Primate social organization evolved from a flexible pair-living ancestor

Explaining the evolution of primate social organization has been fundamental to understand human sociality and social evolution more broadly. It has often been suggested that the ancestor of all primates was solitary and that other forms of social organization evolved later, with transitions being driven by various life history traits and ecological factors. However, recent research showed that many understudied primate species previously assumed to be solitary actually live in pairs, and intraspecific variation in social organization is common. We built a detailed database from primary field studies quantifying the number of social units expressing different social organizations in each population. We used Bayesian phylogenetic models to infer the probability of each social organization, conditional on several socioecological and life history predictors. Here, we show that when intraspecific variation is accounted for, the ancestral social organization of primates was inferred to be variable, with the most common social organization being pair-living but with approximately 10 to 20% of social units of the ancestral population deviating from this pattern by being solitary living. Body size and activity patterns had large effects on transitions between types of social organizations. As in other mammalian clades, pair-living is closely linked to small body size and likely more common in ancestral species. Our results challenge the assumption that ancestral primates were solitary and that pair-living evolved afterward emphasizing the importance of focusing on field data and accounting for intraspecific variation, providing a flexible statistical framework for doing so.

Associations between physical inactivity and dementia prevalence: ecological study using global data

OBJECTIVES

Given the predicted rise in dementia prevalence around the world, targeting modifiable risk factors (often lifestyle related) is a priority. This work sought to understand the role of physical inactivity (PI) as a modifiable risk factor for dementia.

STUDY DESIGN

Ecological study using globally available ecological data (both 2010 and 2016) from 192 countries.

METHODS

Age-standardised PI prevalence and dementia prevalence data were accessed from the World Health Organisation (WHO) and the Global Burden of Disease Study. Linear regression was used to assess the relationship between PI and dementia, with stratified analyses used to further explore the impact of sex, WHO region, and World Bank income group on the relationship.

RESULTS

Linear regression showed a positive association between inactivity and dementia prevalence in 2010 (b = 1.38 [95% confidence interval {CI}: 0.04, 2.71] P = 0.044) and 2016 (coefficient = 2.52 [95% CI: 1.07, 3.96] P = 0.0007). Sub-group analyses of sex-specific data showed the strength of the relationship was stronger in men than in women. Rates of both dementia and inactivity rose with increasing world income group.

CONCLUSIONS

This analysis of global data indicates the presence of a positive relationship between prevalence of PI and dementia prevalence, which has increased in strength with time, and is stronger in men than in women. This highlights the importance of public health interventions on a global scale to reduce the percentage of the population failing to reach or exceed the recommended physical activity guidelines.

Racial Disparities in Family Variant Testing for Cancer Predisposition Genes

PURPOSE

Despite the substantial clinical impact of genetic testing, racial disparities exist in the delivery of this service. Here, we partnered with a commercial laboratory (Invitae) to establish whether there are racial disparities in the uptake of family variant testing (FVT). We also investigated if providing FVT at no cost impacts rates of cascade testing in Black and White families.

METHODS

This is a retrospective analysis comparing rates of FVT in self-reporting Black probands to self-reporting White probands who underwent germline genetic testing for genes associated with hereditary cancer through Invitae. All Black and White patients found to have a pathogenic/likely pathogenic variant P/LPV) in a hereditary cancer syndrome gene were identified up to one year before and up to one year after FVT became no-charge in 1/2017. The proportion of probands with at least one at- risk family member who underwent FVT was compared between Black and White probands using logistic regression, including the interaction between covariates of cost and race.

RESULTS

Between 1/2016 and 1/2018, 8,530 Black and 87,846 White probands underwent genetic testing. Of these, 9.3% (n =791) Black probands and 11.4% (n=9,998) White probands had a P/LPV identified. The uptake of FVT, defined by percentage of positive probands with at least one family member undergoing testing, was significantly lower in Black participants compared to White participants (11.9% versus 21.7%, odds ratio 0.5, 95% CI 0.4-0.6, p<0.001). Period of testing before or after FVT was no-charge did not impact this difference (p=0.23 for the interaction). FVT rates were significantly lower in Black patients compared to White patients both before (8.1% versus 18.7%, OR 0.4, 95% CI 0.2-0.6, p<0.001) and after (13.6% versus 23.1%, OR 0.5, 95% CI 0.4-0.7, p<0.001) testing became no-charge.

