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-
1
Grant AD, Djomand G, De Cock KM, 1997. Natural history and spectrum of disease in adults with HIV/AIDS in Africa. AIDS 11 (Suppl B):S43–S54.
-
2
Colebunders R, Francis H, Mann JM, Bila KM, Izaley L, Kimputu L, Behets F, van der Groen G, Quinn TC, Curran JW, 1987. Persistent diarrhea, strongly associated with HIV infection in Kinshasa, Zaire. Am J Gastroenterol 82 :859–864.
-
3
Brink AK, Mahe C, Watera C, Lugada E, Gilks C, Whitworth J, French N, 2002. Diarrhea, CD4 counts and enteric infections in a community-based cohort of HIV-infected adults in Uganda. J Infect 45 :99–106.
-
4
Kaplan JE, Hu DJ, Holmes KK, Jaffe HW, Masur H, De Cock KM, 1996. Preventing opportunistic infections in human immunodeficiency virus-infected persons: implications for the developing world. Am J Trop Med Hyg 55 :1–11.
-
5
Reiff FM, Roses M, Venczel L, Quick R, Witt VM, 1996. Low-cost safe water for the world: a practical interim solution. J Public Health Policy 17 :389–408.
-
6
Mintz ED, Reiff FM, Tauxe RV, 1995. Safe water treatment and storage in the home: a practical new strategy to prevent water-borne disease. JAMA 273 :948–953.
-
7
Quick RE, Venczel LV, Mintz ED, Soleto L, Aparicio J, Gironaz M, Hutwagner L, Greene K, Bopp C, Maloney K, Chavez D, Sobsey M, Tauxe RV, 1999. Diarrhoea prevention in Bolivia through point-of-use water treatment and safe storage: a promising new strategy. Epidemiol Infect 122 :83–90.
-
8
Quick RE, Kimura A, Thevos A, Tembo M, Shamputa I, Hutwagner L, Mintz E, 2002. Diarrhea prevention through household-level water disinfection and safe storage in Zambia. Am J Trop Med Hyg 66 :584–589.
-
9
Semenza JC, Roberts L, Henderson A, Bogan J, Rubin CH, 1998. Water distribution system and diarrheal disease transmission: a case study in Uzbekistan. Am J Trop Med Hyg 59 :941–946.
-
10
Wiktor SZ, Sassan-Morokro M, Grant AD, Abouya L, Karon JM, Maurice C, Djomand G, Ackah A, Domoua K, Kadio A, Yapi A, Combe P, Tossou O, Roels TH, Lackritz EM, Coulibaly D, De Cock KM, Coulibaly IM, Greenberg AE, 1999. Efficacy of trimethoprim-sulphamethoxazole prophylaxis to decrease morbidity and mortality in HIV-1-infected patients with tuberculosis in Abidjan, Cote d’Ivoire: a randomised controlled trial. Lancet 353 :1469–1475.
-
11
Anglaret X, Chene G, Attia A, Toure S, Lafont S, Combe P, Manlan K, N’Dri-Yoman T, Salamon R, 1999. Early chemo-prophylaxis with trimethoprim-sulphamethoxazole for HIV-1-infected adults in Abidjan, Cote d’Ivoire: a randomised trial. Cotrimo-CI Study Group. Lancet 353 :1463–1468.
-
12
Zachariah R, Spielmann MP, Harries AD, Gomani P, Bakali E, 2002. Cotrimoxazole prophylaxis in HIV-infected individuals after completing anti-tuberculosis treatment in Thyolo, Malawi. Int J Tuberc Lung Dis 6 :1046–1050.
-
13
Joloba ML, Bajaksouzian S, Palavecino E, Whalen C, Jacobs MR, 2001. High prevalence of carriage of antibiotic-resistant Streptococcus pneumoniae in children in Kampala Uganda. Int J Antimicrob Agents 17 :395–400.
-
14
Mermin J, Lule J, Ekwaru JP, Malamba S, Downing R, Ransom R, Kaharuza F, Culver D, Kizito F, Bunnell R, Kigozi A, Nakanjako D, Wafula W, Quick R, 2004. Effect of co-trimoxazole prophylaxis on morbidity, mortality, CD4-cell count, and viral load in HIV infection in rural Uganda. Lancet 364 :1428–1434.
