Suchergebnisse

Given the primacy of Iowa in pork production for the U.S. and global markets, we sought to understand if the same relationship with traditional environmental justice (EJ) variables such as low income and minority populations observed in other concentrated animal feeding operation (CAFO) studies exists in the relationship with swine CAFO densities in Iowa. We examined the potential for spatial clustering of swine CAFOs in certain parts of the state and used spatial regression techniques to determine the relationships of high swine concentrations to these EJ variables. We found that while swine CAFOs do cluster in certain regions and watersheds of Iowa, these high densities of swine are not associated with traditional EJ populations of low income and minority race/ethnicity. Instead, the potential for environmental injustice in the negative impacts of intensive swine production require a more complex appraisal. The clustering of swine production in watersheds, the presence of antibiotics used in swine production in public waterways, the clustering of manure spills, and other findings suggest that a more literal and figurative "downstream" approach is necessary. We document the presence and location of antibiotics used in animal production in the public waterways of the state. At the same time, we suggest a more "upstream" understanding of the structural, political and economic factors that create an environmentally unjust landscape of swine production in Iowa and the Upper Midwest is also crucial. Finally, we highlight the important role of publicly accessible and high quality data in the analysis of these upstream and downstream EJ questions.

The Democratic Republic of the Congo (DRC) has one of the lowest HIV prevalence in sub-Saharan Africa, estimated at 1.1% [0.9-1.3] of adults aged 15-49 in 2013 (UNAIDS). Within the 2 million km2 country, however, there exists spatial variation in HIV prevalence, with the highest HIV prevalence observed in the large cities of Kinshasa and Lubumbashi. Globally, HIV is an increasingly rural disease, diffusing outwards from urban centers of high HIV prevalence to places where HIV was previously absent or present at very low levels. Utilizing data collected during Demographic and Health Surveillance (DHS) in 2007 and 2013 in the DRC, we sought to update the map of HIV prevalence in the DRC as well as to explore whether HIV in the DRC is an increasingly rural disease or remains confined to urban areas. Bayesian kriging and regression indicate that HIV prevalence in rural areas of the DRC is higher in 2013 than in 2007 and that increased distance to an urban area is no longer protective against HIV as it was in 2007. These findings suggest that HIV education, testing and prevention efforts need to diffuse from urban to rural areas just as HIV is doing.

Hepatitis B virus (HBV) is endemic throughout Africa, but its prevalence in the Democratic Republic of the Congo (DRC) is incompletely understood. We used dried blood spot (DBS) samples from the 2013 to 2014 Demographic and Health Survey in the DRC to measure the prevalence of HBV using the Abbott ARCHITECT HBV surface antigen (HBsAg) qualitative assay. We then attempted to sequence and genotype HBsAg-positive samples. The weighted national prevalence of HBV was 3.3% (95% CI: 1.8–4.7%), with a prevalence of 2.2% (95% CI: 0.3–4.1%) among children. Hepatitis B virus cases occurred countrywide and across age strata. Genotype E predominated (60%), and we found a unique cluster of genotype A isolates (30%). In conclusion, DBS-based HBsAg testing from a nationally representative survey found that HBV is common and widely distributed among Congolese adults and children. The distribution of cases across ages suggests ongoing transmission and underscores the need for additional interventions to prevent HBV infection.

BACKGROUND: The Democratic Republic of the Congo (DRC) remains one of the countries most impacted by malaria despite decades of control efforts, including multiple mass insecticide treated net (ITN) distribution campaigns. The multi-scalar and complex nature of malaria necessitates an understanding of malaria risk factors over time and at multiple levels (e.g., individual, household, community). Surveillance of households in both rural and urban settings over time, coupled with detailed behavioral and geographic data, enables the detection of seasonal trends in malaria prevalence and malaria-associated behaviors as well as the assessment of how the local environments within and surrounding an individual's household impact malaria outcomes. METHODS: Participants from seven sites in Kinshasa Province, DRC were followed for over two years. Demographic, behavioral, and spatial information was gathered from enrolled households. Malaria was assessed using both rapid diagnostic tests (RDT) and polymerase chain reaction (PCR) and seasonal trends were assessed. Hierarchical regression modeling tested associations between behavioral and environmental factors and positive RDT and PCR outcomes at individual, household and neighborhood scales. RESULTS: Among 1591 enrolled participants, malaria prevalence did not consistently vary seasonally across the sites but did vary by age and ITN usage. Malaria was highest and ITN usage lowest in children ages 6–15 years across study visits and seasons. Having another member of the household test positive for malaria significantly increased the risk of an individual having malaria [RDT: OR= 4.158 (2.86–6.05); PCR: OR= 3.37 (2.41–4.71)], as did higher malaria prevalence in the 250m neighborhood around the household [RDT: OR= 2.711 (1.42–5.17); PCR: OR= 4.056 (2.3–7.16)]. Presence of water within close proximity to the household was also associated with malaria outcomes. CONCLUSIONS: Taken together, these findings suggest that targeting non-traditional age groups, children >5 years old ...