scholarly journals Missed opportunities for tuberculosis investigation in a municipal hospital in Ghana: evidence from patient exit interviews

2020 ◽  
Author(s):  
Joyce B Der ◽  
Daniel J Grint ◽  
Clement T Narh ◽  
Frank Bonsu ◽  
Alison D Grant
Keyword(s):  
Multivariable Analysis ◽  
Cross Sectional Study ◽  
Hiv Positive ◽  
Symptom Duration ◽  
Hiv Status ◽  
Cross Sectional ◽  
Missed Opportunities ◽  
Tb Treatment ◽  
Symptom Screening ◽  
Night Sweats

Abstract Background We assessed coverage of symptom screening and sputum testing for tuberculosis (TB) in hospital outpatient clinics in Ghana. Methods In a cross-sectional study, we enrolled adults (≥18 years) exiting the clinics reporting ≥1 TB symptom (cough, fever, night sweats or weight loss). Participants reporting a cough ≥2 weeks or a cough of any duration plus ≥2 other TB symptoms (per national criteria) and those self-reporting HIV-positive status were asked to give sputum for testing with Xpert MTB/RIF. Results We enrolled 581 participants (median age 33 years [IQR: 24–48], 510/581 [87.8%] female). The most common symptoms were fever (348, 59.9%), chest pain (282, 48.5%) and cough (270, 46.5%). 386/581 participants (66.4%) reported symptoms to a healthcare worker, of which 157/386 (40.7%) were eligible for a sputum test per national criteria. Only 31/157 (19.7%) had a sputum test requested. Thirty-two additional participants gave sputum among 41 eligible based on positive HIV status. In multivariable analysis, symptom duration ≥2 weeks (adjusted odds ratio [aOR] 6.99, 95% confidence interval [CI] 2.08–23.51) and previous TB treatment (aOR: 6.25, 95% CI: 2.24–17.48) were the strongest predictors of having a sputum test requested. 6/189 (3.2%) sputum samples had a positive Xpert MTB/RIF result. Conclusion Opportunities for early identification of people with TB are being missed in health facilities in Ghana.

scholarly journals Prevalence of suicidal ideation and associated factors among HIV positive perinatal women on follow-up at Gondar town health institutions, Northwest Ethiopia: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Leul Belachew Zewdu ◽  
Mebratu Mitiku Reta ◽  
Niguse Yigzaw ◽  
Koku Sisay Tamirat
Keyword(s):  
Suicidal Ideation ◽  
Unplanned Pregnancy ◽  
Cross Sectional Study ◽  
Hiv Positive ◽  
Hiv Status ◽  
Cross Sectional ◽  
Factors Associated ◽  
Gondar Town ◽  
Perinatal Women ◽  
Significant Factors

Abstract Background Suicidal behaviors cover a range or continuum of acts from suicidal ideations to a series of actions, commonly known as suicidal attempts or deliberate self-harms. Though different mental disorders related studies were conducted among HIV/AIDS patients, there is a scarcity of information about the magnitude and determinants of suicidal thoughts among perinatal women. Therefore, this study aimed to determine the prevalence of suicidal ideation and associated factors among HIV positive perinatal women in the study setting. Methods An institution-based cross-sectional study was conducted among perinatal women on treatment to the prevention of mother to child transmission of HIV/AIDS at Gondar town health facilities. A total of 422 HIV-positive perinatal women were selected systematically and the data collected through medical record review and interview using a Composite International Diagnostic Interview (CIDI) toolkit. A binary and multivariable logistic regression model was employed to identify factors associated with suicidal ideation. An Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was computed to see the strength of association between outcome and independent variables. Characteristics having less than 0.05 p-value had been taken as significant factors associated with the outcome of interest. Result The prevalence of suicidal ideation was found to be 8.2% (95% CI; 5.7 to 11.3) and with a standard error of 0.013. Perinatal depression (AOR=4.40, 95%CI: 1.63 11.85), not disclosed HIV status (AOR=3.73, 95%CI: 1.44 9.65), and unplanned pregnancy (AOR=2.75, 95%CI: 1.21 6.21) were significant factors associated with suicidal ideation. Conclusion The magnitude of suicidal ideation among HIV positive perinatal women was found to be low. Perinatal depression, non-disclosed HIV status, and unplanned pregnancy were factors significantly associated with suicidal ideation. This finding suggests the integration of mental health services with maternal and HIV support programs.

