Diagnosis and case finding according to key partner risk populations of people living with HIV in Nigeria: A retrospective analysis of community-led index partner testing services

As The Proportions Of People Living With HIV Who Do Not Know Their HIV Infection Status Decrease, Reaching The Last Mile Of Those Who Are Asymptomatic And Not In Contact With The Health Care System Becomes A Critical Challenge. This Project Will Use An Explanatory Sequential Mixed-Methods Study Design. It Will Be Conducted In Three High-Volume Health Facilities In Matero Sub-District 3 Of Lusaka District In Zambia Over A Period Of One Year. The Specific Objectives Are: To Understand The Perceived Facilitators And Barriers To HIV Partner Testing From The Perspective Of The Health-Care Provider; To Propose Interventions Necessary For Improved HIV Case Finding; And To Reach High Risk But Hard To Reach Populations In HIV Programs Such As Middle-Aged Men And Adolescent Girls And Young Women (AGYW). The Permission To Conduct This Study Will Be Obtained From The Lusaka Provincial Health Office Before Its Commencement. Ethical Clearance Will Be Sought And Obtained From The ERES Converge Research Ethical Committee. The Authority To Conduct Research Will Be Sought From The National Health Research Authority. The Expected Main Findings Following The Address Of The Identified Challenges Are: Increased Number Of Recipients Of Care Indexed, Increased Index Contact Elicitation Ration From 1:1 To At Least 1:2, Improved Rate Of Contacts Tested On Time, Improved HIV Case Finding Through Index Testing, And Overall, Increased HIV Index Testing Positivity Rate From Below 25% (Baseline) To Above 40% (At The End Of The Project).

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Programmatic Evaluation of an Algorithm for Intensified Tuberculosis Case Finding and Isoniazid Preventive Therapy for People Living With HIV in Thailand and Vietnam

JAIDS Journal of Acquired Immune Deficiency Syndromes ◽

10.1097/qai.0000000000001551 ◽

2017 ◽

Vol 76 (5) ◽

pp. 512-521 ◽

Cited By ~ 1

Author(s):

Tori L. Cowger ◽

Le Hung Thai ◽

Bui Duc Duong ◽

Junya Danyuttapolchai ◽

Somyot Kittimunkong ◽

...

Keyword(s):

Preventive Therapy ◽

Case Finding ◽

Isoniazid Preventive Therapy ◽

People Living With Hiv ◽

Tuberculosis Case ◽

Programmatic Evaluation ◽

Living With Hiv

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Late Presentation to Care among People Living with HIV in Cotonou, Benin: A Retrospective Analysis from 2003 to 2014

Open Journal of Internal Medicine ◽

10.4236/ojim.2017.74013 ◽

2017 ◽

Vol 07 (04) ◽

pp. 123-134 ◽

Cited By ~ 1

Author(s):

Djimon Marcel Zannou ◽

Pacos Bray Gandaho ◽

Angèle Azon-Kouanou ◽

Carin Ahouada ◽

Kuessi Anthelme Agbodande ◽

...

Keyword(s):

Retrospective Analysis ◽

Late Presentation ◽

People Living With Hiv ◽

Living With Hiv

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Low Partner Testing in High HIV Prevalence Setting in Freetown, Sierra Leone: A Retrospective Study

10.21203/rs.2.11135/v3 ◽

2019 ◽

Author(s):

Sulaiman Lakoh ◽

Emmanuel Firima ◽

Darlinda F. Jiba ◽

Momodu Sesay ◽

Mariama Marco Conteh ◽

...

