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Poor access to existing care for diabetic retinopathy (DR) limits effectiveness of proven treatments. We examined whether outreach screening in rural China improves equity of access. We compared prevalence of female sex, age > = 65 years, primary education or below, and requiring referral care for DR between three cohorts with diabetes examined for DR in neighboring areas of Guangdong, China: passive case detection at secondary-level hospitals (n = 193); persons screened during primary-level DR outreach (n = 182); and individuals with newly- or previously-diagnosed diabetes in a population survey (n = 579). The latter reflected the \"ideal\" reach of a screening program. Compared to the population cohort, passive case detection reached fewer women (50·8% vs. 62·3%, p = 0·006), older adults (37·8% vs. 51·3%, p < 0·001), and less-educated persons (39·9% vs. 89·6%, p < 0·001). Outreach screening, compared to passive case detection, improved representation of the elderly (49·5% vs. 37·8%, p = 0·03) and less-educated (70·3% vs. 39·9%, p<0·001). The proportion of women (59.8% vs 62.3%, P>0.300) and persons aged > = 65 years (49.5% vs 51.3%, p = 0.723) in the outreach screening and population cohorts did not differ significantly. Prevalence of requiring referral care for DR was significantly higher in the outreach screening cohort (28·0%) than the population (14·0%) and passive case detection cohorts (7·3%, p<0·001 for both). Primary-level outreach screening improves access for the poorly-educated and elderly, and removes gender inequity in access to DR care in this setting, while also identifying more severely-affected patients than case finding in hospital.

Summary Points * Involving male partners in programmes to prevent mother-to-child transmission of HIV may improve programme coverage and infant outcomes. * Rates of male partner involvement remain low worldwide, and detailed guidelines to increase involvement are lacking in South Africa. * We recommend that South African national and provincial guidelines and policies for preventing mother-to-child HIV transmission be adjusted to explicitly include a focus on increasing male partner involvement and that they include concrete descriptions of how to achieve this. * We propose recommendations for improving male partner involvement at a policy, facility, and community level. * Challenges to improving male partner involvement include the nature of relationships and family structures in South Africa and the capacity of health systems to implement recommendations.

Introduction Guidelines in resource‐poor settings have progressively included interventions to reduce postnatal HIV transmission through breast milk. In addition to HIV‐free survival, infant growth and non‐HIV infections should be considered. Determining the effect of these interventions on infant growth and non‐HIV infections will inform healthcare decisions about feeding HIV‐exposed infants. We synthesize findings from studies comparing breast to formula feeding, early weaning to standard‐duration breastfeeding, breastfeeding with extended antiretroviral (ARV) to short‐course ARV prophylaxis, and alternative preparations of infant formula to standard formula in HIV‐exposed infants, focusing on infant growth and non‐HIV infectious morbidity outcomes. The review objectives were to collate and appraise evidence of interventions to reduce postnatal vertical HIV transmission, and to estimate their effect on growth and non‐HIV infections from birth to two years of age among HIV‐exposed infants. Methods We searched PubMed, SCOPUS, and Cochrane CENTRAL Controlled Trials Register. We included randomized trials and prospective cohort studies. Two authors independently extracted data and evaluated risk of bias. Rate ratios and mean differences were used as effect measures for dichotomous and continuous outcomes, respectively. Where pooling was possible, we used fixed‐effects meta‐analysis to pool results across studies. Quality of evidence was assessed using the GRADE approach. Results and discussion Prospective cohort studies comparing breast‐ versus formula‐fed HIV‐exposed infants found breastfeeding to be protective against diarrhoea in early life [risk ratio (RR)=0.31; 95% confidence interval (CI)=0.13 to 0.74]. The effect of breastfeeding against diarrhoea [hazard ratio (HR)=0.74; 95% CI=0.57 to 0.97] and respiratory infections (HR=0.65; 95% CI=0.41 to 1.00) was significant through two years of age. The only randomized controlled trial (RCT) available showed that breastfeeding tended to be protective against malnutrition (RR=0.63; 95% CI=0.36 to 1.12). We found no statistically significant differences in the rates of non‐HIV infections or malnutrition between breast‐fed infants in the extended and short‐course ARV prophylaxis groups. Conclusions Low to moderate quality evidence suggests breastfeeding may improve growth and non‐HIV infection outcomes of HIV‐exposed infants. Extended ARV prophylaxis does not appear to increase the risk for HIV‐exposed infants for adverse growth or non‐HIV infections compared to short‐course ARV prophylaxis.

We evaluated the relative efficacy of six pheromone-baited traps used in trapping Agriotes obscurus (L.) click beetles (Coleoptera: Elateridae): original Yatlor Traps, Yatlor Funnel Traps, Vernon Beetle Traps, Unitraps, Baited Pitfall Traps, and Vernon Pitfall Traps. Traps were rated according to quantitative and qualitative criteria of importance for each of four trap uses: general surveys, scientific studies, IPM monitoring, and mass trapping. Measurable quantitative categories included: total catch of A. obscurus; time for assembly, installation, and inspection; exclusion of nontarget invertebrates; and cost. Qualitative criteria were small mammal exclusion, flooding, design and handling variability, and convenience for various field uses. The most desirable characteristics were determined for the above four uses, and the cumulative ranking based on quantitative criteria and all four uses was Vernon Pitfall Trap, Baited Pitfall Trap, Original Yatlor Trap, Vernon Beetle Trap, Yatlor Funnel Trap, and Unitrap.

