmes worldwide are transforming as they push to deliver universal access to essential prevention, care and treatment services to persons living with HIV and their communities. The characteristics and capacity of these HIV programmes affect patient outcomes and quality of care. Despite the importance of ensuring optimal outcomes, few studies have addressed the capacity of HIV programmes to deliver comprehensive care. We sought to describe such capacity in HIV programmes in seven regions worldwide. Methods Staff from 128 sites in 41 countries participating in the International epidemiologic Databases to Evaluate AIDS completed a site survey from 2009 to 2010, including sites in the Asia-Pacific region (n=20), Latin America and the Caribbean (n=7), North America (n=7), Central Africa (n=12), East Africa (n=51), Southern Africa (n=16) and West Africa (n=15). We computed a measure of the comprehensiveness of care based on seven World Health Organization-recommended essential HIV services. Results Most sites reported serving urban (61%; region range (rr): 33–100%) and both adult and paediatric populations (77%; rr: 29–96%). Only 45% of HIV clinics that reported treating children had paediatricians on staff. As for the seven essential services, survey respondents reported that CD4+ cell count testing was available to all but one site, while tuberculosis (TB) screening and community outreach services were available in 80 and 72%, respectively. The remaining four essential services – nutritional support (82%), combination antiretroviral therapy adherence support (88%), prevention of mother-to-child transmission (PMTCT) (94%) and other prevention and clinical management services (97%) – were uniformly available. Approximately half (46%) of sites reported offering all seven services. Newer sites and sites in settings with low rankings on the UN Human Development Index (HDI), especially those in the President's Emergency Plan

  8. Lack of Sexual Minorities' Rights as a Barrier to HIV Prevention Among Men Who Have Sex with Men and Transgender Women in Asia: A Systematic Review.

    PubMed

    Anderson, James E; Kanters, Steve

    2015-03-01

    This study set out to assess the relationship between variation in human rights for sexual minorities in Asian countries and indicators of HIV prevention among men who have sex with men (MSM) and transgender women. To quantitatively measure the relationship between variation in HIV prevention and variation in human rights for sexual minorities, this study developed the Sexual Orientation and Gender Identity (SOGI) Human Rights Index (an original index with scores ranging from 0.0 to 1.0). Subsequently, this study collected 237 epidemiological and behavioral studies from 22 Asian countries and performed a series of meta-analyses in order to calculate national averages for five indicators of HIV prevention: HIV prevalence, inconsistent condom use, recent HIV testing, adequate HIV knowledge, and exposure to HIV prevention services. A change of human rights for sexual minorities from a score of 0.0 to 1.0 as measured by the SOGI Human Rights Index was correlated with a decrease in unprotected anal intercourse by 25.5% (p=0.075), and increases in recent HIV testing by 42.9% (p=0.011), HIV knowledge by 29.5% (p=0.032), and exposure to HIV prevention services by 37.9% (p=0.119). The relationship between HIV prevalence and variation in human rights for sexual minorities was not statistically significant. Our study found correlations between human rights and indicators of HIV prevention, further supporting the need for increased rights among marginalized populations. The paucity of studies from many Asian countries as well as the disparity in how indicators of HIV prevention are measured reveals a need for increased coverage and standardization of MSM serological and behavioral data in order to better inform evidence-based policymaking. PMID:26790014

  9. Field Evaluation of Dried Blood Spots for Routine HIV-1 Viral Load and Drug Resistance Monitoring in Patients Receiving Antiretroviral Therapy in Africa and Asia

    PubMed Central

    Monleau, Marjorie; Eymard-Duvernay, Sabrina; Dagnra, Anoumou; Kania, Dramane; Ngo-Giang-Huong, Nicole; Touré-Kane, Coumba; Truong, Lien X. T.; Chaix, Marie-Laure; Delaporte, Eric; Ayouba, Ahidjo; Peeters, Martine

    2014-01-01

    Dried blood spots (DBS) can be used in developing countries to alleviate the logistic constraints of using blood plasma specimens for viral load (VL) and HIV drug resistance (HIVDR) testing, but they should be assessed under field conditions. Between 2009 and 2011, we collected paired plasma-DBS samples from treatment-experienced HIV-1-infected adults in Burkina Faso, Cameroon, Senegal, Togo, Thailand, and Vietnam. The DBS were stored at an ambient temperature for 2 to 4 weeks and subsequently at −20°C before testing. VL testing was performed on the plasma samples and DBS using locally available methods: the Abbott m2000rt HIV-1 test, generic G2 real-time PCR, or the NucliSENS EasyQ version 1.2 test. In the case of virological failure (VF), i.e., a plasma VL of ≥1,000 copies/ml, HIVDR genotyping was performed on paired plasma-DBS samples. Overall, we compared 382 plasma-DBS sample pairs for DBS VL testing accuracy. The sensitivities of the different assays in different laboratories for detecting VF using DBS varied from 75% to 100% for the m2000rt test in labs B, C, and D, 91% to 93% for generic G2 real-time PCR in labs A and F, and 85% for the NucliSENS test in lab E. The specificities varied from 82% to 97% for the m2000rt and NucliSENS tests and reached only 60% for the generic G2 test. The NucliSENS test showed good agreement between plasma and DBS VL but underestimated the DBS VL. The lowest agreement was observed for the generic G2 test. Genotyping was successful for 96/124 (77%) DBS tested, and 75/96 (78%) plasma-DBS pairs had identical HIVDR mutations. Significant discrepancies in resistance interpretations were observed in 9 cases, 6 of which were from the same laboratory. DBS can be successfully used as an alternative to blood plasma samples for routine VL and HIVDR monitoring in African and Asian settings. However, the selection of an adequate VL measurement method and the definition of the VF threshold should be considered, and laboratory

  10. Structural modeling of Vpu from HIV-1 based on solid-state NMR observables

    NASA Astrophysics Data System (ADS)

    Ahn, SeonJoo; Lim, GyuTae; Nam, Seungyoon; Lee, Jinhyuk

    2014-04-01

    Vpu is one of the accessory proteins of HIV-1, and is involved in viral particle release. Viral particle release is enhanced by two proposed functions of Vpu: (i) tetherin interaction and (ii) membrane polarization. Two Vpu functions in viral particle release are still controversial. Here, we investigated the proposed functions by extensive structural modeling of Vpu based on solid-state NMR (Nuclear Magnetic Resonance) observables. We found that Vpu can co-exist in two structural forms: left-handed and right-handed conformation. The co-existence of the two conformations provides a clue to reconcile the controversial issue of its two functions in virus particle release.

  11. Observation of HIV-1 Nucleocapsid Protein induced TAR DNA melting at the single molecule level

    NASA Astrophysics Data System (ADS)

    Cosa, Gonzalo; Harbron, Elizabeth; O'Connor, Donald; Musier-Forsyth, Karin; Barbara, Paul

    2003-03-01

    Reverse transcription of the HIV-1 RNA genome involves several nucleic acid rearrangement steps, and the HIV-1 nucleocapsid protein (NC) plays a key role in this process. NC is a nucleic acid chaperone protein, which facilitates the formation of the most stable nucleic acid structures. Single molecule fluorescence resonance energy transfer (SM-FRET) measurements enable us to observe the NC-induced conformational fluctuations of a transactivation response region (TAR) DNA hairpin, which is part of the initial product of reverse transcription known as minus-strand strong-stop DNA. SM-FRET studies show that the majority of conformational fluctuations of the fluorescently-labeled TAR DNA hairpin in the presence of NC occur in <100 ms. A single molecule explores a wide range of confomations unpon NC binding, with fluctuations encompassing as many as 40 bases in both arms of the hairpin. No conformational fluctuations are observed with the dye-labeled TAR DNA hairpin in the absence of NC or when a labeled TAR DNA hairpin variant lacking bulges and internal loops is analyzed in the presence of NC. This study represents the first real-time observation of NC-mediated nucleic acid conformational fluctuations, revealing new insights into NC's nucleic acid chaperone activity.

  12. Alkalization of yellow sand and its long-term effects on acid rain in East Asia: Observed Evidence and Simulation

    NASA Astrophysics Data System (ADS)

    Wang, Z.; Uno, I.; Akimoto, H.

    2001-05-01

    Acid rain has been one of the serious environmental problems in East Asia for the rapid industrialization in the last two decades. The contour line of pH value less than 5 has come up to the Yellow River region (35 deg N) from the southern China bounded by the Yangtze River (25 deg N) during these ten years. The objective of EANET ( Acid Deposition Moniroring Network in East Asia) is to create a common understanding of the state of the acid deposition problems in East Asia. There are 38 monitoring sites for wet deposition monitoring and data was collected since January 1999. The analysis of datasets in 1999 shows that aerosol has alkalization effects on pH of rain, especially in spring. An Air Quality Prediction Modeling System (AQPMS) was used to investigate the neutralization of acid rain by the yellow-sand in East Asia. The AQPMS includes all the major processes such as emission, advection, diffusion, chemistry, dry deposition, wet deposition and micro-physical processes. A new deflation module for the dust uptake is designed to estimate the dust loading (Wang et. al.,2000). The gas-phase chemical reaction scheme is a slightly modified version of the CBM-IV. Changes in trace species concentrations due to chemical reactions of soluble and reactive gases in in-cloud and below-cloud droplets are computed using a box aqueous chemical model. Numerical simulation was performed for two cases, that is, with and without the neutralization effects of Kosa in 1999. The predicted pH values and sulfate- and nitrate-ion levels of precipitation, together with the surface concentrations of gaseous pollutants, were compared with measured datasets of EANET and a reasonable agreement was obtained. The simulation results of 1999 exhibited a strong neutralization of the precipitation by the yellow-sand in the spring. The aerosol has alkalization effects on pH of rain, which reduces the H+ of rain.

  13. Warmer and wetter or warmer and dryer? Observed versus simulated covariability of Holocene temperature and rainfall in Asia

    NASA Astrophysics Data System (ADS)

    Rehfeld, Kira; Laepple, Thomas

    2016-02-01

    Temperatures in Asia, and globally, are very likely to increase with greenhouse gas emissions, but future projections of rainfall are far more uncertain. Here we investigate the linkage between temperature and precipitation in Asia on interannual to multicentennial timescales using instrumental data, late Holocene paleoclimate proxy data and climate model simulations. We find that in the instrumental and proxy data, the relationship between temperature and precipitation is timescale-dependent. While on annual to decadal timescales, negative correlations dominate and thus cool summers tend to be rainy summers, on longer timescales precipitation and temperature are positively correlated; cool centuries tend to be dryer centuries in monsoonal Asia. In contrast, the analyzed CMIP5/PMIP3 climate model simulations show a negative correlation between precipitation and temperature on all timescales. Although many uncertainties exist in the interpretation of the proxy data, there is consistency between them and the instrumental evidence. This, and the persistence of the result across independent proxy datasets, suggests that the climate model simulations might be considerably biased, overestimating the short-term negative associations between regional rainfall and temperature and lacking long-term positive relationships between them.

  14. Diagnosis of Pulmonary Tuberculosis in HIV-Positive Patients by Microscopic Observation Drug Susceptibility Assay ▿

    PubMed Central

    Ha, Dang Thi Minh; Lan, Nguyen Thi Ngoc; Kiet, Vo Sy; Wolbers, Marcel; Hang, Hoang Thi Thanh; Day, Jeremy; Hien, Nguyen Quang; Tien, Nguyen Anh; An, Pham Thuy; Anh, Truong Thi; Oanh, Do Thi Tuong; Hoa, Chau Luong; Chau, Nguyen Thi Minh; Hai, Nguyen Ngoc; Binh, Ngo Thanh; Ngoc, Le Hong; Phuong, Doan Thanh; Quyet, Tran Van; Tuyen, Nguyen Thi Bich; Ha, Vo Thi; Nho, Nguyen Thi; Hoa, Dai Viet; Anh, Phan Thi Hoang; Dung, Nguyen Huy; Farrar, Jeremy; Caws, Maxine

    2010-01-01

    The microscopic observation drug susceptibility assay (MODS) is a novel and promising test for the early diagnosis of tuberculosis (TB). We evaluated the MODS assay for the early diagnosis of TB in HIV-positive patients presenting to Pham Ngoc Thach Hospital for Tuberculosis and Lung Diseases in southern Vietnam. A total of 738 consecutive sputum samples collected from 307 HIV-positive individuals suspected of TB were tested by smear, MODS, and the mycobacteria growth indicator tube method (MGIT). The diagnostic sensitivity and specificity of MODS compared to the microbiological gold standard (either smear or MGIT) were 87 and 93%, respectively. The sensitivities of smear, MODS, and MGIT were 57, 71, and 75%, respectively, against clinical gold standard (MODS versus smear, P < 0.001; MODS versus MGIT, P = 0.03). The clinical gold standard was defined as patients who had a clinical examination and treatment consistent with TB, with or without microbiological confirmation. For the diagnosis of smear-negative patients, the sensitivities of MODS and MGIT were 38 and 45%, respectively (P = 0.08). The median times to detection using MODS and MGIT were 8 and 11 days, respectively, and they were 11 and 17 days, respectively, for smear-negative samples. The original bacterial/fungal contamination rate of MODS was 1.1%, while it was 2.6% for MGIT. The cross-contamination rate of MODS was 4.7%. In conclusion, MODS is a sensitive, specific, and rapid test that is appropriate for the detection of HIV-associated TB; its cost and ease of use make it particularly useful in resource-limited settings. PMID:20926704

  15. Loss to follow-up in the Australian HIV Observational Database

    PubMed Central

    McManus, Hamish; Petoumenos, Kathy; Brown, Katherine; Baker, David; Russell, Darren; Read, Tim; Smith, Don; Wray, Lynne; Giles, Michelle; Hoy, Jennifer; Carr, Andrew; Law, Matthew

    2015-01-01

    Background Loss to follow-up (LTFU) in HIV-positive cohorts is an important surrogate for interrupted clinical care which can potentially influence the assessment of HIV disease status and outcomes. After preliminary evaluation of LTFU rates and patient characteristics, we evaluated the risk of mortality by LTFU status in a high resource setting. Methods Rates of LTFU were measured in the Australian HIV Observational Database for a range of patient characteristics. Multivariate repeated measures regression methods were used to identify determinants of LTFU. Mortality by LTFU status was ascertained using linkage to the National Death Index. Survival following combination antiretroviral therapy initiation was investigated using the Kaplan-Meier (KM) method and Cox proportional hazards models. Results Of 3,413 patients included in this analysis, 1,632 (47.8%) had at least one episode of LTFU after enrolment. Multivariate predictors of LTFU included viral load (VL)>10,000 copies/ml (Rate ratio (RR) 1.63 (95% confidence interval (CI):1.45–1.84) (ref ≤400)), time under follow-up (per year) (RR 1.03 (95% CI: 1.02–1.04)) and prior LTFU (per episode) (RR 1.15 (95% CI: 1.06–1.24)). KM curves for survival were similar by LTFU status (p=0.484). LTFU was not associated with mortality in Cox proportional hazards models (univariate hazard ratio (HR) 0.93 (95% CI: 0.69–1.26) and multivariate HR 1.04 (95% CI: 0.77–1.43)). Conclusions Increased risk of LTFU was identified amongst patients with potentially higher infectiousness. We did not find significant mortality risk associated with LTFU. This is consistent with timely re-engagement with treatment, possibly via high levels of unreported linkage to other health care providers. PMID:25377928

  16. HIV Patient Characteristics that Affect Adherence to Exercise Programmes: An Observational Study

    PubMed Central

    Petróczi, Andrea; Hawkins, Kim; Jones, Gareth; Naughton, Declan P

    2010-01-01

    Background: Benefits of exercise for HIV-infected persons have been documented, although in clinical practice, diminished adherence to exercise limits the effectiveness of this auxiliary treatment. Exercise intervention studies carry the caveat that the results are limited to volunteers with good compliance and completion profiles. Objectives: This study aimed to identify characteristics contributing to adherence vs non-adherence to prescribed supervised 10-week 75-minute aerobic and progressive resistance exercise programme in a clinical setting that requires twice-weekly attendance at the physiotherapy gym. Study Design: This observational study was comprised of 11 males and 11 females, physician-assessed, HIV seropositive patients referred to exercise programmes in a tertiary multi-disciplinary outpatient service for HIV patients at an urban Teaching Hospital in London (UK). Measurements taken prior to the exercise programme were used as dependent variables and include CD4 count, fitness level, flexibility and perceived physical-, emotional-, functional- and psychological- well-being. Attendance records were categorised into a dichotomous independent variable of adherence based on a natural break that occurred at 8/20 attended sessions. Results: Prior-to-treatment differences in perceived physical, functional and psychological well-being exist between adherent and non-adherent patients, but no differences were found in age, CD4 count or fitness level. Perceived well-being explained 55.7% of the variances in attendance. Gender and reason for referral appear to be independent of adherence, whereas ethnicity may play an influential role. Conclusion: Perceived well-being appears to differentiate between adherent and non-adherent patients. Further studies are required to investigate other psychological characteristics and barriers to maintaining exercise. PMID:20871752

  17. Micro-plate tectonics and kinematics in Northeast Asia inferred from a dense set of GPS observations

    NASA Astrophysics Data System (ADS)

    Jin, Shuanggen; Park, Pil-Ho; Zhu, Wenyao

    2007-05-01

    The plate tectonics of Northeast Asia are very complex with diffuse and sparse seismicity in the broad plate deformation zones embedded by a number of micro-plates, particularly the controversial Amurian plate. Now the increasingly dense GPS networks in this area provide an important tool to investigate plate tectonic kinematics and to identify the approximate plate tectonic geometries. In this paper, we have processed GPS data (1998-2005) collected by an extensive GPS network (China and South Korea) with more than 85 continuous sites and about 1000 campaign GPS stations. The kinematics of Northeast Asia is studied by modeling GPS-derived velocities with rigid block rotations and elastic deformation. We find that the deformation in Northeast Asia can be well described by a number of rotating blocks, which are independent of the Eurasian plate motion with statistical significance above the 99% confidence level. The tectonic boundary between the North China and Amuria plates is the Yin Shan-Yan Shan Mountain belts with about 2.4 mm/yr extension. Along the boundary between North China and South China, the Qinling-Dabie fault is moving left laterally at about 3.1 mm/yr. The Amuria and South Korea blocks are extending at about 1.8 mm/yr. The Baikal Rift between the Amurian and Eurasian plates is spreading at about 3.0 mm/yr. The 9-17 mm/yr relative motion between the Amuria and Okhotsk blocks is accommodated at the East Sea-Japan trench zone. Localized deformation near the Qinling-Dabie fault and Yin Shan-Yan Shan Mountain belts may be elastic strain accumulation due to interseismic locking of faults.

  18. Asia Lakes

    Atmospheric Science Data Center

    2013-04-16

    article title:  Central Asia - Mongolia, China and Russia     View Larger ... Imaging SpectroRadiometer (MISR) image of Mongolia, China and Russia covers an area of about 317 kilometers x 412 kilometers, and ...

  19. Seasonal variation of spherical aerosols distribution in East Asia based on ground and space Lidar observation and a Chemical transport model

    NASA Astrophysics Data System (ADS)

    Hara, Y.; Yumimoto, K.; Uno, I.; Shimizu, A.; Sugimoto, N.; Ohara, T.

    2009-12-01

    The anthropogenic aerosols largely impact on not only human health but also global climate system, therefore air pollution in East Asia due to a rapid economic growth has been recognized as a significant environmental problem. Several international field campaigns had been conducted to elucidate pollutant gases, aerosols characteristics and radiative forcing in East Asia. (e.g., ACE-Asia, TRACE-P, ADEC, EAREX 2005). However, these experiments were mainly conducted in springtime, therefore seasonal variation of aerosols distribution has not been clarified well yet. National Institute for Environmental Studies (NIES) has been constructing a lidar networks by automated dual wavelength / polarization Mie-lidar systems to observe the atmospheric environment in Asian region since 2001. Furthermore, from June 2006, space-borne backscatter lidar, Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP), onboard NASA/CALIPSO satellite, measures continuous global aerosol and cloud vertical distribution with very high spatial resolution. In this paper, we will show the seasonal variation of aerosols distribution in East Asia based on the NIES lidar network observation, Community Multi-scale Air Quality Modeling System (CMAQ) chemical transport model simulation and CALIOP observation over the period from July 2006 to December 2008. We found that CMAQ result explains the typical seasonal aerosol characteristics by lidar observations. For example, CMAQ and ground lidar showed a summertime peak of aerosol optical thickness (AOT) at Beijing, an autumn AOT peak at Guangzhou and summertime AOT trough at Hedo, Okinawa. These characteristics are mainly controlled by seasonal variations of Asian summer/winter monsoon system. We also examined the CMAQ seasonal average aerosol extinction profiles with ground lidar and CALIOP extinction data. These comparisons clarified that the CMAQ reproduced the observed aerosol layer depth well in the downwind region. Ground lidar and CALIOP seasonal

  20. Home sampling for sexually transmitted infections and HIV in men who have sex with men: a prospective observational study.

    PubMed

    Fisher, Martin; Wayal, Sonali; Smith, Helen; Llewellyn, Carrie; Alexander, Sarah; Ison, Catherine; Parry, John V; Singleton, Garth; Perry, Nicky; Richardson, Daniel

    2015-01-01

    To determine uptake of home sampling kit (HSK) for STI/HIV compared to clinic-based testing, whether the availability of HSK would increase STI testing rates amongst HIV infected MSM, and those attending a community-based HIV testing clinic compared to historical control. Prospective observational study in three facilities providing STI/HIV testing services in Brighton, UK was conducted. Adult MSM attending/contacting a GUM clinic requesting an STI screen (group 1), HIV infected MSM attending routine outpatient clinic (group 2), and MSM attending a community-based rapid HIV testing service (group 3) were eligible. Participants were required to have no symptomatology consistent with STI and known to be immune to hepatitis A and B (group 1). Eligible men were offered a HSK to obtain self-collected specimens as an alternative to routine testing. HSK uptake compared to conventional clinic-based STI/HIV testing in group 1, increase in STI testing rates due to availability of HSK compared to historical controls in group 2 and 3, and HSK return rates in all settings were calculated. Among the 128 eligible men in group 1, HSK acceptance was higher (62.5% (95% CI: 53.5-70.9)) compared to GUM clinic-based testing (37.5% (95% CI: 29.1-46.5)), (p = 0.0004). Two thirds of eligible MSM offered an HSK in all three groups accepted it, but HSK return rates varied (highest in group 1, 77.5%, lowest in group 3, 16%). HSK for HIV testing was acceptable to 81% of men in group 1. Compared to historical controls, availability of HSK increased the proportion of MSM testing for STIs in group 2 but not in group 3. HSK for STI/HIV offers an alternative to conventional clinic-based testing for MSM seeking STI screening. It significantly increases STI testing uptake in HIV infected MSM. HSK could be considered as an adjunct to clinic-based services to further improve STI/HIV testing in MSM. PMID:25848769

  1. Live-cell observation of cytosolic HIV-1 assembly onset reveals RNA-interacting Gag oligomers

    PubMed Central

    Hendrix, Jelle; Baumgärtel, Viola; Schrimpf, Waldemar; Ivanchenko, Sergey; Digman, Michelle A.; Gratton, Enrico; Kräusslich, Hans-Georg; Müller, Barbara

    2015-01-01

    Assembly of the Gag polyprotein into new viral particles in infected cells is a crucial step in the retroviral replication cycle. Currently, little is known about the onset of assembly in the cytosol. In this paper, we analyzed the cytosolic HIV-1 Gag fraction in real time in live cells using advanced fluctuation imaging methods and thereby provide detailed insights into the complex relationship between cytosolic Gag mobility, stoichiometry, and interactions. We show that Gag diffuses as a monomer on the subsecond timescale with severely reduced mobility. Reduction of mobility is associated with basic residues in its nucleocapsid (NC) domain, whereas capsid (CA) and matrix (MA) domains do not contribute significantly. Strikingly, another diffusive Gag species was observed on the seconds timescale that oligomerized in a concentration-dependent manner. Both NC- and CA-mediated interactions strongly assist this process. Our results reveal potential nucleation steps of cytosolic Gag fractions before membrane-assisted Gag assembly. PMID:26283800

  2. Three-Dimensional Distribution of a Major Desert Dust Outbreak over East Asia in March 2008 Derived from IASI Satellite Observations

    NASA Technical Reports Server (NTRS)

    Cuesta, Juan; Eremenko, Maxim; Flamant, Cyrille; Dufour, Gaelle; Laurent, Benoît; Bergametti, Gilles; Hopfner, Michael; Orphal, Johannes; Zhou, Daniel

    2015-01-01

    We describe the daily evolution of the three-dimensional (3D) structure of a major dust outbreak initiated by an extratropical cyclone over East Asia in early March 2008, using new aerosol retrievals derived from satellite observations of IASI (Infrared Atmospheric Sounding Interferometer). A novel auto-adaptive Tikhonov-Phillips-type approach called AEROIASI is used to retrieve vertical profiles of dust extinction coefficient at 10 microns for most cloud-free IASI pixels, both over land and ocean. The dust vertical distribution derived from AEROIASI is shown to agree remarkably well with along-track transects of Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP) spaceborne lidar vertical profiles (mean biases less than 110 meters, correlation of 0.95, and precision of 260 meters for mean altitudes of the dust layers). AEROIASI allows the daily characterization of the 3D transport pathways across East Asia of two dust plumes originating from the Gobi and North Chinese deserts. From AEROIASI retrievals, we provide evidence that (i) both dust plumes are transported over the Beijing region and the Yellow Sea as elevated layers above a shallow boundary layer, (ii) as they progress eastward, the dust layers are lifted up by the ascending motions near the core of the extratropical cyclone, and (iii) when being transported over the warm waters of the Japan Sea, turbulent mixing in the deep marine boundary layer leads to high dust concentrations down to the surface. AEROIASI observations and model simulations also show that the progression of the dust plumes across East Asia is tightly related to the advancing cold front of the extratropical cyclone.