scholarly journals Cancer in HIV-positive and HIV-negative adolescents and young adults in South Africa: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e043941
Author(s):  
Tafadzwa Dhokotera ◽  
Julia Bohlius ◽  
Matthias Egger ◽  
Adrian Spoerri ◽  
Jabulani Ronnie Ncayiyana ◽  
...  
Keyword(s):  
South Africa ◽  
Young Adults ◽  
Cross Sectional Study ◽  
Adolescents And Young Adults ◽  
Hiv Positive ◽  
Sectional Study ◽  
Hiv Status ◽  
Cross Sectional ◽  
Laboratory Service ◽  
Living With Hiv

ObjectiveTo determine the spectrum of cancers in adolescents and young adults (AYAs) living with and without HIV in South Africa.DesignCross-sectional study with cancer records provided by the National Cancer Registry (NCR) and HIV records from the National Health Laboratory Service (NHLS).Setting and participantsThe NHLS is the largest provider of pathology services in the South African public sector. The NCR is a division of the NHLS. We included AYAs (aged 10–24 years) diagnosed with cancer by public health sector laboratories between 2004 and 2014 (n=8479). HIV status was obtained through record linkages and text mining.Primary and secondary outcomesWe determined the spectrum of cancers by HIV status in AYAs. We used multivariable logistic regression to describe the association of cancer in AYAs with HIV, adjusting for age, sex, ethnicity and calendar period. We imputed (post hoc) the HIV status for AYA with unknown HIV status.Results8479 AYAs were diagnosed with cancer, HIV status was known for 45% (n=3812). Of those whose status was known, about half were HIV positive (n=1853). AYAs living with HIV were more likely to have Kaposi’s sarcoma (adjusted OR (aOR) 218, 95% CI 89.9 to 530), cervical cancer (aOR 2.18, 95% CI 1.23 to 3.89), non-Hodgkin’s lymphoma (aOR 2.12, 95% CI 1.69 to 2.66) and anogenital cancers other than cervix (aOR 2.73, 95% CI 1.27 to 5.86) than AYAs without HIV. About 44% (n=1062) of AYAs with HIV-related cancers had not been tested for HIV.ConclusionsTargeted HIV testing for AYAs diagnosed with cancer, followed by immediate start of antiretroviral therapy, screening for cervical precancer and vaccination against human papilloma virus is needed to decrease cancer burden in AYAs living with HIV in South Africa.

scholarly journals Prevalence and socio-demographic correlates of HIV among Tuberculosis patients of DOTS centre in Delhi

2015 ◽  
Vol 7 (1) ◽  
pp. 53-58 ◽  
Author(s):  
Vishal C Soyam ◽  
Jyoti Das ◽  
Rajeeva TC ◽  
Pallavi Boro ◽  
Charu Kohli
Keyword(s):  
Cross Sectional Study ◽  
Point Of View ◽  
Hiv Care ◽  
Hiv Status ◽  
Medical Sciences ◽  
Hiv Diagnosis ◽  
Cross Sectional ◽  
Continuation Phase ◽  
Tb Treatment ◽  
Demographic Correlates

