scholarly journals Successful Simultaneous Screening of Sickle Cell Disease, HIV and Tuberculosis in Rural Guinea Bissau, West Africa through Rapid Tests and a Standardized Clinical Questionnaire: An Outreach Program Due to a Public-Private Partnership

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 4715-4715
Author(s):  
Federica Menzato ◽  
Luca Bosa ◽  
Armando Sifna ◽  
Luisa Da Silva ◽  
Elena Gasperoni ◽  
...  
Keyword(s):  
Pilot Study ◽  
Clinical Examination ◽  
Rural Areas ◽  
Rapid Test ◽  
Hiv Positive ◽  
Cell Disease ◽  
Guinea Bissau ◽  
Rapid Tests ◽  
The Village

Abstract Introduction: Previous studies demonstrated that sickle cell disease (SCD), HIV and Tuberculosis (TB) represent high, yet under recognized health issues in Guinea Bissau, West Africa. A public National Reference Center for TB, Hospital Raoul Follereau (HRF) managed by the Italian NGO AHEAD is present in the capital city of Bissau with specialized local health staff capable of managing HIV and TB; the hospital has a SCD Clinic. Access to health services for rural population is limited and in some villages basic health care and routine screening are also seldom available due to lack of resources, specialized staff or diagnostic capacity. Therefore, people are not diagnosed or diagnosed late for SCD, HIV, TB. Nevertheless, rapid tests for both HIV and SCD are available on the market and one for TB is being developed. Simultaneous screening of three big diseases at the point of care (POC) in rural areas would allow saving of time and resources, while identifying people in need of further specialized diagnostic or follow up. Objectives: To evaluate the feasibility of simultaneous screening of HIV, SCD and TB at the POC in a rural area of Guinea Bissau through rapid tests for HIV and SCD and a standardized clinical questionnaire (Figure 1) with clinical examination for TB. To identify patients with HIV, SCD or both and enroll them in appropriate follow up programs; to identify suspects of TB eligible for in depth diagnostic screening. Methods: During the first phase of the project a temporary outreach health post was organized for 10 days in March 2018 in the village of Fanhè, by the NGO AGB already operating in the village. 1) The chiefs of the rural community village informed all the households through collective meetings and home visits regarding the objectives and modalities of the health project after accepting the proposal made by the NGOs and the HRF staff (February-March 2018); 2) the local chiefs organized a schedule of visits according to households; 3) 3 nurses and 2 physicians from the HRF in Bissau, linguistically competent for Creole and local dialects, administered the standardized questionnaire and the physical examination respectively; 3) 2 pediatric residents from Italy aided in clinical examination, a nurse and 2 other physicians in performing the rapid tests for HIV (Determine®) and SCD (Sickle Scan, Biomedomics) after informed consent; patients with Sickle Scan positive results were immediately collected another blood sample on Guthrie card for molecular analysis confirmation to be performed in Italy at the Azienda Ospedaliera Università di Padova. During the second phase of the project (April-May 2018) subjects with suspect of TB and/or HIV received free transportation to the HRF for TB diagnostic evaluation according to the national protocol and second HIV confirmatory test. Results: All 898 inhabitants (32 families) accepted the screening and performed clinical examination with clinical questionnaire; all performed the finger prick for HIV and SCD rapid test. At SickleScan 16 were HbSA (children 9/16); none were HbAC or HbSS. All received information on the carrier state. At Determine 61 were HIV positive (children 9/61). 93 presented clinical suspect of TB (children 33/93). 12 had a suspected of TB and were HIV positive(children: 2/12). For subjects with a suspect of TB or who were HIV positive free transportation was arranged to the HRF for complete TB diagnostic workup and second HIV confirmatory Rapid Test. All HIV positive tests were confirmed and patients enrolled in clinical care in a nearby village; 30% of patients with TB suspect had the diagnosis confirmed by Xray/sputum smear examination and were enrolled in appropriate care programss. All 16 Sicklescan positive HbSA samples underwent molecular analysis and the results were confirmed. Conclusions: This pilot study demonstrate the feasibility of a simultaneous population screening at the POC in rural areas for three "big diseases" (SCD, HIV and TB) through a temporary outreach clinic organized by local specialized staff in collaboration with local communities and international Academic Institutions and NGOs. The simultaneous screening with rapid test and standardized clinical examination is a model that could replicated in other rural settings in low resource countries. A further pilot study which will include a rapid test for TB, HIV and SCD is currently being planned. Figure. Figure. Disclosures Colombatti: NOVARTIS: Consultancy; Global Blood Therapeutics: Consultancy; BlueBirdBio: Consultancy; ADDMEDICA: Consultancy.

