scholarly journals The impact of antiretroviral treatment on mortality trends of HIV‐positive adults in rural Uganda: a longitudinal population‐based study, 1999–2009

2012 ◽  
Vol 17 (8) ◽  
Author(s):  
Ivan Kasamba ◽  
Kathy Baisley ◽  
Billy N. Mayanja ◽  
Dermot Maher ◽  
Heiner Grosskurth
Keyword(s):  
Antiretroviral Treatment ◽  
Population Based ◽  
Hiv Positive ◽  
Mortality Trends ◽  
Population Based Study ◽  
Hiv Positive Adults ◽  
The Impact

scholarly journals Drug resistance in HIV-positive adults during the initial year of antiretroviral treatment at Ethiopian health centers

2021 ◽  
Author(s):  
Anton Reepalu ◽  
Dawit A Arimide ◽  
Taye T Balcha ◽  
Habtamu Yeba ◽  
Adinew Zewdu ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Antiretroviral Treatment ◽  
Health Centers ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Antiretroviral Drug Resistance ◽  
Antiretroviral Drug ◽  
Increased Risk ◽  
Hiv Positive Adults ◽  
The Impact

Abstract Objectives The increasing prevalence of antiretroviral drug resistance in sub-Saharan Africa threatens the success of HIV programs. We have characterized patterns of drug resistance mutations (DRM) during the initial year of antiretroviral treatment (ART) in HIV-positive adults receiving care at Ethiopian health centers and investigated the impact of tuberculosis on DRM acquisition. Methods Participants were identified from a cohort of ART-naïve individuals aged ≥18 years, all of whom had been investigated for active tuberculosis at inclusion. Individuals with viral load (VL) data at 6 and/or 12 months after ART initiation were selected for this study. Genotypic testing was performed on samples with VL≥500 copies/mL obtained on these occasions, and on pre-ART samples from those with detectable DRM during ART. Logistic regression analysis was used to investigate the association between DRM acquisition and tuberculosis. Results Among 621 included individuals (110 [17.5%] with concomitant tuberculosis), 101/621 (16.3%) had VL≥500 copies/mL at 6 and/or 12 months. DRM were detected in 64/98 cases with successful genotyping (65.3%). DRM were detected in 7/56 (12.5%) pre-ART samples from these individuals. High pre-ART VL and low mid-upper arm circumference were associated with increased risk of DRM acquisition, whereas no such association was found for concomitant tuberculosis. Conclusions Among adults receiving health-center based ART in Ethiopia, most patients without virological suppression during the first year of ART had detectable DRM. Acquisition of DRM during this period was the dominant cause of antiretroviral drug resistance in this setting. Tuberculosis did not increase the risk of DRM acquisition.

scholarly journals Prevalence of nocturia among community-dwelling adults: a population-based study in Malaysia

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hui-Yin Yow ◽  
John Jeh Lung Tiong ◽  
Chun-Wai Mai ◽  
Esther van der Werf ◽  
Zulkifli Md Zainuddin ◽  
...  
Keyword(s):  
Medical Condition ◽  
Population Based ◽  
Community Dwelling ◽  
Medical Attention ◽  
Night Time ◽  
Cross Sectional ◽  
Population Based Study ◽  
Waking Up ◽  
The Impact

Abstract Background Nocturia is widely prevalent condition with detrimental effects on quality of life and general health. In Malaysia, there is a lack of up-to-date prevalence study on nocturia. This study aimed to investigate the prevalence of nocturia and awareness pertaining to nocturia among Malaysian adults. Methods A cross-sectional population-based study was conducted among Malaysian adults aged ≥ 18 years old. The data was collected by mixed mode self-administered questionnaire from May 2019 to September 2019. Nocturia was defined as one or more voids at night. Results There were a total of 4616 respondents with 74.5% of response rate. The overall prevalence of nocturia among Malaysian adults was found to be 57.3%. In multivariate analysis, respondents aged 31–40 (1.91 [1.52–2.40]) or > 60 years old (2.03 [1.48–2.71]), and those who presented with hypertension (2.84 [2.28–3.53]), diabetes mellitus (1.78 [1.42–2.25]), renal disease (3.58 [1.93–6.63]) or overactive bladder (1.61 [1.10–2.35]) were associated with higher prevalence of nocturia. A significantly lower disease prevalence (p < 0.05) was noted among those aged 41–50 (0.73 [0.59–0.91]), male (0.78 [0.69–0.88]) and Chinese (0.47 [0.30–0.74]) or Indian (0.34 [0.21–0.54]) ethnicities. A total of 37.3% of respondents with nocturia reported that they faced sleeping difficulty about half the time or more after waking up in the middle of night. Those who had ≥ 2 voids per night experienced significantly higher mean bother score than those who had 1 void per night (p < 0.001). Approximately half (56.7%) of all respondents were not aware that night time urination is a medical condition. Only 25.2% of respondents with nocturia had sought medical attention for their nocturia. Conclusions The prevalence of nocturia among Malaysian adults is high and strongly influenced by age, sex, race and comorbidities. However, the general awareness pertaining to nocturia being a health issue remains low among Malaysians. The findings also highlighted the impact of nocturia on sleep and the need for nocturia education to better address this disease.

scholarly journals The Impact of Geography in Hepatocellular Carcinoma: A Retrospective Population Based Study

2021 ◽  
Vol 28 (1) ◽  
pp. 396-404
Author(s):  
Irene S. Yu ◽  
Shiru L. Liu ◽  
Valeriya Zaborska ◽  
Tyler Raycraft ◽  
Sharlene Gill ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Retrospective Chart Review ◽  
Population Based ◽  
Tumor Board ◽  
Treatment Center ◽  
Population Based Study ◽  
Therapeutic Modalities ◽  
Quaternary Center ◽  
Statistics Canada ◽  
The Impact

Background: The treatment of hepatocellular carcinoma (HCC) includes different therapeutic modalities and multidisciplinary tumor board reviews. The impact of geography and treatment center type (quaternary vs. non-quaternary) on access to care is unclear. Methods: A retrospective chart review was performed on HCC patients who received sorafenib in British Columbia from 2008 to 2016. Patients were grouped by Statistics Canada population center (PC) size criteria: large PC (LPC), medium PC (MPC), and small PC (SPC). Access to specialists, receipt of liver-directed therapies, and survival outcomes were compared between the groups. Results: Of 286 patients, the geographical distribution was: LPC: 75%; MPC: 16%; and SPC: 9%. A higher proportion of Asians (51% vs. 9% vs. 4%; p < 0.001), Child–Pugh A (94% vs. 83% vs. 80%; p = 0.022), and hepatitis B (37% vs. 15% vs. 4%; p < 0.001) was observed in LPC vs. MPC vs. SPC, respectively. LPC patients were more likely referred to a hepatologist (62% vs. 48% vs. 40%; p = 0.031) and undergo transarterial chemoembolization (TACE) (43% vs. 24% vs. 24%; p = 0.018). Sixty percent were treated at a quaternary center, and the median overall survival (OS) was higher for patients treated at a quaternary vs. non-quaternary center (28.0 vs. 14.6 months, respectively; p < 0.001) but similar when compared by PC size. Treatment at a quaternary center predicted an improved survival on multivariate analysis (hazard ratio (HR): 0.652; 95% confidence interval (CI): 0.503–0.844; p = 0.001). Conclusions: Geography did not appear to impact OS but patients from LPC were more likely to be referred to hepatology and undergo TACE. Treatment at a quaternary center was associated with an improved survival.

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