-
15
Luscher D, Altwegg M, 1994. Detection of Shigellae, enteroin-vasive and enterotoxigenic Escherichia coli using the polymerase chain reaction (PCR) in patients returning from tropical countries. Mol Cell Probes 8 :285–290.
-
16
NCCLS, 1999. Performance Standards for Antimicrobial Disk and Dilution Susceptibility Tests for Bacteria Isolated from Animals. Approved standard M31-A. Wayne, PA: National Committee for Clinical Laboratory Standards, 19.
-
17
Mates A, Shaffer M, 1989. Membrane filtration differentiation of E. coli from coliforms in the examination of water. J Appl Bacteriol 67 :343–346.
-
18
Wright JGS, Conroy R, 2003. Household drinking water in developing countries: a systematic review of microbiological contamination between source and point-of-use. Trop Med Int Health 9 :106–117.
-
19
Curtis V, Cairncross S, 2003. Effect of washing hands with soap on diarrhoea risk in the community: a systematic review. Lancet Infect Dis 3 :275–281.
-
20
Esrey SA, Potash JB, Roberts L, Shiff C, 1991. Effects of improved water supply and sanitation on ascariasis, diarrhoea, dracunculiasis, hookworm infection, schistosomiasis, and trachoma. Bull World Health Organ 69 :609–621.
-
21
Kirschner D, 1999. Dynamics of co-infection with M. tuberculosis and HIV-1. Theor Popul Biol 55 :94–109.
-
22
Mayanja-Kizza H, Johnson JL, Hirsch CS, Peters P, Surewicz K, Wu M, Nalugwa G, Mubiru F, Luzze H, Wajja A, Aung H, Ellner JJ, Whalen C, Toossi Z, 2001. Macrophage-activating cytokines in human immununodeficiency virus type 1-infected and -uninfected patients with pulmonary tuberculosis. J Infect Dis 183 :1805–1809.
-
23
Toossi Z, 2003. Virological and immunological impact of tuberculosis on human immunodeficiency virus type 1 disease. J Infect Dis 188 :1146–1155.
-
24
Toossi Z, Mayanja-Kizza H, Hirsch CS, Edmonds KL, Spahlinger T, Hom DL, Aung H, Mugyenyi P, Ellner JJ, Whalen CW, 2001. Impact of tuberculosis (TB) on HIV-1 activity in dually infected patients. Clin Exp Immunol 123 :233–238.
-
25
Wahl SM, Orenstein JM, 1997. Immune stimulation and HIV-1 viral replication. J Leukoc Biol 62 :67–71.
-
26
WHO, 2004. Evaluation of the Costs and Benefits of Water and Sanitation Improvements at the Global Level. Geneva: World Health Organization.
-
27
Jong-wook L, 2003. Attacking AIDS and Its Ally, Hunger; World AIDS Day. The International Herald Tribune, Dec 01, 2003.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 308 | 308 | 37 |
| Full Text Views | 2985 | 827 | 0 |
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EFFECT OF HOME-BASED WATER CHLORINATION AND SAFE STORAGE ON DIARRHEA AMONG PERSONS WITH HUMAN IMMUNODEFICIENCY VIRUS IN UGANDA
JOHN R. LULE
JOHN R. LULE
Centers for Disease Control and Prevention-Uganda, Entebbe, Uganda and Global AIDS Program, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia; Uganda Virus Research Institute, Entebbe, Uganda; Medical Research Council Programme on AIDS in Uganda, Entebbe, Uganda; The AIDS Support Organization, Entebbe, Uganda; Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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JONATHAN MERMIN
JONATHAN MERMIN
Centers for Disease Control and Prevention-Uganda, Entebbe, Uganda and Global AIDS Program, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia; Uganda Virus Research Institute, Entebbe, Uganda; Medical Research Council Programme on AIDS in Uganda, Entebbe, Uganda; The AIDS Support Organization, Entebbe, Uganda; Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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JOHN PAUL EKWARU
JOHN PAUL EKWARU
Centers for Disease Control and Prevention-Uganda, Entebbe, Uganda and Global AIDS Program, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia; Uganda Virus Research Institute, Entebbe, Uganda; Medical Research Council Programme on AIDS in Uganda, Entebbe, Uganda; The AIDS Support Organization, Entebbe, Uganda; Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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SAMUEL MALAMBA
SAMUEL MALAMBA
Centers for Disease Control and Prevention-Uganda, Entebbe, Uganda and Global AIDS Program, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia; Uganda Virus Research Institute, Entebbe, Uganda; Medical Research Council Programme on AIDS in Uganda, Entebbe, Uganda; The AIDS Support Organization, Entebbe, Uganda; Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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ROBERT DOWNING
