Poverty Collection

Global Theme Issue

PLoS Medicine

Thirty Ways to Improve the Health of the World's Poorest People.

The editors discuss a special collection of articles in PLoS Medicine that aims to highlight the profound influence of poverty upon health.

The PLoS Medicine Editors

EDITORIAL | doi:10.1371/journal.pmed.0040310

Which Single Intervention Would Do the Most to Improve the Health of Those Living on Less Than $1 per Day?

PLoS Medicine put this question to a wide variety of commentators worldwide, including medical researchers, policy makers, health reporters, and members of poor rural communities in Peru.

Yamey G on Behalf of the Interviewees

DEBATES | doi:10.1371/journal.pmed.0040303

Slum Health: From Understanding to Action

The defining physical and legal characteristics of slums profoundly affect the health of these communities and may also serve as potential targets for immediate intervention.

Unger A, Riley LW, et al.

ESSAYS | doi:10.1371/journal.pmed.0040295

Child Rights and Child Poverty: Can the International Framework of Children's Rights be Used to Improve Child Survival Rates?

The authors explain how the international framework of human rights can be better used to help reduce child poverty and improve child survival rates.

Pemberton S, Gordon D, Nandy S, Pantazis C, Townsend P

ESSAYS | doi:10.1371/journal.pmed.0040307

Squaring The Circle: AIDS, Poverty and Human Development

The authors discuss the "downstream" effects of AIDS on poverty, and the "upstream" effects of poverty upon acquiring HIV.

Piot P, Greener R, Russell S

ESSAYS | doi:10.1371/journal.pmed.0040314

Integration of Information Technologies in Clinical Studies in Nicaragua

The authors report their experience of integrating information technologies in clinical and epidemiological studies of dengue infection in Nicaragua.

Avilés W, Ortega O, Kuan G, Coloma J, Harris E

HEALTH IN ACTION | doi:10.1371/journal.pmed.0040291

Access to Health Care in Contexts of Livelihood Insecurity: A Framework for Analysis and Action

The authors present a framework for analysis and action to explore and improve access to health care in resource-poor countries, especially in Africa.

Obrist B, Iteba N, Lengeler C, Makemba A, Mshana C, et al.

POLICY FORUM | doi:10.1371/journal.pmed.0040308

Food Insecurity—A Risk Factor for HIV Infection

Nigel Rollins discusses a new study showing that food insufficiency is a risk factor for increased sexual risk-taking in women in Botswana and Swaziland.

Rollins N

PERSPECTIVE | doi:10.1371/journal.pmed.0040301

Food Insufficiency Is Associated with High-Risk Sexual Behavior among Women in Botswana and Swaziland

In a cross-sectional study, Sheri Weiser and colleagues found that food insufficiency was an important risk factor for increased sexual risk-taking in women in Botswana and Swaziland.

Weiser SD, Leiter K, Bangsberg DR, Butler LM, Percy-de Korte F, et al.

RESEARCH ARTICLES | doi:10.1371/journal.pmed.0040260

Safe To Walk? Neighborhood Safety and Physical Activity Among Public Housing Residents

Garry Bennett and colleagues measured exercise levels and obtained opinions on neighborhood safety. They concluded that residing in a neighborhood perceived to be unsafe at night is a barrier to regular physical activity.

Bennett GG, McNeill LH, Wolin KY, Duncan DT, Puleo E, et al.

RESEARCH ARTICLES | doi:10.1371/journal.pmed.0040306

PLoS Biology

Biology and Health Inequality

Intriguing parallels between civil servant and nonhuman primate hierarchies suggest that highly stratified societies foster health inequalities. Determining how social differences translate into chronic disease remains a challenge, but neuroendocrine pathways appear to play a role.

Brunner E

ESSAY | doi:10.1371/journal.pbio.0050267

The Costs of Exclusion: Recognizing a Role for Local Communities in Biodiversity Conservation

Two cross-cultural, community-based conservation initiatives in Borneo and Papua New Guinea incorporate poverty eradication into their biodiversity conservation programs in areas harboring some of the world's most endangered species.

Ancrenaz M, Dabek L, O'Neil S

COMMUNITY PAGE | doi:10.1371/journal.pbio.0050289

Poverty, Human Development, and Basic Biology

Taking a slight departure from our normal fare, PLoS Biology features two articles with a special focus on poverty and human development: one explores the biological mechanisms of health inequalities; the second discusses the value of including local communities in biodiversity conservation.

Gross L

EDITORIAL | doi:10.1371/journal.pbio.0050295

PLoS Neglected Tropical Diseases

Comparing Models for Early Warning Systems of Neglected Tropical Diseases

Luis Fernando Chaves and Mercedes Pascual show that early warning systems are a feasible ecological application for American cutaneous leishmaniasis.

Chaves LF, Pascual M

RESEARCH ARTICLES | doi:10.1371/journal.pntd.0000033

Related Articles

PLoS Medicine

How Can Biomedical Journals Help to Tackle Global Poverty?

