scholarly journals Feasibility of identifying out of care HIV-positive patients in a hospital setting and enrolling them in a retention intervention

2017 ◽  
Vol 18 (2) ◽  
pp. 75-82 ◽  
Author(s):  
Jessica A. Davila ◽  
Christine Hartman ◽  
Jeffrey Cully ◽  
Melinda Stanley ◽  
K. Rivet Amico ◽  
...  
Keyword(s):  
Hospital Setting ◽  
Hiv Positive ◽  
Retention Intervention

scholarly journals Predictive Factors for Positive HIV Test Results in a Hospital Setting

2021 ◽  
Vol 16 (3) ◽  
Author(s):  
Sulmaz Ghahramani ◽  
Hassan Joulaei ◽  
Amir Human Hoveidaei ◽  
Mohammad Reza Rajabi ◽  
Kamran Bagheri Lankarani
Keyword(s):  
Risk Factors ◽  
Hospital Admission ◽  
Hiv Testing ◽  
General Hospital ◽  
Hospital Setting ◽  
Hiv Positive ◽  
Control Group ◽  
Test Results ◽  
Hiv Test ◽  
Test Result

Background: Hospital admission for any reason provides the situation for voluntary HIV testing and consultation. Identifying the predictors of positivity may lead to a cost-effective method while enhancing professionalism. Objectives: To find the predictors of HIV-positive test result in a general hospital in Shiraz compared to a control group. Methods: In this case-control study, the records of all patients who received HIV testing upon their hospitalization in a general hospital in Shiraz, south of Iran, from January 2017 to the end of December 2017 were reviewed. For each HIV-positive case, at least one control from the same ward in the hospital with negative HIV test result was randomly selected. Based on the best-fitted model of logistic regression, the probability of positive HIV test results was estimated for each participant according to the risk factors, and a receiver operating characteristic (ROC) curve was drawn. Results: Out of 7333 persons who accepted to be tested, 77 patients tested positive for HIV, of whom 55 (71.4%) were male with the mean age of 41.5 ± 9.5 years. None of the HIV-positive patients were intravenous drug users, nor had they a history of imprisonment. The odds ratio (OR) was 21 for hepatitis-positive patients (hepatitis B and/or C) compared to negative ones, which was seven times higher in opium addicts than non-opium addicts. We developed a model using age, sex, opium addiction, and HBV and HCV status to predict the probability of being positive for HIV with an AUC of 0.853 (95% confidence interval 0.797 to 0.909). Conclusions: Hospital admission could be an appropriate momentum for providing voluntary counseling and testing. Infection with HBV and HCV are important risk factors for HIV infection, and additional testing should be offered, especially to these patients.

scholarly journals Infant feeding practices among HIV-positive mothers at Tembisa hospital, South Africa

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Armelia Chaponda ◽  
Daniel T. Goon ◽  
Muhammad E. Hoque
Keyword(s):  
Infant Feeding ◽  
Hospital Setting ◽  
Nursing Personnel ◽  
Hiv Positive ◽  
Coding System ◽  
Urban Hospital ◽  
New Mothers ◽  
Hiv Positive Mothers ◽  
Feeding Choice ◽  
Feeding Choices

