Carotenoids are one of the widespread and ubiquitous lipid-soluble pigments that produce a wide range of colours which are universally found in various plants, microalgae, bacteria and fungi. Recently, interest in using carotenoids as feed ingredients has increased markedly owing to their bioactive and health-promoting properties. In terms of applications, carotenoid-rich products are widely available in the form of food and feed additive, supplements and natural colourants. Carotenoids play a versatile biological role that contributes to therapeutic effects, including anticancer, immunomodulators, anti-inflammatory, antibacterial, antidiabetic and neuroprotective. Dietary supplementation of carotenoids not only improves the production performance and health of poultry birds, but also enhances the quality of egg and meat. Several studies have suggested that the supplementation of plant derived carotenoids revealed numerous health-promoting activities in poultry birds. Carotenoids reduce the oxidative stress in pre-hatched and post-hatched birds through different mechanisms, including quench free radicals, activating antioxidant enzymes and inhibiting the signalling pathways. Use of carotenoids in poultry feed as a part of nutrient that confers bird health and improve product quality. Carotenoids play a critical role for the pigmentation of egg yolk, skin, legs, beak, comb, feather and fat. Birds consumed carotenoid deficient diet resulting hues of their egg yolk or pale coloured skin. Therefore, uniform pigmentation generally indicates the health status and quality of the poultry products. This review aims to gather recent information regarding bioactive properties of carotenoids and highlight pharmaceutical and health beneficial effects of carotenoids for the poultry industry. Additionally, it explores the importance of carotenoids as alternative feed ingredients for poultry to boost the production performance and replace synthetic medicine and nutrients.
Background: In April 2019, an HIV screening camp for all ages was established in response to a report of an unusually large number of paediatric HIV diagnoses in Larkana, Pakistan. A cross-sectional study to understand the clinical profile of children who registered for HIV care was performed. Methods: Age-and sex-stratified HIV prevalence among individuals screened was estimated. Data on children who registered for HIV care including clinical history, HIV disease stage, Hepatitis B and C status and CD4 count was abstracted from clinical records and analysed using percentages and chi square tests. Findings: Between April-July 2019, 31,239 individuals underwent HIV testing of whom 930 tested HIV-positive. Of these, 763 (82•0%) were aged <16 years. Estimated HIV prevalence was 3.0% overall; 7.4% (283/3803) in children aged 0-2 years, 5.9% (321/5412) in children aged 3-5 years, and 1•3% (148/11251) in adults aged 16-49 years. Of the 591 children who registered for HIV care, 80.9% (478/591) were ≤5 years, 64•1% (379/591) were male and 53•4% (315/590) had a weight-forage Z-score <-3. Hepatitis B surface antigen and Hepatitis C antibody positivity was 8•4% (48/574) and 2•6% (15/574) respectively. Of children whose mothers tested for HIV, only 39/371 (10•5%) had HIV-positive mothers. Most children (89•2%, 404/453) reported multiple previous injections and 40/453 (8•8%) reported blood transfusions. Interpretation: This is an unprecedented HIV outbreak among children in Pakistan: a 54% increase in paediatric HIV diagnoses over the past 13 years. Epidemiological and molecular studies to understand the full extent of the outbreak and its drivers are needed to guide HIV control strategies.
IntroductionIn April 2019, 14 children were diagnosed with HIV infection by a private healthcare provider in Larkana district, Sindh province, Pakistan. Over the next 3 months, 930 individuals were diagnosed with HIV, >80% below 16 years, the largest ever outbreak of HIV in children in Pakistan. In this protocol paper, we describe research methods for assessing likely modes of HIV transmission in this outbreak and investigate spatial and molecular epidemiology.Methods and analysisA matched case–control study will be conducted with 406 cases recruited. Cases will be children aged below 16 years registered for care at the HIV treatment centre at Shaikh Zayed Children Hospital in Larkana City. Controls will be children who are HIV-uninfected (confirmed by a rapid HIV test) matched 1:1 by age (within 1 year), sex and neighbourhood. Following written informed consent from the guardian, a structured questionnaire will be administered to collect data on sociodemographic indices and exposure to risk factors for parenteral, vertical and sexual (only among those aged above 10 years) HIV transmission. A blood sample will be collected for hepatitis B and C serology (cases and controls) and HIV lineage studies (cases only). Mothers of participants will be tested for HIV to investigate the possibility of mother-to-child transmission. Conditional logistic regression will be used to investigate the association of a priori defined risk factors with HIV infection. Phylogenetic analyses will be conducted. Global positioning system coordinates of participants’ addresses will be collected to investigate concordance between the genetic and spatial epidemiology.Ethics and disseminationEthical approval was granted by the Ethics Review Committee of the Aga Khan University, Karachi. Study results will be shared with Sindh and National AIDS Control Programs, relevant governmental and non-governmental organisations, presented at national and international research conferences and published in international peer-reviewed scientific journals.
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