Cytologic and biomolecular diagnosis of polyomavirus infection in urine specimens of HIV-positive patients

OBJECTIVE: To evaluate the frequency of human polyomavirus reactivation in urine specimens from HIV-positive patients; compare the sensitivity of cytology, immunohistochemistry and molecular biology; differentiate viral genotypes; and correlate the results with urinary cytologic abnormalities. STUDY DESIGN: Urine specimens from 78 unselected HIV-positive patients were evaluated by means of cytology, immunohistochemistry and nested polymerase chain reaction (n-PCR) to evaluate the presence of polyomaviruses. Restriction fragment length polymorphism (RFLP) was carried out in positive cases in order to differentiate BK virus (BKV) from JC virus (JCV). CD4 cells and serum creatinine levels were evaluated as indices of immune status and renal function, respectively, whereas the presence of red blood cells was used as an index of urogenital damage. RESULTS: Cytologic evidence of polyomavirus infection was found in 17 samples and immunohistochemically confirmed in 9; another 6 cytologically negative cases were detected by means of immunohistochemistry. In all cases, only one or two cells showed typical viral inclusions or positive staining. n-PCR identified 44 positive samples, thus confirming all of the cytologically and immunohistochemically positive cases and detecting polyomavirus genome in a further 21. RFLP detected 39 JCV, 1 BKV and 4 JCV-BKV infections. No correlation was found between the presence or type of polyomavirus and immune status, but red blood cells were found more frequently in the positive than in the negative samples. Serum creatinine levels fell within the normal range in all cases. CONCLUSION: Molecular biology is the most sensitive tool for detecting polyomavirus urinary infection in HIV-positive patients and the only reliable method of differentiating JCV and BKV viral genotypes.     

Participatory appraisal for potential community-based mangrove management in East Africa

Mangroves are among the most threatened ecosystems in the world and the coastal forests of East Africa are no exception to this trend. Although conservation, rehabilitation and sustainable management plans have been developed in various tropical regions, only a few locally based approaches have been launched along the Indian Ocean coast of Africa. In order to identify possible conditions for sustainable management of mangroves based on socio-economic and ecological considerations, we present a participatory approach designed to evaluate the relationships between mangroves and human activities and the use of multi-criterion analysis to identify management solutions. To achieve this goal, all the subjects involved in mangrove management (local communities, institutions and researchers) took an active part in the process. The research was carried out in three communities relying on mangrove swamps: Kisakasaka village on the island of Zanzibar, Mida Creek in Kenya, both relying on mangrove forests known to be endangered by over-exploitation, and Inhaca Island in Mozambique, where mangroves are more pristine. Families were the hub of the research and the importance of each of their economic activities was assessed. We then examined the methods by which mangroves are exploited by the local community and by other stakeholders working in the study areas. Our results show that the mangroves in Inhaca are exploited only for household needs and the pressure on the forests is still ecologically sustainable. In contrast, there is a well-established demand for mangrove products in Kisakasaka and Mida Creek and the mangroves represent an essential source of income for the families, resulting in an ecologically unsustainable rate of exploitation. Therefore, possible alternatives to the current management practices were identified in the two areas by means of a participatory approach. Multi-criterion analysis was then used to compare and discuss the alternatives in terms of social, economic and ecological criteria.