Background: Despite the nutritional, physiological and emotional benefits of breastfeeding, HIV-positive mothers cannot practise exclusive breastfeeding for six months because of a range of influences on their feeding choice – thereby creating a caveat for morbidity in infants.Aim: This study explored factors influencing the infant feeding choice of HIV-positive mothers at a peri-urban hospital in Tembisa, South Africa.Methods: This study was qualitative and was conducted among 30 purposefully selected postnatal HIV-positive mothers at Tembisa hospital, Gauteng, from May to June 2011. In-depth interviews were conducted mainly in isiZulu and Sepedi which were then transcribed into English. An open coding system of analysis was used for thematic analysis.Results: Nurses significantly influenced the feeding choices of new mothers – sometimes with inconsistent information. The grandmothers of infants also influenced the new mothers’ feeding options, in some cases with the new mother coming under duress. Other relatives like the sisters and aunts of mothers appeared to significantly affect feeding choices. The time frames expressed for the initiation of a supplementary diet were as follows: before 1 month, at 1 month and at 4 months. The main reason was the belief that infants required more than breast milk as sustenance during this period.Conclusion: In the postnatal hospital setting of this study, the feeding choices of mothers were influenced by nursing personnel. Nursing personnel could marry the influential ‘authority’ they have with correct and consistent information, in order to change feeding behaviour. Significant ‘others’ like grandmothers and other relatives also influenced decisions on infant feeding. As such, family dynamics need to be considered when encouraging breastfeeding.

scholarly journals Status of referral to physiotherapy among hiv positive patients at Chris Hani Baragwaneth hospital johannesburg South Africa 2005

2007 ◽  
Vol 63 (2) ◽  
Author(s):  
H. Myezwa ◽  
A. Stewart ◽  
N. Mbambo ◽  
P. Nesara
Keyword(s):  
South Africa ◽  
Medical Model ◽  
Hospital Setting ◽  
Hiv Positive ◽  
Management Approach ◽  
Major Health Problem ◽  
Functional Deficits ◽  
Comprehensive Management ◽  
Starting Point ◽  
Referral Status

HIV continues to be a major health problem in South Africa.The multiple diagnoses that the disease presents with, needs a holistic and comprehensive management approach. Physiotherapy and rehabilitation play a role in this management approach. Understanding the full scope of conditions that are present and those that are suitable for physiotherapy intervention is an essential prerequisite to developing appropriate curricula, intervention models or systems. It is accepted that HIV rehabilitation interventions are based largely on functional deficits ( O’Dell  1996), however  in South Africa functional deficits have not been fully explored. A common starting point, with the medical model of management was considered to be at the diagnosis level as this information would be more readily available than functional deficits.Purpose: This study aimed to establish how much and in which aeitiology is physiotherapy involved in the management of HIV within an inpatient hospital setting at Chris Hani Baragwaneth Hospital. This minor study forms part of a larger study establishing physiotherapy curricula needs.Method: Aretrospective review of patient records was carried out in order to identify conditions suitable for physiotherapy and to determine the referral patterns to physiotherapy.Findings: Of the 732 records reviewed and used in the study, 47% (n=344) of the patients were HIV positive. From theserecords, 19% (n=139) had diagnoses considered suitable for physiotherapy and only 2% (n=3) of these 139 patientswere referred to physiotherapy.Conclusion: Almost half of the patients in the medical units were HIV positive. Although the referral rate was verylow, some of these patients presented with diagnosis that are traditionally seen by physiotherapists.  None of the patients’records indicated examination of the patients’ physical status such as exercise tolerance, mobility, muscle strength,lung function or pain. This study is by no means fully representative of the full scope of the epidemiology of conditionsthat can be seen by physiotherapists or their referral status but does give some indication of what conditions are, and could potentially interface with physiotherapy.

scholarly journals Prevalence of chronic kidney diseases and determinants among TDF users of pregnant and lactating women based on eGFR-cg, and MDRD-4 in hospital setting of north east Amhara, Ethiopia

2018 ◽  
Vol 6 (1) ◽  
pp. 6
Author(s):  
Eyob Gebretsadikk ◽  
Azmach Hadush ◽  
Mohammed Hussien ◽  
Getahun Asres
Keyword(s):  
High Risk ◽  
Kidney Diseases ◽  
Hospital Setting ◽  
Risk Estimate ◽  
Hiv Positive ◽  
Tubular Damage ◽  
Chronic Kidney Diseases ◽  
Lactating Women ◽  
Method Of Calculation ◽  
Incidence Of Ckd

