scholarly journals A study on co-morbidities and treatment outcome based on updated definitions among tuberculosis patients registered at a tuberculosis unit, Bangalore

2017 ◽  
Vol 4 (4) ◽  
pp. 1071
Author(s):  
Anwith H. H. Shivalingaiah ◽  
Chethana Ramegowda ◽  
N. R. Ramesh Masthi
Keyword(s):  
Treatment Outcome ◽  
Treatment Success ◽  
Public Health Problem ◽  
Chronic Obstructive ◽  
People Living With Hiv ◽  
Major Public Health Problem ◽  
Obstructive Pulmonary Disease ◽  
Tuberculosis Patients ◽  
Common Opportunistic Infection ◽  
Living With Hiv

Background: Tuberculosis remains one of the world‘s deadliest communicable diseases and a major public health problem and is a most common opportunistic infection in people living with HIV. The treatment outcome of Tuberculosis is influenced by numerous factors of which presence of co-morbidities is one of the factors. The present study was done with following objectives, to assess the proportion of co-morbidities and treatment outcome of the Tuberculosis cases registered for DOTS treatment at the Tuberculosis unit.Methods:  A Descriptive study was conducted at a Tuberculosis Unit in Bangalore with 80 subjects     selected by purposive sampling satisfying inclusion & exclusion criteria. Data was collected using a pretested semi structured proforma administered to all the study subjects by trained investigators. Data regarding socio demographic profile, profile of tuberculosis, medical co-morbidities which the subjects were suffering were collected and these patients were followed up till their treatment completion and outcome of treatment was given based on new WHO definitions.Results: The present study showed that, 38 (47.50%) of the study subjects had one or the other comorbidities with chronic obstructive pulmonary disease being the most common 18(22.5%) followed by Diabetes 13(16.25%). On determining the treatment outcome of the study subjects the overall treatment success rate was 86.25% which included the cured and treatment completed subjects. However there was no statistically significant (p = 0.614) association between treatment success and presence of comorbidity.Conclusions: The cure rate among the tuberculosis patients, following DOTS therapy was found to be slightly less than the RNTCP standards.

scholarly journals An Emerging Syndemic of Smoking and Cardiopulmonary Diseases in People Living with HIV in Africa

2021 ◽  
Vol 18 (6) ◽  
pp. 3111
Author(s):  
Emmanuel Peprah ◽  
Mari Armstrong-Hough ◽  
Stephanie H. Cook ◽  
Barbara Mukasa ◽  
Jacquelyn Y. Taylor ◽  
...  
Keyword(s):  
Current Evidence ◽  
Chronic Obstructive ◽  
People Living With Hiv ◽  
African Countries ◽  
Obstructive Pulmonary Disease ◽  
Cardiopulmonary Disease ◽  
Current Trends ◽  
Significant Public Health ◽  
Artery Disease ◽  
Living With Hiv

Background: African countries have the highest number of people living with HIV (PWH). The continent is home to 12% of the global population, but accounts for 71% of PWH globally. Antiretroviral therapy has played an important role in the reduction of the morbidity and mortality rates for HIV, which necessitates increased surveillance of the threats from pernicious risks to which PWH who live longer remain exposed. This includes cardiopulmonary comorbidities, which pose significant public health and economic challenges. A significant contributor to the cardiopulmonary comorbidities is tobacco smoking. Indeed, globally, PWH have a 2–4-fold higher utilization of tobacco compared to the general population, leading to endothelial dysfunction and atherogenesis that result in cardiopulmonary diseases, such as chronic obstructive pulmonary disease and coronary artery disease. In the context of PWH, we discuss (1) the current trends in cigarette smoking and (2) the lack of geographically relevant data on the cardiopulmonary conditions associated with smoking; we then review (3) the current evidence on chronic inflammation induced by smoking and the potential pathways for cardiopulmonary disease and (4) the multifactorial nature of the syndemic of smoking, HIV, and cardiopulmonary diseases. This commentary calls for a major, multi-setting cohort study using a syndemics framework to assess cardiopulmonary disease outcomes among PWH who smoke. Conclusion: We call for a parallel program of implementation research to promote the adoption of evidence-based interventions, which could improve health outcomes for PWH with cardiopulmonary diseases and address the health inequities experienced by PWH in African countries.