Acceptability of dual HIV/syphilis rapid test in community- and home-based testing strategy among transgender women in Buenos Aires, Argentina

2021 ◽  
Vol 32 (6) ◽  
pp. 501-509
Author(s):  
Virginia Zalazar ◽  
Claudia E Frola ◽  
Ana Gun ◽  
Pablo D Radusky ◽  
Natalia K Panis ◽  
...  
Keyword(s):  
Buenos Aires ◽  
Treatment Initiation ◽  
Rapid Test ◽  
Transgender Women ◽  
Hiv Positive ◽  
Testing Strategy ◽  
Treatment Uptake ◽  
Home Based ◽  
Rapid Tests ◽  
Positive Results

Background: Little is known of acceptability and feasibility of dual HIV and syphilis rapid tests in community- and home-based provider-initiated strategies among transgender women (TGW), in Latin America. Objectives were (1) to assess the acceptability of this strategy and, (2) to determine the percentage of positive results of HIV and syphilis, analyze the correlates of HIV or syphilis positive results, and measure the rates of effective referral and treatment completion among TGW. Methods: A multidisciplinary team tested 89 TGW in Buenos Aires. An acceptability survey was administered after the HIV/syphilis Duo test was used. All confirmed cases were referred for treatment initiation. Results: We found high levels of acceptability (98.8%) of this strategy among TGW. However, only 60.7% preferred simultaneous HIV and syphilis diagnosis test. Moreover, we found 9% of positive results of HIV, 51.7% of syphilis, and 3.4% of positive results for both infections. Only not being tested before was associated with an HIV positive result, and only low level of education was associated with a positive syphilis result. Among 8 TGW who tested positive for HIV, 37.5% ( n = 3) started antiretroviral therapy. Of 46 who tested positive for syphilis, only 73.9% ( n = 34) were effectively referred and from 23 who started treatment, only 39.1% completed it. Conclusions: Community- and home-based dual HIV and syphilis rapid test is a feasible and highly acceptable approach for this hard-to-reach population. Implementing similar strategies could improve screening uptake and accessibility. However, these results highlight the need to improve strategies for treatment uptake, in order to reduce morbidity and risk of onward transmission.

Improvement of Sickle Cell Disease Morbimortality in Children: Experience in a Remote Area of an African Country

2020 ◽  
Author(s):  
Benoît Mukinayi MBIYA ◽  
Didier Kalenda Kalombo ◽  
Yannick Nkesu Mukendi ◽  
John Kalenda Mpoyi ◽  
Parola Mukendi Biboyi ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Rural Areas ◽  
African Country ◽  
Public Health Problem ◽  
Annual Number ◽  
Cell Disease ◽  
African Countries ◽  
Referral Center

Abstract Background: Sickle cell disease (SCD) is a public health problem in the Democratic Republic of Congo. While reference sickle cell centers have been implemented in capital cities of African countries and have proven to be beneficial for SCD patients, they have never been set up in rural areas for families with very low sources of income. Method: A cohort of 143 children with SCD aged 10 years old (IQR (interquartile range): 6–15 years) (sex ratio male/female = 1.3) were clinically followed for 12 months without any specific intervention aside from the management of acute events, and then for 12 months with a monthly medical visit, biological follow-up, and regular prophylaxis. Results: The median age of patients at the diagnosis of SCD was 2 years (IQR: 1–5). The implementation of standardized and regular follow-ups in a new sickle cell referral center in a remote city showed an increase in the annual mean hemoglobin level from 50 to 70 g/L (p = 0.001), and a decrease in the lymphocyte count and spleen size (p < 0.001). A significant decrease (p < 0.001) in the average annual number of hospitalizations and episodes of vaso-occlusive crises, blood transfusions, infections, and acute chest syndromes were also observed. Conclusions: Creation of a sickle cell referral center and the regular follow-up of children with SCD are possible and applicable in the context of a remote city of an African country and represent simple and accessible measures that can reduce the morbimortality of children with sickle cell disease.

