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Age-dependent mortality changes in haematophagous insects are difficult to measure but are important determinants of population dynamics and vectorial capacity. A Markov process was used to model age-dependent changes in wing fray in tsetse (Glossina spp), calibrated using published mark-recapture data for male G. m. morsitans in Tanzania. The model was applied to female G. m. morsitans, captured in Zimbabwe using a vehicle-mounted electric net and subjected to ovarian dissection and wing fray analysis. Rates of fray increased significantly with age in males but not females, where the rate was constant for ovarian categories 0-3. A jump in mean fray between ovarian categories 3 and 4 + 4n is consistent with the latter category including flies that have ovulated 4, 8, 12, 16 times and so on. The magnitude of the jump could, theoretically, facilitate improved mortality estimates. In practice, although knowledge of fly mortality was required for modelling wing fray, mortality estimates derived from ovarian dissection data are independent of patterns and rates of change in wing fray. Significantly better fits to ovarian age data resulted when age-specific mortality was modelled as the sum of two exponentials, with high mortality in young and old flies, than when mortality was constant at 2.3% per day.

A population model for tsetse species was used to assess the optimal number and spacing of airborne sprays to reduce or eradicate a tsetse population. It was found that the optimal spray spacing was determined by the time (days) from adult emergence to the first larviposition and, for safety, spacing was assigned to that duration minus 2 days. If sprays killed all adults, then the number of sprays required for eradication is determined by a simple formula. If spray efficiency is less than 100% kill per spray, then a simulation was used to determine the optimal number, which was strongly affected by spray efficiency, mean daily temperature, pupal duration, age to first larviposition and the acceptance threshold for control, rather than eradication. For eradication, it is necessary to have a spray efficiency of greater than 99.9% to avoid requiring an excessive number of sprays. Output from the simulation was compared with the results of two aerial spraying campaigns against tsetse and a least squares analysis estimated that, in both cases, the kill efficiency of the sprays was not significantly less than 100%.

BackgroundSampling with traps provides the most common means of investigating the abundance, composition and condition of tsetse populations. It is thus important to know the size of the area from which the samples originate, but that topic is poorly understood.Methods and principal findingsThe topic was clarified with the aid of a simple deterministic model of the mobility, births and deaths of tsetse. The model assessed how the sampled area changed according to variations in the numbers, arrangement and catching efficiency of traps deployed for different periods in a large block of homogeneous habitat subject to different levels of fly mortality. The greatest impacts on the size of the sampled area are produced by the flies’ mean daily step length and the duration of trapping. There is little effect of trap type. The daily death rate of adult flies is unimportant unless tsetse control measures increase the mortality several times above the low natural rates. Formulae are suggested for predicting the probability that any given captured fly will have originated from various areas around the trap.ConclusionsFormulae for predicting the probability that any given captured fly originated from various areas around the trap are produced. Using a mean daily step length (d)of 395m, typical of a savannah species of tsetse, then any fly caught by a single trap in a 5-day trapping period could be regarded, with roughly 95% confidence, as originating from within a distance of 1.3km of the trap, that is from an area of 5.5km2.Authors SummaryWe produced a simple, deterministic model to highlight important principles in the neglected matter of the probability that any trapped tsetse will have originated from various sizes of area around the trapping site. The modelling was kept simple by envisaging the use of just one trap, or a group of only five traps, evenly spaced inside a circular area within a large block of homogeneous habitat and operated for no more than 30 days. In deriving formulae for the sampled area, we found it appropriate to consider only the flies’ mean daily step length, and the number of days duration of trapping. The type of trap employed was unimportant. The daily mortality of the adult tsetse population had little effect unless the death rates imposed by control measures were several times greater than the natural rates.

Under laboratory conditions, the alkane hydrocarbon n-pentadecane attracts gravid female tsetse (Glossina morsitans morsitans Westwood) to potential larviposition sites. We describe field-testing of this chemical, which is the first such test for any putative tsetse larviposition pheromone. We replicated randomised block experiments at 11 sites near Rekomitjie Research Station, Zambezi Valley, Zimbabwe. Each site comprised a cluster of four artificial warthog burrows constructed from 200-litre steel drums. We placed six trays, filled with sand and covered with leaf litter, inside each burrow. Both species of tsetse inhabiting this region entered these artificial burrows and deposited 1282 pupae in the trays during the experiments. In 13 experiments, n-pentadecane was tested at three different concentrations against a control. We were unable to find any conclusive evidence that the presence of n-pentadecane resulted in an increased larviposition rate for either G. m. morsitans or G. pallidipes. This finding was independent of the concentration of n-pentadecane used, and was not influenced by the presence or absence of added water, acetone or warthog urine. Any small effect of the pheromone is likely masked by the important physical characteristics of burrow larviposition sites. Order of magnitude increases in larviposition rates when leaf litter was added to larviposition sites were far greater than those due to the use of putative larviposition pheromones.

Biomarkers for detecting early HIV infection and estimating HIV incidence should minimize false-recent rates (FRRs) while maximizing mean duration of recent infection (MDRI). We compared HIV subtypes B, E and D (BED) capture enzyme immunoassay (BED), Sedia limiting antigen (LAg) avidity enzyme immunoassay, and Bio-Rad avidity incidence (BRAI) assays using samples from Zimbabwean postpartum women infected with clade C HIV. We calculated MDRIs using 590 samples from 351 seroconverting postpartum women, and FRRs using samples from 2,825 women known to be HIV positive for >12 months. Antibody kinetics were more predictable with LAg and had higher precision compared with BED or BRAI. BRAI also exhibited more variability, and avidity reversal in some cases. For BED, LAg, and BRAI, used alone or with viral load, MDRI values in days were: BED-188 and 170 at normalized optical density (ODn) 0.8; LAg-104 and 100 at ODn cutoff 1.5; BRAI-135 and 134 at avidity index cutoff 30%. Corresponding FRRs were: BRAI 1.1% and 1.0% and LAg 0.57% and 0.35%: these were 3.8-10.9 times lower than BED values of 4.8% and 3.8%. BRAI and LAg have significantly lower FRRs and MDRIs than in published studies, and much lower than BED and could be used to estimate incidence in perinatal women and to measure population-level HIV incidence in HIV control operations in Africa.

Environmental temperature is an important driver of the population dynamics of tsetse (Glossinaspp) because the fly's immature stages are particularly vulnerable to temperatures (T) outside the rangeT= 16–32°C. Laboratory experiments carried out 50 years ago provide extensive measures of temperature-dependent rates of development, fat consumption and mortality in tsetse pupae. We improve on the models originally fitted to these data, providing better parameter estimates for use in population modelling. A composite function accurately models rates of pupal development forT= 8–32°C. Pupal duration can be estimated by summing the temperature-dependent daily percentage of development completed. Fat consumption is modelled as a logistic function of temperature; the total fat consumed during pupal development takes a minimum forT≈ 25°C. Pupae experiencing constant temperatures T≤ 30°C, the fat consumption during this period. The new results will be particularly useful in the construction of various models for tsetse population dynamics, and will have particular relevance for agent-based models where the lives of individual tsetse are simulated using a daily time step.

Background It has been suggested that attempts to eradicate populations of tsetse (Glossina spp.) using stationary targets might fail because smaller, less mobile individuals are unlikely to be killed by the targets. If true, tsetse caught in stationary traps should be larger than those from mobile baits, which require less mobility on the part of the flies. Results Sampling tsetse in the Zambezi Valley of Zimbabwe, we found that the number of tsetse caught from stationary traps, as a percent of total numbers from traps plus a mobile vehicle, was ~5% for male G. morsitans morsitans (mean wing length 5.830 mm; 95% CI: 5.800–5.859 mm) and ~10% for females (6.334 mm; 95% CI: 6.329–6.338 mm); for G. pallidipes the figures were ~50% for males (6.830 mm; 95% CI: 6.821–6.838 mm) and ~75% for females (7.303 mm, 95% CI: 7.302–7.305 mm). As expected, flies of the smaller species (and the smaller sex) were less likely to be captured using stationary, rather than mobile sampling devices. For flies of a given sex and species the situation was more complex. Multivariable analysis showed that, for females of both species, wing lengths changed with ovarian age and the month, year and method of capture. For G. pallidipes, there were statistically significant interactions between ovarian age and capture month, year and method. For G. m. morsitans, there was only a significant interaction between ovarian age and capture month. The effect of capture method was, however, small in absolute terms: for G. pallidipes and G. m. morsitans flies caught on the mobile vehicle had wings only 0.24 and 0.48% shorter, respectively, than flies caught in stationary traps. In summary, wing length in field samples of tsetse varies with ovarian age, capture month and year and, weakly, with capture method. Suggestions that a target-based operation against G. f. fuscipes in Kenya caused a shift towards a smaller, less mobile population of tsetse, unavailable to the targets, failed to account for factors other than capture method. Conclusions The results are consistent with the successful use of targets to eradicate populations of tsetse in Zimbabwe. Until further, more nuanced, studies are conducted, it is premature to conclude that targets alone could not, similarly, be used to eradicate G. f. fuscipes populations in Kenya. Electronic supplementary material The online version of this article (10.1186/s13071-018-3274-x) contains supplementary material, which is available to authorized users.