In recent days, it is common to see increasing incidence of Fanconi, proximal kidney tubular damage and chronic kidney diseases-CKD among high risk populations that drew the clinicians’ attention to monitor closely. Among these risk populations with potential CKD incidence; HIV positive patients who uses TDF as a component of HAART need to be monitored for the incidence of CKD as a toxicity of TDF before initiation and during treatment despite the fact that the current monitoring practice in Ethiopia in most hospitals remain to be poor. Hence this study aimed at measuring the incidence of CKD among high risk segment of HIV positive pregnant and lactating women who uses TDF as part of their HAART treatment. Using a non-proportionate stratified sampling, a total of 111 HIV+ pregnant and lactating women who are on TDF based HAART treatment were enrolled to measure the incidence of CKD based on NKF K/DOQI Classification. Using the Android application of Medicalc GFR-cg, and MDRD-4; the prevalence of stage-2 CKD was 16.2 % (60-89 ml/min) and Stage 5-CKD/Renal Failure who require dialysis were 3.6% (CrCl < 15ml/min/1.72m2) by both method of calculation CrCl (GFR-cg and MDRD-4). Women who were lactating had a relative risk of 0.918 (95% CI lies within 0.845-0.998) of acquiring CKD (P= 0.045). The other associated factors were BMI less than 18.5 (P= 0.004 and adjusted OR of 7.82), WHO clinical stage-1 (P=0.014, odds ratio of 5.4 and 95% CI of 1.24-24.42), baseline CD4 count > 500 (P=0.02), and duration on TDF (> 12 months on treatment) and low haematocrit of 30 had a higher risk of falling into Stage 2 CKD with cohort risk estimate of 4.103 (95 % CI of 1.02, 16.54). The risk estimate of WHO stage 2 to acquire stage-4 CKD was 1.087 (95% CI of 1.002, 1.180) statistically significant (P=0.05.). The prevalence of stage 2 CKD among pregnant and lactating women by GFR-cg method of calculation was higher than MDRD-4 calculation. In this study, MDRD-4 method underestimated stage 2 CKD. Hence it is worth and highly recommended to use GFR-cg method in the baseline and during treatment monitoring of TDF toxicity to the kidney particularly for diagnosing the early stage of CKD.

Cytopathology Including Fine-Needle Aspiration in Sub-Saharan Africa: A Cameroon Experience

2011 ◽  
Vol 135 (2) ◽  
pp. 200-206
Author(s):  
Kelly Guggisberg ◽  
Chukwudi Okorie ◽  
Moosa Khalil
Keyword(s):  
Fine Needle Aspiration ◽  
False Negative ◽  
Hospital Setting ◽  
Needle Aspiration ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Tuberculous Lymphadenitis ◽  
Fine Needle ◽  
Laboratory Services ◽  
Sub Saharan

Abstract Context.—Surgical pathology is unavailable in most of sub-Saharan Africa because of equipment costs and lack of expertise. Cytopathology is an inexpensive and reliable alternative. Objective.—To explore the utility of cytopathology in a rural hospital setting in Africa. Design.—A cytopathologist and a pathology resident from Calgary, Alberta, Canada, went to Cameroon to provide a cytopathology service at the Banso Baptist Hospital. Both performed the fine-needle aspiration procedures. Direct smears were fixed in alcohol and stained with hematoxylin-eosin. Surgical specimens subsequently obtained from the patients were processed and reported at Calgary Laboratory Services, Canada. The histopathologic diagnoses were the gold standard for determining the accuracy of the cytologic diagnoses. Results.—Fifty-nine patients were examined during a 5-week period, 33 females (56%) and 26 males (44%). Sixteen (27%) were known to be HIV positive. Forty-four fine-needle aspiration procedures were performed for 43 patients (73%). The cost of each procedure was approximately US $10. Head and neck and breast were the sites most frequently sampled for aspirates. Cervical smears from 5 patients were also assessed, as were 8 fluid specimens and 2 touch preparations of prostatic core biopsies. The most frequent diagnoses for malignancy were carcinoma and lymphoma. Tuberculous lymphadenitis was diagnosed in 6 patients, 4 of whom were HIV positive. Surgical specimens were received from 18 patients (30%). Cytohistologic and clinicopathologic correlation revealed 1 false-positive (1.6%) and 1 false-negative (1.6%) diagnosis. Conclusion.—Cytopathology is a reliable alternative for tissue diagnosis in low-resource settings.

