More on Regush
John Liesch
http://www.globeandmail.ca/gam/Commentary/20000504/COWENT04.html
John Liesch
Gary Stein
news:u483hs8nnf1o4me81...@4ax.com...
> Commentary in today's Globe and Mail
>
> http://www.globeandmail.ca/gam/Commentary/20000504/COWENT04.html
>
> John Liesch
From the article;
"What is the quality of Mr. Regush's journalism? Well, in 1996, the
CBC's the fifth estate ran a full-hour program he both proposed and
produced. It was a medical exposé called, The Heart of the Matter. It
insinuated that a certain heart medication was not only unsafe, but
was killing thousands of patients, and that two Canadian doctors were
hushing up the truth about this killer drug because they had ties to
big drug companies.
Both doctors took the CBC and Mr. Regush to court for libel, and both
won. Last fall, Dr. Martin Myers was awarded $200,000. Two weeks ago,
Dr. Frans Leenen was awarded $950,000 -- the highest damage award in
Canadian media history. The judge in the Leenen case slammed Mr.
Regush for his "slanted and reprehensible story line," docked him
personally for $200,000 in aggravated and punitive damages, and wrote:
"Parasitic sensationalists should not be allowed to prey upon
society's obsession with scandal and to reap personal benefit from
their irresponsible actions."
--
Gary Stein
ges...@starpower.net
http://www.mischealthaids.org
"Usenet is like a herd of performing elephants with diarrhea
massive, difficult to redirect, awe-inspiring, entertaining, and
a source of mind- boggling amounts of excrement when you least expect
it."
(Gene Spafford)
Alex
John Liesch heeft geschreven in bericht ...
>Commentary in today's Globe and Mail
>
>http://www.globeandmail.ca/gam/Commentary/20000504/COWENT04.html
This "commentary" isn't very well founded and is full of rather the usual
hysterical overstatements and untruths.
For instance, if you thought that the foremost critic of AIDS science
today was dr. Peter Duesberg, Margaret Wente states:
"The foremost critic of AIDS science in the world today is South Africa's
president, Thabo Mbeki."
Last time I looked, President Thabo Mbeki hadn't pronounced a verdict
for or against - but he seems to have incurred the wrath of the establishment
for simply holding a conference to look at the points from either side.
Meanwhile, after aligning Thabo Mbeki with the extreme right (ho-hum),
she goes on to swallow the AIDS epidemiology, which is the most
questionable part of the theory anyway, hook, line an sinker when
she states:
"Meantime, AIDS is poised to devastate South Africa, which has one of
the highest infection rates in the world. More than 10 per cent of the
population is infected with HIV, and 3.5 million of them will probably die
in the next decade."
AIDS has been "poised to devastate" for 20 years now. It's supposed
to have already devastated Uganda, but Uganda is growing!!
I remember watching a German documentary 15 years ago, showing
the summum bonum of promiscuity in Africa, a bar with young
people slow-dancing! And this was the proof that Uganda
was at the 'epicenter' of an epidemic that would devastate the continent, etc.
Well, that was _15 years_ ago, and there still isn't a country which has
been 'devastated' by AIDS yet.
She doesn't seem to have a clue as to how an std is supposed
to infect 10% of the population (and the figure usually bandied
about is 25%). Does 10% of the Southafrican population have
hepatitis? And hepatitis is much more easy to catch than HIV.
Does she, as a "journalist", question how these figures were
arrived at?
"Throughout subsaharan Africa, 23 million people are now infected. Not
far behind: Southeast Asia, India, China, Latin America, the Caribbean."
Not far behind? But hey, after all, that's where all them thar colored folk
live, aint it? Guess they're more likely to catch HIV that the Westerners are.
She also likes to conflagrate those who believe that HIV doesn't exist,
those who believe that HIV exists but is harmless, and those who
believe that HIV exists and is harmful but don't think that the
extent of the epidemic has been correctly established.
How convenient - by simply throwing in everyone who opposes the
standard theory and figures with their weakest link (that HIV doesn't
exist), she then no longer has to talk about the extent of the epidemic
or the specificity of HIV tests, especially in tropical regions.
This all doens't smack to me of "junk science" but of junk journalism.
She smugly concludes:
"Those who deny those facts are contributing to the death of
thousands, maybe millions. They don't deserve a hearing. They deserve
contempt."
I have no doubt that when it is proven that the extent of the epidemic
in Africa is hugely exaggerated, and that there is no imminent
heterosexual epidemic, anywhere on this planet, will face no
scrutiny, will never face one day in jail, for all the pregnant
women who have been forced to take a chemical like AZT.
Already, people have died in "experiments" and some drug trials in South Africa
have been stopped.
(British Medical Journal at http://www.bmj.com/cgi/content/full/320/7241/1028 )
Who will apologize to their families? Who will
take responsibility for the exaggeration of the extent of the epidemic
by journalists like Margaret Wente et al, that has lead to an explosion
of drugs trials and experiments?
What's the certainty that a single Elisa test, performed on pregnant
women in malaria invested areas, who also have been exposed
to TB or leprosy bacteria, is correct when it turns out "positive"?
But then, there has always been safety in numbers.
Alex
Alex
Gary Stein heeft geschreven in bericht <8es9hs$8nh$1...@bob.news.rcn.net>...
>Both doctors took the CBC and Mr. Regush to court for libel, and both
>won. Last fall, Dr. Martin Myers was awarded $200,000. Two weeks ago,
>Dr. Frans Leenen was awarded $950,000 -- the highest damage award in
>Canadian media history. The judge in the Leenen case slammed Mr.
>Regush for his "slanted and reprehensible story line," docked him
>personally for $200,000 in aggravated and punitive damages, and wrote:
>"Parasitic sensationalists should not be allowed to prey upon
>society's obsession with scandal and to reap personal benefit from
>their irresponsible actions."
And sometimes journalists who stick their necks out are wrong.
That's why it is called sticking your neck out.
Alex
John Liesch
American article?
http://www.sciam.com/2000/0500issue/0500ezzel.html
John Liesch
Alex
John Liesch heeft geschreven in bericht ...
>American article?
>
>http://www.sciam.com/2000/0500issue/0500ezzel.html
John, thank you very much for drawing my attention to this article.
It highlights exactly what is wrong here.
Namely, that there HIV can only truly be diagnosed by testing,
not by looking around. And that one can only extrapolate from
data that is both sound, as well as representative.
The article tries to hit you over the head first, by images of
emaciated, dying people (where did we see that before?).
"The face of HIV is everywhere: on the taxi driver who drove me to my first appointment this
morning, on my waiter last night, on the woman selling roasted corn on the cob at the side
of the road, on the businessman emerging from his Mercedes."
The truth is, people in the tropics can often look drawn. That isn't AIDS, and it
certainly isn't HIV. That's _the heat_. Add to that bad water, and presto.
