Treatment failure and mortality factors in patients receiving second-line HIV therapy in resource-limited countries

Context Long-term antiretroviral therapy (ART) use in resource-limited countries leads to increasing numbers of patients with HIV taking second-line therapy. Limited access to further therapeutic options makes essential the evaluation of second-line regimen efficacy in these settings. Objectives To investigate failure rates in patients receiving second-line therapy and factors associated with failure and death. Design, Setting, and Participants Multicohort study of 632 patients >14 years old receiving second-line therapy for more than 6 months in 27 ART programs in Africa and Asia between January 2001 and October 2008. Main Outcome Measures Clinical, immunological, virological, and immunovirological failure (first diagnosed episode of immunological or virological failure) rates, and mortality after 6 months of second-line therapy use. Sensitivity analyses were performed using alternative CD4 cell count thresholds for immunological and immunovirological definitions of failure and for cohort attrition instead of death. Results The 632 patients provided 740.7 person-years of follow-up; 119 (18.8%) met World Health Organization failure criteria after a median 11.9 months following the start of second-line therapy (interquartile range [IQR], 8.7-17.0 months), and 34 (5.4%) died after a median 15.1 months (IQR, 11.9-25.7 months). Failure rates were lower in those who changed 2 nucleoside reverse transcriptase inhibitors (NRTIs) instead of 1 (179.2 vs 251.6 per 1000 person-years; incidence rate ratio [IRR], 0.64; 95% confidence interval [CI], 0.42-0.96), and higher in those with lowest adherence index (383.5 vs 176.0 per 1000 person-years; IRR, 3.14; 95% CI, 1.67-5.90 for <80% vs ≥95% [percentage adherent, as represented by percentage of appointments attended with no delay]). Failure rates increased with lower CD4 cell counts when second-line therapy was started, from 156.3 vs 96.2 per 1000 person-years; IRR, 1.59 (95% CI, 0.78-3.25) for 100 to 199/μL to 336.8 per 1000 person-years; IRR, 3.32 (95% CI, 1.81-6.08) for less than 50/μL vs 200/μL or higher; and decreased with time using second-line therapy, from 250.0 vs 123.2 per 1000 person-years; IRR, 1.90 (95% CI, 1.19-3.02) for 6 to 11 months to 212.0 per 1000 person-years; 1.71 (95% CI, 1.01-2.88) for 12 to 17 months vs 18 or more months. Mortality for those taking second-line therapy was lower in women (32.4 vs 68.3 per 1000 person-years; hazard ratio [HR], 0.45; 95% CI, 0.23-0.91); and higher in patients with treatment failure of any type (91.9 vs 28.1 per 1000 person-years; HR, 2.83; 95% CI, 1.38-5.80). Sensitivity analyses showed similar results. Conclusions Among patients in Africa and Asia receiving second-line therapy for HIV, treatment failure was associated with low CD4 cell counts at second-line therapy start, use of suboptimal second-line regimens, and poor adherence. Mortality was associated with diagnosed treatment failure.

Cotton insect populations : development and impact of predators and other mortality factors /

Cover title.

Mortality Risk in Insects

Understanding how and why insect numbers fluctuate through time and space has been a central theme in ecological research for more than a century. Life tables have been used to understand temporal and spatial patterns in insect numbers. In this study, we estimated cause-of-death probabilities for phytophagous insects using multiple decrement life tables and the irreplaceable mortality analytic technique. Multiple decrement life tables were created from 73 insect life tables published from 1954 to 2004. Irreplaceable mortality (the portion of mortality that cannot be replaced by another cause) from pathogens, predators, and parasitoids was 8.6 +/- 7.2, 7.8 +/- 4.9, and 6.2 +/- 1.6%, respectively. In contrast, the mean irreplaceable mortality from all non-natural enemy mortality factors (mortality from factors other than natural enemies) was 35.1 +/- 4.4%. Irreplaceable mortality from natural enemies was significantly lower compared with non-natural enemy factors. Our results may partially explain cases of unsuccessful efficacy in classical biological control, after successful establishment, by showing low irreplaceable mortality for natural enemies, including 5.2 +/- 1.6% for introduced natural enemies. We suggest that the environment (i.e., the degree of environmental stability) influences the magnitude of the irreplaceable mortality from natural enemies. Our results lead to several testable hypotheses and emphasize that it is not possible to estimate the effect of any mortality factor without considering its interaction with competing mortality factors, which has far-reaching consequences for population biology and applied ecology.