ROBERT DOWNING
Centers for Disease Control and Prevention-Uganda, Entebbe, Uganda and Global AIDS Program, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia; Uganda Virus Research Institute, Entebbe, Uganda; Medical Research Council Programme on AIDS in Uganda, Entebbe, Uganda; The AIDS Support Organization, Entebbe, Uganda; Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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RAYMOND RANSOM
RAYMOND RANSOM
Centers for Disease Control and Prevention-Uganda, Entebbe, Uganda and Global AIDS Program, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia; Uganda Virus Research Institute, Entebbe, Uganda; Medical Research Council Programme on AIDS in Uganda, Entebbe, Uganda; The AIDS Support Organization, Entebbe, Uganda; Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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DAMALIE NAKANJAKO
DAMALIE NAKANJAKO
Centers for Disease Control and Prevention-Uganda, Entebbe, Uganda and Global AIDS Program, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia; Uganda Virus Research Institute, Entebbe, Uganda; Medical Research Council Programme on AIDS in Uganda, Entebbe, Uganda; The AIDS Support Organization, Entebbe, Uganda; Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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WINNIE WAFULA
WINNIE WAFULA
Centers for Disease Control and Prevention-Uganda, Entebbe, Uganda and Global AIDS Program, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia; Uganda Virus Research Institute, Entebbe, Uganda; Medical Research Council Programme on AIDS in Uganda, Entebbe, Uganda; The AIDS Support Organization, Entebbe, Uganda; Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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PETER HUGHES
PETER HUGHES
Centers for Disease Control and Prevention-Uganda, Entebbe, Uganda and Global AIDS Program, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia; Uganda Virus Research Institute, Entebbe, Uganda; Medical Research Council Programme on AIDS in Uganda, Entebbe, Uganda; The AIDS Support Organization, Entebbe, Uganda; Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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REBECCA BUNNELL
REBECCA BUNNELL
Centers for Disease Control and Prevention-Uganda, Entebbe, Uganda and Global AIDS Program, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia; Uganda Virus Research Institute, Entebbe, Uganda; Medical Research Council Programme on AIDS in Uganda, Entebbe, Uganda; The AIDS Support Organization, Entebbe, Uganda; Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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FRANK KAHARUZA
FRANK KAHARUZA
Centers for Disease Control and Prevention-Uganda, Entebbe, Uganda and Global AIDS Program, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia; Uganda Virus Research Institute, Entebbe, Uganda; Medical Research Council Programme on AIDS in Uganda, Entebbe, Uganda; The AIDS Support Organization, Entebbe, Uganda; Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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ALEX COUTINHO
ALEX COUTINHO
Centers for Disease Control and Prevention-Uganda, Entebbe, Uganda and Global AIDS Program, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia; Uganda Virus Research Institute, Entebbe, Uganda; Medical Research Council Programme on AIDS in Uganda, Entebbe, Uganda; The AIDS Support Organization, Entebbe, Uganda; Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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AMINAH KIGOZI
AMINAH KIGOZI
Centers for Disease Control and Prevention-Uganda, Entebbe, Uganda and Global AIDS Program, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia; Uganda Virus Research Institute, Entebbe, Uganda; Medical Research Council Programme on AIDS in Uganda, Entebbe, Uganda; The AIDS Support Organization, Entebbe, Uganda; Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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ROBERT QUICK
ROBERT QUICK
