scholarly journals Incremental detection of pulmonary tuberculosis among presumptive patients by GeneXpert MTB/RIF® over fluorescent microscopy in Mwanza, Tanzania: an operational study

2015 ◽  
Vol 3 (1) ◽  
Author(s):  
Jeremiah Seni ◽  
Benson R. Kidenya ◽  
Mercy Anga ◽  
Anthony Kapesa ◽  
John R. Meda ◽  
...  

Laboratory confirmation among presumptive tuberculosis (PTB) patients is pivotal in ensuring prompt management. Limited information exists in Tanzania regarding the performance of GeneXpert MTB/RIF® in comparison with conventional methods. An operational study was conducted involving 806 PTB patients at Sekou Toure Hospital in Mwanza, Tanzania from June to November 2013. Patients’ information was obtained and their respective sputum samples analyzed by lightemitting diode fluorescent microscopy (LED FM) and GeneXpert MTB/RIF®. The mean age of study participants was 39.6±16.0 years, with males accounting for 50.5%. The majority of patients (97.5%) were new cases. The proportions of PTB patients confirmed by LED FM and GeneXpert MTB/RIF® were 14.1% (114/806) and 23.7% (191/806) respectively, resulting into a 9.6% incremental detection rate by GeneXpert MTB/RIF® over LED FM. The detection rate among HIV positive individuals was also higher [23.6% (63/267) <em>vs</em> 14.2% (38/267), respectively], with an incremental detection of 9.4%. The incremental detection of PTB by GeneXpert MTB/RIF® over LED FM calls for expansion of its use to increase detection of smear negative PTB among people living with HIV.

Cannabis ◽  
2021 ◽  
Vol 4 (1) ◽  
pp. 40-52
Author(s):  
Ruba Sajdeya ◽  
Verlin Joseph ◽  
Nichole Setten ◽  
Gladys Ibañez ◽  
Yan Wang ◽  
...  

Therapeutic and recreational marijuana use are common among people living with HIV (PLWH). However, the distinction between perceived "therapeutic" and "recreational" use is blurred, with little information about the specific reasons for use and perceived marijuana effectiveness in adults with chronic conditions. We aimed to compare reasons for use and reason-specific perceived marijuana effectiveness between therapeutic and recreational users among PLWH. In 2018-2019, 213 PLWH currently using marijuana (mean age 48 years, 59% male, 69% African American) completed a questionnaire assessing their specific reasons for using marijuana, including the "main reason." Participants were categorized into one of three motivation groups: therapeutic, recreational, or both equally. For each specific reason, participants rated marijuana effectiveness as 0-10, with 10 being the most effective. The mean effectiveness scores were compared across the three motivation groups via ANOVA, with p <0.05 considered statistically significant. The most frequent main reasons for marijuana use in the therapeutic (n=63, 37%), recreational (n=48, 28%), and both equally (n=59, 35%) categories were "Pain" (21%), "To get high" (32%), and "To relax" (20%), respectively. Compared to recreational users, therapeutic and both equally users provided significantly higher mean effectiveness scores for "Pain," and "To reduce anger." The "Both equally" group also provided significantly higher mean effectiveness scores for "To feel better in general," "To get high," and "To relax" compared to the other two categories. There is a significant overlap in self-reported reasons for marijuana use in primarily therapeutic or recreational users. Perceived marijuana effectiveness was lowest among recreational users.


2019 ◽  
Vol 34 (2) ◽  
pp. 123-133
Author(s):  
Hamid Emadi-Koochak ◽  
Zeinab Siami ◽  
Jayran zebardast ◽  
SeyedAhmad SeyedAlinaghi ◽  
Ali Asadollahi-Amin

Purpose During the ART era, persistent immune activation remains a significant challenge in people living with HIV (PLWH). Microbial translocation play an essential role in this setting. Probiotics have several immunological benefits which can reverse this process. The purpose of this paper is to investigate the safety and efficacy of probiotics on CD4 counts among Iranian PLWH. Design/methodology/approach In total, 50 PLWH with CD4 counts above 350 cells/mm3 did not receive ART participated in a randomized, double-blind trial and underwent 24 weeks of treatment with either LactoCare® or placebo twice daily. CD4 counts of the patients were measured at baseline, 12 weeks and 24 later in the two groups. Side effects were measured monthly using a specific checklist. Findings The mean CD4 count of the patients showed a significant difference between the two groups after six months. Through six months follow up, the mean CD4 count of the patients showed a significant reduction as compared to the baseline in the placebo group; however, it did not show a significant difference in the probiotic group. Repeated Measures Anova test showed a significant effect for time × treatment interaction on the CD4 count during the trial course. No significant difference between the two groups concerning adverse events was reported. Originality/value It seems the use of probiotics in PLWH with a CD4 count above 350 cells/mm3 who are not receiving antiretroviral drugs is safe and can reduce the devastating process of CD4+ T cells in these patients.


