scholarly journals Clinical Characteristics of Children with HIV Initiated on Antiretroviral Treatment at HIV Clinics in Bloemfontein, South Africa

2021 ◽  
Vol 10 (1) ◽  
pp. 146-155
Author(s):  
Andrew Walubo ◽  
Refuoe Baleni ◽  
Hillary Mukudu ◽  
Henry Kambafwile ◽  
Mukesh Dhedha ◽  
...  
Keyword(s):  
South Africa ◽  
Global Health ◽  
Clinical Characteristics ◽  
Treatment Guidelines ◽  
Age Groups ◽  
World Health ◽  
Severe Illness ◽  
Age Group ◽  
National Guidelines ◽  
Number Of Children

Background and Objective: Over the past 15 years, there have been three major updates to the South African national guidelines for the management of human immunodeficiency virus (HIV) in children. The purpose of this study is to describe the clinical characteristics of children who were initiated on antiretroviral therapy (ART) in Bloemfontein, South Africa, following these national treatment guidelines. Methods: Clinical information during initiation of ART in children aged 0-13 years was obtained from five HIV clinics in Bloemfontein from 2004 to 2019 as part of the establishment of an antiretroviral (ARV) pediatric registry at the University of the Free State. Data were analyzed for patient demographics, clinical presentation (World Health Organization (WHO) HIV-staging, growth rate and comorbid conditions), types of investigations done, and medicines prescribed. Results: The number of children initiated on ART increased from 168 in the period 2004-2009 to 349 (107.8%) in 2010-2014, and then dropped to 162 in the period 2015-2019. The increase in 2010-2014 was mainly in the <2 years age group by 54.8%, and in the 5 to 10 years age group by 344.4%. In the same period, the number of children with severe illness (WHO HIV-stage 4) decreased by 20.7%, while those with mild to moderate illness (WHO HIV-stage 2 and 3) increased by 17.3%. HIV infection was more severe in children under two years as more patients in this age group presented with WHO HIV-stages 3 and 4, severe underweight (below 3rd percentile), severely suppressed CD4 count (< 25%), and a high viral load (> 1000 copies/ml). There was increased use of ABC/3TC/LPVr in the < 3-year age group and ABC/3TC/EFV in the > 3-year age group. There was reduced use of the stavudine and other regimens. Conclusion and Global Health Implications: More children were started on ART and safer ARV drugs. Children under 2 years were the most debilitated by HIV, and there was an increase in HIV prevalence among children > 5 years. New strategies for the prevention and management of HIV among children in these two age groups are needed.   Copyright © 2021 Walubo et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.

scholarly journals Dental caries prevalence among 12–15-year-olds in Lithuania between 1983 and 2005

Medicina ◽  
2009 ◽  
Vol 45 (1) ◽  
pp. 68 ◽  
Author(s):  
Simona Milčiuvienė ◽  
Eglė Bendoraitienė ◽  
Vilija Andruškevičienė ◽  
Julija Narbutaitė ◽  
Jurgina Sakalauskienė ◽  
...  
Keyword(s):  
Dental Caries ◽  
Oral Hygiene ◽  
Age Groups ◽  
Fluoride Concentration ◽  
World Health ◽  
Age Group ◽  
Caries Prevalence ◽  
Number Of Children ◽  
T Score ◽  
Health Organization

Objective. To analyze the dynamics of prevalence and severity of dental caries among 12- and 15-year-old schoolchildren in six regions of Lithuania. Material and methods. A total of 5910 schoolchildren aged 12 and 15 years were examined. Dental caries was diagnosed according to the criteria of World Health Organization. The prevalence of dental caries was calculated by dividing the number of children with caries by the number of all children examined and expressed as percentage. Severity of dental caries was described by DMF-T index. DMF-T indices of individual persons as well as each age group were determined. Oral hygiene was evaluated by a simplified oral hygiene index. Fluoride concentration in Kretinga was 1.6–2.2 ppm; in the other regions, it varied between 0.2 to 0.4 ppm. Results. The prevalence of dental caries among 12-year-olds was 88.4% in 1983 and 85.5% in 2005; among 15-year-olds, it was 95.5% and 92.9%, respectively. Mean DMF-T score decreased from 4.5 (in 1983) to 3.7 (in 2005) among 12-year-olds and from 6.4 (in 1983) to 5.6 (in 2005) among 15-year-olds. Oral hygiene index decreased from 1.69 in 1983 to 1.34 in 2005 among 12-year-olds and from 1.46 to 1.22 among 15-year-olds, respectively. Conclusions. A tendency towards decrease in the prevalence and severity of dental caries was observed, when caries prevention program was running. Correlation between oral hygiene and DMF-T was observed in both age groups. Decreased prevalence and intensity of dental caries among 12- and 15-year-olds were associated with improved oral hygiene, usage of fluoride toothpaste, and fluoride content in drinking water.