CONCLUSION

While FVT rates were low overall, they were significantly lower in Black families compared to White families. Cost of FVT did not have a significant impact on the racial disparity seen, suggesting additional barriers exist. Recognizing these disparities and determining the contributing factors are crucial to developing tailored interventions that would ultimately advance racial equity in cancer care.

A novel alphaherpesvirus and concurrent respiratory cryptococcosis in a captive koala ( Phascolarctos cinereus )

A novel alphaherpesvirus was detected in a captive adult, lactating, female koala (Phascolarctos cinereus) admitted to James Cook University Veterinary Emergency Teaching & Clinical Hospital in March 2019, showing signs of anorexia and severe respiratory disease. Postmortem examination revealed gross pathology indicative of pneumonia. Histopathology demonstrated a chronic interstitial pneumonia, multifocal necrotising adrenalitis and hepatitis. Intranuclear inclusion bodies were detected by light microscopy in the respiratory epithelium of the bronchi, bronchioles, alveoli, and hepatocytes, biliary epithelium and adrenal gland associated with foci of necrosis. Cryptococcus gattii was isolated from fresh lung on necropsy, positively identified by PCR, and detected histologically by light microscopy, only in the lung tissue. A universal viral family‐level PCR indicated that the virus was a member of the Herpesviruses. Sequence analysis in comparison to other known and published herpesviruses, indicated the virus was a novel alphaherpesvirus, with 97% nucleotide identity to macropodid alphaherpesvirus 1. We provisionally name the novel virus phascolarctid alphaherpesvirus 3 (PhaHV‐3). Further research is needed to determine the distribution of this novel alphaherpesvirus in koala populations and establish associations with disease in this host species.

A scoping review of live wildlife trade in markets worldwide

Wet markets sell fresh food and are a global phenomenon. They are important for food security in many regions worldwide but have come under scrutiny due to their potential role in the emergence of infectious diseases. The sale of live wildlife has been highlighted as a particular risk, and the World Health Organisation has called for the banning of live, wild-caught mammalian species in markets unless risk assessment and effective regulations are in place. Following PRISMA guidelines, we conducted a global scoping review of peer-reviewed information about the sale of live, terrestrial wildlife in markets that are likely to sell fresh food, and collated data about the characteristics of such markets, activities involving live wildlife, the species sold, their purpose, and animal, human, and environmental health risks that were identified. Of the 56 peer-reviewed records within scope, only 25% (n = 14) focussed on disease risks; the rest focused on the impact of wildlife sale on conservation. Although there were some global patterns (for example, the types of markets and purpose of sale of wildlife), there was wide diversity and huge epistemic uncertainty in all aspects associated with live, terrestrial wildlife sale in markets such that the feasibility of accurate assessment of the risk of emerging infectious disease associated with live wildlife trade in markets is currently limited. Given the value of both wet markets and wildlife trade and the need to support food affordability and accessibility, conservation, public health, and the social and economic aspects of livelihoods of often vulnerable people, there are major information gaps that need to be addressed to develop evidence-based policy in this environment. This review identifies these gaps and provides a foundation from which information for risk assessments can be collected.

Changes in air quality in Mexico City, London and Delhi in response to various stages and levels of lockdowns and easing of restrictions during COVID-19 pandemic

The impacts of COVID-19 lockdown restrictions have provided a valuable global experiment into the extent of improvements in air quality possible with reductions in vehicle movements. Mexico City, London and Delhi all share the problem of air quality failing WHO guideline limits, each with unique situations and influencing factors. We determine, discuss and compare the air quality changes across these cities during the COVID-19, to understand how the findings may support future improvements in their air quality and associated health of citizens. We analysed ground-level PM₁₀, PM_2.5, NO₂, O₃ and CO changes in each city for the period 1st January to August 31, 2020 under different phases of lockdown, with respect to daily average concentrations over the same period for 2017 to 2019. We found major reductions in PM₁₀, PM_2.5, NO₂ and CO across the three cities for the lockdown phases and increases in O₃ in London and Mexico City but not Delhi. The differences were due to the O₃ production criteria across the cities, for Delhi production depends on the VOC-limited photochemical regime. Levels of reductions were commensurate with the degree of lockdown. In Mexico City, the greatest reduction in measured concentration was in CO in the initial lockdown phase (40%), in London the greatest decrease was for NO₂ in the later part of the lockdown (49%), and in Delhi the greatest decrease was in PM₁₀, and PM_2.5 in the initial lockdown phase (61% and 50%, respectively). Reduction in pollutant concentrations agreed with reductions in vehicle movements. In the initial lockdown phase vehicle movements reduced by up to 59% in Mexico City and 63% in London. The cities demonstrated a range of air quality changes in their differing geographical areas and land use types. Local meteorology and pollution events, such as forest fires, also impacted the results.