  3. Three-dimensional distribution of a major desert dust outbreak over East Asia in March 2008 derived from IASI satellite observations

    NASA Astrophysics Data System (ADS)

    Cuesta, Juan; Eremenko, Maxim; Flamant, Cyrille; Dufour, Gaëlle; Laurent, Benoît; Bergametti, Gilles; Höpfner, Michael; Orphal, Johannes; Zhou, Daniel

    2015-07-01

    We describe the daily evolution of the three-dimensional (3D) structure of a major dust outbreak initiated by an extratropical cyclone over East Asia in early March 2008, using new aerosol retrievals derived from satellite observations of IASI (Infrared Atmospheric Sounding Interferometer). A novel auto-adaptive Tikhonov-Phillips-type approach called AEROIASI is used to retrieve vertical profiles of dust extinction coefficient at 10 µm for most cloud-free IASI pixels, both over land and ocean. The dust vertical distribution derived from AEROIASI is shown to agree remarkably well with along-track transects of CALIOP spaceborne lidar vertical profiles (mean biases less than 110 m, correlation of 0.95, and precision of 260 m for mean altitudes of the dust layers). AEROIASI allows the daily characterization of the 3D transport pathways across East Asia of two dust plumes originating from the Gobi and North Chinese deserts. From AEROIASI retrievals, we provide evidence that (i) both dust plumes are transported over the Beijing region and the Yellow Sea as elevated layers above a shallow boundary layer, (ii) as they progress eastward, the dust layers are lifted up by the ascending motions near the core of the extratropical cyclone, and (iii) when being transported over the warm waters of the Japan Sea, turbulent mixing in the deep marine boundary layer leads to high dust concentrations down to the surface. AEROIASI observations and model simulations also show that the progression of the dust plumes across East Asia is tightly related to the advancing cold front of the extratropical cyclone.

  4. Variability of hydrological extreme events in East Asia and their dynamical control: a comparison between observations and two high-resolution global climate models

    NASA Astrophysics Data System (ADS)

    Freychet, N.; Duchez, A.; Wu, C.-H.; Chen, C.-A.; Hsu, H.-H.; Hirschi, J.; Forryan, A.; Sinha, B.; New, A. L.; Graham, T.; Andrews, M. B.; Tu, C.-Y.; Lin, S.-J.

    2016-04-01

    This work investigates the variability of extreme weather events (drought spells, DS15, and daily heavy rainfall, PR99) over East Asia. It particularly focuses on the large scale atmospheric circulation associated with high levels of the occurrence of these extreme events. Two observational datasets (APHRODITE and PERSIANN) are compared with two high-resolution global climate models (HiRAM and HadGEM3-GC2) and an ensemble of other lower resolution climate models from CMIP5. We first evaluate the performance of the high resolution models. They both exhibit good skill in reproducing extreme events, especially when compared with CMIP5 results. Significant differences exist between the two observational datasets, highlighting the difficulty of having a clear estimate of extreme events. The link between the variability of the extremes and the large scale circulation is investigated, on monthly and interannual timescales, using composite and correlation analyses. Both extreme indices DS15 and PR99 are significantly linked to the low level wind intensity over East Asia, i.e. the monsoon circulation. It is also found that DS15 events are strongly linked to the surface temperature over the Siberian region and to the land-sea pressure contrast, while PR99 events are linked to the sea surface temperature anomalies over the West North Pacific. These results illustrate the importance of the monsoon circulation on extremes over East Asia. The dependencies on of the surface temperature over the continent and the sea surface temperature raise the question as to what extent they could affect the occurrence of extremes over tropical regions in future projections.

  5. AIDS. Grim news for Asia.

    PubMed

    1992-12-01

    While Asia was the last region to be exposed to the global spread of HIV and AIDS, the incidence of HIV infection there is increasing fastest. The Asian Development Bank predicts mortality from AIDS will cause some town and village populations to begin declining by the year 2000. With an estimated 1 million people infected in India, and 400,000 in Thailand, these 2 countries are particularly exposed to the risk of epidemic HIV spread. In 5 years, more people may be affected by AIDS in India than anywhere else in the world. Concern over a growing presence of HIV is also merited for the Philippines, Indonesia, China, and the drug trade's Golden Triangle. The Second International Conference on AIDS in Asia and the Pacific in November 1992 stressed that AIDS no longer affects only homosexual and IV drug using populations. 50% of new infections worldwide in the first half of 1992 were among women, 65% of Thailand's AIDS cases are among heterosexuals, and 3-5% of Thailand's long-haul truck drivers have tested positive for HIV infection. HIV and AIDS robs economies and societies of their best workers. The immediate costs of caring for AIDS patients will pale next to the far greater losses to be realized in private sector economic productivity. Asia's more developed economies will probably be able to survive the epidemic, but small, poor countries like Laos will wilt. Prompt action must be taken to overcome public and religious ignorance and objections to promoting and using condoms throughout the region. For the first time, Beijing has organized an AIDS awareness conference for male homosexuals. Further, Singapore has implemented compulsory testing for lower-income foreign workers. Pakistan has even solicited educational assistance and support from Islamic religious leaders; similar action is being considered in Bangladesh. PMID:12285939

  6. A model for the radiative forcing during ACE-Asia derived from CIRPAS Twin Otter and R/V Ronald H. Brown data and comparison with observations

    NASA Astrophysics Data System (ADS)

    Conant, William C.; Seinfeld, John H.; Wang, Jian; Carmichael, Gregory R.; Tang, Youhua; Uno, Itsushi; Flatau, Piotr J.; Markowicz, Krzysztof M.; Quinn, Patricia K.

    2003-12-01

    Vertical profiles of aerosol size, composition, and hygroscopic behavior from Center for Interdisciplinary Remotely Piloted Aircraft Studies (CIRPAS) Twin Otter and National Oceanic and Atmospheric Administration R/V Ronald H. Brown observations are used to construct a generic optical model of the Asian Pacific Regional Aerosol Characterization Experiment (ACE-Asia) aerosol. The model accounts for sulfate, black carbon, organic carbon, sea salt, and mineral dust. The effects of relative humidity and mixing assumptions (internal versus external, coating of dust by pollutants) are explicitly accounted for. The aerosol model is integrated with a Monte Carlo radiative transfer model to compute direct radiative forcing in the solar spectrum. The predicted regional average surface aerosol forcing efficiency (change in clear-sky radiative flux per unit aerosol optical depth at 500 nm) during the ACE-Asia intensive period is -65 Wm-2 for pure dust and -60 Wm-2 for pure pollution aerosol (clear skies). A three-dimensional atmospheric chemical transport model (Chemical Weather Forecast System (CFORS)) is used with the radiative transfer model to derive regional radiative forcing during ACE-Asia in clear and cloudy skies. Net regional solar direct radiative forcing during the 5-15 April 2001 dust storm period is -3 Wm-2 at the top of the atmosphere and -17 W m-2 at the surface for the region from 20°N to 50°N and 100°E to 150°E when the effects of clouds on the direct forcing are included. The model fluxes and forcing efficiencies are found to be in good agreement with surface radiometric observations made aboard the R.H. Brown. Mean cloud conditions are found to moderate the top of atmosphere (TOA) radiative forcing by a factor of ˜3 compared to clear-sky calculations, but atmospheric absorption by aerosol is not strongly affected by clouds in this study. The regional aerosol effect at the TOA ("climate forcing") of -3 Wm-2 is comparable in magnitude, but of opposite

  7. Estimating Trends in the Proportion of Transmitted and Acquired HIV Drug Resistance in a Long Term Observational Cohort in Germany

    PubMed Central

    Schmidt, Daniel; Kollan, Christian; Fätkenheuer, Gerd; Schülter, Eugen; Stellbrink, Hans-Jürgen; Noah, Christian; Jensen, Björn-Erik Ole; Stoll, Matthias; Bogner, Johannes R.; Eberle, Josef; Meixenberger, Karolin; Kücherer, Claudia; Hamouda, Osamah; Bartmeyer, Barbara

    2014-01-01

    Objective We assessed trends in the proportion of transmitted (TDR) and acquired (ADR) HIV drug resistance and associated mutations between 2001 and 2011 in the German ClinSurv-HIV Drug Resistance Study. Method The German ClinSurv-HIV Drug Resistance Study is a subset of the German ClinSurv-HIV Cohort. For the ClinSurv-HIV Drug Resistance Study all available sequences isolated from patients in five study centres of the long term observational ClinSurv-HIV Cohort were included. TDR was estimated using the first viral sequence of antiretroviral treatment (ART) naïve patients. One HIV sequence/patient/year of ART experienced patients was considered to estimate the proportion of ADR. Trends in the proportion of HIV drug resistance were calculated by logistic regression. Results 9,528 patients were included into the analysis. HIV-sequences of antiretroviral naïve and treatment experienced patients were available from 34% (3,267/9,528) of patients. The proportion of TDR over time was stable at 10.4% (95% CI 9.1–11.8; p for trend = 0.6; 2001–2011). The proportion of ADR among all treated patients was 16%, whereas it was high among those with available HIV genotypic resistance test (64%; 1,310/2,049 sequences; 95% CI 62–66) but declined significantly over time (OR 0.8; 95% CI 0.77–0.83; p for trend<0.001; 2001–2011). Viral load monitoring subsequent to resistance testing was performed in the majority of treated patients (96%) and most of them (67%) were treated successfully. Conclusions The proportion of TDR was stable in this study population. ADR declined significantly over time. This decline might have been influenced by broader resistance testing, resistance test guided therapy and the availability of more therapeutic options and not by a decline in the proportion of TDR within the study population. PMID:25148412

  8. Contemporary changes of water resources, water and land use in Central Asia based on observations and modeling.

    NASA Astrophysics Data System (ADS)

    Shiklomanov, A. I.; Prousevitch, A.; Sokolik, I. N.; Lammers, R. B.

    2015-12-01

    Water is a key agent in Central Asia ultimately determining human well-being, food security, and economic development. There are complex interplays among the natural and anthropogenic drivers effecting the regional hydrological processes and water availability. Analysis of the data combined from regional censuses and remote sensing shows a decline in areas of arable and irrigated lands and a significant decrease in availability of arable and irrigated lands per capita across all Central Asian countries since the middle of 1990thas the result of post-Soviet transformation processes. This change could lead to considerable deterioration in food security and human system sustainability. The change of political situation in the region has also resulted in the escalated problems of water demand between countries in international river basins. We applied the University of New Hampshire - Water Balance Model - Transport from Anthropogenic and Natural Systems (WBM-TrANS) to understand the consequences of changes in climate, water and land use on regional hydrological processes and water availability. The model accounts for sub-pixel land cover types, glacier and snow-pack accumulation/melt across sub-pixel elevation bands, anthropogenic water use (e.g. domestic and industrial consumption, and irrigation for most of existing crop types), hydro-infrastructure for inter-basin water transfer and reservoir/dam regulations. A suite of historical climate re-analysis and temporal extrapolation of MIRCA-2000 crop structure datasets has been used in WBM-TrANS for this project. A preliminary analysis of the model simulations over the last 30 years has shown significant spatial and temporal changes in hydrology and water availability for crops and human across the region due to climatic and anthropogenic causes. We found that regional water availability is mostly impacted by changes in extents and efficiency of crop filed irrigation, especially in highly arid areas of Central Asia

  9. Springtime variability of lower tropospheric ozone over Eastern Asia: contributions of cyclonic activity and pollution as observed from space with IASI

    NASA Astrophysics Data System (ADS)

    Dufour, G.; Eremenko, M.; Cuesta, J.; Doche, C.; Foret, G.; Beekmann, M.; Cheiney, A.; Wang, Y.; Cai, Z.; Liu, Y.; Takigawa, M.; Kanaya, Y.; Flaud, J.-M.

    2015-03-01

    We use satellite observations from IASI (Infrared Atmospheric Sounding Interferometer) on board the MetOp-A satellite to evaluate the springtime daily variability of lower tropospheric ozone at the scale of Eastern Asia. Lower tropospheric partial columns from surface to 6 km are retrieved from IASI with a maximum of sensitivity between 3 and 4 km. We focus our analysis on the month of May 2008 for which tropospheric ozone presents typically amongst the largest concentrations along the year. We combine IASI observations with meteorological reanalyses from ERA-Interim in order to investigate the processes that control the spatial and temporal distribution of lower tropospheric ozone, especially in case of ozone enhancement. The succession of low- and high-pressure systems drives the day-to-day variability of lower tropospheric ozone over North East Asia. The analysis of two episodes with ozone enhancement at the synoptic scale of East Asia shows that the reversible subsiding and ascending ozone transfers in the UTLS region occurring in the vicinity of low-pressure systems and related to tropopause height affect the upper and lower tropospheric ozone over large regions, especially north to 40° N and largely explain the ozone enhancement observed with IASI for these latitudes. Irreversible downward transport of ozone-rich air masses from the UTLS to the lower troposphere occurs more locally. Its contribution to the lower tropospheric ozone column is difficult to dissociate from the tropopause perturbations induced by the weather systems. For regions south to 40° N, a significant correlation between lower tropospheric ozone and carbon monoxide (CO) observations from IASI has been found, especially over North China Plain (NCP). Considering carbon monoxide observations as pollutant tracer, the O3-CO correlation indicates that the photochemical production of ozone from primary pollutants emitted over such large polluted regions significantly contributes to the ozone

  10. Universal Definition of Loss to Follow-Up in HIV Treatment Programs: A Statistical Analysis of 111 Facilities in Africa, Asia, and Latin America

    PubMed Central

    Chi, Benjamin H.; Yiannoutsos, Constantin T.; Westfall, Andrew O.; Newman, Jamie E.; Zhou, Jialun; Cesar, Carina; Brinkhof, Martin W. G.; Mwango, Albert; Balestre, Eric; Carriquiry, Gabriela; Sirisanthana, Thira; Mukumbi, Henri; Martin, Jeffrey N.; Grimsrud, Anna; Bacon, Melanie; Thiebaut, Rodolphe

    2011-01-01

    Background Although patient attrition is recognized as a threat to the long-term success of antiretroviral therapy programs worldwide, there is no universal definition for classifying patients as lost to follow-up (LTFU). We analyzed data from health facilities across Africa, Asia, and Latin America to empirically determine a standard LTFU definition. Methods and Findings At a set “status classification” date, patients were categorized as either “active” or “LTFU” according to different intervals from time of last clinic encounter. For each threshold, we looked forward 365 d to assess the performance and accuracy of this initial classification. The best-performing definition for LTFU had the lowest proportion of patients misclassified as active or LTFU. Observational data from 111 health facilities—representing 180,718 patients from 19 countries—were included in this study. In the primary analysis, for which data from all facilities were pooled, an interval of 180 d (95% confidence interval [CI]: 173–181 d) since last patient encounter resulted in the fewest misclassifications (7.7%, 95% CI: 7.6%–7.8%). A secondary analysis that gave equal weight to cohorts and to regions generated a similar result (175 d); however, an alternate approach that used inverse weighting for cohorts based on variance and equal weighting for regions produced a slightly lower summary measure (150 d). When examined at the facility level, the best-performing definition varied from 58 to 383 d (mean = 150 d), but when a standard definition of 180 d was applied to each facility, only slight increases in misclassification (mean = 1.2%, 95% CI: 1.0%–1.5%) were observed. Using this definition, the proportion of patients classified as LTFU by facility ranged from 3.1% to 45.1% (mean = 19.9%, 95% CI: 19.1%–21.7%). Conclusions Based on this evaluation, we recommend the adoption of ≥180 d since the last clinic visit as a standard LTFU definition. Such

  11. High Rates of Sexually transmitted infections in HIV-positive patients in the Australian HIV Observational Database - a prospective cohort study

    PubMed Central

    Mulhall, Brian P; Wright, Stephen; Allen, Debbie; Brown, Katherine; Dickson, Bridget; Grotowski, Miriam; Jackson, Eva; Petoumenos, Kathy; Read, Phillip; Read, Timothy; Russell, Darren; Smith, David J; Templeton, David J; Fairley, Christopher K; Law, Matthew G

    2015-01-01

    Background Sexually transmitted infections (STI) may directly increase the risk of HIV infection, or may indicate sexual practices that increase the risk of HIV infection. In persons with HIV they probably also increase the infectiousness of HIV, even in the context of treatment with antiretroviral drugs (ARV). Estimating STI in this group has proved problematic, and there are few longitudinal studies able to accurately measure incidence. Methods In 2010, we established a cohort of individuals from ten widely dispersed sexual health clinics that were already enrolled in the Australian HIV Observational Database (AHOD). We calculated retrospective diagnosis rates for four STI (chlamydia, gonorrhoea, infectious syphilis, anogenital warts) from 2005-2010, and prospective incidence rates from 2010-2011. Results At baseline (2010) , the patient characteristics (n=554) were similar to the rest of AHOD (n=1767), namely they were predominantly male, homosexual, middle-aged, and pre- treated with ARV. Overall, the incidence of any STI was 12.5/100 person years (py). There was a gradual increase in chlamydial infections , from 3.4/100 py (95% CI 1.9-5.7) in 2005 to 6.7/100py (95% CI 4.5-9.5) in 2011, with a substantial peak of 8.1/100py (95% CI 5.6-11.2) in 2010. The cases were distributed between rectal ( 61.9%), urethral (34%), and pharyngeal (6.3%) sites. Similarly, gonococcal infections increased, with a peak in 2010 of 4.7/100py (95% CI 5.6-11.2), (p value for trend=0.0099), distributed between rectal (63.9%), urethral (27.9%), and pharyngeal (14.8%) sites. Infectious syphilis showed several peaks, the largest in 2008 (5.3/100py , (95% CI 3.3-8.0), but the overall trend was not significant (p=0.113). Diagnoses of genital warts declined from 7.5/100py (95% CI 4.8-11.3) in 2005 (95% CI 4.8-11.3) to 2.4/100py (95% CI 1.1-4.5) in 2011 (p value for trend=0.0016). Conclusions The incidence of chlamydial and gonococcal infections in this cohort was higher than previous

  12. Satellite-observed NO2, SO2, and HCHO Vertical Column Densities in East Asia: Recent Changes and Comparisons with Regional Model

    NASA Astrophysics Data System (ADS)

    Kim, H. C.; Lee, P.; Kim, S.; Mok, J.; Yoo, H. L.; Bae, C.; Kim, B. U.; Lim, Y. K.; Woo, J. H.; Park, R.

    2015-12-01

    This study reports the recent changes in tropospheric NO2, SO2, and HCHO vertical column densities (VCD) in East Asia observed from multiple satellites, highlighting especially the annual trend changes of NO2 and SO2 over Beijing-Tianjin-Hebei (BTH) region of China since 2010. Tropospheric VCD data from Global Ozone Monitoring Experiment (GOME), SCanning Imaging Absorption spectroMeter for Atmospheric CHartographY (SCIAMACHY), Ozone Monitoring Instrument (OMI) and GOME-2, retrieved from the Royal Netherlands Meteorological Institute (KNMI) and OMI National Aeronautics and Space Administration (NASA) standard products, are utilized to investigate the annual trends of NO2, SO2, and HCHO VCDs from 2001 to 2015. They are also compared with simulations from Community Multi-scale Air Quality Model (CMAQ) based forecast system by the Integrated Multi-scale Air Quality System for Korea (IMAQS-K) of Ajou University. Until 2011, the changes in NO2 VCD over East Asian countries agree well with the findings of previous research, including the impact of the economic downturn during 2008-2009 and the subsequent quick recovery in China. After peaking in 2011, the NO2 VCD observations from active instruments (OMI and GOME-2) over China started to show a slower decreasing trend, mostly led by the rapid changes in the BTH region in northern China. On the other hand, SO2 started to decline earlier, from 2007, but inclined back from 2010 to 2012, and then back to declining trend since 2012. While satellite observations show dramatic recent changes, the model could not reproduce those changes mostly due to its use of fixed emission inventory. We conclude that rapid update of latest emission inventory is necessary for an accurate forecast of regional air quality in east Asia, especially for upcoming international sports events in PyeongChang (Korea), Tokyo (Japan) and Beijing (China) in 2018, 2020 and 2022, respectively.

  13. Springtime daily variations in lower-tropospheric ozone over east Asia: the role of cyclonic activity and pollution as observed from space with IASI

    NASA Astrophysics Data System (ADS)

    Dufour, G.; Eremenko, M.; Cuesta, J.; Doche, C.; Foret, G.; Beekmann, M.; Cheiney, A.; Wang, Y.; Cai, Z.; Liu, Y.; Takigawa, M.; Kanaya, Y.; Flaud, J.-M.

