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Objective: To estimate facility-level average cost for ART services and explore unit cost variations using pooled facility-level cost estimates from four HIV empirical cost studies conducted in five African countries .Methods: Through a literature search we identified studies reporting facility-level costs for ART programmes. We requested the underlying data and standardised the disparate data sources to make them comparable. Subsequently, we estimated the annual cost per patient served and assessed the cost variation among facilities and other service delivery characteristics using descriptive statistics and meta-analysis. All costs were converted to 2017 US dollars ($). Results: We obtained and standardised data from four studies across five African countries and 139 facilities. The weighted average cost per patient on ART was $251 (95% CI: 193-308). On average, 46% of the mean unit cost correspond to antiretroviral (ARVs) costs, 31% to personnel costs, 20% other recurrent costs, and 2% to capital costs. We observed a lot of variation in unit cost and scale levels between countries. We also observed a negative relationship between ART unit cost and the number of patients served in a year.Conclusion: Our approach allowed us to explore unit cost variation across contexts by pooling ART costs from multiple sources. Our research provides an example of how to estimate costs based on heterogeneous sources reconciling methodological differences across studies and contributes by giving an example on how to estimate costs based on heterogeneous sources of data. Also, our study provides additional information on costs for funders, policy-makers, and decision-makers in the process of designing or scaling-up HIV interventions.

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The Geoffroy’s cat Leopardus geoffroyi (d’Orbigny & Gervais, 1844) is a small cat found in the Southern Cone of South America and, depending on the author, four or five subspecies have been usually recognized (L. g. geoffroyi, L. g. paraguae, L. g. euxanthus, L. g. salinarum and L. g. leucobaptus), mainly based on external morphological characters, such as color pattern of the pelage. In order to clarify the taxonomy of L. geoffroyi, I analyzed approximately 200 specimens housed in museums. I have examined the external and craniodental morphology in quantitative and qualitative terms in the search for patterns of congruent characters that would indicate the existence of taxonomic units. Twenty craniodental measurements were taken and tested by univariate and multivariate (MANOVA, PCA and DFA) procedures. In this study I detected a great variation in the morphological characters, and thus it was not possible to determine whether any of these were geographically consistent and could be used to determine any taxonomic unit. Based on this, I do not recognize any subspecific division for L. geoffroyi. Along its geographic range, a gradual and subtle change from one color pattern to the next along the latitude was detected, but the morphological characters that were used to define the putative subspecies were also detected in a same population. Furthermore, the present study is congruent with the results obtained by previous molecular data, suggesting that L. geoffroyi has a high level of genetic diversity with no geographic structure. This indicates the existence of a large panmictic population with no significant barriers to gene flow and, as a consequence, no subspecies should be recognized.

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The Geoffroys cat Leopardus geoffroyi (dOrbigny & Gervais, 1844) is a small cat found in the Southern Cone of South America and, depending on the author, four or five subspecies have been usually recognized (L. g. geoffroyi, L. g. paraguae, L. g. euxanthus, L. g. salinarum and L. g. leucobaptus), mainly based on external morphological characters, such as color pattern of the pelage. In order to clarify the taxonomy of L. geoffroyi, I analyzed approximately 200 specimens housed in museums. I have examined the external and craniodental morphology in quantitative and qualitative terms in the search for patterns of congruent characters that would indicate the existence of taxonomic units. Twenty craniodental measurements were taken and tested by univariate and multivariate (MANOVA, PCA and DFA) procedures. In this study I detected a great variation in the morphological characters, and thus it was not possible to determine whether any of these were geographically consistent and could be used to determine any taxonomic unit. Based on this, I do not recognize any subspecific division for L. geoffroyi. Along its geographic range, a gradual and subtle change from one color pattern to the next along the latitude was detected, but the morphological characters that were used to define the putative subspecies were also detected in a same population. Furthermore, the present study is congruent with the results obtained by previous molecular data, suggesting that L. geoffroyi has a high level of genetic diversity with no geographic structure. This indicates the existence of a large panmictic population with no significant barriers to gene flow and, as a consequence, no subspecies should be recognized.(AU)