scholarly journals The use of 0.01M phosphate buffered saline as detection buffer for Alere Determine® HIV rapid test in resource limited settings

2017 ◽  
Vol 19 (2) ◽  
Author(s):  
Mariam M. Mirambo ◽  
Martha F. Mushi ◽  
Ley Shilewangwa ◽  
Caroline A. Minja ◽  
Benson R. Kidenya ◽  
...  
Keyword(s):  
Negative Impact ◽  
Rapid Test ◽  
Hiv Positive ◽  
Resource Limited Settings ◽  
Perfect Agreement ◽  
Resource Limited ◽  
Rapid Tests ◽  
Alternative Detection ◽  
Phosphate Buffered Saline ◽  
Hiv Negative

Insufficient supply of manufacture’s buffers/diluents in relation to the number of strips per kit has been found to have negative impact on patients’ results. Some laboratories personnel tend to use diluents from other rapid tests manufacturers such as Bioline, Unigold as well as malaria rapid diagnostic test (MRDT). This study aimed at evaluating the use of 0.01M phosphate buffered saline (PBS) as detection buffer for Alere Determine® HIV rapid test. This study was carried out at Bugando School of Medicine in Mwanza, Tanzania. A total of 300 whole blood specimens; 150 HIV positive specimens from patients attending Care and Treatment Centreand 150 HIV negative specimens were retested for HIV status using Alere Determine® HIV rapid test employing normal Alere buffer and 0.01M PBS as buffer.Of the total specimens tested; 150 (100%) of HIV positive were positive by using both Alere buffer and 0.01M PBS while 150(100%) of HIV negative samples were negative by both Alere Determine® and 0.01M PBS. The agreement between 0.01M PBS and Alere Determine® buffer was 100%. The value of kappa indicates perfect agreement between 0.01M PBS and Alere Determine® buffer (100%). A 0.01M PBS is recommended as alternative detection buffer for Alere Determine® in cases of insufficient supply. Further investigation to evaluate the suitable buffer for other rapid tests for HIV and other diseases is recommended especially in resource limited settings. 

scholarly journals Improvement of Sickle Cell Disease Morbimortality in Children: Experience in a Remote Area of an African Country

2020 ◽  
Author(s):  
Benoît Mukinayi Mbiya ◽  
Didier Kalenda Kalombo ◽  
Yannick Nkesu Mukendi ◽  
Valery Daubie ◽  
John Kalenda Mpoyi ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Rural Areas ◽  
African Country ◽  
Public Health Problem ◽  
Annual Number ◽  
Cell Disease ◽  
African Countries ◽  
Referral Center

Background: Sickle cell disease (SCD) is a public health problem in the Democratic Republic of Congo. While reference sickle cell centers have been implemented in capital cities of African countries and have proven to be beneficial for SCD patients, they have never been set up in rural areas for families with very low sources of income. Method: A cohort of 143 children with SCD aged 10 years old (IQR (interquartile range): 6&ndash;15 years) (sex ratio male/female = 1.3) were clinically followed for 12 months without any specific intervention aside from the management of acute events, and then for 12 months with a monthly medical visit, biological follow-up, and regular prophylaxis. Results: The median age of patients at the diagnosis of SCD was 2 years (IQR: 1&ndash;5). The implementation of standardized and regular follow-ups in a new sickle cell referral center in a remote city showed an increase in the annual mean hemoglobin level from 50 to 70 g/L (p = 0.001), and a decrease in the lymphocyte count and spleen size (p &lt; 0.001). A significant decrease (p &lt; 0.001) in the average annual number of hospitalizations and episodes of vaso-occlusive crises, blood transfusions, infections, and acute chest syndromes were also observed. Conclusions: Creation of a sickle cell referral center and the regular follow-up of children with SCD are possible and applicable in the context of a remote city of an African country and represent simple and accessible measures that can reduce the morbimortality of children with sickle cell disease.