    2015-09-01

    We use satellite observations from IASI (Infrared Atmospheric Sounding Interferometer) on board the MetOp-A satellite to evaluate the springtime daily variations in lower-tropospheric ozone over east Asia. The availability of semi-independent columns of ozone from the surface up to 12 km simultaneously with CO columns provides a powerful observational data set to diagnose the processes controlling tropospheric ozone enhancement on synoptic scales. By combining IASI observations with meteorological reanalyses from ERA-Interim, we develop an analysis method based only on IASI ozone and CO observations to identify the respective roles of the stratospheric source and the photochemical source in ozone distribution and variations over east Asia. The succession of low- and high-pressure systems drives the day-to-day variations in lower-tropospheric ozone. A case study analysis of one frontal system and one cut-off low system in May 2008 shows that reversible subsiding and ascending ozone transfers in the upper-troposphere-lower-stratosphere (UTLS) region, due to the tropopause perturbations occurring in the vicinity of low-pressure systems, impact free and lower-tropospheric ozone over large regions, especially north of 40° N, and largely explain the ozone enhancement observed with IASI for these latitudes. Irreversible stratosphere-troposphere exchanges of ozone-rich air masses occur more locally in the southern and southeastern flanks of the trough. The contribution to the lower-tropospheric ozone column is difficult to dissociate from the tropopause perturbations generated by weather systems. For regions south of 40° N, a significant correlation has been found between lower-tropospheric ozone and carbon monoxide (CO) observations from IASI, especially over the North China Plain (NCP). Considering carbon monoxide observations as a pollutant tracer, the O3-CO correlation indicates that the photochemical production of ozone from primary pollutants emitted over such

  14. Missed opportunities to offer HIV tests to high-risk groups during general practitioners’ STI-related consultations: an observational study

    PubMed Central

    Joore, I K; Reukers, D F M; Donker, G A; van Sighem, A I; Op de Coul, E L M; Prins, J M; Geerlings, S E; Barth, R E; van Bergen, J E A M; van den Broek, I V

    2016-01-01

    Objectives Prior research has shown that Dutch general practitioners (GPs) do not always offer HIV testing and the number of undiagnosed HIV patients remains high. We aimed to further investigate the frequency and reasons for (not) testing for HIV and the contribution of GPs to the diagnosis of HIV infections in the Netherlands. Design Observational study. Setting (1) Dutch primary care network of 42–45 sentinel practices where report forms during sexually transmitted infection (STI)-related consultations were routinely collected, 2008–2013. (2) Dutch observational cohort with medical data of HIV-positive patients in HIV care, 2008–2013. Outcome measures The proportion of STI-related consultations in patients from high-risk groups tested for HIV, with additional information requested from GPs on HIV testing preconsultation or postconsultation for whom HIV testing was indicated, but not performed. Next, information was collected on the profile of HIV-positive patients entering specialised HIV care following diagnosis by GPs. Results Initially, an HIV test was reported (360/907) in 40% of STI-related consultations in high-risk groups. Additionally, in 26% of consultations an HIV test had been performed in previous or follow-up consultations or at different STI-care facilities. The main reasons for not testing were perceived insignificant risk; ‘too’ recent risk according to GPs or the reluctance of patients. The initiative of the patient was a strong determinant for HIV testing. GPs diagnosed about one third of all newly found cases of HIV. Compared with STI clinics, HIV-positive patients diagnosed in general practice were more likely to be older, female, heterosexual male or sub-Saharan African. Conclusions In one-third of the STI-related consultations of persons from high-risk groups, no HIV test was performed in primary care, which is lower than previously reported. Risk-based testing has intrinsic limitations and implementation of new additional

  15. Treatment and disease outcomes of migrants from low- and middle-income countries in the Australian HIV Observational Database cohort.

    PubMed

    Tilley, Donna M; Griggs, Elizabeth; Hoy, Jennifer; Wright, Stephen T; Woolley, Ian; Burke, Michael; O'Connor, Catherine C

    2015-01-01

    People from culturally and linguistically diverse backgrounds, including low- and middle-income countries, account for a third of new HIV diagnoses in Australia and are a priority for HIV prevention and treatment programs. We describe the demographic and clinical characteristics of participants in the Australian HIV Observational Database (AHOD) and compare disease outcomes, progression to AIDS and treatment outcomes of those born in low- and middle-income countries, with those born in high-income countries and Australia. All participants enrolled in AHOD sites where country of birth is routinely collected were included in the study. Age, CD4 count, HIV viral load, antiretroviral therapy, hepatitis co-infection, all-cause mortality and AIDS illness were analysed. Of 2403 eligible participants, 77.3% were Australian born, 13.7% born in high-income countries and 9.0% born in middle- or low-income countries. Those born in Australia or high-income countries were more likely to be male (96%) than those from middle- or low-income countries (76%), p < .0001 and more likely to have acquired HIV via male to male sexual contact (77%; 79%) compared with those from middle- or low-income countries (50%), p < .0001. At enrolment, mean CD4 cell count was higher in Australian born (528 cells/µL) than both those born in high-income countries (468 cells/µL) and those born in middle- and low-income countries (451 cells/µL), p < .0001; whereas the mean HIV RNA level (log10 copies/mL) was similar in all three groups (4.44, 4.76 and 4.26, respectively), p = .19.There was no difference in adjusted incidence risk ratios for all-cause mortality and AIDS incidence in all three groups, p = .39. These findings reflect successful outcomes of people born in low- and middle-income countries once engaged in HIV care. PMID:26679270

  16. The long-term outcomes of antiretroviral treatment initiated with mono or dual nucleoside reverse transcriptase inhibitors in HIV-1-infected children: an Asian observational study

    PubMed Central

    Wittawatmongkol, Orasri; Mohamed, Thahira J; Le, Thoa PK; Ung, Vibol; Maleesatharn, Alan; Hansudewechakul, Rawiwan; Nguyen, Lam V; Kumarasamy, Nagalingeswaran; Lumbiganon, Pagakrong; Sudjaritruk, Tavitiya; Bunupuradah, Torsak; Yusoff, Nik KN; Kurniati, Nia; Fong, Moy S.; Nallusamy, Revathy; Kariminia, Azar; Sohn, Annette H.; Chokephaibulkit, Kulkanya

    2016-01-01

    After a median of 115.9 months of follow-up, 90% of 206 HIV-1-infected children in a cohort in Asia who initiated antiretroviral treatment (ART) with mono or dual nucleoside reverse transcriptase inhibitors were alive and had comparable immunological and virological outcomes as compared to the 1,915 children who had started with highly active antiretroviral regimens. However, these children had higher rates of treatment-related adverse events, opportunistic infections, and cumulative mortality, and were more likely to require protease inhibitor-containing regimens or other more novel ART-based regimens. PMID:27076917

  17. Detection of HIV type 1 env subtypes A, B, C, and E in Asia using dried blood spots: a new surveillance tool for molecular epidemiology.

    PubMed

    Cassol, S; Weniger, B G; Babu, P G; Salminen, M O; Zheng, X; Htoon, M T; Delaney, A; O'Shaughnessy, M; Ou, C Y

    1996-10-10

    Global surveillance of HIV-1 subtypes for genetic characterization is hampered by the biohazard of processing and the difficulties of shipping whole blood or cells from many developing country regions. We developed a technique for the direct automated sequencing of viral DNA from dried blood spot (DBS) specimens collected on absorbent paper, which can be mailed unrefrigerated in sturdy paper envelopes with low biohazard risk. DBS were collected nonrandomly from HIV-1-infected, mostly asymptomatic, patients in five Asian countries in 1991, and shipped via airmail or hand carried without refrigeration to Bangkok, and then transshipped to North America for processing. After more than 2 years of storage, including 6 months at ambient temperatures, proviral DNA in the DBS was amplified by nested PCR, and a 389-nucleotide segment of the C2-V3 env gene region was sequenced, from which 287 base pairs were aligned and subtyped by phylogenetic analysis with neighbor-joining and other methods. From southern India, there were 25 infections with subtype C and 2 with subtype A. From Myanmar (Burma), we identified the first subtype E infection, as well as six subtype BB, a distinct cluster within subtype B that was first discovered in Thailand and that has now appeared in China, Malaysia, and Japan. From southwest China, one BB was identified, while a "classical" B typical of North American and European strains was found in Indonesia. From Thailand, five DBS of ambiguous serotype were identified as three B, one BB, and one E. A blinded control serotype E specimen was correctly identified, but a serotype BB control was not tested. Most HIV-1 in southern India appears to be env subtype C, with rare A, as others have reported in western and northern India. The subtypes BB and E in Myanmar, and the BB in China, suggest epidemiological linkage with these subtypes in neighboring Thailand. DBS are a practical, economical technique for conducting large-scale molecular epidemiological

  18. Asia. Vancouver Conference Review.

    PubMed

    Brown, T

    1997-02-01

    The 1997 International AIDS Conference in Vancouver gave relatively little attention to the rapid spread of HIV/AIDS in most of the developing world. The popular press reported mainly prevention success stories from Thailand and Uganda, and the successes realized in reducing viral loads with combination drug therapies using protease inhibitors. Societal efforts in Thailand have dramatically reduced the rate of new infections, slowing the growth of the epidemic substantially. Few heard from the conference about how the HIV/AIDS epidemic is spreading rapidly and largely unchecked in much of the world, especially in Asia. Thailand, India, Myanmar, and Cambodia are the most heavily affected countries. Thailand and India, as well as Japan, were therefore heavily represented in the scientific program, while most other countries presented far fewer reports. With the exception of one report on a training course in Fiji, the Pacific Island nations were absent from the program. Vietnam, Malaysia, China, and Hong Kong have rapidly-evolving situations, while Japan, the Philippines, Bangladesh, Nepal, Singapore, Indonesia, Taiwan, Laos, South Korea, Mongolia, and Pakistan should be watched closely. The Asian epidemics are constantly evolving over time. PMID:9155914

  19. Time trends in drug resistant HIV-1 infections in the United Kingdom up to 2009: multicentre observational study

    PubMed Central

    2012-01-01

    Objective To evaluate whether the prevalence of HIV-1 transmitted drug resistance has continued to decline in infections probably acquired within the United Kingdom. Design Multicentre observational study. Setting All UK public laboratories conducting tests for genotypic HIV resistance as a part of routine care. Participants 14 584 patients infected with HIV-1 subtype B virus, who were first tested for resistance before receiving antiretroviral therapy between January 2002 and December 2009. Main outcome measure Prevalence of transmitted drug resistance, defined as one or more resistance mutations from the surveillance list recommended by the World Health Organization. Results 1654 (11.3%, 95% confidence interval 10.8% to 11.9%) patients had one or more mutations associated with transmitted HIV-1 drug resistance; prevalence was found to decline from 15.5% in 2002 to 9.6% in 2007, followed by a slight increase to 10.9% in 2009 (P=0.21). This later rise was mainly a result of increases in resistance to nucleos(t)ide reverse transcriptase inhibitors (from 5.4% in 2007 to 6.6% in 2009, P=0.24) and protease inhibitors (1.5% to 2.1%, P=0.12). Thymidine analogue mutations, including T215 revertants, remained the most frequent mutations associated with nucleos(t)ide reverse transcriptase inhibitors, despite a considerable fall in stavudine and zidovudine use between 2002 and 2009 (from 29.4% of drug regimens in 2002 to 0.8% in 2009, from 47.9% to 8.8%, respectively). Conclusions The previously observed decline in the prevalence of transmitted drug resistance in HIV-1 infections probably acquired in the UK seems to have stabilised. The continued high prevalence of thymidine analogue mutations suggests that the source of this resistance may be increasingly from patients who have not undergone antiretroviral therapy and who harbour resistant viruses. Testing of all newly diagnosed HIV-1 positive people should be continued. PMID:22915687

  20. Observation of ozone enhancement in the lower troposphere over East Asia from a space-borne ultraviolet spectrometer

    NASA Astrophysics Data System (ADS)

    Hayashida, S.; Liu, X.; Ono, A.; Yang, K.; Chance, K.

    2015-09-01

    We report observations from space using ultraviolet (UV) radiance for significant enhancement of ozone in the lower troposphere over central and eastern China (CEC). The recent retrieval products of the Ozone Monitoring Instrument (OMI) onboard the Earth Observing System (EOS) Aura satellite revealed the spatial and temporal variation of ozone distributions in multiple layers in the troposphere. We compared the OMI-derived ozone over Beijing with airborne measurements by the Measurement of Ozone and Water Vapor by Airbus In-Service Aircraft (MOZAIC) program. The correlation between OMI and MOZAIC ozone in the lower troposphere was reasonable, which assured the reliability of OMI ozone retrievals in the lower troposphere under enhanced ozone conditions. The ozone enhancement was clearly observed over CEC, with Shandong Province as its center, and was most notable in June in any given year. Similar seasonal variations were observed throughout the 9-year OMI measurement period of 2005 to 2013. A considerable part of this ozone enhancement could be attributed to the emissions of ozone precursors from industrial activities and automobiles, and possibly from open crop residue burning (OCRB) after the winter wheat harvest. The ozone distribution presented in this study is also consistent with some model studies. The lower tropospheric ozone distribution is first shown from OMI retrieval in this study, and the results will be useful in clarifying any unknown factors that influence ozone distribution by comparison with model simulations.

  1. Assessment of atmospheric acidified pollutants trends observed by EANET in North-East Asia in the first decade of XXI century

    NASA Astrophysics Data System (ADS)

    Gromov, Sergey A.; Trifonova-Yakovleva, Alisa; Gromov, Sergey S.

    2015-04-01

    Owing to rapid development and subsequent enormous increase in energy consumption/fossil fuel use, anthropogenic emissions of sulphur and nitrogen oxides in China and other Asian countries surpass those in North America and Europe since mid-1990s. Consequently, regional air pollution has become an issue for the most of developing countries in North-East Asia. Since 1998, the Acid Deposition Monitoring Network in East Asia (EANET, http://www.eanet.asia/) provides constant monitoring of the air quality and precipitation (including gaseous and particulate phase chemistry) in 13 countries of the region. The measurements are conducted at 45 rural and remote stations using both filter pack sampling techniques and automatic monitoring equipment. In this study we present a comprehensive trend analysis of the long-term (last 15 years) air pollution monitoring data from selected EANET monitoring sites. Using several statistical approaches, we estimate the quality of the data and perform distribution tests, single out special events (detect outliers) and calculate an ensemble of trends (monthly, seasonal, long-term and quartile) and their statistical significance for a suite of observed compounds. Based on this analysis, we further estimate the statistics and overall significance of the observed temporal dynamics for each pollutant. Ultimately we derive more than 20 trend estimates for a total of up to 12 gas-phase and particulate compounds for each station. Our calculations ascertain that about half of the trends (either negative or positive) observed at the EANET stations in Russia, Korea and Japan are significant. Whilst an increase in SO2, HCl, Cl-, NO3 (except for the stations in Russia) concentrations is distinct, small or insignificant trends are reckoned for HNO3-. A marked decrease in K+ content is seen at all regarded stations. We commonly find station-wise correlation for the trends of the remaining compounds, and for several species we conclude a general spatial

  2. Observation of ozone enhancement in the lower troposphere over East Asia from a space-borne ultraviolet spectrometer

    NASA Astrophysics Data System (ADS)

    Hayashida, S.; Liu, X.; Ono, A.; Yang, K.; Chance, K.

    2015-01-01

    We report observations from space using ultraviolet (UV) radiance for significant enhancement of ozone in the lower troposphere over Central and Eastern China (CEC). The recent retrieval products of the Ozone Monitoring Instrument (OMI) onboard the Earth Observing System (EOS)/Aura satellite revealed the spatial and temporal variation of ozone distributions in multiple layers in the troposphere. We compared the OMI-derived ozone over Beijing with airborne measurements by the Measurement of Ozone and Water Vapor by Airbus In-Service Aircraft (MOZAIC) program. The correlation between OMI and MOZAIC ozone in the lower troposphere was reasonable, which assured the reliability of OMI ozone retrievals in the lower troposphere under enhanced ozone conditions. The ozone enhancement was clearly observed over CEC, with Shandong Province as its center, and most notable in June in any given year. Similar seasonal variations were observed throughout the nine-year OMI measurement period of 2005 to 2013. The ozone enhancement in June was associated with the enhancement of carbon monoxide (CO) and hotspots, which is consistent with previous studies of in-situ measurements such those made by the MTX2006 campaign. A considerable part of this ozone enhancement could be attributed to the emissions of ozone precursors from open crop residue burning (OCRB) after the winter wheat harvest, in addition to emissions from industrial activities and automobiles. The ozone distribution presented in this study is also consistent with some model studies that apply emissions from OCRB. The lower tropospheric ozone distribution is first shown from OMI retrieval in this study, and the results will be useful in clarifying any unknown factors that influence ozone distribution by comparison with model simulations.

  3. Southeast Asia

    NASA Technical Reports Server (NTRS)

    2002-01-01

    Home to beautiful jungles, booming industry, and age-old temples, Southeast Asia has become a confluence of ancient and modern life. This true-color image of mainland Southeast Asia was acquired on November 30, 2001, by the Moderate-resolution Imaging Spectroradiometer (MODIS), flying aboard NASA's Terra spacecraft. The body of water in the upper righthand corner of the image is the Gulf of Tonkin. East and southeast of the gulf are the dark green jungles of Vietnam, Laos, and Cambodia. The light brown Mekong River winds its way through the center of the Cambodian jungle and into southern Vietnam. The dark blue patch to the left of the river at the bottom of the image is the Tonle Sap. Literally translated to mean 'Great Lake,' the Tonle Sap is the largest freshwater lake in Southeast Asia. During the rainy season from May to October, the lake will more than double in size growing from its wintertime extent of 3,000 square kilometers to over 7,500 square kilometers. North of the lake, approximately in the center of the image, is a saucer-shaped patch of reddish brown land known as the Khorat Plateau. Situated 90 to 200 meters above sea level in eastern Thailand, the dry plateau is mostly covered with farmland and savanna-type grasses and shrubs. Moving south again, the large body of light blue water at the bottom central portion of the image is the Gulf of Thailand. By switching to the full resolution image (250 meters per pixel) and following the Gulf of Thailand to its northernmost extent, one can see a pinkish beige patch of terrain covered by a faint latticework of fine lines. These are likely to be the network of roads that crisscross Bangkok and its surrounding suburbs and fertile farmland. The narrow strip of land to the east of the Gulf of Thailand is the Malay Peninsula. The body of water to the left of the peninsula is the Gulf of Martaban, which borders Myanmar (Burma). At the far upper lefthand corner of the image, the water has turned light brown from

  4. Trend analysis of satellite-observed tropospheric NO2 vertical column densities over East Asia for 2005-2014

    NASA Astrophysics Data System (ADS)

    Muto, T.; Irie, H.; Itahashi, S.

    2015-12-01

    Nitrogen dioxide (NO2) plays a central role in the troposphere as a toxic substance for the respiratory system and a precursor for ozone and aerosols. Furthermore, the OH concentration is dependent on the NO2 concentration. While trend analysis for tropospheric NO2 concentrations in several specific regions all over the world was made in literature for period until 2011, the latest trends after 2011 have not been reported yet. The time period after 2011 is of interest, because it corresponds to the 12th 5-year-plan regulating NOx emissions in China and the period with the power substitution of thermal power generation for the nuclear power generation in Japan. In this study, we first compared satellite-observed tropospheric NO2 VCDs (Vertical Column Densities) with those observed by ground-based Multi-Axis Differential Optical Absorption Spectroscopy (MAX-DOAS) instruments installed at Chiba University in order to clarify whether or not there is degradation in OMI and GOME-2 NO2 VCDs data after 2011. We concluded that there is no significant degradation in OMI and GOME-2 data, since the comparison results are similar to those reported by previous validation studies. Based on the results, tropospheric NO2 VCD trends over Central Eastern China (CEC; 30-40°N, 110.0-123.0°E) and Japan (JPN; 33.5-37.0°N, 133.0-141.0°E) regions were estimated using the regression analysis for annual mean values. Although an increase in NO2 VCDs occurred at a rate of 6%(8%) per year in OMI (GOME-2) data from 2005(2007) to 2011 over CEC, we found a decrease at a rate of 10%(11%) per year from 2011 to 2014. This reduction may be a result from the regulation of NOx emissions from coal fired power generation, iron foundry, cement plant, etc., and installation of the denitrification units during the period of 12th 5-year-plan. For JPN, both OMI and GOME-2 data sets showed that the NO2 VCDs decreased at a rate of 4% per year before 2011. The decreasing trends continued until 2014, with a

  5. Infant feeding practices at routine PMTCT sites, South Africa: results of a prospective observational study amongst HIV exposed and unexposed infants - birth to 9 months

    PubMed Central

    2012-01-01

    Background We sought to investigate infant feeding practices amongst HIV-positive and -negative mothers (0-9 months postpartum) and describe the association between infant feeding practices and HIV-free survival. Methods Infant feeding data from a prospective observational cohort study conducted at three (of 18) purposively-selected routine South African PMTCT sites, 2002-2003, were analysed. Infant feeding data (previous 4 days) were gathered during home visits at 3, 5, 7, 9, 12, 16, 20, 24, 28, 32 and 36 weeks postpartum. Four feeding groups were of interest, namely exclusive breastfeeding, mixed breastfeeding, exclusive formula feeding and mixed formula feeding. Cox proportional hazards models were fitted to investigate associations between feeding practices (0-12 weeks) and infant HIV-free survival. Results Six hundred and sixty five HIV-positive and 218 HIV-negative women were recruited antenatally and followed-up until 36 weeks postpartum. Amongst mothers who breastfed between 3 weeks and 6 months postpartum, significantly more HIV-positive mothers practiced exclusive breastfeeding compared with HIV-negative: at 3 weeks 130 (42%) versus 33 (17%) (p < 0.01); this dropped to 17 (11%) versus 1 (0.7%) by four months postpartum. Amongst mothers practicing mixed breastfeeding between 3 weeks and 6 months postpartum, significantly more HIV-negative mothers used commercially available breast milk substitutes (p < 0.02) and use of these peaked between 9 and 12 weeks. The probability of postnatal HIV or death was lowest amongst infants living in the best resourced site who avoided breastfeeding, and highest amongst infants living in the rural site who stopped breastfeeding early (mean and standard deviations: 10.7% ± 3% versus 46% ± 11%). Conclusions Although feeding practices were poor amongst HIV-positive and -negative mothers, HIV-positive mothers undertake safer infant feeding practices, possibly due to counseling provided through the routine PMTCT programme. The

  6. Continuous generation and two-dimensional structure of equatorial plasma bubbles observed by high-density GPS receivers in Southeast Asia

    NASA Astrophysics Data System (ADS)

    Buhari, S. M.; Abdullah, M.; Hasbi, A. M.; Otsuka, Y.; Yokoyama, T.; Nishioka, M.; Tsugawa, T.

    2014-12-01

    High-density GPS receivers located in Southeast Asia (SEA) were utilized to study the two-dimensional structure of ionospheric plasma irregularities in the equatorial region. The longitudinal and latitudinal variations of tens of kilometer-scale irregularities associated with equatorial plasma bubbles (EPBs) were investigated using two-dimensional maps of the rate of total electron content change index (ROTI) from 127 GPS receivers with an average spacing of about 50-100 km. The longitudinal variations of the two-dimensional maps of GPS ROTI measurement on 5 April 2011 revealed that 16 striations of EPBs were generated continuously around the passage of the solar terminator. The separation distance between the subsequent onset locations varied from 100 to 550 km with 10 min intervals. The lifetimes of the EPBs observed by GPS ROTI measurement were between 50 min and over 7 h. The EPBs propagated 440-3000 km toward the east with velocities of 83-162 m s-1. The longitudinal variations of EPBs by GPS ROTI keogram coincided with the depletions of 630 nm emission observed using the airglow imager. Six EPBs were observed by GPS ROTI along the meridian of Equatorial Atmosphere Radar (EAR), while only three EPBs were detected by the EAR. The high-density GPS receivers in SEA have an advantage of providing time continuous descriptions of latitudinal/longitudinal variations of EPBs with both high spatial resolution and broad geographical coverage. The spatial periodicity of the EPBs could be associated with a wavelength of the quasiperiodic structures on the bottomside of the F region which initiate the Rayleigh-Taylor instability.

