In 188 HIV-infected children receiving efavirenz, a lower mid-dose (C12) was associated with a higher risk of HIV-1 viral load >400 copies/mL (P = 0.03). Simulations for a normalized population receiving US Food and Drug Administration weight-band dosing predicted that 15% of children would have a C12 below target threshold (<1.0 mg/L) with a 23% risk of viral replication.

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Introduction. In recent decades, the developing countries of Southeast Asia, including the Lao People’s Democratic Republic (Lao PDR), have experienced a rapid growth of their urban population. Partly as a result of that, issues of undernutrition and overnutrition became a significant public health problem. Objective. To examine the prevalence of overweight and obesity and their related factors, among the school-attending adolescents in the Lao capital of Vientiane. Methods. A cross-sectional data on 300 adolescents aged 15–19 were collected during the months of March, April, and May 2018 by means of a self-administrated questionnaire. Anthropometric measurements were used to obtain data on height and weight. Pearson’s chi-squared test, Fisher exact tests, and univariable and multivariable logistic regressions were applied in the course of the statistical analysis. Results. The study found a high prevalence of overweight/obesity (23.3%) and thinness (10.3%). Poor eating habits were noted in 67.0% of adolescents, even though 78.0% of them had a good knowledge of nutrition. Factors significantly associated with the overweight/obesity were low physical activities (aOR = 18.3; 95% CI: 5.51–60.66) and adolescents living with their guardians (aOR = 0.25; 95% CI: 0.08–0.79). Results also indicated that, in 47.3% of the cases, teachers, acting as a source of health and nutrition information, can prevent the risk of adolescents’ overweight/obesity (aOR = 2.05, 95% CI = 1.11–3.80) but not their thinness (aOR = 0.4, 95% CI = 0.17–0.88). Conclusions. Laotian adolescents are facing the spectrum of malnutrition in urban areas. To improve adolescents’ nutritional status, there is a need for a collaborative approach of public health agencies that would address the issues of an effective food and nutrition policy. The school curricula should also include programs on nutrition and physical education.

Fishermen work in an unfavorable working environment, which faces many disadvantages such as inclement weather conditions, prolonged working time with hard labor and are effected by adverse environmental factors, in which noise is the most common agent but there are very few studies on the effects of noise to fishermen's health especially on blood pressure. Methodology: A cross-sectional study was conducted on 159 fishermen who were working in 14 offshore ships, a sound level meter was used for noise measurement and the noise exposures were calculated based on the average working time in 8 hours. Questionnaires were used for interviewing, blood pressure was measured by trained local doctors. Result: It was found that 71.1% fishermen were expose to the working noise which is over 85 dBA for 8 working hours a day. The highest average sound level was recorded in the engine room (min-max: 91.8-96.2), follow by driving cabin (min-max: 83.1-92.2). Blood pressure measurements showed a result of 28.9% hypertensive fishermen. There was not statistically significant between hypertension and exposure to noise. Conclusions: It can be concluded that almost three quarters of the fishermen exposed to noise in the working environment exceeds 85 dBA for 8 hours. Futher studies are required to provide comprehensive approach between noise and hypertension.

Background To access the long term relationship between efavirenz plasma concentrations and evolution of HIV RNA loads and CD4 cell counts in children. Methods Retrospective analysis of data from HIV-infected children on first line efavirenz-containing regimen. A population pharmacokinetic-pharmacodynamic (PK-PD) model was developed to describe the evolution of HIV RNA load and CD4 cell count (efficacy outcomes) in relation to efavirenz plasma concentration. Individual CYP2B6 516 G>T genotype data were not available for this analysis. A score ( IS EFV ) quantifying the effect of efavirenz concentrations on the long-term HIV replication was calculated from efavirenz concentrations and PD parameters and, a value of IS EFV below which HIV replication is likely not suppressed was determined. Cox proportional hazards regression models were used to assess the association of the risk of viral replication with IS EFV , and with efavirenz mid-dose concentration( C 12 ). Results At treatment initiation, median (interquartile range, IQR) age was 8 years (5 to 10), body weight 17 kg (14 to 23), HIV RNA load 5.1 log 10 copies/mL (4.6 to 5.4), and CD4 cell count 71 cells/mm 3 . A model of PK-PD viral dynamics assuming that efavirenz decreases the rate of infected host cells adequately described the relationship of interest. After adjusting for age, baseline HIV RNA load and CD4 cell counts an IS EFV <85% was significantly associated with a higher risk of viral replication ( p -value <0.001) while no significant association was observed with C 12 <1.0 mg/L. Conclusion The IS EFV score was a good predictor of viral replication in children on efavirenz-based treatment.