Background: Knowledge of HIV status of a TB patient is critical from both patient and public health point of view. Early HIV diagnosis among TB patients could serve as an entry point for HIV care and treatment. Surveillance of HIV among TB patients has been recognized to be important as the HIV epidemic continues to fuel TB epidemics. Hence, this study was conducted with an objective to assess the socio-demographic profile and the prevalence of HIV among TB patients.Methodology: Cross sectional study was carried out in eight DOTS cum DMCs of Delhi. Data was collected from January 2012 to December 2012. Registered TB patients (new and retreatment) were interviewed on a predesigned questionnaire at the end of five months of treatment.Results: In 2012, out of the total 552 TB patients interviewed, 524 (94.9%) had been tested for HIV by the end of fifth month of their TB treatment. In them, 13 patients (2.4%) were HIV positive. All of them had been initiated on ART and CPT during continuation phase of TB treatment. In present study no variable was found to be significantly associated with HIV status except number family member and patients on retreatment category.Conclusions: The prevalence of HIV infection in TB patients in current study was (2.4%) substantially lower than reported in studies from other states. If HIV testing done by all TB patients then routine reporting of HIV status for all TB patients would provide even better information on which to base future planning.Asian Journal of Medical Sciences Vol.7(1) 2015 53-58

scholarly journals Cancer in HIV-positive and HIV-negative adolescents and young adults in South Africa: a cross-sectional study

2020 ◽  
Author(s):  
Tafadzwa G Dhokotera ◽  
Julia Bohlius ◽  
Matthias Egger ◽  
Adrian Spoerri ◽  
Jabulani Ncayiyana ◽  
...  
Keyword(s):  
South Africa ◽  
Cervical Cancer ◽  
Cross Sectional Study ◽  
Hiv Positive ◽  
Sectional Study ◽  
Hiv Status ◽  
Cross Sectional ◽  
Cancer Data ◽  
Living With Hiv ◽  
Hiv Negative

Objective: To determine the spectrum of cancers in AYAs living with HIV in South Africa compared to their HIV negative peers. Design: Cross sectional study with cancer data provided by the National Cancer Registry and HIV data from the National Health Laboratory Service. Setting and participants: The NHLS is the largest provider of pathology services in the South African public sector with an estimated coverage of 80%. The NCR is a division of the NHLS. We included AYAs (aged 10-24 years) diagnosed with cancer by public health sector laboratories between 2004 and 2014 (n=8 479). We included 3 672 in the complete case analysis. Primary and secondary outcomes: We used linked NCR and NHLS data to determine the spectrum of cancers by HIV status in AYAs. We also used multivariable logistic regression to describe the association of cancer in AYAs with HIV, adjusting for age, sex (as appropriate), ethnicity, and calendar period. Due to the large proportion of unknown HIV status we also imputed (post-hoc) the missing HIV status. Results: From 2004-2014, 8 479 AYAs were diagnosed with cancer, HIV status was known for only 45% (n=3812); of those whose status was known, about half were HIV positive (n=1853). AYAs living with HIV were more likely to have Kaposi's sarcoma (adjusted odds ratio (aOR) 218, 95% CI 89.9-530), cervical cancer (aOR 2.18, 95% CI 1.23-3.89), non-Hodgkin's lymphoma (aOR 2.12, 95% CI 1.69-2.66), and anogenital cancers other than cervix (aOR 2.73, 95% CI 1.27-5.86). About 44% (n=1 062) of AYAs with HIV related cancers had not been tested for HIV, though they were very likely to have the disease. Conclusions: Cancer burden in AYAs living with HIV in South Africa could be reduced by screening young women for cervical cancer and vaccinating them against human papilloma virus (HPV) infection.

scholarly journals Retention in HIV Care among Children Aged 0-14 Years and the Associated Family and Caregiver Factors in Embu County, Kenya

2021 ◽  
Vol 11 (7) ◽  
pp. 293-302
Author(s):  
Ikiara, Eliza Kathure ◽  
Orinda, George Owino ◽  
Thigiti, Joseph Mwangi
Keyword(s):  
Retention In Care ◽  
Cross Sectional Study ◽  
Hiv Care ◽  
Hiv Positive ◽  
Hiv Status ◽  
Cross Sectional ◽  
Number Of Factors ◽  
Retention In Hiv Care ◽  
The Family ◽  
Associated Family