  7. Studying Peculiarities of Ionospheric Response to the 2015 March 17-19 Geomagnetic Storm in East Asia: Observations and Simulation

    NASA Astrophysics Data System (ADS)

    Romanova, Elena; Zherebtsov, Gelii; Polekh, Nelya; Wang, Xiao; Wang, Guojun; Zolotukhina, Nina; Shi, Jiankui

    2016-07-01

    We report results of the research into effects of the strong geomagnetic storm in the ionosphere of high, middle, and low latitudes on March 17-19, 2015. The research relies on measurements made at the network of ionospheric stations located near the 120°E meridian. The analysis of experimental data has revealed that at the beginning of the main storm phase the equatorial wall of the main ionospheric trough (MIT) shifted towards geographic latitudes 58-60°N, which caused negative disturbances in subauroral latitudes and positive disturbances in middle latitudes. Further displacement of the MIT equatorial wall towards a geographic latitude of 52° N led to a decrease in the F2-layer critical frequency (foF2) up to 2 MHz in middle latitudes during evening and night hours, and to the appearance of sporadic layers in these latitudes due to energetic particle precipitation. Such phenomena are largely specific to the subauroral ionosphere. During the recovery storm phase on March 18, 2015 during daylight hours, negative disturbances were recorded at all the stations. Since prolonged negative disturbances are usually associated with a reduction in the ratio of concentrations of atomic oxygen and molecular nitrogen [O]/[N2] which is transported by disturbed thermospheric wind from auroral latitudes to middle and low ones, we analyzed measurements of [O]/[N2], made by GUVI (Global Ultraviolet Imager, http://guvi.jhuapl.edu/site/gallery/guvi-galleryl3on2.shtml), during this storm. The storm appeared to be characterized by very low values of [O]/[N2] which were recorded in the longitude sector 60 - 150°E up to 15°N on March 18. The discovered peculiarities of the ionospheric response to the storm were interpreted using a theoretical model of ionosphere-plasmosphere coupling developed at ISTP SB RAS. The simulation showed that the displacement of MIT equatorial wall resulted in foF2 variations similar to those observed during the main storm phase in subauroral and middle

  8. Challenges and potential barriers to the uptake of antiretroviral-based prevention in Asia and the Pacific region.

    PubMed

    Lo, Ying-Ru; Kato, Masaya; Phanuphak, Nittaya; Fujita, Masami; Duc, Duong Bui; Sopheap, Seng; Pendse, Razia; Yu, Dongbao; Wu, Zunyou; Chariyalertsak, Suwat

    2014-07-01

    Evidence has emerged over the past few years on the effectiveness of antiretroviral-based prevention technologies to prevent (i) HIV transmission while decreasing morbidity and mortality in HIV-infected persons, and (ii) HIV acquisition in HIV-uninfected individuals through pre-exposure prophylaxis (PrEP). Only few of the planned studies on treatment as prevention (TasP) are conducted in Asia. TasP might be more feasible and effective in concentrated rather than in generalised epidemics, as resources for HIV testing and antiretroviral treatment could focus on confined and much smaller populations than in the generalised epidemics observed in sub-Saharan Africa. Several countries such as Cambodia, China, Thailand and Vietnam, are now paving the way to success. Similar challenges arise for both TasP and PrEP. However, the operational issues for PrEP are amplified by the need for frequent retesting and ensuring adherence. This paper describes challenges for the implementation of antiretroviral-based prevention and makes the case that TasP and PrEP implementation research in Asia is much needed to provide insights into the feasibility of these interventions in populations where firm evidence of 'real world' effectiveness is still lacking. PMID:25007911

  9. HIV in Europe.

    PubMed

    Põder, Airi; Haldre, Madli

    2014-01-01

    In 2011, the estimated number of people living with HIV in Europe and Central Asia was 2.3 million. This is more than twice the 2001 figure. At the same time, approximately 50% of the infected people may not know their HIV status. The Europe/Central Asia region is one of only two regions in which HIV infections continue to increase. The estimated prevalence rate in the west and center of the region, however, has remained stable at 0.2%. The HIV epidemics in Eastern Europe and Central Asia are typically driven by unsafe drug injection and by onward transmission to the sexual partners of people who inject drugs. In the western part of the region, the epidemic remains concentrated among men who have sex with men and migrants from countries with generalized epidemics. Means of preventing and fighting HIV should, first and foremost, be directed to those parts of the population that are most exposed to the risk of the infection. Proceeding from the data presented, recommendations are given for ways of decreasing HIV prevalence in the region, such as promoting dialogue and awareness among multistakeholders, including policy makers, donors, and population groups most exposed to the infection. PMID:24559564

  10. Do High-Risk Young Adults Use the HIV Self-Test Appropriately? Observations from a Think-Aloud Study.

    PubMed

    Schnall, Rebecca; John, Rita Marie; Carballo-Dieguez, Alex

    2016-04-01

    The purpose of this study was to understand high-risk young adults' use of the rapid human immunodeficiency virus (HIV) self-test. The highest rate of new HIV infections occurs in people between 15 and 24 years. Improving identification of young people infected with HIV is a critical public health priority. The first rapid HIV self-testing kit was approved in the US in 2012. Despite the product's promise, its use by untrained young adults is not well-understood. We conducted a mixed methods study using surveys, a think-aloud protocol, observations, and in-depth interviews. A systematic checklist was developed to assess participants' use of the test. A total of 21 racial and/or ethnic minority young adults aged 18-24 participated in this study. Analysis of our interview data was guided by the theory of reasoned action (TRA). Participants completed the initial procedures of the test with a mean time of 8:36 min (range of 2:04'-16:33'). On a 14-point checklist, participants had a mean score of 10.8 (SD 2.26, range 3-14). In the qualitative analysis of the participants' interviews, guided by the theoretical constructs of the TRA, the following themes emerged: "Did I use it correctly?", "Can I trust the results?" (attitude); "How will my partner react?!", "What will people think?" (subjective norm); "Quick, easy and blood free," and "Avoids the hassle of dealing with the healthcare system" (behavioral intention). This study provided evidence of the usefulness of the test perceived by young adults, especially in light of their concerns about lack of privacy in medical settings. Since many participants did not follow all of the instructions while using the test, it is not evident that young adults can correctly use the HIV self-test. Development of instructions manuals that are understandable and guide proper use of medical devices is a great need, especially in the context of home testing technology. PMID:26518679

  11. Short-term risk of anaemia following initiation of combination antiretroviral treatment in HIV-infected patients in countries in sub-Saharan Africa, Asia-Pacific, and central and South America

    PubMed Central

    2012-01-01

    Background The objective was to examine the short-term risk and predictors of anaemia following initiation of combination antiretroviral therapy (cART) in HIV-infected patients from the Western Africa, Eastern Africa, Southern Africa, Central Africa, Asian-Pacific, and Caribbean and Central and South America regions of the International Epidemiologic Databases to Evaluate AIDS (IeDEA) collaboration. Methods Anaemia was defined as haemoglobin of < 10 g/dL. Patients were included if they started cART with three or more drugs, had prior haemoglobin of > = 10 g/dL, and had one or more follow-up haemoglobin tests. Factors associated with anaemia up to 12 months were examined using Cox proportional hazards models and stratified by IeDEA region. Results Between 1998 and 2008, 19,947 patients initiated cART with baseline and follow-up haemoglobin tests (7358, 7289, 2853, 471, 1550 and 426 in the Western Africa, Eastern Africa, Southern Africa, Central Africa, Asian-Pacific, and Caribbean and Central and South America regions, respectively). At initiation, anaemia was found in 45% of Western Africa patients, 29% of Eastern Africa patients, 21% of Southern Africa patients, 36% of Central Africa patients, 15% of patients in Asian-Pacific and 14% of patients in Caribbean and Central and South America. Among patients with haemoglobin of > = 10 g/dL at baseline (13,445), the risks of anaemia were 18.2, 6.6, 9.7, 22.9, 11.8 and 19.5 per 100 person-years in the Western Africa, Eastern Africa, Southern Africa, Central Africa, Asian, and Caribbean and Central and South America regions, respectively. Factors associated with anaemia were female sex, low baseline haemoglobin level, low baseline CD4 count, more advanced disease stage, and initial cART containing zidovudine. Conclusions In data from 34 cohorts of HIV-infected patients from sub-Saharan Africa, Central and South America, and Asia, the risk of anaemia within 12 months of initiating cART was moderate. Routine haemoglobin

  12. New directions in hydro-climatic histories: observational data recovery, proxy records and the atmospheric circulation reconstructions over the earth (ACRE) initiative in Southeast Asia

    NASA Astrophysics Data System (ADS)

    Williamson, Fiona; Allan, Rob; Switzer, Adam D.; Chan, Johnny C. L.; Wasson, Robert James; D'Arrigo, Rosanne; Gartner, Richard

    2015-12-01

    The value of historic observational weather data for reconstructing long-term climate patterns and the detailed analysis of extreme weather events has long been recognized (Le Roy Ladurie, 1972; Lamb, 1977). In some regions however, observational data has not been kept regularly over time, or its preservation and archiving has not been considered a priority by governmental agencies. This has been a particular problem in Southeast Asia where there has been no systematic country-by-country method of keeping or preserving such data, the keeping of data only reaches back a few decades, or where instability has threatened the survival of historic records. As a result, past observational data are fragmentary, scattered, or even absent altogether. The further we go back in time, the more obvious the gaps. Observational data can be complimented however by historical documentary or proxy records of extreme events such as floods, droughts and other climatic anomalies. This review article highlights recent initiatives in sourcing, recovering, and preserving historical weather data and the potential for integrating the same with proxy (and other) records. In so doing, it focuses on regional initiatives for data research and recovery - particularly the work of the international Atmospheric Circulation Reconstructions over the Earth's (ACRE) Southeast Asian regional arm (ACRE SEA) - and the latter's role in bringing together disparate, but interrelated, projects working within this region. The overarching goal of the ACRE SEA initiative is to connect regional efforts and to build capacity within Southeast Asian institutions, agencies and National Meteorological and Hydrological Services (NMHS) to improve and extend historical instrumental, documentary and proxy databases of Southeast Asian hydroclimate, in order to contribute to the generation of high-quality, high-resolution historical hydroclimatic reconstructions (reanalyses) and, to build linkages with humanities researchers

  13. Temporal and spatial distribution of tropospheric NO2 over arid areas of Central Asia by OMI Satellite observations: Evidence for a strong contribution of soil biogenic nitric oxide

    NASA Astrophysics Data System (ADS)

    Mamtimin, Buhalqem; Qi, Yue; Beirle, Steffen; Wagner, Thomas; Meixner, Franz X.

    2013-04-01

    We present results observations of tropospheric NO2 carried out by Ozone Monitoring Instrument (OMI) over the Central Asian arid areas from 2005 to 2011. We selected 8 oases (Ruoqiang, Milan, Waxxari, Qiemo, Minfeng, Shache, Awati and Kuche) in Taklimakan desert (part of the great Central Asian deserts). For these, spatial distributions, seasonal variations, and trends of tropospheric NO2 Vertical Column Densities (VCDs) retrieved are discussed. In the Taklimakan desert, oases are the centers of all human activities and the economy of the selected oases are dominated by oasis agriculture. Irrigation and fertilization favor the microbial production of nitric oxide in soils, which after emission is converted to NO2 by ozone. Consequently, tropospheric NO2-VCDs are a good proxy for biogenic NO emissions from soils. For contrast, we examined also the NO2-VCDs in the area of the growing megacity Urumqi (43.85°N, 87.62°E), which is known as an anthropogenic highly polluted city in the Central Asian deserts. For 2005-2011, all selected oases are hot spots of NO/NO2 in the Taklimakan desert. Higher NO2-VCDs were observed during growing seasons over all 8 oases. NO2-VCDs observed in summer generally increased from 2005 to 2011. NO2-VCDs over Urumqi were generally at least 1 order of magnitude higher than those over the oases. In contrast to the oases, wintertime NO2-VCDs over Urumqi are higher than in summer. We evaluated governmental statistical agricultural data of the 8 oasis, and compared the trends with corresponding summertime NO2-VCDs. Inter-annual trends of NO2-VCDs over the oases show similar patterns to those of N-fertilizer application and sown (and irrigated) areas. Highest NO2-VCDs observed in summer for agriculturally dominated oases are a strong indication that soil biogenic NO emission is the main contributor to the tropospheric NO2 over all 8 oases, while in Urumqi fossil fuel combustion, particularly during winter, is the main source for NO/NO2. With

  14. Community-based treatment of advanced HIV disease: introducing DOT-HAART (directly observed therapy with highly active antiretroviral therapy).

    PubMed Central

    Farmer, P.; Léandre, F.; Mukherjee, J.; Gupta, R.; Tarter, L.; Kim, J. Y.

    2001-01-01

    In 2000, acquired immunodeficiency syndrome (AIDS) overtook tuberculosis (TB) as the world's leading infectious cause of adult deaths. In affluent countries, however, AIDS mortality has dropped sharply, largely because of the use of highly active antiretroviral therapy (HAART). Antiretroviral agents are not yet considered essential medications by international public health experts and are not widely used in the poor countries where human immunodeficiency virus (HIV) takes its greatest toll. Arguments against the use of HAART have mainly been based on the high cost of medications and the lack of the infrastructure necessary for using them wisely. We re- examine these arguments in the setting of rising AIDS mortality in developing countries and falling drug prices, and describe a small community-based treatment programme based on lessons gained in TB control. With the collaboration of Haitian community health workers experienced in the delivery of home-based and directly observed treatment for TB, an AIDS-prevention project was expanded to deliver HAART to a subset of HIV patients deemed most likely to benefit. The inclusion criteria and preliminary results are presented. We conclude that directly observed therapy (DOT) with HAART, "DOT-HAART", can be delivered effectively in poor settings if there is an uninterrupted supply of high-quality drugs. PMID:11799447

  15. Aerosol properties computed from aircraft-based observations during the ACE- Asia campaign. 2; A case study of lidar ratio closure and aerosol radiative effects

    NASA Technical Reports Server (NTRS)

    Kuzmanoski, Maja; Box, M. A.; Schmid, B.; Box, G. P.; Wang, J.; Russell, P. B.; Bates, D.; Jonsson, H. H.; Welton, Ellsworth J.; Flagan, R. C.

    2005-01-01

    For a vertical profile with three distinct layers (marine boundary, pollution and dust), observed during the ACE-Asia campaign, we carried out a comparison between the modeled lidar ratio vertical profile and that obtained from collocated airborne NASA AATS-14 sunphotometer and shipborne Micro-Pulse Lidar (MPL) measurements. Vertically resolved lidar ratio was calculated from two size distribution vertical profiles - one obtained by inversion of sunphotometer-derived extinction spectra, and one measured in-situ - combined with the same refractive index model based on aerosol chemical composition. The aerosol model implies single scattering albedos of 0.78 - 0.81 and 0.93 - 0.96 at 0.523 microns (the wavelength of the lidar measurements), in the pollution and dust layers, respectively. The lidar ratios calculated from the two size distribution profiles have close values in the dust layer; they are however, significantly lower than the lidar ratios derived from combined lidar and sunphotometer measurements, most probably due to the use of a simple nonspherical model with a single particle shape in our calculations. In the pollution layer, the two size distribution profiles yield generally different lidar ratios. The retrieved size distributions yield a lidar ratio which is in better agreement with that derived from lidar/sunphotometer measurements in this layer, with still large differences at certain altitudes (the largest relative difference was 46%). We explain these differences by non-uniqueness of the result of the size distribution retrieval and lack of information on vertical variability of particle refractive index. Radiative transfer calculations for this profile showed significant atmospheric radiative forcing, which occurred mainly in the pollution layer. We demonstrate that if the extinction profile is known then information on the vertical structure of absorption and asymmetry parameter is not significant for estimating forcing at TOA and the surface

  16. Understanding patterns of variability in tropospheric ozone over Europe and eastern Asia in 2005-2009 using TES observations and the TM5 chemistry transport model

    NASA Astrophysics Data System (ADS)

    Verstraeten, W. W.; van Geel, M. H. A.; Boersma, K. F.

    2012-04-01

    TM5 runs at the global scale returned r values of 0.97 for the lower troposphere (LT, surface - 500 hPa) and 0.98 for the higher troposphere (UT, < 500 hPa). At the 464 hPa level, on average, the percentage difference in ozone concentrations between TES and TM5 is 15% which is in line with earlier reported comparisons between TES v2 and sonde data. Generally, at the global scale, the TES-TM5 overestimations at the 468 hPa level were located at higher latitudes, whereas underestimations were observed at lower latitudes. In January the absolute differences in ozone concentration between TES and TM5 at the 464 hPa level are smaller compared to July. At the regional scale at 464 hPa, TES v4 time series (2005-2010) show an increasing trend of ozone concentrations in eastern Asia (NE China) in addition to reported increasing concentrations of NOx with higher differences between TES and TM5 in July compared to January. For Europe, no clear-cut trends in time series of ozone concentrations were observed. For better understanding the increases and/or decreases in tropospheric ozone in some parts of the world different TM5 model runs with varying anthropogenic emissions will be run in future research.

  17. The Continuous Generation of Equatorial Plasma Bubbles during the Passage of the Solar Terminator, Observed with a Densely-Clustered Network of GPS Receivers in Southeast Asia.

    NASA Astrophysics Data System (ADS)

    Buhari, S. M.; Tsunoda, R. T.; Abdullah, M.; Hasbi, A. M.; Otsuka, Y.; Yokoyama, T.; Nishioka, M.; Tsugawa, T.

    2014-12-01

    Equatorial plasma bubbles (EPBs) are three-dimensional structures of depleted plasma density that are often observed in the nighttime equatorial ionosphere. They are initiated near the magnetic dip equator, in the bottomside of the F layer, and develop with time, upward in altitude and poleward in latitude (into both hemispheres), taking the form of longitudinally-narrow, vertically-extended wedges that penetrate deep into the topside of the F layer. Moreover, these structures drift zonally as they evolve in time. Much of what is not yet known about EPBs stems from our inability (1) to capture spatial descriptions of these structures, and (2) to monitor their evolution as a function of time. An objective of this presentation is to report the existence and availability of total electron content (TEC) data from densely-clustered networks of GPS receivers that are capable of providing time-continuous descriptions of EPBs with both high spatial resolution and broad geographical coverage. The networks include the Malaysia Real-Time Kinematics GNSS Network (MyRTKnet), Sumatera GPS Array (SUGAR) network and International GNSS Service (IGS) located in Southeast Asia (SEA). These networks contain 127 GPS receivers with average spacing of about 50 to 100 km. With the ability to resolve space-time ambiguities, we are able to follow the temporal evolution of EPB structures over an extended longitude sector (90 to 120 degrees, East longitude). We will present results from a case study (April 5, 2011) in which 16 EPBs were detected in longitude and tracked in time. We show, for the first time, that the births of 10 out of 16 observed EPBs coincided with the time of passage of the solar terminator across the longitude of birth. The distance between birth locations varied between 100 and 550 km with 10-minute interval. These EPBs were found to persist for 50 minutes to 7 hours, while drifting eastward at a speed of 92 to 150 ms-1. The finding that as many as 16 EPBs can be

  18. Accuracy in HIV Rapid Testing among Laboratory and Non-laboratory Personnel in Zambia: Observations from the National HIV Proficiency Testing System

    PubMed Central

    Mwangala, Sheila; Musonda, Kunda G.; Monze, Mwaka; Musukwa, Katoba K.; Fylkesnes, Knut

    2016-01-01

    Background Despite rapid task-shifting and scale-up of HIV testing services in high HIV prevalence countries, studies evaluating accuracy remain limited. This study aimed to assess overall accuracy level and factors associated with accuracy in HIV rapid testing in Zambia. Methods Accuracy was investigated among rural and urban HIV testing sites participating in two annual national HIV proficiency testing (PT) exercises conducted in 2009 (n = 282 sites) and 2010 (n = 488 sites). Testers included lay counselors, nurses, laboratory personnel and others. PT panels of five dry tube specimens (DTS) were issued to testing sites by the national reference laboratory (NRL). Site accuracy level was assessed by comparison of reported results to the expected results. Non-parametric rank tests and multiple linear regression models were used to assess variation in accuracy between PT cycles and between tester groups, and to examine factors associated with accuracy respectively. Results Overall accuracy level was 93.1% (95% CI: 91.2–94.9) in 2009 and 96.9% (95% CI: 96.1–97.8) in 2010. Differences in accuracy were seen between the tester groups in 2009 with laboratory personnel being more accurate than non-laboratory personnel, while in 2010 no differences were seen. In both PT exercises, lay counselors and nurses had more difficulties interpreting results, with more occurrences of false-negative, false-positive and indeterminate results. Having received the standard HIV rapid testing training and adherence to the national HIV testing algorithm were positively associated with accuracy. Conclusion The study showed an improvement in tester group and overall accuracy from the first PT exercise to the next. Average number of incorrect test results per 1000 tests performed was reduced from 69 to 31. Further improvement is needed, however, and the national HIV proficiency testing system seems to be an important tool in this regard, which should be continued and needs to be urgently

  19. Country watch: South-East Asia.

    PubMed

    Bagasao, T M

    1996-01-01

    Nongovernmental organizations (NGO) and community-based groups working on HIV/AIDS in Thailand, Sri Lanka, the Philippines, Malaysia, and other countries participated in a February 1991 workshop during which they recognized that human rights are inextricably linked with HIV prevention, the provision of services, and improving the quality of life of people living with HIV/AIDS and other vulnerable, marginalized groups. They also noted how rarely environments were supportive with respect to either legal structures or sociocultural norms. The groups resolved to act as a watchdog, an advocacy and lobbying group to monitor legislation, provide public information, and empower people with HIV/AIDS as visible and active partners. Meeting again in 1993 to assess progress, the groups found few gains in addressing human rights violations such as the denial of medical services to people with HIV/AIDS and the deportation of HIV-positive migrant workers. The Asia Pacific Council of AIDS Service Organizations (APCASO) responded by developing a pilot documentation, monitoring, and reporting system in the region to record HIV-related human rights violations. That system is described. PMID:12347180

  20. Drug problem in southeast and southwest Asia.

    PubMed

    Kulsudjarit, Kongpetch

    2004-10-01

    In 2002, the drug problem in Southeast and Southwest Asia was serious, particularly in the production of opium and heroin in Afghanistan, Myanmar, and Laos, the three largest producers of illicit opium in the world. The increasing illicit manufacture of ATS, particularly methamphetamine, in Southeast Asia, mainly in China and Myanmar, was also a major concern. Some reports indicated that ephedrine, used for illicitly producing methamphetamine in Southeast Asia, is diverted and smuggled out of China and India, whereas caffeine, the adulterant used for producing methamphetamine tablets, is mainly smuggled into Myanmar through its border with Thailand. Seizure data showed a dramatic increase in trafficking in MDMA through Southeast Asia. In terms of the drug epidemic, in 2002, cannabis remained overall the main drug of abuse in all of the countries of Southeast and Southwest Asia. Opiates, mainly opium and heroin, were also the drugs of choice except in Thailand, where opiate abuse declined, but ATS was the main drug of abuse due to its low cost and availability. A significant increase in ATS abuse, amphetamine, methamphetamine, and MDMA among the youth who smoked, sniffed, and inhaled them was reported in Cambodia, China, Indonesia, Laos, Myanmar, the Philippines, and Thailand. Injecting drug use among opiate abusers has been identified as the prime cause of the rapid spread of HIV/AIDS in Southeast and Southwest Asia. PMID:15542748

