High Incidence of Tuberculosis in the Absence of Isoniazid and Cotrimoxazole Preventive Therapy in Children Living with HIV in Northern Ethiopia: A Retrospective Follow-Up Study

Abstract Background Ethiopia is striving to achieve a goal of “zero human immune deficiency virus/acquired immune deficiency syndrome (HIV/AIDS)-related deaths.” However, little has been documented on the factors that hamper the progress towards achieving this goal. Therefore, the ultimate aim of this study was to determine predictors of mortality among adult people living with HIV/AIDS on antiretroviral therapy (ART). Methods A retrospective follow-up study was employed on all adult HIV/AIDS patients who started ART between January 1 and December 30, 2010, at Suhul Hospital, Tigrai Region, Northern Ethiopia. Data were collected by trained fourth-year Public Health students using a checklist. Finally, the collected data were entered into SPSS version 16. Then after, Kaplan-Meier curves were used to estimate survival probability, the log-rank test was used for comparing the survival status, and Cox proportional hazards model were applied to determine predictors of mortality. Results The median follow-up period was 51 months (ranging between 1 and 60 months, inter-quartile range (IQR) = 14 months). At the end of follow-up, 37 (12.5%) patients were dead. The majority of these cumulative deaths, 19 (51.4%) and 29 (78.4%), occurred within 3 and 4 years of ART initiation respectively. Consuming alcohol (adjusted hazard ratio (AHR) = 2.23, 95% CI = 1.15, 4.32), low body weight (AHR = 2.38, 95% CI = 1.03, 5.54), presence of opportunistic infections (AHR = 2.18, 95% CI = 1.09, 4.37), advanced WHO clinical stage (AHR = 2.75, 95% CI = 1.36, 5.58), and not receiving isoniazid prophylactic therapy (AHR = 3.00, 95% CI = 1.33, 6.74) were found to be independent predictors of mortality. Conclusion The overall mortality was very high. Baseline alcohol consumption, low body weight, advanced WHO clinical stage, the presence of opportunistic infections, and not receiving isoniazid prophylactic therapy were predictors of mortality. Strengthening behavioral and nutritional counseling with close clinical follow-up shall be given much more emphasis in the ART care and support program.

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Current Perspectives on Neonatal Screening for Propionic Acidemia in Japan: An Unexpectedly High Incidence of Patients with Mild Disease Caused by a Common PCCB Variant

International Journal of Neonatal Screening ◽

10.3390/ijns7030035 ◽

2021 ◽

Vol 7 (3) ◽

pp. 35

Author(s):

Go Tajima ◽

Reiko Kagawa ◽

Fumiaki Sakura ◽

Akari Nakamura-Utsunomiya ◽

Keiichi Hara ◽

...

Keyword(s):

Neonatal Screening ◽

Acid Metabolism ◽

Neonatal Period ◽

Propionic Acidemia ◽

Cardiac Complications ◽

Mild Disease ◽

Follow Up Study ◽

Organic Acid Metabolism ◽

High Incidence

Propionic acidemia (PA) is a disorder of organic acid metabolism which typically presents with acute encephalopathy-like symptoms associated with metabolic acidosis and hyperammonemia during the neonatal period. The estimated incidence of symptomatic PA in Japan is 1/400,000. The introduction of neonatal screening using tandem mass spectrometry has revealed a far higher disease frequency of approximately 1/45,000 live births due to a prevalent variant of c.1304T>C (p.Y435C) in PCCB, which codes β-subunit of propionyl-CoA carboxylase. Our questionnaire-based follow-up study reveals that most of these patients remain asymptomatic. However, reports on symptomatic patients exhibiting cardiac complications such as cardiomyopathy and QT prolongation have been increasing. Moreover, there were even cases in which these cardiac complications were the only symptoms related to PA. A currently ongoing study is investigating the risk of cardiac complications in patients with neonatal screening-detected PA caused by this common variant.

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Survival analysis of people living with human immunodeficiency virus: a study in a teaching hospital

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20203596 ◽

2020 ◽

Vol 7 (9) ◽

pp. 1339

Author(s):

S. Bhagyabati Devi ◽

T. Jeetenkumar Singh ◽

Kshetrimayum Birendra Singh ◽

N. Biplab Singh ◽

Robinson Ningshen ◽

...

Keyword(s):

Antiretroviral Therapy ◽

People Living With Hiv ◽

Good Adherence ◽

National Programme ◽

Immunodeficiency Virus ◽

Centre Of Excellence ◽

High Incidence ◽

Good Nutrition ◽

Living With Hiv

Background: Antiretroviral therapy (ART) have changed the outlook of people living with HIV (PLHIV) by transforming the dreaded infection to a chronically manageable disease. However, there is scant of reports which analyses quantitatively the survival benefit of PLHIV under ART. Objectives of this study were to determine the survival time of adult PLHIV who are on ARV. To analyse the factors determining survival outcome of PLHIV on ARV.Methods: This was an observational study in centre of excellence (COE) ART Centre, RIMS, Imphal from April 2004 to December 2009. Details from the data entered in documents of the ART programme were followed up every 3 months for 60 months from the date of initiation of ARV. All PLHIV above 18 years of age and undergoing antiretroviral therapy were included.Results: Survival rate following initiation of ARV was found to be significantly high among PLHIV. Higher CD4 count at the time of ARV initiation had better prognosis. Mortality was high among IDUs and they had high incidence of co-infections with HCV and HBV. The currently available ARV drugs under NACO programme have better suppression of HIV, are less toxic, low pill burden. The combined regimen used in the earlier days were not much inferior to the current ARV drugs if initiated timely with proper prophylaxis of OIs, good adherence, good nutrition and timely management of toxicities and IRIS.Conclusions: Timely treatment with ARV drugs provided under the national programme with good adherence and regular follow-up improves the survival of PLHIV.