Author(s):  
Noreen Dadirai Mdege ◽  
Fredrick Edward Makumbi ◽  
Ronald Ssenyonga ◽  
Frances Thirlway ◽  
Joseph Matovu ◽  
...  

Abstract Introduction This study aimed to assess smoking patterns, behaviours and associated factors among people living with HIV (PLWH) in Uganda. Methods A cross-sectional survey was conducted among adults in HIV care in Uganda. Descriptive statistics were used to describe smoking patterns and behaviours. Logistic regression was used to identify factors associated with current smoking status. Results We recruited 777 participants between October and November 2019: 387 (49.8%) current smokers and 390 (50.2%) non-smokers. 60.9% were males, and the mean age was 40.5 (SD 10.7) years. In multivariate logistic regression, the following increased the odds of being a current smoker: being male (OR 6.60 (95%CI= 4.34 to 10.04)), having at least two smokers among five closest friends (OR 3.97 (95%CI= 2.08 to 7.59)), living in smoking-permitted households (OR 5.83 (95%CI= 3.32 to 10.23)), alcohol use (OR 3.96 (95%CI= 2.34 to 6.71)), a higher perceived stress score (OR 2.23 (95%CI= 1.50 to 3.34)), and higher health-related quality of life (OR 5.25 (95%CI= 1.18 to 23.35)). Among smokers, the mean Fagerstrom Test for Nicotine Dependence score was 3.0 (SD 1.9), and 52.5% were making plans to quit. Self-efficacy to resist smoking and knowledge of the impact of smoking on PLWH’s health were low. Conclusions Being male, having at least two smokers among five closest friends, living in smoking-permitted households, alcohol use, higher perceived stress scores and higher health-related quality of life were associated with being a current smoker. Smokers had low to moderate nicotine dependence, high willingness to quit, and low self-efficacy. Implications Future behavioural smoking cessation interventions for PLWH should address co-consumption with alcohol and comorbid mental health conditions that are common among PLWH such as stress. In addition, they should take into account the lack of knowledge among this population of the impact of smoking on their health, and low self-efficacy. Given the relatively low levels of nicotine dependency and high levels of willingness to quit in our sample, smoking cessation interventions, if offered, are likely to support this population in achieving long-term smoking abstinence.


2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S478-S478
Author(s):  
Ping Du ◽  
John Zurlo ◽  
Tarek Eshak ◽  
Tonya Crook ◽  
Cynthia Whitener

Abstract Background Young people living with HIV (YPLWH) have lower rates of retention in care and HIV viral suppression. Multiple barriers exist to engage YPLWH in care. As nearly all YPLWH use their mobile phones to access health information and to communicate with other people, we implemented a mobile technology-based intervention with the goal to improve HIV care continuum in YPLWH. Methods YPLWH were eligible for this study if they were: (1) aged 18–34 years; (2) newly diagnosed with HIV; (3) having a history of being out of care; or (4) not virally suppressed. We recruited YPLWH during January 2017-May 2018 and followed them every 6 months. We developed a HIPAA-compliant mobile application, “OPT-In For Life,” and let participants use this app to manage their HIV care. The app integrated multiple features that enabled users to communicate with the HIV treatment team via a secure messaging function, to access laboratory results and HIV prevention resources, and to set up appointment or medication reminders. We obtained participants’ demographics, app-usage data, and medical records to evaluate if this mobile technology-based intervention would improve HIV care continuum among YPLWH. We used a quasi-experiment study design to compare the rates of retention in care and HIV viral suppression every 6 months between study participants and YPLWH who were eligible but not enrolled in the study. Results 92 YPLWH participated in this study (70% male, 56% Hispanics or Blacks, 54% retained in care, and 66% virally suppressed at baseline). On average study participants used the app 1–2 times/week to discuss various health issues and supportive services with HIV providers, to access HIV-related health information, and to manage their HIV care. At the 6-month evaluation, compared with 88 eligible YPLWH who were not enrolled in this intervention, study participants had increased rates of retention in care (baseline-to-6-month between participants and nonparticipants: 54%–84% vs. 26%–25%) and HIV viral suppression (66%–80% vs. 56%–60%). Conclusion Our study demonstrates using a HIPAA-compliant mobile app as an effective intervention to engage YPLWH in care. This intervention can be adapted by other HIV programs to improve HIV care continuum for YPLWH or broader HIV populations. Disclosures All authors: No reported disclosures.