Published analysis of genetic material from field-collected tsetse (Glossina spp, primarily from the Palpalis group) has been used to predict that the distance (δ) dispersed per generation increases as effective population densities (De) decrease, displaying negative density-dependent dispersal (NDDD). Using the published data we show this result is an artefact arising primarily from errors in estimates of S, the area occupied by a subpopulation, and thereby in De. The errors arise from the assumption that S can be estimated as the area (S^) regarded as being covered by traps. We use modelling to show that such errors result in anomalously high correlations between δ^ and S^ and the appearance of NDDD, with a slope of -0.5 for the regressions of log(δ^) on log(D^e), even in simulations where we specifically assume density-independent dispersal (DID). A complementary mathematical analysis confirms our findings. Modelling of field results shows, similarly, that the false signal of NDDD can be produced by varying trap deployment patterns. Errors in the estimates of δ in the published analysis were magnified because variation in estimates of S were greater than for all other variables measured, and accounted for the greatest proportion of variation in δ^. Errors in census population estimates result from an erroneous understanding of the relationship between trap placement and expected tsetse catch, exacerbated through failure to adjust for variations in trapping intensity, trap performance, and in capture probabilities between geographical situations and between tsetse species. Claims of support in the literature for NDDD are spurious. There is no suggested explanation for how NDDD might have evolved. We reject the NDDD hypothesis and caution that the idea should not be allowed to influence policy on tsetse and trypanosomiasis control., Author summary Published analysis of genetic material from field-sampled tsetse (Glossina spp) has been used to suggest that, as tsetse population densities decrease, rates of dispersal increase–displaying negative density-dependent dispersal (NDDD), perhaps in all tsetse species. It is further suggested that tsetse control operations might, as a consequence of NDDD, unleash enhanced invasion of areas cleared of tsetse, prejudicing the long-term success of control campaigns. We demonstrate that NDDD in tsetse is an artefact consequent on multiple errors of analysis and interpretation. The most serious of these errors stems from a misunderstanding of the way in which traps sample tsetse, resulting in large errors in estimates of the areas covered by the traps, and occupied by the subpopulations being sampled. Our modelling studies show that these errors can produce the false signal of NDDD, even in situations where DID is assumed. Errors in census population estimates are made worse through failure to adjust for variations in trapping intensity, trap performance, and in capture probabilities between geographical situations, and between tsetse species. We reject the NDDD hypothesis and caution that the idea should not be allowed to influence policy on tsetse and trypanosomiasis control.

Accurate models are crucial for predicting the spread of vector-borne diseases, and for developing appropriate control policies. Simple models often ignore finer details of vector biology, commonly due to lack of pertinent field data. However, for tsetse (Glossina spp), vectors of the parasites causing debilitating human and livestock trypanosomiasis in Africa, extensive field and laboratory data facilitate improved models and predictions of vector control outcomes. We review studies on the effects of environmental temperature, and fly age and sex, on survival and reproduction in tsetse, savannah species particularly–emphasizing the extreme maternal investment and sensitivity of early life stages to high temperatures. We consider implications of these results for predictive models of tsetse populations, and of the transmission and control of African trypanosomiasis. We discuss how further research on vectors, and improved models of vector populations and disease dynamics, can lead to improved predictions of vector abundance and disease spread.

Analysis of genetic material from field-collected tsetse (Glossinaspp) in ten study areas has been used to predict that the distance (δ) dispersed per generation increases as effective population densities (De) decrease, displaying negative density dependent dispersal (NDDD). This result is an artefact arising primarily from errors in estimates ofS, the area occupied by a subpopulation, and thereby inDe, the effective subpopulation density. The fundamental, dangerously misleading, error lies in the assumption thatScan be estimated as the area (Ŝ) regarded as being covered by traps. Errors in the estimates ofδare magnified because variation in estimates ofSis greater than for all other variables measured, and accounts for the greatest proportion of variation inδ. The errors result in anomalously high correlations betweenδandS, and the appearance of NDDD, with a slope of −0.5 for the regressions of log(δ) on log(e), even in simulations where dispersal has been set as density independent. A complementary mathematical analysis confirms these findings. Improved error estimates for the crucial parameterb, the rate of increase in genetic distance with increasing geographic separation, suggest that three of the study areas should have been excluded becausebis not significantly greater than zero. Errors in census population estimates result from a fundamental misunderstanding of the relationship between trap placement and expected tsetse catch. These errors are exacerbated through failure to adjust for variations in trapping intensity, trap performance, and in capture probabilities between geographical situations and between tsetse species. Claims of support in the literature for NDDD are spurious. There is no suggested explanation for how NDDD might have evolved. We reject the NDDD hypothesis and caution that the idea should not be allowed to influence policy on tsetse and trypanosomiasis control.Author summaryGenetic analysis of field-sampled tsetse (Glossinaspp) has been used to suggest that, as tsetse population densities decrease, rates of dispersal increase – displaying negative density dependent dispersal (NDDD). It is further suggested that NDDD might apply to all tsetse species and that, consequently, tsetse control operations might unleash enhanced invasion of areas cleared of tsetse, prejudicing the long-term success of control campaigns. We demonstrate that NDDD in tsetse is an artefact consequent on multiple errors of analysis and interpretation. The most serious of these errors stems from a fundamental misunderstanding of the way in which traps sample tsetse, resulting in huge errors in estimates of the areas sampled by the traps, and occupied by the subpopulations being sampled. Errors in census population estimates are made worse through failure to adjust for variations in trapping intensity, trap performance, and in capture probabilities between geographical situations, and between tsetse species. The errors result in the appearance of NDDD, even in modelling situations where rates of dispersal are expressly assumed independent of population density. We reject the NDDD hypothesis and caution that the idea should not be allowed to influence policy on tsetse and trypanosomiasis control.

As insect populations decline, due to climate change and other environmental disruptions, there has been an increased interest in understanding extinction probabilities. Generally, the life cycle of insects occurs in well-defined stages: when counting insects, questions naturally arise about which life stage to count. Using tsetse flies (vectors of trypanosomiasis) as a case study, we develop a model that works when different life stages are counted. Previous branching process models for tsetse populations only explicitly represent newly emerged adult female tsetse and use that subpopulation to keep track of population growth/decline. Here, we directly model other life stages. We analyse reproduction numbers and extinction probabilities and show that several previous models used for estimating extinction probabilities for tsetse populations are special cases of the current model. We confirm that the reproduction number is the same regardless of which life stage is counted, and show how the extinction probability depends on which life stage we start from. We demonstrate, and provide a biological explanation for, a simple relationship between extinction probabilities for the different life stages, based on the probability of recruitment between stages. These results offer insights into insect population dynamics and provide tools that will help with more detailed models of tsetse populations. Population dynamics studies of insects should be clear about life stages and counting points.

A deterministic model of the distribution of tsetse flies (Glossina spp) was used to assess the extent to which the efficacy of control operations would be affected by three different modes of density dependence in per capita adult dispersal: (i) density-independent dispersal which has been commonly adopted in previous models, (ii) positive density-dependent dispersal which has occasionally been discussed in the tsetse literature, (iii) negative density-dependent dispersal (NDDD). The last has recently been suggested, from genetic studies, to change the dispersal rate of tsetse by up to 200-fold, thereby posing a severe risk for the success of tsetse control operations. Modelling outputs showed that NDDD poses no such risk, provided the mean daily dispersal of tsetse is below about 1 km, which is greater than any rate actually recorded in the field or indicated by the genetic studies. NDDD can be problematic only if tsetse disperse at rates that appear highly unlikely, or even impossible, on energetic grounds. Under some circumstances these high rates would help rather than hinder the control officer. NDDD is not necessary to explain the results of control operations, and not sufficient to explain the results of successful control programmes.

