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    • We propose that the same geospatial statistical

    2019-06-27

    We propose that the same geospatial statistical techniques can be applied to HIV. We used these techniques to estimate the number of HIV-infected individuals in Maseru (a health-care district in Lesotho) and establish their geographical location. The district of Maseru is a relatively large area, about 4300 km, and Lesotho has one of the most severe HIV epidemics in the world. We used HIV prevalence data collected in the 2009–10 Lesotho Demographic and Health Survey, which was based on cluster sampling. Handheld GPS devices were used to establish the geographical coordinates at each sample site. Of the Demographic and Health Survey sample sites in Maseru, 31 were in urban areas and 28 were in rural areas (). A map of Kriging estimates (ie, prevalence predictions) for individuals aged 15–49 years, based on the georeferenced prevalence data, is shown in ; spatial N-Methyl-D-aspartic acid molecular is 100m. The predictive map shows that prevalence is high (on average >20%) throughout Maseru, but that prevalence varies substantially with geography. Prevalence is predicted to be highest along the northwest border of the Maseru district where the city of Maseru (the capital of Lesotho) is located, and also in the centre of the district around the city of Roma. The standard error of the prediction estimates () range from 2·4% (black shading) to 6·8% (white shading). shows the geographical distribution of HIV-infected individuals and the density of infection; density ranges from 4·2 HIV-infected individuals per 100 m (red shading) to less than 0·05 HIV-infected individuals per 100 m (white shading). The map was used to determine that about 46 000 HIV-infected individuals aged 15–49 years live in the Maseru district. Geospatial statistical techniques have been used for more than 40 years in studies of many infectious diseases. They have provided important new insights into epidemics and, more recently, have assisted in the design of health policies for dengue, influenza, malaria, rotavirus, and tuberculosis. Their use could greatly assist the design of health policies to fight HIV epidemics. We recommend that—to maximise efficiency and cost-effectiveness—a geospatial approach should be used in decisions about how to roll out treatment-as-prevention and other public-health interventions in sub-Saharan Africa. At a minimum, this geospatial approach could be used to find HIV-infected individuals in high-prevalence epidemics, establish where they live, and estimate the burden of disease. We declare that we have no conflicts of interest. This work was supported by .
    The WHO Global Strategy on Food Safety, which is now a decade old, focuses on three principal lines of action: to advocate and support the development of risk-based, sustainable, integrated food safety systems; to devise science-based measures along the food production chain; and to assess and manage food-borne risks and communicate information. In this strategy, food safety is considered largely as a supply-side issue—reliant on producers, retailers, handlers, and regulators. Issues on the consumption side also affect food safety, which relates to how consumers acquire, cook, store, and consume foods. WHO\'s strategy does not fully address consumers\' behaviours that also introduce risks. Taking India as an example, we put forth a perspective that seeks to prioritise both sides of the issue. WHO\'s campaign is used to educate food manufactures and handlers in several countries about food hygiene. The campaign promotes personal hygiene, adequate cooking, avoidance of cross contamination, safe temperatures for food storage, and avoidance of foods from unsafe sources. Such campaigns offer little protection unless the cultural, behavioural, and contextual forces that shape specific practices—from food purchase to preparation and consumption—are addressed. In India, as in many countries, diverse food habits, hygiene practices, and centuries-old traditions coexist with the changes introduced by globalisation. With such conditions and scarcity of resources, promotion of food safety becomes a daunting public-health task.