Knowledge, attitudes and management of bovine viral diarrhoea virus among eastern Australian cattle producers: results from a 2013 cross-sectional study

Bovine viral diarrhoea virus (BVDV) is an economically significant disease affecting the Australian cattle industry, with losses stemming from decreased production and reproductive performance and control costs. However, these losses can be difficult to appreciate, particularly in endemic regions. Overall, there is a variable but high herd-level seroprevalence in Australia. Despite a potentially high financial burden of the disease, the onus for control ultimately falls on producers and strategies employed will vary between regions. A cross-sectional study, using a postal survey, was conducted in 2013 to evaluate the BVDV knowledge, attitudes and management practices utilised by Australian cattle producers. A total of 192 producers participated in the study, and results indicate that knowledge and attitudes towards disease risk are variable and can be improved. Producer knowledge of how persistently infected (PI) animals are produced was higher than that of disease outcomes or transmission pathways. Implementation of biosecurity practices was limited, with approximately half of respondents employing quarantine procedures for introduced stock and only 2% indicating they would antigen test introduced stock for BVDV. Approximately a third (36%) of producers reported engaging in BVDV control, with the majority of these using vaccination strategies over deliberate exposure to a PI. Knowledge of and engagement with BVDV control was positively influenced by the producer relationships with veterinarians. Findings from this study suggest that building on education and delivering a consistent message among stakeholders would likely improve producer awareness and understanding in relation to BVDV and support decision making in BVDV management.

Objectively-measured sedentary time, habitual physical activity and bone strength in adults aged 62 years: the Newcastle Thousand Families Study

BACKGROUND

The influence of sedentary time and habitual physical activity on the bone health of middle aged adults is not well known.

METHODS

Bone mineral density (BMD) and hip bone geometry were evaluated in 214 men (n = 92) and women (n = 112) aged 62.1 ± 0.5 years from the Newcastle Thousand Families Study birth cohort. Accelerometry was used to measure physical activity (PA) and sedentary time over 4 days. Regression models were adjusted for clinical risk factor covariates.

RESULTS

Men were more sedentary than women (P < 0.05), and sedentary time was negatively associated with spine BMD in men, with 84 minutes more sedentary time corresponding to 0.268 g.cm-2 lower BMD (β = -0.268; P = 0.017). In men, light PA and steps/day were positively associated with bone geometry and BMD. Steps/day was positively associated with bone geometry and femur BMD in women, with a positive difference of 1415 steps/day corresponding to 0.232 g.cm-2 greater BMD (β = 0.232, P = 0.015).

CONCLUSIONS

Sedentary time was unfavourably associated with bone strength in men born in North East England at age 62 years. Higher volumes of light PA, and meeting the public health daily step recommendations (10 000 steps/day) was positively associated with bone health in both sexes.

The importance of understanding end user acceptability of new technology to support animal health management

This pilot study investigates the acceptability of a mobile application (app) developed to assist livestock producers make better animal health decisions with the support of a local veterinarian. With the increase in new technologies available for producers, acceptability evaluation is important to ensure that technology is designed considering end users' needs. An acceptability qualitative study, using semi-structured interviews, was designed including a purposive selection of sheep producers and livestock veterinarians. Eleven producers and six veterinarians participated in the study. Results suggest that producers would use such a tool to contact private veterinarians in non-emergency situations to obtain animal health advice. From veterinarians' perspective, while features of the app, such as messaging and notifications, were considered useful, concerns were raised about its capacity to enhance business opportunities and potential privacy implications. This study highlights the importance of engaging with end users in the early stages of the design and the introduction of new technology to maximise potential for adoption.

Student selection to a rural veterinary school. 2: predictors of student performance and attrition

OBJECTIVE

To evaluate the extent to which current selection processes at Charles Sturt University, New South Wales, Australia, predict performance within and attrition from the veterinary degree program.

DESIGN

Retrospective evaluation of application details and student performance data.