In the absence of national control programmes against Rhodesian human African trypanosomiasis, farmer-led treatment of cattle with pyrethroid-based insecticides may be an effective strategy for foci at the edges of wildlife areas, but there is limited evidence to support this. We combined data on insecticide use by farmers, tsetse abundance and trypanosome prevalence, with mathematical models, to quantify the likely impact of insecticide-treated cattle. Sixteen percent of farmers reported treating cattle with a pyrethroid, and chemical analysis indicated 18% of individual cattle had been treated, in the previous week. Treatment of cattle was estimated to increase daily mortality of tsetse by 5–14%. Trypanosome prevalence in tsetse, predominantly from wildlife areas, was 1.25% for T. brucei s.l. and 0.03% for T. b. rhodesiense. For 750 cattle sampled from 48 herds, 2.3% were PCR positive for T. brucei s.l. and none for T. b. rhodesiense. Using mathematical models, we estimated there was 8–29% increase in mortality of tsetse in farming areas and this increase can explain the relatively low prevalence of T. brucei s.l. in cattle. Farmer-led treatment of cattle with pyrethroids is likely, in part, to be limiting the spill-over of human-infective trypanosomes from wildlife areas., Author summary The acute form of sleeping sickness in Africa is caused by the parasite Trypanosoma brucei rhodesiense. It is transmitted by tsetse flies and can be maintained in cycles involving both livestock and wildlife as hosts. Humans are incidentally infected and are particularly at risk of infection near protected areas where there is both wildlife and suitable habitat for tsetse. In these regions, the tsetse vector cannot be eradicated, nor can infection be prevented in wildlife. Here we use field studies of tsetse and livestock in combination with mathematical models of tsetse population change and trypanosome transmission to show that use of pyrethroid-based insecticides on cattle–by farmers at the edge of protected areas–could be contributing to lowering the risk of sleeping sickness in Serengeti District, Tanzania. To our knowledge, our study is the first to report farmer-led tsetse control, co-incident with tsetse decline and relatively low prevalence of T. brucei s.l. in cattle.

BackgroundA relatively simple life history allows us to derive an expression for the extinction probability of populations of tsetse, vectors of African sleeping sickness. We present the uncertainty and sensitivity analysis of extinction probability for tsetse population, to offer key insights into parameters in the control/eradication of tsetse populations.MethodsWe represent tsetse population growth as a branching process, and derive closed form estimates of population extinction from that model. Statistical and mathematical techniques are used to analyse the uncertainties in estimating extinction probability, and the sensitivity of the extinction probability to changes in input parameters representing the natural life history and vital dynamics of tsetse populations.ResultsFor fixed values of input parameters, the sensitivity of extinction probability depends on the baseline parameter values. For example, extinction probability is more sensitive to the probability that a female is inseminated by a fertile male when daily pupal mortality is low, whereas the extinction probability is more sensitive to daily mortality rate for adult females when daily pupal mortality, and extinction probabilities, are high. Global uncertainty and sensitivity analysis showed that daily mortality rate for adult females has the highest impact on the extinction probability.ConclusionsThe strong correlation between extinction probability and daily female adult mortality gives a strong argument that control techniques to increase daily female adult mortality may be the single most effective means of ensuring eradication of tsetse population.Author summaryTsetse flies (Glossina spp) are vectors of Trypanosomiasis, a deadly disease commonly called sleeping sickness in humans and nagana in livestock. The relatively simple life history of tsetse enabled us to model its population growth as a stochastic branching process. We derived a closed-form expression for the probability that a population of tsetse goes extinct, as a function of death, birth, development and insemination rates in female tsetse. We analyzed the sensitivity of the extinction probability to the different input parameters, in a bid to identify parameters with the highest impact on extinction probability. This information can, potentially, inform policy direction for tsetse control/elimination. In all the scenarios we considered, the daily mortality rate for adult females has the greatest impact on the magnitude of extinction probability. Our findings suggest that the mortality rate in the adult females is the weakest link in tsetse life history, and this fact should be exploited in achieving tsetse population control, or even elimination.

Background A relatively simple life history allows us to derive an expression for the extinction probability of populations of tsetse, vectors of African sleeping sickness. We present the uncertainty and sensitivity analysis of the extinction probability, to offer key insights into factors affecting the control or eradication of tsetse populations. Methods We represent tsetse population growth as a branching process, and derive closed form estimates of population extinction from that model. Statistical and mathematical techniques are used to analyse the uncertainties in estimating extinction probability, and the sensitivity of the extinction probability to changes in input parameters representing the natural life history and vital dynamics of tsetse populations. Results For fixed values of input parameters, the sensitivity of extinction probability depends on the baseline parameter values. Extinction probability is most sensitive to the probability that a female is inseminated by a fertile male when daily pupal mortality is low, whereas the extinction probability is most sensitive to daily mortality rate for adult females when daily pupal mortality, and extinction probabilities, are high. Global uncertainty and sensitivity analysis show that daily mortality rate for adult females has the highest impact on the extinction probability. Conclusions The high correlation between extinction probability and daily female adult mortality gives a strong argument that control techniques which increase daily female adult mortality may be the single most effective means of ensuring eradication of tsetse population., Author summary Tsetse flies (Glossina spp.) are vectors of African trypanosomiasis, a deadly disease commonly called sleeping sickness in humans and nagana in livestock. The relatively simple life history of tsetse enabled us to model its population growth as a stochastic branching process. We derived a closed-form expression for the probability that a population of tsetse goes extinct, as a function of death, birth, development and insemination rates in female tsetse. We analyzed the sensitivity of the extinction probability to the different input parameters, in a bid to identify parameters with the highest impact on extinction probability. This information can, potentially, inform policy direction for tsetse control/elimination. In all the scenarios we considered for the global sensitivity analysis, the daily mortality rate for adult females had the greatest impact on the magnitude of extinction probability. Our findings suggest that the mortality rate in the adult females is the weakest link in tsetse life history, and this fact should be exploited in achieving tsetse population control, or even eradication.

Increases in temperature over recent decades have led to a significant reduction in the populations of tsetse flies (Glossinaspp) in parts of the Zambezi Valley of Zimbabwe. If this is true for other parts of Africa, populations of tsetse may actually be going extinct in some parts of the continent. Extinction probabilities for tsetse populations have not so far been estimated as a function of temperature. We develop a time-homogeneous branching process model for situations where tsetse flies live at different levels of fixed temperatures. We derive a probability distributionpk(T) for the number of female offspring an adult female tsetse is expected to produce in her lifetime, as a function of the fixed temperature at which she is living. We show thatpk(T) can be expressed as a geometric series: its generating function is therefore a fractional linear type. We obtain expressions for the extinction probability, expected number of female offspring per female tsetse, and time to extinction. No tsetse population can escape extinction if subjected, for extended periods, to temperatures outside the range 16 °C - 32°C. Extinction probability increases more rapidly as temperatures approach and exceed the upper and lower limits. If the number of females is large enough, the population can still survive even at high temperatures (28°C - 31°C). Small decreases or increases in constant temperature in the neighbourhoods of 16°C and 31°C, respectively, can drive tsetse populations to extinction. Further study is needed to estimate extinction probabilities for tsetse populations in field situations where temperatures vary continuously.Author summaryTsetse flies (Glossinaspp) are the vectors of the African sleeping sickness. We derived an expression for the extinction probability, and mean time to extinction, of closed populations of the flies experiencing different levels of fixed temperatures. Temperatures play a key role in tsetse population dynamics: no tsetse populations can escape extinction at constant temperatures < 16°C > 32°C. The effect of temperature is more severe if tsetse populations are already depleted. Increasingly high temperatures due to climate change may alter the distribution of tsetse populations in Africa. The continent may witness local extinctions of tsetse populations in some places, and appearances in places hitherto too cold for them.

Laboratory assays that identify recent HIV infections are important for assessing impacts of interventions aimed at reducing HIV incidence. Kinetics of HIV humoral responses can vary with inherent assay properties, and between HIV subtypes, populations, and physiological states. They are important in determining mean duration of recent infection (MDRI) for antibody-based assays for detecting recent HIV infections. We determined MDRIs for multi-subtype peptide representing subtypes B, E and D (BED)-capture enzyme immunoassay, limiting antigen (LAg), and Bio-Rad Avidity Incidence (BRAI) assays for 101 seroconverting postpartum women, recruited in Harare from 1997 to 2000 during the Zimbabwe Vitamin A for Mothers and Babies trial, comparing them against published MDRIs estimated from seroconverting cases in the general population. We also compared MDRIs for women who seroconverted either during the first 9 months, or at later stages, postpartum. At cutoffs (C) of 0.8 for BED, 1.5 for LAg, and 40% for BRAI, estimated MDRIs for postpartum mothers were 192, 104, and 144 days, 33%, 32%, and 52% lower than published estimates of 287, 152 and 298 days, respectively, for clade C samples from general populations. Point estimates of MDRI values were 7%–19% shorter for women who seroconverted in the first 9 months postpartum than for those seroconverting later. MDRI values for three HIV incidence biomarkers are longer in the general population than among postpartum women, particularly those who recently gave birth, consistent with heightened immunological activation soon after birth. Our results provide a caution that MDRI may vary significantly between subjects in different physiological states.