2001 ◽  
Vol 12 (10) ◽  
pp. 670-676 ◽  
Author(s):  
Jeffrey Grierson ◽  
Richard de Visser ◽  
Michael Bartos

The aim of this study was to assess whether the lives of Australian people living with HIV/AIDS (PLWHA) have improved to the extent hoped for following the introduction of new antiretroviral (ARV) drugs for HIV. In 1997, 925 Australian PLWHA completed the first national survey of the social impacts of HIV/AIDS. In 1999, 924 Australian PLWHA were recruited for a repeat of the survey. Study participants completed an anonymous self-administered questionnaire. The data revealed that although new ARV drugs have improved the clinical profiles of many PLWHA, there have not been corresponding improvements in the physical well-being, levels of employment, or financial circumstances of many PLWHA. Nevertheless, PLWHA express favourable attitudes toward ARV drugs. Australian PLWHA have a complex relationship with their ARV medication that is likely to change over time as their HIV disease progresses and new treatments become available.


2020 ◽  
Vol 14 (11.1) ◽  
pp. 88S-93S
Author(s):  
Svitlana Yesypenko ◽  
Ruzanna Grigoryan ◽  
Yulia Sereda ◽  
Olga Denisuk ◽  
Liana Kovtunovich ◽  
...  

Introduction: Odesa province has the highest TB/HIV prevalence in Ukraine, exceeding the total prevalence in the country by 3 times. The objective of this study was to investigate the unfavorable treatment outcomes and associated factors in patient with drug-resistant (DR) TB in people living with HIV (PLH) in Odesa. Methodology: A cohort study with secondary data analysis was conducted among 373 PLH with confirmed pulmonary DR TB for 2014-2016. Results: About 2/3rd of the cohort were males from urban areas. Mean age and CD4 counts were 39 and 203, respectively. The overall treatment success was 44.2% with the most unfavorable treatment outcomes being observed in extensively and pre-extensively drug resistant (XDR and PreXDR) TB. The mean time between the results of GeneXpert (manufactured by Cepehid) and DR TB treatment based on GeneXpert was 1.3 days. However, the mean time between DR TB treatment based on GeneXpert and results of drug susceptibility test (DST) was 37.0 days referring to a late reporting of DST and to a late adjustment of previously prescribed treatment. The factors associated with the treatment unfavorable outcome included XDR and Pre-XDR TB, lack of antiretroviral treatment (ART), contrimoxazole preventive therapy (CPT) and CD4 test. Conclusions: The rate of successful DR TB treatment in PLH in Odesa remains low. The delayed reporting of DST contributes to lack of timely adjusted treatments. XDR and Pre-XDR TB, lack of ART and CPT are associated with unfavorable treatment outcomes. Additional studies would help to understand the temporal relationship between CD4 test and treatment outcomes.


Author(s):  
Azreen Abdullah ◽  
Adibah Hanim Ismail ◽  
Ching Siew Mooi

Introduction:HIV stigma refers to negative beliefs, feelings and attitudes towards people living with HIV (PLWH), groups associated with PLWH and other key populations at higher risk of HIV infection, such as people who inject drugs, sex workers, men who have sex with men and transgender people. Despite the advancement made in the knowledge and treatment of HIV, PLWH continues to be stigmatized.Objective: To determine the level of HIV stigma and its predictors among people living with HIV/AIDS in a tertiary hospital in Malaysia.Methods: A cross sectional study was conducted among HIV/AIDS patients aged 18 and above at infectious disease clinic in Hospital Sungai Buloh, Gombak, Malaysia. HIV stigma was assessed using Berger’s HIV stigma scale, which is available in Bahasa Malaysia and English.A self-administered questionnaire was used to determine their demographic and clinical characteristics. Multiple linear regression analysis was used to identify the predictors.Results: 526 subjects participated in this study. The mean age of the study population was 33.5± 8.4 years. The majority of the participants were male (90.9%) and contracted HIV through sexual activities (87.8%). The mean score of HIV stigma was 104.7 ± 19.5. Based on multiple linear regression analysis, patients who were unemployed (B = -8.00, 95% confidence interval (CI) = -12.12,-3.88, p = < 0.001) and being on antiretroviral treatment (B = 4.95, 95% (CI) = 0.30, 9.60, p = < 0.037) had higher level of HIV stigma.Conclusions: The level of HIV stigma was high (mean score =104.7 ± 19.5). HIV/AIDS patients who are unemployed and on antiretroviral agents were at risks of having higher level of HIV stigma. Future study is needed urgently to implement intervention that can minimize the stigmatization among patients with HIV/AIDS.International Journal of Human and Health Sciences Vol. 04 No. 01 January’20 Page : 26-35