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The participation of reactive oxygen species and reactive nitrogen speciesin hypertension is a well recognized fact. As vitamins C and E are knownto possess antioxidant activity by scavenging reactive oxygen and nitrogen species, this study aimed at describing the intake of vitamins C and E in a group with hypertension and normal blood pressure along with previous data on oxidative stress in these populations, that was evaluated as positive for the fi rst group. We investigated seven reports on 24 h-dietary recalls, 19 of which presented hypertension and 20 had normal blood pressure. The intake of total calories, carbohydrates, proteins, lipids and vitamins C and E compared with the DRIs were analyzed, together with the evaluation of the intake of servings of fruits and vegetables compared with the recommendations of the Food Guide for the Brazilian Population. The variability of the diet was assessed by the coeffi cients of intra-individual and intra-group variations and, also, the variation between groups. There was no signifi cant variation in energy intake in both groups, and the distribution of macronutrients was considered appropriate for the majority of the individuals. The group with hypertension showed greater variation and lower mean intake of vitamin C and greater mean intake and lower variation of vitamin E. Although this profi le of intake may be related to oxidative stress, the complexity of the antioxidant system in human body does not allow the establishment of an association of this diet profi le with the presence of redox imbalance in this group, even if reasonable.

La participación de especies reactivas de oxigeno y nitrógeno en la hipertensión es un hecho bien reconocido. Como las vitaminas C y E ejercen actividad antioxidante al capturar especies reactivas de oxigeno y nitrógeno (ERON) el presente estudio tuvo como objetivo describir laingestión de tales vitaminas en dos grupos: uno de hipertensos y otro de no hipertensos, los cuales habían sido sometidos previamente a un estudiodel estrés oxidativo que fue detectado solamente en el grupo de hipertensos. Fueron evaluados siete recordatorios de ingestión de alimentos, de 24 horas de 19 individuos hipertensos y de 20 no hipertensos. La ingestión de calorías totales, carbohidratos, proteínas, lípidos y vitaminas C y E fue analizada, comparándose la ingestión de estas dos últimas con las DRIs. También fue evaluada la ingestión de porciones de frutas, legumbres y verduras comparada con las recomendaciones del Guía Alimentar para la Población Brasileña. La variabilidad de la dieta fue evaluada por medio de coefi cientes devariación intraindividual, intra-grupos y entre grupos. No hubo variación significativa de ingestión de energía en cualquiera de los grupos,siendo la distribución de macronutrientes adecuada para la mayoría de los individuos. El grupo de hipertensos presentó menor ingestión y mayor variabilidad de vitamina C y mayor ingestión y menor variabilidad de vitamina E. A pesar de que tal perfi l de ingestión puede estarrelacionado con el estrés oxidativo, la complejidad del sistema antioxidante en el organismo humano no permite establecer una asociación de ese perfi l de dieta con la presencia del desequilibrio redox en ese grupo, aún siendo pertinente.

A participação de espécies reativas de oxigênio e de nitrogênio na hipertensão é fato bem reconhecido. Como as vitaminas C e E exercematividade antioxidante, ao capturar espécies reativas de oxigênio e nitrogênio (ERON), o presente estudo teve como objetivo descrever aingestão de tais vitaminas em dois grupos: de hipertensos e de não hipertensos, estudados anteriormente quanto ao balanço redox, sendoconstatado estresse oxidativo no primeiro grupo. Foram avaliados sete inquéritos dietéticos do tipo recordatório de 24 horas de 19 indivíduoshipertensos e 20 indivíduos não hipertensos. A ingestão de calorias totais, carboidratos, proteínas, lipídios e das vitaminas C e E foi analisada, comparando-se a ingestão das duas últimas com as DRIs. Foi avaliada, ainda, a ingestão de porções de frutas, legumes e verduras, comparando-a com as recomendações do Guia Alimentar para a População Brasileira.A variabilidade da dieta foi avaliada por meio de coefi cientes de variação intraindividual, intragrupos e entre grupos. Não houve variaçãosignificativa de ingestão de energia em qualquer dos grupos, sendo a distribuição de macronutrientes adequada para a maioria dosindivíduos. O grupo de hipertensos apresentou menor ingestão e maior variabilidade de vitamina C e maior ingestão e menor variabilidade de vitamina E. Apesar de tal perfi l de ingestão poder estar relacionado como estresse oxidativo, a complexidade do sistema antioxidante no organismo humano não permite estabelecer uma associação desse perfi lde dieta com a presença do desbalanço redox nesse grupo, mesmo sendo pertinente.

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