Exploring the Validity and Operational Impact of Using Allied Health Assistants to Conduct Dysphagia Screening for Low-Risk Patients Within the Acute Hospital Setting

2020 ◽  
Vol 29 (4) ◽  
pp. 1944-1955 ◽  
Author(s):  
Maria Schwarz ◽  
Elizabeth C. Ward ◽  
Petrea Cornwell ◽  
Anne Coccetti ◽  
Pamela D'Netto ◽  
...  
Keyword(s):  
At Risk ◽  
Allied Health ◽  
Assessment Tool ◽  
Hospital Setting ◽  
Low Risk ◽  
False Negatives ◽  
Exact Agreement ◽  
Risk Patients ◽  
Impact Phase ◽  
Operational Impact

Purpose The purpose of this study was to examine (a) the agreement between allied health assistants (AHAs) and speech-language pathologists (SLPs) when completing dysphagia screening for low-risk referrals and at-risk patients under a delegation model and (b) the operational impact of this delegation model. Method All AHAs worked in the adult acute inpatient settings across three hospitals and completed training and competency evaluation prior to conducting independent screening. Screening (pass/fail) was based on results from pre-screening exclusionary questions in combination with a water swallow test and the Eating Assessment Tool. To examine the agreement of AHAs' decision making with SLPs, AHAs ( n = 7) and SLPs ( n = 8) conducted an independent, simultaneous dysphagia screening on 51 adult inpatients classified as low-risk/at-risk referrals. To examine operational impact, AHAs independently completed screening on 48 low-risk/at-risk patients, with subsequent clinical swallow evaluation conducted by an SLP with patients who failed screening. Results Exact agreement between AHAs and SLPs on overall pass/fail screening criteria for the first 51 patients was 100%. Exact agreement for the two tools was 100% for the Eating Assessment Tool and 96% for the water swallow test. In the operational impact phase ( n = 48), 58% of patients failed AHA screening, with only 10% false positives on subjective SLP assessment and nil identified false negatives. Conclusion AHAs demonstrated the ability to reliably conduct dysphagia screening on a cohort of low-risk patients, with a low rate of false negatives. Data support high level of agreement and positive operational impact of using trained AHAs to perform dysphagia screening in low-risk patients.

Triumphs and Challenges of Implementing a Nursing Bedside Swallow Screening Tool: A Stroke Coordinator's Perspective

2009 ◽  
Vol 18 (4) ◽  
pp. 129-133 ◽  
Author(s):  
Kelly Poskus
Keyword(s):  
Screening Tool ◽  
Hospital Setting ◽  
Swallow Screening

Abstract The bedside swallow screen has become an essential part of the evaluation of a patient after stroke in the hospital setting. Implementing this type of tool should be simple. However, reinforcement and monitoring of the tool presents a challenge. Verifying the consistency and reliability of nurses performing the bedside swallow screen can be a difficult task. This article will document the journey of implementing and maintaining a reliable and valid nursing bedside swallow screen.

Developing theory-based risk-reduction interventions for HIV-positive young people with haemophilia

Haemophilia ◽  
2001 ◽  
Vol 7 (1) ◽  
pp. 64-71 ◽  
Author(s):  
J. R. Schultz ◽  
R. B. Butler ◽  
L. Mckernan ◽  
R. Boelsen ◽  
Keyword(s):  
Young People ◽  
Risk Reduction ◽  
Hiv Positive
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