scholarly journals Delivery of TB preventive therapy to incarcerated people living with HIV in southern African correctional facilities

2021 ◽  
Vol 11 (4) ◽  
pp. 171-173
Author(s):  
L. Chimoyi ◽  
H. Smith ◽  
H. Hausler ◽  
K. Fielding ◽  
C. J. Hoffmann ◽  
...  
Keyword(s):  
Preventive Treatment ◽  
Preventive Therapy ◽  
Future Research ◽  
Correctional Facilities ◽  
People Living With Hiv ◽  
Short Course ◽  
Correctional Settings ◽  
Hard To Reach Populations ◽  
Living With Hiv ◽  
New Strategies

TB preventive treatment (TPT) is recommended for high-risk and hard-to-reach populations such as incarcerated people living with HIV (PLHIV). To assess implementation of TPT delivery in correctional settings, we conducted an exploratory analysis of data from a multisite cohort study in South Africa and Zambia. From 975 participants, 648 were screened for TB, and 409 initiated TPT mostly within a month after initiation of antiretroviral therapy (190/409, 46.5%). We observed a median gap of one month (IQR 0.6–4.7) in TPT delivery to incarcerated PLHIV. Future research should examine standardised quality improvement tools and new strategies such as short-course regimens to improve TPT initiation in this population.

scholarly journals Cost‐effectiveness of a 12 country‐intervention to scale up short course TB preventive therapy among people living with HIV

2020 ◽  
Vol 23 (10) ◽  
Author(s):  
Hyejeong Shin ◽  
Youngji Jo ◽  
Richard E Chaisson ◽  
Karin Turner ◽  
Gavin Churchyard ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Scale Up ◽  
Preventive Therapy ◽  
People Living With Hiv ◽  
Short Course ◽  
Living With Hiv

scholarly journals Pulmonary tuberculosis screening in anti-retroviral treated adults living with HIV in Kenya

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jill K. Gersh ◽  
Ruanne V. Barnabas ◽  
Daniel Matemo ◽  
John Kinuthia ◽  
Zachary Feldman ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Preventive Therapy ◽  
World Health ◽  
People Living With Hiv ◽  
Tuberculosis Screening ◽  
Hiv Positive Adults ◽  
Health Organization ◽  
A Prospective Study ◽  
Living With Hiv ◽  
Tuberculosis Prevalence

Abstract Background People living with HIV (PLHIV) who reside in high tuberculosis burden settings remain at risk for tuberculosis disease despite treatment with anti-retroviral therapy and isoniazid preventive therapy (IPT). The performance of the World Health Organization (WHO) symptom screen for tuberculosis in PLHIV receiving anti-retroviral therapy is sub-optimal and alternative screening strategies are needed. Methods We enrolled HIV-positive adults into a prospective study in western Kenya. Individuals who were IPT-naïve or had completed IPT > 6 months prior to enrollment were eligible. We evaluated tuberculosis prevalence overall and by IPT status. We assessed the accuracy of the WHO symptom screen, GeneXpert MTB/RIF (Xpert), and candidate biomarkers including C-reactive protein (CRP), hemoglobin, erythrocyte sedimentation rate (ESR), and monocyte-to-lymphocyte ratio for identifying pulmonary tuberculosis. Some participants were evaluated at 6 months post-enrollment for tuberculosis. Results The study included 383 PLHIV, of whom > 99% were on antiretrovirals and 88% had received IPT, completed a median of 1.1 years (IQR 0.8–1.55) prior to enrollment. The prevalence of pulmonary tuberculosis at enrollment was 1.3% (n = 5, 95% CI 0.4–3.0%): 4.3% (0.5–14.5%) among IPT-naïve and 0.9% (0.2–2.6%) among IPT-treated participants. The sensitivity of the WHO symptom screen was 0% (0–52%) and specificity 87% (83–90%). Xpert and candidate biomarkers had poor to moderate sensitivity; the most accurate biomarker was CRP ≥ 3.3 mg/L (sensitivity 80% (28–100) and specificity 72% (67–77)). Six months after enrollment, the incidence rate of pulmonary tuberculosis following IPT completion was 0.84 per 100 person-years (95% CI, 0.31–2.23). Conclusions In Kenyan PLHIV treated with IPT, tuberculosis prevalence was low at a median of 1.4 years after IPT completion. WHO symptoms screening, Xpert, and candidate biomarkers were insensitive for identifying pulmonary tuberculosis in antiretroviral-treated PLHIV.

