Point-of-Care Urine Antigen Screening Tests for Tuberculosis and Cryptococcosis: Potential for Mortality Reduction in Antiretroviral Treatment Programs in Africa

SummaryAlthough platelets act as central players of haemostasis only their cross-talk with other blood cells, plasma factors and the vascular compartment enables the formation of a stable thrombus. Multiple activation processes and complex signalling networks are responsible for appropriate platelet function. Thus, a variety of platelet function tests are available for platelet research and diagnosis of platelet dysfunction. However, universal platelet function tests that are sensitive to all platelet function defects do not exist and therefore diagnostic algorithms for suspected platelet function disorders are still recommended in clinical practice.Based on the current knowledge of human platelet activation this review evaluates point-of-care related screening tests in comparison with specific platelet function assays and focuses on their diagnostic utility in relation to severity of platelet dysfunction. Further, systems biology-based platelet function methods that integrate global and specific analysis of platelet vessel wall interaction (advanced flow chamber devices) and posttranslational modifications (platelet proteomics) are presented and their diagnostic potential is addressed.

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Insights into Adherence among a Cohort of Adolescents Aged 12–20 Years in South Africa: Reported Barriers to Antiretroviral Treatment

AIDS Research and Treatment ◽

10.1155/2016/4161738 ◽

2016 ◽

Vol 2016 ◽

pp. 1-12 ◽

Cited By ~ 8

Author(s):

Mhairi Maskew ◽

Matthew P. Fox ◽

Denise Evans ◽

Darshini Govindasamy ◽

Lise Jamieson ◽

...

Keyword(s):

South Africa ◽

Cohort Study ◽

Medical Records ◽

Antiretroviral Treatment ◽

Treatment Programs ◽

Significant Challenge ◽

Improve Treatment ◽

Older Adolescents ◽

Missed Visits ◽

Barrier To Care

Adolescents experience disproportionately high rates of poor ART outcomes compared to adults despite prolonged use of antiretroviral therapy in Southern African treatment programs, presenting a significant challenge to national attempts to meet the UNAIDS 90-90-90 targets for 2020. This cohort study among adolescents aged 12–20 years accessing ART care at two urban public-sector clinics in Johannesburg between September and November 2013 aimed to identify factors potentially associated with poor attendance at clinic visits. Patients were followed up through routine medical records to identify missed visits (failing to attend clinic within 30 days of scheduled visit date) up to 2 years after enrolment. We enrolled 126 adolescents on ART for a median of 6.3 years (IQR: 2.7–8.4). A total of 47 (38%) adolescents missed a scheduled visit within 24 months of enrolment. Older adolescents (18–20 years) were more likely to miss a visit compared to adolescents aged 12–14 years (risk ratio (RR) = 1.72; 95% CI: 1.00–2.95). Those who were identified to have difficulty in taking medication (RR = 1.57; 95% CI: 1.13–2.18) as a barrier to care were more likely to miss a visit compared to adolescents who did not. Awareness of treatment fatigue, challenges to taking ART, and caregiver difficulties is important when considering interventions to improve treatment outcomes among adolescents.

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Could point-of-care testing be effective for reducing the prevalence of trichomoniasis in remote Aboriginal communities?

Sexual Health ◽

10.1071/sh14035 ◽

2014 ◽

Vol 11 (4) ◽

pp. 370

Author(s):

Ben B. Hui ◽

James Ward ◽

Louise Causer ◽

Rebecca J. Guy ◽

Matthew G. Law ◽

...

Keyword(s):

Mathematical Modelling ◽

Older Women ◽

Point Of Care ◽

Indigenous Communities ◽

Treatment Programs ◽

Point Of Care Testing ◽

Aboriginal Communities ◽

Sexually Transmissible Infections ◽

High Prevalence ◽

The Impact

High prevalence of trichomoniasis is reported for many remote Indigenous communities despite intensive screening and treatment programs. Mathematical modelling has previously been used to show that point-of-care (POC) testing for gonorrhoea and chlamydia has the potential to increase the impact of screening in reducing the prevalence of these sexually transmissible infections. The study was extended to estimate the impact of a rapid POC test for trichomoniasis. The results suggest that POC testing in place of conventional testing will also provide additional reductions in trichomoniasis prevalence. However, more emphasis should be placed on testing for trichomoniasis in older women due to the high prevalence observed in this group.

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