Paranoia strikes with this reporter, as is should anyone who buys into this
idiocy:
"The likelihood that one in every four people I meet is infected with HIV haunts me as I walk the
streets of Harare."
However, and this is really the crux of the story and the problem, how were these
numbers arrived at?
"The statistic derives from blood samples collected periodically from
pregnant women who show up at a dozen maternity clinics around the country--a
system that even Evaristo Marowa, director of the NACP, acknowledges is inaccurate."
**Of course it is inaccurate** - pregnancy is a co-factor in attaining false positives,
especially from Elisa. And, pregnant women are not representitive for the whole
of society. (And in case Bennet responds - pregnancy may be a cofactor
_in the West_ in 1.9% of cases, but it is likely to be much more relevant
in the tropics, but that's another thread. Once you begin to wonder _why_
pregnancy would give false positives for HIV antibodies, then you must take
into account that it is because there are antibodies to other diseases much
more rife in the tropics which may exacerbate this factor. In the tropics,
women will have antibodies to hosts of tropical diseases, many more than
pregnant women in the West.)
Now John, and I'm saying this to you in total honousty and without sarcasm,
both of us must ask ourselves - in a country that is relatively prosperous like
Zimbabwe, why isn't anyone taking the trouble to find out the real statistics,
that is, do a statistical study on a large sample of people, that is demographically
representative for the entire population, and perform tests as they would be done
in the West, that is, first an Elisa, then a Western Blot for backup.
Simple. But it isn't done. Why not?
Another note - there is no evidence that "promiscuity" in Africa is greater
than anywhere else on the planet. However, that's the myth that the reporter
happily buys into (she's even buying into the antics of a cabby. :-) - of course,
in true form, she assumes he's having sex with even more women than
he's boasting about. And of course, you can't know if someone died of AIDS
before they've been tested - I'll bet none of his relatives were tested.)
Hard figures, not prejudice about African society etc. are what are going to resolve
this issue.
She doesn't even know much about Africa's sociology - she even uses the word
'tribal', which as a term has been discredited for decades in anthropology
(mainly because anthropologists in the past used it as freely as they once
used the word 'race' to denote empires, kingdoms, emirates, linguistic groups,
ethnic groups, nations and towns and villages; they used it to such an extent that
as a term it lost it's content. Anyway, Zimbabwe isn't "torn by tribal violence", as
for once accurately stated).
If you want to read more about the myth about sex as practiced in Africa,
which are so abundant in this piece (right up to the 'dry sex' thing), check
out this article by Charles Geshekter, who actually is a professor of
African History.
A CRITICAL REAPPRAISAL OF AFRICAN AIDS
RESEARCH AND WESTERN SEXUAL STEREOTYPES
http://www.virusmyth.com/aids/data/cgstereotypes.htm
However, what everyone needs in this discussion, is accurate,
reliable statistics.
Alex
Bennett
>
<snip>
(And in case Bennet responds - pregnancy may be a cofactor
>_in the West_ in 1.9% of cases, but it is likely to be much more relevant
>in the tropics, but that's another thread.
Okay, I'll bite :o) Why more relevant? Is it purely because a lot of the
data is arrived at from testing pregnant women, or are you hinting at
something more?
Once you begin to wonder _why_
>pregnancy would give false positives for HIV antibodies, then you must take
>into account that it is because there are antibodies to other diseases much
>more rife in the tropics which may exacerbate this factor.
Whoa there: from what I've read, the best explaination for false-positives
in pregnant women is a response to the activation of endogenous retroviruses
that are important in placenta function/immune-suppression. I kid ye not.
>
>Now John, and I'm saying this to you in total honousty and without sarcasm,
>both of us must ask ourselves - in a country that is relatively prosperous
like
>Zimbabwe, why isn't anyone taking the trouble to find out the real
statistics,
>that is, do a statistical study on a large sample of people, that is
demographically
>representative for the entire population, and perform tests as they would
be done
>in the West, that is, first an Elisa, then a Western Blot for backup.
I have a feeling they are...I've pulled a couple of African studies off the
web recently, a few of which were from the same area as this SciAm report,
and they used the standard testing protocol (2 ELISAs with WB). In terms of
practical management of preventing HIV spread, I know that some areas rely
on ELISA alone, but in terms of practical use this is good enough. I'm
getting the distinct impression that the data that actually gets _published_
and used for estimates is considerably more stringent...but the only way to
say that for sure is to read the methods sections of all the relevant papers
(they don't always say they've used ELISA+WB in the abstracts). However,
it's interesting that the data is consistant between the reports, suggesting
that either the methods _are_ being applied rigourously elsewhere, or the
false-positive rate isn't as significant as many say.
Bennett
--
University of Cambridge Dept of Medicine
Opinions expressed are mine - I'll take the rap for my own mistakes.
(swap cam for spam to reply via email)
Big fish, little fish, put it in a box. Stacking boxes, stacking boxes...
Gary Stein
news:3911c00d$0$10...@reader1.casema.net...
True but sticking ones neck out simply to sell a story rather then in
a search for truth is the issue that must be examined when looking at
Regush's reporting and his new book. In the above case he was not even
discussing an experimental drug, the data that was used against him in
the trial was available to him before he produced the piece in
question. One needs then ask when a particular journalists work is so
one sided as to not report the other sides position on a topic could
the motivation of the journalist be suspect? In both Regush and
Farber's work I think one must ask this question often. Both totally
ignore balanced reporting much in the same way you complained that
this reporter did. Should you then not apply the same level of
scientism to there work?
John Liesch
>
>However, what everyone needs in this discussion, is accurate,
>reliable statistics.
Do you know where they can be found?
John Liesch
Gary Stein
Certainly not on the Virusmyth site.........................
Alex
Gary Stein heeft geschreven in bericht <8esm2p$dn$1...@bob.news.rcn.net>...
Perhaps you can then tell us all where data on a comprehensive,
statistically representative study that is large enough (i.e., sound)
and Elisa AND Western Blot testing based study can be found.
Could it be, Gary, that it isn't to be found on the Virusmyth website,
because it can't be found anywhere? That it can't be found
on any of the establishment websites either?
Alex
Alex
Bennett heeft geschreven in bericht <8eskop$88s$1...@pegasus.csx.cam.ac.uk>...
>Alex wrote in message <3911d17a$0$10...@reader1.casema.net>...
>>
><snip>
>(And in case Bennet responds - pregnancy may be a cofactor
>>_in the West_ in 1.9% of cases, but it is likely to be much more relevant
>>in the tropics, but that's another thread.
>
>Okay, I'll bite :o) Why more relevant? Is it purely because a lot of the
>data is arrived at from testing pregnant women, or are you hinting at
>something more?