Journals have been slow to realize their potential as a tool for reducing poverty and addressing global inequities, say the PLoS Medicine editors.

The PLoS Medicine Editors

EDITORIAL | doi:10.1371/journal.pmed.0030380

Moral Imagination: The Missing Component in Global Health

Benatar explores the underlying reasons for our failure to make adequate progress in improving global health.

Benatar SR

ESSAY | doi:10.1371/journal.pmed.0020400

Putting It Together: AIDS and the Millennium Development Goals

Failure to halt and reverse the HIV/AIDS epidemic, say the authors, will continue to jeopardize progress on achieving a wide range of the MDGs.

Hecht R, Alban A, Taylor K, Post S, Andersen NB, et al.

POLICY FORUM | doi:10.1371/journal.pmed.0030455

"Rapid-Impact Interventions": How a Policy of Integrated Control for Africa's Neglected Tropical Diseases Could Benefit the Poor

Controlling seven tropical infections in Africa would cost just 40 cents per person per year, and would permanently benefit hundreds of millions of people.

Molyneux DH, Hotez PJ, Fenwick A

NEGLECTED DISEASES | doi:10.1371/journal.pmed.0020336

Is It Ethical for Patients with Renal Disease to Purchase Kidneys from the World's Poor?

There is a worldwide shortage of kidneys for transplantation. Bakdash and Scheper-Hughes debate the ethics of buying a kidney from a living donor.

Bakdash T, Scheper-Hughes N

DEBATE | doi:10.1371/journal.pmed.0030349

Geographic Data on Health Inequities: Understanding Policy Implications

Pappas discusses a new study that examines US health disparities using county-level data.

Pappas G

PERSPECTIVE | doi:10.1371/journal.pmed.0030357

Eight Americas: Investigating Mortality Disparities across Races, Counties, and Race-Counties in the United States

US mortality rates were calculated according to "race-county" units and divided into the "eight Americas", across which there are enormous disparities in life expectancy.

Murray CJL, Kulkarni SC, Michaud C, Tomijima N, Bulzacchelli MT, et al.

RESEARCH ARTICLES | doi:10.1371/journal.pmed.0030260

Rethinking the "Diseases of Affluence" Paradigm: Global Patterns of Nutritional Risks in Relation to Economic Development

Cardiovascular diseases, traditionally thought of as diseases of affluence, are likely to become a substantial public health issue in low-income and middle-income countries.

Ezzati M, Vander Hoorn S, Lawes CMM, Leach R, James WPT, et al.

RESEARCH ARTICLES | doi:10.1371/journal.pmed.0020133

Use of Modern Contraception by the Poor Is Falling Behind

Analysis of demographic and health surveys from 55 developing countries confirms the increasing use of modern contraceptives, but their use by people living in absolute poverty lags considerably behind.

Gakidou E, Vayena E

RESEARCH ARTICLES | doi:10.1371/journal.pmed.0040031

Indigenous Health and Socioeconomic Status in India

Indigenous groups in India were found to have excess mortality rates compared with non-indigenous groups. A socioeconomic gradient within indigenous populations was also found.

Subramanian SV, Smith GD, Subramanyam M

RESEARCH ARTICLES | doi:10.1371/journal.pmed.0030421

PLoS Neglected Tropical Diseases

Ivermectin Resistance in Onchocerca volvulus: Toward a Genetic Basis

The authors of this expert commentary discuss the potential public health implications of a study which found that ivermectin causes genetic selection on O. volvulus worms.

Lustigman S, McCarter JP

EXPERT COMMENTARY | doi:10.1371/journal.pntd.0000076

Genetic Selection of Low Fertile Onchocerca volvulus by Ivermectin Treatment

In a study of O. volvulus adult worms from patients with river blindness, Roger Prichard and colleagues found that ivermectin treatment selected for heterozygotes at the beta-tubulin locus and that this selection was dependent on the number of doses.

Bourguinat C, Pion SDS, Kamgno J, Gardon J, Duke BOL, et al.

RESEARCH ARTICLES | doi:10.1371/journal.pntd.0000072

The bandit, a New DNA Transposon from a Hookworm–Possible Horizontal Genetic Transfer between Host and Parasite

Thewarach Laha and colleagues speculate that bandit, a transposon gene in the hookworm chromosome, may have transferred horizontally from primates to hookworm, or vice versa, as part of a co-evolutionary host-parasite relationship.

Laha T, Loukas A, Wattanasatitarpa S, Somprakhon J, Kewgrai N, et al.

RESEARCH ARTICLES | doi:10.1371/journal.pntd.0000035

PLoS Biology

Biodiversity Loss Threatens Human Well-Being

Biodiversity lies at the core of ecosystem processes fueling our planet's vital life-support systems; its degradation—by us—is threatening our own well-being and will disproportionately impact the poor.

