Relation between Alkaline Phosphatase and Ca<Superscript>2+</Superscript>-ATPase in Calcium Transport

SEVERAL recent studies suggest that at least part of the effect of vitamin D on intestinal calcium transport may be mediated by a calcium-stimulated ATPase (Ca ATPase) situated in the brush borders of intestinal mucosal cells¹. Intestinal brush borders are known to contain several other enzymes which may be involved in digestion and transport, but the relationship between them is poorly understood². In the case of the disaccharidases, the question of the number of enzymes responsible for the various activities has been raised³. Alkaline phosphatase is also present in brush borders but its function is unknown. During studies of the effect of various agents On intestinal calcium transport we noted a close correlation between the activities of alkaline phosphatase and Ca ATPase. We therefore wondered whether the activities might be due to a single enzyme species. Haussler et al.⁴ and Norman et al.⁵ have also noted a close relationship between the two activities under a variety of conditions but Holdsworth⁶ thinks the two activities are not related. We report here further evidence, based on denaturation by heat and on various dietary manipulations in the rat, which suggest that the two enzymes may be part of a single enzyme complex.     

Are neighbour methods preferable to analysis of variance for completely systematic designs? 'Silly designs are silly!'

It is shown that the usual analysis of a complete-block designis weakly valid under a range of assumptions but that more sophisticatedanalyses of systematic block designs may not be.     

Missed Opportunities for Early Access to Care of HIV-Infected Infants in Burkina Faso

Objective

The World Health Organization (WHO) has recommended a universal antiretroviral therapy (ART) for all HIV-infected children before the age of two since 2010, but this implies an early identification of these infants. We described the Prevention of Mother-to-Child HIV Transmission (PMTCT) cascade, the staffing and the quality of infrastructures in pediatric HIV care facilities, in Ouagadougou, Burkina Faso.

Methods

We conducted a cross-sectional survey in 2011 in all health care facilities involved in PMTCT and pediatric HIV care in Ouagadougou. We assessed them according to their coverage in pediatric HIV care and WHO standards, through a desk review of medical registers and a semi-structured questionnaire administered to health-care workers (HCW).

Results

In 2011, there was no offer of care in primary health care facilities for HIV-infected children in Ouagadougou. Six district hospitals and two university hospitals provided pediatric HIV care. Among the 67 592 pregnant women attending antenatal clinics in 2011, 85.9% were tested for HIV. The prevalence of HIV was 1.8% (95% Confidence Interval: 1.7%–1.9%). Among the 1 064 HIV-infected pregnant women attending antenatal clinics, 41.4% received a mother-to-child HIV transmission prevention intervention. Among the HIV-exposed infants, 313 (29.4%) had an early infant HIV test, and 306 (97.8%) of these infants tested received their result within a four-month period. Among the 40 children initially tested HIV-infected, 33 (82.5%) were referred to a health care facility, 3 (9.0%) were false positive, and 27 (90.0%) were initiated on ART. Although health care facilities were adequately supplied with HIV drugs, they were hindered by operational challenges such as shortage of infrastructures, laboratory reagents, and trained HCW.

Conclusions

The PMTCT cascade revealed bottle necks in PMTCT intervention and HIV early infant diagnosis. The staffing in HIV care and quality of health care infrastructures were also insufficient in 2011 in Ouagadougou.