>
>>Once you begin to wonder _why_
>>pregnancy would give false positives for HIV antibodies, then you must take
>>into account that it is because there are antibodies to other diseases much
>>more rife in the tropics which may exacerbate this factor.
>
>Whoa there: from what I've read, the best explaination
And that's just one explanation...
>for false-positives
>in pregnant women is a response to the activation of endogenous retroviruses
>that are important in placenta function/immune-suppression. I kid ye not.
Let's look at it more basically - what are these viruses (?) that can make
these tests come out positively when these tests are supposed to be
specific for antibodies against hiv only, and why are they so similar?
Basically, are there viruses out there so similar (I assume) to HIV that
tests for anti-bodies against HIV also turn positive for _their_ antibodies?
Are these viruses (if that's what they are) more common in the tropics
than they are in the North?
And what if this childbirth process also causes a woman to give her
child antibodies against malaria, tb, etc.?
>>Now John, and I'm saying this to you in total honousty and without sarcasm,
>>both of us must ask ourselves - in a country that is relatively prosperous like
>>Zimbabwe, why isn't anyone taking the trouble to find out the real statistics,
>>that is, do a statistical study on a large sample of people, that is demographically
>>representative for the entire population, and perform tests as they would be done
>>in the West, that is, first an Elisa, then a Western Blot for backup.
>
>I have a feeling they are...I've pulled a couple of African studies off the
>web recently, a few of which were from the same area as this SciAm report,
>and they used the standard testing protocol (2 ELISAs with WB). In terms of
>practical management of preventing HIV spread, I know that some areas rely
>on ELISA alone, but in terms of practical use this is good enough.
Not if it's _your_ life on the line.
>I'm
>getting the distinct impression that the data that actually gets _published_
>and used for estimates is considerably more stringent...but the only way to
>say that for sure is to read the methods sections of all the relevant papers
>(they don't always say they've used ELISA+WB in the abstracts). However,
>it's interesting that the data is consistant between the reports, suggesting
>that either the methods _are_ being applied rigourously elsewhere, or the
>false-positive rate isn't as significant as many say.
So now not only doesn't pregnancy not cause false positives, neither
do malaria, tb, leprocy, etc?? And the discrepancy between Africa and
America, as discrepancy which just happens to coincide with the
diseases??
Well, whatever your gut says, I'd rather have evidence. For instance, the
statistics gathered for Zimbabwe, from these childbirth clinics.
What they're based on, and why they're only gathered from pregnant women,
not from any representative sample of the population.
Alex
(PS, I've also checked on the HIVInsite website from the UCSF, but
_unlike_ the articles on www.Virusmyth.com, they don't have footnotes
to show where their data comes from.)
John Liesch
>
>Well, whatever your gut says, I'd rather have evidence. For instance, the
>statistics gathered for Zimbabwe, from these childbirth clinics.
>What they're based on, and why they're only gathered from pregnant women,
>not from any representative sample of the population.
>
in a population?
While you are waiting for a study done to your standards, why don't
you review the studies already done and let us know how each sample
was determined and whether or not that sample was representative or
not and if not, why not, and how seropositivity was determined in each
study.
John Liesch
Alex
John Liesch heeft geschreven in bericht ...
>>
>>Well, whatever your gut says, I'd rather have evidence. For instance, the
>>statistics gathered for Zimbabwe, from these childbirth clinics.
>>What they're based on, and why they're only gathered from pregnant women,
>>not from any representative sample of the population.
>>
>Wouldn't pregnant women be representative of the sexually active women
>in a population?
>
>While you are waiting for a study done to your standards,
My standards? Sounds like basic, sound statistics, or at least
it was then I went to university.
Alex
John Liesch
I see. You have already surveyed the literature and found it wanting.
Would you care to elaborate? With specifics to each study?
John Liesch
Alex
John Liesch heeft geschreven in bericht ...
>
>>
>>However, what everyone needs in this discussion, is accurate,
>>reliable statistics.
>
>Do you know where they can be found?
Trick question, of course. They don't exist, as far as I know.
However, if anyone knows where they can be found, feel
free to direct all of us into their direction.
Alex
Bennett
>>Whoa there: from what I've read, the best explaination
>
>And that's just one explanation...
>
>>for false-positives
>>in pregnant women is a response to the activation of endogenous
retroviruses
>>that are important in placenta function/immune-suppression. I kid ye not.
>
>
>Let's look at it more basically - what are these viruses (?) that can make
>these tests come out positively when these tests are supposed to be
>specific for antibodies against hiv only, and why are they so similar?
These viruses are human endogenous retroviruses (HERVs). There are several
examples, and even a degree of categorisation has been attempted to clump
them into families. You might already know that as part of a retrovirus
lifecycle it integrates into the DNA of the host cell. If such an event
occured in a germ cell, that later became a sperm or ovum, then the viral
DNA would get passed onto future generations. This is different from a
transmission event such as seen in HIV in mother->child infection: the ERV
effectively becomes a gene. There is also evidence that retroviruses
actually started life _as_ genes, and later acquired the "env" protein that
allowed them to exist outside cells and pass between them, effectively
becoming a virus as we commonly think of them. That's a whole new
discussion though.
Why are they similar? Well the genetic similarities I've seen have been in
the "env" region, gp41 and gp120 in HIV. AFAIK antibodies to this are
tested for in the ELISA, among other proteins. However, the endogenous RV's
that I know of lack the accessory proteins that characterise HIV and other
so-called "complex" RV's.
It's known that antibodies _are_ produced to some of these HERVs, which may
or may not activate in any one human. The titres are far lower than those
seen against HIV. I think at least 2 HERVs have been implicated in
pregnancy. One is apparently responsible for immune-suppression to protect
the foetus (which is not much better than a transplant, and vunerable to
rejection). Another HERV has an env protein that is important in fusing
cells together to form the syncitium that is vital for good nutrient/gas
exchange between mother and foetus. The bizarre conclusion is that at some
point a retrovirus infected an animal X and allowed it to form more complex
placentas, or even placentas at all. This may have been the origin of
mammals (ooer, very odd) or responsible for species divergence. Env
proteins of RV's, as well as membrane proteins of other viruses (measles is
the classic) can also result in this cell-fusion process. In HIV, the
emergence of syncitia-forming strains was associated with progression to
AIDS, but it's not a clear-cut thing.
>
>Basically, are there viruses out there so similar (I assume) to HIV that
>tests for anti-bodies against HIV also turn positive for _their_
antibodies?
Depends what antibodies you use and what you're looking for. Based on what
I know about HERVs, I wouldn't be surprised if antibodies specific for
"HIV-1 env" cross-reacted with env from some HERVs. This could light up an
ELISA, but I don't think they react to give a positive WB - possible an
indeterminate result though.
>
>Are these viruses (if that's what they are) more common in the tropics
>than they are in the North?
They are present as genes in the human species. I don't know of any racial
differences, they are no less a "human gene" than our versions of insulin,
the globin chains, p53 etc etc etc....