A COMPARATIVE STUDY OF ABG PATTERN IN PATIENTS OF COPD WITH OR WITHOUT COR PULMONALE

2021 ◽  
pp. 64-66
Author(s):  
Md Shoeb Alam ◽  
Rahul Ranjan ◽  
V N Jha
Keyword(s):  
Hypoxic Pulmonary Vasoconstriction ◽  
Respiratory Acidosis ◽  
Public Health Problem ◽  
Cor Pulmonale ◽  
Chronic Obstructive ◽  
P Value ◽  
Major Public Health Problem ◽  
Close Monitoring ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is a major public health problem. COR PULMONALE describes the enlargement and failure of the right ventricle of the heart as a response to increased vascular resistance or increased pulmonary artery pressure. Hypoxic pulmonary vasoconstriction, hypercapnia, respiratory acidosis and pulmonary vascular remodeling in COPD can cause an increase in right ventricular (RV) after load, which in turn, results in RVfailure leading to COR PULMONALE AIM:The purpose of the study is to compare the ABG pattern in patients of COPD with or without COR PULMONALE. MATERIALS AND METHODS: This prospective observational study was conducted in the Department of Medicine of DMCH, Laheriasarai, Bihar. The study was conducted with duration of 2 years. Atotal of 100 patients admitted as a case of COPD with or without COR PULMONALE. The patients were put into two subgroups, COPD with and without COR PULMONALE. RESULT: The mean duration was 10.17 years and 9.20 years respectively in patients with and without COR PULMONALE. There was no statistically signicant difference regarding mean duration of disease (p value =0.304). Mean CAT score was 16.59 ± 6.26 and mean mMRC was 3.19± 0.45 in COPD patients with COR PULMONALE group. Mean CAT score was 14.06 ± 4.46 and mean mMRC was 3.10 ± 0.44 in COPD patients without COR PULMONALE group. We found no signicant difference among these variables between groups. Although COR PULMONALE patients had higher CATscore and mMRC score, the difference was not signicant (p value = >0.05). CONCLUSION:ABG ANALYSIS should be recommended for all patients of COPD with or without COR PULMONALE to assess the degree of hypoxemia, hypercapnea, respiratory acidosis and also, we can identify individuals who need more close monitoring and intensive treatment.

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 Factors Associated with Anemia among People Living with HIV/AIDS Taking ART in Ethiopia

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Ketema Bizuwork Gebremedhin ◽  
Tadesse Bedada Haye
Keyword(s):  
Addis Ababa ◽  
Clinical Stage ◽  
Public Health Problem ◽  
People Living With Hiv ◽  
Major Public Health Problem ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Factors Associated ◽  
Living With Hiv ◽  
Hiv Aids

Background. Globally, anemia, among people living with HIV/AIDS, is a major public health problem. It has a significant effect on the progression of HIV/AIDS to advanced stages and there are a number of factors that often affect anemia. However, there is little insight regarding factors affecting anemia among HIV/AIDS patients in developing countries, including Ethiopia. Objective. This study aimed at investigating factors affecting anemia among people living with HIV/AIDS taking ART drug at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods. A hospital based cross-sectional study design was used to assess factors affecting anemia among people living with HIV/AIDS. Structured checklist was used to gather information from charts of patients selected by simple random sampling method. We analyzed the data to identify factors associated with anemia among people with HIV/AIDS using logistic regression models. Results. A total of 301 selected charts were reviewed. The median age was 38 ± 10.38. The majority (62.5%) of the patients were taking ZDV-containing ART drug (ZDV/3TC/NVP). The overall anemia prevalence was 34.6%, while about 5%, 15.6%, and 14% of the patients had severe, moderate, and mild prevalence of anemia, respectively. Factors that were found to affect anemia among these patients include gender (OR = 2.26 [95% CI: 1.22, 4.16]), occupation (OR: 0.57 [95%CI: 0.35, 0.92]), WBC count (OR = 2.30 [95% CI: 1.29, 4.09]), platelet count (OR = 2.89 [95% CI: 0.99, 8.41]), nutritional status (OR = 2.05 [95% CI: 0.69, 6.02]), and WHO clinical stage of HIV/AIDS (OR = 3.69 [95% CI: 1.86, 7.31]). Conclusions. About one in three patients was found to be anemic. Intervention aimed at diagnosing and treating anemia among people living with HIV/AIDS should be considered.

scholarly journals Machine-learning based feature selection for a non-invasive breathing change detection

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Juliana Alves Pegoraro ◽  
Sophie Lavault ◽  
Nicolas Wattiez ◽  
Thomas Similowski ◽  
Jésus Gonzalez-Bermejo ◽  
...  
Keyword(s):  
New Technologies ◽  
Load Capacity ◽  
Public Health Problem ◽  
Signal Amplitude ◽  
Respiratory Pattern ◽  
Chronic Obstructive ◽  
Rate Variation ◽  
Major Public Health Problem ◽  
Breathing Rate ◽  
Obstructive Pulmonary Disease