Keyword(s):

Retrospective Study ◽

Sierra Leone ◽

Tertiary Hospital ◽

Hiv Prevalence ◽

People Living With Hiv ◽

Hiv Diagnosis ◽

Partner Testing ◽

Hiv Test ◽

Living With Hiv ◽

Testing And Counseling

Abstract Objective: Despite a 1.5% national HIV prevalence, 33% of people living with HIV in Sierra Leone know their status. Limited activities on testing partners of HIV patients could be contributory to this substantial unawareness of HIV status. We carried out a retrospective study aimed at assessing partner testing and HIV prevalence among adults (≥15 years) tested using DetermineTM and SD Bioline as recorded in the HIV testing registers from January to December 2017 at Connaught Hospital, an urban tertiary hospital in Sierra Leone. Results: Of the 3808 clients tested for HIV, 2048(53.8%) were females. The median age was 31 (IQR 24 – 42) years and 2104 (55.3%) were single. While 3014(79.1%) had Provider-Initiated Testing and Counseling (PITC), 794 (20.9%) had Client-Initiated Testing and Counseling (CITC). HIV test was positive in 925 (24.3%) {CI 22.9 – 25.6, P< 0.001} clients. Of the 17 (0.4%) partners tested for HIV, 9 (52.9%) were positive. PITC yielded more HIV positive cases (760, 25.2%) than CITC (165, 20.8%). Partner testing (P=0.007), female sex (P<0.001) and PITC (P=0.006) were associated with a positive HIV diagnosis. With high HIV prevalence and low partner testing, activities on partner testing are needed to improve the response to the epidemic.

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Low partner testing in high HIV prevalence setting in Freetown, Sierra Leone: a retrospective study

BMC Research Notes ◽

10.1186/s13104-019-4662-9 ◽

2019 ◽

Vol 12 (1) ◽

Cited By ~ 1

Author(s):

Sulaiman Lakoh ◽

Emmanuel Firima ◽

Darlinda F. Jiba ◽

Momodu Sesay ◽

Mariama Marco Conteh ◽

...

Keyword(s):

Retrospective Study ◽

Sierra Leone ◽

Tertiary Hospital ◽

Hiv Prevalence ◽

People Living With Hiv ◽

Hiv Diagnosis ◽

Partner Testing ◽

Hiv Test ◽

Living With Hiv ◽

Testing And Counseling

Abstract Objective Despite a 1.5% National HIV prevalence, less than 40% of people living with HIV in Sierra Leone know their status. Limited activities on testing partners of HIV patients could be contributory to this substantial unawareness of HIV status. We carried out a retrospective study aimed at assessing partner testing and HIV prevalence among adults (≥ 15 years) tested using Determine™ and SD Bioline as recorded in the HIV testing registers from January to December 2017 at Connaught Hospital, an urban tertiary hospital in Sierra Leone. Results Of the 3808 clients tested for HIV, 2048 (53.8%) were females. The median age was 31 (IQR 24–42) years and 2104 (55.3%) were single. While 3014 (79.1%) had Provider-Initiated Testing and Counseling (PITC), 794 (20.9%) had Client-Initiated Testing and Counseling (CITC). HIV test was positive in 925 (24.3%) {CI 22.9–25.6, P < 0.001} clients. Of the 17 (0.4%) partners tested for HIV, 9 (52.9%) were positive. PITC yielded more HIV positive cases (760, 25.2%) than CITC (165, 20.8%). Partner testing (P = 0.007), female sex (P < 0.001) and PITC (P = 0.006) were associated with a positive HIV diagnosis. With high HIV prevalence and low partner testing, activities on partner testing are needed to improve the response to the epidemic.

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Clinical features associated with neurosyphilis in people living with HIV and late latent syphilis

International Journal of STD & AIDS ◽

10.1177/09564624211063091 ◽

2022 ◽

pp. 095646242110630

Author(s):

Pedro Martínez-Ayala ◽

Alejandro Quiñonez-Flores ◽

Luz Alicia González-Hernández ◽

Vida Verónica Ruíz-Herrera ◽

Sergio Zúñiga-Quiñones ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Viral Load ◽