2020 ◽  
Author(s):  
Fatuma Degu ◽  
Yeneabat Birhanu ◽  
Abere Azagew

Abstract Background Sleep disturbance is the leading health problem in the era of HIV/AIDS. The exact cause of sleep disturbance was not well known, but it is related to HIV itself, antiretroviral drugs side effect, and other HIV related disorders. This study aimed to assess the prevalence of sleep disturbance and associated factors among adult people living with HIV/AIDS. Methods A cross-sectional study was conducted. A total of 419 study participants participated in the study. A systematic random sampling method was employed. An interviewer-administered a method of data collection with a chart review was used. Pittsburg Sleep Quality of Index for assessing sleep disturbance was used. A binary logistic regression was conducted. The variables having a p-value < 0.05 with 95% CI were used to declare an association. Results The prevalence of sleep disturbance was 36% (95% CI: 31–41%). The study revealed that being female (AOR = 3.45, 95% CI: 1.52–7.79), viral loads ≥ 1000 copies /ml (AOR = 6.88, 95% CI: 2.79–16.9), CD4 cell count < 200 cells/mm3 (AOR = 6.85, 95% CI: 2.42–19.39), WHO stage II and III(AOR = 4.29, 95%CI: 1.05–17.53), having anxiety (AOR = 10,95% CI: 4.21–23.9), having depression (AOR = 4.4, 95% CI: 1.95–10.1), having not a separated bedroom (AOR = 3.94, 95% CI: 1.86–8.36), and living alone (AOR = 6, 95% CI: 2.81–13.12) were found to be factors associated with sleep disturbance. Conclusion In this study, more than one - thirds of the study participants were developed sleep disturbance. Being female, low CD4 cell counts, viral load ≥ 1000copies/ml, WHO stage II and III, having depression and anxiety, living alone, and have not a separate bedroom have increased the experience of sleep disturbance.


2020 ◽  
Vol 31 (12) ◽  
pp. 1222-1224
Author(s):  
Mauro Bertolini ◽  
María Felicitas Mutti ◽  
José AE Barletta ◽  
Adriana Falak ◽  
Daniel Cuatz ◽  
...  

Limited information is available concerning the coexistence of COVID-19 and opportunistic infections in people living with HIV. The possible association of COVID-19 with AIDS-related respiratory diseases should be considered, particularly in patients with advance immunosuppression. We report the case of a male patient with AIDS-related disseminated histoplasmosis associated with COVID-19.


Author(s):  
A T Podany ◽  
J Leon-Cruz ◽  
J Hakim ◽  
K Supparatpinyo ◽  
A Omoz-Oarhe ◽  
...  

Abstract Background The use of rifamycin antibiotics for TB prevention carries a risk of detrimental drug–drug interactions with concomitantly used ART. Objectives To evaluate the interaction of the antiretroviral drug nevirapine in combination with 4 weeks of daily rifapentine and isoniazid for TB prevention in people living with HIV. Methods Participants were individuals enrolled in the BRIEF-TB study receiving nevirapine and randomized to the rifapentine/isoniazid arm of the study. Participants provided sparse pharmacokinetic (PK) sampling at baseline and weeks 2 and 4 for trough nevirapine determination. Nevirapine apparent oral clearance (CL/F) was estimated and the geometric mean ratio (GMR) of CL/F prior to and during rifapentine/isoniazid was calculated. Results Seventy-eight participants had evaluable PK data: 61 (78%) female, 51 (65%) black non-Hispanic and median (range) age of 40 (13–66) years. Median (IQR) nevirapine trough concentrations were: week 0, 7322 (5266–9302) ng/mL; week 2, 5537 (3552–8462) ng/mL; and week 4, 5388 (3516–8243) ng/mL. Sixty out of 78 participants (77%) had nevirapine concentrations ≥3000 ng/mL at both week 2 and 4. Median (IQR) nevirapine CL/F values were: week 0 pre-rifapentine/isoniazid, 2.03 (1.58–2.58) L/h; and during rifapentine/isoniazid, 2.62 (1.81–3.42) L/h. The GMR (90% CI) for nevirapine CL/F was 1.30 (1.26–1.33). Conclusions The CL/F of nevirapine significantly increased with concomitant rifapentine/isoniazid. The decrease in nevirapine trough concentrations during rifapentine/isoniazid therapy suggests induction of nevirapine metabolism, consistent with known rifapentine effects. The magnitude of this drug–drug interaction suggests daily rifapentine/isoniazid for TB prevention should not be co-administered with nevirapine-containing ART.


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