Centers for Disease Control and Prevention-Uganda, Entebbe, Uganda and Global AIDS Program, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia; Uganda Virus Research Institute, Entebbe, Uganda; Medical Research Council Programme on AIDS in Uganda, Entebbe, Uganda; The AIDS Support Organization, Entebbe, Uganda; Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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Diarrhea is frequent among persons infected with human immunodeficiency virus (HIV) but few interventions are available for people in Africa. We conducted a randomized controlled trial of a home-based, safe water intervention on the incidence and severity of diarrhea among persons with HIV living in rural Uganda. Between April 2001 and November 2002, households of 509 persons with HIV and 1,521 HIV-negative household members received a closed-mouth plastic container, a dilute chlorine solution, and hygiene education (safe water system [SWS]) or simply hygiene education alone. After five months, HIV-positive participants received daily cotrimoxazole prophylaxis (160 mg of trimethoprim and 800 mg of sulfamethoxazole) and were followed for an additional 1.5 years. Persons with HIV using SWS had 25% fewer diarrhea episodes (adjusted incidence rate ratio [IRR] = 0.75, 95% confidence interval [CI] = 0.59–0.94, P = 0.015), 33% fewer days with diarrhea (IRR = 0.67, 95% CI = 0.48–0.94, P = 0.021), and less visible blood or mucus in stools (28% versus 39%; P < 0.0001). The SWS was equally effective with or without cotrimoxazole prophylaxis (P = 0.73 for interaction), and together they reduced diarrhea episodes by 67% (IRR = 0.33, 95% CI = 0.24–0.46, P < 0.0001), days with diarrhea by 54% (IRR = 0.46, 95% CI = 0.32–0.66, P < 0.0001), and days of work or school lost due to diarrhea by 47% (IRR = 0.53, 95% CI = 0.34–0.83, P < 0.0056). A home-based safe water system reduced diarrhea frequency and severity among persons with HIV living in Africa and large scale implementation should be considered.
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-
1
Grant AD, Djomand G, De Cock KM, 1997. Natural history and spectrum of disease in adults with HIV/AIDS in Africa. AIDS 11 (Suppl B):S43–S54.
-
2
Colebunders R, Francis H, Mann JM, Bila KM, Izaley L, Kimputu L, Behets F, van der Groen G, Quinn TC, Curran JW, 1987. Persistent diarrhea, strongly associated with HIV infection in Kinshasa, Zaire. Am J Gastroenterol 82 :859–864.
-
3
Brink AK, Mahe C, Watera C, Lugada E, Gilks C, Whitworth J, French N, 2002. Diarrhea, CD4 counts and enteric infections in a community-based cohort of HIV-infected adults in Uganda. J Infect 45 :99–106.
-
4
Kaplan JE, Hu DJ, Holmes KK, Jaffe HW, Masur H, De Cock KM, 1996. Preventing opportunistic infections in human immunodeficiency virus-infected persons: implications for the developing world. Am J Trop Med Hyg 55 :1–11.
-
5
Reiff FM, Roses M, Venczel L, Quick R, Witt VM, 1996. Low-cost safe water for the world: a practical interim solution. J Public Health Policy 17 :389–408.
-
6
Mintz ED, Reiff FM, Tauxe RV, 1995. Safe water treatment and storage in the home: a practical new strategy to prevent water-borne disease. JAMA 273 :948–953.
-
7
Quick RE, Venczel LV, Mintz ED, Soleto L, Aparicio J, Gironaz M, Hutwagner L, Greene K, Bopp C, Maloney K, Chavez D, Sobsey M, Tauxe RV, 1999. Diarrhoea prevention in Bolivia through point-of-use water treatment and safe storage: a promising new strategy. Epidemiol Infect 122 :83–90.
-
8
Quick RE, Kimura A, Thevos A, Tembo M, Shamputa I, Hutwagner L, Mintz E, 2002. Diarrhea prevention through household-level water disinfection and safe storage in Zambia. Am J Trop Med Hyg 66 :584–589.
-
9
Semenza JC, Roberts L, Henderson A, Bogan J, Rubin CH, 1998. Water distribution system and diarrheal disease transmission: a case study in Uzbekistan. Am J Trop Med Hyg 59 :941–946.
-
10
Wiktor SZ, Sassan-Morokro M, Grant AD, Abouya L, Karon JM, Maurice C, Djomand G, Ackah A, Domoua K, Kadio A, Yapi A, Combe P, Tossou O, Roels TH, Lackritz EM, Coulibaly D, De Cock KM, Coulibaly IM, Greenberg AE, 1999. Efficacy of trimethoprim-sulphamethoxazole prophylaxis to decrease morbidity and mortality in HIV-1-infected patients with tuberculosis in Abidjan, Cote d’Ivoire: a randomised controlled trial. Lancet 353 :1469–1475.