>And what if this childbirth process also causes a woman to give her
>child antibodies against malaria, tb, etc.?
I've no idea how effective this would be - I presume reasonably good, since
it's a normal function of maternity. Again, it would depend on what effect
those Abs would have in real terms. And remember that malaria at least
doesn't seem to be a factor at all in that context.
The thing is, what difference would it make? Serological diagnosis of
newborns is suspect anyway: you have to wait for symptoms of infection, or
do a PCR, or look for IgA instead of IgG, or wait for maternal antibodies to
wane and see if the child produces some of their own. Begs the question:
how _do_ they diagnose newborns without more complex techniques..?
<snip>
>>I have a feeling they are...I've pulled a couple of African studies off
the
>>web recently, a few of which were from the same area as this SciAm report,
>>and they used the standard testing protocol (2 ELISAs with WB). In terms
of
>>practical management of preventing HIV spread, I know that some areas rely
>>on ELISA alone, but in terms of practical use this is good enough.
>
>Not if it's _your_ life on the line.
In that context, it's better to be safe than sorry. When I say "practical"
I mean that literally. If you're screening people for blood donations
you're better off turning away slightly more than normal than risking
getting HIV into the system. Those who are told their blood "isn't good
enough" (such a nice euphormism) go back to their lives and nothing more is
done.
>
>>I'm
>>getting the distinct impression that the data that actually gets
_published_
>>and used for estimates is considerably more stringent...but the only way
to
>>say that for sure is to read the methods sections of all the relevant
papers
>>(they don't always say they've used ELISA+WB in the abstracts). However,
>>it's interesting that the data is consistant between the reports,
suggesting
>>that either the methods _are_ being applied rigourously elsewhere, or the
>>false-positive rate isn't as significant as many say.
>
>So now not only doesn't pregnancy not cause false positives, neither
>do malaria, tb, leprocy, etc??
Malaria, I don't think is an issue. Mycobacteria: I don't know either way.
My point was that regardless of the _potential_ for such problems, if you
look into the literature they seem to be being avoided since most data seem
to fit that that collected under stringent conditions. There are also
degrees of false-positive, depending on whether WB is used or not.
And the discrepancy between Africa and
>America, as discrepancy which just happens to coincide with the
>diseases??
The discrepancies can be explained mostly in terms of transmission
behaviours, as far as I can tell.
>
>Well, whatever your gut says, I'd rather have evidence. For instance, the
>statistics gathered for Zimbabwe, from these childbirth clinics.
>What they're based on, and why they're only gathered from pregnant women,
>not from any representative sample of the population.
I imagine they're based on pregnant women because they're a sample who turn
up for blood tests. I agree with you that the key issue is what the stats
are based on. The hospital referred to in the SciAm report seems to do
things properly, and other paper from that area also say they've used 2
ELISA +WB in diagnosis.
One issue that hasn't so far been mentioned, is that if the diagnoses were
that suspect, would the paper get published? Some of these are in the
Lancet, Nature, BMJ: the problems with false-positives are known from the
past, so wouldn't you expect the reviewers to question any results? There
are WHO guidelines to diagnosis that I imagine researchers would have to
meet as a minimum to have their data considered reliable.
I suppose one way to help lay the issue to rest is to follow up the refs
from places like the WHO and UNAIDS and see what the methods were.
>
>(PS, I've also checked on the HIVInsite website from the UCSF, but
>_unlike_ the articles on www.Virusmyth.com, they don't have footnotes
>to show where their data comes from.)
www.unaids.org have data factsheets on most countries which include
appendices of references that were used in compiling the data. Not all are
amenable to easy follow-up (being official govt reports and the like).
Cheers
Bennett
--
University of Cambridge Dept of Medicine
Opinions expressed are mine - I'll take the rap for my own mistakes.
(swap cam for spam to reply via email)
A half-truth is like half a brick: You can throw it further
Gary Stein
>
> Gary Stein heeft geschreven in bericht
<8esm2p$dn$1...@bob.news.rcn.net>...
> >"John Liesch" <jli...@home.com> wrote in message
> >news:qhm3hsg39448lefn1...@4ax.com...
> >wrote:
> >>
> >> >
> >> >However, what everyone needs in this discussion, is accurate,
> >> >reliable statistics.
> >>
> >> Do you know where they can be found?
> >
>
>
> Perhaps you can then tell us all where data on a comprehensive,
> statistically representative study that is large enough (i.e.,
sound)
> and Elisa AND Western Blot testing based study can be found.
>
> Could it be, Gary, that it isn't to be found on the Virusmyth
website,
> because it can't be found anywhere? That it can't be found
> on any of the establishment websites either?
Well you could start with the following;
http://www.unaids.org/hivaidsinfo/documents.html#determinants
http://www.unaids.org/publications/documents/epidemiology/surveillance
/wad1999/Una99e53.doc
http://www.unaids.org/publications/documents/epidemiology/determinants
/una98e9.pdf
http://www.unaids.org/publications/documents/epidemiology/determinants
/una199912kme.pdf
http://www.unaids.org/hivaidsinfo/documents.html
http://www.unaids.org/hivaidsinfo/statistics/june98/fact_sheets/index.
html#h1
Once you've analyzed these documents and have clear ideas as to how
you think they are flawed you could then come back with specific
recommendations and or questions.
mcoo...@my-deja.com
>
> >Both doctors took the CBC and Mr. Regush to court for libel, and both
> >won. Last fall, Dr. Martin Myers was awarded $200,000. Two weeks ago,
> >Dr. Frans Leenen was awarded $950,000 -- the highest damage award in
> >Canadian media history. The judge in the Leenen case slammed Mr.
> >Regush for his "slanted and reprehensible story line," docked him
> >personally for $200,000 in aggravated and punitive damages, and
wrote:
> >"Parasitic sensationalists should not be allowed to prey upon
> >society's obsession with scandal and to reap personal benefit from
> >their irresponsible actions."
>
> And sometimes journalists who stick their necks out are wrong.
>
>
> Alex
No, Alex, no. Regush and his partner were found guilty of LIBEL. That
means the court found that he had INTENTIONALLY lied about the facts.
That is NOT sticking one's neck out. Journalists do sometimes stick
their necks out and get things wrong. But that is normally determined
after the fact. At least with honest journalists. Regush wrote things
he knew to be false.
Your credulity on this topic does not bode well for your understanding
of rather more complicated topic of estimating African AIDS cases.