  1. Alterations in the Fecal Microbiota of Patients with HIV-1 Infection: An Observational Study in A Chinese Population.

    PubMed

    Ling, Zongxin; Jin, Changzhong; Xie, Tiansheng; Cheng, Yiwen; Li, Lanjuan; Wu, Nanping

    2016-01-01

    The available evidence suggests that alterations in gut microbiota may be tightly linked to the increase in microbial translocation and systemic inflammation in patients with human immunodeficiency virus 1 (HIV-1) infection. We profiled the fecal microbiota as a proxy of gut microbiota by parallel barcoded 454-pyrosequencing in 67 HIV-1-infected patients (32 receiving highly active antiretroviral therapy [HAART] and 35 HAART naïve) and 16 healthy controls from a Chinese population. We showed that α-diversity indices did not differ significantly between the healthy control and HIV-1-infected patients. The ratio of Firmicutes/Bacteroidetes increased significantly in HIV-1-infected patients. Several key bacterial phylotypes, including Prevotella, were prevalent in HIV-1-infected patients; whereas Phascolarctobacterium, Clostridium XIVb, Dialister and Megamonas were significantly correlated with systemic inflammatory cytokines. After short-term, effective HAART, the viral loads of HIV-1 were reduced; however, the diversity and composition of the fecal microbiota were not completely restored. and the dysbiosis remained among HIV-1-infected subjects undergoing HAART. Our detailed analysis demonstrated that dysbiosis of fecal microbiota might play an active role in HIV-1 infection. Thus, new insights may be provided into therapeutics that target the microbiota to attenuate the progression of HIV disease and to reduce the risk of gut-linked disease in HIV-1-infected patients. PMID:27477587

  2. Alterations in the Fecal Microbiota of Patients with HIV-1 Infection: An Observational Study in A Chinese Population

    PubMed Central

    Ling, Zongxin; Jin, Changzhong; Xie, Tiansheng; Cheng, Yiwen; Li, Lanjuan; Wu, Nanping

    2016-01-01

    The available evidence suggests that alterations in gut microbiota may be tightly linked to the increase in microbial translocation and systemic inflammation in patients with human immunodeficiency virus 1 (HIV-1) infection. We profiled the fecal microbiota as a proxy of gut microbiota by parallel barcoded 454-pyrosequencing in 67 HIV-1-infected patients (32 receiving highly active antiretroviral therapy [HAART] and 35 HAART naïve) and 16 healthy controls from a Chinese population. We showed that α-diversity indices did not differ significantly between the healthy control and HIV-1-infected patients. The ratio of Firmicutes/Bacteroidetes increased significantly in HIV-1-infected patients. Several key bacterial phylotypes, including Prevotella, were prevalent in HIV-1-infected patients; whereas Phascolarctobacterium, Clostridium XIVb, Dialister and Megamonas were significantly correlated with systemic inflammatory cytokines. After short-term, effective HAART, the viral loads of HIV-1 were reduced; however, the diversity and composition of the fecal microbiota were not completely restored. and the dysbiosis remained among HIV-1-infected subjects undergoing HAART. Our detailed analysis demonstrated that dysbiosis of fecal microbiota might play an active role in HIV-1 infection. Thus, new insights may be provided into therapeutics that target the microbiota to attenuate the progression of HIV disease and to reduce the risk of gut-linked disease in HIV-1-infected patients. PMID:27477587

  3. Understanding how adherence goals promote adherence behaviours: a repeated measure observational study with HIV seropositive patients

    PubMed Central

    2012-01-01

    Background The extent to which patients follow treatments as prescribed is pivotal to treatment success. An exceptionally high level (> 95%) of HIV medication adherence is required to suppress viral replication and protect the immune system and a similarly high level (> 80%) of adherence has also been suggested in order to benefit from prescribed exercise programmes. However, in clinical practice, adherence to both often falls below the desirable level. This project aims to investigate a wide range of psychological and personality factors that may lead to adherence/non-adherence to medical treatment and exercise programmes. Methods HIV positive patients who are referred to the physiotherapist-led 10-week exercise programme as part of the standard care are continuously recruited. Data on social cognitive variables (attitude, intention, subjective norms, self-efficacy, and outcome beliefs) about the goal and specific behaviours, selected personality factors, perceived quality of life, physical activity, self-reported adherence and physical assessment are collected at baseline, at the end of the exercise programme and again 3 months later. The project incorporates objective measures of both exercise (attendance log and improvement in physical measures such as improved fitness level, weight loss, improved circumferential anthropometric measures) and medication adherence (verified by non-invasive hair analysis). Discussion The novelty of this project comes from two key aspects, complemented with objective information on exercise and medication adherence. The project assesses beliefs about both the underlying goal such as following prescribed treatment; and about the specific behaviours such as undertaking the exercise or taking the medication, using both implicit and explicit assessments of patients’ beliefs and attitudes. We predict that i) the way people think about the underlying goal of their treatments explains medication and exercise behaviours over and above

  4. HIV-Positive-to-HIV-Positive Liver Transplantation.

    PubMed

    Calmy, A; van Delden, C; Giostra, E; Junet, C; Rubbia Brandt, L; Yerly, S; Chave, J-P; Samer, C; Elkrief, L; Vionnet, J; Berney, T

    2016-08-01

    Most countries exclude human immunodeficiency virus (HIV)-positive patients from organ donation because of concerns regarding donor-derived HIV transmission. The Swiss Federal Act on Transplantation has allowed organ transplantation between HIV-positive donors and recipients since 2007. We report the successful liver transplantation from an HIV-positive donor to an HIV-positive recipient. Both donor and recipient had been treated for many years with antiretroviral therapy and harbored multidrug-resistant viruses. Five months after transplantation, HIV viremia remains undetectable. This observation supports the inclusion of appropriate HIV-positive donors for transplants specifically allocated to HIV-positive recipients. PMID:27109874

  5. Long-term MAX-DOAS network observations of NO2 in Russia and Asia (MADRAS) during the period 2007-2012: instrumentation, elucidation of climatology, and comparisons with OMI satellite observations and global model simulations

    NASA Astrophysics Data System (ADS)

    Kanaya, Y.; Irie, H.; Takashima, H.; Iwabuchi, H.; Akimoto, H.; Sudo, K.; Gu, M.; Chong, J.; Kim, Y. J.; Lee, H.; Li, A.; Si, F.; Xu, J.; Xie, P.-H.; Liu, W.-Q.; Dzhola, A.; Postylyakov, O.; Ivanov, V.; Grechko, E.; Terpugova, S.; Panchenko, M.

    2014-08-01

    We conducted long-term network observations using standardized Multi-Axis Differential optical absorption spectroscopy (MAX-DOAS) instruments in Russia and ASia (MADRAS) from 2007 onwards and made the first synthetic data analysis. At seven locations (Cape Hedo, Fukue and Yokosuka in Japan, Hefei in China, Gwangju in Korea, and Tomsk and Zvenigorod in Russia) with different levels of pollution, we obtained 80 927 retrievals of tropospheric NO2 vertical column density (TropoNO2VCD) and aerosol optical depth (AOD). In the technique, the optimal estimation of the TropoNO2VCD and its profile was performed using aerosol information derived from O4 absorbances simultaneously observed at 460-490 nm. This large data set was used to analyze NO2 climatology systematically, including temporal variations from the seasonal to the diurnal scale. The results were compared with Ozone Monitoring Instrument (OMI) satellite observations and global model simulations. Two NO2 retrievals of OMI satellite data (NASA ver. 2.1 and Dutch OMI NO2 (DOMINO) ver. 2.0) generally showed close correlations with those derived from MAX-DOAS observations, but had low biases of up to ~50%. The bias was distinct when NO2 was abundantly present near the surface and when the AOD was high, suggesting a possibility of incomplete accounting of NO2 near the surface under relatively high aerosol conditions for the satellite observations. Except for constant biases, the satellite observations showed nearly perfect seasonal agreement with MAX-DOAS observations, suggesting that the analysis of seasonal features of the satellite data were robust. Weekend reduction in the TropoNO2VCD found at Yokosuka and Gwangju was absent at Hefei, implying that the major sources had different weekly variation patterns. While the TropoNO2VCD generally decreased during the midday hours, it increased exceptionally at urban/suburban locations (Yokosuka, Gwangju, and Hefei) during winter. A global chemical transport model, MIROC

  6. Multiple T-cell responses are associated with better control of acute HIV-1 infection: An observational study.

    PubMed

    Sun, Jianping; Zhao, Yan; Peng, Yanchun; Han, Zhen; Liu, Guihai; Qin, Ling; Liu, Sai; Sun, Huanhuan; Wu, Hao; Dong, Tao; Zhang, Yonghong

    2016-07-01

    Cytotoxic T lymphocyte (CTL) responses play pivotal roles in controlling the replication of human immunodeficiency virus type 1 (HIV-1), but the correlation between CTL responses and the progression of HIV-1 infection are controversial on account of HIV immune escape mutations driven by CTL pressure were reported.The acute HIV-1-infected patients from Beijing were incorporated into our study to investigate the effects of CTL response on the progression of HIV-1 infection.A longitudinal study was performed on acute HIV-1-infected patients to clarify the kinetic of T-cell responses, the dynamic of escape mutations, as well as the correlation between effective T-cell response and the progression of HIV infection.Seven human leukocyte antigen-B51+ (HLA-B51+) individuals were screened from 105 acute HIV-1 infectors. The detailed kinetic of HLA-B51-restricted CTL responses was described through blood sampling time points including seroconversion, 3 and 6 months after HIV-1 infection in the 7 HLA-B51+ individuals, by using 16 known HLA-B51 restricted epitopes. Pol743-751 (LPPVVAKEI, LI9), Pol283-289 (TAFTIPSI, TI8), and Gag327-3459 (NANPDCKTI, NI9) were identified as 3 dominant epitopes, and ranked as starting with LI9, followed by TI8 and NI9 in the ability to induce T-cell responses. The dynamics of escape mutations in the 3 epitopes were also found with the same order as T-cell response, by using sequencing for viral clones on blood sampling at seroconversion, 3 and 6 months after HIV-1 infection.We use solid evidence to demonstrate the correlation between T-cell response and HIV-1 mutation, and postulate that multiple T-cell responses might benefit the control of HIV-1 infection, especially in acute infection phase. PMID:27472741

  7. Viral hepatitis and human immunodeficiency virus co-infections in Asia

    PubMed Central

    Utsumi, Takako; Lusida, Maria I

    2015-01-01

    Hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) affect many people in Asian countries, although there are geographic differences. Both HBV and HIV (HBV/HIV) and HCV/HIV co-infections are highly prevalent in Asia. Hetero- and homosexual, injection drug use, and geographic area are strong predictors of HBV, HCV, and HIV serostatus. In HBV endemic regions, the prevalence and genotype distribution of HBV/HIV co-infection is almost comparable with that in the general population. In Japan, where HBV has low endemicity, the prevalence of HBV/HIV co-infection is approximately 10-fold higher than that in the general population, and HBV Ae is the most common subgenotype among HIV infected individuals. Highly active antiretroviral therapy (HAART) is an effective treatment for HIV/Acquired Immune Deficiency Syndrome. Lamivudine, a component of HAART, is an effective treatment for HBV, HIV, and HBV/HIV co-infection; however, cost, emerging drug resistance, antiretroviral-associated liver toxicity and liver-related morbidity due to HCV progression are particular concerns. HCV/HIV co-infection may accelerate the clinical progression of both HCV and HIV. The high prevalence of HBV/HIV and HCV/HIV co-infections in Asia underscores the need to improve prevention and control measures, as fewer evidence-based prevention strategies are available (compared with Western countries). In this review, the most recent publications on the prevalence of HBV/HIV and HCV/HIV co-infections and related issues, such as therapy and problems in Asia, are updated and summarized. PMID:25964874

  8. Measuring the Quality of Data Collection in a Large Observational Cohort of HIV and AIDS

    PubMed Central

    Hillebregt, Mariska; de Lange-de Klerk, Elly; Knol, Dirk; de Wolf, Frank; Smit, Colette

    2010-01-01

    The aim of this study was to examine the quality of data collection by studying the validity of collected data. Data were extracted from the clinic charts of two anonymous outpatients by 38 data collectors. A standard for the data to be collected was determined (168 items). The validity was measured by comparing the collected items with the standard; in this way, the percentages of the collected items that were ‘correct’ could be calculated. The percentage ‘correct’ was higher for clinic chart 1 (mean: 83% correct, SD 7%) than for clinic chart 2 (mean: 78% correct, SD 8%). All categories contained incorrectly collected data. These data were divided into missing data, incorrect start-stop dates, and surplus collected data. Almost all start-stop dates would change into ‘correct’ if ‘monthyear’ was considered correct (instead of the standard ‘daymonthyear’). Not all data collectors used specific protocols, and sources other than the written comments were not always checked. This study shows that a high proportion of data was correctly collected. However, the collection of start-stop dates was not optimal, and the collected data included surplus and missing data. Data collectors should be more knowledgeable about HIV disease and trained in the use of difficult protocols, so that they can better recognize what data to collect and how it should be collected. Among physicians, there should be more agreement about what information to record in the charts, to facilitate data extraction for data collectors. PMID:20657828

  9. Asia needs political commitment to fight AIDS.

    PubMed

    1997-06-01

    Delegates from China, Cambodia, Indonesia, Malaysia, Burma, Thailand, and Vietnam to a Joint UN Program on HIV/AIDS (UNAIDS) workshop in Bangkok urged their governments to give priority to the prevention of HIV and AIDS. There are already approximately 3 million people infected with HIV in Asia. Their numbers should increase by 1-2 million by the year 2000. However, devoid of any prevention measures, 2-5 million more people could instead become infected over the same period. Thailand, where many people have adopted condom use and the patronage of brothels and prostitutes has declined, was noted as a success story at the workshop in preventing the further spread of HIV. The level of risky sexual behavior in Thailand has declined to such an extent that HIV case projections made in 1991 for the year 2000 have been revised to a lower number. An estimated more than 100,000 people are infected with HIV in Indonesia, a country in which the epidemic may grow to 2.5 million cases by 2000 unless successful prevention programs are implemented. PMID:12347936

  10. Harm reduction history, response, and current trends in Asia.

    PubMed

    Thomson, Nicholas

    2013-12-01

    HIV epidemics in Asia have been initially driven through injecting drug use and the use of shared needles and syringes. Molecular epidemiological work has shown that where there is heroin trafficking and use, so too is there HIV. Given the often strict enforcement of national anti-narcotic laws, harm reduction responses to HIV infections driven by injecting drug use have been historically slow. As it became clear that preventing HIV meant embracing harm reduction, many countries in the region have adopted harm reduction as part of their national AIDS strategy and increasingly as part of their national drug strategy. Initial successes have proven that harm reduction, as it pertains to HIV among IDUs, can and does work in Asia. These initial successes have led to more comprehensive scale-up of other essential components of HIV prevention among IDUs, including increased availability of opiate substitution programs. Still, multiple challenges remain as overall coverage of services in the region remains poor. Changes in the availability and patterns of use of drugs, including the exponential increase in the use of amphetamine-type stimulants, is providing ongoing challenges to both the law enforcement and public health sectors. This paper reflects on the history of harm reduction in Asia and the shifting trends forcing policy makers to adapt and expand harm reduction strategies to include an ever widening approach to criminal justice, policing, public health, and human rights. PMID:25264414

  11. Reduce HIV Risk

    MedlinePlus

    ... are increasing among younger people from 13 to 30 years of age. The key to defeating HIV lies ... Control and Prevention (CDC) has used them as models, and Dr. Jemmott was invited to South Africa to help decrease HIV/AIDS there. "For the past 15 years, I have observed how the HIV/AIDS epidemic ...

  12. Genome sequence of a novel HIV-1 circulating recombinant form 54_01B from Malaysia.

    PubMed

    Ng, Kim Tien; Ong, Lai Yee; Takebe, Yutaka; Kamarulzaman, Adeeba; Tee, Kok Keng

    2012-10-01

    We report here the first novel HIV-1 circulating recombinant form (CRF) 54_01B (CRF54_01B) isolated from three epidemiologically unlinked subjects of different risk groups in Malaysia. These recently sampled recombinants showed a complex genome organization composed of parental subtype B' and CRF01_AE, with identical recombination breakpoints observed in the gag, pol, and vif genes. Such a discovery highlights the ongoing active generation and spread of intersubtype recombinants involving the subtype B' and CRF01_AE lineages and indicates the potential of the new CRF in bridging HIV-1 transmission among different risk groups in Southeast Asia. PMID:22997423

  13. Theoretical Foundations of Research Focused on HIV Prevention Among Substance-Involved Women: A Review of Observational and Intervention Studies.

    PubMed

    Auerbach, Judith D; Smith, Laramie R

    2015-06-01

    Although substance use continues to be a significant component of HIV risk among women worldwide, to date, relatively little attention has been paid in research, services, or policy to substance-involved women (SIW). HIV acquisition for SIW stems from transmission risks directly related to substance use and risks associated with sexual activity in which power to negotiate risk and safety are influenced by dynamics of male partnerships, sex work, and criminalization (of both drug use and sex work), among other factors. As such, HIV risk for SIW resides as much in the environment—physical, social, cultural, economic, and political—in which drug use occurs as it does from transmission-related behaviors of individual women. To reduce HIV infections among SIW, it is important to specify the interaction of individual- and environmental-level factors, including, but not limited to those related to women's own substance use, that can and ought to be changed. This involves theorizing about the interplay of gender, substance use, and HIV risk, and incorporating that theoretical understanding into intervention design and evaluation. A review of the published literature focused on HIV prevention among SIW revealed a general lack of theoretical and conceptual foundation specific to the gender-related and environmental drivers of HIV in this population. Greater theoretical linkages to intersectionality and syndemic approaches are recommended to better identify and target relevant mechanisms by which the interplay of gender dynamics and substance use potentiate the likelihood of HIV acquisition and transmission among SIW. PMID:25978481

  14. Late presentation for HIV care across Europe: update from the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) study, 2010 to 2013.

    PubMed

    Mocroft, Amanda; Lundgren, Jens; Antinori, Andrea; Monforte, Antonella d'Arminio; Brännström, Johanna; Bonnet, Fabrice; Brockmeyer, Norbert; Casabona, Jordi; Castagna, Antonella; Costagliola, Dominique; De Wit, Stéphane; Fätkenheuer, Gerd; Furrer, Hansjakob; Jadand, Corinne; Johnson, Anne; Lazanas, Mario; Leport, Catherine; Moreno, Santiago; Mussini, Christina; Obel, Niels; Post, Frank; Reiss, Peter; Sabin, Caroline; Skaletz-Rorowski, Adriane; Suarez-Loano, Ignacio; Torti, Carlo; Warszawski, Josiane; Wittkop, Linda; Zangerle, Robert; Chene, Genevieve; Raben, Dorthe; Kirk, Ole

    2015-01-01

    Late presentation (LP) for HIV care across Europe remains a significant issue. We provide a cross-European update from 34 countries on the prevalence and risk factors of LP for 2010-2013. People aged ≥ 16 presenting for HIV care (earliest of HIV-diagnosis, first clinic visit or cohort enrollment) after 1 January 2010 with available CD4 count within six months of presentation were included. LP was defined as presentation with a CD4 count < 350/mm(3) or an AIDS defining event (at any CD4), in the six months following HIV diagnosis. Logistic regression investigated changes in LP over time. A total of 30,454 people were included. The median CD4 count at presentation was 368/mm(3) (interquartile range (IQR) 193-555/mm(3)), with no change over time (p = 0.70). In 2010, 4,775/10,766 (47.5%) were LP whereas in 2013, 1,642/3,375 (48.7%) were LP (p = 0.63). LP was most common in central Europe (4,791/9,625, 49.8%), followed by northern (5,704/11,692; 48.8%), southern (3,550/7,760; 45.8%) and eastern Europe (541/1,377; 38.3%; p < 0.0001). There was a significant increase in LP in male and female people who inject drugs (PWID) (adjusted odds ratio (aOR)/year later 1.16; 95% confidence interval (CI): 1.02-1.32), and a significant decline in LP in northern Europe (aOR/year later 0.89; 95% CI: 0.85-0.94). Further improvements in effective HIV testing strategies, with a focus on vulnerable groups, are required across the European continent. PMID:26624933

  15. Sex trafficking in South Asia.

    PubMed

    Huda, S

    2006-09-01

    Economic and social inequalities and political conflicts have led to the movement of persons within each country and across the borders in South Asia. Globalization has encouraged free mobility of capital, technology, experts and sex tourism. Illiteracy, dependency, violence, social stigma, cultural stereotypes, gender disparity and endemic poverty, among other factors, place women and children in powerless, non-negotiable situations that have contributed to the emergence and breeding of the cavernous problem of sex trafficking in the entire region. This alarming spread of sex trafficking has fuelled the spread of HIV infection in South Asia, posing a unique and serious threat to community health, poverty alleviation and other crucial aspects of human development. Although the SAARC (South Asian Association for Regional Cooperation) Convention on Trafficking in Women and Children has been an important breakthrough, most of the countries in the region do not have anti-trafficking legislation or means to protect the victims. Countries of the region should make a concerted effort to treat trafficking victims as "victims" of human rights violations in all anti-trafficking strategies and actions. PMID:16846602

  16. Thailand conference prevention efforts point to home. International (Asia).

    PubMed

    1995-10-01

    There are an estimated 800,000 cases of HIV and 24,000 cases of advanced AIDS in Thailand, with some studies projecting that infection rates in Thailand could rise to as high as 4 million by the year 2000 if there is no change in sex behavior. Poverty and unprotected sexual intercourse with HIV-infected prostitutes are two major contributory factors in the high incidence and prevalence of HIV infection in the country. The World Health Organization estimates that 33% of the projected HIV cases worldwide will be in Asia by the year 2000, with India and Thailand taking the lead. More than 2000 delegates from 60 countries attended the Third International Conference on AIDS in Asia and the Pacific held September 17-22, 1995, in Chiang Mai, Thailand. Participants discussed how AIDS is affecting the economic and social fabric of their countries. An estimated 2.5 million Asians are infected with HIV. One former government minister believes that the adverse effects of AIDS upon tourism, foreign investments, remittances from abroad, and the mortality of young, productive Thais has cost Thailand 10 years of development. Thailand has gone the farthest among Asian/Pacific countries to stem the spread of HIV, but much remains to be accomplished. Social prejudice against people with HIV remains prevalent throughout Thailand. PMID:12290611

  17. Central Asia Active Fault Database

    NASA Astrophysics Data System (ADS)

    Mohadjer, Solmaz; Ehlers, Todd A.; Kakar, Najibullah

    2014-05-01

    The ongoing collision of the Indian subcontinent with Asia controls active tectonics and seismicity in Central Asia. This motion is accommodated by faults that have historically caused devastating earthquakes and continue to pose serious threats to the population at risk. Despite international and regional efforts to assess seismic hazards in Central Asia, little attention has been given to development of a comprehensive database for active faults in the region. To address this issue and to better understand the distribution and level of seismic hazard in Central Asia, we are developing a publically available database for active faults of Central Asia (including but not limited to Afghanistan, Tajikistan, Kyrgyzstan, northern Pakistan and western China) using ArcGIS. The database is designed to allow users to store, map and query important fault parameters such as fault location, displacement history, rate of movement, and other data relevant to seismic hazard studies including fault trench locations, geochronology constraints, and seismic studies. Data sources integrated into the database include previously published maps and scientific investigations as well as strain rate measurements and historic and recent seismicity. In addition, high resolution Quickbird, Spot, and Aster imagery are used for selected features to locate and measure offset of landforms associated with Quaternary faulting. These features are individually digitized and linked to attribute tables that provide a description for each feature. Preliminary observations include inconsistent and sometimes inaccurate information for faults documented in different studies. For example, the Darvaz-Karakul fault which roughly defines the western margin of the Pamir, has been mapped with differences in location of up to 12 kilometers. The sense of motion for this fault ranges from unknown to thrust and strike-slip in three different studies despite documented left-lateral displacements of Holocene and late

  18. Year-round observations of water-soluble ionic species and trace metals in Sapporo aerosols: implication for significant contributions from terrestrial biological sources in Northeast Asia

    NASA Astrophysics Data System (ADS)

    Pavuluri, C. M.; Kawamura, K.; Mihalopoulos, N.; Fu, P.

