Reestablishing a stepping-stone population of the threatened elkhorn coral Acropora palmata to aid regional recovery

Recovery of the elkhorn coral Acropora palmata is critical to reversing coral reef ecosystem collapse in the western Atlantic, but the species is severely threatened. To gauge potential for the species’ restoration in Florida, USA, we conducted an assisted migration experiment where 50 coral fragments of 5 nursery-raised genetic strains (genets) from the upper Florida Keys were moved to 5 sites across 350 km of the offshore reef. Additionally, 4 fragments from the 1 remaining colony of A. palmata in Dry Tortugas National Park (DRTO) were added to the 2 DRTO experimental sites to test for local adaptation. To measure coral performance, we tracked coral survival, calcification, growth, and condition from May 2018 to October 2019. All 24 corals relocated to the DRTO sites survived and calcified ~85% faster than the fewer surviving corals transplanted to the 2 upper Keys sites. While coral survival across the entire experiment did not depend on genet, there was a weak but statistically significant genetic effect on calcification rate among the corals relocated to DRTO. The DRTO native genet was among the fastest growing genets, but it was not the fastest, suggesting a lack of local adaptation at this scale. Our results indicate that DRTO, a remote reef system inhabited by the species during the Holocene and located at the nexus of major ocean currents, may be a prime location for reestablishing A. palmata. Assisted migration of A. palmata to DRTO could restore a sexually reproducing population in <10 yr, thereby promoting the species’ regional recovery.

The development and evaluation of a community-based clinical diagnosis tool and treatment regimen for postpartum sepsis in Bangladesh and Pakistan

BACKGROUND

Postpartum sepsis accounts for most maternal deaths between three and seven days postpartum, when most mothers, even those who deliver in facilities, are at home. Case fatality rates for untreated women are very high. Newborns of ill women have substantially higher infection risk.

METHODS/DESIGN

The objectives of this study are to: (1) create, field-test and validate a tool for community health workers to improve diagnostic accuracy of suspected puerperal sepsis; (2) measure incidence and identify associated risk factors and; (3) describe etiologic agents responsible and antibacterial susceptibility patterns. This prospective cohort study builds on the Aetiology of Neonatal Infection in South Asia study in three sites: Sylhet, Bangladesh and Karachi and Matiari, Pakistan. Formative research determined local knowledge of symptoms and signs of postpartum sepsis, and a systematic literature review was conducted to design a diagnostic tool for community health workers to use during ten postpartum home visits. Suspected postpartum sepsis cases were referred to study physicians for independent assessment, which permitted validation of the tool. Clinical specimens, including urine, blood, and endometrial material, were collected for etiologic assessment and antibiotic sensitivity. All women with puerperal sepsis were given appropriate antibiotics.

DISCUSSION

This is the first large population-based study to expand community-based surveillance for diagnoses, referral and treatment of newborn sepsis to include maternal postpartum sepsis. Study activities will lead to development and validation of a diagnostic tool for use by community health workers in resource-poor countries. Understanding the epidemiology and microbiology of postpartum sepsis will inform prevention and treatment strategies and improve understanding of linkages between maternal and neonatal infections.