scholarly journals Ophthalmic pathologies in an older HIV-positive Tanzanian population and their association with neurological morbidity and evaluation of a low-resource screening strategy

2021 ◽  
Author(s):  
Grace George ◽  
Declan C Murphy ◽  
HD Jeffry Hogg ◽  
Japhet Bright Boniface ◽  
Sarah Urasa ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Screening Strategy ◽  
Cross Sectional ◽  
Low Resource ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Retinal Screening ◽  
Systematic Sample ◽  
Potential Strategy ◽  
Living With Hiv

Abstract Background Globally, 43 million people are living with HIV, 90% in developing countries. Increasing life expectancy with combination antiretroviral therapy (cART) results in chronic complications, including HIV-associated neurocognitive disorders (HAND) and eye diseases. HAND screening is currently challenging. Objectives To evaluate clinical utility of HIV-retinopathy as a screening measure of HAND in older cART-treated individuals in Tanzania and feasibility of smartphone-based retinal screening in this low-resource setting. Methods A cross-sectional systematic sample aged ≥ 50-years attending routine HIV follow-up in Tanzania were comprehensively assessed for HAND by American Academy of Neurology criteria and received ophthalmic assessment including smartphone-based retinal imaging. HAND and ophthalmic assessments were independent and blinded. Diagnostic accuracy was evaluated by AUROC curves. Results Of 129 individuals assessed, 69.8% were visually impairment. Six had suspected HIV retinopathy. HAND prevalence was 66.7%. HIV retinopathy was significantly associated with HAND but HIV-disease factors (CD4, viral load) were not. Diagnostic accuracy of HIV-retinopathy for HAND was poor (AUROC 0.545–0.617) but specificity and positive predictive value were high. Conclusions Ocular pathology and HAND appear highly prevalent in this low-resource setting. Although retinal screening cannot be used alone identify HAND, prioritization of individuals with abnormal retinal screening is a potential strategy in low-resource settings.

scholarly journals Prevalence and risk factors for obesity among elderly patients living with HIV/AIDS in a low-resource setting

Medicine ◽  
2021 ◽  
Vol 100 (15) ◽  
pp. e25399
Author(s):  
Patrick Dakum ◽  
Yohanna Kambai Avong ◽  
James Okuma ◽  
Temilade Sorungbe ◽  
Bolajoko Jatau ◽  
...  
Keyword(s):  
Risk Factors ◽  
Elderly Patients ◽  
Low Resource ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Living With Hiv ◽  
Hiv Aids

scholarly journals Home Recording And Video Selection: Their use In A Low-Resource Setting For Epilepsy Diagnosis

2021 ◽  
pp. 77-86
Author(s):  
Joseph. O. Yaria ◽  
Adesola Ogunniyi
Keyword(s):  
Video Recording ◽  
Clinical History ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Low Resource ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Epilepsy Diagnosis ◽  
Home Recording ◽  
Seizure Classification

Objective: In management of epilepsy, identification of an epileptic seizure, classification, epilepsy syndromes, and management decisions relies heavily on seizure semiology. However, since most seizures are not witnessed, obtained semiology has its limitations. This study aimed to determine how many patients could successfully submit a home recording of a seizure event and if adapted video compilations would improve epilepsy diagnosis and classification in a low resource setting. Methods: A prospective cross-sectional study carried out at a neurology clinic in a teaching hospital in a low-resource setting. Sixty-seven randomly selected patients with recurrent unprovoked seizures and an informant who had regular observed the seizures and had access to video recording facilities were enrolled. Participants were required to fill an interviewer-administered questionnaire, select from a pre-designed video compilation what best described seizure witnessed, then encouraged on acquisition of video recordings at home. In the absence of video electroencephalography, information obtained was compared with a pre-defined algorithm which combined clinical history, physical examination, EEG results and neuro-images. Accuracy and reliability was calculated for different semiological signs and seizure classification. Results: Sixty seven patients were recruited comprising of 30 females and 37 male patients. Only eight (12%) participants returned with an adequate home recording of seizure episode. Incorporating video selection with questionnaire obtained description improved accuracy for generalized seizure (0.85 vs 0.79) and focal onset seizure (0.84 vs 0.73). Test-retest reliability on video selections by informants showed kappa coefficients ranging from 0.88 – 1.000.  Significance: Home video recording may not be as practical in our environment depending on the setting as adjustments may be required to make it routine. However, selecting videos from pre-selected video compilation may be a viable alternative to improve accuracy.

Does Liquid-Based Technology Improve Detection of Cervical Epithelial Abnormalities and Worth in Low Resource Setting?

2021 ◽  
Vol 3 (5) ◽  
pp. 01-06
Author(s):  
Sushna Maharjan ◽  
Mamata Tiwari
Keyword(s):  
Pap Smear ◽  
Cervical Dysplasia ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Low Resource ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Significant Difference

Introduction: Cervical cancer is the most frequent cancer among Nepalese women. Aims: This study was undertaken to assess the strength of liquid-based cytology (LBC) and conventional Pap smear (CPS) in detecting cervical dysplasia/cancer, and assess feasibility of LBC in our setting. Methods: It was a cross-sectional study. Samples were collected from 312 patients for CPS and LBC by split sampling technique. Smears were interpreted according to the Bethesda System. The results between two methods were compared and analyzed statistically by applying Chi-square and t-tests. Results: There was no significant difference in adequacy rates, representativeness, detection of organisms and epithelial abnormalities between two methods. Neutrophils, haemorrhage, mucus and debris were more in CPS than LBC (P value <0.05). Conclusion: We didn’t find significant difference between two methods in detecting cervical epithelial abnormalities. The high cost of LBC makes CPS still a better option in the countries with low resource setting.

scholarly journals Factors associated with maternal mortality from sepsis in a low-resource setting: a five-year review at Mpilo Central Hospital, Bulawayo, Zimbabwe

2019 ◽  
Vol 50 (1) ◽  
pp. 12-15
Author(s):  
Solwayo Ngwenya
Keyword(s):  
Maternal Mortality ◽  
Reproductive Age ◽  
Central Hospital ◽  
Cross Sectional ◽  
Maternal Deaths ◽  
Factors Associated ◽  
Low Resource ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Mpilo Central Hospital

Sepsis remains a major cause of maternal deaths globally. It is one of the major causes of maternal morbidity and mortality in women of reproductive age. It is important that such a major contributor is studied in low-resource settings. The aims of this study were to document the percentage of maternal deaths from sepsis among the total number of maternal deaths in a low-resource setting and to determine factors associated with maternal mortality from sepsis at Mpilo Central Hospital. This was a retrospective, descriptive, cross-sectional study carried out at Mpilo Central Hospital. Nearly one-third (29.3%) of maternal deaths were due to sepsis. The major factor associated with maternal mortality was post-abortal sepsis (41.7%).

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