scholarly journals Factors facilitating trained NIMART nurses’ adherence to treatment guidelines: A vital matter in the management of TB/HIV treatment in South Africa

2020 ◽  
Author(s):  
LUFUNO MAKHADO ◽  
Mashudu Davhana-Maselesele ◽  
Rachel Tsakani Lebese ◽  
Sonto Maria Maputle
Keyword(s):  
South Africa ◽  
Treatment Guidelines ◽  
Behavioural Change ◽  
Hiv Treatment ◽  
World Health ◽  
Adherence To Treatment ◽  
African Region ◽  
Continuous Training ◽  
North West ◽  
Training Support

Abstract Background: Globally, the burden of tuberculosis or human immunodeficiency virus (TB/HIV) is at 24% and this alarming rate compelled the World Health Organization (WHO) to declare the African region as a critical workforce shortage area. To facilitate adherence to treatment guidelines, WHO recommended a strategy of task shifting for countries with high health workforce shortages. The strategy aimed at the redistribution of health care tasks to available workers. The study aimed to determine the factors facilitating nurse-initiated management of antiretroviral therapy (NIMART) trained nurses’ adherence to TB/HIV treatment guidelines. Methods: The study employed an exploratory-descriptive design. The study was conducted in Ugu and Ngaka Modiri Molema Districts of KwaZulu-Natal (KZN) and North West (NW) Provinces of South Africa. The population comprised of 24 participants who were purposively selected. The in-depth focus group discussions were conducted and ATLAS T.I. was used for data analysis following the basic steps of notice-collect-think (NCT) analysis. Trustworthiness and adherence to ethics were ensured. Results: The singular theme of factors facilitating NIMART trained nurses’ adherence to treatment guidelines which included positive attitudinal needs and positive behavioural change emerged from raw data. Conclusion: Continuous training, support supervision, and improved relationships with colleagues need to be enhanced to enable NIMART trained nurses to adhere to treatment guidelines.

scholarly journals 1101. Comparison of Clinical Characteristics and Demographics of GII.4 vs. Other GII Noroviruses Associated With Sporadic Acute Gastroenteritis in Children in Nashville, TN, 2012–2015

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S330-S330
Author(s):  
Einas Batarseh ◽  
Lubna Hamdan ◽  
Bhinnata Piya ◽  
Laura Stewart ◽  
James D Chappell ◽  
...  
Keyword(s):  
Acute Gastroenteritis ◽  
Clinical Characteristics ◽  
Age Groups ◽  
Severe Illness ◽  
Genotype Distribution ◽  
Research Support ◽  
Inpatient Settings ◽  
Prevalent Strain ◽  
Stool Specimens ◽  
Sporadic Acute Gastroenteritis