Sent via Deja.com http://www.deja.com/
Before you buy.
fran...@my-deja.com
"Gary Stein" <ges...@starpower.net> wrote:
> Well you could start with the following;
[snipped list of references, they reappear in my comments below]
> Once you've analyzed these documents and have clear ideas as to how
> you think they are flawed you could then come back with specific
> recommendations and or questions.
but alex never said these documents were flawed (obviously, since you
just listed them for us). he was merely asking if there are any
studies that used both elisa and western blot as the method of
determining HIV status in african populations.
now, whoever it is that thinks elisa and western blot should both be
used in africa to determine HIV status, but can't say for sure if they
are, that person has some research to do. and that would include you,
gary, should you believe those two test should be used. so perhaps both
of you can analyze the documents at the references you posted and tell
us of any flaws you find and whether or not they support your views.
i've done some preliminary research for you:
four references you posted were:
http://www.unaids.org/publications/documents/epidemiology/surveillance/w
ad1999/Una99e53.doc
http://www.unaids.org/publications/documents/epidemiology/determinants/u
na98e9.pdf
the above two documents won't help here as they do not specify the
methods used, nor are there any references that would allow us to
determine the methods used.
three other references you posted were:
http://www.unaids.org/hivaidsinfo/documents.html
http://www.unaids.org/hivaidsinfo/documents.html#determinants
http://www.unaids.org/hivaidsinfo/statistics/june98/fact_sheets/index.ht
ml#h1
http://www.unaids.org/publications/documents/epidemiology/determinants/u
na199912kme.pdf
these refs takes you to pages where you can navigate to articles about
africa (or straight to an article if you go to the last ref). i looked
at 10 or more of these articles from the first three refs and none of
them specified the testing methods used, but some did give references
that might allow you to find out. the article at the last ref doesn't
specify the methods in the text either, but it does list references. i
suggest that you take some of these articles as your starting point.
Robert S. Holzman
fran...@my-deja.com wrote:
>
[snip]
[snip]
Anyone who wants to go to deja news and do a power search on my
postings with "ebola" in the title or "standards" in the keywords
window will find an exchange with franmerk on this subject last
october. Over the years I have posted many research papers from
standard journals such as the Journal of Infectious Disease which
indicate that the western blot is being used in africa in medium
to large scale research, if not for routine serodiagnosis. In
addition studies validating the use of epidemiologic diagnoses
against ELISA/Western blotting have shown that the epidemiologic
diagnoses have high predictive values (better than 85%) both for
negative and positives when compared to the serologic tests.
For studies on the western blot test, itself, in africa and
africans, go to aidsline and construct the following search..
1 africa/ 1433
2 blotting, western 3349
3 wb.tw. 1271 (this catches use of wb in
abstracts)1
4 1 and (2 or 3) 35
I have put some of the abstracts below:
Unique Identifier
01330391
Authors
Gershy-Damet. Bettinger S. Martin J. Herranen A. Somme G.
Institution
Institut Pasteur - Abidjan - Cote d'Ivoire
Title
Rapid serological diagnosis of HIV1 and HIV2 infections
using synthetic
peptides.
Source
Int Conf AIDS. 7(1):373 (abstract no. M.C.3303), 1991 Jun
16-21.
Abstract
OBJECTIVES: HIV1 and HIV2 infections remain a severe problem
in many developing countries. In many African countries, anti-HIV
screening is technically and economically difficult while the
demand for blood is often great and the prevalence of HIV
infections is high. To implement routine screening for HIV in
developing countries effectively, simple assays are needed, which
give reliable results in less time than the conventional Elisa
method. We describe here results obtained in african fields with
such a test: RAPID HIV1/HIV2 Ab is a dot immunobinding assay that
can be used to screen blood samples and that can differentiate
between anti-HIV1 and anti-HIV2 antibodies. This serotyping is
especially useful in countries where seroprevalence of both
infections is high, to distinguish between true dual infections
and type cross-reactivities. METHODS: RAPID HIV1/HIV2 Ab involves
binding of HIV antibodies by two synthetic peptides (HIV1 and
HIV2 antigens), which are adsorbed on a porous membrane in two
diametrically opposed spots. Binding of specific antibodies is
revealed by addition of a peroxidase ate and enzyme substrate. A
color change from white to blue indicates a positive specimen.
Results are recorded as negative if the test control (blue
peripheral ring) appear only on the membrane. Results are
recorded as positive if one (or two) dots appear with the ring on
the membrane. RESULTS: A total of 650 sera from West and Central
Africa were selected on the basis of clinical and epidemiological
data, and were divided in three groups: AIDS, asymptomatic HIV
positive and HIV negative groups. Among the 150 AIDS patients
tested (50 anti-HIV1, 50 anti-HIV2 and 50 anti-HIV 1+HIV2), all
were diagnosed according to their specificity by Western blot.
Likewise, among the 300 asymptomatic HIV positive patients
tested, 100 were found HIV1, 100 HIV2 and 100 HIV1 + HIV2
positives as do the reference technique. 200 healthy or sick
(other diseases) african people were used as control population
and found negative in all cases. CONCLUSION: This evaluation
shows that the RAPID HIV1/HIV2 Ab test is very sensitive and
specific with serum and specimens from african origin, whatever
their serologic status. Types of infections are perfectly
distinguished in this study, according to the previous western
blot results. The test can be performed quickly, needs no
instrumentation and interpretation is very easy (no inter-reader
variability). It should be interesting to study under what
conditions this test could be used in developing countries, for
which specific algorithmes are needed. (Abstract by: Author)
Unique Identifier
91232300
Authors
Mitchell SW. Mboup S. Mingle J. Sambe D. Tukei P. Milenge K.
Nyamongo J. Mubarak OK. Sankale JL. Hanson DS. et al.
Institution
Family Health International, Research Triangle Park Branch,
Durham, North
Carolina 27709.
Title
Field evaluation of alternative HIV testing strategy with a
rapid
immunobinding assay and an agglutination assay.
Source
Lancet. 337(8753):1328-31, 1991 Jun 1.
Local Messages
At Medical Library, see MEDCAT for holdings
Abstract
A rapid immunobinding assay ('HIVCHEK', Ortho) and an
agglutination assay ('Serodia-HIV', Fujirebio) were evaluated as
an alternative to enzyme-linked immunosorbent assay (ELISA) and
western blot under field conditions in Africa for detection of
antibody to human immunodeficiency virus (HIV). 7106 specimens
were tested at 25 laboratories in Kenya, Ghana, Senegal, and
Zaire. HIVCHEK was used as a screening test, and serodia-HIV as a
supplemental test to evaluate these assays in an alternative
testing strategy to the standard ELISA/western blot testing
prcedure. In each country, HIVCHEK was more sensitive and
specific than
ELISA when compared with western blot. The sensitivity of HIVCHEK
ranged from 87.0 to 96.3% and the specificity from 99.0 to 100%.