Background: Retention of children in HIV care is influenced by a number of factors, among them family and caregiver factors. Objective: To determine the family and caregiver factors associated with retention in care. Methods: We conducted a cross sectional study in level 4 and 5 hospitals in Embu county. Data were collected through interviews using a predesigned questionnaire. Descriptive and inferential data analysis was performed. Results: We enrolled 238 participants between January and April 2018, comprising 143 males (50.5%) and 140 females (49.5%). The median age of the participants was 12 years (IQR 5). Two thirds of the minors were in primary school (192, 67.8%). More of the children’s mothers were HIV positive compared to the fathers (257 vs 99) though a greater number of the fathers had an unknown HIV status compared to the mothers (138 vs 21). Most minors (241, 85.2%) were retained in care throughout having never missed an appointment. The number of siblings alive (aOR 0.72, 95% CI: 0.56, 0.92), siblings with HIV (aOR 0.26, 95% CI: 0.10, 0.68), a HIV positive caregiver (aOR 5.48, 95% CI: 2.44, 12.97), stigma (aOR 0.35, 95% CI: 0.15, 0.77), work duties of the caregiver (aOR 0.28, 95% CI 0.13, 0.58) and denial of HIV status by the caregiver (aOR 0.10, 95% CI 0.02, 0.47) were all associated with retention in HIV care. Conclusion: A HIV positive caregiver was most likely to ensure a child is retained in care. Stigma and denial of HIV status still hinder retention. Key words: Retention, HIV, children, caregiver.

scholarly journals Effect of Diabetes Mellitus on Tuberculosis Treatment Outcomes among Tuberculosis Patients in Kelantan, Malaysia

2020 ◽  
Author(s):  
Siti Rohana AHMAD ◽  
Nor Azwany YAACOB ◽  
Mat Zuki JAEB ◽  
Zalmizy HUSSIN ◽  
Wan Mohd Zahiruddin WAN MOHAMMAD
Keyword(s):  
Treatment Outcomes ◽  
Multivariable Analysis ◽  
Significant Risk ◽  
Control Program ◽  
Educational Status ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Tb Treatment ◽  
Unsuccessful Treatment ◽  
Using Data

Background: There is growing evidence that DM may play an important role in the occurrence of unsuccessful TB treatment outcomes. This study was undertaken to examine the prevalence of DM among TB population, compare the profile of TB patients with and without DM and determine the effect of DM on unsuccessful treatment outcomes among TB patients in Kelantan state, Malaysia from 2012 to 2016. Methods: A cross sectional study was conducted in Sep 2017 using data from registered TB cases in Kelantan state, Malaysia from 2012 to 2016. The profile of TB patients with and without DM were compared in univariable analysis. Multiple logistic regression was used to determine association between DM and unsuccessful treatment outcomes. Results: A total of 1854 TB patients were diagnosed with DM. The annual proportion was ranging from 26 to 29%. TB patients with DM had an older age, live single, low educational status, poor chest x ray finding and diagnosed with smear positive sputum compared to TB patients without DM. TB patients with DM had three times higher risk to develop unsuccessful TB treatment outcomes compared to TB patients without DM (95% CI 2.47-3.58; P = 0.012) in multivariable analysis. Conclusion: Those with DM had the worst prognosis of TB outcomes among the significant risk factors. TB control program in Malaysia will need to expand efforts to focus on treatment of TB-DM patients to improve their cure rates in order to achieve the goals of tuberculosis elimination.    

scholarly journals Serum n-6 Fatty Acids are Positively Associated with Growth in 6-to-10-Year Old Ugandan Children Regardless of HIV Status—A Cross-Sectional Study

Nutrients ◽  
2019 ◽  
Vol 11 (6) ◽  
pp. 1268 ◽  
Author(s):  
Raghav Jain ◽  
Amara E. Ezeamama ◽  
Alla Sikorskii ◽  
William Yakah ◽  
Sarah Zalwango ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Growth Parameters ◽  
Cross Sectional Study ◽  
Child Growth ◽  
Gas Chromatography Mass Spectrometry ◽  
Hiv Positive ◽  
Omega 3 ◽  
Hiv Status ◽  
Cross Sectional ◽  
Omega 6