Abstract Background Norovirus is a leading cause of acute gastroenteritis (AGE) in all age groups. Although at least 28 different genotypes infecting humans have been reported, most outbreaks over the last 15 years have been caused by genogroup II (GII) viruses, of which GII.4 viruses have caused more than 50%. Since clinical differences between different genotypes are poorly understood, we sought to compare clinical characteristics in children infected with GII.4 and non-GII.4 viruses. Methods Children between 15 days and 17 years who presented with AGE defined as diarrhea (≥3 loose stools in a 24 hour period) or vomiting (≥1 episodes in a 24 hour period) within 10 days duration were recruited in outpatient, emergency, and inpatient settings in Nashville, TN, during 2012–2015. Stool specimens were tested by RT-qPCR for GI and GII norovirus. Norovirus-positive specimens were genotyped by sequencing of a partial region of the capsid gene. In this study, we excluded children infected with GI, mixed GI/GII and non-typeable GII viruses. Results Of 3,705 AGE subjects enrolled, 2,892 (78%) specimens were collected, 637 (22%) tested norovirus-positive (567 [89%] GII, 62 [10%] GI, and 8 [1%] mixed GI/GII). Of the 567 GII viruses, 461 (81%) were able to be genotyped and of those 238/461 (51.6%) were typed as GII.4 and 223/461 (48.3%) were typed as other GII genotypes (non-GII.4, primarily GII.3 [65/ 461, 14.1%], GII.6 [48/461, 10.4%] and GII.7 [36/461, 7.8%]). Over three AGE seasons, GII.4 represented 64/117 (54%), 79/178 (44%), and 71/166 (57%), of the GII infections, respectively. Compared with non-GII.4 subjects, GII.4 subjects were more likely to be younger (15.5 vs. 21.3 months, P &lt; 0.01), and less likely to attend daycare (23% vs. 39%, P &lt; 0.01). GII.4 subjects also were more likely to present with diarrhea (75% vs. 57%, P &lt; 0.01) and had higher median modified Vesikari score (7 vs. 6, P &lt; 0.01). Conclusion Children infected with GII.4 viruses were younger, less likely to attend child care, more likely to present with diarrhea, and had a more severe illness compared with those with non-GII.4 infections. These data provide important information on the genotype distribution of norovirus in children with AGE in Tennessee and highlight GII.4 as the most prevalent strain. Disclosures N. Halasa, sanofi pasteur: Investigator, Research support. GSK: Consultant, Consulting fee. Moderna: Consultant, Consulting fee.

scholarly journals Consumer Perceptions and Acceptability of Traditional Dishes Prepared with Provitamin A-Biofortified Maize and Sweet Potato

Nutrients ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 1577
Author(s):  
Laurencia Govender ◽  
Kirthee Pillay ◽  
Muthulisi Siwela ◽  
Albert Thembinkosi Modi ◽  
Tafadzwanashe Mabhaudhi
Keyword(s):  
South Africa ◽  
Rural Communities ◽  
Sweet Potato ◽  
Vitamin A Deficiency ◽  
Age Groups ◽  
Food Samples ◽  
Consumer Perceptions ◽  
Provitamin A ◽  
Consumer Acceptability ◽  
Age Group

Vitamin A deficiency (VAD) is prevalent in South Africa, particularly among predominantly poor rural communities. Provitamin A (PVA)-biofortified crops could be used to address VAD; however, there are challenges of poor consumer acceptability. This study investigated the effect of replacing white maize and cream-fleshed sweet potato (CFSP) with PVA-biofortified maize and orange-fleshed sweet potato (OFSP), respectively, on consumer acceptability and perceptions of traditional dishes of rural communities in South Africa. Consumer acceptability of PVA-biofortified phutu (a crumbly maize porridge) served with either curried cabbage, chicken or bambara groundnut, separately, and boiled OFSP was evaluated by black South African adults (n = 120) using a five-point facial hedonic scale. Focus group discussions (FGDs) were conducted with 56 subjects recruited from the consumer panel to assess consumer perceptions of the food samples. The majority of the participants rated the composite dishes containing PVA-biofortified phutu as “4 = good” and the acceptability of the composite dishes varied significantly (p < 0.05). Compared to other age groups, the 50–59-year age group showed higher preference for white phutu and chicken curry, whereas the 30–39-year age group showed higher preference for PVA-biofortified phutu and chicken curry. The acceptability of OFSP and CFSP was similar. The study participants showed positive perceptions of the OFSP, as well as PVA-biofortified phutu if served with either curried chicken or cabbage. The findings suggest that PVA-biofortified maize and OFSP can replace white maize and CFSP, respectively, in selected traditional dishes of the rural communities studied to alleviate VAD.

scholarly journals Major depressive disorder in different age groups and quality of life

2017 ◽  
Vol 28 (2) ◽  
pp. 58-61 ◽  
Author(s):  
Umme Salma Talukder ◽  
MM Jalal Uddin ◽  
Niaz Mohammad Khan ◽  
Md Mostarshid Billah ◽  
Tufayel Ahmed Chowdhury ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Age Groups ◽  
World Health ◽  
Age Group ◽  
Major Depressive ◽  
World Health Organization Quality ◽  
Quality Of Life Scale

