Abstract. Since 1980, visceral leishmaniasis (VL) has reemerged as a public health problem in lowland Nepal. We conducted a case-control study to identify risk factors. In univariate analyses among 84 cases and 105 controls, protective factors included sleeping on a bed or cot (Odds ratio [OR] 0.44, P Ͻ 0.01) and sleeping under a bed-net regularly (OR 0.23, P Ͻ 0.001) or in the warm months (OR 0.20, P Ͻ 0.001). The bed-nets in use in this region were commercially available and untreated with insecticide. Ownership of a cow or buffalo was protective (OR 0.34, P Ͻ 0.001), whereas dampness observed in the mud floor of the house was a strong risk factor (OR 4.0, P Ͻ 0.001). In multivariable models, bed-net usage, cow or buffalo ownership, and damp floors were significantly associated with altered risk. A program to increase bed-net usage could therefore decrease the incidence of VL in Nepal.
Abstract. We evaluated the field use of two serologic tests for visceral leishmaniasis (VL), the direct agglutination test (DAT) and rK39 dipstick test, in the context of a case-control study. Most VL cases in Nepal are currently diagnosed on clinical grounds and with relatively non-specific tests such as the formol-gel test. Among 14 newly diagnosed VL patients with bone-marrow slides confirmed positive in two independent laboratories, the sensitivity of both tests was 100%. Among 113 controls with no personal or household history of VL, the specificity of the rK39 was 100% while that of the DAT was 93%. The rK39 was less expensive than DAT, and has the advantages of ease of use and obtaining results within minutes. The wider use of the rK39 dipstick test could improve the specificity of VL diagnosis in Nepal.
A fast spectral-domain method is proposed to evaluate the reaction terms between the macro basis functions in regular and non-regular arrays made of identical printed antennas. The presented technique first exploits the filtering capabilities of the macro basis functions in the spectral domain. The method is then strongly accelerated with the help of a newly formulated fast Fourier transform (FFT)-based technique, which is applicable to a contour integration in the complex plane. We name the method as contour-FFT (C-FFT). Besides an effective homogeneous medium term treated with multipoles, a computational complexity of order is achieved for the tabulation of substrate-related reaction terms for any possible relative positions. The complexity of the proposed method is independent from the complexity of the elements. Numerical results obtained with the proposed method are compared with those from a pre-validated reference solution based on the traditional macro basis functions technique; an excellent agreement is observed.
Index Terms-Contour deformation, contour-fast Fourier transform (FFT), Green's function, large irregular arrays, macro basis function (MBF), method of moments (MoM), printed antenna, spectral domain method.
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