Mortality dynamics of spodoptera frugiperda (lepidoptera: noctuidae) immatures in maize

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Life tables of the processionary caterpillar Ochrogaster lunifer Herrich-Schaffer (Lepidoptera : Thaumetopoeidae) at local and regional scales

A major ongoing debate in population ecology has surrounded the causative factors underlying the abundance of phytophagous insects and whether or not these factors limit or regulate herbivore populations. However, it is often difficult to identify mortality agents in census data, and their distribution and relative importance across large spatial scales are rarely understood. Were, we present life tables for egg batches and larval cohorts of the processionary caterpillar Ochrogaster lunifer Herrich-Schaffer, using intensive local sampling combined with extensive regional monitoring to ascertain the relative importance of different mortality factors at different localities. Extinction of entire cohorts (representing the entire reproductive output of one female) at natural localities was high, with 82% of the initial 492 cohorts going extinct. Mortality was highest in the egg and early instar stages due to predation from dermestid beetles, and while different mortality factors (e.g. hatching failure, egg parasitism and failure to establish on the host) were present at many localities, dermestid predation, either directly observed or inferred from indirect evidence, was the dominant mortality factor at 89% of localities surveyed. Predation was significantly higher in plantations than in natural habitats. The second most important mortality factor was resource depletion, with 14 cohorts defoliating their hosts. Egg and larval parasitism were not major mortality agents. A combination of predation and resource depletion consistently accounted for the majority of mortality across localities, suggesting that both factors are important in limiting population abundance. This evidence shows that O. lunifer is not regulated by natural enemies alone, but that resource patches (Acacia trees) ultimately, and frequently, act together to limit population growth.

Pine processionary moth (Thaumetopoea pityocampa) and great tit (Parus major) in Portugal

In the present work, we studied a common outbreaking Lepidoptera species in Portuguese pine stands – Thaumetopoea pityocampa (Den. & Schiff.) - and one of its potential predators – Parus major (L.). The population dynamics of the immature stages of the Lepidoptera was studied in several types of Pinus pinaster (Aiton) plantations in three different areas: Setúbal Peninsula, Abrantes and National Pine Forest of Leiria. Location and plantation structure was the most important factors determining population density of T. pityocampa. Setubal and Abrantes was highly susceptible to attacks by the Lepidoptera, whereas Leiria had lower densities. Young and homogeneous pine stands was more susceptible to attacks than older and more heterogeneous pines stands. However, a desynchronized population of T. pityocampa, in which the larvae develops during summer instead of during winter, reached high densities also in Leiria. The impact of several mortality factors and climatic conditions on the immature stages of the insect (eggs and larvae), in normal and desynchronized populations are discussed, as well as possible evolutionary implications of the sudden appearance of the new version of T. pityocampa. The break of the pupa diapause and adult emergence times the annual life cycle of this insect. Adults from the desynchronized population emerged earlier than adults from the normal population, which in turn determined the change in the larvae development period. Different factors, potentially affecting the timing of adult emergence in both normal and abnormal populations are also discussed. To study P. Major, nest-boxes were placed in the areas of Setúbal and Leiria and they were monitored during three seasons. The nest-boxes increased the density of breeding and wintering birds in the studied pine plantations, indicating that a lack of natural holes are in fact a limiting factor for this populations. The earliest breeding start for this species was recorded in my study area, indicating that Portuguese coastal pines provide good breeding conditions earlier than in other areas of Europe and North Africa. This leads to an overlap between the end of the larvae stage of T. pityocampa and the beginning of the breeding season of P. major. Key-words: Thaumetopoea pityocampa, Parus major, Pinus pinaster, population dynamics, Portugal.

Pattern of attack of a galling insect reveals an unexpected preference-performance linkage on medium-sized resources

Pattern of attack of a galling insect reveals an unexpected preference-performance linkage on medium-sized resources. The Plant Vigor Hypothesis (PVH) predicts oviposition preference and higher offspring performance on longer and fast-growing shoots, and although several studies have tested its predictions, long-term studies concerning the patterns of host selection by galling species are still lacking. The PVH was tested in this study using Bauhinia brevipes (Fabaceae) as the host of a leaf gall midge, Asphondylia microcapillata (Diptera, Cecidomyiidae) during three consecutive years. Shoots were collected from the same 80 plants between 2001 and 2003 and shoot length, number of healthy and galled leaves, gall number, and mortality factors were recorded. Nearly 600 galls were found on the 5,800 shoots collected. Medium-sized shoots supported from 46 to 70% of all galls, with greater gall survival rate in 2002 and 2003. A decrease in parasitism rate coupled with an increase in gall predation lead to a constant similar gall survivorship rate in all years (x = 22.7%). Although gall abundance varied among years (122 in 2001, 114 in 2002 and 359 in 2003) preference for longer shoots was not observed because the percentage of galled shoots and galled leaves were higher on medium shoot length classes in all years. The observed distribution of gall abundance and galled shoots were always greater than the expected distribution on medium shoot length classes. These findings do not support the PVH, and show that A. microcapillata can maximize the female preference and larval performance on medium-sized shoots of B. brevipes.