Major Depressive Disorder (MDD) is a significant public health problem due to its impact on the quality of life. The aim of the study was to determine the presentation of depression in different age group and quality of life among the respondents. This was a descriptive cross sectional study conducted from May, 2012 to February, 2013 among 65 patients aged 18 to 65 years with major depressive disorder in both outpatient and inpatient departments of National Institute of Mental Health (NIMH), Dhaka by using convenient sampling technique. Diagnostic and Statistical Manual of Mental Disorders- Text version (DSM-IV-TR), Beck Depression Inventory and World Health Organization Quality of Life Scale, Brief version (WHOQOL-BREF) were used to diagnose depressive disorder, to measure severity of depressive illness and Quality of Life (QOL) respectively. Level of depression was compared with the QOL. Quality of life deteriorated in patients with depression. Presence and level of depression was compared in different age groups of depressed patients. The results showed that most of the depressed people (17) were found in the age group of 21-25 years and most of the patients were severely depressed which was thirty nine (39). The study revealed that young people were mostly depressed and their quality of life was decreasing. lt needs further study to explore more information about pattern of presentation of depression and its effect on the quality of life.Bang J Psychiatry Dec 2014; 28(2): 58-61

scholarly journals High Incidence of Severe Influenza among Individuals over 50 Years of Age

2011 ◽  
Vol 18 (11) ◽  
pp. 1918-1924 ◽  
Author(s):  
Anna J. X. Zhang ◽  
Kelvin K. W. To ◽  
Herman Tse ◽  
Kwok-Hung Chan ◽  
Kun-Yuan Guo ◽  
...  
Keyword(s):  
Influenza Vaccination ◽  
Incidence Rate ◽  
Old Age ◽  
H1n1 Virus ◽  
Severe Disease ◽  
Age Groups ◽  
Respiratory Viruses ◽  
World Health ◽  
Pandemic H1n1 ◽  
Age Group

ABSTRACTAge-specific epidemiological data on asymptomatic, symptomatic, and severe infections are essential for public health policies on combating influenza. In this study, we incorporated data on microbiologically confirmed infections and seroprevalence to comprehensively describe the epidemiology of pandemic H1N1 2009 influenza. Seroprevalence was determined from 1,795 random serum samples collected in our hospital in January 2007 (before the first wave of the pandemic) and March 2010 (after the second wave). Data on microbiologically confirmed infection and severe cases were obtained from the Centre for Health Protection in Hong Kong. Severe cases were most common in the 51- to 60-year-old age group. The microbiologically confirmed incidence rate was highest for children aged ≤10 years and dropped sharply for the adult population (ρ = −1.0;P< 0.01), but the incidence rate for severe disease was highest for the 51- to 60-year-old age group. For the 51- to 60-year-old age group, the seroprevalence was similar to that for the younger age groups, but the proportion of severe cases relative to seroprevalence was significantly higher than that for 11- to 50-year-old age groups. As judged from the percentage of specimens positive for other respiratory viruses compared with that for pandemic H1N1 virus, the impact of symptomatic disease due to pandemic H1N1 virus was higher than that for other respiratory viruses in people aged ≤50 years. In conclusion, the 51- to 60-year-old age group, which had the highest overall incidence and the highest rate of severe disease but is currently not considered by the World Health Organization to be an at-risk group, should be prioritized for influenza vaccination in areas where universal influenza vaccination is not practiced.

scholarly journals A comparative study of the clinical characteristics and outcomes of HR-positive HER2-negative breast cancer patients over and under 65 years old

2021 ◽  
Vol 17 (1) ◽  
pp. 1-7
Author(s):  
Chang Shin Jung ◽  
Youn Joo Jung ◽  
Dong Il Kim ◽  
Seungju Lee ◽  
Seok Kyung Kang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Clinical Characteristics ◽  
Age Groups ◽  
Older Age ◽  
Age Group ◽  
Breast Cancer Patients ◽  
Her2 Breast Cancer ◽  
Surgical Methods ◽  
Two Age Groups

Purpose: The purpose of this study was to compare the clinical characteristics and outcomes of hormone receptor-positive (HR+) human epidermal growth factor 2-negative (HER2–) breast cancer among elderly patients (over 65 years old) and younger patients.Methods: This was a retrospective cohort study of 328 patients who were treated for breast cancer at Pusan National University Yangsan Hospital between January 2009 and December 2014. Tumor characteristics, surgical methods, and survival outcomes were compared between the two age groups (<65 and ≥65 years old). Kaplan-Meier curves for disease-free survival (DFS) and overall survival (OS) were also constructed according to the age groups.Results: Among the 328 patients with HR+ HER2– breast cancer, 184 (56.1%) were <65 years old and 144 (43.9%) were ≥65 years old. Breast cancer stages were similar between the two age groups, but the older patients were treated less often with chemotherapy (81% vs. 66%, P=0.002). During the follow-up period, 17 deaths and 36 cases of recurrence or metastasis were reported. There was no difference in DFS between the two groups (P=0.840); however, the OS of the older age group was significantly lower than that of the younger age group (P=0.015).Conclusion: This study suggested that HR+ HER2– breast cancer patients belonging to the two age groups had no significant difference in DFS. However, older age is an independent factor affecting OS rate. Therefore, even if patients are old, but their physical condition is satisfactory, standard and active treatment may be necessary, similar to that given to younger patients.