Background Quantifying the effects of climate change on the entomological and epidemiological components of vector-borne diseases is an essential part of climate change research, but evidence for such effects remains scant, and predictions rely largely on extrapolation of statistical correlations. We aimed to develop a mechanistic model to test whether recent increases in temperature in the Mana Pools National Park of the Zambezi Valley of Zimbabwe could account for the simultaneous decline of tsetse flies, the vectors of human and animal trypanosomiasis. Methods and findings The model we developed incorporates the effects of temperature on mortality, larviposition, and emergence rates and is fitted to a 27-year time series of tsetse caught from cattle. These catches declined from an average of c. 50 flies per animal per afternoon in 1990 to c. 0.1 in 2017. Since 1975, mean daily temperatures have risen by c. 0.9°C and temperatures in the hottest month of November by c. 2°C. Although our model provided a good fit to the data, it cannot predict whether or when extinction will occur. Conclusions The model suggests that the increase in temperature may explain the observed collapse in tsetse abundance and provides a first step in linking temperature to trypanosomiasis risk. If the effect at Mana Pools extends across the whole of the Zambezi Valley, then transmission of trypanosomes is likely to have been greatly reduced in this warm low-lying region. Conversely, rising temperatures may have made some higher, cooler, parts of Zimbabwe more suitable for tsetse and led to the emergence of new disease foci., Jennifer Lord and colleagues model how climate change will affect Tsetse fly numbers in the Zambezi Valley in Zimbabwe; falling populations may impact cases of human and animal trypanosomiasis., Author summary Why was this study done? Tsetse flies are blood-feeding insects that transmit pathogens causing fatal diseases of humans and livestock across sub-Saharan Africa. The birth and death rates of tsetse are influenced by environmental conditions, particularly temperature. Since 1975, mean daily temperatures at Rekomitjie, a research station in the Zambezi Valley of Zimbabwe, have risen by c. 0.9°C and temperatures in the hottest month of November by c. 2°C. These increases in temperature may have impacted tsetse populations and the diseases they transmit. What did the researchers do and find? Since the 1960s, wild tsetse have been caught regularly from cattle for insecticide tests conducted at Rekomitjie. Prior to 1990, catches were on average >50 flies per animal per afternoon; however, in 2017, teams frequently failed to catch a single fly. A mathematical model of tsetse population change, which included temperature-dependent rates for births and deaths, suggests that the decline in tsetse is related to rising temperatures. What do these findings mean? Our findings provide a first step in linking the effects of increasing temperatures to the distribution of diseases caused by tsetse. If the effect extends across the Zambezi Valley, then tsetse-borne disease is likely to have been reduced across the region. Conversely, rising temperatures may have made some higher, cooler areas more suitable, leading to the emergence of new disease foci.

Monitoring abundance is essential for vector management, but it is often only possible in a fraction of managed areas. For vector control programmes, sampling to estimate abundance is usually carried out at a local‐scale (10s km2), while interventions often extend across 100s km2. Geostatistical models have been used to interpolate between points where data are available, but this still requires costly sampling across the entire area of interest. Instead, we used geostatistical models to predict local‐scale spatial variation in the abundance of tsetse—vectors of human and animal African trypanosomes—beyond the spatial extent of data to which models were fitted, in Serengeti, Tanzania.We sampled Glossina swynnertoni and Glossina pallidipes >10 km inside the Serengeti National Park (SNP) and along four transects extending into areas where humans and livestock live. We fitted geostatistical models to data >10 km inside the SNP to produce maps of abundance for the entire region, including unprotected areas.Inside the SNP, the mean number of G. pallidipes caught per trap per day in dense woodland was 166 (± 24 SE), compared to 3 (±1) in grassland. Glossina swynnertoni was more homogenous with respective means of 15 (±3) and 15 (±8). In general, models predicted a decline in abundance from protected to unprotected areas, related to anthropogenic changes to vegetation, which was confirmed during field survey. Synthesis and applications. Our approach allows vector control managers to identify sites predicted to have relatively high tsetse abundance, and therefore to design and implement improved surveillance strategies. In East and Southern Africa, trypanosomiasis is associated with wilderness areas. Our study identified pockets of vegetation which could sustain tsetse populations in farming areas outside the Serengeti National Park. Our method will assist countries in identifying, monitoring and, if necessary, controlling tsetse in trypanosomiasis foci. This has specific application to tsetse, but the approach could also be developed for vectors of other pathogens., Our approach allows vector control managers to identify sites predicted to have relatively high tsetse abundance, and therefore to design and implement improved surveillance strategies. In East and Southern Africa, trypanosomiasis is associated with wilderness areas. Our study identified pockets of vegetation which could sustain tsetse populations in farming areas outside the Serengeti National Park. Our method will assist countries in identifying, monitoring and, if necessary, controlling tsetse in trypanosomiasis foci. This has specific application to tsetse, but the approach could also be developed for vectors of other pathogens.

In Zimbabwe, female tsetse Glossina pallidipes Austen, collected from artificial warthog burrows and subjected to ovarian dissection and nutritional analysis, provide the first field estimates of resource allocation from mother to offspring across all of pregnancy. Approximately 45% of 1833 females captured are full-term pregnant on entering the burrow. The remainder presumably use burrows as refuges at temperatures >32 °C. Maternal residual dry weight (RDW) increases by 1.5 mg after the first feed post-larviposition but, thereafter, only by 1.4 mg by 90% of pregnancy completion. Uterine RDW changes little by 60% of pregnancy completion but increases by >6 mg by parturition. Between the times of 5% and 90% pregnancy completion, maternal RDW is approximately constant: it then declines 2.8 mg by parturition, balancing larval gains of 2.6 mg. Mothers accumulate 6.3 mg of fat in the first 80% of pregnancy, while uterine fat increases by only 0.8 mg. Thereafter, by parturition, larval fat increases by 4.1 mg, whereas maternal fat declines by 3.3 mg. The larva deposited is 5% heavier than its mother and has 52% more fat. RDW and fat levels, corrected for fly size and haematin, are 1 and 2 mg, respectively, lower in females from traps than those from burrows. Burrow catches provide an improved picture of tsetse pregnancy dynamics, highlighting a reproductive strategy involving resource commitment to the larva being delayed until late pregnancy when sufficient stores guarantee viable pupal production. Larval development in tsetse starts significantly later than the analogous changes during pregnancy in two mammals and two viviparous fish.

Theory suggests females should optimize resource allocation across reproductive bouts to maximize lifetime reproduction, balancing current and future reproductive efforts according to physiological state and projected survival and reproduction. Tests of these ideas focus on long-lived vertebrates: few measure age-related reproductive output in iteroparous invertebrates, or partition reserves between those allocated to offspring versus mothers. We investigated how maternal age, and environmental and physiological factors influence reproductive investment in wild tsetse, Glossina pallidipes Austen and G. morsitans morsitans Westwood. Tsetse provide a tractable system to measure reproductive allocation. Females exhibit high maternal investment, producing single, large offspring that rely exclusively on maternal reserves. We find that mothers in better physiological condition and experiencing cooler temperatures produce larger offspring. Pupal size increases significantly but weakly with age. In both species, females with less fat invest proportionately more in offspring. Post-partum fat decreases in flies with badly frayed wings: poor flight capability may limit their feeding efficiency, or they may sacrifice more reserves as a terminal investment. Our results support evidence that offspring size increases with maternal size, investment depends on the environment, and females with lower chances of future reproduction invest more into current offspring. We discuss the implications of maternal effects for predicting vector population responses to environmental change.

We present a mathematical model for the transmission of Trypanosoma brucei rhodesiense by tsetse vectors to a multi-host population. To control tsetse and T. b. rhodesiense, a proportion, ψ, of cattle (one of the hosts considered in the model) is taken to be kept on treatment with insecticides. Analytical expressions are obtained for the basic reproduction number, R 0n in the absence, and $R_{0n}^{T}$ in the presence of insecticide-treated cattle (ITC). Stability analysis of the disease-free equilibrium was carried out for the case when there is one vertebrate host untreated with insecticide. By considering three vertebrate hosts (cattle, humans and wildlife) the sensitivity analysis was carried out on the basic reproduction number ( $R_{03}^{T}$ ) in the absence and presence of ITC. The results show that $R_{03}^{T}$ is more sensitive to changes in the tsetse mortality. The model is then used to study the control of tsetse and T. b. rhodesiense in humans through application insecticides to cattle either over the whole-body or to restricted areas of the body known to be favoured tsetse feeding sites. Numerical results show that while both ITC strategies result in decreases in tsetse density and in the incidence of T. b. rhodesiense in humans, the restricted application technique results in improved cost-effectiveness, providing a cheap, safe, environmentally friendly and farmer based strategy for the control of vectors and T. b. rhodesiense in humans.

