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1.
PLoS Med ; 8(11): e1001128, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22140363

RESUMO

BACKGROUND: The global HIV prevention community is implementing voluntary medical male circumcision (VMMC) programs across eastern and southern Africa, with a goal of reaching 80% coverage in adult males by 2015. Successful implementation will depend on the accessibility of commodities essential for VMMC programming and the appropriate allocation of resources to support the VMMC supply chain. For this, the United States President's Emergency Plan for AIDS Relief, in collaboration with the World Health Organization and the Joint United Nations Programme on HIV/AIDS, has developed a standard list of commodities for VMMC programs. METHODS AND FINDINGS: This list of commodities was used to inform program planning for a 1-y program to circumcise 152,000 adult men in Swaziland. During this process, additional key commodities were identified, expanding the standard list to include commodities for waste management, HIV counseling and testing, and the treatment of sexually transmitted infections. The approximate costs for the procurement of commodities, management of a supply chain, and waste disposal, were determined for the VMMC program in Swaziland using current market prices of goods and services. Previous costing studies of VMMC programs did not capture supply chain costs, nor the full range of commodities needed for VMMC program implementation or waste management. Our calculations indicate that depending upon the volume of services provided, supply chain and waste management, including commodities and associated labor, contribute between US$58.92 and US$73.57 to the cost of performing one adult male circumcision in Swaziland. CONCLUSIONS: Experience with the VMMC program in Swaziland indicates that supply chain and waste management add approximately US$60 per circumcision, nearly doubling the total per procedure cost estimated previously; these additional costs are used to inform the estimate of per procedure costs modeled by Njeuhmeli et al. in "Voluntary Medical Male Circumcision: Modeling the Impact and Cost of Expanding Male Circumcision for HIV Prevention in Eastern and Southern Africa." Program planners and policy makers should consider the significant contribution of supply chain and waste management to VMMC program costs as they determine future resource needs for VMMC programs.


Assuntos
Circuncisão Masculina/economia , Atenção à Saúde/economia , Eliminação de Resíduos de Serviços de Saúde/economia , Serviços Preventivos de Saúde/economia , Infecções Sexualmente Transmissíveis/prevenção & controle , Adulto , África Oriental/epidemiologia , África Austral/epidemiologia , Atenção à Saúde/normas , Aconselhamento Diretivo/economia , Equipamentos Médicos Duráveis/economia , Infecções por HIV/economia , Infecções por HIV/prevenção & controle , Custos de Cuidados de Saúde , Humanos , Masculino , Eliminação de Resíduos de Serviços de Saúde/normas , Serviços Preventivos de Saúde/organização & administração , Infecções Sexualmente Transmissíveis/economia , Infecções Sexualmente Transmissíveis/epidemiologia
2.
Dev Biol ; 300(1): 308-20, 2006 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-17078943

RESUMO

The only eukaryotic mRNAs that are not polyadenylated are the replication-dependent histone mRNAs in metazoans. The sea urchin genome contains two sets of histone genes that encode non-polyadenylated mRNAs. One of these sets is a tandemly repeated gene cluster with a 5.6-kb repeat unit containing one copy of each of the five alpha-histone genes and is present as a single large cluster which spans over 1 Mb. There is a second set of genes, consisting of 39 genes, containing two histone H1 genes, 34 genes encoding core histone proteins (H2a, H2b, H3 and H4) and three genes expressed only in the testis. Unlike vertebrates where these genes are clustered, the sea urchin late histone genes, expressed in embryos, larvae and adults, are dispersed throughout the genome. There are also genes encoding polyadenylated histone mRNAs, which encode histone variants, including all variants found in other metazoans, as well as a unique set of five cleavage stage histone proteins expressed in oocytes. The cleavage stage histone H1 is the orthologue of an oocyte-specific histone H1 protein found in vertebrates.


Assuntos
Histonas/genética , Ouriços-do-Mar/genética , Animais , Sequência de Bases , Sequência Consenso , Variação Genética , Masculino , Dados de Sequência Molecular , Fases de Leitura Aberta , Filogenia , RNA Mensageiro/genética , Alinhamento de Sequência , Homologia de Sequência do Ácido Nucleico , Espermatócitos/fisiologia , Testículo/fisiologia
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