scholarly journals Feasibility of oral HIV self-testing in female sex workers in Gaborone, Botswana

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259508
Author(s):  
Emily Shava ◽  
Laura M. Bogart ◽  
Kutlo Manyake ◽  
Charlotte Mdluli ◽  
Kamogelo Maribe ◽  
...  
Keyword(s):  
Pilot Study ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Hiv Positive ◽  
Hiv Status ◽  
Governmental Organization ◽  
Brief Training ◽  
Self Testing ◽  
Hiv Negative

Background Oral HIV self-testing (HIVST) may be useful for increasing testing in persons at elevated risk of acquiring HIV. Methods We conducted a pilot study to evaluate the feasibility (defined by uptake) of HIVST among FSW in Gaborone, Botswana. FSW age 18 years and above were recruited through a non-governmental organization serving FSW. FSW with unknown or negative HIV status at screening performed HIVST in the study clinic following brief training. FSW testing HIV-negative were each given two test kits to take home: one kit to perform unassisted HIVST and another to share with others. Feasibility (use) of HIVST (and sharing of test kits with others) was assessed in these women at a study visit four months later. Results Two hundred FSW were screened. Their average age was 34 years (range 18–59), and 115 (58%) were HIV-positive. Eighty-five (42%) tested HIV-negative at entry and were eligible to take part in the HIVST pilot study. All 85 (100%) agreed to take home HIVST kits. Sixty-nine (81%) of these 85 participants had a follow-up visit, 56 (81%) of whom reported performing HIVST at a mean of three and half months after the initial visit. All 56 participants who performed HIVST reported negative HIVST results. Fifty (73%) of the 69 participants who took HIVST kits home shared them with others. Of the 50 women sharing HIVST kits, 25 (50%) shared with their non-client partners, 15 with a family member, 8 with friends, and 3 with a client. One participant did not test herself but shared both her test kits. Most participants 53/56 (95%) found oral HIVST very easy to use whilst 3/56 (5%) felt it was fairly easy. Conclusion Oral HIVST is feasible among FSW in Gaborone, Botswana. The majority of FSW used the HIVST kits themselves and also shared extra HIVST kits with other individuals.

A Pilot Study of Mobile Telephone Message Interventions with Suicide Attempters in China

Crisis ◽  
2010 ◽  
Vol 31 (2) ◽  
pp. 109-112 ◽  
Author(s):  
Hui Chen ◽  
Brian L. Mishara ◽  
Xiao Xian Liu
Keyword(s):  
Pilot Study ◽  
Effective Means ◽  
Text Message ◽  
Text Messages ◽  
Mobile Telephone ◽  
Future Research ◽  
Quick Method ◽  
Suicide Attempters ◽  
To Receive

Background: In China, where follow-up with hospitalized attempters is generally lacking, there is a great need for inexpensive and effective means of maintaining contact and decreasing recidivism. Aims: Our objective was to test whether mobile telephone message contacts after discharge would be feasible and acceptable to suicide attempters in China. Methods: Fifteen participants were recruited from suicide attempters seen in the Emergency Department in Wuhan, China, to participate in a pilot study to receive mobile telephone messages after discharge. All participants have access to a mobile telephone, and there is no charge for the user to receive text messages. Results: Most participants (12) considered the text message contacts an acceptable and useful form of help and would like to continue to receive them for a longer period of time. Conclusions: This suggests that, as a low-cost and quick method of intervention in areas where more intensive follow-up is not practical or available, telephone messages contacts are accessible, feasible, and acceptable to suicide attempters. We hope that this will inspire future research on regular and long-term message interventions to prevent recidivism in suicide attempters.