Whitefly population dynamics in okra plantations

The control of whitefly Bemisia tabaci (Gennadius) biotype B (Hemiptera: Aleyrodidae) on okra (Abelmoschus esculentus L.) consists primarily in the use of insecticides, due to the lack of information on other mortality factors. The objective of this study was to evaluate the spatial and temporal population dynamics of the whitefly B. tabaci biotype B on two successive A. esculentus var. "Santa Cruz" plantations. Leaf chemical composition, leaf nitrogen and potassium contents, trichome density, canopy height, plant age, predators, parasitoids, total rainfall and median temperature were evaluated and their relationships with whitefly on okra were determined. Monthly number estimates of whitefly adults, nymphs (visual inspection) and eggs (magnifying lens) occurred on bottom, middle and apical parts of 30 plants/plantation (one leaf/plant). Plants senescence and natural enemies, mainly Encarsia sp., Chrysoperla spp. and Coccinellidae, were some of the factors that most contributed to whitefly reduction. The second okra plantation, 50 m apart from the first, was strongly attacked by whitefly, probably because of the insect migration from the first to the second plantation. No significant effects of the plant canopy on whitefly eggs and adults distribution were found. A higher number of whitefly nymphs was found on the medium part than on the bottom part.

Sélection des risques de morbidité et de mortalité en Afrique subsaharienne aux fins d’une tarification en assurance-vie

Résumé: Les progrès réalisés dans le domaine médical ont permis un prolongement de l’espérance de vie, l’amélioration de la qualité de vie des patients; ce qui implique aussi des changements dans des domaines comme l’assurance-vie. Le principe de la tarification en assurance-vie est basé sur la comparaison du risque (probabilité) de décès d’un individu candidat à une police d’assurance à celui d’une population de référence la plus proche possible du candidat. C’est ainsi que l’analyse de la littérature médicale est devenue un outil indispensable dans la sélection des risques. L’assurance-vie est présente en Afrique subsaharienne depuis environ deux cents ans, mais les assureurs ne disposaient pas jusqu'à nos jours d’outils de tarification spécifiques au contexte africain. A notre connaissance notre travail est le premier effort de ce type à s’intéresser à ce sujet. Son objectif est d’élaborer un outil de tarification qui tiendra compte des aspects spécifiques de la mortalité et de la morbidité sur le continent africain. Dans une première partie nous avons conduit une revue de la littérature médicale disponible sur différents problèmes de santé; dans une seconde étape nous avons identifié les facteurs de risque de morbidité et de mortalité afin de proposer une sélection des risques pour une tarification. Les résultats montrent que les études de mortalité, et principalement les cohortes de suivi à long terme sont rares en Afrique subsaharienne; la majorité des études sont de courte durée et en plus elles enrôlent un nombre restreint de patients. Ces insuffisances ne permettent pas une analyse actuarielle approfondie et les résultats sont difficiles à extrapoler directement dans le domaine de la tarification. Cependant, l’identification des facteurs d’aggravation de la mortalité et de la morbidité permettra un ajustement de la tarification de base. Le sujet noir africain présente un profil de mortalité et de morbidité qui est sensiblement différent de celui du sujet caucasien, d’où la nécessité d’adapter les outils de tarification actuellement utilisés dans les compagnies d’assurance qui opèrent en Afrique subsaharienne. L’Afrique au sud du Sahara a besoin aujourd’hui plus que jamais de données épidémiologiques solides qui permettront de guider les politiques sanitaires mais aussi servir au développement d’une sélection des risques adaptés au contexte africain. Ceci passera par la mise en place d’un réseau coordonné de santé publique, un système de surveillance démographique fiable et un suivi continu des mouvements de la population. Pour atteindre un tel objectif, une collaboration avec les pays développés qui sont déjà très avancés dans de tels domaines sera nécessaire.