Abstract Background Chronic Obstructive Pulmonary Disease (COPD) is one of the top 10 causes of death worldwide, representing a major public health problem. Researchers have been looking for new technologies and methods for patient monitoring with the intention of an early identification of acute exacerbation events. Many of these works have been focusing in breathing rate variation, while achieving unsatisfactory sensitivity and/or specificity. This study aims to identify breathing features that better describe respiratory pattern changes in a short-term adjustment of the load-capacity-drive balance, using exercising data. Results Under any tested circumstances, breathing rate alone leads to poor capability of classifying rest and effort periods. The best performances were achieved when using Fourier coefficients or when combining breathing rate with the signal amplitude and/or ARIMA coefficients. Conclusions Breathing rate alone is a quite poor feature in terms of prediction of breathing change and the addition of any of the other proposed features improves the classification power. Thus, the combination of features may be considered for enhancing exacerbation prediction methods based in the breathing signal.Trial Registration : ClinicalTrials NCT03753386. Registered 27 November 2018, https://clinicaltrials.gov/show/NCT03753386

scholarly journals Impact of human immunodeficiency virus on pulmonary vascular disease

2021 ◽  
Vol 2021 (2) ◽  
Author(s):  
Ashok Kumar ◽  
Aatish Mahajan ◽  
Ethan A Salazar ◽  
Kevin Pruitt ◽  
Christian Arce Guzman ◽  
...  
Keyword(s):  
Vascular Disease ◽  
Clinical Manifestations ◽  
Pulmonary Vasculature ◽  
Pulmonary Vascular Disease ◽  
Chronic Obstructive ◽  
People Living With Hiv ◽  
Obstructive Pulmonary Disease ◽  
Advantages And Disadvantages ◽  
Complex Interactions ◽  
Living With Hiv

With the advent of anti-retroviral therapy, non-AIDS-related comorbidities have increased in people living with HIV. Among these comorbidities, pulmonary hypertension (PH) is one of the most common causes of morbidity and mortality. Although chronic HIV-1 infection is independently associated with the development of pulmonary arterial hypertension, PH in people living with HIV may also be the outcome of various co-morbidities commonly observed in these individuals including chronic obstructive pulmonary disease, left heart disease and co-infections. In addition, the association of these co-morbidities and other risk factors, such as illicit drug use, can exacerbate the development of pulmonary vascular disease. This review will focus on these complex interactions contributing to PH development and exacerbation in HIV patients. We also examine the interactions of HIV proteins, including Nef, Tat, and gp120 in the pulmonary vasculature and how these proteins alter the endothelial and smooth muscle function by transforming them into susceptible PH phenotype. The review also discusses the available infectious and non-infectious animal models to study HIV- associated PAH, highlighting the advantages and disadvantages of each model, along with their ability to mimic the clinical manifestations of HIV-PAH. 

scholarly journals Alterations to the Gastrointestinal Microbiome Associated with Methamphetamine Use among Young Men who have Sex with Men

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Ryan R. Cook ◽  
Jennifer A. Fulcher ◽  
Nicole H. Tobin ◽  
Fan Li ◽  
David J. Lee ◽  
...  
Keyword(s):  
Public Health Problem ◽  
16S Rrna Gene Sequencing ◽  
The United States ◽  
Rrna Gene ◽  
People Living With Hiv ◽  
Major Public Health Problem ◽  
Microbiome Composition ◽  
Rrna Gene Sequencing ◽  
Sex With Men ◽  
Living With Hiv

Abstract Methamphetamine (MA) use is a major public health problem in the United States, especially among people living with HIV (PLWH). Many MA-induced neurotoxic effects are mediated by inflammation and gut microbiota may play a role in this process, yet the effects of MA on the microbiome have not been adequately explored. Therefore, we performed 16S rRNA gene sequencing on rectal swab samples from 381 men who have sex with men, 48% of whom were PLWH and 41% of whom used MA. We compared microbiome composition between MA users and non-users while testing for potential interactions with HIV and controlling for numerous confounders using inverse probability of treatment weighting. We found that MA use explained significant variation in overall composition (R2 = 0.005, p = 0.008) and was associated with elevated Finegoldia, Parvimonas, Peptoniphilus, and Porphyromonas and reduced Butyricicoccus and Faecalibacterium, among others. Genera including Actinomyces and Streptobacillus interacted with HIV status, such that they were increased in HIV+ MA users. Finegoldia and Peptoniphilus increased with increasing frequency of MA use, among others. In summary, MA use was associated with a microbial imbalance favoring pro-inflammatory bacteria, including some with neuroactive potential and others that have previously been associated with poor HIV outcomes.