Computerized cognitive training in pediatric sickle cell disease: A randomized controlled pilot study.

2020 ◽  
Vol 8 (4) ◽  
pp. 390-401 ◽  
Author(s):  
Taryn M. Allen ◽  
Lindsay M. Anderson ◽  
Samuel M. Brotkin ◽  
Jennifer A. Rothman ◽  
Melanie J. Bonner
Keyword(s):  
Pilot Study ◽  
Sickle Cell Disease ◽  
Cognitive Training ◽  
Sickle Cell ◽  
Cell Disease ◽  
Computerized Cognitive Training ◽  
Randomized Controlled ◽  
Pediatric Sickle Cell Disease

Antiretroviral Treatment-Associated Labia Majora Lipohypertrophy: A Rare Case and Plastic Surgical Treatment Options

2017 ◽  
Vol 2 (1) ◽  
pp. 43
Author(s):  
Akmal Hisham ◽  
Devananthan Ilenghoven ◽  
Wan Syazli Wan Ahmad Kamal ◽  
Salina Ibrahim ◽  
Shah Jumaat Mohd Yussof
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Daily Living ◽  
Treatment Options ◽  
Hiv Positive ◽  
Highly Active ◽  
Labia Majora ◽  
The Face ◽  
Central Fat

The emergence of highly active antiretroviral therapy (HAART) has revolutionized the prognosis of HIV-infected patients. However, the extended use of HAART is associated with a disfiguring complication termed lipodystrophy, a disorder of body fat maldistribution causing peripheral fat loss (lipoatrophy) and central fat accumulation (lipohypertrophy). Lipoatrophy commonly affects the face, legs, buttocks and arm, whilst lipohypertrophy frequently favours the abdomen, breast and dorsocervical region. To our knowledge, we present only the second documented case in the literature of a labia majora lipohypertrophy in a HIV-positive patient receiving long-term HAART. The severity of labial abnormality caused significant physical and functional morbidities. Labiaplasty with dermolipectomy of the labia majora and excisional lipectomy of the mons pubis was successfully performed. At a 6-month follow-up, patient had no recurrence with resolution of symptoms and resumption of normal activities of daily living (ADL).

KEBANGGAAN TERHADAP BATIK MADURA BAGI WARGA SUMENEP

2014 ◽  
Vol 4 (2) ◽  
Author(s):  
Sayyida Sayyida ◽  
Nurdody Zakki
Keyword(s):  
Logistic Regression ◽  
Rural Areas ◽  
Research Method ◽  
Community Group ◽  
Parametric Regression ◽  
Logit Function ◽  
The Village ◽  
The City ◽  
Level Of Risk ◽  
Non Parametric

Diversity of Indonesian Batik hanging area. One of the very well-known Indonesian batik is Batik Madura. Batik Madura has become a pride for Indonesia, especially for Madura. The purpose of the study is to model the Sumenep pride to Batik Madura and to see the level of risk or tendency of batik madura pride for the community group Sumenep. This research method uses a non parametric regression used a non-parametric regression because the dependent variable in this study is the variable Y are variables not normally distributed. The results of this study states that the level of risk of the village in Sumenep proud of batik is almost 5 times higher than the islands while people in this city who live in the district town at risk Sumenep proud of Batik Madura 8-fold compared to the archipelago. So it can be concluded that the city is much more proud of batik than those who reside in rural areas especially those who reside in the islands. This study uses data from 100 questionnaires were analyzed using logistic regression analysis. The conclusion of this study is the pride of the batik model as follows: Function logistic regression / logit function: g (x) = 0,074 + 1,568X4(1)+2,159X4(2 this is case the islands as a comparison, X4(1)  is the place to stay in the village and X4(2)  is the place to stay in town, so the Model Opportunities p(x) = EXP(g(x))/1+EXP(g(x)).  Hopes for further research is to conduct research on the development of batik in an integrated region, the need to be disseminated to potential areas of particular potential in Madura batik, especially for residents who reside in the Islands.Keywords: Pride, Batik, Sumenep.

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