A published study used a stochastic branching process to derive equations for the mean and variance of the probability of, and time to, extinction in population of tsetse flies (Glossina spp) as a function of adult and pupal mortality, and the probabilities that a female is inseminated by a fertile male. The original derivation was partially heuristic and provided no proofs for inductive results. We provide these proofs, together with a more compact way of reaching the same results. We also show that, while the published equations hold good for the case where tsetse produce male and female offspring in equal proportion, a different solution is required for the more general case where the probability (β) that an offspring is female lies anywhere in the interval (0, 1). We confirm previous results obtained for the special case where β = 0.5 and show that extinction probability is at a minimum for β > 0.5 by an amount that increases with increasing adult female mortality. Sensitivity analysis showed that the extinction probability was affected most by changes in adult female mortality, followed by the rate of production of pupae. Because females only produce a single offspring approximately every 10 days, imposing a death rate of greater then about 3.5% per day will ensure the eradication of any tsetse population. These mortality levels can be achieved for some species using insecticide-treated targets or cattle – providing thereby a simple, effective and cost-effective method of controlling and eradicating tsetse, and also human and animal trypanosomiasis. Our results are of further interest in the modern situation where increases in temperature are seeing the real possibility that tsetse will go extinct in some areas, without the need for intervention, but have an increased chance of surviving in other areas where they were previously unsustainable due to low temperatures.Author summaryWe derive equations for the mean and variance of the probability of, and time to, extinction in population of tsetse flies (Glossina spp), the vectors of trypanosomiasis in sub-Saharan Africa. In so doing we provide the complete proofs for all results, which were not provided in a previously published study. We also generalise the derivation to allow the probability that an offspring is female to lie anywhere in the interval (0, 1). The probability of extinction was most sensitive to changes in adult female mortality. The unusual tsetse life cycle, with very low reproductive rates means that populations can be eradicated as long as adult female mortality is raised to levels greater than about 3.5% per day. Simple bait methods of tsetse control, such as insecticide-treated targets and cattle, can therefore provide simple, affordable and effective means of eradicating tsetse populations. The results are of further interest in the modern situation where increases in temperature are seeing the real possibility that tsetse will go extinct in some areas, but have an increased chance of surviving in others where they were previously unsustainable due to low temperatures.

BackgroundIn several recent papers it has been suggested that HIV prevalence and incidence are declining in Zimbabwe as a result of changing sexual behavior. We provide further support for these suggestions, based on an analysis of more extensive, age-stratified, HIV prevalence data from 1990 to 2009 for perinatal women in Harare, as well as data on incidence and mortality.Methodology/principal findingsPooled prevalence, incidence and mortality were fitted using a simple susceptible-infected (SI) model of HIV transmission; age-stratified prevalence data were fitted using double-logistic functions. We estimate that incidence peaked at 5.5% per year in 1991 declining to 1% per year in 2010. Prevalence peaked in 1998/9 [35.9% (CI95: 31.3–40.7)] and decreased by 67% to 11.9% (CI95: 10.1–13.8) in 2009. For women

Tsetse exhibit a U-shaped age-mortality curve, with high losses after eclosion and a well-marked ageing process, which is particularly dramatic in males. A three-parameter (k(1) -k(3) ) model for age-dependent adult instantaneous mortality rates was constructed using mark-recapture data for the tsetse fly Glossina morsitans morsitans Westwood (Diptera: Glossinidae). Mortality changed linearly with k(1) over all ages; k(2) affected only losses in roughly the first week of adult life, and k(3) controlled the ageing rate. Mortality pooled over age was twice as sensitive to changes in k(3) as in k(1) . Population growth rate was, however, similarly affected by these two parameters, reflecting the disproportionate effect of k(3) on mortality in the oldest flies that contribute least to the growth rate. Pooled-age mortality and growth rate were insensitive to changes in k(2) . The same model also provided good fits to data for laboratory colonies of female G. m. morsitans and Glossina austeni Newstead and should be applicable to all tsetse of both sexes. The new model for tsetse mortality should be incorporated into models of tsetse and trypanosome population dynamics; it will also inform the estimation of adult female mortality from ovarian dissection data.

To determine the effect of daily acyclovir on genital shedding of HIV-1 and herpes simplex virus type 2 (HSV-2) in a randomised placebo-controlled trial among rural Zimbabwean sex workers.214 women were recruited and tested for HIV-1 and HSV-2 antibodies, HIV plasma viral load, CD4 lymphocyte count and genital swabs for qualitative detection of HIV-1 and HSV-2 genital shedding. Women were randomly assigned to acyclovir 400 mg twice a day for 12 weeks or matching placebo and were followed weekly to detect HIV-1 or HSV-2 genital shedding. Shedding analyses were only undertaken on 125 women co-infected with HSV-2 and HIV-1. Data were analysed using logistic regression, with random effects modelling used to account for repeated measurements on the same women.All women were randomly assigned to acyclovir or placebo; 125 of whom were co-infected with HIV-1 and HSV-2. 69 women were randomly assigned to acyclovir and 56 to placebo. Although twice daily acyclovir reduced rates of HSV-2 genital shedding, (adjusted odds ratio (AOR) 0.24; 95% CI 0.12 to 0.48; less than p0.001), it had no effect on the proportion of visits at which HIV-1 shedding was detected (AOR 1.08; 95% CI 0.48 to 2.42; p = 0.9). Adherence varied between participants but even when adherence was high (as determined by pill count and extent of HSV-2 suppression) HIV-1 shedding was not reduced.Among these HIV-1 and HSV-2-seropositive women, suppressive acyclovir therapy had no effect on the rate of HIV genital shedding despite a reduction in genital HSV-2. Treatment adherence and its measurement clearly affect the interpretation of these results.

Background Prevention of mother-to-child transmission of HIV (PMTCT) programs collect socio-demographic and HIV testing information similar to that collected by unlinked anonymous testing sero-surveillance (UAT) in antenatal settings. Zimbabwe evaluated the utility of PMTCT data in replacing UAT. Methods A UAT dataset was created by capturing socio-demographic, testing practices from the woman’s booking-card and testing remnant blood at a laboratory from 1 June to 30 September 2012. PMTCT data were collected retrospectively from ANC registers. UAT and PMTCT data were linked by bar-code labels that were temporarily affixed to the ANC register. A questionnaire was used to obtain facility-level data at 53 sites. Results Pooled HIV prevalence was 15.8 % (95 % CI 15.3–16.4) among 17,349 women sampled by UAT, and 16.3 % (95 % CI 15.8 %–16.9 %) among 17,150 women in PMTCT datasets for 53 sites. Pooled national percent-positive agreement (PPA) was 91.2 %, and percent-negative agreement (PNA) was 98.7 % for 16,782 women with matched UAT and PMTCT data. Based on UAT methods, overall median prevalence was 12.9 % (Range 4.0 %–19.4 %) among acceptors and refusers of HIV test in PMTCT compared to 12.5 % ((Range 3.4 %–19.5 %) among acceptors in ANC registers. There were variations in prevalence by site. Conclusion Although, there is no statistical difference between pooled HIV prevalence in UAT compared to PMTCT program, the overall PPA of 91.2 % and PNA of 98.7 % fall below World Health Organisation (WHO) benchmarks of 97.6 % and 99.6 % respectively. Zimbabwe will need to strengthen quality assurance (QA) of rapid HIV testing and data collection practices. Sites with good performance should be prioritised for transitioning. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-1425-2) contains supplementary material, which is available to authorized users.

Background The behaviour of insect vectors has an important bearing on the epidemiology of the diseases they transmit, and on the opportunities for vector control. Two sorts of electrocuting device have been particularly useful for studying the behaviour of tsetse flies (Glossina spp), the vectors of the trypanosomes that cause sleeping sickness in humans and nagana in livestock. Such devices consist of grids on netting (E-net) to catch tsetse in flight, or on cloth (E-cloth) to catch alighting flies. Catches are most meaningful when the devices catch as many as possible of the flies potentially available to them, and when the proportion caught is known. There have been conflicting indications for the catching efficiency, depending on whether the assessments were made by the naked eye or assisted by video recordings. Methodology/Principal Findings Using grids of 0.5m2 in Zimbabwe, we developed catch methods of studying the efficiency of E-nets and E-cloth for tsetse, using improved transformers to supply the grids with electrical pulses of ~40kV. At energies per pulse of 35–215mJ, the efficiency was enhanced by reducing the pulse interval from 3200 to 1ms. Efficiency was low at 35mJ per pulse, but there seemed no benefit of increasing the energy beyond 70mJ. Catches at E-nets declined when the fine netting normally used became either coarser or much finer, and increased when the grid frame was moved from 2.5cm to 27.5cm from the grid. Data for muscoids and tabanids were roughly comparable to those for tsetse. Conclusion/Significance The catch method of studying efficiency is useful for supplementing and extending video methods. Specifications are suggested for E-nets and E-cloth that are ~95% efficient and suitable for estimating the absolute numbers of available flies. Grids that are less efficient, but more economical, are recommended for studies of relative numbers available to various baits., Author Summary With a view to refining studies of tsetse fly behaviour, we used a catch method, in the field in Zimbabwe, to assess and improve the efficiency of 0.5m2 electrocuting grids commonly used to sample tsetse that collide with netting while in flight or which alight on cloth. We found that the efficiency of both sorts of grid was improved if the ~40kV electricity supply pulsed at 1ms intervals, as opposed to the 5–15ms commonly used in the past. Efficiency was also improved if the energy per pulse was at least 70mJ. For the netting grid, which is ideally required to be invisible to the flies, the visibility seemed reduced if the netting were much finer than that used previously, and if the distance between the grid and its supporting frame were increased from 2.5cm to 27.5cm. The indications for muscoids and tabanids were much the same as for tsetse. Using these field results and a simple model of grid performance, we suggest the specification of grids suitable for various sampling purposes.

