scholarly journals Reasons for Antiretroviral Treatment Change Among Adult HIVAIDS Patients at Nedjo General Hospital, Western Ethiopia

2019 ◽  
Vol 13 (1) ◽  
pp. 65-73
Author(s):  
Ginenus Fekadu ◽  
Lencho Bati ◽  
Habte Gebeyehu
Keyword(s):  
General Hospital ◽  
Antiretroviral Treatment ◽  
Clinical Stage ◽  
Treatment Success ◽  
World Health ◽  
Fixed Dose ◽  
Frequent Change ◽  
New Drug ◽  
Regimen Change ◽  
The Common

Background: Frequent change of Antiretroviral Treatment (ART) regimen is a challenging problem especially in a resource-limited setting like Ethiopia where treatment options are limited. This study was aimed to identify reasons for ART regimen change among adult HIV patients at Nedjo General Hospital (NGH). Methods: An institutional-based retrospective cross-sectional study was conducted at NGH by reviewing patient information cards from 2006 to 2016. Results: From a total of 117 included patients, 50.4% were females and the median (IQR) age of the patients was 28 (24-47) years. Majority of patients, 63 (53.9%) started their treatment at world health organization (WHO) clinical stage III (53.9%) and CD4 count of between 200-350 cells/mm3 (44.54%). At the beginning of ART, 56 (47.9%) patients were on a fixed-dose combination of stavudine-lamivudine-nevirapine (D4T/3TC/NVP). The single-drug substitutions were D4T (n = 63), NVP (n = 34), AZT (n =5), EFV (n = 2), and TDF (n = 1). Majority of the patients, 35(29.9%) switched their initial ART regimen after 3 years of regimen commencement. The common reasons reported for initial regimen change was availability of new drug 46 (39.3%) followed by toxicity/side effects 34 (29.2%). From all toxicities, peripheral neuropathy (47.1%) was the most common toxicity followed by rash (20.6%). After regimen change, 47 (40.2%) were received AZT+3TC+NVP. Conclusion: Availability of new drug and toxicity were the common reasons for regimen modifications. There should be updated guidelines, sustainable supply of affordable ART drugs, and effective laboratory materials to increase treatment success and minimize the toxicity of the drugs.

scholarly journals Impact of adverse events of antiretroviral treatment on regimen change and mortality in Ugandan children

2010 ◽  
Vol 2 (1) ◽  
Author(s):  
Ntambwe Malangu ◽  
Yvonne Karamagi
Keyword(s):  
Adverse Events ◽  
Antiretroviral Treatment ◽  
Causes Of Death ◽  
Clinical Stage ◽  
Retrospective Chart Review ◽  
Severe Anaemia ◽  
Duration Of Treatment ◽  
Regimen Change ◽  
Common Causes ◽  
Collection Form

Background: Outcomes of antiretroviral treatment have been documented in both developed and developing countries. It has been reported consistently that the treatment is associated with many adverse events. However, little is known about their impact on the quality of life, clinical management, and survival in children aged less than 6 years in Uganda.Objectives: The purpose of this study was to determine the prevalence of the adverse events of antiretroviral treatment, their impact on mortality and the change in regimens prescribed to children treated at Mildway Centre in Uganda.Method: A retrospective chart review was performed for children younger than 6 years, treated since the Mildway Centre was opened in 1999. In order to achieve a larger sample, the records of children treated from January 2000 to July 2005 were included in the study. A pre-tested data collection form was used to collate socio-demographic and clinical data of the patients. These included the documented adverse events, causes of death, stage of infection, duration of treatment, regimen prescribed, year of enrolment into the treatment program, as well as whether or not they were still alive. Descriptive statistics were used in the analysis of data.Results: Of the 179 children, the majority were males and had a median age of 4 years. The majority (58.8%) of children had suffered from severe immune depression since they met the WHO clinical stage III and IV, 73.8% had a baseline CD4T of less than 15%. Four regimens were prescribed to the children. The most common was a regimen containing zidovudine, lamivudine, and nevirapine (34.6%), followed by a regimen containing stavudine, lamivudine, and nevirapine (27.9%). Eleven children (6.1%) had their regimen changed, of which six (54.5%) were due to adverse events. The prevalence of adverse events was 8%; of the 14 documented adverse events, the most common were severe anaemia (3), vomiting (3), and skin rashes (3). After 12 months on treatment, 8% of the patients had died. The most common causes of death were infectious diseases (28.6%), severe anaemia (21.4%), and severe dehydration (21.4%).Conclusion: The prevalence of adverse events was 8%; they were responsible for 54.5% of regimen changes and 21.4% of deaths in children treated at the study site. These findings suggest the need for incorporating pharmacovigilance practices into the provision of antiretroviral treatment.