-
11
Anglaret X, Chene G, Attia A, Toure S, Lafont S, Combe P, Manlan K, N’Dri-Yoman T, Salamon R, 1999. Early chemo-prophylaxis with trimethoprim-sulphamethoxazole for HIV-1-infected adults in Abidjan, Cote d’Ivoire: a randomised trial. Cotrimo-CI Study Group. Lancet 353 :1463–1468.
-
12
Zachariah R, Spielmann MP, Harries AD, Gomani P, Bakali E, 2002. Cotrimoxazole prophylaxis in HIV-infected individuals after completing anti-tuberculosis treatment in Thyolo, Malawi. Int J Tuberc Lung Dis 6 :1046–1050.
-
13
Joloba ML, Bajaksouzian S, Palavecino E, Whalen C, Jacobs MR, 2001. High prevalence of carriage of antibiotic-resistant Streptococcus pneumoniae in children in Kampala Uganda. Int J Antimicrob Agents 17 :395–400.
-
14
Mermin J, Lule J, Ekwaru JP, Malamba S, Downing R, Ransom R, Kaharuza F, Culver D, Kizito F, Bunnell R, Kigozi A, Nakanjako D, Wafula W, Quick R, 2004. Effect of co-trimoxazole prophylaxis on morbidity, mortality, CD4-cell count, and viral load in HIV infection in rural Uganda. Lancet 364 :1428–1434.
-
15
Luscher D, Altwegg M, 1994. Detection of Shigellae, enteroin-vasive and enterotoxigenic Escherichia coli using the polymerase chain reaction (PCR) in patients returning from tropical countries. Mol Cell Probes 8 :285–290.
-
16
NCCLS, 1999. Performance Standards for Antimicrobial Disk and Dilution Susceptibility Tests for Bacteria Isolated from Animals. Approved standard M31-A. Wayne, PA: National Committee for Clinical Laboratory Standards, 19.
-
17
Mates A, Shaffer M, 1989. Membrane filtration differentiation of E. coli from coliforms in the examination of water. J Appl Bacteriol 67 :343–346.
-
18
Wright JGS, Conroy R, 2003. Household drinking water in developing countries: a systematic review of microbiological contamination between source and point-of-use. Trop Med Int Health 9 :106–117.
-
19
Curtis V, Cairncross S, 2003. Effect of washing hands with soap on diarrhoea risk in the community: a systematic review. Lancet Infect Dis 3 :275–281.
-
20
Esrey SA, Potash JB, Roberts L, Shiff C, 1991. Effects of improved water supply and sanitation on ascariasis, diarrhoea, dracunculiasis, hookworm infection, schistosomiasis, and trachoma. Bull World Health Organ 69 :609–621.
-
21
Kirschner D, 1999. Dynamics of co-infection with M. tuberculosis and HIV-1. Theor Popul Biol 55 :94–109.
-
22
Mayanja-Kizza H, Johnson JL, Hirsch CS, Peters P, Surewicz K, Wu M, Nalugwa G, Mubiru F, Luzze H, Wajja A, Aung H, Ellner JJ, Whalen C, Toossi Z, 2001. Macrophage-activating cytokines in human immununodeficiency virus type 1-infected and -uninfected patients with pulmonary tuberculosis. J Infect Dis 183 :1805–1809.
-
23
Toossi Z, 2003. Virological and immunological impact of tuberculosis on human immunodeficiency virus type 1 disease. J Infect Dis 188 :1146–1155.
-
24
Toossi Z, Mayanja-Kizza H, Hirsch CS, Edmonds KL, Spahlinger T, Hom DL, Aung H, Mugyenyi P, Ellner JJ, Whalen CW, 2001. Impact of tuberculosis (TB) on HIV-1 activity in dually infected patients. Clin Exp Immunol 123 :233–238.
-
25
Wahl SM, Orenstein JM, 1997. Immune stimulation and HIV-1 viral replication. J Leukoc Biol 62 :67–71.
-
26
WHO, 2004. Evaluation of the Costs and Benefits of Water and Sanitation Improvements at the Global Level. Geneva: World Health Organization.
-
27
Jong-wook L, 2003. Attacking AIDS and Its Ally, Hunger; World AIDS Day. The International Herald Tribune, Dec 01, 2003.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 308 | 308 | 37 |
| Full Text Views | 2985 | 827 | 0 |
| PDF Downloads | 130 | 27 | 0 |