Potential of dual-use policies to meet family planning and HIV prevention needs: a case study of Zimbabwe and Mozambique

BACKGROUND AND METHODOLOGY: The fight against the HIV epidemic in many high-prevalence countries is a struggle to motivate culturally relevant risk reduction in general populations that have been educated to associate HIV risk with commercial sex, injection drug use and other stigmatised behaviours. Common concurrent partnerships, which facilitate transmission of HIV in many high-prevalence countries, are only beginning to receive the attention they deserve. This has made the promotion of dual-use methods, such as condoms, for individuals who require both HIV protection and contraception very difficult. Recent research on concurrent partnerships and the implications for high HIV risk in sexually networked but sexually modest general populations is forcing another assessment of the response to HIV. In the light of the epidemic, it is important to better understand which policies will better meet HIV prevention and family planning (FP) needs. This article explores the potential of dual-use policies by examining Zimbabwe and Mozambique. RESULTS: Zimbabwe, with a vertically driven, stronger FP programme predating the HIV epidemic, has not yet seen an increase in condom use to the level desired by their moderately strong HIV prevention programme - one that has adopted a primarily single-use condom policy. Mozambique, however, continues to have a much weaker FP programme, but is witnessing a significant increase in condom use driven by their strong HIV programme - one that is further integrated with FP content. DISCUSSION: Integration of HIV and FP programmes has the potential to meet the need for HIV and pregnancy prevention more efficiently. By themselves, these programmes are unable to meet the need for condoms. The poorest of the poor are feeling the brunt of this inadequacy. Countries such as Zimbabwe and Mozambique have the potential to tremendously improve their efforts in increasing condom use. We suggest that thoughtful and detailed integration of HIV and FP programmes will work synergistically to reach common goals. Until a more promising method besides condoms is commercially available for protection against unintended pregnancy and sexually transmitted infections such as HIV, effective strategies must include dual-use policies as well as counselling on all available contraceptive methods so that women can maximise the benefits of mixing methods.     

Induction of immunogenicity by live attenuated Leishmania donovani centrin deleted parasites in dogs

Zoonotic visceral leishmaniasis, caused by the intracellular protozoan parasite Leishmania infantum, is a neglected tropical disease that is often fatal when untreated. Dogs are considered the main reservoir of L. infantum in zoonotic VL as the presence of infected dogs may increase the risk for human infection. Canine visceral leishmaniasis (CVL) is a major veterinary and public health problem in Southern Europe, Middle East and South America. Control of animal reservoirs relies on elimination of seropositive dogs in endemic areas. However, treatment of infected dogs is not considered a favorable approach as this can lead to emergence of drug resistance since the same drugs are used to treat human infections. Therefore, vaccination against CVL remains the best alternative in control of the animal reservoirs. In this study, we present data on the immunogenicity profile of a live attenuated parasite LdCen^−/− in a canine infection model and compared it to that of Leishmune^®, a commercially available recombinant vaccine. The immunogenicity of the LdCen^−/− parasites was evaluated by antibody secretion, production of intracytoplasmic and secreted cytokines, activation and proliferation of T cells. Vaccination with LdCen^−/− resulted in high immunogenicity as revealed by the higher IgGTotal, IgG1, and IgG2 production and higher lymphoproliferative response. Further, LdCen^−/− vaccinated dogs showed higher frequencies of activated CD4+ and CD8+ T cells, IFN-γ production by CD8+ T cells, increased secretion of TNF-α and IL-12/IL-23p40 and decreased secretion of IL-4. These results contribute to the understanding of immunogenicity elicited by live attenuated L. donovani parasites and, consequently, to the development of effective vaccines against visceral leishmaniasis.     

LC determination of rofecoxib in bulk and pharmaceutical formulations

An isocratic reversed phase-liquid chromatographic (RP-LC) method has been developed for the determination and purity evaluation of rofecoxib in bulk and pharmaceutical dosage forms using photodiode array detection set at 225 nm. The method is simple, rapid and selective. The method is capable of detecting all process intermediates and other related compounds, which may be present at trace levels in finished products. Hence the method is very useful for process monitoring during the production of rofecoxib. Chlorophenyl methyl sulphone has been used as internal standard for the quantitative determination of rofecoxib. The method is linear in the range of 125-500 microg. The precision for inter- and intra-day assay variation of rofecoxib is below 1.6% relative standard deviation (R.S.D.). The accuracy determined as relative mean error (R.M.E.) for the intra-day assay is within +/-2.0%. The drug was extracted from tablets (Vioxx) using acetonitrile. The percentage recoveries from dosage forms were ranged from 98.2 to 102.6.     

Isolation, synthesis and characterization of impurities in celecoxib, a COX-2 inhibitor

During the impurity profile of Celecoxib, four polar impurities (impurity I, II, III and IV) and one non-polar impurity (impurity V) with respect to Celecoxib were detected by HPLC. LC-MS has been employed in this impurity profile study. The three polar impurities (I, II and III) were found to be process related while impurities (IV and V) turned out to be isomers. The impurities III, IV and V were isolated with the help of preparative HPLC. The structure of impurities III, IV (ortho-isomer) and V (regio-isomer) were confirmed as [5-(4-methylphenyl)-3-trifluoromethyl-1H-pyrazole], 4-[5-(2'-methyl phenyl)-3-(trifluoromethyl)-1H-pyrazol-1-yl] benzenesulfonamide, and 4-[4-(4'-methylphenyl)-3-(trifluoromethyl)-1H-pyrazol-1-yl]-benzenesulfonamide, respectively. The structures of impurities I, II, III and IV were confirmed by synthesis and structural characterization using spectral data. However, the impurity V was not synthesized.     

Calculating prevalence of hepatitis B in India: Using population weights to look for publication bias in conventional meta-analysis

Publication bias can result from the propensity of researchers to document what is unusual. This can distort the inferences drawn in systematic reviews. To measure the distortion, it has been suggested that a second analysis be done; using weights proportional to the size of the population from which the samples are drawn. We re-evaluate data from a published meta-analysis on prevalence of hepatitis B in India, to see how this approach alters the results. Prevalence of hepatitis B among tribal and non-tribal populations in different States was analyzed. Weights were then assigned according to population of the State. The overall country prevalence was then calculated. Using population-weights it is estimated that the point-prevalence of hepatitis B among non-tribal populations is 3.07% [95% CI: 2.5–3.64]. Among tribal populations it is 11.85% (CI 10.76–12.93). Overall prevalence was 3.70 (CI: 3.17–4.24) (corresponding to a chronic carrier rate of 2.96%). The present analysis using population-weights has resulted in the estimated prevalence among non tribal populations increasing by 24% and that among tribal populations decreasing by 25.5% when compared to figures of the meta-analysis published earlier. The advantages and drawbacks of this procedure are discussed.