METHODS

Database records of 424 students entering the veterinary program were retrieved from university records, including all students graduating (n = 356) or leaving the program without completing (n = 68) between 2005 and 2016. Demographic data were related to results of selection processes and achievement within the degree using univariable and multivariable general linear and logistic regression analyses.

RESULTS

The grade point average achieved over the 6 years of the degree was influenced by academic achievement prior to entry, gender (females performed ≈ 2% better than males) and interview scores. Preceptor evaluation of final-year clinical performance was associated with interview scores, gender (males performed ≈ 4% better than females) and residential address at the time of application. Attrition for personal reasons was more common for female students and students who had completed a prior degree, and students who experienced academic or personal attrition had lower written application scores. Factors that have been previously linked to poor academic outcomes, including rural or low socioeconomic background, were not associated with adverse student outcomes.

CONCLUSION

Selection processes did not systematically disadvantage students admitted to the degree program. Gender differences in personal attrition and academic and clinical performance warrant further evaluation. Factors in addition to academic aptitude predicted student success.

Dairy goat producers' understanding, knowledge and attitudes towards biosecurity and Q-fever in Australia

The Australian dairy goat sector is an emerging animal industry undergoing rapid expansion. Limited information is available within this industry in relation to socio-demographic characteristics and biosecurity implementation. Q-Fever, caused by the bacterium Coxiella burnetii, is a zoonotic disease endemic in Australia, with a range of domestic and wild-animal reservoir species, including goats, with infected pregnant goats posing a significant public health risk. The aim of the current study was to investigate the socio-demographics of Australian dairy goat producers, their biosecurity implementation and levels of understanding, knowledge and attitudes towards Q-Fever. To achieve this aim, a cross-sectional study was conducted, using an online survey and follow-up semi-structured interviews among dairy goat producers. A total of 106 goat producers participated in the online survey (35.3% response rate) and 14 participated in the semi-structured interviews. Findings from this study suggest that most goat producers implement biosecurity practices related to direct animal husbandry, such as separating sick goats (86%), vaccinations (79%) and providing separate kidding space (75%); and, practices minimizing the risk of disease introduction, such as maintaining boundary fences (86%) and isolating incoming animals (67%). However, implementation of other biosecurity practices, such as keeping records of visitors and visitor biosecurity requirements, was inadequate. Furthermore, this study identifies a deficit of knowledge and understanding surrounding Q-Fever in the Australian dairy goat sector, and a disconnect between producers' perception of risk and implementation of known appropriate biosecurity measures. The research has identified that producers rely on 'trusted' community networks to provide advice on biosecurity implementation, due to a perceived absence of industry-specific, reputable information sources. Producers identified those outside of these networks as the 'other'. The creation of this other allows producers to deflect responsibility for individual biosecurity on to the other. A multifaceted approach is necessary to increase knowledge, understanding and perception of risk surrounding Q-fever, and promote positive uptake of biosecurity measures, for improved outcomes for animal and human health.

WP1-6 The syndrome of the trephined

Objectives

Syndrome of the Trephined (SoT) or sinking skin flap syndrome is characterised by neurological deterioration occurring after a delay post-craniectomy, with or without a significant postural component, that may improve with cranioplasty. The symptoms and signs seen are heterogeneous and can be readily missed. With increasing numbers of patients surviving after decompressive craniectomies, and often a long delay before cranioplasty, we think it important that awareness of this potentially lethal but reversible condition is raised.

Design

Case Series.

Subjects

Cases with suspected SoT were identified retrospectively from all admissions to a Level 1 Neurorehabilitation Unit over 2 years.

Methods

Cases were identified by their treating clinicians. Their clinical features are described, and outcomes after cranioplasty are discussed.

Results

From 36 patients admitted after craniectomy over 2 years, 4 patients with suspected SoT were identified, with a latency of 4–12 months post-injury. Late neurological deterioriation included reduced alertness and mobility, cognitive decline and headache. Two patients had a clear postural component to their symptoms. Coexisting hydrocephalus was sometimes seen, and complicated neurosurgical management. All cases improved after cranioplasty.

Conclusions

SoT is an under-reported and under-recognised complication of craniectomy. It is a potentially reversible cause of significant late deterioration following craniectomy. Further research into the optimal timing for cranioplasty is needed.