scholarly journals Factors facilitating trained NIMART nurses’ adherence to treatment guidelines: A vital matter in the management of TB/HIV treatment in South Africa

2020 ◽  
Author(s):  
LUFUNO MAKHADO ◽  
Mashudu Davhana-Maselesele ◽  
Rachel Tsakani Lebese ◽  
Sonto Maria Maputle
Keyword(s):  
South Africa ◽  
Health Workforce ◽  
Treatment Guidelines ◽  
Behavioural Change ◽  
Treatment Guideline ◽  
Hiv Treatment ◽  
World Health ◽  
Adherence To Treatment ◽  
Continuous Training ◽  
Training Support

Abstract Background: Globally the burden of tuberculosis or human immunodeficiency virus (TB/HIV) is at 24% with 3% global health workforce and this an alarming rate that World Health Organization (WHO) declared African region as a critical workforce shortage area. To facilitate adherence to treatment guidelines, WHO recommended a strategy of task shifting for these countries with high health workforce shortages. The strategy aimed at the redistribution of health care tasks to available workers. The purpose of the study was to determine factors facilitating trained nurse-initiated management of antiretroviral therapy (NIMART) nurses’ adherence to TB/HIV treatment guidelines in KwaZulu-Natal (KZN) and North West (NW) Provinces of South Africa.Design: The study was qualitative, explorative and descriptive in nature. The population comprised of 24 participants who were purposively selected. The in-depth focus group discussion was conducted. Data analysis was through the used of ATLAS T.I. software program (version 7.0) and followed the basic steps of notice-collect-think (NCT) analysis. Trustworthiness and ethical consideration were ensured.Results: The following one theme namely; marked identified needs to be met to promote adherence to treatment guidelines and sub-themes emerged from raw data: Expected positive attitudinal needs outlined and an outline of a positive behavioural change. Conclusion: Factors such as continuous training, support supervision and improved relationships with colleagues need to be enhanced to enable NIMART nurses to adhere to treatment guideline.

scholarly journals Factors facilitating trained NIMART nurses’ adherence to treatment guidelines: A vital matter in the management of TB/HIV treatment in South Africa

2020 ◽  
Author(s):  
LUFUNO MAKHADO ◽  
Mashudu Davhana-Maselesele ◽  
Rachel Tsakani Lebese ◽  
Sonto Maria Maputle
Keyword(s):  
South Africa ◽  
Treatment Guidelines ◽  
Behavioural Change ◽  
Hiv Treatment ◽  
World Health ◽  
Adherence To Treatment ◽  
African Region ◽  
Continuous Training ◽  
North West ◽  
Training Support

Abstract Background: Globally, the burden of tuberculosis or human immunodeficiency virus (TB/HIV) is at 24% and this alarming rate compelled the World Health Organization (WHO) to declare the African region as a critical workforce shortage area. To facilitate adherence to treatment guidelines, WHO recommended a strategy of task shifting for countries with high health workforce shortages. The strategy aimed at the redistribution of health care tasks to available workers. The purpose of this study was to determine factors facilitating trained nurse-initiated management of antiretroviral therapy (NIMART) adherence to TB/HIV treatment guidelines in KwaZulu-Natal (KZN) and North West (NW) Provinces of South Africa.Design: The study was qualitative, exploratory-descriptive in nature. The population comprised of 24 participants who were purposively selected. The in-depth focus group discussions were conducted and data analysis was through ATLAS T.I. software program (version 7.0). This followed the basic steps of notice-collect-think (NCT) analysis. Trustworthiness and adherence to ethics were ensured.Results: The singular theme of factors facilitating trained NIMART nurses’ adherence to treatment guidelines which included positive attitudinal needs and positive behavioural change emerged from raw data. Conclusion: Continuous training, support supervision and improved relationships with colleagues need to be enhanced to enable NIMART nurses to adhere to treatment guidelines.

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