Novelties in evaluation and monitoring of HIV-1 infection: Is standard virological suppression enough for measuring antiretroviral treatment success?

Aids Reviews ◽  
2017 ◽  
Vol 19 (4) ◽  
Author(s):  
Valentina Svicher ◽  
Giulia Marchetti ◽  
Adrianna Ammassari ◽  
Francesca Ceccherini-Silberstein ◽  
Loredana Sarmati ◽  
...  
Keyword(s):  
Antiretroviral Treatment ◽  
Treatment Success ◽  
Virological Suppression ◽  
Evaluation And Monitoring ◽  
Hiv 1

Current updates on COVID-19 - A review

2020 ◽  
Vol 10 (1) ◽  
pp. 1-8
Author(s):  
Ghotekar D S ◽  
Vishal N Kushare ◽  
Sagar V Ghotekar
Keyword(s):  
World Health Organization ◽  
Common Cold ◽  
Respiratory Diseases ◽  
Gastrointestinal Diseases ◽  
Hubei Province ◽  
World Health ◽  
The World ◽  
The Common ◽  
Novel Coronavirus ◽  
Health Organization

Coronaviruses are a family of viruses that cause illness such as respiratory diseases or gastrointestinal diseases. Respiratory diseases can range from the common cold to more severe diseases. A novel coronavirus outbreak was first documented in Wuhan, Hubei Province, China in December 2019. The World Health Organization (WHO) has declared the coronavirus disease 2019 (COVID-19) a pandemic. A global coordinated effort is needed to stop the further spread of the virus. A novel coronavirus (nCoV) is a new strain that has not been identified in humans previously. Once scientists determine exactly what coronavirus it is, they give it a name (as in the case of COVID-19, the virus causing it is SARS-CoV-2).

Myths about COVID-19

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 907-912
Author(s):  
Deepika Masurkar ◽  
Priyanka Jaiswal
Keyword(s):  
World Health ◽  
Indian Society ◽  
Common People ◽  
The World ◽  
New Type ◽  
The Media ◽  
Personal Level ◽  
Novel Virus ◽  
The Common ◽  
Health Organization

Recently at the end of 2019, a new disease was found in Wuhan, China. This disease was diagnosed to be caused by a new type of coronavirus and affected almost the whole world. Chinese researchers named this novel virus as 2019-nCov or Wuhan-coronavirus. However, to avoid misunderstanding the World Health Organization noises it as COVID-19 virus when interacting with the media COVID-19 is new globally as well as in India. This has disturbed peoples mind. There are various rumours about the coronavirus in Indian society which causes panic in peoples mind. It is the need of society to know myths and facts about coronavirus to reduce the panic and take the proper precautionary actions for our safety against the coronavirus. Thus this article aims to bust myths and present the facts to the common people. We need to verify myths spreading through social media and keep our self-ready with facts so that we can protect our self in a better way. People must prevent COVID 19 at a personal level. Appropriate action in individual communities and countries can benefit the entire world.

Use of Phosphatidylcholine in the Treatment of Localized Fat Deposits. Results and expectations

2017 ◽  
Vol 68 (7) ◽  
pp. 1438-1441 ◽  
Author(s):  
Sorin Berbece ◽  
Dan Iliescu ◽  
Valeriu Ardeleanu ◽  
Alexandru Nicolau ◽  
Radu Cristian Jecan
Keyword(s):  
World Health Organisation ◽  
Normal Weight ◽  
World Health ◽  
Basic Substance ◽  
Physical Exercises ◽  
Fat Deposits ◽  
The World ◽  
The Common ◽  
Global Health Problem ◽  
Over Time

Obesity represents a global health problem. According to the latest studies released by the World Health Organisation (WHO), 1.7 billion currently in excess of normal weight individuals, of which approx. 75% are overweight (body mass index - BMI 25 to 30). The common form of excess adipose tissue manifestation in overweight individuals is localized fat deposits with high (abdominal) or low (buttocks and thighs) disposition. Although the overweight can be corrected relatively easy by changing behavioral habits or food, a constant physical exercises program or following a diet food are not accessible to all through the efforts of will, financial and time involved. Several methods have been studied and tested over time to eliminate more or less invasive fat deposits with varying efficacy and adverse effects. Chemical lipolysis using phosphatidylcholine as the basic substance was initially used in hypercholesterolemia and its complications and was rapidly adopted in mesotherapy techniques for the treatment of fat deposits. This study reveals the results obtained using Dermastabilon on a sample of 16 patients, the time allocated to treatment and discomfort being minimal, and rapid and notable results. There were no side effects.