Fatty acids (FAs) are crucial in child growth and development. In Uganda, antiretroviral therapy (ART) has drastically reduced perinatal human immunodeficiency virus (HIV) infection of infants, however, the interplay of FAs, ART, and HIV in relation to child growth is not well understood. To investigate this, serum was collected from 240 children between 6–10 years old in Uganda and analyzed for FAs using gas-chromatography mass-spectrometry. HIV status and anthropometric measurements were taken, and relationships with FAs were assessed. No significant differences in growth parameters or serum FAs were found between HIV uninfected children with and without exposure to ART. HIV positive children had significantly lower height-for-age-z-scores (HAZ) than uninfected children (p < 0.001). HIV-positive children had higher arachidonic acid than uninfected children (p = 0.003). Total omega-6 FAs were significantly associated with HAZ regardless of HIV status (p = 0.035). Mean total omega-3 FAs (2.90%) were low in this population compared to other cohorts in Africa. These results provide reference serum FA values for 6–10-year-old children in Uganda and may be used to inform lipid supplementation programs to promote child growth. Future studies should investigate the relationships between child growth trajectories in relation to HIV status and serum FAs.

scholarly journals Contribution of Xpert® MTB/RIF to tuberculosis case finding among pregnant women in Botswana

2020 ◽  
Vol 10 (2) ◽  
pp. 76-81
Author(s):  
S. G. Hamda ◽  
J. G. Tshikuka ◽  
D. Joel ◽  
V. Setlhare ◽  
G. Monamodi ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Cross Sectional Study ◽  
Hiv Status ◽  
Tuberculosis Case ◽  
Cross Sectional ◽  
Exact Test ◽  
Symptom Screening ◽  
Screening Algorithm ◽  
Standard Culture ◽  
Hiv Negative

Setting: Seven health facilities with antenatal care (ANC) clinics in two districts near Gaborone, Botswana.Objectives: To determine 1) the prevalence of tuberculosis (TB) and HIV-TB co-infection in pregnancy, and 2) the sensitivities of symptomatic TB screening and Xpert testing against gold standard culture.Design: This was a cross-sectional study. Pregnant women were randomly enrolled and screened using TB symptoms. HIV status was determined from ANC clinics’ client records. Two sputum specimens were collected from all clients and each was tested using Xpert® and culture for Mycobacterium tuberculosis.Results: Of 407 cases, eight had one or more TB symptoms, and all tested negative with Xpert® and culture. Another two (0.5%, 95%CI 0.08–1.96) asymptomatic clients tested positive with both tests. The adjusted TB prevalence was higher than that of the general population (0.6% vs. 0.24%; P < 0.001). The prevalence of TB among HIV-positive and HIV-negative clients was 1/69 (1.45%, 95%CI 0.29–2.61) and 1/336 (0.3%, 95%CI 0.23–0.83), respectively (Fisher’s exact test P = 0.312). Xpert® demonstrated a 100% sensitivity and 100% specificity, while symptom screening had 0.0% sensitivity and 98% specificity.Conclusions: TB prevalence among pregnant women was high and TB symptom screening had limited ability to detect TB. An alternative TB screening algorithm for pregnant women is urgently needed irrespective of TB symptoms.

scholarly journals Clinico-Epidemiological Profile of Children Orphaned due to AIDS Residing in Care Giving Institutions in Coastal South India

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Rekha Thapar ◽  
Meher Singha ◽  
Nithin Kumar ◽  
Prasanna Mithra ◽  
Bhaskaran Unnikrishnan ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Cross Sectional Study ◽  
Hiv Positive ◽  
Hiv Status ◽  
Cross Sectional ◽  
Institutional Ethics ◽  
Care Giving ◽  
Z Scores ◽  
Draw Conclusion ◽  
Epidemiological Profile

