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For the rat, detailed information about the vagal innervation of the GI tract has made feasible a series of analyses on vagal regeneration. In particular, the characteristic pattern of normal vagal innervation provides two particularly useful features for observations on plasticity. First, because vagal axons in the stomach fan out circularly in a characteristic pattern from the lower esophageal sphincter and because these fibers end in two differentiated types of terminals within the smooth muscle wall, each with a characteristic regional distribution 1, 25 ; , it is practical to evaluate the rate, extent, and accuracy of vagal fiber regeneration. Second, the vagal innervation of the rat stomach is almost completely lateralized. This has the practical application that one wall of the stomach can be left innervated while the other is denervated, and the animal is then monitored for regeneration. Such a unilateral vagotomy strategy offers the advantage that the regeneration period is essentially unaffected by the nutritional and other physiological disturbances that often accompany bilateral vagotomy. Observations with such a preparation demonstrate that rat vagal afferents have considerable capacity for regeneration. When the animal sustains a unilateral truncal vagotomy above the highest abdominal branch i.e., hepatic ; , afferents regenerate into the stomach and duodenal smooth muscle walls 16, 17 ; . These afferents continue to extend and ramify more and more distally within the stomach and duodenum over 45 wk after vagotomy. In this progressive regeneration, many afferents display growth cone profiles and eventually reestablish endings that appear normal in appearance and location; other fibers produce endings that are disordered in structure and or location. Even at 45 wk after vagotomy, vagal regeneration in the rat appears incomplete and partially disordered 16 ; . Because it has been established that the normal patterns of vagal innervation of the mouse GI tract are similar to those of the rat, in terms of projections and regional distributions and in terms of lateralized innervation patterns 9 ; , the present experiment was designed to evaluate the patterns of afferent vagal regeneration in the mouse GI tract. We hypothesized that the spatial pattern of regrowth would be similar to that in the rat.

The Impact on the Health Sector In all affected countries the HIV AIDS epidemic is bringing additional pressure to bear on the health sector. As the epidemic matures, the demand for care for those living with HIV AIDS rises, as does the toll among health workers. In sub-Saharan Africa, the annual direct medical costs of AIDS excluding antiretroviral therapy ; have been estimated at about US per capita, at a time when overall public health spending is less that US for most African countries. Health-care services face different levels of strain, depending on the number of people who seek services, the nature of their need, and the capacity to deliver that care. The Effect on Hospitals As HIV infection progresses to AIDS, there is an increase in total hospitalisation. The 2001 Swaziland Human Development Report estimated that people living with HIV AIDS occupied half of the beds in some health care centres in Swaziland. HIV prevalence among hospitalised patients was almost 33% in one Tanzanian hospital, making HIV infection the major cause of illness leading to hospitalisation. Without major interventions, the problem will worsen. The World Bank estimates that the number of hospital beds needed for AIDS patients could exceed the total number of beds available in Swaziland by 2004 and in Namibia by 20051. The HIV AIDS epidemic is also having a negative impact on the overall quality of care provided in hospitals. A shortage of beds, for example, means that people tend to be admitted only at the later stages of illness, reducing their chances of recovery, as some Kenyan hospitals have discovered. Lengthy hospital stays are being reported in Botswana's hospitals, along with staff shortages and staff burnout. Also, more time has to be spent diagnosing cases that are more complex as the epidemic deepens. Health Care Workers At the same time as the demand for health services is expanding, so more-health care professionals are being affected by HIV AIDS. For example, Malawi and Zambia are experiencing a 5-6 fold increase in health worker illness and death rates. Increased workloads and stress might may also spur emigration by health professionals.

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