Exploring patient-provider factors for risk of developing Multi-drug Resistance Tuberculosis in Southern Ethiopia: Qualitative Operation Research (Preprint)

2019 ◽  
Author(s):  
Yitagesu Habtu ◽  
Tesema Bereku ◽  
Girma Alemu ◽  
Ermias Abera
Keyword(s):  
Phenomenological Study ◽  
Treatment Success ◽  
World Health ◽  
Multi Drug Resistance ◽  
Southern Ethiopia ◽  
Drug Resistant ◽  
Related Factors ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis

BACKGROUND Ethiopia is one of among thirty high burden countries of multi-drug resistant tuberculosis (MDR-TB) in the regions of world health organization. Contextual evidence on the emergence of the disease is limited at a program level. OBJECTIVE The aim of the study is to explore patient-provider factors that may facilitate the emergence of multi-drug resistant tuberculosis. METHODS We used a phenomenological study design of qualitative approach from June to July, 2015. We conducted ten in-depth interviews and 4 focus group discussions with purposely selected patients and providers. We designed and used an interview guide to collect data. Verbatim transcribes were exported to open code 3.4 for emerging thematic analysis. Domain summaries were used to support core interpretation. RESULTS The study explored patient-provider factors facilitating the emergence of multi-drug resistant tuberculosis. These factors as underlying, health system and patient-related factors. Especially, the a shows conflicting finding between having a history of discontinuing drug-susceptible tuberculosis and emergence of multi-drug resistant tuberculosis. CONCLUSIONS The patient-provider factors may result in poor early case identification, adherence to and treatment success in drug sensitive or multi-drug resistant tuberculosis. Our study implies the need for awareness creation about multi-drug resistant tuberculosis for patients and further familiarization for providers. This study also shows that patients developed multi-drug resistant tuberculosis though they had never discontinued their drug-susceptible tuberculosis treatment. Therefore, further studies may require for this discording finding.

scholarly journals Bedaquiline-containing regimens in patients with pulmonary multidrug-resistant tuberculosis in China: focus on the safety

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Jing-Tao Gao ◽  
Juan Du ◽  
Gui-Hui Wu ◽  
Yi Pei ◽  
Meng-Qiu Gao ◽  
...  
Keyword(s):  
Adverse Events ◽  
Multidrug Resistant ◽  
World Health ◽  
Chinese Patients ◽  
Prolonged Treatment ◽  
Drug Resistant ◽  
Aminosalicylic Acid ◽  
Clinical Patient ◽  
New Drug ◽  
Resistant Tuberculosis

Abstract Background World Health Organization recommends countries introducing new drug and short treatment regimen for drug resistant tuberculosis (DR-TB) should develop and implement a system for active pharmacovigilance that allows for detection, reporting and management of adverse events. The aim of the study is to evaluate the frequency and severity of adverse events (AEs) of bedaquiline-containing regimen in a cohort of Chinese patients with multidrug-resistant (MDR)/extensively drug-resistant (XDR)-TB based on active drug safety monitoring (aDSM) system of New Drug Introduction and Protection Program (NDIP). Methods AEs were prospectively collected with demographic, bacteriological, radiological and clinical data from 54 sites throughout China at patient enrollment and during treatment between February, 2018 and December, 2019. This is an interim analysis including patients who are still on treatment and those that have completed treatment. A descriptive analysis was performed on the patients evaluated in the cohort. Results By December 31, 2019, a total of 1162 patients received bedaquiline-containing anti-TB treatment. Overall, 1563 AEs were reported, 66.9% were classified as minor (Grade 1–2) and 33.1% as serious (Grade 3–5). The median duration of bedaquiline treatment was 167.0 [interquartile range (IQR): 75–169] days. 86 (7.4%) patients received 36-week prolonged treatment with bedaquiline. The incidence of AEs and serious AEs was 47.1% and 7.8%, respectively. The most frequently reported AEs were QT prolongation (24.7%) and hepatotoxicity (16.4%). There were 14 (1.2%) AEs leading to death. Out of patients with available corrected QT interval by Fridericia's formula (QTcF) data, 3.1% (32/1044) experienced a post-baseline QTcF ≥ 500 ms, and 15.7% (132/839) had at least one change of QTcF ≥ 60 ms from baseline. 49 (4.2%) patients had QT prolonged AEs leading to bedaquiline withdrawal. One hundred and ninety patients reported 361 AEs with hepatotoxicity ranking the second with high occurrence. Thirty-four patients reported 43 AEs of hepatic injury referred to bedaquiline, much lower than that referred to protionamide, pyrazinamide and para-aminosalicylic acid individually. Conclusions Bedaquiline was generally well-tolerated with few safety concerns in this clinical patient population without any new safety signal identified. The mortality rate was generally low. These data inform significant positive effect to support the WHO recent recommendations for the wide use of bedaquiline.

