scholarly journals Two diseases, same person: moving toward a combined HIV and tuberculosis continuum of care

2018 ◽  
Vol 29 (9) ◽  
pp. 873-883 ◽  
Author(s):  
Reuben Granich ◽  
Somya Gupta
Keyword(s):  
Public Health ◽  
Disease Control ◽  
Treatment Success ◽  
World Health ◽  
People Living With Hiv ◽  
Global Public Health ◽  
Tb Treatment ◽  
Immunodeficiency Virus ◽  
Health Organization ◽  
Living With Hiv

The human immunodeficiency virus (HIV) and Mycobacterium tuberculosis syndemic remains a global public health threat. Separate HIV and tuberculosis (TB) global targets have been set; however, success will depend on achieving combined disease control objectives and care continua. The objective of this study was to review available policy, budgets, and data to reconceptualize TB and HIV disease control objectives by combining HIV and TB care continua. For 22 World Health Organization (WHO) TB and TB/HIV priority countries, we used 2015 data from the HIV90–90–90watch website, UNAIDS AIDSinfo, and WHO 2016 and 2017 Global TB Reports. Global resources available in TB and HIV/TB activities for 2003–2017 were collected from publicly available sources. In 22 high-burden countries, people living with HIV on antiretroviral therapy ranged from 9 to 70%; viral suppression was 38–63%. TB treatment success ranged from 71 to 94% with 14 (81% HIV/TB burden) countries above 80% TB treatment success. From 2003 to 2017, reported global international and domestic resources for HIV-associated TB and TB averaged $2.85 billion per year; the total for 2003–2017 was 43 billion dollars. Reviewing combined HIV and TB targets demonstrate disease control progress and challenges. Using an integrated HIV and TB continuum supports HIV and TB disease control efforts focused on improving both individual and public health.

scholarly journals Two diseases, same person: moving towards a combined HIV and TB continuum of care

2017 ◽  
Author(s):  
Reuben Granich ◽  
Somya Gupta
Keyword(s):  
Public Health ◽  
Disease Control ◽  
Viral Suppression ◽  
Treatment Success ◽  
People Living With Hiv ◽  
Hiv Disease ◽  
Global Public Health ◽  
Tb Treatment ◽  
Immunodeficiency Virus ◽  
Living With Hiv

SummarySettingThe Human Immunodeficiency Virus (HIV) and Mycobacterium tuberculosis syndemic remains a global public health threat. Separate HIV and TB global targets have been set, however, success will depend on achieving combined disease control objectives and care continua.ObjectiveReview available policy, budgets and data to re-conceptualize TB and HIV disease control objectives by combining HIV and TB care continua.MethodsFor 22 WHO TB and TB/HIV priority countries, we used 2014 and 2015 data from the HIV90-90-90watch website, UNAIDS Aidsinfo, and WHO 2016 Global TB Report. Global resources available in TB and HIV/TB activities for 2003-2017 was collected from publically available sources.ResultsIn 22 high burden countries people living with HIV (PLHIV) on ART ranged from 9-70%; viral suppression was 38-63%. TB treatment success ranged from 34-94% with 13 (43% HIV/TB burden) countries above 80% TB treatment success. From 2003-2017, global international and domestic resources for HIV-associated TB and TB averaged $2.6 billion per year; the total for 2003-2017 was 39 billion dollars.ConclusionReviewing combined HIV and TB targets demonstrate disease control progress and challenges. Using an integrated HIV and TB continuum supports HIV and TB disease control efforts focused on improving both individual and public health.FundingNone

scholarly journals Gaps in tuberculosis control in Armenia: How to improve the care system?

2020 ◽  
Vol 14 (11.1) ◽  
pp. 133S-139S
Author(s):  
Hayk Davtyan ◽  
Ani Petrosyan ◽  
Garry Aslanyan ◽  
Seda Aghabekyan ◽  
Deborah De Basso ◽  
...  
Keyword(s):  
Scientific Evidence ◽  
Treatment Success ◽  
Treatment Guideline ◽  
Public Health Problem ◽  
People Living With Hiv ◽  
Global Public Health ◽  
Tb Treatment ◽  
Living With Hiv ◽  
Lost To Follow Up ◽  
Care System