    2013-03-01

    High aerosol loadings are prevalent in the atmosphere of East Asia, where the aerosols impact the Earth's climate system and human health; however, their sources and seasonal variations are not clearly understood. To better understand the sources of water-soluble ionic species and trace metals in Northeast Asia, we studied atmospheric aerosol samples collected in Sapporo, northern Japan for one-year period. SO42- (average 3.47 ± 1.03 μg m-3) was found as the most abundant ionic species, which accounted for on average 43 ± 15% of the measured total ionic mass followed by Cl- (13 ± 12%) ≈ NO3- ≈ Na+ > NH4+ > Ca2+ > Mg2+ > K+ > MSA-. Among the metals determined, Ca was found as the most abundant (45 ± 5.2%) followed by Fe (27 ± 4.5%), Al (21± 3.1%), Zn (3.2 ± 1.7), Ti, Mn, Ni, Pb, Cu, V, As, Cr and Cd. Based on factor analysis, linear relations of selected species with biomarkers, and backward air mass trajectories, we found that long-range atmospheric transport of soil dust (∼ 33%) from arid regions of Mongolia and/or Northeast China is a major source for Sapporo aerosols as well as terrestrial biogenic emissions (≥ 24%) including microbial activities and biomass burning mostly from distant source region(s) (e.g. Siberia). We also found that the contributions of soil dust to the aerosols maximized in early spring whereas those of vegetational emissions maximized in spring/summer. Contributions of microbial activities to aerosols peaked in autumn whereas forest fires/biomass burning peaked in autumn/winter. On the contrary, fossil fuel combustion/industrial activities and oceanic emissions to Sapporo aerosols are suggested to be rather minor. This study also suggests that fungal spores contribute to some trace metals (i.e. Ni, Cu, As) while pollen contributes to Zn in aerosols.

  19. Counseling to reduce high-risk sexual behavior in HIV care: a multi-center, direct observation study.

    PubMed

    Flickinger, Tabor E; Berry, Stephen; Korthuis, P Todd; Saha, Somnath; Laws, M Barton; Sharp, Victoria; Moore, Richard D; Beach, Mary Catherine

    2013-07-01

    A key opportunity to reduce HIV transmission lies with healthcare providers counseling HIV-infected patients about safer sex. We audio-recorded and transcribed clinical encounters between 45 healthcare providers and 417 of their HIV-infected patients at four outpatient sites in the United States. We used logistic regressions to evaluate associations between patient and provider characteristics, and the occurrence of discussion (any talk about sex) and counseling (advice about safer sex). Of the 417 encounters, discussion of sex occurred in 187 (45% of encounters, 95% CI: 40-50%). Counseling occurred for 49% (95% CI: 35-63%) of patients reporting unsafe sex. Discussion of sex was more likely with younger or less-educated patients and with less cultural difference between patient and provider, while counseling was associated with greater provider mindfulness and lower provider empathy. These findings suggest targets to improve communication regarding sexual risk reduction in HIV care. PMID:23802144

  20. Weight as predictors of clinical progression and treatment failure: Results from the TREAT Asia Pediatric HIV Observational Database (TApHOD)

    PubMed Central

    Kariminia, Azar; Durier, Nicolas; Jourdain, Gonzague; Saghayam, Suneeta; Do, Chau V.; Van Nguyên, Lam; Hansudewechakul, Rawiwan; Lumbiganon, Pagakrong; Chokephaibulkit, Kulkanya; Truong, Khanh Huu; Sirisanthana, Virat; Ung, Vibol; Vonthanak, Saphonn; Ananworanich, Jintanat; Yusoff, Nik Khairulddin N.; Kurniati, Nia; Razali, Kamarul Azahar; Fong, Moy Siew; Nallusamy, Revathy; Wati, Dewi Kumara

    2014-01-01

    Objective To evaluate the value of time-updated weight and height in predicting clinical progression, immunological and virological failure in children receiving combination antiretroviral therapy (cART). Methods We used Cox regression to analyse data of a cohort of Asian children. Results 2608 children were included; median age at cART was 5.7 years. Time-updated weight for age Z score <−3 was associated with mortality (P < 0.001) independent of CD4%; and <−2 was associated with immunological failure (P ≤ 0.03) independent of age at cART. Conclusion Weight monitoring provides useful data to inform clinical management of children on cART in resource-limited settings. PMID:24872132

  1. [Epidemiology of HIV].

    PubMed

    Ledergerber, Bruno; Battegay, Manuel

    2014-08-01

    Globally, an estimated 35 million people were living with HIV in 2012; of these, 69 % in sub-Saharan Africa. There were 2.3 million new HIV infections globally and 1.6 million AIDS deaths in 2012. As a result of large roll-out programs with integrated voluntary counselling and testing and prevention programs in resource limited settings, sexual transmission of HIV decreased substantially over the last years. However, the world is not on track to reduced HIV transmission among people who inject drugs. Especially in Eastern Europe and Asia prevention coverage for people who inject drugs remains low. In addition, effective prevention among these people is undermined by stigmatisation, discrimination, punitive policy frameworks and law enforcement practices, which discourage people from seeking the health and social services they need. Antiretroviral coverage among pregnant women living with HIV reached 62 % in 2012 resulting in a reduction of newly infected children by 35 % from 2009. In 2012, 9.7 million people in low and middle-income countries received antiretroviral therapy, representing 61 % of all who were eligible under the 2010 WHO HIV treatment guidelines. Under the 2013 guidelines, this represents only 34 % of the 28.3 million people eligible in 2013. A new concept to curb the HIV epidemic is "Test and Treat" which involves population-wide HIV tests with immediate initiation of antiretroviral therapy among all HIV infected individuals. However, there are concerns regarding the sustainability of such treatment programs for decades due to lost to follow up and insufficient adherence and the danger of a large increase of resistant HIV which jeopardize the effectiveness of affordable treatments. PMID:25093307

  2. The Number and Complexity of Pure and Recombinant HIV-1 Strains Observed within Incident Infections during the HIV and Malaria Cohort Study Conducted in Kericho, Kenya, from 2003 to 2006.

    PubMed

    Billings, Erik; Sanders-Buell, Eric; Bose, Meera; Bradfield, Andrea; Lei, Esther; Kijak, Gustavo H; Arroyo, Miguel A; Kibaya, Rukia M; Scott, Paul T; Wasunna, Monique K; Sawe, Frederick K; Shaffer, Douglas N; Birx, Deborah L; McCutchan, Francine E; Michael, Nelson L; Robb, Merlin L; Kim, Jerome H; Tovanabutra, Sodsai

    2015-01-01

    Characterization of HIV-1 subtype diversity in regions where vaccine trials are conducted is critical for vaccine development and testing. This study describes the molecular epidemiology of HIV-1 within a tea-plantation community cohort in Kericho, Kenya. Sixty-three incident infections were ascertained in the HIV and Malaria Cohort Study conducted in Kericho from 2003 to 2006. HIV-1 strains from 58 of those individuals were full genome characterized and compared to two previous Kenyan studies describing 41 prevalent infections from a blood bank survey (1999-2000) and 21 infections from a higher-risk cohort containing a mix of incident and prevalent infections (2006). Among the 58 strains from the community cohort, 43.1% were pure subtypes (36.2% A1, 5.2% C, and 1.7% G) and 56.9% were inter-subtype recombinants (29.3% A1D, 8.6% A1CD, 6.9% A1A2D, 5.2% A1C, 3.4% A1A2CD, and 3.4% A2D). This diversity and the resulting genetic distance between the observed strains will need to be addressed when vaccine immunogens are chosen. In consideration of current vaccine development efforts, the strains from these three studies were compared to five candidate vaccines (each of which are viral vectored, carrying inserts corresponding to parts of gag, pol, and envelope), which have been developed for possible use in sub-Saharan Africa. The sequence comparison between the observed strains and the candidate vaccines indicates that in the presence of diverse recombinants, a bivalent vaccine is more likely to provide T-cell epitope coverage than monovalent vaccines even when the inserts of the bivalent vaccine are not subtype-matched to the local epidemic. PMID:26287814

  3. AED in Asia

    ERIC Educational Resources Information Center

    Academy for Educational Development, 2004

    2004-01-01

    Founded in 1961, the Academy for Educational Development (AED) is an independent, nonprofit, charitable organization that operates development programs in the United States and throughout the world. This directory presents an overview of AED endeavors in Asia. AED's work in Asia has centered on institution-building, taking advantage of its…

  4. ESP in Southeast Asia.

    ERIC Educational Resources Information Center

    Crooks, Tony, Ed.

    Seven conference papers discuss English language training and political development in Asia, including language project design and evaluation, counterparting, sustainability, appropriate technology, and languages and the politics of development. Papers included are: "Linguistic and Cultural Considerations of Writing ELT Texts for Use in Asia"…

  5. Loss to Follow-Up as a Competing Risk in an Observational Study of HIV-1 Incidence

    PubMed Central

    Graham, Susan M.; Raboud, Janet; McClelland, R. Scott; Jaoko, Walter; Ndinya-Achola, Jeckoniah; Mandaliya, Kishor; Overbaugh, Julie; Bayoumi, Ahmed M.

    2013-01-01

    Objective Conventional survival estimates may be biased if loss to follow-up (LTF) is associated with the outcome of interest. Our goal was to assess whether the association between sexual risk behavior and HIV-1 acquisition changed after accounting for LTF with competing risks regression. Methods HIV-1-seronegative women who enrolled in a Kenyan sex worker cohort from 1993–2007 were followed prospectively and tested for HIV at monthly clinic visits. Our primary predictor was self-reported sexual risk behavior in the past week, analyzed as a time-dependent covariate. Outcomes included HIV-1 acquisition and LTF. We analyzed the data using Cox proportional hazards regression and competing risks regression, in which LTF was treated as a competing event. Results A total of 1,513 women contributed 4,150 person-years (py), during which 198 (13.1%) acquired HIV-1 infection (incidence, 4.5 per 100 py) and 969 (64.0%) were LTF (incidence, 23.4 per 100 py). After adjusting for potential confounders, women reporting unprotected sex with multiple partners were less likely to be lost to follow-up (adjusted sub-hazard ratio (aSHR) 0.50, 95% confidence interval (CI) 0.32–0.76, relative to no sexual activity). The risk of HIV-1 acquisition after reporting unprotected sex with multiple partners was similar with Cox regression (adjusted hazard ratio (aHR) 2.41, 95% CI 1.36–4.27) and competing risks regression (aSHR 2.47, 95% CI 1.33–4.58). Conclusions Unprotected sex with multiple partners was associated with higher HIV-1 acquisition risk, but lower attrition. This differential attrition did not substantially bias Cox regression estimates when compared to competing risks regression results. PMID:23555041

  6. Asia-MIP: Multi Model-data Synthesis of Terrestrial Carbon Cycles in Asia

    NASA Astrophysics Data System (ADS)

    Ichii, K.; Kondo, M.; Ito, A.; Kang, M.; Sasai, T.; SATO, H.; Ueyama, M.; Kobayashi, H.; Saigusa, N.; Kim, J.

    2013-12-01

    Asia, which is characterized by monsoon climate and intense human activities, is one of the prominent understudied regions in terms of terrestrial carbon budgets and mechanisms of carbon exchange. To better understand terrestrial carbon cycle in Asia, we initiated multi-model and data intercomparison project in Asia (Asia-MIP). We analyzed outputs from multiple approaches: satellite-based observations (AVHRR and MODIS) and related products, empirically upscaled estimations (Support Vector Regression) using eddy-covariance observation network in Asia (AsiaFlux, CarboEastAsia, FLUXNET), ~10 terrestrial biosphere models (e.g. BEAMS, Biome-BGC, LPJ, SEIB-DGVM, TRIFFID, VISIT models), and atmospheric inversion analysis (e.g. TransCom models). We focused on the two difference temporal coverage: long-term (30 years; 1982-2011) and decadal (10 years; 2001-2010; data intensive period) scales. The regions of covering Siberia, Far East Asia, East Asia, Southeast Asia and South Asia (60-80E, 10S-80N), was analyzed in this study for assessing the magnitudes, interannual variability, and key driving factors of carbon cycles. We will report the progress of synthesis effort to quantify terrestrial carbon budget in Asia. First, we analyzed the recent trends in Gross Primary Productivities (GPP) using satellite-based observation (AVHRR) and multiple terrestrial biosphere models. We found both model outputs and satellite-based observation consistently show an increasing trend in GPP in most of the regions in Asia. Mechanisms of the GPP increase were analyzed using models, and changes in temperature and precipitation play dominant roles in GPP increase in boreal and temperate regions, whereas changes in atmospheric CO2 and precipitation are important in tropical regions. However, their relative contributions were different. Second, in the decadal analysis (2001-2010), we found that the negative GPP and carbon uptake anomalies in 2003 summer in Far East Asia is one of the largest

  7. Bacteremia as a Cause of Fever in Ambulatory, HIV-Infected Mozambican Adults: Results and Policy Implications from a Prospective Observational Study

    PubMed Central

    Moon, Troy D.; Silva, Wilson P.; Buene, Manuel; Morais, Luís; Valverde, Emilio; Vermund, Sten H.; Brentlinger, Paula E.

    2013-01-01

    Fever is typically treated empirically in rural Mozambique. We examined the distribution and antimicrobial susceptibility patterns of bacterial pathogens isolated from blood-culture specimens, and clinical characteristics of ambulatory HIV-infected febrile patients with and without bacteremia. This analysis was nested within a larger prospective observational study to evaluate the performance of new Mozambican guidelines for fever and anemia in HIV-infected adults (clinical trial registration NCT01681914, www.clinicaltrials.gov); the guidelines were designed to be used by non-physician clinicians who attended ambulatory HIV-infected patients in very resource-constrained peripheral health units. In 2012 (April-September), we recruited 258 HIV-infected adults with documented fever or history of recent fever in three sites within Zambézia Province, Mozambique. Although febrile patients were routinely tested for malaria, blood culture capacity was unavailable in Zambézia prior to study initiation. We confirmed bacteremia in 39 (15.1%) of 258 patients. The predominant organisms were non-typhoid Salmonella, nearly all resistant to multiple first-line antibiotics (ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole). Features most associated with bacteremia included higher temperature, lower CD4+ T-lymphocyte count, lower hemoglobin, and headache. Introduction of blood cultures allowed us to: 1) confirm bacteremia in a substantial proportion of patients; 2) tailor specific antimicrobial therapy for confirmed bacteremia based on known susceptibilities; 3) make informed choices of presumptive antibiotics for patients with suspected bacteremia; and 4) construct a preliminary clinical profile to help clinicians determine who would most likely benefit from presumptive bacteremia treatment. Our findings demonstrate that in resource-limited settings, there is urgent need to expand local microbiologic capacity to better identify and treat cases of bacteremia in HIV

  8. Lack of Effectiveness of Antiretroviral Therapy in Preventing HIV Infection in Serodiscordant Couples in Uganda: An Observational Study

    PubMed Central

    Birungi, Josephine; Min, Jeong Eun; Muldoon, Katherine A.; Kaleebu, Pontiano; King, Rachel; Khanakwa, Sarah; Nyonyintono, Maureen; Chen, YaLin; Mills, Edward J.; Lyagoba, Fred; Ragonnet-Cronin, Manon; Wangisi, Jonathan; Lourenco, Lillian; Moore, David M.

    2015-01-01

    Background We examined the real-world effectiveness of ART as an HIV prevention tool among HIV serodiscordant couples in a programmatic setting in a low-income country. Methods We enrolled individuals from HIV serodiscordant couples aged ≥18 years of age in Jinja, Uganda from June 2009 – June 2011. In one group of couples the HIV positive partner was receiving ART as they met clinical eligibility criteria (a CD4 cell count ≤250 cells/ μL or WHO Stage III/IV disease). In the second group the infected partner was not yet ART-eligible. We measured HIV incidence by testing the uninfected partner every three months. We conducted genetic linkage studies to determine the source of new infections in seroconverting participants. Results A total of 586 couples were enrolled of which 249 (42%) of the HIV positive participants were receiving ART at enrollment, and an additional 99 (17%) initiated ART during the study. The median duration of follow-up was 1.5 years. We found 9 new infections among partners of participants who had been receiving ART for at least three months and 8 new infections in partners of participants who had not received ART or received it for less than three months, for incidence rates of 2.09 per 100 person-years (PYRs) and 2.30 per 100 PYRs, respectively. The incidence rate ratio for ART-use was 0.91 (95% confidence interval 0.31-2.70; p=0.999). The hazard ratio for HIV seroconversion associated with ART-use by the positive partner was 1.07 (95% CI 0.41-2.80). A total of 5/7 (71%) of the transmissions on ART and 6/7 (86%) of those not on ART were genetically linked. Conclusion Overall HIV incidence was low in comparison to previous studies of serodiscordant couples. However, ART-use was not associated with a reduced risk of HIV transmission in this study. PMID:26171777

  9. Decreasing intensity of the last glacial stadials in low latitude terrestrial East Asia inferred by a new observation of pollen records in central Taiwan

    NASA Astrophysics Data System (ADS)

    Liew, Ping-Mei; Chen, Bing-Cheng; Hsieh, Meng-Long; Huang, Shu-Yue; Lee, Cheng-Yi

    2013-06-01

    The cold intensity of the last glacial stadials corresponding to marine isotope stage (MIS) 5d (or 5b), MIS 4 and MIS 2 in terrestrial East Asia monsoon area is not discussed much due to the paucity of long continuous pollen records. A palynological study of drilling cores from three closely-linked intramontane basins (Toushe, Sun-moon Lake and Yuchi) in central Taiwan provides a history of shifting altitudinal vegetation zones in surrounding mountains during late Quaternary climate changes. By integrating these records, we found that the alpine conifer forest approached its lowest altitude, about 614 m, during the earliest stadial (≒MIS 5d or 5b), and 745 m during the early stadial (≒MIS 4) based on records of Yuchi Basin and Sun-moon Lake. In addition, the pollen records of Toushe Basin and Sun-moon Lake show more temperate conditions for the late stadial (≒MIS 2) than the early stadial (≒MIS 4). This leads to an interpretation of a decreasing intensity of stadials during the last glaciation, which might follow the regional insolation amplitude. Such a decreasing trend in coldness during the last glacial stadials does not exist in the record for the South China Sea which reflects a different sensitivity and response to climatic forcings between terrestrial and marine.

  10. Applying artificial neural network to derive long-term foF2 trends in the Asia/Pacific sector from ionosonde observations

    NASA Astrophysics Data System (ADS)

    Yue, Xinan; Wan, Weixing; Liu, Libo; Ning, Baiqi; Zhao, Biqiang

    2006-10-01

    An artificial neural network (ANN) method is first used for deriving long-term trends of the F2-layer critical frequency (foF2) at 19 ionospheric stations in the Asia/Pacific sector. It is found that the ANN method can eliminate the geomagnetic activity effect on foF2 more effectively than usual regression methods. Of the selected 19 stations, there are significant long-term trends corresponding to a confidence level ≥90% at 14 stations and 12 of these stations present negative trends. An average trend of -0.05% per year in the selected area can be obtained if the 12 stations with significant negative long-term trends be considered. No pronounced diurnal and latitudinal effects in trends and no uniform pattern of seasonal variation in most stations are detected. The long-term trends for low latitude and equatorial stations differ from other stations suggest that some special dynamical processes may take effects in the equatorial anomaly region. Many factors which can influence ionosphere, such as the greenhouse effect, solar and geomagnetic activity, and neutral background gas, might contribute to the trend.

  11. Validation of the on-line aerosol retrieval and error characterization algorithm from the OMI Near-UV observations during the DRAGON-NE Asia 2012 campaign

    NASA Astrophysics Data System (ADS)

    Jeong, U.; Ahn, C.; Kim, J.; Bhartia, P. K.; Torres, O.; Spurr, R. J. D.; Liu, X.; Chance, K.; Holben, B. N.

    2014-12-01

    One of the representative advantages of using ultraviolet channel to retrieve aerosol optical property is that the results are less affected by the uncertainty of surface reflectance database. The retrieved aerosol products have relatively uniform quality at both land and ocean except the ice-snow surface. The near UV technique of aerosol remote sensing has additional merit that it has long period database since TOMS (Total Ozone Mapping Spectrometer) including aerosol absorption properties. Thus the retrieved product using the near UV technique using TOMS and OMI (Ozone Monitoring Instrument) measurement is quite appropriate for climatological research. For such purposes, assessment of accuracy of the retrieved product is essential to evaluate the radiative forcing of the aerosols. In this study, the error characterizations of the near UV technique using OMI measurements have been performed with the optimal estimation method during the DRAGON-NE Asia 2012 campaign. In order to avoid the interpolation error, we developed the on-line retrieval scheme based on the traditional near UV method. The retrieval noise and smoothing error of retrieved AOT (Aerosol Optical Thickness) were compared with the biases between 380 nm AOT from AERONET and retrieved 388 nm AOT. They showed positive correlations which infer the possibility of the estimated errors using the optimal estimation method to be used to evaluate the error of retrieved products. Forward model parameter errors were analyzed separately which depends on the quality of the used database, thus can be reduced by improving the database.

  12. Neurology in Asia.

    PubMed

    Tan, Chong-Tin

    2015-02-10

    Asia is important as it accounts for more than half of the world population. The majority of Asian countries fall into the middle income category. As for cultural traditions, Asia is highly varied, with many languages spoken. The pattern of neurologic diseases in Asia is largely similar to the West, with some disease features being specific to Asia. Whereas Asia constitutes 60% of the world's population, it contains only 20% of the world's neurologists. This disparity is particularly evident in South and South East Asia. As for neurologic care, it is highly variable depending on whether it is an urban or rural setting, the level of economic development, and the system of health care financing. To help remedy the shortage of neurologists, most counties with larger populations have established training programs in neurology. These programs are diverse, with many areas of concern. There are regional organizations serving as a vehicle for networking in neurology and various subspecialties, as well as an official journal (Neurology Asia). The Asian Epilepsy Academy, with its emphasis on workshops in various locations, EEG certification examination, and fellowships, may provide a template of effective regional networking for improving neurology care in the region. PMID:25666629

  13. Identifying Perceived Barriers along the HIV Care Continuum: Findings from Providers, Peer Educators, and Observations of Provider–Patient Interactions in Ethiopia

    PubMed Central

    Kulkarni, Sarah; Hoffman, Susie; Gadisa, Tsigereda; Melaku, Zenebe; Fantehun, Mesganaw; Yigzaw, Muluneh; El-Sadr, Wafaa; Remien, Robert; Tymejczyk, Olga; Nash, Denis; Elul, Batya

    2015-01-01

    Increasing the proportion of HIV-positive individuals who link promptly to and are retained in care remains challenging in sub- Saharan Africa, but little evidence is available from the provider perspective. In 4 Ethiopian health facilities, we (1) interviewed providers and peer educators about their perceptions of service delivery- and patient-level barriers and (2) observed provider–patient interactions to characterize content and interpersonal aspects of counseling. In interviews, providers and peer educators demonstrated empathy and identified nonacceptance of HIV status, anticipated stigma from unintended disclosure, and fear of antiretroviral therapy as patient barriers, and brusque counseling and insufficient counseling at provider-initiated testing sites as service delivery-related. However, observations from the same clinics showed that providers often failed to elicit patients’ barriers to retention, making it unlikely these would be addressed during counseling. Training is needed to improve interpersonal aspects of counseling and ensure providers elicit and address barriers to HIV care experienced by patients. PMID:26173944

  14. Identifying Perceived Barriers along the HIV Care Continuum: Findings from Providers, Peer Educators, and Observations of Provider-Patient Interactions in Ethiopia.