T Cell ◽

Cell Count ◽

Retrospective Analysis ◽

Laboratory Data ◽

Neurological Symptoms ◽

People Living With Hiv ◽

Living With Hiv ◽

Latent Syphilis

Background The diagnosis of neurosyphilis is a challenge, and the criteria for deciding when to perform a lumbar puncture are still controversial, especially in people living with HIV with a late latent syphilis diagnosis. Methods Retrospective analysis of demographic, clinical, and laboratory data of people with HIV and documented late latent syphilis or syphilis of unknown duration with a cerebrospinal fluid VDRL test. Results 122 patients were evaluated, of whom 52 had the diagnosis of neurosyphilis. Patients with and without neurosyphilis presented a similar viral load and lymphocyte CD4+ T-cell count. Neurological symptoms (OR 6.4, 95% CI 2.1–22.4; p < 0.01), serum VDRL titers of 1:32 ( p<0.01), 1:64 ( p = 0.055), and ≥1:128 ( p < 0.001) were associated with neurosyphilis. Furthermore, serum VDRL ≥1:32 were associated with (OR 24.9, 95% CI 5.45–154.9; p < 0.001) or without (OR 6.5, 95% CI 2.0–29.2; p = 0.004) neurological symptoms with neurosyphilis; however, VDRL ≤1:16 with neurological symptoms can be associated with neurosyphilis (OR 7.6, 95% CI 1.03–64.3; p = 0.046). Conclusion Neurological symptoms, particularly headache, were predictors of neurosyphilis in people with HIV irrespective of their viral load and lymphocyte CD4+ T-cell count in late latent syphilis. A serum VDRL ≥1:32 increased the risk of neurosyphilis in patients with or without any symptoms.

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Assessment of the tuberculosis case-finding and prevention cascade among people living with HIV in Zambia – 2018: a cross-sectional cluster survey

BMC Public Health ◽

10.1186/s12889-021-10929-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Michael Melgar ◽

Ray W. Shiraishi ◽

Clifford Tende ◽

Sydney Mwanza ◽

Joyce Mulenga ◽

...

Keyword(s):

Healthcare Workers ◽

Case Finding ◽

Hiv Care ◽

People Living With Hiv ◽

Tuberculosis Case ◽

Initiation Rate ◽

Cross Sectional ◽

Symptom Screening ◽

Living With Hiv ◽

Tuberculosis Disease

Abstract Background The Ministry of Health Zambia recommends tuberculosis preventive treatment (TPT) with 6 months daily isoniazid for all people living with human immunodeficiency virus (HIV) after ruling out active tuberculosis disease. We sought to estimate the percentage of people living with HIV who progress through each stage of the tuberculosis case-finding and prevention cascade in two provinces with the highest tuberculosis burden in Zambia. Methods In this cross-sectional survey, we used a two-stage cluster sampling method. We sampled 12 healthcare facilities with probability proportional to size. Patient volume determined facility cluster size. During October 2018, from each facility we systematically sampled medical records of adults and children living with HIV. Our primary outcome of interest was TPT initiation rate among eligible people living with HIV, weighted for complex survey design. The Rao-Scott adjusted chi-square test was used to test for differences in TPT initiation rate and other indicators from the tuberculosis prevention cascade by age group and province of residence. Additionally, we conducted semi-structured interviews with healthcare workers at each facility to assess TPT knowledge and identify challenges to its implementation. Results We sampled 482 records of people living with HIV (including 128 children living with HIV). Excluding two people diagnosed with tuberculosis disease before enrollment in HIV care, 93.4% underwent tuberculosis symptom screening. Of those, 4.7% were diagnosed with tuberculosis disease and 95.3% were TPT-eligible, of whom 24.7% initiated TPT. TPT initiation was lower among eligible children (7.7%) compared with adults (25.2%, p = 0.03) and Copperbelt residents (3.1%) compared with Lusaka residents (35.8%, p < 0.01). TPT completion rate was 38.4% among people living with HIV who initiated the 6-month course. Among interviewed healthcare workers, 58.3% (unweighted) incorrectly relayed the number of symptoms needed for a positive tuberculosis symptom screen, 83.3% (unweighted) reported insufficient isoniazid stockpile for completion at the time of TPT initiation, and only 27.3% (unweighted) reported receiving TPT-specific training. Conclusions TPT uptake among people living with HIV in Zambia is challenged by inconsistent tuberculosis screening, lack of TPT training for healthcare workers, and supply chain inefficiencies. Addressing these barriers may increase TPT initiations and improve outcomes among people living with HIV.

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