The sensitivity and specificity of serodia-HIV ranged from 85 to
98% and from 88 to 98%, respectively. The sensitivity and
specificity were affected by the presence of HIV-2 in Ghana and
Senegal. Overall, with an HIV-1 prevalence of 14.8% in Kenya and
22.5% in Zaire, the sensitivities of the alternative strategy
were 96.4% and 91.4%, the specificities 99.6% and 100%, the
positive predictive values 97.6% and 100%, and the negative
predictive values 99.3% and 97.9% for Kenya and Zaire,
respectively. With this testing format there was an
estimated average cost saving of up to 82% over the conventional
strategy with ELISA/western blot. This procedure constitutes a
reasonable alternative to the standard ELISA/western blot
combination. (Abstract by: Author)
Unique Identifier
96920873
Authors
Peeters M. Mboup S. Gueye A. Liegeois F. Patrel D. Vanden
Haesevelde M. Delaporte E.
Institution
Service de Bacterio - virologie Hopital de Dantec B.P.,
Dakar, Senegal. Fax:
22121 64 42.
Title
Survey on HIV-1 group O infection in 12 different African
countries.
Source
Int Conf AIDS. 11(1):14 (abstract no. Mo.A.510), 1996 Jul
7-12.
Abstract
Objective: To determine to what extend HIV-1 group O strains
are present in different African countries Materials and Methods:
11985 sera from 12 different African countries were tested
(Senegal, Mali, Togo, Burkina Faso, Niger, Nigeria, Tchaad,
Cameroon, Gabon, Congo, Burundi, Zambia). The sera were collected
among AIDS patients, tuberculosis patients, pregnant women, blood
donors, prostitutes and STD patients. All the sera were tested
for group O antibodies with an improved ELISA using a combination
of V3 peptides from ANT-70 and MVP-5180 (Research product,
Innogenetics, Belgium). Sera reactive by Elisa were retested in a
line immuno assay(LIA), in which different biotinylated V3
peptides (consensus, MAL, ANT-70, VI686, MVP-5180) were applied
as a streptavidin complex in parallel lines on nylon strips
(Research product, Innogenetics, Belgium). Samples reactive in
Elisa were also retested on an in-house western blot for the
presence of antibodies to gp120 of HIVHIV-1 ant-70. Sera were
considered as positive for HIV-1 group O antibodies if they
reacted on LIA exclusively with group O peptides whether or not
there was reaction on the ANT-70 WB, or when antibodies to group
O and M peptides were revealed by LIA accompanied by reactivity
with gp120 on ANT-70 WB. Samples reactive with group O and M
peptides without reaction to gp120 on ANT70 WB were considered as
indeterminate for HIV group O antibodies. Results: Among the
11985 sera tested, 5533 were HIV-positive, 5881 were HIV-negative
and 276 were HIV indeterminate. On the total amount of sera
tested, 17 were positive for HIV-1 group O antibodies and 52 were
indeterminate. Sera considered as positive for group O were all
previously identified as being HIV-positive and were found in 7
of the 12 African countries tested (Senegal (1),Togo (1), Niger
(2), Tchaad (3), Gabon (2), Cameroon (7) and Nigeria (1)). Among
the 52 group O indeterminate sera 51 were HIV-positive and 1 was
HIV indeterminate and they were identified in all the 12
countries included in this study. Conclusions: The prevalence of
HIV-1 group O viruses is very low (0,3% among HIV-1 positive
sera) but is not restricted to Cameroon and neighboring countries
like Gabon and Nigeria and can also be found in West Africa.
(Abstract by: Author)
Unique Identifier
94313119
Authors
Kline R. Newhouse R. Granade T. Phillips S. Moss M. Quinn
TC.
Institution
Johns Hopkins Univ., Baltimore, MD.
Title
Evaluation of the MicroTrak II HIV-1/HIV-2 recombinant
antigen enzyme
immunoassay.
Source
Abstr Gen Meet Am Soc Microbiol. 94:622 (abstract no. V-28),
1994.
Abstract
In a study, the reliability, sensitivity, and specificity of
the MicroTrak II HIV-1/HIV-2 EIA (MT II) were compared to
licensed EIAs and Western Blot (WB). 2490 sera from various
populations in the US, Africa, and India were evaluated at 3
different sites using the MT II and licensed HIV-1/HIV-2 EIAs
(Genetic Systems or Abbott). All repeatedly reactive sera were
reconfirmed by WB for HIV-1. Sera that were indeterminate by WB,
had discrepant results, or were previously known to be HIV-2
positive were retested using a licensed HIV-2 EIA (Genetic
Systems). All reactive samples were confirmed by HIV-2 WB.
Discrepant samples were also tested using a peptide assay (Select
HIV). Final interpretation of serological results was primarily
based on WB and, in some cases, RIPA, PCR, and culture. WB and
other confirmatory testing identified 910 HIV-1/HIV-2 positive
samples and 1580 hiv-1/HIV-2 negative samples. MT II detected
all 910 positive samples for a sentivity of 100% and the
licensed HIV-1/HIV-2 EIAs detected 904 positive samples for a
sensitivity of 99.3%. MT II characterized 1574 negative samples
as negative for a specificity of 99.6% and the licensed EIAs
detected 1565 negative samples as negative for a specificity of
99.1%. The 6 false positives by MT II were all sera from Africa.
The MicroTrak II HIV-1/HIV-2 EIA is a reliable assay that has a
slightly higher sensitivity and specificity compared to other
licensed EIAs. (Abstract by: Author)
Unique Identifier
93291862
Authors
Haynes T. Mazzaferro P. Lowery K. Flowers T. Shockley K.
Institution
Murex Corporation, Norcross, GA.
Title
Evaluation and assessment of the SUDS HIV-1/2 antibody test.
Source
Abstr Gen Meet Am Soc Microbiol. 93:556 (abstract no. V-25),
1993.
Abstract
Infection with HIV with subsequent development of AIDS
requires accurate serologic procedures to identify infected
individuals. Since the identification of HIV-1 in 1983 and HIV-2
in 1985/1986, numerous HIV serologic tests have been developed
and employed on a truly global scale. Current strategies in most
countries require testing for both HIV-1 and HIV-2. We report on
the evaluation and assessment of a prototype rapid (10
minutes) combined HIV-1/HIV-2 antibody test. A total of 1.259
serum/plasma samples previously tested with an FDA approved EIA
and/or Western Immunoblot were used to evaluate the SUDS HIV-1/2
Antibody Test. Of the samples tested, 1,035 were of United
States origin and 224 from African origin. Discrepant samples
were retested with the SUDS HIV-1/2 and Western Immunoblot. The
SUDS HIV-1/2 Antibody Test exhibited 100% sensitivity and 99.6%
specificity. The positive predictive and negative predictive
values were 99.4% and 100%, respectively. The SUDS HIV-1/2
Antibody Test demonstrates excellent sensitivity and specificity
and comparable efficacy with current FDA approved EIA's. The SUDS
HIV-1/2 Antibody Test provides a rapid procedure for detection
of HIV antibodies. (Abstract by: Author)
Unique Identifier
00905053
Authors
Proulx A. Stella M. Georges MC. Lapage C. Riggin C. Georges
AJ.