Background The biology of adult tsetse (Glossina spp), vectors of trypanosomiasis in Africa, has been extensively studied – but little is known about larviposition in the field. Methodology/Principal Findings In September-November 1998, in the hot-dry season in Zimbabwe’s Zambezi Valley, we used artificial warthog burrows to capture adult females as they deposited larvae. Females were subjected to ovarian dissection and were defined as perinatal flies, assumed to have entered burrows to larviposit, if oocyte sizes indicated >95% pregnancy completion. Perinatal flies were defined as full-term pregnant if there was a late third instar larva in utero, or postpartum if the uterus was empty. All other females were defined as pre-full-term pregnant (pre-FT). Of 845 G. m. morsitans captured, 91% (765) were female and 295/724 (41%) of females dissected were perinatal flies. By contrast, of 2805 G. pallidipes captured only 71% (2003) were female and only 33% (596/1825) of females were perinatal. Among all perinatal females 67% (596/891) were G. pallidipes. Conversely, in burrows not fitted with traps – such that flies were free to come and go – 1834 (59%) of pupae deposited were G. m. morsitans and only 1297 (41%) were G. pallidipes. Thus, while more full-term pregnant G. pallidipes enter burrows, greater proportions of G. m. morsitans larviposit in them, reflecting a greater discrimination among G. pallidipes in choosing larviposition sites. Catches of males and pre-FT females increased strongly with temperatures above 32°C, indicating that these flies used burrows as refuges from high ambient temperatures. Conversely, catches of perinatal females changed little with maximum temperature but declined from late September through November: females may anticipate that burrows will be inundated during the forthcoming wet season. Ovarian age distributions of perinatal and pre-FT females were similar, consistent with all ages of females larvipositing in burrows with similar probability. Conclusions/Significance Artificial warthog burrows provide a novel method for collecting tsetse pupae, studying tsetse behaviour at larviposition, assessing the physiological status of female tsetse and their larvae, and of improving understanding of the physiological dynamics of terminal pregnancy, and population dynamics generally, with a view to improving methods of trypanosomiasis control., Author Summary Adult tsetse, vectors of trypanosomiasis, have been extensively studied for more than 100 years, but little is known about larviposition behaviour in the field. Pupae are generally collected in the field via arduous searches of putative larviposition sites. Females have never been sampled in the field as they deposit a larva, leading to confusion about the physiological dynamics at the end of pregnancy. We overcome these problems through the use of artificial warthog burrows, where tsetse deposit pupae during the hot dry season in the Zambezi Valley of Zimbabwe. When burrows were fitted with a retaining trap it was also possible to sample perinatal (full-term pregnant and postpartum) female tsetse. Comparisons of the numbers of pupae deposited in burrows without the trap, with the numbers of perinatal flies trapped in burrows, showed that many full-term pregnant female tsetse enter burrows but then leave without depositing a larva. G. pallidipes are more discriminating in this regard than G. m. morsitans. Capture of perinatal females will make it possible, for the first time, to compare the physiological status of female tsetse and the pupa they have just deposited, with important implications for the understanding of tsetse population dynamics.

Summary Objective To examine the relationships between maternal knowledge and concern about HIV status, adoption of preventive practices and risk of acquiring HIV in Zimbabwe. Methods Knowledge and behavioural data were collected via interview from 2595 mothers enrolled in ZVITAMBO, a randomized trial of postpartum vitamin A supplementation that also offered education on safer infant feeding and sexual practices. Mothers were tested for HIV at delivery; those uninfected at baseline were retested during study follow-up. Logistic regression methods were used to identify variables associated with adoption of preventive behaviours and, for HIV-negative mothers, their relationship to risk of acquiring HIV post-delivery. Results A total of 518 mothers (20%) reported practicing safer sex and 289 mothers (11%) reported modifying their feeding behaviour because of HIV. Fear of transmitting HIV (50.4%) and protecting the baby's health (30.9%) were the most frequently cited reasons for behaviour change. Forty-nine HIV-negative mothers acquired HIV during the first postpartum year. After taking into account other significant covariates, mothers who were concerned about their own HIV status were 1.9 times more likely (95% CI: 1.05–3.52; P = 0.03), and those reporting safer sex practices were 58% less likely to become infected (adjusted odds ratio: 0.42; 95% CI: 0.17–1.04; P = 0.06). Married women who reported practicing abstinence to prevent HIV were 3.2 times more likely to become infected than non-abstaining mothers (P = 0.01), while there were no new HIV infections among abstaining single mothers. Conclusions Greater emphasis should be given to safer sex practices among women who test negative in mother-to-child HIV prevention programmes. Objectifs Examiner les associations entre la connaissance des meres et les inquietudes au sujet du statut VIH, l'adoption de pratiques preventives et le risque d'acquisition du VIH au Zimbabwe. Methode Les donnees sur la connaissance et les comportements ont ete collectees a l'occasion d'interviews avec 2595 meres recrutees a Svitambo, lors d'un essai randomise de supplementation post-partum de vitamine A au cours de laquelle une education sur la nutrition des enfants et des pratiques sexuelles plus sure a ete procure. Les meres ont ete testees pour le VIH a l'accouchement. Celles qui etaient infectees a la base ont ete retestees au cours d'un suivi. Des methodes de regression logistique ont ete utilisees pour identifier des variables associees avec l'adoption de comportements preventifs et, pour les meres VIH negatives, l'association de ces comportements avec le risque d'acquisition du VIH apres l'accouchement. Resultats 518 meres (20%) ont rapporte des pratiques sexuelles sures et 289 (11%) des modifications dans leurs comportements pour la nutrition des bebes a cause du VIH. La crainte de transmette le VIH (50,4%) et le desir de proteger la sante du bebe (30,9%) etaient les raisons les plus citees pour le changement de comportement. 49 meres VIH negatives ont acquis le VIH durant la 1ere annee de post-partum. Apres la prise en compte d'autres covariables importants, les meres qui etaient inquietes au sujet de leur propre statut VIH etaient 1,9 fois plus susceptibles (IC95%: 1,05–3,52; p = 0,03) et celles qui rapportaient avoir des pratiques sexuelles plus sures etaient 58% moins susceptibles de devenir infectees (OR ajustes = 0,42, IC95%: 0,17–1,04; p = 0,06). Les femmes mariees ayant rapporte la pratique de l'abstinence etaient 3,2 fois plus susceptibles que les meres non abstinentes de devenir infectees (p = 0,06), alors qu'il n'y avait pas de nouvelle infections chez les meres celibataires abstinentes. Conclusions Une attention plus importante devrait etre accordee pour des pratiques sexuelles plus sures chez les femmes avec un test negatif dans les programmes de prevention de la transmission VIH mere-enfant. Objetivo Examinar la relacion entre el conocimiento materno y la preocupacion sobre el estatus de VIH, la adopcion de practicas de prevencion y el riesgo de adquirir VIH en Zimbabwe. Metodos Se recogieron datos sobre conocimiento y conducta mediante entrevistas a 2595 madres que participaban en ZVITAMBO, un ensayo aleatorizado de suplementacion posparto con vitamina A que ademas ofrecia educacion sobre practicas sexuales y de lactancia mas seguras. Las mujeres fueron testadas para VIH despues del parto; a aquellas no infectadas se les realizo de nuevo la prueba durante el periodo de seguimiento. Se utilizaron metodos de regresion logistica para identificar variables asociadas con la adopcion de un comportamiento preventivo, y para las madres seronegativas, su relacion con el riesgo de adquirir el VIH tras el parto. Resultados 518 madres (20%) reportaron practicar sexo seguro y 289 madres (11%) reportaron haber modificado sus practicas de lactancia por el VIH. Las razones mas frecuentemente citadas para explicar el cambio de comportamiento eran el miedo a transmitir el VIH (50.4%) y proteger la salud del bebe (30.9%). Cuarenta y nueve mujeres VIH negativas se infectaron durante el primer ano de posparto. Despues de tener en cuenta otras covariables significativas, las madres que se mostraban preocupadas sobre su propio estatus de VIH tenian una probabilidad 1.9 veces mayor de infectarse (95% CI: 1.05–3.52; p = 0.03), mientras que aquellas que reportaban el practicar sexo seguro tenian un 58% menos de probabilidad de infectarse (Adj. OR: 0.42; 95% CI: 0.17–1.04; p = 0.06). Las mujeres casadas que reportaban el practicar la abstinencia como metodo para prevenir el VIH, tenian un probabilidad 3.2 veces mayor de infectarse que aquellas madres que no se abstenian (p = 0.01), mientras que no hubo nuevas infecciones por VIH entre madres solteras que practicaban la abstinencia. Conclusiones Deberia enfatizarse mas la importancia de la practica del sexo seguro entre aquellas madres que son negativas para VIH al ingresar en programas de prevencion de transmision sexual.

