Understanding patient-level costs of weekly isoniazid-rifapentine (3HP) among people living with HIV in Uganda.

BACKGROUND: Twelve weeks of weekly isoniazid and rifapentine (3HP) prevents TB disease among people with HIV (PWH), but the costs to people of taking TB preventive treatment is not well described.METHODS: We surveyed PWH who initiated 3HP at a large urban HIV/AIDS clinic in Kampala, Uganda, as part of a larger trial. We estimated the cost of one 3HP visit from the patient perspective, including both out-of-pocket costs and estimated lost wages. Costs were reported in 2021 Ugandan shillings (UGX) and US dollars (USD; USD1 = UGX3,587)RESULTS: The survey included 1,655 PWH. The median participant cost of one clinic visit was UGX19,200 (USD5.36), or 38.5% of the median weekly income. Per visit, the cost of transportation was the largest component (median: UGX10,000/USD2.79), followed by lost income (median: UGX4,200/USD1.16) and food (median: UGX2,000/USD0.56). Men reported greater income loss than women (median: UGX6,400/USD1.79 vs. UGX3,300/USD0.93), and participants who lived further than a 30-minute drive to the clinic had higher transportation costs than others (median: UGX14,000/USD3.90 vs. UGX8,000/USD2.23).CONCLUSION: Patient-level costs to receive 3HP accounted for over one-third of weekly income. Patient-centered approaches to averting or defraying these costs are needed.

Phagocytosis and killing of Pseudomonas aeruginosa by mouse polymorphonuclear leukocytes in vitro promoted by antiserum to the slime glycolipoprotein.

The resistance of Pseudomonas aeruginosa to phagocytosis by polymorphonuclear leukocytes was overcome by opsonization with antibody to slime glycolipoprotein or, to a lesser extent, with complement. Resistance was most effectively overcome in the presence of both. Protection against viable-cell challenge conferred by anti-glycolipoprotein serum in experimental infection is discussed briefly in the light of these findings.

Diet and mortality from malignant disease in 32 countries

W.H.O. mortality figures for 26 different types of malignant disease taken from 32 countries were correlated with data on the composition of the diet, as well as with certain indices reflecting aspects of general development, for those of the 32 countries for which they were available. For a majority of tumors the results were negative, but most showed a strong association with dietary factors. These included a positive correlation with the national consumption of fats and oils, total calories, and sugar, and a negative correlation with cereal consumption. For malignant tumours the rectum, breast, prostate, skin, nervous system, and bladder, and for leukaemia, lymphosarcoma and multiple myeloma, the probability of this association occurring by chance was less than 1 in 1,000. In seven cases the relationship with dietary factors was of a similar order to that of arteriosclerotic and degenerative heart disease. For all of the 18 separate types associated with diet, the correlation was higher than with the indices of general development,i.e., gross national product, newsprint consumption, percentage of the population engaged in agricultue and infant mortality. (AU)