Institution
Cambridge BioScience Corporation, Worcester, Massachusetts
01605
Title
HIV-1 antibody testing using recombinant antigens with latex
and enzyme
immunoassays on African sera.
Source
Abstr Annu Meet Am Soc Microbiol. 90:434 (abstract no. V-4),
1990 May 13-17.
Abstract
We evaluated the performance of Recombigen HIV-1 Latex
Agglutination (LA), and Recombigen HIV-1 EIA (E &G) relative to
viral lysate EIA and Western blot (WB) on African sera. The LA
test consists of latex particles coated with recombinant env,
CBre3. LA is a 5 minute test performed upon a card, which is easy
to use and requires no equipment. The Recombigen HIV-1 EIA test
uses both recombinant env and gag, CBrg3, in a 1.5 hour
microtiter format. A total of 889 freshly collected serum samples
were screened. Samples testing positive by any test were
confirmed by viral lysate Western blot. The results compare the
performance of the recombinant based assays to the viral lysate
assays. There were 72 confirmed positive samples and the
sensitivity of the recombinant assays with these samples was
found to be 100%. The recombinant assays were found to have
superior specificity as compared to that of the viral lysate
assay, thereby reducing the number of false positive samples.
(Abstract by: Author)
Unique Identifier
30021390
Authors
van der Groen G. Van kerckhoven I. Vercauteren G. Piot P.
Esparza J. Tamashiro H.
Institution
Institute of Tropical Medicine, Antwerp, Belgium
Title
Operational characteristics of commercially available assays
to determine
antibodies to HIV-1 and/or HIV-2 in human sera.
Source
Int Conf AIDS. 6(3):133 (abstract no. S.C.213), 1990 Jun
20-23.
Abstract
OBJECTIVE: In order to advise Member States of WHO on the
selection of the appropriate HIV antibody assays, a study was
undertaken to obtain objective information on the characteristics
of commercially available assays. The study focused mainly upon
the comparative determination of operational aspects of these
assays, such as ease of performance, suitability for use in small
blood collection centres and sensitivity and specificity using
a small panel of well-characterized sera. METHOD: Most assays
were performed on a panel of 361 to 518 sera (including
anti-HIV-2) of African, European and South American origin. The
tests were compared to Western blot (WB) HIV-1, (Dupont) and a WB
HIV-2 (New Lav blot II, Pasteur). RESULT: The study evaluated 18
assays (9 ELISAs, 6 simple tests and 3 supplemental assays) with
an emphasis of ascertainment of simple/rapid tests. Two ELISAs, 1
simple test and 1 supplemental assay are designed for detecting
both anti-HIV-1 and anti-HIV-2 (combined assays). Performance
(sensitivity and specificity) of the simple assays was as good as
that of ELISAs regardless to the type of antigens used. First and
second generation EIAs were comparable. The combined assays
showed high sensitivity and specificity comparable to specific
assays for HIV-1 or HIV-2. Other operational factors of these
assays will be presented in detail. CONCLUSION: The detailed
information on these operational characteristics generated from
this study was found to be very useful to health policy decision
makers, directors of blood banks, managers of national AIDS
control programs and others. Reports will be made available
periodically to keep Member States informed of recent
developments on HIV diagnosis. (Abstract by: Author)
Alex
fran...@my-deja.com heeft geschreven in bericht <8evbub$obi$1...@nnrp1.deja.com>...
>In article <8euik0$4a3$1...@bob.news.rcn.net>,
>three other references you posted were:
>
>http://www.unaids.org/hivaidsinfo/documents.html
>http://www.unaids.org/hivaidsinfo/documents.html#determinants
>http://www.unaids.org/hivaidsinfo/statistics/june98/fact_sheets/index.ht
>ml#h1
>http://www.unaids.org/publications/documents/epidemiology/determinants/u
>na199912kme.pdf
From the last item's references, there is one that sounds slightly promising, namely:
Brockmeyer R. and Quinn T.C. Estimation of current human-immunodeficiency-virus
incidence rates from a cross-sectional survey using early diagnostic tests.
American Journal of Epidemiology 1995 141: 166-172
There's another one with an intrigueing title, though:
Gregson S., Zhuwau T., Anderson R.M. et al.
Age and religion selection biases in HIV-prevalence data from antenatal
clinics in Manicaland (spelling?) Zimbabwe.
Central African Journal of Medicine, 1995 41: 339-345.
Mulder D.W., Nunn A.l., Kamali A. and Kengeya-Kayondo J.F.
Decreasing HIV-1seroprevalence in young men in rural Ugandan cohort.
British Medical Journal, 1995 311: 833-836
If any details on the tests exist, maybe they're in the BMJ or
Central African Journal of Medicine, etc.
By the way, firstly on how and what HIV tests should be sufficient, according
to UNAIDS, I did find this piece on the UNAIDS website:
http://www.unaids.org/publications/documents/sectors/workplace/unstaff.html
"The first antibody test a person gets is called a screening test. If the screening test is negative,
it means that no antibodies were found. The person tested is considered HIV-negative and
confirmatory tests are not necessary. If the screening test is repeatedly positive, it must be
confirmed. Confirmation can be done by using special tests, e.g. Western Blot or line
immunoassays (LIA). It is also possible to confirm a positive result by using combinations
of ELISA or S/R tests. Although the confirmation can be done on the same sample of blood,
it is preferable to do the confirmation on a second blood sample in order to avoid any errors."
Kind of makes a joke of the "Bangui Definition" though, doesn't it?
Ok, so I did find one piece where Elisa was used with Western Blot,
but this is:
a) In South Africa, one of the richest countries in the area, and Western Blot
is often not performed _because of cost_ hence the existence and use of the
"Bangui Definition" or "clinical" diagnosis
b) Note well, that even in this survey, using Western Blot was _only one of 3 options_.
The article also does not say _how often_ this combination was used.
It also doesn't say if these different tests might actually be responsible for
the differences found in the 3 testing areas/clinics.
http://www.mrc.ac.za/hlabisa/anchiv.htm
"Antenatal surveys
"In March 1992 (n=884), November 1993 (n=709) and June 1995 (n=314), three anonymous
surveys of HIV infection in women attending the 10 antenatal clinics were conducted. Serum
left over from the antenatal blood testing of consecutive women at each clinic over a defined
time period, had personal identifiers removed and was marked only with the patient’s age and the
name of clinic. Serum was stored at 40C and transported to the regional hospital within 48 hours
for testing for antibody to HIV. Two different method ELISA tests were used, according to laboratory
practice at that time, and in accordance with international guidelines (8). Specimens were deemed
HIV positive if both ELISAs were positive or if one positive ELISA was confirmed with a Western Blot
or an immunofluorescent assay (8). Confidential and voluntary HIV testing and counselling was
available in all clinics at the times of these surveys."