Introduction: Tuberculosis (TB) continues to be a global public health problem. People with weakened immune systems are more vulnerable to TB. It is one of the top 10 causes of death worldwide and is a leading cause of death for people living with HIV (PLWH). The aim of the current study was to perform programmatic data analysis of TB cases treated with the first-line drugs, registered in Armenia for the period of January 2017 – August 2018, and to identify gaps in TB care system in Armenia. Methodology: A retrospective cohort study using programmatic data from National TB Program. Results: Overall treatment success rate for the period of study was 79%. HIV had impact only on “died” outcome with odds ratio (OR) of 20.9. More than a third (34%) of all HIV-positive patients died during TB treatment and 45% of patients who had non-Armenian citizenship were lost to follow-up during the treatment (OR = 3.3). Treatment duration for the 8% of all cases (mainly with brain or bone localization) was > 9 months and lasted up to 500 days. Conclusions: Better collaboration and partial integration of TB and HIV services in Armenia is required. The access to care for non-Armenian citizens needs to be improved. The national TB treatment guideline needs to be updated based on scientific evidence. This study demonstrates that continuous analysis of the available data and tailoring of the system is required to address the needs of key populations and achieve universal care coverage.

scholarly journals Repurposing of Chloroquine and Its Derivative, Hydroxychloroquine for COVID-19: Implications for People Living with HIV in Africa

2020 ◽  
Author(s):  
Chiagoziem Otuechere
Keyword(s):  
Immune System ◽  
Antiviral Agents ◽  
World Health ◽  
People Living With Hiv ◽  
Short Term ◽  
Confounding Variables ◽  
Immunodeficiency Virus ◽  
Proven Efficacy ◽  
Health Organization ◽  
Living With Hiv

The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2, has been declared by the World Health Organization (WHO) as a pandemic. Unfortunately, finding a vaccine or developing drugs from the scratch is a time-consuming luxury given the widespread and high fatality rates of the virus. In the short term, repurposing of drugs already in use seem to be the most rational step to quickly and effectively curb the virus. Several antiviral agents had been proposed as possible remedies, but the 4-aminoquinolines, Chloroquine (CHQ) and hydroxychloroquine (HCHQ) appear to be generating more interest. They are generic, cheaply available and have proven efficacy against malaria parasites in Africa. The human immunodeficiency virus (HIV), on the other hand, targets the immune system thereby reducing the patient’s ability to fight infections. Sadly, 68% of the global HIV burden occur in Africa. It is therefore anticipated that incidence of severe forms of COVID-19 could occur in Africa because of associated endemic conditions that compromise the immune system. With CHQ and HCHQ being considered for clinical use against COVID-19, there is a need to highlight their potential merits and confounding variables in the subgroup of patients with or without HIV.

scholarly journals Summary of Guidelines for Managing Histoplasmosis among People Living with HIV

2021 ◽  
Vol 7 (2) ◽  
pp. 134
Author(s):  
Freddy Perez ◽  
Diego Caceres ◽  
Nathan Ford ◽  
Giovanni Ravasi ◽  
Beatriz Gomez ◽  
...  
Keyword(s):  
Maintenance Therapy ◽  
Treatment Guidelines ◽  
Severe Disease ◽  
World Health ◽  
People Living With Hiv ◽  
Tb Treatment ◽  
Health Organization ◽  
Policy Guidance ◽  
Living With Hiv ◽  
Laboratory Assay

Histoplasmosis is a frequent fungal opportunistic infection in people living with HIV (PLHIV), associated every year to a total of 5% to 15% of AIDS-related deaths among this population. In 2020, the first global guidelines for diagnosing and managing disseminated histoplasmosis among PLHIV was published. This document recommends (1) detection of circulating Histoplasma antigens as the recommended laboratory assay to diagnose histoplasmosis among PLHIV; (2) the use of liposomal amphotericin for induction therapy in severe or moderately severe disease, followed by a maintenance therapy with itraconazole for 12 months; a shorter maintenance therapy could be considered if the patient is clinically stable and if immune status has improved; (3) antiretroviral therapy initiation as soon as possible among patients with histoplasmosis without involvement of central nervous system; and (4) that for the treatment of co-infection with histoplasmosis and tuberculosis (TB), treatment of TB should be initiated according to the World Health Organization treatment guidelines. Appropriate health education of providers, supportive supervision, and policy guidance for the care of PLHIV are required.

scholarly journals Pulmonary tuberculosis screening in anti-retroviral treated adults living with HIV in Kenya

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jill K. Gersh ◽  
Ruanne V. Barnabas ◽  
Daniel Matemo ◽  
John Kinuthia ◽  
Zachary Feldman ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Preventive Therapy ◽  
World Health ◽  
People Living With Hiv ◽  
Tuberculosis Screening ◽  
Hiv Positive Adults ◽  
Health Organization ◽  
A Prospective Study ◽  
Living With Hiv ◽  
Tuberculosis Prevalence

