BackgroundAdolescents have been identified as a high-risk group for poor adherence to and defaulting from combination antiretroviral therapy (cART) care. However, data on outcomes for adolescents on cART in resource-limited settings remain scarce.MethodsWe developed an observational study of patients who started cART at The AIDS Service Organization (TASO) in Uganda between 2004 and 2009. Age was stratified into three groups: children (≤10 years), adolescents (11–19 years), and adults (≥20 years). Kaplan-Meier survival curves were generated to describe time to mortality and loss to follow-up, and Cox regression used to model associations between age and mortality and loss to follow-up. To address loss to follow up, we applied a weighted analysis that assumes 50% of lost patients had died.FindingsA total of 23,367 patients were included in this analysis, including 810 (3.5%) children, 575 (2.5%) adolescents, and 21 982 (94.0%) adults. A lower percentage of children (5.4%) died during their cART treatment compared to adolescents (8.5%) and adults (10%). After adjusting for confounding, other features predicted mortality than age alone. Mortality was higher among males (p<0.001), patients with a low initial CD4 cell count (p<0.001), patients with advanced WHO clinical disease stage (p<0.001), and shorter duration of time receiving cART (p<0.001). The crude mortality rate was lower for children (22.8 per 1000 person-years; 95% CI: 16.1, 29.5), than adolescents (36.5 per 1000 person-years; 95% CI: 26.3, 46.8) and adults (37.5 per 1000 person-years; 95% CI: 35.9, 39.1).InterpretationThis study is the largest assessment of adolescents receiving cART in Africa. Adolescents did not have cART mortality outcomes different from adults or children.

Earlier initiation of cART is associated with increased survival benefits over deferred treatment.

As antiretroviral treatment cohorts mature, the proportion of patients who are elderly will inevitably increase. Elderly patients may require focused clinical care that extends beyond HIV treatment.

lobal health research typically takes place within the North-South divide, 1-3 where the Northern partner is highly trained in research methods and comes from a resource-rich environment, while the Southern partner has a paucity of these skills and resources. 4 As a result, Southern partners often have little input into the research process (e.g., research design, development of instruments, etc.) and remain dependent on Northern partners to conduct research. 4-10 Accordingly, many North-South partnerships are criticized for remaining semi-colonial in nature, as the control and benefits of research (e.g., publications, results, research skills, etc.) continue to accrue in the North. 6,7 Unfortunately, there are very few successful models of how to develop a mutually beneficial research relationship. One of the few comes from community-based participatory research (CBPR), which is designed to mitigate the challenges inherent in asymmetric research relationships. 11,12 Although beginning to gain traction, 13,14 CBPR projects remain uncommon in the context of global health. Another collaborative model that may have relevance to the North-South divide was the development of the Canadian First Nations Information Governance Committee and the principles of Ownership, Control, Access and Possession (OCAP). OCAP principles help Aboriginal people in Canada regain control over research to mitigate neo-colonial aspects of research. 15 Globally, Southern partners continue to 'host' research led by Northern researchers, while struggling to build the necessary capacity for Southern-led research. 16 The objective of this study was to document North-South research collaborations and provide insight into the ongoing benefits and challenges of engaging in the research process from the Southern perspective. These examples demonstrate that opportunities to build research capacity in the South are often present within global research partnerships, but not always optimized. METHODS The AIDS Support Organization (TASO) in Uganda was founded in 1987 and since that time has been involved in research with organ

Forty-eight crossbred Landrace × Large white pigs with an average body weight of 8.5 ± 0.4 kg and aged 2 months were used to evaluate performance and carcass characteristics of pigs fed two diets in which bran from maize or wheat was used as the energy source. A third diet based on whole maize grain was used as a control. Animals in groups of four, balanced for litter, sex and weight were allotted to dietary treatments in a completely randomised design with four replications. Data were collected on feed intake and weight gain for a period of 4 months. A digestibility trial was carried at the end of the feeding trial using two male pigs per treatment while six pigs per treatment were randomly selected for slaughter to determine carcass characteristics. Daily gain averaged 0.23, 0.31 and 0.13 kg/day, for pigs fed maize bran, wheat bran and whole maize diets, respectively. Average feed intake and final body weight were significantly (P < 0.05) affected by diets. Digestibility of dry matter, crude fibre and calcium were higher (P < 0.05) for pigs fed maize bran while crude protein digestibility was highest (P < 0.05) for the pigs fed wheat bran. There were significant differences (P < 0.05) between the diets in carcass yield, ham, head, trotters and heart weights and also for rib weight, rib eye muscle and other tissues. This study indicates that comparable performance of growing pigs fed cereal bran and full-grain diets are real.