Challenges for diagnosis and control of cystic hydatid disease

This paper is based on the experience of the authors, with the aim to define the challenges for Echinococcus granulosus (E.g./CE) diagnosis and control for those countries that may now or in the future be contemplating control of hydatid disease. A variety of methods are available for diagnosis in humans but a universal gold standard is lacking. Diagnosis in definitive hosts can avoid necropsy by the use of methods such as coproantigen detection but test performance is variable between populations. A sylvatic cycle adds challenges in some countries and the epidemiology of the parasite in these hosts is poorly understood. Control by solely administering praziquantel to dogs is not effective in developing countries where the disease is endemic. Additional avenues to pursue include the instigation of participatory planning, use of an existing vaccination for intermediate hosts and development of a vaccine and long-acting anthelmitic implants for definitive hosts. Promoting public acceptance of control of the dog population by humane euthanasia and reduced reproduction is also essential.     

Monozygotic twins affected with major depressive disorder have greater variance in methylation than their unaffected co-twin

Our understanding of major depressive disorder (MDD) has focused on the influence of genetic variation and environmental risk factors. Growing evidence suggests the additional role of epigenetic mechanisms influencing susceptibility for complex traits. DNA sequence within discordant monozygotic twin (MZT) pairs is virtually identical; thus, they represent a powerful design for studying the contribution of epigenetic factors to disease liability. The aim of this study was to investigate whether specific methylation profiles in white blood cells could contribute to the aetiology of MDD. Participants were drawn from the Queensland Twin Registry and comprised 12 MZT pairs discordant for MDD and 12 MZT pairs concordant for no MDD and low neuroticism. Bisulphite treatment and genome-wide interrogation of differentially methylated CpG sites using the Illumina Human Methylation 450 BeadChip were performed in WBC-derived DNA. No overall difference in mean global methylation between cases and their unaffected co-twins was found; however, the differences in females was significant (P=0.005). The difference in variance across all probes between affected and unaffected twins was highly significant (P<2.2 × 10⁻¹⁶), with 52.4% of probes having higher variance in cases (binomial P-value<2.2 × 10⁻¹⁶). No significant differences in methylation were observed between discordant MZT pairs and their matched concordant MZT (permutation minimum P=0.11) at any individual probe. Larger samples are likely to be needed to identify true associations between methylation differences at specific CpG sites.     

Differential returns from globalization to women smallholder coffee and food producers in rural Uganda

Background

Globalization-related measures to liberalize trade and stimulate export production were applied in Uganda in the late 1980s, including in the coffee production sector, to revitalize agricultural production, increase incomes to farmers and improve rural food security.

Objective

To explore the different effects of such measures on the health and dietary outcomes of female coffee and food small holder farmers in Uganda.

Methods

We gathered evidence through a cross-sectional comparative interview survey of 190 female coffee producers and 191 female food producers in Ntungamo district. The study mostly employed quantitative methods of data collection, targeting the sampled households. We also utilized qualitative data; collected three months after the household survey data had been collected and their analysis had been accomplished. Using qualitative interviews based on an unstructured interview guide, extra qualitative information was collected from key informants at national, district and community levels. This was among other underlying principles to avoid relying on snapshot information earlier collected at household level in order to draw valid and compelling conclusions from the study. We used indicators of production, income, access to food and dietary patterns, women''s health and health care. Of the two groups selected from the same area, female coffee producers represented a higher level of integration into liberalised export markets.

Results

Document review suggests that, although Uganda''s economy grew in the period, the household economic and social gains after the liberalization measures may have been less than expected. In the survey carried out, both food and coffee producers were similarly poor, involved in small-scale production, and of a similar age and education level. Coffee producers had greater land and livestock ownership, greater access to inputs and higher levels of income and used a wider variety of markets than food producers, but they had to work longer hours to obtain these economic returns, and spent more cash on health care and food from commercial sources. Their health outcomes were similar to those of the food producers, but with poorer dietary outcomes and greater food stress.

Conclusions

The small-scale women farmers who are producing food cannot rely on the economic infrastructure to give them support for meaningful levels of production. However, despite having higher incomes than their food producing counterparts, the evidence showed that women who are producing coffee in Uganda as an export commodity cannot rely on the income from their crops to guarantee their health and nutritional wellbeing, and that the income advantage gained in coffee-producing households has not translated into consistently better health or food security outcomes. Both groups have limited levels of autonomy and control to address these problems.