PATTERNS OF COLONIZATION AND INCIPIENT NEST SURVIVAL IN ACROMYRMEX-NIGER AND ACROMYRMEX-BALZANI (HYMENOPTERA, FORMICIDAE)

Patterns of colonization by queens and incipient nest survival of the leaf-cutting ants Acromyrmex niger and Acromyrmex balzani were studied by means of belt transects and individually marked incipient nests. No relation was found between colony density and the number of colonization attempts. Both species are not claustral, and high rates of queen mortality were attributed to conspecific executions and predation. of other discernable mortality factors, failure of fungal garden establishment was the most important. Only 34 of 296 A. balzani and 13 of 154 A. niger marked colonies were alive at the end of one year. These figures are higher than those reported for species of Atta. These results are contrasted with those of claustral-founding Atta species. Small colonies are occasionally raided by larger colonies which robbed brood.

Índice de infestação e fatores de mortalidade do bicudo-do-algodoeiro (Coleoptera: Curculionidae) no semi-árido do sudoeste da Bahia, Brasil

The boll weevil (Anthonomus grandis Boheman, 1843) (Coleoptera: Curculionidae) is a pest that limits the production of cotton, especially in the North East of Brazil. The present study aimed to estimate the infestation index and natural mortality of boll weevil at Caraibas County, located in the semi-arid of the Southwest ofBahia. The experiment was performed using the cultivar BSR Aroeira, at Fazenda Lagoa Seca, in 2006. Weekly evaluations were performed, in five sampling areas 25m2, collecting blossoms fallen on the ground. The infestation was estimated by counting the oviposition punctures and /or the feeding on blossoms, and also by the presence of one of the phases of the boll weevil in the inside. Mortality factors were studied through the dissection of blossoms, estimating predation, parasitism, dissection and disease. The results obtained allowed to conclude that the boll weevil determines high infestation levels in the region. Parasitism, dissection and predation, following this order, determine high rates of real mortality of the pest. Catolaccus grandis Burks, 1954 (Hymenoptera: Pteromalidae) and Bracon sp.(Hymenoptera: Braconidae) are parasitoids of boll weevil reported in sothwestern Bahia, being the first one the predominant species. © 2009, Sociedad Venezolana de Entomología.

Demographic bottlenecks in tropical plant regeneration: A comparative analysis of causal influences

Mortality factors that act sequentially through the demographic transitions from seed to sapling may have critical effects on recruitment success. Understanding how habitat heterogeneity influences the causal factors that limit propagule establishment in natural populations is central to assess these demographic bottlenecks and their consequences. Bamboos often influence forest structure and dynamics and are a major factor in generating landscape complexity and habitat heterogeneity in tropical forests. To understand how patch heterogeneity influences plant recruitment we studied critical establishment stages during early recruitment of Euterpe edulis, Sloanea guianensis and Virola bicuhyba in bamboo and non-bamboo stands in the Brazilian Atlantic forest. We combined observational studies of seed rain and seedling emergence with seed addition experiments to evaluate the transition probabilities among regeneration stages within bamboo and non-bamboo stands. The relative importance of each mortality factor was evaluated by determining how the loss of propagules affected stage-specific recruitment success. Our results revealed that the seed addition treatment significantly increased seedling survivorship for all three species. E. edulis seedling survival probability increased in the addition treatment in the two stand types. However, for S. guianensis and V. bicuhyba this effect depended strongly on artificially protecting the seeds, as both species experienced increased seed and seedling losses due to post-dispersal seed predators and herbivores. Propagules of all three species had a greater probability of reaching subsequent recruitment stages when protected. The recruitment of large-seeded V. bicuhyba and E. edulis appears to be much more limited by post-dispersal factors than by dispersal limitation, whereas the small-seeded S. guianensis showed an even stronger effect of post-dispersal factors causing recruitment collapse in some situations. We demonstrated that E. edulis, S. guianensis and V. bicuhyba are especially susceptible to predation during early compared with later establishment stages and this early stage mortality can be more crucial than stand differences as determinants of successful regeneration. Among-species differences in the relative importance of dispersal vs. establishment limitation are mediated by variability in species responses to patch heterogeneity. Thus, bamboo effects on the early recruitment of non-bamboo species are patchy and species-specific, with successional bamboo patches exerting a far-reaching influence on the heterogeneity of plant species composition and abundance. © 2012 Perspectives in Plant Ecology, Evolution and Systematics.

Fatores naturais de mortalidade de ovos de Diatraea saccharalis (Fabricius, 1794) (Lepidoptera: Crambidae) e diversidade de artrópodes em diferentes sistemas de colheita de cana-de-açúcar

Pós-graduação em Agronomia (Entomologia Agrícola) - FCAV

Dinâmica dos fatores de mortalidade de Spodoptera frugiperda (J. E. Smith) (Lepidoptera: Noctuidae) em milho com e sem liberação de Telenomus remus Nixon (Hymenoptera: Platygastridae)

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)