High Prevalence of Cryptococcal Antigenemia among HIV-infected Patients Receiving Antiretroviral Therapy in Ethiopia

Background

Cryptococcal disease is estimated to be responsible for significant mortality in Sub-Saharan Africa; however, only scarce epidemiology data exists. We sought to evaluate the prevalence of and risk factors for cryptococcal antigenemia in Ethiopia.

Methods

Consecutive adult HIV-infected patients from two public HIV clinics in Addis Ababa, Ethiopia were enrolled into the study. A CD4 count ≤200 cells/μl was required for study participation. Patients receiving anti-retroviral therapy (ART) were not excluded. A cryptococcal antigen test was performed for all patients along with an interview, physical exam, and medical chart abstraction. Logistic regression analysis was used to assess risk factors for cryptococcal antigenemia.

Results

369 HIV-infected patients were enrolled; mean CD4 123 cells/μl and 74% receiving ART. The overall prevalence of cryptococcal antigenemia was 8.4%; 11% in patients with a CD4 count <100 cells/μl, 8.9% with CD4 100 to 150 cells/μl and 5.7% with CD4150-200 cell/μl. 84% of patients with cryptococcal antigenemia were receiving ART. In multivariable analysis, increasing age, self reported fever, CD4 count <100 cells/μl, and site of screening were associated with an increased risk of cryptococcal antigenemia. No individual or combination of clinical symptoms had optimal sensitivity or specificity for cryptococcal antigenemia.

Conclusion

Cryptococcal antigenemia is high in Ethiopia and rapid scale up of screening programs is needed. Screening should be implemented for HIV-infected patients with low CD4 counts regardless of symptoms or receipt of ART. Further study into the effect of location and environment on cryptococcal disease is warranted.     

Butterfly–host plant synchrony determines patterns of host use across years and regions

Variation in the degree of synchrony among host plants and herbivores can disrupt or intensify species interactions, alter the strength of natural selection on traits associated with phenological timing, and drive novel host plant associations. We used field observations from three regions during four seasons to examine how timing of the butterfly herbivore Anthocharis cardamines relative to six host plant species (Arabis hirsuta, Cardamine pratensis, Arabis glabra, Arabidopsis thaliana, Thlaspi caerulescens and Capsella bursa‐pastoris) influenced host species use and the choice of host plant individuals within populations. Butterflies laid a larger fraction of their eggs on species that were closer to the butterfly's preferred stage of development than on other host species. Within host plant populations, butterflies showed a stronger preference for individuals with a late phenology when plants within the population were on average more developed at the time of butterfly flight. Our results suggest that changes in synchrony between herbivores and their host plants are associated with changes in both host species use and the choice of host plant individuals differing in phenology within populations. This is likely to be an important mechanism generating variation in interaction intensities and trait selection in the wild, and therefore also relevant for understanding how anthropogenic induced changes, such as global warming, will influence natural communities.     

Stream ecosystem properties and processes along a temperature gradient

We surveyed macrophyte community structure and measured community metabolism and nutrient uptake along a temperature gradient (9.7–17.4°C) in four Icelandic streams influenced by geothermal heating. The study streams are part of the geothermal area in Hengill that is uniquely characterised by streams with comparable water chemistry despite the geothermal influence. Stream metabolism was studied applying the diurnal upstream–downstream dissolved oxygen change technique. Nutrient uptake was studied by adding solutions of nitrogen and phosphorus together with a conservative tracer. Rates of primary production (GPP) and uptake of nitrate–N and phosphate-P increased with increasing stream temperature. GPP was 20 times higher (up to 12.99 g O₂ m⁻² day⁻¹) and rates of nutrient uptake were up to 30-times higher (up to 22.99, 13.31 and 7.94 mg m⁻² h⁻¹ for ammonium, nitrate and phosphate, respectively) in the warmest streams compared with the coldest. Furthermore, macrophytes, when present, were strongly controlling ecosystem processes. Our study implies that temperature may affect stream ecosystem processes both directly (i.e. physiologically) and indirectly (i.e. by changing other structural parameters).     

Hydrological and environmental variables outperform spatial factors in structuring species,trait composition,and beta diversity of pelagic algae

There has been increasing interest in algae‐based bioassessment, particularly, trait‐based approaches are increasingly suggested. However, the main drivers, especially the contribution of hydrological variables, of species composition, trait composition, and beta diversity of algae communities are less studied. To link species and trait composition to multiple factors (i.e., hydrological variables, local environmental variables, and spatial factors) that potentially control species occurrence/abundance and to determine their relative roles in shaping species composition, trait composition, and beta diversities of pelagic algae communities, samples were collected from a German lowland catchment, where a well‐proven ecohydrological modeling enabled to predict long‐term discharges at each sampling site. Both trait and species composition showed significant correlations with hydrological, environmental, and spatial variables, and variation partitioning revealed that the hydrological and local environmental variables outperformed spatial variables. A higher variation of trait composition (57.0%) than species composition (37.5%) could be explained by abiotic factors. Mantel tests showed that both species and trait‐based beta diversities were mostly related to hydrological and environmental heterogeneity with hydrological contributing more than environmental variables, while purely spatial impact was less important. Our findings revealed the relative importance of hydrological variables in shaping pelagic algae community and their spatial patterns of beta diversities, emphasizing the need to include hydrological variables in long‐term biomonitoring campaigns and biodiversity conservation or restoration. A key implication for biodiversity conservation was that maintaining the instream flow regime and keeping various habitats among rivers are of vital importance. However, further investigations at multispatial and temporal scales are greatly needed.     

Evaluating effects of weed cutting on water level and ecological status in Danish lowland streams

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Latitudinal variation in thermal reaction norms of post‐winter pupal development in two butterflies differing in phenological specialization

Latitudinal clines in thermal reaction norms of development are a common phenomenon in temperate insects. Populations from higher latitudes often develop faster throughout the range of relevant temperatures (i.e countergradient variation) because they must be able to complete their life cycle within a shorter seasonal time window compared to populations at lower latitudes. In the present study, we experimentally demonstrate that two species of butterflies Anthocharis cardamines (L.) and Pieris napi (L.) instead show a cogradient variation in thermal reaction norms of post‐winter pupal development so that lower latitude populations develop faster than higher latitude populations. The two species share host plants but differ in the degree of phenological specialization, as well as in the patterns of voltinism. We suggest that the pattern in A. cardamines, a univoltine phenological specialist feeding exclusively on flowers and seedpods, is the result of selection for matching to the phenological pattern of its local host plants. The other species, P. napi, is a phenological generalist feeding on the leaves of the hosts and it shows a latitudinal cline in voltinism. Because the latitudinal pattern in P. napi was an effect of slow development in a fraction of the pupae from the most northern population, we hypothesize that this population may include both bivoltine and univoltine genotypes. Consequently, although the two species both showed cogradient patterns in thermal reaction norms, it appears likely that this was for different reasons. © 2014 The Linnean Society of London, Biological Journal of the Linnean Society, 2014, 113 , 981–991.     

Transplanting macrophytes to rehabilitate streams: experience and recommendations

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The threatened plant intermediate wintergreen (<Emphasis Type="Italic">Pyrola media</Emphasis>) associates with a wide range of biotrophic fungi in native Scottish pine woods

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