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Delay to initiate treatment is associated with unsuccessful treatment outcome among new pulmonary tuberculosis patients in Tigray, Northern Ethiopia: a follow up study

10.21203/rs.3.rs-527930/v1 ◽

2021 ◽

Author(s):

kiros Tedla ◽

Girmay Medhin ◽

Gebretsadik Berhe ◽

Afework Mulugeta ◽

Nega Berhe

Keyword(s):

Treatment Outcome ◽

Pulmonary Tuberculosis ◽

Treatment Outcomes ◽

Treatment Initiation ◽

Statistical Significance ◽

Northern Ethiopia ◽

Follow Up Study ◽

Unsuccessful Treatment ◽

Increased Risk

Abstract Background : Previous studies in Ethiopia indicated that tuberculosis (TB) patient’s elapse long time before treatment initiation. However, there is very limited evidence on the association of delay to initiate treatment with treatment outcome. Objective : To investigate the association of time to treatment initiation delay with treatment outcomes of new adult TB patients in Tigray region of Ethiopia. Methods : We conducted a follow up study from October 2018 to April 2020 by recruiting 875 newly diagnosed Pulmonary Tuberculosis (PTB) patients from 21 randomly selected health facilities. Study participants were selected using simple random sampling technique during treatment initiation from October 1/2018 to October 30/2019. Delay to initiate treatment and treatment outcome were collected using standardized questionnaire and laboratory investigation. Adherence of TB patients to their treatment was collected using a 10 points linear visual analogue scale (VAS) at the end of treatment. The association of delay to initiate treatment with treatment outcome was modeled using log binomial regression model. Statistical significance was reported whenever p-value was less than 0.05. Data was analyzed using SPSS software version 21. Result : The median total delay to treatment initiation was 62 days with inter-quartile range of 16-221 days. A unite increase in a day to initiate treatment results in increment of risk of unsuccessful treatment outcome by 2.3. Other factors associated with unsuccessful treatment outcomes were being less adherent to the treatment, HIV co infection, being smear positive at initiation of treatment and after 2 months of treatment initiation. Conclusion : delay in a day to initiate treatment is associated with increased risk of unsuccessful treatment outcome. Any effort targeted towards reducing the negative effects of PTB should target on strategies that reduces the length of delay to initiate treatment and strengthen community engagement to improve treatment adherence of patients that have started treatment.

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High incidence of vertebral and non-vertebral fractures in the OSTRA cohort study: a 5-year follow-up study in postmenopausal women with rheumatoid arthritis

Osteoporosis International ◽

10.1007/s00198-010-1517-6 ◽

2011 ◽

Vol 22 (9) ◽

pp. 2413-2419 ◽

Cited By ~ 42

Author(s):

M. Vis ◽

E. A. Haavardsholm ◽

P. Bøyesen ◽

G. Haugeberg ◽

T. Uhlig ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Cohort Study ◽

Postmenopausal Women ◽

Vertebral Fractures ◽

Follow Up Study ◽

High Incidence

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A Long-term Retrospective Follow-up Study of Patients Treated with Prophylactic Lithium Carbonate

The British Journal of Psychiatry ◽

10.1192/bjp.150.2.175 ◽

1987 ◽

Vol 150 (2) ◽

pp. 175-179 ◽

Cited By ~ 45

Author(s):

C. Page ◽

S. Benaim ◽

F. Lappin

Keyword(s):

Side Effects ◽

Complete Remission ◽

Lithium Carbonate ◽

Favourable Outcome ◽

Lithium Level ◽

Follow Up Study ◽

High Incidence ◽

Average Serum

Patients suffering from unipolar and bipolar affective illness, who began treatment with prophylactic lithium carbonate during a 5-year period, were followed up and 59 out of 101 interviewed. Most had been taking lithium for at least 13 years: 49% had a complete remission, 41% a partial but significant response, and 10% no response. No specific individual or illness factor was found to correlate with favourable outcome, and no correlation between average serum lithium level and outcome. No side-effects could be associated specifically with the long-term use of lithium, but there was a surprisingly high incidence of clinical hypothyroidism.

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The Expectation of Outcome from Maintenance Therapy in Chronic Schizophrenic Patients

The British Journal of Psychiatry ◽

10.1192/bjp.128.3.246 ◽

1976 ◽

Vol 128 (3) ◽

pp. 246-250 ◽

Cited By ~ 37

Author(s):

D. A. W. Johnson

Keyword(s):

Maintenance Therapy ◽

Patient Population ◽

Significant Proportion ◽

Community Services ◽

Neuroleptic Drugs ◽

Follow Up Study ◽

High Incidence ◽

Schizophrenic Patients ◽

Long Acting

SummaryThe results from a prospective follow-up study of a group of schizophrenic patients suggest that a significant proportion (41 per cent) are likely to relapse during a two-year period despite the prescription of long-acting injectable neuroleptic drugs. Some will relapse because of a failure of the regime, but others (32–37 per cent) because the pharmacological protection of these drugs would appear to be less effective in certain patients. Even with the major advantages of the long-acting injectable neuroleptics over oral medication, the schizophrenic patient population remains a group with a high incidence of psychiatric and social morbidity which continues to require the full resources of both the hospital and community services.

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