    PubMed

    Kulkarni, Sarah; Hoffman, Susie; Gadisa, Tsigereda; Melaku, Zenebe; Fantehun, Mesganaw; Yigzaw, Muluneh; El-Sadr, Wafaa; Remien, Robert; Tymejczyk, Olga; Nash, Denis; Elul, Batya

    2016-07-01

    Increasing the proportion of HIV-positive individuals who link promptly to and are retained in care remains challenging in sub-Saharan Africa, but little evidence is available from the provider perspective. In 4 Ethiopian health facilities, we (1) interviewed providers and peer educators about their perceptions of service delivery- and patient-level barriers and (2) observed provider-patient interactions to characterize content and interpersonal aspects of counseling. In interviews, providers and peer educators demonstrated empathy and identified nonacceptance of HIV status, anticipated stigma from unintended disclosure, and fear of antiretroviral therapy as patient barriers, and brusque counseling and insufficient counseling at provider-initiated testing sites as service delivery-related. However, observations from the same clinics showed that providers often failed to elicit patients' barriers to retention, making it unlikely these would be addressed during counseling. Training is needed to improve interpersonal aspects of counseling and ensure providers elicit and address barriers to HIV care experienced by patients. PMID:26173944

  15. Reconstructing the epidemic history of HIV-1 circulating recombinant forms CRF07_BC and CRF08_BC in East Asia: the relevance of genetic diversity and phylodynamics for vaccine strategies.

    PubMed

    Takebe, Yutaka; Liao, Huanan; Hase, Saiki; Uenishi, Rie; Li, Yue; Li, Xiao-Jie; Han, Xiaoxu; Shang, Hong; Kamarulzaman, Adeeba; Yamamoto, Naoki; Pybus, Oliver G; Tee, Kok Keng

    2010-05-26

    HIV-1 CRF07_BC and CRF08_BC are closely related circulating recombinant forms (CRFs) with serious public health consequences in China. The temporal and spatial dynamics of these CRFs were determined by estimating their times of divergence, using phylogenetic and Bayesian coalescent methods. Studies of the timelines of CRF07_BC and CRF08_BC trace the expansion of these strains back their origins to Yunnan province. The present study highlights the relevance of incorporating evolutionary and molecular epidemiological analyses into an in-depth understanding of the genesis of HIV epidemic, providing information for determining regional and global public health policies, including future vaccine strategies. PMID:20510742

  16. Sentinel Asia step 2 utilization for disaster management in Malaysia

    NASA Astrophysics Data System (ADS)

    Moslin, S. I.; Wahap, N. A.; Han, O. W.

    2014-02-01

    With the installation of Wideband InterNetworking engineering test and Demonstration Satellite (WINDS) communication system in the National Space Centre, Banting; officially Malaysia is one of the twelve Sentinel Asia Step2 System Regional Servers in the Asia Pacific region. The system will be dedicated to receive and deliver images of disaster struck areas observed by Asia Pacific earth observation satellites by request of the Sentinel Asia members via WINDS satellite or 'Kizuna'. Sentinel Asia is an initiative of collaboration between space agencies and disaster management agencies, applying remote sensing and web-GIS technologies to assist disaster management in Asia Pacific. When a disaster occurred, participating members will make an Emergency Observation Request (EOR) to the Asian Disaster Reduction Centre (ADRC). Subsequently, the Data Provider Node (DPN) will execute the emergency observation using the participating earth observation satellites. The requested images then will be processed and analysed and later it will be uploaded on the Sentinel Asia website to be utilised for disaster management and mitigation by the requestor and any other international agencies related to the disaster. Although the occurrences of large scale natural disasters are statistically seldom in Malaysia, but we can never be sure with the unpredictable earth climate nowadays. This paper will demonstrate the advantage of using Sentinel Asia Step2 for local disaster management. Case study will be from the recent local disaster occurrences. In addition, this paper also will recommend a local disaster management support system by using the Sentinel Asia Step2 facilities in ANGKASA.

  17. Observations on two cases of apparent submandibular gland cysts in HIV positive patients: MR and CT findings

    SciTech Connect

    Gottesman, R.I.; Som, P.M.; Mester, J.; Silvers, A.R.

    1996-05-01

    To present two cases of probable lymphoepithelial cysts of the submandibular glands in patients who were human immunodeficiency virus (HIV) positive and who also had lymphoepithelial cysts of the parotid glands. Computed tomography and MRI of two HIV positive patients with lymphoepithelial cysts of the parotid glands and cysts in tile submandibular glands were correlated with the histories and the possible presence of other known causes of submandibular gland multiple cysts. Because of the present treatment philosophy regarding HIV positive patients with major salivary gland cysts, surgical resection of these glands was not performed. All other known causes of multiple submandibular gland cysts were excluded by either history or laboratory data. Computed tomography and MRI on two patients with known HIV infection and bilateral parotid lymphoepithelial cysts are presented. Both patients also had bilateral multiple submandibular gland cysts and no evidence of obstructive glandular diseases autoimmune disease, or other organ system cysts. These cases of presumed submandibular gland lymphoepithelial cysts are rare in the literature. They are presented in the hope that other radiologists will be stimulated to document the occurrence of this entity. 22 refs., 2 figs.

  18. Stroke in Asia.

    PubMed

    Thammaroj, Jureerat; Subramaniam, Valarmathi; Bhattacharya, Joti J

    2005-05-01

    The epidemic of cardiovascular disease across most of Asia is at a different stage from that in the West; the incidence and prevalence of stroke are increasing steadily, associated with nutritional changes and aging of the population. Epidemiologic data, crucial in combating stroke, have been relatively sparse in Asian populations, but a few international collaborative studies on stroke have been in progress for several years. Through these, we now know that ischemic stroke is actually the most frequent type of cerebrovascular accident in Asia, although hemorrhagic stroke remains more common in Asia than in the West. Also, the percentage of ischemic stroke attributable to intracranial vascular disease is much higher than in the West. In Japan and a few other countries, stroke rates are declining; however, increasing rates in most other countries make primary prevention of critical importance in minimizing the severe impact of this epidemic in Asia. PMID:16198940

  19. Pass Over Southeastern Asia

    NASA Video Gallery

    This video over Southeastern Asia was taken by the crew of Expedition 29 aboard the International Space Station. This sequence of shots was taken on Oct. 7, 2011, from 12:41:10 to 12:50:46 GMT, on ...

  20. Scaling Up Paediatric HIV Care with an Integrated, Family-Centred Approach: An Observational Case Study from Uganda

    PubMed Central

    Luyirika, Emmanuel; Towle, Megan S.; Achan, Joyce; Muhangi, Justus; Senyimba, Catherine; Lule, Frank; Muhe, Lulu

    2013-01-01

    Family-centred HIV care models have emerged as an approach to better target children and their caregivers for HIV testing and care, and further provide integrated health services for the family unit’s range of care needs. While there is significant international interest in family-centred approaches, there is a dearth of research on operational experiences in implementation and scale-up. Our retrospective case study examined best practices and enabling factors during scale-up of family-centred care in ten health facilities and ten community clinics supported by a non-governmental organization, Mildmay, in Central Uganda. Methods included key informant interviews with programme management and families, and a desk review of hospital management information systems (HMIS) uptake data. In the 84 months following the scale-up of the family-centred approach in HIV care, Mildmay experienced a 50-fold increase of family units registered in HIV care, a 40-fold increase of children enrolled in HIV care, and nearly universal coverage of paediatric cotrimoxazole prophylaxis. The Mildmay experience emphasizes the importance of streamlining care to maximize paediatric capture. This includes integrated service provision, incentivizing care-seeking as a family, creating child-friendly service environments, and minimizing missed paediatric testing opportunities by institutionalizing early infant diagnosis and provider-initiated testing and counselling. Task-shifting towards nurse-led clinics with community outreach support enabled rapid scale-up, as did an active management structure that allowed for real-time review and corrective action. The Mildmay experience suggests that family-centred approaches are operationally feasible, produce strong coverage outcomes, and can be well-managed during rapid scale-up. PMID:23936337

  1. Does hormonal contraceptive use increase women’s risk of HIV acquisition? A meta-analysis of observational studies

    PubMed Central

    Ralph, Lauren J.; McCoy, Sandra I.; Shiu, Karen; Padian, Nancy S.

    2015-01-01

    Background Epidemiologic research has yielded inconsistent evidence on whether use of hormonal contraception (HC) increases women’s risk of HIV acquisition. A robust meta-analysis of existing data can yield a valid summary estimate to inform guidelines, models and future studies. Methods We updated a recent systematic review to identify studies examining the relationship between various HC methods and women’s risk of HIV. We assessed statistical heterogeneity, and, when appropriate, combined point estimates using random effects models. We explored heterogeneity through subgroup and stratified analyses according to study populations and design features. Findings We identified 26 studies, 12 of which met inclusion criteria. There was evidence of a modest increase in HIV risk in the ten studies examining depot-medroxyprogesterone acetate (DMPA) [pooled relative risk (RR) =1.40, 95% CI: 1.16, 1.69]. This risk was lower in the eight studies conducted with women in the general population [pooled RR=1.31, 95% CI: 1.10, 1.57]. There was substantial between study heterogeneity in secondary analyses of trials (n=7, I2=51.1%). Although individual study estimates suggested an elevated risk, substantial heterogeneity between the two studies conducted with high risk women (I2=54%) precluded pooling estimates. There was no evidence of an elevated HIV risk in the ten studies examining oral contraceptive pills (OCPs) [pooled RR = 1.00, 95% CI: 0.86, 1.16] or the five studies examining norethisterone enanthate (Net-En) ([pooled RR=1.10; 95% CI: 0.88, 1.37]. Interpretation The risks of HIV found here would not merit complete withdrawal of DMPA, OCPs, or Net-En from the contraceptive method mix in most settings for women in the general population. PMID:25578825

  2. Diagnosis of Photochemical Ozone Production Rates and Limiting Factors based on Observation-based Modeling Approach over East Asia: Impact of Radical Chemistry Mechanism and Ozone-Control Implications

    NASA Astrophysics Data System (ADS)

    Kanaya, Y.

    2015-12-01

    Growth of tropospheric ozone, causing health and climate impacts, is concerned over East Asia, because emissions of precursors have dramatically increased. Photochemical production rates of ozone and limiting factors, primarily studied for urban locations, have been poorly assessed within a perspective of regional-scale air pollution over East Asia. We performed comprehensive observations of ozone precursors at several locations with regional representativeness and made such assessment based on the observation-based modeling approach. Here, diagnosis at Fukue Island (32.75°N, 128.68°E) remotely located in western Japan (May 2009) is highlighted, where the highest 10% of hourly ozone concentrations reached 72‒118 ppb during May influenced by Asian continental outflow. The average in-situ ozone production rate was estimated to be 6.8 ppb per day, suggesting that in-travel production was still active, while larger buildup must have occurred beforehand. Information on the chemical status of the air mass arriving in Japan is important, because it affects how further ozone production occurs after precursor addition from Japanese domestic emissions. The main limiting factor of ozone production was usually NOx, suggesting that domestic NOx emission control is important in reducing further ozone production and the incidence of warning issuance (>120 ppb). VOCs also increased the ozone production rate, and occasionally (14% of time) became dominant. This analysis implies that the VOC reduction legislation recently enacted should be effective. The uncertainty in the radical chemistry mechanism governing ozone production had a non-negligible impact, but the main conclusion relevant to policy was not altered. When chain termination was augmented by HO2-H2O + NO/NO2 reactions and by heterogeneous loss of HO2 on aerosol particle surfaces, the daily ozone production rate decreased by <24%, and the fraction of hours when the VOC-limited condition occurred varied from 14% to 13

  3. Is Central Asia really exsiccating?

    NASA Astrophysics Data System (ADS)

    Aizen, V. B.; Aizen, E. M.; Surazakov, A. B.

    2008-12-01

    At the end of 20th and the beginning of 21st century central Asia oases suffered from serious drought caused lack of water for agriculture, economy growth and population increase. However, people of this region always experienced lack of water for irrigation and fought a war over the rights to control river streams. The drying up of central Asian rivers is not a new phenomenon according to the ancient manuscripts. Thus, lets see about what has happened with the past century climate and water resources of central Asia using the long-term observational data. We analyzed data from more than 200 meteorological stations and stream gauges over the central Asia in elevation range from 25 m. b.s.l. to 4,000 m. a.s.l. to understand the last 100 years variability in climate and water resources, examining changes in the extreme and mean monthly air temperatures, precipitation and river runoff. The evaluation of seasonal snow and glacier's covered areas between 1970th and 2007th in central Asia derived from AVHRR, MODIS, Hexagon KH-9, Landsat ETM and ASTER data exhibit 15% reduction of the seasonal snow covered area and 10.1% of the glacier area. It has been found that during last twenty years the duration of snowmelt, from the date of maximum snow cover to date of its disappearance, reduced by 30 days and in 2007 was equal to 138 days in the central Asian mountains. The decrease of seasonal snow cover is not a linear process. The further decrease may be accelerated due to increase of rainfall instead of snowfall in early spring months at high elevations, and consequently a lesser heat expenditure for the snowmelt. The growth in summer air temperatures, especially observable since the 1970th, accompanied by increase of evapotranspiration and precipitation, notably in summer and autumn, and at high elevations over 3,000 m, and at the western peripheral mountain ridges. Average difference in the means of annual air temperatures for the two thirty-year periods before and after

  4. Rising HIV infection rates in Ho Chi Minh City herald emerging AIDS epidemic in Vietnam.

    PubMed

    Lindan, C P; Lieu, T X; Giang, L T; Lap, V D; Thuc, N V; Thinh, T; Lurie, P; Mandel, J S

    1997-09-01

    An analysis of annual sentinel surveillance data from Viet Nam indicates that Ho Chi Minh City is at the forefront of a new HIV epidemic. Since 1990, data on HIV cases have been collected from prenatal clinics, blood banks, centers for the treatment of sexually transmitted diseases (STDs) and tuberculosis, and rehabilitation centers for injecting drug users and commercial sex workers. The first HIV case in Viet Nam was reported in 1990 in Ho Chi Minh City. By the end of 1996, a cumulative total of 4961 HIV cases had been documented in Viet Nam, 2774 of which were in Ho Chi Minh City. In Ho Chi Minh City, 86.5% of cumulative HIV infections involved men. The distribution of total HIV cases by group has been: injecting drug users, 86.0%; tuberculosis patients, 3.3%; sex workers, 2.5%; STD patients, 2.5%; and pregnant women, 0.6%. By 1996, 42 of Viet Nam's 53 provinces had reported HIV cases and infection rates are rising dramatically in border areas near China and Cambodia. The pattern documented in this analysis resembles that observed in Thailand a decade ago: rapidly rising HIV rates among injecting drug users and infection already established among sex workers, without dissemination to the general population. The necessary infrastructure and resources for control of the epidemic are far more limited in Viet Nam than Thailand, however. Recommended, to prevent the further spread of HIV in Viet Nam, are educational activities targeted at injecting drug users and sex workers outside of rehabilitation centers, the availability of condoms and sterile needles, establishment of anonymous testing sites, control of STDs, and the coordination of programs within southeast Asia. PMID:9376101

  5. High rates of lifetime and recent violence observed among harder-to-reach women living with HIV.

    PubMed

    Borwein, Alexandra; Salters, Kate A; Palmer, Alexis K; Miller, Cari L; Duncan, Katrina C; Chan, Keith; Montaner, Julio S G; Hogg, Robert S

    2014-01-01

    This study examined the prevalence and correlates associated with lifetime and recent violence among a sample of harder-to-reach human immunodeficiency virus (HIV)-positive women living in British Columbia (BC), Canada. Interviewer-led surveys with 1000 participants gathered quantitative data on social, economic, and structural characteristics such as housing status, relationship status, family structure, history of drug use, and sexual behavior. Logistic regression analysis modeled associations between independent variables and experiences of violence at baseline. Cox regression analyses with time-dependent covariates determined correlates of lifetime and recent violence among HIV-positive women. Of the 249 women in the study, an overwhelming proportion of women (81%) reported experiences of violence in their lifetime. Among those, 22% reported recent experiences of violence, and 56% of the women reported more than five violent episodes in their lifetime. Lifetime violence was independently associated with HIV-related stigma (adjusted odds ratio [AOR] = 2.18, 95% confidence interval [CI] = 1.14-5.70), previous tobacco use (AOR = 2.79, 95% CI = 1.10-7.07), ever having a drinking problem (AOR = 2.82, 95% CI = 1.28-6.23), and ever having received care for a mental health condition (AOR = 2.42, 95% CI = 1.06-5.52). Recent violence was associated with the current illicit drug use (AOR = 2.60, 95% CI = 1.14-5.90), and currently residing in unstable housing (AOR = 2.75, 95% CI = 1.31-5.78). This study underscores the need to consider potential experiences of historical and current violence as part of comprehensive care for women living with HIV. PMID:24111944

  6. HIV Symptoms

    MedlinePlus

    ... Submit Home > HIV/AIDS > What is HIV/AIDS? HIV/AIDS This information in Spanish ( en español ) HIV symptoms Photo courtesy of AIDS.gov More information ... and brain Return to top More information on HIV symptoms Explore other publications and websites Basic Information ...

  7. The current status of Zika virus in Southeast Asia

    PubMed Central

    2016-01-01

    OBJECTIVES: Zika virus currently poses a global threat and is a major public health issue throughout Latin America and the Caribbean. However, Zika virus infections in humans have also been observed in other regions, including Southeast Asia, where arboviral diseases are very common. In this study, we summarize the current status of Zika virus in Southeast Asia. This review aims to provide an overview of the current situation and also to suggest ways of adequately managing the emergence of Zika virus in Southeast Asia. METHODS: The literature searching for the reports on Zika virus in Southeast Asia was done using standard database PubMed and the re-analysis and summarization on the reports was done. RESULTS: A limited number of reports have addressed Zika virus disease in Southeast Asia, but it is has been confirmed that a problem already exists. Individual case reports and outbreaks of Zika virus have been confirmed in Southeast Asia. Several reports have also described patients becoming infected after visiting Southeast Asia. In addition, the concurrent circulation of Zika virus with other arboviruses has been confirmed. CONCLUSIONS: As a tropical region with a high prevalence of arboviral diseases, the emergence of Zika virus in Southeast Asia is a major concern. It is essential for local medical personnel to recognize this disease. Given the status of Southeast Asia as a globally important tourist destination, continuous updates on the status of Zika virus in Southeast Asia are required and should be incorporated into global health advisories regarding travel. PMID:27336445

  8. Knowledge, Perceptions and Attitudes of Youths in India Regarding HIV/AIDS: A Review of Current Literature

    ERIC Educational Resources Information Center

    Banerjee, Priya; Mattle, Courtney

    2005-01-01

    The HIV/AIDS pandemic is steadily increasing in severity throughout the developing world. Recently, Southeast Asia has become a rising concern for health care professionals in the field of infectious disease (UNAIDS, 2004). Most of Southeast Asia is experiencing surging prevalence and incidence rates of HIV infection. One particular country of…

  9. Continuous evidence of fast HIV disease progression related to class-wide resistance to antiretroviral drugs: a 6 year follow-up analysis of a large observational database.

    PubMed

    Mauro, Zaccarelli; Federica, Forbici; Patrizia, Lorenzini; Francesca, Ceccherini-Silberstein; Valerio, Tozzi; Paola, Trotta Maria; Patrizia, Marconi; Pasquale, Narciso; Federico, Perno Carlo; Andrea, Antinori

    2007-08-20

    Class-wide resistance (CWR) was increasingly associated with a higher risk of HIV progression after 72 months of follow-up among 1392 patients genotypic-tested after failure (AIDS risk 13% for no CWR to 34% for three CWR; AIDS/death risk 21-54%). At multivariate analysis, the detection of two and three CWR was significantly associated with a two and threefold increased risk, respectively, of death and AIDS/death, suggesting that extended resistance is a marker of disease progression in long-term observation. PMID:17690586

  10. The Philippines: HIV/AIDS, condoms, and human rights.

    PubMed

    2004-08-01

    Influential leaders are increasingly attacking condoms through HIV-prevention programs that focus on sexual abstinence and marital fidelity. In May 2004 Human Rights Watch (HRW) released a report that examines the impact of these policies in the Philippines, the largest Roman Catholic country in Asia and a major recipient of US HIV/AIDS funding. PMID:15540338

  11. HIV Prevention

    MedlinePlus

    ... to treat HIV infection (called antiretroviral therapy, or ART) the right way, every day and his or ... way, every day, the medicine to treat HIV (ART) reduces the amount of HIV (called “viral ...

  12. Causes of Death Among Patients Infected with HIV at a Tertiary Care Hospital in China: An Observational Cohort Study.

    PubMed

    Xiao, Jiang; Du, Shuxu; Tian, Yunfei; Su, Wenjing; Yang, Di; Zhao, Hongxin

    2016-08-01

    The objective of this study was to elucidate the causes of death and mortality in a cohort of inpatients infected with HIV. The causes of death and mortality were evaluated by using the clinical data of 1,076 patients admitted to the Center for Infectious Diseases, Beijing Ditan Hospital, between January 1, 2009, and November 30, 2012, and who were followed for 6 months after discharge. During the 4-year study period, 216 patients had died by the 6-month follow-up (mortality rate, 20.1%). Opportunistic infections were the most common causes of death (42.0%), followed by malignancies (23.1%), unexplained central nervous system infections and occupying lesions (18.1%), infectious shock (10.2%), severe hepatitis and decompensated cirrhosis (3.2%), sudden death (1.4%), lactic acidosis (0.9%), and uremia (0.9%). The strong risk factors for mortality were cost constraints and unaffordable further diagnosis and treatment (adjusted hazard ratio [AHR] = 134.394, 95% confidence interval [CI] = 25.748-701.481, p < .001), unexplained etiologies (AHR = 12.551, 95% CI = 6.642-23.716, p < .001), and multiple complications (AHR = 5.798, 95% CI = 2.973-11.308, p < .001). Mortality was not associated with CD4 levels or combined antiretroviral therapy (cART) in a cohort of inpatients at a special hospital for HIV/AIDS patients in China. AIDS-related infections and malignancies were the most common causes of death in patients infected with HIV, and improvement of the etiological diagnosis would help physicians provide appropriate treatment and reduce mortality rates. PMID:26971827

  13. Peritoneal dialysis in Asia.

    PubMed

    Cheng, I K

    1996-01-01

    The socioeconomic status of Asian countries is diverse, and government reimbursement policies for treatment of patients suffering from end-stage renal disease (ESRD) vary greatly from one country to another. Both of these factors have a major impact not only on the choice of treatment for ESRD but also on the utilization of peritoneal dialysis (PD) in this region. Based on the data collected from 11 representative Asian countries, several observations can be made. First, the treatment rates for ESRD in these countries correlated closely with their gross domestic product (GDP) per capita income. Second, the PD utilization rate appeared to have a biphasic relationship with the GDP per capita income and treatment rate, in that countries with the highest and the lowest treatment rates tended to have lower PD utilization rates, whereas countries with modest treatment rates tended to have higher PD utilization rates. The reason for low PD utilization in countries with the highest treatment rates differs from that in countries with low treatment rates. In the former, because of full government reimbursement, there is little physician incentive to introduce PD as an alternative form of ESRD treatment to in-center hemodialysis (HD), whereas in the latter, the complete lack of government reimbursement prevents the introduction of PD as a form of treatment. This pattern is likely to change in the future because, of the 11 countries surveyed, all except Thailand have recorded a growth rate which is higher for PD than HD over the last three years. The rate of utilization of different PD systems varies greatly among different Asian countries. Automated PD has yet to gain popularity in Asia. Conventional straight-line systems remain the dominant PD systems in use in Hong Kong, Korea, Thailand, and the Philippines, while in Malaysia and Singapore UV germicidal connection devices are most popular. However, in all these countries there has been a progressive shift over the last

  14. Integration of remote sensing data and surface observations to estimate the impact of the Russian wildfires over Europe and Asia during August 2010

    NASA Astrophysics Data System (ADS)

    Mei, L.; Xue, Y.; de Leeuw, G.; Guang, J.; Wang, Y.; Li, Y.; Xu, H.; Yang, L.; Hou, T.; He, X.; Wu, C.; Dong, J.; Chen, Z.

