scholarly journals Integrated Tuberculosis/Human Immunodeficiency Virus Community-Based Case Finding in Rural South Africa: Implications for Tuberculosis Control Efforts

2017 ◽  
Vol 4 (3) ◽  
Author(s):  
Sheela V Shenoi ◽  
Anthony P. Moll ◽  
Ralph P. Brooks ◽  
Tassos Kyriakides ◽  
Laurie Andrews ◽  
...  
Keyword(s):  
South Africa ◽  
Human Immunodeficiency Virus ◽  
Hiv Testing ◽  
Case Finding ◽  
Hiv Positive ◽  
Community Based ◽  
Rural South ◽  
Number Needed To Screen ◽  
Immunodeficiency Virus ◽  
Rural South Africa

Abstract Background Intensive case finding is endorsed for tuberculosis (TB) control in high-risk populations. Novel case-finding strategies are needed in hard-to-reach rural populations with high prevalence of TB and human immunodeficiency virus (HIV). Methods We performed community-based integrated HIV and TB intensive case finding in a rural South African subdistrict from March 2010 to June 2012. We offered TB symptom screening, sputum collection for microbiologic diagnosis, rapid fingerstick HIV testing, and phlebotomy for CD4 cell count. We recorded number of cases detected and calculated population-level rates and number needed to screen (NNS) for drug-susceptible and -resistant TB. Results Among 5615 persons screened for TB at 322 community sites, 91.2% accepted concurrent HIV testing, identifying 510 (9.9%) HIV-positive individuals with median CD4 count of 382 cells/mm3 (interquartile range = 260–552). Tuberculosis symptoms were reported by 2049 (36.4%), and sputum was provided by 1033 (18.4%). Forty-one (4.0%) cases of microbiologically confirmed TB were detected for an overall case notification rate of 730/100000 (NNS = 137); 11 (28.6%) were multidrug-resistant or extensively drug-resistant TB. Only 5 (12.2%) TB cases were HIV positive compared with an HIV coinfection rate of 64% among contemporaneously registered TB cases (P = .001). Conclusion Community-based integrated intensive case finding is feasible and is high yield for drug-susceptible and -resistant TB and HIV in rural South Africa. Human immunodeficiency virus–negative tuberculosis predominated in this community sample, suggesting a distinct TB epidemiology compared with cases diagnosed in healthcare facilities. Increasing HIV/TB integrated community-based efforts and other strategies directed at both HIV-positive and HIV-negative tuberculosis may contribute to TB elimination in high TB/HIV burden regions.

Mandatory HIV testing in critical care/emergency patients

1990 ◽  
Vol 10 (10) ◽  
pp. 22-25
Author(s):  
DW Unkle
Keyword(s):  
Human Immunodeficiency Virus ◽  
Critical Care ◽  
Hiv Testing ◽  
Healthcare Services ◽  
Hiv Positive ◽  
Controversial Issues ◽  
Seropositive Patient ◽  
Delivery Of Healthcare ◽  
Immunodeficiency Virus ◽  
Social Ostracism

Testing for the presence of the human immunodeficiency virus (HIV) remains one of the most controversial issues of this decade. Among persons diagnosed to be HIV positive, social ostracism and exaggerated atypical behavior are common. The resulting impact on the delivery of healthcare services to the seropositive patient has raised many ethical and professional dilemmas. Discussion of HIV testing and the subsequent effects of seropositivity on the delivery of healthcare will be emphasized.

scholarly journals Modelling the epidemiologic impact of achieving UNAIDS fast-track 90-90-90 and 95-95-95 targets in South Africa

2019 ◽  
Vol 147 ◽  
Author(s):  
N. N. Abuelezam ◽  
A. W. McCormick ◽  
E. D. Surface ◽  
T. Fussell ◽  
K. A. Freedberg ◽  
...  
Keyword(s):  
South Africa ◽  
Human Immunodeficiency Virus ◽  
Fast Track ◽  
Viral Suppression ◽  
Hiv Transmission ◽  
Hiv Positive ◽  
Agent Based ◽  
Percentage Points ◽  
Immunodeficiency Virus ◽  
The Continuum