Abstract Background People living with HIV (PLHIV) who reside in high tuberculosis burden settings remain at risk for tuberculosis disease despite treatment with anti-retroviral therapy and isoniazid preventive therapy (IPT). The performance of the World Health Organization (WHO) symptom screen for tuberculosis in PLHIV receiving anti-retroviral therapy is sub-optimal and alternative screening strategies are needed. Methods We enrolled HIV-positive adults into a prospective study in western Kenya. Individuals who were IPT-naïve or had completed IPT > 6 months prior to enrollment were eligible. We evaluated tuberculosis prevalence overall and by IPT status. We assessed the accuracy of the WHO symptom screen, GeneXpert MTB/RIF (Xpert), and candidate biomarkers including C-reactive protein (CRP), hemoglobin, erythrocyte sedimentation rate (ESR), and monocyte-to-lymphocyte ratio for identifying pulmonary tuberculosis. Some participants were evaluated at 6 months post-enrollment for tuberculosis. Results The study included 383 PLHIV, of whom > 99% were on antiretrovirals and 88% had received IPT, completed a median of 1.1 years (IQR 0.8–1.55) prior to enrollment. The prevalence of pulmonary tuberculosis at enrollment was 1.3% (n = 5, 95% CI 0.4–3.0%): 4.3% (0.5–14.5%) among IPT-naïve and 0.9% (0.2–2.6%) among IPT-treated participants. The sensitivity of the WHO symptom screen was 0% (0–52%) and specificity 87% (83–90%). Xpert and candidate biomarkers had poor to moderate sensitivity; the most accurate biomarker was CRP ≥ 3.3 mg/L (sensitivity 80% (28–100) and specificity 72% (67–77)). Six months after enrollment, the incidence rate of pulmonary tuberculosis following IPT completion was 0.84 per 100 person-years (95% CI, 0.31–2.23). Conclusions In Kenyan PLHIV treated with IPT, tuberculosis prevalence was low at a median of 1.4 years after IPT completion. WHO symptoms screening, Xpert, and candidate biomarkers were insensitive for identifying pulmonary tuberculosis in antiretroviral-treated PLHIV.

OBESITY IN SARS-COV-2 INFECTION: LITERATURE REVIEW

2021 ◽  
pp. 19-23
Author(s):  
Donizete Tavares Da Silva ◽  
Priscila De Sousa Barros Lima ◽  
Renato Sampaio Mello Neto ◽  
Gustavo Magalhães Valente ◽  
Débora Dias Cabral ◽  
...  
Keyword(s):  
Public Health ◽  
Acute Respiratory Distress Syndrome ◽  
Gastrointestinal Tract ◽  
Severe Acute Respiratory Syndrome ◽  
Distress Syndrome ◽  
Circulatory System ◽  
World Health ◽  
Global Public Health ◽  
The World ◽  
Health Organization

In March 2020, the World Health Organization (1) declared COVID-19 as a pandemic and a threat to global public health (2). The virus mainly affects the lungs and can cause acute respiratory distress syndrome (ARDS). In addition, coronavirus 2 severe acute respiratory syndrome (SARSCOV2) also has devastating effects on other important organs, including the circulatory system, brain, gastrointestinal tract, kidneys and liver

scholarly journals An Uncertain Risk: The World Health Organization's Account of H1N1

2014 ◽  
Vol 27 (3) ◽  
pp. 511-529 ◽  
Author(s):  
Sudeepa Abeysinghe
Keyword(s):  
Public Health ◽  
Influenza Pandemic ◽  
Scientific Evidence ◽  
H1n1 Influenza ◽  
World Health ◽  
Scientific Uncertainty ◽  
Global Public Health ◽  
The World ◽  
Public Risk ◽  
Health Organization

ArgumentScientific uncertainty is fundamental to the management of contemporary global risks. In 2009, the World Health Organization (WHO) declared the start of the H1N1 Influenza Pandemic. This declaration signified the risk posed by the spread of the H1N1 virus, and in turn precipitated a range of actions by global public health actors. This article analyzes the WHO's public representation of risk and examines the centrality of scientific uncertainty in the case of H1N1. It argues that the WHO's risk narrative reflected the context of scientific uncertainty in which it was working. The WHO argued that it was attempting to remain faithful to the scientific evidence, and the uncertain nature of the threat. However, as a result, the WHO's public risk narrative was neither consistent nor socially robust, leading to the eventual contestation of the WHO's position by other global public health actors, most notably the Council of Europe. This illustrates both the significance of scientific uncertainty in the investigation of risk, and the difficulty for risk managing institutions in effectively acting in the face of this uncertainty.

scholarly journals Four pandemics: lessons learned, lessons lost

2020 ◽  
Keyword(s):  
Public Health ◽  
Lessons Learned ◽  
World Health ◽  
Swine Flu ◽  
Global Public Health ◽  
Health Crisis ◽  
The World ◽  
Spanish Flu ◽  
Future Events ◽  
Health Organization