Introduction: Herpes simplex virus type 2 (HSV-2) facilitates sexual acquisition of HIV-1 but data on transmission are less clear. In this study the interaction between genital shedding of HIV-1 and HSV-2 was explored among Zimbabwean sex workers. Methods: Women (n = 214) were interviewed about genital symptoms. Blood samples were analysed for HIV-1 and HSV-2 antibodies, HIV-1 plasma viral load (PVL) and CD4 lymphocyte count and genital swabs for detection of HIV-1 and HSV-2 genital shedding, Chlamydia trachomatis, Neisseria gonorroheae and Trichomonas vaginalis, and a cervico-vaginal lavage (CVL) for quantitative measurement of HIV-1 shedding. Shedding analyses were undertaken on women co-infected with HSV-2 and HIV-1. Results: A total of 124 women were co-infected with HIV-1 and HSV-2; 58 were infected with HSV-2 alone. Most HIV-1-infected women were co-infected with HSV-2 (95.4%). Genital HIV-1 shedding was detected in 84.3% of co-infected women and was associated with low CD4 cell count and high PVL but not with reported symptoms of genital herpes or genital shedding of HSV-2. There was no difference in HIV-1 shedding among women shedding HSV-2 (79.3%) and women not shedding HSV-2 (83.2%) (P = 0.64). The adjusted odds ratio for HIV-1 shedding between HSV-2 shedders and non-shedders was 0.8 [95% confidence interval (CI), 0.2-3.3]. HIV-1 PVL(log(10)) and CVL viral load(log(10)) were correlated (r = 0.38; 95% Cl, 0.2-0.5). After adjusting for PVL, genital symptoms and age, HSV-2 shedding had no effect on CVL viral load (P = 0.13). Conclusion: Rate and quantity of HIV-1 genital shedding do not appear to be altered by presence of HSV-2 genital shedding. (C) 2006 Lippincott Williams & Wilkins.

The distributions of insecticide-treated cattle from sites in Tanzania and Zimbabwe were assessed from interviews with livestock owners, analysis of secondary livestock data and mapping technologies. The time-course of tsetse control operations at these sites were then simulated using a mathematical model that assumed diffusive movement and logistic growth in fly populations. A simulation of a tsetse control operation in Mudzi district, north-east Zimbabwe, was in accord with observations that the use of insecticide-treated cattle was unable to prevent substantial re-invasion of tsetse from Mozambique, consequent on the patchy distribution of cattle. The simulation was also consistent with the observed efficacy of a 10-km wide barrier of insecticide-treated targets deployed evenly at 4 km−2. Simulation of a control operation on Mkwaja Ranch in Tanzania was in accord with the observation that the use of insecticide-treated cattle reduced the tsetse population on the ranch by c. 90%. Insecticide-treated cattle were used to better effect in the Kagera Region of Tanzania. Simulation of this operation predicts that the deployment of 35,000 treated cattle in the area would result in > 99% control of the tsetse population, consistent with the observed decline, by 1–2 orders of magnitude, in cases of trypanosomiasis in the region. The greater success of the Kagera operation was due to the size and shape of the treated area and, particularly, to the restriction of re-invasion to 20% of the perimeter, compared with > 80% on Mkwaja. Simulation was used to assess how tsetse control could have been improved at Mkwaja. The results suggest that splitting herds into smaller, more numerous, units could have achieved some improvement but, in general, the disease problem would not have been solved by the use of insecticide-treated cattle alone. Only by deploying odour-baited targets in ungrazed areas, or in a 1–3-km barrier around the ranch, could substantially better control (99–99.9%) have been achieved. Sensitivity analyses of the Mkwaja simulation showed that the general conclusions were robust to assumptions regarding cattle distribution and the rates of fly movement and growth. Properly managed and appropriately applied insecticide-treated baits are powerful weapons for tsetse control but should not be used without regard to potential levels of re-invasion, consequent largely on considerations of the size and shape of the treatment area and the density and distribution of the baits.

Objective: To determine the feasibility and acceptability of conducting a community randomized trial (CRT) of an adolescent reproductive health intervention (ARHI) using biological measures of effectiveness.Setting: Four secondary schools and surrounding communities in rural Zimbabwe.Methods: Discussions were held with pupils, parents, teachers and community leaders to determine acceptability. A questionnaire and urine sampling survey was undertaken among Form 1 and 2 pupils. Studies were undertaken to inform likely participation and follow up in a future CRT A community survey of 16-19-year-olds was conducted to determine levels of secondary school attendance and likely HIV prevalence at final follow up in the event of a trial.Results: Form 1 and 2 pupils aged 12-18 years (n = 723; median age, 15 years) participated in the research. Prevalences of HIV, Chlamydia and gonorrhoea were 3.6% [95% confidence interval (CI), 2.3-5.3%], 0.4% (95% CI, 0.1-1.3%) and 1.9% (95% CI, 1.0-3.3%) respectively. There was poor correlation between biological evidence of sexual experience and questionnaire responses, due to concerns about confidentiality. Only 13% (95% CI, 4-27%) of those infected with HIV and/or a sexually transmitted disease admitted to having had sex. in the community survey of 573 adolescents aged 16-19 years, 6.6% (95% CI, 3.9-10.3%) of females and 5.1% (95% CI, 2.9-8.2%) of males were HIV positive. High participation and retention rates are achievable within a trial in this setting.Conclusions: It is acceptable and feasible to conduct rand omized trials to establish the effectiveness of ARHIs. However, self-reported behavioural outcomes will probably be biased, emphasizing the importance of using externally validated biological outcome measures to determine effectiveness. (C) 2002 Lippincott Williams Wilkins.

Human and animal trypanosomiasis, spread by tsetse flies (Glossina spp), is a major public health concern in much of sub-Saharan Africa. The basic reproduction number of vector-borne diseases, such as trypanosomiasis, is a function of vector mortality rate. Robust methods for estimating tsetse mortality are thus of interest for understanding population and disease dynamics and for optimal control. Existing methods for estimating mortality in adult tsetse, from ovarian dissection data, often use invalid assumptions of the existence of a stable age distribution, and age-invariant mortality and capture probability. We develop a dynamic model to estimate tsetse mortality from ovarian dissection data in populations where the age distribution is not necessarily stable. The models correspond to several hypotheses about how temperature affects mortality: no temperature dependence (model 1), identical temperature dependence for mature adults and immature stages, i.e., pupae and newly emerged adults (model 2), and differential temperature dependence for mature adults and immature stages (model 3). We fit our models to ovarian dissection data for G. pallidipes collected at Rekomitjie Research Station in the Zambezi Valley in Zimbabwe. We compare model fits to determine the most probable model, given the data, by calculating the Akaike Information Criterion (AIC) for each model. The model that allows for a differential dependence of temperature on mortality for immature stages and mature adults (model 3) performs significantly better than models 1 and 2. All models produce mortality estimates, for mature adults, of approximately 3% per day for mean daily temperatures below 25°C, consistent with those of mark-recapture studies performed in other settings. For temperatures greater than 25°C, mortality among immature classes of tsetse increases substantially, whereas mortality remains roughly constant for mature adults. As a sensitivity analysis, model 3 was simultaneously fit to both the ovarian dissection and trap data; while this fit also produces comparable mortality at temperatures below 25°C, it is not possible to obtain good fits to both data sources simultaneously, highlighting the uncertain correspondence between trap catches and population levels and/or the need for further improvements to our model. The modelling approach employed here could be applied to any substantial time series of age distribution data., Author summary Trypanosomiasis, spread by tsetse flies (Glossina spp.), is a disease that is fatal for both humans and livestock if left untreated, and is a serious threat to public health in many regions of sub-Saharan Africa. In order to understand the dynamics of the disease it is important also to understand tsetse population dynamics. Tsetse fly mortality estimates are central to this understanding, but are difficult to acquire from wild populations. Previous methods for estimating mortality from age-distribution data assume a stable age structure and age-invariant mortality and capture probability. Based on prior fieldwork, none of these assumptions appears justified. Building on previous mortality estimation techniques, and incorporating what is known about tsetse population dynamics, we develop simulation techniques to estimate mortality for tsetse populations where the age distribution is not necessarily stable. We fit our models to age-distribution data produced in 1991 and 1992 at Rekomitjie Research Station in the Zambezi Valley in Zimbabwe. Our final model produces mortality estimates consistent with those of mark-recapture studies performed in other settings. We find that mortality increases with temperature, a result consistent with field and laboratory findings, and that the temperature effects are much more severe for pupae and newly emerged adults than for mature adults. Our dynamical modelling approach could be used for mortality estimation for any population where substantial age distribution data are available: specifically, it could be used to answer substantive questions about tsetse flies in other settings.