    2011-12-01

    A series of wildfires broke out in Western Russia starting in late July of 2010. Harmful particulates and gases released into the local Russian atmosphere have been reported, as have possible negative consequences for the global atmosphere. In this study, an extremely hazy area and its transport trajectory on Russian wildfires were analysed using aerosol optical depth (AOD) images retrieved via the synergy method from Moderate Resolution Imaging Spectroradiometer (MODIS) data. In addition, we used trace gases (NO2 and SO2) and CO2 products measured using Ozone Monitoring Instrument (OMI) data, vertical distribution of AOD data retrieved from Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observation (CALIPSO) data, the mass trajectory analyses, synoptic maps from a HYSPLIT model simulation and ground-based data, including AERONET (both AOD and Ångström exponent) data and PM2.5. First, an Optimal Smoothing (OS) scheme was used to develop more precise and reliable AOD data based on multiple competing predictions made using several AOD retrieval models; then, integrated AOD and PM2.5 data were related using a chemical transport model (GEOS-Chem), and the integrated AOD and visibility data were related using the 6S radiative transfer code. The results show that the PM2.5 concentration is enhanced by a factor of 3-5 as determined from both satellite and in situ observations with peak daily mean concentrations of approximately 500 μg m3. Also, the visibility in many parts of Russia, for instance in Moscow, was less than 100 m; in some areas, the visibility was less than 50 m. Additionally, the possible impact on neighbouring countries due to long-transport was analysed for 31 July and 15 August 2010. A comparison of the satellite aerosol products and ground observations from the neighbouring countries suggests that wildfires in Western Russian had little impact on most european and asian countries, the exceptions being Finland, Estonia, Ukraine and Kyrgyzstan

  15. Maternal HIV infection influences the microbiome of HIV-uninfected infants.

    PubMed

    Bender, Jeffrey M; Li, Fan; Martelly, Shoria; Byrt, Erin; Rouzier, Vanessa; Leo, Marguerite; Tobin, Nicole; Pannaraj, Pia S; Adisetiyo, Helty; Rollie, Adrienne; Santiskulvong, Chintda; Wang, Shaun; Autran, Chloe; Bode, Lars; Fitzgerald, Daniel; Kuhn, Louise; Aldrovandi, Grace M

    2016-07-27

    More than 1 million HIV-exposed, uninfected infants are born annually to HIV-positive mothers worldwide. This growing population of infants experiences twice the mortality of HIV-unexposed infants. We found that although there were very few differences seen in the microbiomes of mothers with and without HIV infection, maternal HIV infection was associated with changes in the microbiome of HIV-exposed, uninfected infants. Furthermore, we observed that human breast milk oligosaccharides were associated with bacterial species in the infant microbiome. The disruption of the infant's microbiome associated with maternal HIV infection may contribute to the increased morbidity and mortality of HIV-exposed, uninfected infants. PMID:27464748

  16. [Tuberculosis in Asia].

    PubMed

    2002-10-01

    populations. These factors pose particular problems for implementing DOTS in various ways. Socio-cultural and environmental factors are particularly important in Nepal, and several measures have been developed to overcome these difficulties. One is active community participation through the DOTS committee. The committee consists of a group of motivated people, including social workers, political leaders, health services providers, journalists, teachers, students, representatives of local organizations, medical schools and colleges, industries, private practitioners, and TB patients. One DOTS committee is formed in every treatment center. A key role of the DOTS committee is to identify local problems and their solutions. It increases public awareness about TB and DOTS; supports people with TB in the community by providing treatment observers and tracing late patients; and encourages cooperation among health institutions, health workers, NGOs, and political leaders. The case finding rate is now 69%, and nearly 95% of diagnosed TB cases are being treated under DOTS. The treatment success rate of new smear-positive cases is nearly 90%. Thus, DOTS increases the case finding and treatment success. 3. Cambodia: HIV/TB and the health sector reform: Tan Eang Mao (National Center for Tuberculosis and Leprosy Control, Cambodia) Cambodia is one of the 23 high burden countries of tuberculosis in the world. Moreover, HIV/AIDS has been spreading rapidly since 1990s, which is worsening the tuberculosis epidemics. To cope with the burden, Cambodia has started implementation of DOTS in 1994 and has expanded it to most of public hospitals across the country by 1998. NTP of Cambodia is now enjoying high cure rate of more than 90%. However, due to the constraints such as weak infrastructure and the poverty, it is proved that many of TB sufferers do not have access to the TB services, resulting in still low case detection rate. It is for this reason that the NTP has decided to expand DOTS to

  17. Literature of Southeast Asia.

    ERIC Educational Resources Information Center

    Echols, John M.

    This paper provides a brief description of the literature of Southeast Asia. This area, which embraces the region south of China and east of India, includes the modern nations of Burma, Thailand, Cambodia, Laos, Vietnam, The Philippines, Malaysia and Indonesia. The earliest historical influence came from India around the beginnings of the…

  18. OCLC in Asia Pacific.

    ERIC Educational Resources Information Center

    Chang, Min-min

    1998-01-01

    Discusses the Online Computer Library Center (OCLC) and the changing Asia Pacific library scene under the broad headings of the three phases of technology innovation. Highlights include WorldCat and the OCLC shared cataloging system; resource sharing and interlibrary loan; enriching OCLC online catalog with Asian collections; and future outlooks.…

  19. Multicultural Central Asia.

    ERIC Educational Resources Information Center

    Boyle, Eric D.

    This article addresses the multicultural aspect of Central Asia in response to the discussion on diversity in U.S. classrooms. Many areas of the world are more diverse than the U.S., and these areas experience successes and failures with many of the same issues the U.S. is currently struggling with. Comparing the U.S. diversity debate with similar…

  20. HRD Issues in Asia.

    ERIC Educational Resources Information Center

    1998

    This document contains four papers from a symposium on human resource development (HRD) issues in Asia. "The Japanese Human Resource Development System" (Kiyoe Harada) provides a comprehensive model of the Japanese HRD system based on the current state of the art, including management practices and issues and trends in Japanese HRD. "Structured…

  1. Integration of remote sensing data and surface observations to estimate the impact of the russian wildfires over Europe and Asia during August 2010

    NASA Astrophysics Data System (ADS)

    Mei, L.; Xue, Y.; de Leeuw, G.; Guang, J.; Wang, Y.; Li, Y.; Xu, H.; Yang, L.; Hou, T.; He, X.; Wu, C.; Dong, J.; Chen, Z.

    2011-08-01

    A series of wildfires broke out in western Russia starting in late July of 2010. Harmful particulates and gases released into the local Russian atmosphere have been reported, as have possible negative consequences for the global atmosphere. In this study, an extremely hazy area and its transport trajectory on Russian wildfires were analysed using aerosol optical depth (AOD) images retrieved via the synergy method from Moderate Resolution Imaging Spectroradiometer (MODIS) data. In addition, we used trace gases (NO2 and SO2) and CO2 products measured using Ozone Monitoring Instrument (OMI) data, vertical distribution of AOD data retrieved from Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observation (CALIPSO) data, the mass trajectory analyses, synoptic maps from a HYSPLIT model simulation and ground-based data, including AERONET (both AOD and Ångström exponent) data and PM2.5. First, an Optimal Smoothing (OS) scheme was used to develop more precise and reliable AOD data based on multiple competing predictions made using several AOD retrieval models; then, integrated AOD and PM2.5 data were related using a chemical transport model (GEOS-Chem), and the integrated AOD and visibility data were related using a 6S model. The results show that the PM2.5 concentration is 3-5 times the normal amount based on both satellite data and in situ values with peak daily mean concentrations of approximately 500 μg m-3. Also, the visibility of many parts of Russia, even Moscow, was less than 100 m; in some areas, the visibility was less than 50 m. Additionally, the possible impact on neighbouring countries due to the long-transport effect was also analysed during 31 July and 15 August 2010. A comparison of the satellite aerosol products and ground observations from the neighbouring countries suggests that wildfires in western Russian have had little impact on most European and Asian countries, the exceptions being Finland, Estonia, Ukraine and Kyrgyzstan. However, a

  2. Amplitude-phase characteristics of SAT annual cycle in Asia: tendencies of change derived from observations and reanalyses and from numerical experiments with IAP RAS CM

    NASA Astrophysics Data System (ADS)

    Eliseev, Alexey V.; Mokhov, Igor I.

    2002-02-01

    Amplitude-phase characteristics (APCs) of surface air temperature (SAT) annual cycle (SAT) are analyzed. From meteorological observations from the XX century and meteorological reanalyses for its second half it is found that alongside with the well-known negative correlation of SAT AC amplitude Ts,1 with annual mean SAT Ts,m a peculiarity in the North Pacific exists where Ts,1 and Ts,m are positively intercorrelated. In contrast, SAT AC phase characteristics show more regional behavior. In particular southward of the characteristic annual mean position of the snow-ice boundary (SIB) SAT AC is harmonized under climate warming while northward it is deharmonized. In the Far East (southward about 50 degree(s)N) SAT AC shifts as a whole with its extrema occurring earlier with increasing annual mean SAT. From the energy-balance climate considerations these tendencies of change of the SAT AC APCs in the middle and high latitudes are associated to the influence of the albedo-SAT feedback due to the SIB movement and in the Far East - to the interannual cloudiness variability. Tendencies of change for SAT AC related to the SIB movement are simulated reasonably well by the climate model of intermediate complexity in the experiments with greenhouse gases atmospheric loading. In contrast, the tendencies resulting from the cloudiness variability are not reproduced by this model.

  3. Safety, tolerability, and efficacy of metformin extended-release oral antidiabetic therapy in patients with type 2 diabetes: An observational trial in Asia

    PubMed Central

    Kim, Chul-Hee; Han, Kyung-Ah; Oh, Han-Jin; Tan, Kevin Eng-Kiat; Sothiratnam, Radhakrishna; Tjokroprawiro, Askandar; Klein, Marcus

    2012-01-01

    Background The aim of the present prospective observational study was to assess the tolerability and antihyperglycemic efficacy of metformin extended-release (MXR) in the routine treatment of patients with type 2 diabetes mellitus (T2DM) from six Asian countries. Methods Data from 3556 patients treated with once-daily MXR for 12 weeks, or until discontinuation, were analyzed. Results Treatment with MXR was well tolerated, with 97.4% of patients completing 12 weeks of treatment. Only 3.3% of patients experienced one or more gastrointestinal (GI) side-effects and only 0.7% of patients discontinued for this reason (primary endpoint). The incidence of GI side-effects and related discontinuations appeared to be considerably lower during short-term MXR therapy than during previous treatment (mean 2.71 years’ duration), most commonly with immediate-release metformin. A 12-week course of MXR therapy also reduced HbA1c and fasting glucose levels from baseline. Conclusions The present study provides new insights into the incidence of GI side-effects with MXR in Asian patients with T2DM and on the tolerability of MXR in non-Caucasian populations. Specifically, these data indicate that once-daily MXR not only improves measures of glycemic control in Asian patients with T2DM, but also has a favorable GI tolerability profile that may help promote enhanced adherence to oral antidiabetic therapy. PMID:22742083

  4. Acceptability and feasibility of mHealth and community-based directly observed antiretroviral therapy to prevent mother-to-child HIV transmission in South African pregnant women under Option B+: an exploratory study

    PubMed Central

    Nachega, Jean B; Skinner, Donald; Jennings, Larissa; Magidson, Jessica F; Altice, Frederick L; Burke, Jessica G; Lester, Richard T; Uthman, Olalekan A; Knowlton, Amy R; Cotton, Mark F; Anderson, Jean R; Theron, Gerhard B

    2016-01-01

    Objective To examine the acceptability and feasibility of mobile health (mHealth)/short message service (SMS) and community-based directly observed antiretroviral therapy (cDOT) as interventions to improve antiretroviral therapy (ART) adherence for preventing mother-to-child human immunodeficiency virus (HIV) transmission (PMTCT). Design and methods A mixed-method approach was used. Two qualitative focus group discussions with HIV-infected pregnant women (n=20) examined the acceptability and feasibility of two ART adherence interventions for PMTCT: 1) SMS text messaging and 2) patient-nominated cDOT supporters. Additionally, 109 HIV-infected, pregnant South African women (18–30 years old) receiving PMTCT services under single-tablet antiretroviral therapy regimen during pregnancy and breastfeeding and continuing for life (“Option B+”) were interviewed about mobile phone access, SMS use, and potential treatment supporters. Setting A community primary care clinic in Cape Town, South Africa. Participants HIV-infected pregnant women. Main outcomes Acceptability and feasibility of mHealth and cDOT interventions. Results Among the 109 women interviewed, individual mobile phone access and SMS use were high (>90%), and 88.1% of women were interested in receiving SMS ART adherence support messages such as reminders, motivation, and medication updates. Nearly all women (95%) identified at least one person close to them to whom they had disclosed their HIV status and would nominate as a cDOT supporter. Focus group discussions revealed that cDOT supporters and adherence text messages were valued, but some concerns regarding supporter time availability and risk of unintended HIV status disclosure were expressed. Conclusion mHealth and/or cDOT supporter as interventions to improve ART adherence are feasible in this setting. However, safe HIV status disclosure to treatment supporters and confidentiality of text messaging content about HIV and ART were deemed crucial. PMID

  5. Prevalence and Predictors of Mental/Emotional Distress Among HIV+ Jail Detainees at Enrollment in an Observational Study

    PubMed Central

    Lincoln, Thomas; Simon-Levine, Dominique; Smith, JuliAnna; Donenberg, Geri R.; Springer, Sandra A.; Zaller, Nickolas; Altice, Frederick L.; Moore, Kevin; Jordan, Alison O.; Draine, Jeffrey; Desabrais, Maureen

    2015-01-01

    This study evaluates the prevalence of mental/emotional distress and its specific correlates among people living with HIV/AIDS (PLWHA) in 20 jail systems across the United States. Of the 878 PLWHA jail detainees, 52% had high levels of mental/emotional distress, defined by the composite Addiction Severity Index score. High mental/emotional distress was found to be associated with the inmate living in a city with lower income inequality, lower health ranking, and higher degree of danger. Proximate variables included being female, bisexual orientation, poorer physical health, and increased severity of substance abuse. Inmates in jails with accredited health services and those satisfied with family support had lower mental/emotional distress scores. These findings indicate the need for expanded mental health assessment of PLWHAs entering jail. PMID:25788608

  6. Prevalence and Predictors of Mental/Emotional Distress Among HIV+ Jail Detainees at Enrollment in an Observational Study.

    PubMed

    Lincoln, Thomas; Simon-Levine, Dominique; Smith, JuliAnna; Donenberg, Geri R; Springer, Sandra A; Zaller, Nickolas; Altice, Frederick L; Moore, Kevin; Jordan, Alison O; Draine, Jeffrey; Desabrais, Maureen

    2015-04-01

    This study evaluates the prevalence of mental/emotional distress and its specific correlates among people living with HIV/AIDS (PLWHA) in 20 jail systems across the United States. Of the 878 PLWHA jail detainees, 52% had high levels of mental/emotional distress, defined by the composite Addiction Severity Index score. High mental/emotional distress was found to be associated with the inmate living in a city with lower income inequality, lower health ranking, and higher degree of danger. Proximate variables included being female, bisexual orientation, poorer physical health, and increased severity of substance abuse. Inmates in jails with accredited health services and those satisfied with family support had lower mental/emotional distress scores. These findings indicate the need for expanded mental health assessment of PLWHAs entering jail. PMID:25788608

  7. Dynamics of continental deformation in Asia

    NASA Astrophysics Data System (ADS)

    Vergnolle, M.; Calais, E.; Dong, L.

    2007-11-01

    The relevance of plate tectonics concepts to the description of deformation of large continental areas like Asia is subject to much debate. For some, the deformation of continents is better described by rigid motion of lithospheric blocks with strain concentrated along narrow fault zones. For others, it is better described by viscous flow of a continuously deforming solid in which faults play a minor role. Discriminating these end-member hypotheses requires spatially dense measurements of surface strain rates covering the whole deforming area. Here we revisit the issue of the forces and rheological structure that control present-day deformation in Asia. We use the "thin sheet" theory, with deformation driven by the balance of boundary and buoyancy stresses acting on a faulted lithosphere with laterally varying strength. Models are validated against a recent, homogeneous, GPS velocity field that covers most of Asia. In the models, deformation in compressional areas (Himalayas, Tien Shan, Altay) is well reproduced with strong coupling at the India/Eurasia plate contact, which allows for boundary forces to transfer into Asia. Southeastward motions observed in north and south China, however, require tensional, oceanward directed stresses, possibly generated by gravitational potential energy gradients across the Indonesian and Pacific subductions. Model and observed strain rates show that a large part of Asia undergoes no resolvable strain, with a kinematics apparently consistent with block- or plate-like motions. Internal strain, possibly continuous, is limited to high-elevation, mechanically weaker areas. Lateral variations of lithospheric strength appear to control the style of deformation in Asia, with a dynamics consistent with the thin sheet physical framework.

  8. Practical Management of HIV-Associated Anemia in Resource-Limited Settings: Prospective Observational Evaluation of a New Mozambican Guideline.

    PubMed

    Brentlinger, Paula E; Silva, Wilson P; Vermund, Sten H; Valverde, Emilio; Buene, Manuel; Moon, Troy D

    2016-01-01

    Mozambique's updated guideline for management of HIV-associated anemia prompts clinicians to consider opportunistic conditions, adverse drug reactions, and untreated immunosuppression in addition to iron deficiency, intestinal helminthes, and malaria. We prospectively evaluated this guideline in rural Zambézia Province. Likely cause(s) of anemia were determined through prespecified history, physical examination, and laboratory testing. Diagnoses were "etiologic" if laboratory confirmed (sputum microscopy, blood culture, Plasmodium falciparum malaria rapid test) or "syndromic" if not. To assess hemoglobin response, we used serial point-of-care measurements. We studied 324 ambulatory, anemic (hemoglobin <10 g/dl) HIV-infected adults. Study clinicians treated nearly all [315 (97.2%)] for suspected iron deficiency and/or helminthes; 56 (17.3%) had laboratory-confirmed malaria. Other assigned diagnoses included tuberculosis [30 (9.3%)], adverse drug reactions [26 (8.0%)], and bacteremia [13 (4.1%)]. Etiologic diagnosis was achieved in 79 (24.4%). Of 169 (52.2%) subjects who improved (hemoglobin increase of ≥1 g/dl without indications for hospitalization), only 65 (38.5%) received conventional management (iron supplementation, deworming, and/or antimalarials) alone. Thirty (9.3%) died and/or were hospitalized, and 125 (38.6%) were lost to follow-up. Multivariable linear and logistic regression models described better hemoglobin responses and/or outcomes in subjects with higher CD4(+) T-lymphocyte counts, pre-enrollment antiretroviral therapy and/or co-trimoxazole prophylaxis, discontinuation of zidovudine for suspected adverse reaction, and smear-positive tuberculosis. Adverse outcomes were associated with fever, low body mass index, bacteremia, esophageal candidiasis, and low or missing CD4(+) T cell counts. In this severely resource-limited setting, successful anemia management often required interventions other than conventional presumptive treatment, thus

  9. Atmospheric transport of ozone between Southern and Eastern Asia.

    PubMed

    Chakraborty, T; Beig, G; Dentener, F J; Wild, O

    2015-08-01

    This study describes the effect of pollution transport between East Asia and South Asia on tropospheric ozone (O3) using model results from the Task Force on Hemispheric Transport of Air Pollution (TF HTAP). Ensemble mean O3 concentrations are evaluated against satellite-data and ground observations of surface O3 at four stations in India. Although modeled surface O3 concentrations are 1020ppb higher than those observed, the relative magnitude of the seasonal cycle of O3 is reproduced well. Using 20% reductions in regional anthropogenic emissions, we quantify the seasonal variations in pollution transport between East Asia and South Asia. While there is only a difference of 0.05 to 0.1ppb in the magnitudes of the regional contributions from one region to the other, O3 from East Asian sources affects the most densely populated parts of South Asia while Southern Asian sources only partly affect the populated parts of East Asia. We show that emission changes over East Asia between 2000 and 2010 had a larger impact on populated parts of South Asia than vice versa. This study will help inform future decisions on emission control policy over these regions. PMID:25847313

  10. Achieving universal access and moving towards elimination of new HIV infections in Cambodia

    PubMed Central

    Vun, Mean Chhi; Fujita, Masami; Rathavy, Tung; Eang, Mao Tang; Sopheap, Seng; Sovannarith, Samreth; Chhorvann, Chhea; Vanthy, Ly; Sopheap, Oum; Welle, Emily; Ferradini, Laurent; Sedtha, Chin; Bunna, Sok; Verbruggen, Robert

    2014-01-01

    Introduction In the mid-1990s, Cambodia faced one of the fastest growing HIV epidemics in Asia. For its achievement in reversing this trend, and achieving universal access to HIV treatment, the country received a United Nations millennium development goal award in 2010. This article reviews Cambodia’s response to HIV over the past two decades and discusses its current efforts towards elimination of new HIV infections. Methods A literature review of published and unpublished documents, including programme data and presentations, was conducted. Results and discussion Cambodia classifies its response to one of the most serious HIV epidemics in Asia into three phases. In Phase I (1991–2000), when adult HIV prevalence peaked at 1.7% and incidence exceeded 20,000 cases, a nationwide HIV prevention programme targeted brothel-based sex work. Voluntary confidential counselling and testing and home-based care were introduced, and peer support groups of people living with HIV emerged. Phase II (2001–2011) observed a steady decline in adult prevalence to 0.8% and incidence to 1600 cases by 2011, and was characterized by: expanding antiretroviral treatment (coverage reaching more than 80%) and continuum of care; linking with tuberculosis and maternal and child health services; accelerated prevention among key populations, including entertainment establishment-based sex workers, men having sex with men, transgender persons, and people who inject drugs; engagement of health workers to deliver quality services; and strengthening health service delivery systems. The third phase (2012–2020) aims to attain zero new infections by 2020 through: sharpening responses to key populations at higher risk; maximizing access to community and facility-based testing and retention in prevention and care; and accelerating the transition from vertical approaches to linked/integrated approaches. Conclusions Cambodia has tailored its prevention strategy to its own epidemic, established