AbstractUNAIDS established fast-track targets of 73% and 86% viral suppression among human immunodeficiency virus (HIV)-positive individuals by 2020 and 2030, respectively. The epidemiologic impact of achieving these goals is unknown. The HIV-Calibrated Dynamic Model, a calibrated agent-based model of HIV transmission, is used to examine scenarios of incremental improvements to the testing and antiretroviral therapy (ART) continuum in South Africa in 2015. The speed of intervention availability is explored, comparing policies for their predicted effects on incidence, prevalence and achievement of fast-track targets in 2020 and 2030. Moderate (30%) improvements in the continuum will not achieve 2020 or 2030 targets and have modest impacts on incidence and prevalence. Improving the continuum by 80% and increasing availability reduces incidence from 2.54 to 0.80 per 100 person-years (−1.73, interquartile range (IQR): −1.42, −2.13) and prevalence from 26.0 to 24.6% (−1.4 percentage points, IQR: −0.88, −1.92) from 2015 to 2030 and achieves fast track targets in 2020 and 2030. Achieving 90-90-90 in South Africa is possible with large improvements to the testing and treatment continuum. The epidemiologic impact of these improvements depends on the balance between survival and transmission benefits of ART with the potential for incidence to remain high.

scholarly journals Why increasing availability of ART is not enough: a rapid, community-based study on how HIV-related stigma impacts engagement to care in rural South Africa

2015 ◽  
Vol 16 (1) ◽  
Author(s):  
Sarah Treves-Kagan ◽  
Wayne T. Steward ◽  
Lebogang Ntswane ◽  
Robin Haller ◽  
Jennifer M. Gilvydis ◽  
...  
Keyword(s):  
South Africa ◽  
Community Based ◽  
Rural South ◽  
Related Stigma ◽  
Rural South Africa

scholarly journals Contact tracing versus facility-based screening for active TB case finding in rural South Africa: A pragmatic cluster-randomized trial (Kharitode TB)

PLoS Medicine ◽  
2019 ◽  
Vol 16 (4) ◽  
pp. e1002796 ◽  
Author(s):  
Colleen F. Hanrahan ◽  
Bareng A. S. Nonyane ◽  
Lesego Mmolawa ◽  
Nora S. West ◽  
Tsundzukani Siwelana ◽  
...  
Keyword(s):  
South Africa ◽  
Randomized Trial ◽  
Cluster Randomized Trial ◽  
Case Finding ◽  
Contact Tracing ◽  
Rural South ◽  
Cluster Randomized ◽  
Rural South Africa

Index testing among HIV-positive patients is feasible and successful in identifying additional HIV infections in Pakistan

2021 ◽  
pp. 6-10
Author(s):  
Arshad Altaf ◽  
Syed Sharaf Ali Shah ◽  
Safdar Pasha ◽  
Altaf Ahmed Soomro ◽  
Nazia Farrukh ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Testing ◽  
Hiv Infections ◽  
Control Programme ◽  
Hiv Positive ◽  
Outreach Workers ◽  
Immunodeficiency Virus ◽  
Testing Approach ◽  
Immunodeficiency Syndrome ◽  
Study Participants

Objective: To assess the feasibility of index testing approach to test the parents and siblings of human immunodeficiency virus (HIV)-positive children, and identify HIV-positive individuals. Methods: The study was conducted at Ratodero, Pakistan. Study participants were enrolled from September 2019 to February 2020.  The list of HIV-positive persons was provided by the Provincial Acquired Immunodeficiency Syndrome (AIDS) Control Programme. Families of 706 HIV-positive persons were approached and all of them agreed to participate. The first test was performed by trained outreach workers. All those with a reactive first test were transported to the nearest health facility for further testing and confirmation. Mothers and siblings were tested at home while additional visits were carried out to reach the fathers.  Results: A total of 1766 persons were tested through HIV index testing. Biological siblings accounted for 81% of the contacts. We were able to test 413/463 (89.2%) mothers, 232/413 (56.2%) fathers and 1121/1392 (80.5%) siblings. Out of these, 7 mothers (1.7%) and 22 siblings (2.0%) were confirmed to be HIV-positive, while no one was found to be positive among the fathers. The overall HIV prevalence was 1.6% (29/1766). All HIV-positive persons were guided for treatment and care.  Conclusion: Results indicate that index-testing approach is feasible in Pakistan to expand HIV testing services through home visits.  Key words: Human immunodeficiency virus, HIV, HIV testing, Pakistan, Index testing, HIV outbreak, Prevalence.

scholarly journals ‘Testing Together Challenges the Relationship’: Consequences of HIV Testing as a Couple in a High HIV Prevalence Setting in Rural South Africa

PLoS ONE ◽  
2013 ◽  
Vol 8 (6) ◽  
pp. e66390 ◽  
Author(s):  
Hanani Tabana ◽  
Tanya Doherty ◽  
Birgitta Rubenson ◽  
Debra Jackson ◽  
Anna Mia Ekström ◽  
...  
Keyword(s):  
South Africa ◽  
Hiv Testing ◽  
Hiv Prevalence ◽  
Rural South ◽  
The Relationship ◽  
Rural South Africa
Sign in / Sign up

Export Citation Format

Share Document