Evaluating Integrated Care for People Living With HIV and Multidrug-Resistant Tuberculosis in South Africa

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Keri Geiger ◽  
Alanna Bergman ◽  
Jason E. Farley
MedAlliance ◽  
2020 ◽  
pp. 6-13

In the article, a review of foreign and Russian literature suggests that both multidrug-resistant tuberculosis spread and the HIV epidemic are factors maintaining the high tuberculosis burden worldwide and in the Russian Federation. The main transmission pathway for HIV-infection in the Russian Federation, as well as in other countries of Eastern Europe and Central Asia, is now attributed to heterosexual contact, which has surpassed the intravenous injection route of transmission. A rise in heterosexual risk of HIV transmission is accelerating epidemic progression amongst the general population, thereby contributing to a generalization of the epidemic process. The authors also provide an analytical review of publications related to risk factors for multidrug-resistant tuberculosis development in HIV-infected patients. It is found that such literature is limited in foreign countries, as well as in the Russian Federation. There is information about the general role of HIV infection in tuberculosis burden, but the influence of socio-demographic, epidemiological and clinical factors for multidrug-resistant tuberculosis development in people living with HIV is not sufficiently studied. Thus, there is a need for further studies designed to analyze the socio-demographic, epidemiological and clinical characteristics of patients with multidrug-resistant tuberculosis and HIV co-infection in comparison with those who are HIV-negative. Knowledge of the main risk factors for multidrug-resistant tuberculosis development in people living with HIV will allow selective and targeted use of resources to achieve effective outcomes in treatment of HIV/TB co-infected patients.


2020 ◽  
Author(s):  
Nomawethu Somfongo ◽  
Wiseman Mupindu ◽  
nozuko mangi

Abstract Background Multi Drug Resistance (MDR) Tuberculosis (TB) is a global risk. Several suboptimal results were noticed which resulted to introduction of a standardised short regimen of 9-12 to optimise favourable outcomes. This new intervention has not been evaluated for effectiveness since inception in the Eastern Cape Province. Objective: T o evaluate multidrug resistant tuberculosis conversion rate following initiation on short regimen. Methods A retrospective study using a descriptive design was used to collect data from conveniently sampled 71 documents at Nkqubela TB and Duncan Village Day hospitals. Data were collected using a self-designed structured questionnaire and analysed using Statistical Packages for Social Sciences (SPSS) version 24. Results Sixteen percent (n=19) of 71 records had no consecutive smear results. Demographic findings showed that the majority of the affected age group was between the ages of 36-45 years in both genders (34.7%, n=47) with males being highly affected more than females. The majority of participants were unemployed (51.7%), people living with HIV/AIDS (62.7%), use alcohol and smoking. Conversion rate was 68, 5%. Conclusion There is a need to review EDR web to accommodate sputum results irrespective of TB treatment start date. An extensive, ongoing counselling, support and health education needs to be provided for patients and families until the completion of treatment to emphasize the importance of monthly sputum collection and importance of treatment adherence. Clinicians need to strengthen their counselling and education skills. The introduction of short regimen to treat MDR has shown an improved sputum conversion rate in RR/MDR TB.


2019 ◽  
Vol 12 (8) ◽  
pp. e230628 ◽  
Author(s):  
Christian Francisco ◽  
Mary Ann Lansang ◽  
Edsel Maurice Salvana ◽  
Katerina Leyritana

Tuberculosis (TB) is common among persons living with HIV. This public health concern is aggravated by infection with multidrug-resistant organisms and adverse effects of polypharmacy. There are few published cases of multidrug-resistant tuberculosis (MDR-TB) in multidrug-resistant HIV (MDR-HIV) infected patients. We report a case of a 29-year-old Filipino man with HIV on zidovudine (AZT)-containing antiretroviral therapy (ART) but was eventually shifted to tenofovir due to anaemia. He presented with left flank tenderness, which was found to be due to an MDR-TB psoas abscess, and for which second-line anti-TB treatment was started. HIV genotyping showed MDR-HIV infection susceptible only to AZT, protease inhibitors and integrase inhibitors. Subsequently, he developed neck abscess that grew Mycobacterium avium complex and was treated with ethambutol and azithromycin. ART regimen was revised to AZT plus lamivudine and lopinavir/ritonavir. Erythropoietin was administered for recurrent AZT-induced anaemia. Both abscesses resolved and no recurrence of anaemia was noted.


PLoS ONE ◽  
2020 ◽  
Vol 15 (4) ◽  
pp. e0230504
Author(s):  
Brittany K. Moore ◽  
Linda Erasmus ◽  
Julia Ershova ◽  
Sarah E. Smith ◽  
Norbert Ndjeka ◽  
...  

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