scholarly journals Quality of selected anti-retroviral medicines: Tanzania Mainland market as a case study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sophia Mziray ◽  
Betty A. Maganda ◽  
Kissa Mwamwitwa ◽  
Adam M. Fimbo ◽  
Seth Kisenge ◽  
...  
Keyword(s):  
Quality Control ◽  
Screening Test ◽  
Product Information ◽  
Healthcare Delivery ◽  
Antiretroviral Drugs ◽  
World Health ◽  
Fixed Dose ◽  
People Living With Hiv ◽  
Quality Control Testing

Abstract Background Antiretroviral drugs (ARVs) have significantly reduced morbidity, mortality and improved the quality of life of people living with HIV infection. Poor quality ARVs may result in harmful consequences such as adverse drug reactions, treatment failure and development of drug resistant strains and sometimes death, which in turn may undermine the healthcare delivery system. To ensure optimal treatment outcomes, medicines quality control must be undertaken regularly. This study was aimed at evaluating the quality of ARVs circulating on the Tanzania Mainland market. Methods This was a survey study. ARVs samples were collected in 20 regions of Tanzania Mainland, between 2012 and 2018. All sampled ARVs were subjected to screening testing using the Global Pharma Health Fund® Mini-Lab kits. Sampled ARV’s that failed screening test or yielded doubtful results and 10 % (10 %) of all that complied with the screening test requirements were selected for full quality control testing. Quality control testing was conducted at the Tanzania Medicines and Medical Devices Authority (TMDA) laboratory a World Health Organisation prequalified. Samples collected from the medicine distribution outlets were also, subjected to product information review. Results A total of 2,630 samples were collected, of which 83.7 % (2200/2630) were from port of entry (POEs). All sampled ARVs were screened and conformed to the specifications, except of the fixed dose combination (FDC) lopinavir/ritonavir 0.27 % (7/2630) and lamivudine/zidovudine/nevirapine 0.27 % (7/2630) that failed the disintegration test. Out of the 100 samples selected for full quality control testing, 3 % of them failed to comply with the specifications, of which FDC stavudine/lamivudine/nevirapine failed disintegration and assay tests 2 % (2/100) and 1 % (1/100), respectively. Samples failing the assay test had low content of stavudine (86.6 %) versus specification limits (90 -110 %). Out of the 430 samples which were subjected to product information review, 25.6 % (110/430) failed to comply with the TMDA packaging and labelling requirements. Conclusions The quality of majority of ARVs circulating on the Tanzania Mainland market was good, even so, significant deficiencies on labelling and packaging were observed. These results call for continuous monitoring of quality of medicines circulating on the Tanzania Mainland market.

scholarly journals Profile of Osteomyelitis Patients Visiting the Orthopedic Clinic of Dr. Hasan Sadikin General Hospital, Indonesia, in 2017–2018

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Aditya Nugraha ◽  
Hermawan Nagar Rasyid ◽  
Hadyana Sukandar
Keyword(s):  
Staphylococcus Aureus ◽  
General Hospital ◽  
Sampling Method ◽  
Operative Procedure ◽  
Bone Destruction ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Male Patients ◽  
The Common ◽  
Age Range

Background: Osteomyelitis is an inflammatory process caused by microorganism infection that leads to bone destruction. Osteomyelitis may affect all bones, particularly long bones, and infects all ages. This disease is hard to diagnose and the treatment is complex due to the disease’s heterogenicity, pathophysiology, clinical presentation, and management. This study aimed to determine the profile of osteomyelitis inpatients and outpatients presented to the Orthopedic Clinic of Dr. Hasan Sadikin General Hospital Bandung, IndonesiaMethods: This was a descriptive cross-sectional study conducted from July to October 2019 using the total sampling method. Data were collected from the medical records of osteomyelitis inpatients and outpatients presented to the Orthopedic Clinic of Dr. Hasan Sadikin General Hospital Bandung, Indonesia from 2017–2018. Data were then analyzed descriptively and the results were presented in frequencies.Result: In total, 90 data were retrieved. Most of data presented male patients (n= 69, 76.7%) with the age range of 20–29 years old (24.4%). The majority of these patients experienced chronic onset of disease (94.4%) located on the tibia (51.1%), which was caused by a post-operative procedure (61.1%). The most common treatment was operative procedure without antibiotic beads (51.1%). Staphylococcus aureus was the common pathogens identified in these patients (22.2%).Conclusion: The majority of osteomyelitis patients are males in productive age with chronic onset of disease located on the tibia caused by a post-operative procedure. Staphylococcus aureus is the common pathogen involved and the most common treatment is an operative procedure without antibiotic beads.

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