scholarly journals Chronic obstructive pulmonary disease prevalence and associated factors in an urban HIV clinic in a low income country

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256121
Author(s):  
Ahmed Ddungu ◽  
Fred C. Semitala ◽  
Barbara Castelnuovo ◽  
Christine Sekaggya-Wiltshire ◽  
William Worodria ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Low Income ◽  
Chronic Obstructive ◽  
People Living With Hiv ◽  
Shortness Of Breath ◽  
Obstructive Pulmonary Disease ◽  
Low Income Country ◽  
Wide Availability ◽  
History Of ◽  
Living With Hiv

Introduction In the last decade, survival of people living with HIV (PLHIV) has dramatically increased due wide availability of effective antiretroviral therapy. However, PLHIV remain at a comparatively higher risk of non-communicable comorbidities. We sought to determine the burden of COPD and its associations in an urban tertiary HIV clinic in Uganda. Methods and findings HIV-infected adults attending the Makerere University Joint AIDS program; aged ≥30 years without acute ailments were screened for COPD using study questionnaires and spirometry (post-bronchodilator FEV1/FVC<0.7). We determined its prevalence and association with demographic characteristics, body mass index (BMI) and known risk factors. Of 288 participants enrolled, 177 (61%) were female; 253 (88%) were from urban residences, median age was 45 years (IQR: 39–51), 71(25%) were ‘ever’ smokers, 284(99%) reported biomass fuel use and 72(25%) had a history of tuberculosis. All except 1 participant were on antiretroviral therapy, median current CD4 (cells/mm3) was 558 (IQR 402–753) and 275(96%) were virologically suppressed. Nearly half (130/288, 45%) had recurrent respiratory symptoms. The prevalence of COPD was 3.1% (9/288) [95% CI: 1.63–5.92]. COPD was associated with: previous tuberculosis, (adjusted odds ratio (AOR): 6.36, [95% CI 1.64–35.84], P = 0.036), self-reported chronic shortness of breath (AOR: 9.06, [95% CI 1.34–61.10], P = 0.024) and a BMI <21 Kg/m2 (AOR: 10.42 [95% CI: 1.61–100.00], P = 0.013). Conclusion In this HIV population, COPD prevalence was low and was associated with previous tuberculosis, self-reported chronic shortness of breath and BMI <21 Kg/m2.

scholarly journals A study on the prevalence of chronic obstructive pulmonary disease among adults in Madurai, Tamil Nadu

2017 ◽  
Vol 4 (11) ◽  
pp. 4113
Author(s):  
Mohamed Saleem ◽  
Sivasubramanian Priya ◽  
Manimaran Pradeep ◽  
Kalifulla Sabeetha
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Tamil Nadu ◽  
Population Sample ◽  
Public Health Problem ◽  
Chronic Obstructive ◽  
Cluster Sampling ◽  
Major Public Health Problem ◽  
Obstructive Pulmonary Disease ◽  
Study Population

Background: Chronic obstructive pulmonary disease (COPD) is a major public health problem with increasing prevalence especially in developing countries. Burden of disease estimation is important for decision making, planning, prioritising and allocating funds. It has been found that the recent data on prevalence of COPD is less in south India, especially Tamil Nadu. Hence this study was undertaken in order to estimate the prevalence of COPD in Madurai among adults and its association with socio demographic variables. Methods: This is a community based cross-sectional study done in Kallendiri block of Madurai district with adults aged >30 years of both the sexes as study population. Sample size was 480. Using cluster sampling method, study participants were interviewed with semi-structured questionnaire and peak expiratory flow rate was measured using peak flow meter. Results: Prevalence of COPD was 22.1% among the study population. Males (39.2%) had higher prevalence than females (12.2%). COPD prevalence was significantly higher among increasing age, male sex, illiteracy, low BMI, smokers, inadequate ventilation and those using biomass fuels for cooking. Conclusions: This study has established the fact that COPD is highly prevalent among adults in rural area. For practitioners, the results call for a high index of suspicion of COPD among >30 years with substantial exposure to risk factors. For health policy makers, the results of the current study urge for the development of COPD prevention programs failing which the burden of COPD might result in increased mortality, morbidity and economic burden. 

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