HIV heterogeneity and proximity of homestead to roads in rural South Africa: an exploration using a geographical information system

OBJECTIVE To describe heterogeneity of HIV prevalence among pregnant women in Hlabisa health district, South Africa and to correlate this with proximity of homestead to roads. METHODS HIV prevalence measured through anonymous surveillance among pregnant women and stratified by local village clinic. Polygons were created around each clinic, assuming women attend the clinic nearest their home. A geographical information system (GIS) calculated the mean distance from homesteads in each clinic catchment to nearest primary (1 degrees) and to nearest primary or secondary (2 degrees) road. RESULTS We found marked HIV heterogeneity by clinic catchment (range 19-31% (P < 0.001). A polygon plot demonstrated lower HIV prevalence in catchments remote from 1 degrees roads. Mean distance from homesteads to nearest 1 degrees or 2 degrees road varied by clinic catchment from 1623 to 7569 m. The mean distance from homesteads to a 1 degrees or 2 degrees road for each clinic catchment was strongly correlated with HIV prevalence (r = 0.66; P = 0.002). CONCLUSIONS The substantial HIV heterogeneity in this district is closely correlated with proximity to a 1 degrees or 2 degrees road. GIS is a powerful tool to demonstrate and to start to analyse this observation. Further research is needed to better understand this relationship both at ecological and individual levels, and to develop interventions to reduce the spread of HIV infection.

Ancient Greek and Roman Worlds

"All are sole-authored, refereed items. I chose these four items because they are the eligible ones that, in my view, are most innovative in terms of content and/or methodology and are having the most impact in terms of reviews and citations."

GLUT4 - At the cross roads between membrane trafficking and signal transduction

GLUT4 is a mammalian facilitative glucose transporter that is highly expressed in adipose tissue and striated muscle. In response to insulin, GLUT4 moves from intracellular storage areas to the plasma membrane, thus increasing cellular glucose uptake. While the verification of this 'translocation hypothesis' (Cushman SW. Wardzala LJ. J Biol Chem 1980;255: 4758-4762 and Suzuki K, Kono T. Proc Natl Acad Sci 1980;77: 2542-2545) has increased our understanding of insulin-regulated glucose transport, a number of fundamental questions remain unanswered. Where is GLUT4 stored within the basal cell? How does GLUT4 move to the cell surface and what mechanism does insulin employ to accelerate this process) Ultimately we require a convergence of trafficking studies with research in signal transduction. However, despite more than 30 years of intensive research we have still not reached this point. The problem is complex, involving at least two separate signal transduction pathways which feed into what appears to be a very dynamic sorting process. Below we discuss some of these complexities and highlight new data that are bringing us closer to the resolution of these questions.

Koala mortality on roads in south-east Queensland: the koala speed-zone trial

In 1995, the Queensland Parks and Wildlife Service, the Queensland Department of Main Roads and Redland Shire Council initiated the Koala Speed Zone Trial in the Koala Coast, south-east Queensland. The aim of the trial was to assess the effect of differential speed signs on the number of koalas ( Phascolarctos cinereus) hit by vehicles in the Koala Coast from 1995 to 1999. On the basis of information collected by the Queensland Parks and Wildlife Service 1407 koalas were hit by vehicles in the Koala Coast during the five-year study ( mean 281 koalas per year, range 251 - 315). Monitoring of vehicle speeds by the Queensland Department of Main Roads suggested that there was no significant reduction in vehicle speed during the trial period from August to December. Consequently, there was no evidence to suggest that a reduction in the number of koalas hit by vehicles occurred during the trial. Approximately 70% of koalas were hit on arterial and sub-arterial roads and approximately 83% did not survive. The location of each koala hit was recorded and the signed speed limit of the road was noted. Most koalas that were hit by vehicles were young healthy males. Pooling of data on koala collisions and road speed limits suggested that the proportion of koalas that survived being hit by vehicles was slightly higher on roads with lower speed limits. However, vehicle speed was not the only factor that affected the number of koalas hit by vehicles. It is suggested that habitat destruction, koala density and traffic volume also contribute to road-associated koala mortality in the Koala Coast.