In the past 100 years, the world has faced four distinctly different pandemics: the Spanish flu of 1918-1919, the SARS pandemic of 2003, the H1N1 or “swine flu” pandemic of 2012, and the ongoing COVID-19 pandemic. Each public health crisis exposed specific systemic shortfalls and provided public health lessons for future events. The Spanish flu revealed a nursing shortage and led to a great appreciation of nursing as a profession. SARS showed the importance of having frontline clinicians be able to work with regulators and those producing guidelines. H1N1 raised questions about the nature of a global organization such as the World Health Organization in terms of the benefits and potential disadvantages of leading the fight against a long-term global public health threat. In the era of COVID-19, it seems apparent that we are learning about both the blessing and curse of social media.

scholarly journals Global Governance of Anti-microbial Resistance: A Legal and Regulatory Toolkit

2020 ◽  
pp. 401-420
Author(s):  
Calvin W. L. Ho ◽  
Tsung-Ling Lee
Keyword(s):  
Public Health ◽  
System Approach ◽  
Action Plan ◽  
World Health ◽  
Health Concern ◽  
Global Public Health ◽  
Agricultural Industry ◽  
Treatment And Prevention ◽  
Global Action ◽  
Health Organization

Abstract Recognizing that antimicrobial resistance (AMR) poses a serious threat to global public health, the World Health Organization (WHO) has adopted a Global Action Plan (GAP) at the May 2015 World Health Assembly. Underscoring that systematic misuse and overuse of drugs in human medicine and food production is a global public health concern, the GAP-AMR urges concerted efforts across governments and private sectors, including pharmaceutical industry, medical professionals, agricultural industry, among others. The GAP has a threefold aim: (1) to ensure a continuous use of effective and safe medicines for treatment and prevention of infectious diseases; (2) to encourage a responsible use of medicines; and (3) to engage countries to develop their national actions on AMR in keeping with the recommendations. While the GAP is a necessary step to enable multilateral actions, it must be supported by effective governance in order to realize the proposed aims. This chapter has a threefold purpose: (1) To identify regulatory principles embedded in key WHO documents relating to AMR and the GAP-AMR; (2) To consider the legal and regulatory actions or interventions that countries could use to strengthen their regulatory lever for AMR containment; and (3) To highlight the crucial role of the regulatory lever in enabling other levers under a whole-of-system approach. Effective AMR containment requires a clearer understanding of how the regulatory lever could be implemented or enabled within health systems, as well as how it underscores and interacts with other levers within a whole-of-system approach.

COMMERCIAL SEX WORKER COMPLIANCE WITH USING CONDOMS IN THE LOCALIZATION OF MANGROVE BAY, BATAM CITY

2021 ◽  
Vol 10 (2) ◽  
pp. 51-55
Author(s):  
Rosyadi Aziz Rahmat ◽  
Devy Lestari Nurul Aulia
Keyword(s):  
Sex Workers ◽  
Public Health Problem ◽  
Sub Saharan Africa ◽  
World Health ◽  
People Living With Hiv ◽  
Commercial Sex ◽  
Global Public Health ◽  
Commercial Sex Workers ◽  
Hiv Virus ◽  
Living With Hiv

Background : According to the World Health Organization (WHO) HIV continues to be a global public health problem, claiming more than 70 million people are infected with the HIV virus and around 35 million people have died. In 2015, approximately 1.1 (940 000-1300000) million people have died due to being infected with the HIV virus. There were an estimated 36.7 (34.0-39.8) million people living with HIV at the end of 2016. Globally, Sub-Saharan Africa is the most affected region, with nearly 1 in 25 adults living with HIV. (WHO 2016). The purpose of this study was to determine the compliance of commercial sex workers on using condoms in the localization of Teluk Bakau, Batam City. Method : This study used a descriptive research design. The location of this research was carried out in the localization of Teluk Bakau, Batam City. The population in this study were all commercial sex workers (CSWs) in the Teluk Bakau brothels with a total of 95 people. The sample is an object under study and is considered to represent the entire population, here the writer uses a purposive technique, namely by means of sampling based on criteria. The measuring instrument in this study using a questionnaire. This analysis was carried out on each variable. These results are in the form of distribution and percentage of each variable. Data analysis was carried out in a univariate manner by looking at the results of the frequency calculation and the presentation of the results which could later be used as benchmarks for discussion and conclusions. Results and conclusions : It can be seen that the compliance of CSWs using condoms in the Bakau Bay brothel, Batam City is the majority of the majority behave obediently as many as 46 respondents (93.9%)

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