Reorienting systematic conservation assessment for effective conservation planning.

Systematic conservation assessment (an information-gathering and prioritization process used to select the spatial foci of conservation initiatives) is often considered vital to conservation-planning efforts, yet published assessments have rarely resulted in conservation action. Conservation assessments may lead more directly to effective conservation action if they are reoriented to inform conservation decisions. Toward this goal, we evaluated the relative priority for conservation of 7 sites proposed for the first forest reserves in the Union of the Comoros, an area with high levels of endemism and rapidly changing land uses in the western Indian Ocean. Through the analysis of 30 indicator variables measured at forest sites and nearby villages, we assessed 3 prioritization criteria at each site: conservation value, threat to loss of biological diversity from human activity, and feasibility of reserve establishment. Our results indicated 2 sites, Yiméré and Hassera-Ndrengé, were priorities for conservation action. Our approach also informed the development of an implementation strategy and enabled an evaluation of previously unexplored relations among prioritization criteria. Our experience suggests that steps taken to ensure the closer involvement of practitioners, include a broader range of social data, encourage stakeholder participation, and consider the feasibility of conservation action can improve the relevance of assessments for conservation planning, strengthen the scientific basis for conservation decisions, and result in a more realistic evaluation of conservation alternatives.

Pneumococcal pneumonia in HIV-infected patients by antiretroviral therapy periods.

OBJECTIVE: To ascertain the relationship between periods of various antiretroviral therapies and the incidence of first community-acquired pneumococcal pneumonia (CAPP) among HIV-1 infected patients. METHODS: We analysed 4075 patients enrolled prospectively in the Lyon section of the French Hospital Database on HIV between 1993 and 2004, stratified into three groups. The first group (G1) included patients for whom enrolment and last follow-up were before the highly active antiretroviral therapy (HAART) period (beginning 1 July 1996); the second group (G2) comprised patients who were enrolled before HAART but had last follow-up in the HAART period; the third group (G3) included patients for whom both enrolment and last follow-up took place in the HAART period. RESULTS: Fifty-five CAPP episodes were identified. The incidence of CAPP per 1000 patient-years declined over time, from 10.6 to 1.5 and 2.5 in calendar periods G1, G2 and G3, respectively (P=0.004 for linear trend). Factors associated with a decreased risk of CAPP were lower age, baseline CD4 count >or=200 cells/microL and more recent years of enrolment, when HAART use became extensive (P<0.001). The use of intravenous drugs increased the risk of CAPP (P<0.001). CONCLUSIONS: There has been a significant reduction in the incidence of CAPP in HIV-1 infected patients since the advent of HAART.