Age-related lens opacification (cataract) remains the leading cause of visual impairment and blindness worldwide. In low- and middle-income countries, utilization of cataract surgical services is often limited despite community-based outreach programmes. Community-led research, whereby researchers and community members collaboratively co-design intervention is an approach that ensures the interventions are locally relevant and that their implementation is feasible and socially accepted in the targeted contexts. Community-led interventions have the potential to increase cataract surgery uptake if done appropriately. In this study, once the intervention is co-designed it will be implemented through a cluster-randomized controlled trial (cRCT) with ward as a unit of randomization. This study will utilise both the qualitative methods for co-designing the intervention and the quantitative methods for effective assessment of the developed community-led intervention through a cRCT in 80 rural wards of Dodoma region, Tanzania (40 Intervention). The ‘intervention package’ will be developed through participatory community meetings and ongoing evaluation and modification of the intervention based on its impact on service utilization. Leask’s four stages of intervention co-creation will guide the development within Rifkin’s CHOICE framework. The primary outcomes are two: the number of patients attending eye disease screening camps, and the number of patients accepting cataract surgery. NVivo version 12 will be used for qualitative data analysis and Stata version 12 for quantitative data. Independent and paired t-tests will be performed to make comparisons between and within groups. P-values less than 0.05 will be considered statistically significant.

Abbreviations:: ANC, ante-natal care; MNCH, maternal, neonatal, and child health; MPI, male partner involvement; NAF, National Action Framework; NSP, National Strategic Plan on HIV, STIs and TB; PMTCT, preventing mother-to-child transmission; UNAIDS, the Joint United Nations Programme on HIV and AIDS Provenance: Commissioned; externally peer-reviewed. Summary Points * Involving male partners in programmes to prevent mother-to-child transmission of HIV may improve programme coverage and infant outcomes. * Rates of male partner involvement remain low worldwide, and detailed guidelines to increase involvement are lacking in South Africa. * We recommend that South African national and provincial guidelines and policies for preventing mother-to-child HIV transmission be adjusted to explicitly include a focus on increasing male partner involvement and that they include concrete descriptions of how to achieve this. * We propose recommendations for improving male partner involvement at a policy, facility, and community level. * Challenges to improving male partner involvement include the nature of relationships and family structures in South Africa and the capacity of health systems to implement recommendations.

Background Blue lights are sometimes placed in public washrooms to discourage injection drug use. Their effectiveness has been questioned and concerns raised that they are harmful but formal research on the issue is limited to a single study. We gathered perceptions of people who use injection drugs on the effects of blue lights with the aim of informing harm reduction practice. Methods We interviewed 18 people in two Canadian cities who currently or previously used injection drugs to better understand their perceptions of the rationale for and consequences of blue lights in public washrooms. Results Participants described a preference for private places to use injection drugs, but explained that the need for an immediate solution would often override other considerations. While public washrooms were in many cases not preferred, their accessibility and relative privacy appear to make them reasonable compromises in situations involving urgent injecting. Participants understood the aim of blue lights to be to deter drug use. The majority had attempted to inject in a blue-lit washroom. While there was general agreement that blue lights do make injecting more difficult, a small number of participants were entirely undeterred by them, and half would use a blue-lit washroom if they needed somewhere to inject urgently. Participants perceived that, by making veins less visible, blue lights make injecting more dangerous. By dispersing public injection drug use to places where it is more visible, they also make it more stigmatizing. Despite recognizing these harms, more than half of the participants were not opposed to the continued use of blue lights. Conclusions Blue lights are unlikely to deter injection drugs use in public washrooms, and may increase drug use-related harms. Despite recognizing these negative effects, people who use injection drugs may be reluctant to advocate against their use. We attempt to reconcile this apparent contradiction by interpreting blue lights as a form of symbolic violence and suggest a parallel with other emancipatory movements for inspiration in advocating against this and other oppressive interventions.

Guidelines in resource?poor settings have progressively included interventions to reduce postnatal HIV transmission through breast milk. In addition to HIV?free survival, infant growth and non?HIV infections should be considered. Determining the effect of these interventions on infant growth and non?HIV infections will inform healthcare decisions about feeding HIV?exposed infants. We synthesize findings from studies comparing breast to formula feeding, early weaning to standard?duration breastfeeding, breastfeeding with extended antiretroviral (ARV) to short?course ARV prophylaxis, and alternative preparations of infant formula to standard formula in HIV?exposed infants, focusing on infant growth and non?HIV infectious morbidity outcomes. The review objectives were to collate and appraise evidence of interventions to reduce postnatal vertical HIV transmission, and to estimate their effect on growth and non?HIV infections from birth to two years of age among HIV?exposed infants. We searched PubMed, SCOPUS, and Cochrane CENTRAL Controlled Trials Register. We included randomized trials and prospective cohort studies. Two authors independently extracted data and evaluated risk of bias. Rate ratios and mean differences were used as effect measures for dichotomous and continuous outcomes, respectively. Where pooling was possible, we used fixed?effects meta?analysis to pool results across studies. Quality of evidence was assessed using the GRADE approach. Low to moderate quality evidence suggests breastfeeding may improve growth and non?HIV infection outcomes of HIV?exposed infants. Extended ARV prophylaxis does not appear to increase the risk for HIV?exposed infants for adverse growth or non?HIV infections compared to short?course ARV prophylaxis.