Now, let's look at what those surveys found.
"The prevalence of HIV infection in women attending antenatal clinics in the Hlabisa district increased
from 4.2% (95% confidence interval [CI] 3.0-5.7) in 1992 to 7.9% (95%CI 6.0-10.1) in 1993, and to
14.0% (95%CI 10.4-18.4) in 1995 (table 1). This increase is highly significant (p=<0.0001).
"The pattern of age-specific prevalence was similar each year (table 1, figure). Highest prevalence
was in the 20-24 year age group, increasing from 6.9% in 1992 to 21.1% in 1995 (p=0.0001).
Results were not significantly affected by age standardisation and the
unadjusted figures are reported here.
"Prevalence was not uniform in the different clinics within the district. Higher prevalence was consistently
measured in the clinic that serves the township situated on the national road (8.5% in 1992; 10.3% in
1993; 29.5% in 1995).
"Comparison with other South African surveys
"HIV prevalence in Hlabisa was consistently lower than that estimated for the province as a whole from
the national surveys (table 2). Prevalence in the Durban antenatal clinic was 19% (95%CI: 16.5-21.7) in
1995, compared to 14% in Hlabisa (p=0.045). The difference in these crude rates can be attributed to
the much higher age-specific prevalence in women aged 15-19 years in Durban (22.4%) than Hlabisa
(7.4%, p=0.004). Other age-specific rates were similar in the two sites."
I'm leaving aside the extrapolations from these young women to the rest of society,
because they're tendentious.
Also, women actually attending antenatal clinics may be a self-selecting group,
as they may be the ones who are attending _because_ they are ill. It doesn't
say what percentage of women delivers at home, or why.
(In other words, pregnant women attending clinics are not a representative
sample of the population in any case. And, all of these tests are in Natal,
which has large level of transience with regards to the mines near
Johannesburg - Eastern Cape levels are much lower, suggesting that
heterosexual spread may not be the cause here and that Natal's
demographics are unique.)
Alex
John Liesch
wrote:
Hmm, no response from Alex. I had truly hoped you weren't just another
AIDS dissident groupie and had actually read the studies you
criticize.
John Liesch
fran...@my-deja.com
fran...@my-deja.com wrote:
>http://www.unaids.org/publications/documents/epidemiology/determinants/
una199912kme.pdf
the above ref discusses some of the problems of determining the extent
of HIV/AIDS. some examples:
"More generally, a number of practical
problems inhibit understanding of the
extent of HIV spread globally and
changes in the incidence and prevalence
of infection. The major problem is the lack
of representativeness of samples used to
monitor the epidemic, which can arise for
a number of reasons:
Sampling biases. The majority of studies
of HIV prevalence are based on conve-nience
samples. Hospital patients, STD
clinic patients, drug users, prisoners,
soldiers and sex workers all include many
with unusually high risks of having
acquired HIV infection. While they
indicate whether the virus has entered a
community and the level of infection in
the specific group they are little use in
determining the extent of the problem
through-out national populations. They
can though provide insights into the
changing pattern of incidence within the
groups they represent and indicate
whether behaviour of those with “high
risks” is altering.
Blood donors and pregnant women
are also often used as sentinel surveillance
groups as they are more likely to repre-sent
the “general” population. However,
blood donors are often pre-screened for
risks of HIV infection; this means that they
tend to underestimate the prevalence of
infection. The situation is complex in the
case of pregnant women who are
believed to represent most closely the
general population. They are in the age
classes where HIV is likely to be most
common and must have recently been
sexually active. However, it may be wrong
to assume that they overestimate HIV
prevalence."
also:
"Data from reviewed
scientific publications are not available
for many localities. In their absence, small
studies, often with no diagnostic test
details being reported, are relied upon to
indicate the course of the HIV epidemic."
not good to rely on such things, IMO. also:
"For
many countries, no data on the preva-lence
of HIV are published, for many
others studies are patchily distributed.
There is a tendency for prevalence to be
monitored in large urban centres. Often
such centres comprise a minority of a
nation’s population. The true extent of
HIV could only be estimated with a
diverse set of urban and rural samples.
There is no reason to believe that the
relationship between urban and rural
prevalences will be in any way fixed
between places and between times, so
extrapolation from urban prevalence to
rural prevalence and thence to national
prevalence should be handled with
extreme care."
i agree with the last statement.
mcoo...@my-deja.com
fran...@my-deja.com wrote:
> In article <8evbub$obi$1...@nnrp1.deja.com>,
> fran...@my-deja.com wrote:
>
>
>http://www.unaids.org/publications/documents/epidemiology/determinants/
> una199912kme.pdf
>
Thanks for the ref, Frank.
So do you now agree that it is the media who has gotten the story wrong
and NOT the public health authoritys responsible for surveillance of
HIV and AIDS? After all, your citations clearly states the limitations
inherent in estimating numbers infected with HIV and people with AIDS.
Further, as the quote in your post indicates, the need for cautious and
tentative reporting is clearly understood and underlined by UNAIDS.
So based on the citation you provided, where do think your problem with
estimates of HIV infection rates and AIDS cases in Africa comes from;
reporting by the news media or the medical establishment?
GMCarter
snip...
>So based on the citation you provided, where do think your problem with
>estimates of HIV infection rates and AIDS cases in Africa comes from;
>reporting by the news media or the medical establishment?
With regard to estimates, many point out that the numbers have been
far too low over the years. The CIA points this out.
In a report entitled The Global Infectious Disease Threat and Its
Implications for the United States (see
http://www.cia.gov/cia/publications/nie/report/nie99-17d.html ), they
state:
"A Word About Data
All data concerning global disease incidence, including WHO data,
should be treated as broadly indicative of trends rather than accurate
measures of disease prevalence. Much disease incidence in developing
countries, in particular, is either unreported or under-reported due
to a lack of adequate medical and administrative personnel, the stigma
associated with many diseases, or the reluctance of countries to incur
the trade, tourism, and other losses that such revelations might
produce. Since much morbidity and mortality are multicausal, moreover,
diagnosis and reporting of diseases can vary and further distort
comparisons. WHO and other international entities are dependent on
such data despite its weaknesses and are often forced to extrapolate
or build models based on relatively small samples, as in the case of
HIV/AIDS. Changes in methodologies, moreover, can produce differing
results. The ranking of AIDS mortality ahead of TB mortality in figure
2, for example, partly owes to the fact that HIV-positive individuals
dying of TB were included in the AIDS mortality category in the most
recent WHO survey."
and then:
"The 1996 joint World Bank/WHO model's projections that HIV/AIDS
deaths would peak in 2006 with 1.7 million deaths, for example, were
already exceeded by the 2.3 million deaths in 1998."
George M. Carter