Household, Moderate Physical Activity and the Risk of Breast Cancer Among Nigerian Women: An Epidemiological Study

Background: Breast cancer incidence in Nigeria has risen by >120% since 2000. The mortality rate (25.9/100,000/yr) ranks highest in Africa. Inverse associations between household physical activities (PA) as well as moderate PA, and breast cancer risk have been suggested in literature. However, the roles of these activities in breast cancer risk have not been widely studied in Africa. As the socioeconomic status of many Nigerian women improves, their household and daily routines are expected to change. These have implications for their level of physical activity. Aim: The aim of this study was to investigate if there is an association between household, as well as moderate PA and breast cancer risk among Nigerian women. Methods: The study was a multisite hospital based case-control design involving 379 histologically confirmed breast cancer cases and 403 controls. The participants aged ≥ 20 years were interviewed in-person between October 2016 and May 2017 using a pretested questionnaire. Cases were selected from oncology wards and controls from ophthalmology wards. Self-reported household and moderate PA were summarized as both hours per week and metabolic equivalents (MET) hours per week (met-hr/wk). Data were analyzed using multivariable logistic regression, adjusting for known confounders. SPSS version 23 was used for all analyses. Results: The odd of having breast cancer (based on MET-hr/wk) was 40% less among women in the upper tertile of household PA than those in the lowest tertile (95% CI, 0.39-0.94). This was stronger among younger (OR: 0.50, 95% CI, 0.26-0.94), premenopausal (OR: 0.46; 95% CI, 0.24-0.89) and lean women (OR: 39, 95% CI, 0.16-0.87). Moderate PA was also associated with reduced breast cancer risk ( P = 0.04). Conclusion: The study suggested that household and moderate physical activities were protective of breast cancer among Nigerian women. Household chores and other routine moderate activities could provide opportunities for breast cancer prevention in Nigeria. Future studies could consider the use of community controls to authenticate the findings.

Maternal body mass index and post-term birth: a systematic review and meta-analysis

Post-term birth is a preventable cause of perinatal mortality and severe morbidity. This review examined the association between maternal body mass index (BMI) and post-term birth at ≥42 and ≥41 weeks' gestation. Five databases, reference lists and citations were searched from May to November 2015. Observational studies published in English since 1990 were included. Linear and nonlinear dose-response meta-analyses were conducted by using random effects models. Sensitivity analyses assessed robustness of the results. Meta-regression and sub-group meta-analyses explored heterogeneity. Obesity classes were defined as I (30.0-34.9 kg m-2 ), II (35.0-39.9 kg m-2 ) and III (≥40 kg m-2 ; IIIa 40.0-44.9 kg m-2 , IIIb ≥ 45.0 kg m-2 ). Searches identified 16,375 results, and 39 studies met the inclusion criteria (n = 4,143,700 births). A nonlinear association between maternal BMI and births ≥42 weeks was identified; odds ratios and 95% confidence intervals for obesity classes I-IIIb were 1.42 (1.27-1.58), 1.55 (1.37-1.75), 1.65 (1.44-1.87) and 1.75 (1.50-2.04) respectively. BMI was linearly associated with births ≥41 weeks: odds ratio is 1.13 (95% confidence interval 1.05-1.21) for each 5-unit increase in BMI. The strength of the association between BMI and post-term birth increases with increasing BMI. Odds are greatest for births ≥42 weeks among class III obesity. Targeted interventions to prevent the adverse outcomes associated with post-term birth should consider the difference in risk between obesity classes.

Neuroinflammatory and morphological changes in late-life depression: the NIMROD study

We studied neuroinflammation in individuals with late-life depression, as a risk factor for dementia, using [¹¹C]PK11195 positron emission tomography (PET). Five older participants with major depression and 13 controls underwent PET and multimodal 3T magnetic resonance imaging (MRI), with blood taken to measure C-reactive protein (CRP). We found significantly higher CRP levels in those with late-life depression and raised [¹¹C]PK11195 binding compared with controls in brain regions associated with depression, including subgenual anterior cingulate cortex, and significant hippocampal subfield atrophy in cornu ammonis 1 and subiculum. Our findings suggest neuroinflammation requires further investigation in late-life depression, both as a possible aetiological factor and a potential therapeutic target.

Preventing type 2 diabetes after gestational diabetes: women's experiences and implications for diabetes prevention interventions

AIMS

To explore factors influencing post-natal health behaviours following the experience of gestational diabetes, and to elicit women's views about the feasibility of lifestyle intervention to prevent diabetes during the first 2 years after childbirth.