Díaz S, Fargione J, Chapin FS, Tilman D

ESSAY | doi:10.1371/journal.pbio.0040277

The Risk of a Mosquito-Borne Infection in a Heterogeneous Environment

A modeling approach reveals that incorporating the demography and behavior of mosquitoes can substantially change estimates of the risk of infection from diseases such as malaria.

Smith DL, Dushoff J, McKenzie FE

RESEARCH ARTICLES | doi:10.1371/journal.pbio.0020368

Synopsis: Predicting Risk of Mosquito-Borne Disease in Variable Environments

SYNOPSIS | doi:10.1371/journal.pbio.0020390

Bridging the Science-Policy Divide

The Millennium Ecosystem Assessment focuses on the benefits people obtain from ecosystems and aims to improve ecosystem management and contribute to human well-being and poverty alleviation.

Reid WV

COMMUNITY PAGE | doi:10.1371/journal.pbio.0020027

Beyond the Fire-Hazard Mentality of Medicine: The Ecology of Infectious Diseases

Information on how infectious organisms, their vectors, and hosts interact with each other and with their environment is essential for an integrated approach to disease prevention and control.

Bradbury J

FEATURE | doi:10.1371/journal.pbio.0000022

PLoS ONE

Acceptance of Anti-Retroviral Therapy among Patients Infected with HIV and Tuberculosis in Rural Malawi Is Low and Associated with Cost of Transport

The findings of Rony Zachariah and colleagues suggest that offering anti-retroviral treatment closer to patients' homes in rural Malawi may help to increase acceptance of therapy.

Zachariah R, Harries AD, Manzi M, Gomani P, Teck R, et al.

doi:10.1371/journal.pone.0000121

Zinc or Multiple Micronutrient Supplementation to Reduce Diarrhea and Respiratory Disease in South African Children: A Randomized Controlled Trial

A randomized trial carried out amongst rural South African children found that supplementation with zinc, or zinc and micronutrients, did not reduce diarrhea and respiratory morbidity.

Luabeya KA, Mpontshane N, Mackay M, Ward H, Elson I, et al.

doi:10.1371/journal.pone.0000541

Natural Selection on Female Life-History Traits in Relation to Socio-Economic Class in Pre-Industrial Human Populations

Jenni Pettay and colleagues show that the intensity of selection pressure on a preindustrial human population varied with wealth.

Pettay JE, Helle S, Jokela J, Lummaa V

doi:10.1371/journal.pone.0000606

PLoS Clinical Trials

Operational Challenges in Large Clinical Trials: Examples and Lessons Learned from the Gambia Pneumococcal Vaccine Trial

The authors of this essay discuss the difficulties, and possible solutions, involved in running large clinical trials in a developing world setting.

Cutts FT, Enwere G, Zaman SMA, Yallop FG

ESSAY | 10.1371/journal.pctr.0010016

Long-term Impact of Malaria Chemoprophylaxis on Cognitive Abilities and Educational Attainment: Follow-up of a Controlled Trial

A follow-up study to a malaria prevention trial from the Gambia suggests that prophylaxis may help to improve long-term mental development and schooling outcomes.

Jukes MCH, Pinder M, Grigorenko EL, Baños Smith H, Walraven G, et al.

RESEARCH ARTICLES | 10.1371/journal.pctr.0010019

PLoS Computational Biology

Prioritizing Genomic Drug Targets in Pathogens: Application to Mycobacterium tuberculosis

Schreiber and colleagues applied a software program they developed to Mycobacterium tuberculosis to identify potential new target genes for drug treatments.

Hasan S, Daugelat S, Rao PSS, Schreiber M

doi:10.1371/journal.pcbi.0020061

PLoS Genetics

Y Chromosome Lineage- and Village-Specific Genes on Chromosomes 1p22 and 6q27 Control Visceral Leishmaniasis in Sudan

Families with multiple cases of visceral leishmaniasis in two Sudanese villages were studied to determine which chromosomes carry susceptibility genes.

Miller EN, Fadl M, Mohamed HS, Elzein A, Jamieson SE, et al.

doi:10.1371/journal.pgen.0030071

PLoS Pathogens

Leishmania Manipulation of Sand Fly Feeding Behavior Results in Enhanced Transmission

Rogers and Bates show that Leishmania can alter the behavior of its sand fly vectors so that infected flies become more tenacious than uninfected flies once the parasites become infective to humans.

Rogers ME, Bates PA

doi:10.1371/journal.ppat.0030091

CD8⁺ T-Cell Responses to Trypanosoma cruzi Are Highly Focused on Strain-Variant trans-Sialidase Epitopes

Martin et al. identify the major proteins in Trypanosoma cruzi—the causative agent of Chagas disease—that allow for its detection and control by CD8⁺ T cells.

Martin DL, Weatherly DB, Laucella SA, Cabinian MA, Crim MT, et al.

doi:10.1371/journal.ppat.0020077