Background. HIV/AIDS has a greater impact on children. Besides being orphaned by the untimely demise of one or both parents due to the disease, these children are more prone for discrimination by the society. Methods. In this cross-sectional study 86 children orphaned by AIDS residing in care giving institutions for HIV positive children in Mangalore were assessed for their clinico-epidemiological profile and nutritional status. Institutional Ethics Committee clearance was obtained before the commencement of the study. The collected data were analyzed using SPSS (Statistical Package for Social Sciences) version 11.5 and the results expressed in mean (standard deviation) and proportions. BMI was calculated and nutritional status assessed using WHO Z scores (BMI for Age) for children between 5 and 19 years separately for boys and girls. Results. The mean age of the children was 13.2 ± 3 years. Majority (n=56, 65.1%) of the children were double orphans. Most of the children orphaned by AIDS (n=78, 90.7%) had a history of both the parents being HIV positive. The median CD4 count of participants at the time of our study was 853.5 (IQR 552–1092) cells/microliter. A higher percentage of orphans were malnourished compared to nonorphans. (41.1% vs. 36.7%). All the educational institutions, wherein the children orphaned by AIDS were enrolled, were aware about their HIV status. Five of the participants felt discriminated in their schools. Only two of the participants felt discriminated by their friends because of their HIV status. Conclusion. From our study we draw conclusion that even though the children orphaned due to AIDS are rehabilitated in terms of having shelter and provision of education and health care, much needs to be done in terms of improving the nutritional status of these children and alleviating the discriminatory attitude of the society towards them.

scholarly journals Factors associated with coinfection and reinfection by chlamydia, gonorrhoea and syphilis in Portugal

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
T Pinho-Bandeira ◽  
V Ricoca Peixoto ◽  
S Dias ◽  
R Sá Machado
Keyword(s):  
Multivariable Analysis ◽  
Cross Sectional Study ◽  
Epidemiological Surveillance ◽  
Hiv Status ◽  
Cross Sectional ◽  
Targeted Interventions ◽  
Factors Associated ◽  
Younger Age ◽  
Multivariable Analyses ◽  
Sex With Men

Abstract In Europe, cases of chlamydia (CT), gonorrhoea (NG) and syphilis (TP) are rising and coinfections and reinfections are common. As there are limited data on factors associated with these events in Portugal, this study may be valuable to inform prevention strategies. We conducted an analytical cross-sectional study with all probable and confirmed cases of CT (including lymphogranuloma venereum), NG and TP notified in Portugal in the national system of epidemiological surveillance (SINAVE®) between January 1st, 2015 and December 31st, 2018. Descriptive and multivariable analyses were conducted and adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated. Among 6506 cases in SINAVE®, 858 (13.2%) were coinfections and 204 (3.1%) were reinfections. Coinfections were found in 14.0% of males and 10.2% of females, while reinfections were present in 3.8% of males and 0.8% of females. In multivariable analysis, coinfections were positively associated with being younger than 26 (aOR 2.45, 95% CI 1.81-3.30), living in Lisbon area (aOR 1.43, 95% CI 1.13-1.81), being symptomatic (aOR 1.82, 95% CI 1.53-2.18), being men who have sex with men (MSM) (aOR 1.63, 95% CI 1.28-2.07), HIV+ status (aOR 1.46, 95% CI 1.19-1.80) and being diagnosed in an NGO (aOR 1.68, 95% CI 1.29-2.19). Reinfections were positively associated with living in Lisbon area (aOR 2.53, 95% CI 1.43-4.47), being symptomatic (aOR 2.37, 95% CI 1.66-3.37), being MSM (aOR 3.69, 95% CI 2.17-6.30) and HIV+ status (aOR 1.68, 95% CI 1.18-2.39). This study contributes to identifying risk profiles for coinfection and reinfection by these STIs in Portugal. Younger age, living in Lisbon area, being MSM, HIV+ status and being diagnosed in an NGO are some of the associated factors. Targeted interventions are needed to tackle specific settings and populations to be successful in lowering STI's incidence in Portugal. Key messages We identified factors associated with coinfection and reinfection by chlamydia, gonorrhoea and syphilis in Portugal, that can be used to target interventions. A study to identify the changes and problems in sexual attitudes and sexual behaviour may be useful to help us understand this paradigm.

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