The structure, and assumed parameter values, of a recent dynamic population model for tsetse (Diptera: Glossinidae) render it unable to fit published data on tsetse control programs using odor-baited targets, insecticide-treated cattle and the sterile insect technique (SIT). The underlying problem is a mismatch between the small size of the mapped cells (1 ha) and the long time-step, which allows flies to move only once every 5 days, and then only to an adjacent cell. Assumed rates of tsetse dispersal and killing by odor-baited targets are consequently at least an order of magnitude lower than observed in the field. Suggestions that Glossina pallidipes could be eradicated more rapidly with SIT, than using hundreds of targets per km2, is contradicted both by the field data and by three other independent modeling studies.

Studies were made of the behaviour of Glossina pallidipes Austen and G. morsitans morsitans Westwood during the hot season (September–November) in Zimbabwe, and attributes of samples of tsetse from refuges, odour-baited traps, targets and mobile baits were compared. Various arrangements of electric nets were used to study tsetse as they entered or left artificial refuges. The peak time of entry into a refuge varied between 0800 h and 1400 h and coincided with the time when the air temperature reached 32°C; the response was stronger if 32°C occurred earlier in the day. The peak time of exit varied between 1500 h and 1700 h, being significantly later on hotter days, but did not show a clear temperature threshold. Micro-meteorological measurements showed that refuges were significantly cooler than the surrounding riverine woodland during the day but warmer at night. There was no significant difference between the air temperatures in leafless mopane woodland and semi-evergreen riverine woodland during the day but at night the riverine woodland was significantly cooler. Combining the micro-meteorological data with the estimated local movements of tsetse suggested that during the hot season, tsetse experienced temperatures 2°C cooler than the daily mean in a Stevenson screen located in mopane woodland. Compared with the catches of tsetse from traps, refuges had higher proportions of G. m. morsitans, males, young flies and females in the later stages of reproduction, and it is suggested that during the hot season, samples from refuges were less biased than traps with respect to species and sex composition, age and reproductive status. During the hot season, tsetse populations declined by c. 90% and although air temperatures exceeded lethal levels (c. 40°C), the refuge-entering responses meant that adult flies probably experienced a maximum of only c. 35°C. It is suggested that the decline in numbers is not due to direct mortality effects of temperature on adults but may be due, in part, to a doubling in the rates of reproductive abnormality during the hot season and an increase in adult mortality related to a temperature-dependent decrease in pupal period.

Fat and haematin levels of mature male Glossina morsitans morsitans Westwood were estimated at different times after feeding at temperatures between 15 and 30°C. Flies were kept (largely inactive) in 7.5 × 2.5 cm tubes, or in actograph cages, where flight activity increased with time after feeding. Haematin excretion was modelled as a series of three first order reactions, all with the same rate parameter. The model accounted for > 98% of the variance in mean haematin in each of seven experiments; the rate parameter increased linearly with temperature and activity level. A similar approach was adopted for modelling fat metabolism. The rate coefficients of lipogenesis increased with temperature, and that for lipolysis with temperature, activity level and their interaction. All experiments were analysed simultaneously to provide equations predicting haematin or fat levels for all times, for active or inactive flies, and for temperatures between 15 and 30°C. Haematin exhibited large variations between individuals, but for active flies the expected haematin content at a given time varied little between flies kept at 25 and at 30°C. In inactive flies kept at 25°C, lipogenesis peaked at ≈ 24 h and lipolysis at ≈ 48 h. For active flies the times were 12 and 24 h, respectively; both rates were about twice as high as in inactive flies. Active flies produced (up to 1 mg) more fat out of a given size of blood meal than inactive flies. Curves of fat content against logarithm of haematin content differed little with temperature, and can therefore be useful for comparative studies of field populations of tsetse.

Backround. Despite consistently meeting international performance targets for tuberculosis case detection and treatment success, areas where tuberculosis is hyperendemic fail to achieve the predicted epidemiological impact. In this article, we explore the anomalous relationship between defined performance targets and actual reduction in tuberculosis transmission. Methods. In areas where tuberculosis is endemic, poorly ventilated social gathering places such as shebeens (informal alcohol drinking places), minibus taxis, and clinic waiting rooms are all potential transmission hot spots. We modeled the transmission reduction achieved by removal of infectious persons in settings with different tuberculosis prevalence rates to demonstrate the concept of transmission elasticity. We then applied this concept to real-life data from a hyperendemic community in Cape Town, South Africa. Results. In a hyperendemic area, reducing the number of infectious people by a given percentage results in a smaller percentage decrease in the annual risk of infection (ARI) compared with a nonendemic area; for example, removing 10% of infectious persons could result in as little as a 5% reduction in the ARI. With use of real-life data and removal of 60% of infectious individuals with tuberculosis, as would be achieved by meeting current performance targets of 70% case detection and 85% cure, the estimated ARI reduction is 50%. Conclusions. The relationship between the number of infectious people removed and the decrease in ARI is nonlinear. The concept of transmission elasticity has important implications for the formulation of universal performance targets, since hyperendemic areas would require more stringent targets to achieve comparable transmission reduction.

Objective The BED assay was developed to estimate the proportion of recent HIV infections in a population. We used the BED assay as a proxy for acute infection to quantify the associated risk of mother-to-child-transmission (MTCT) during pregnancy and delivery. Design A total of 3773 HIV-1 sero-positive women were tested within 96 h of delivery using the BED assay, and CD4 cell count measurements were taken. Mothers were classified according to their likelihood of having recently seroconverted. Methods The risk of MTCT in utero and intra-partum was assessed comparing different groups defined by BED and CD4 cell count, adjusting for background factors using multinomial logistic models. Results Compared with women with BED ≥ 0.8/CD4 ≥ 350 (typical of HIV-1 chronic patients) there was insufficient evidence to conclude that women presenting with BED

Background: Several approaches have been used for measuring HIV incidence in large areas, yet each presents specific challenges in incidence estimation. Methodology/Principal Findings: We present a comparison of incidence estimates for Kenya and Uganda using multiple methods: 1) Epidemic Projections Package (EPP) and Spectrum models fitted to HIV prevalence from antenatal clinics (ANC) and national population-based surveys (NPS) in Kenya (2003, 2007) and Uganda (2004/2005); 2) a survey-derived model to infer age-specific incidence between two sequential NPS; 3) an assay-derived measurement in NPS using the BED IgG capture enzyme immunoassay, adjusted for misclassification using a locally derived false-recent rate (FRR) for the assay; (4) community cohorts in Uganda; (5) prevalence trends in young ANC attendees. EPP/Spectrum-derived and survey-derived modeled estimates were similar: 0.67 [uncertainty range: 0.60, 0.74] and 0.6 [confidence interval: (CI) 0.4, 0.9], respectively, for Uganda (2005) and 0.72 [uncertainty range: 0.70, 0.74] and 0.7 [CI 0.3, 1.1], respectively, for Kenya (2007). Using a local FRR, assay-derived incidence estimates were 0.3 [CI 0.0, 0.9] for Uganda (2004/2005) and 0.6 [CI 0, 1.3] for Kenya (2007). Incidence trends were similar for all methods for both Uganda and Kenya. Conclusions/Significance: Triangulation of methods is recommended to determine best-supported estimates of incidence to guide programs. Assay-derived incidence estimates are sensitive to the level of the assay’s FRR, and uncertainty around high FRRs can significantly impact the validity of the estimate. Systematic evaluations of new and existing incidence assays are needed to the study the level, distribution, and determinants of the FRR to guide whether incidence assays can produce reliable estimates of national HIV incidence.

BACKGROUND: Whereas HAART initiated at CD4 cell counts 351-450 cells/ml reduces mortality compared with starting at lower CD4 levels there is currently no evidence for the advantages of initiating treatment at CD4 cell counts greater than 450 cells/ml. METHODS: Mortality hazard as a function of CD4 cell count was estimated among postpartum HIV-positive women in Zimbabwe using HIV-negative women as the reference group. RESULTS: Mortality within 24 months postpartum was 54 times higher among women with CD4 cell counts less than 200 cells/ml fell to 5.4 times higher for those with CD4 cell counts 400-600 cells/ml but fell little thereafter. For CD4 cell counts greater than 600 cells/ml the hazard was 6.2 (95% confidence interval 3.2-11.9). CONCLUSION: Early HAART initiation for all HIV-positive pregnant women may benefit individual mothers and infants and simultaneously reduce population HIV incidence.