METHODS

Qualitative study using semi-structured interviews with women who had gestational diabetes. In phase 1 (31 women), interviews explored the experience of gestational diabetes, ideas about future risk of diabetes and factors influencing post-natal health-related behaviours. Statements were developed summarizing women's views of lifestyle change to prevent diabetes. In phase 2 (14 women), interviews explored how the passage of time had contributed to changes in health behaviour, and the statements were used to develop views about diabetes interventions.

RESULTS

Women were aware of their risk of developing diabetes, but did not always act on such knowledge. Pregnancy motivated behaviour changes to benefit the unborn child, but after delivery these changes were often not maintained. Tiredness, maternal attachment and childcare demands were prominent barriers in the early post-natal months. Later, work, family and child development became more significant barriers. Many women became more receptive to healthy eating messages around the time of weaning. Women were positive about long-term support for self-management to reduce their diabetes risk.

CONCLUSIONS

There is potential to reduce the risk of Type 2 diabetes post-natally among women with gestational diabetes. Interventions need to be developed that take into account contextual factors and competing demands, are flexible and respond to women's individual circumstances. Randomized trials of such interventions are warranted.

Universal screening to identify gestational diabetes: a multi-centre study in the North of England

We conducted an audit of treatment and outcomes in 116 women with gestational diabetes. These women received intense monitoring and high levels of medical and obstetric intervention. 24% would not have been identified by risk factor based screening. Cost effective strategies to identify all women with gestational diabetes are needed.

White matter damage in asymptomatic patients with sickle cell anemia: screening with diffusion tensor imaging

BACKGROUND AND PURPOSE

Ischemic injury to the brain is a common complication of SCA. To better understand the neurologic impact of SCA, TBSS were applied to DTI data to investigate white matter injuries in pediatric patients with SCA.

MATERIALS AND METHODS

TBSS comparisons of a range of anisotropy and diffusion measures were carried out between age- and background-matched population groups: patients with SCA with no visible lesions, patients with SCA with mild gliosis, and normal controls.

RESULTS

TBSS analysis revealed that both SCA populations exhibited reduced anisotropy and increased diffusivity compared with normal controls in multiple brain regions, including the corpus callosum and centrum semiovale. Furthermore, the results suggest that the severity of SCA is positively correlated with the white matter changes in the corpus callosum.

CONCLUSIONS

The study demonstrates that TBSS is a viable technique in detecting subtle white matter damage in patients with SCA whose conventional anatomic MR imaging scans show no, or minimal, abnormalities and has the potential to evaluate the neurologic impact of the treatment of SCA.

Fasting blood glucose and insulin sensitivity are unaffected by HAART duration in Cameroonians receiving first-line antiretroviral treatment

AIMS

This study assessed the relationship between highly active antiretroviral therapy (HAART) duration and cardiometabolic disorders in HIV-infected Cameroonians.

METHODS

HIV-infected Cameroonians aged 21 years or above were cross-sectionally recruited at the Yaoundé Central Hospital, a certified HIV care centre, and their anthropometry, body composition (impedancemetry), fasting blood glucose (FBG) and lipid levels, and insulin sensitivity (IS; short insulin tolerance test) were measured.

RESULTS

A total of 143 participants with various durations of HAART [treatment-naïve (n=28), 1-13 months (n=44), 14-33 months (n=35) and 34-86 months (n=36)] were recruited. They were mostly women (72%), and had a mean age of 39.5 (SD: 9.8) years. Half (52%) were using a stavudine-containing regimen. There was a significant trend towards a positive change in body mass index and waist-to-hip ratio with increasing duration of HAART (all P=0.02). Systolic (P=0.04) and diastolic (P=0.03) blood pressure, total cholesterol (P=0.01), prevalence of hypertension (P=0.04) and hypercholesterolaemia (P=0.007) were also significantly increased with HAART duration, whereas triglycerides, FBG and IS were unaffected. Clustering of metabolic disorders increased (P=0.02 for ≥1 component of the metabolic syndrome and P=0.09 for ≥2 components) with HAART duration.

CONCLUSION

HAART duration is associated with obesity, fat distribution, blood pressure and cholesterol levels in HIV-infected Cameroonians, but does not appear to significantly affect glucose metabolism.