scholarly journals Childhood tuberculosis: Characteristics and peculiarities

2020 ◽  
Vol 47 (3) ◽  
pp. 190-200
Author(s):  
M.G. Mustapha ◽  
G.M. Ashir ◽  
A.I. Rabasa ◽  
A.G. Farouk ◽  
H.A. Elechi ◽  
...  
Keyword(s):  
Control Program ◽  
Preventive Therapy ◽  
Hiv And Aids ◽  
Control Measures ◽  
Health Concern ◽  
People Living With Hiv ◽  
Strict Adherence ◽  
Childhood Tb ◽  
Adults And Children ◽  
Living With Hiv

Tuberculosis (TB) is an important infectious disease of public health concern. The effects of TB on children in terms of morbidity and mortality is  more than that of adults. These may not be unconnected with the differences in characteristics and peculiarities of the disease in children. Tuberculosis in children is usually primary, paucibacillary, characterized by difficulties in diagnosis of both drug susceptible and resistant TB associated with poor uptake of preventive therapy for those with latent infection, contacts and people living with HIV and AIDS (PLWHA) in most  developing countries.While significant similarities exist between spectrum of TB occurring in adults and children, the characteristics and peculiarities of childhood TB may be unknown to policy makers and some clinicians, hence giving it less focus in control measures. The aim of this review is to highlight some of the characteristics and peculiarities of TB in children using PubMed/PubMed Central (PMC) and MEDLINE databases searched for relevant search strings from December, 2018 to September, 2019. Appropriate hard copies of books and journal articles were also  included. Conclusion: While the management of TB in children is characterized by difficulties due to both peculiarities of children and the disease;  with detailed clinical assessment and examination of necessary specimen in addition to strict adherence to the guidelines of the national TB control  program, more cases of TB in children can be prevented, diagnosed, treated and reported. 

scholarly journals Synthesizing evidence on nutrition challenges among people living with HIV/AIDS in sub- Saharan Africa: a protocol for a scoping review

2019 ◽  
Vol 6 (7) ◽  
pp. 3173 ◽  
Author(s):  
Tafadzwa Dzinamarira ◽  
Moreblessing Chipo Mashora
Keyword(s):  
Health Outcomes ◽  
Scoping Review ◽  
Sub Saharan Africa ◽  
Future Research ◽  
People Living With Hiv ◽  
Nutritional Management ◽  
Sub Saharan ◽  
Living With Hiv ◽  
Improve Health ◽  
Hiv Aids

Background: Good nutritional status is highly significant for individuals who are infected with HIV. However, they still face a number of nutritional challenges. The proposed scoping review will map literature on the nutritional challenges facing people living with HIV/AIDS (PLWH) and guide future research in nutritional management to improve health outcomes for PLWH. Here we outline a scoping review protocol designed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P 2015 Guidelines).Methods: The Arksey and O’Malley’s 2005 scoping methodological framework further improved by Levac et al. 2010 will guide the search and reporting. Searches will be conducted for eligible articles from MEDLINE (PubMed), MEDLINE, CINAHL, Academic Search Complete and ISI Web of Science (Science Citation Index) electronic databases. Two independent reviewers will conduct the search guided by an inclusion and exclusion criteria. Quality appraisal of the included articles will be conducted guided by the mixed methods appraisal tool 2018 version. We will employ NVivo version 12 for thematic content analysis.Conclusions: The findings of this review will guide future research in nutritional management to improve health outcomes for PLWH in sub-Saharan African. This review will be disseminated electronically in a published peer reviewed article and in print.

Urgent need to address the slow scale-up of TB preventive treatment in the WHO South-East Asia Region

2021 ◽  
Vol 25 (5) ◽  
pp. 382-387
Author(s):  
S. Satyanarayana ◽  
V. Bhatia ◽  
P. P. Mandal ◽  
A. Kanchar ◽  
D. Falzon ◽  
...  
Keyword(s):  
High Risk ◽  
East Asia ◽  
Scale Up ◽  
Preventive Treatment ◽  
People Living With Hiv ◽  
South East Asia ◽  
High Level ◽  
Almost All ◽  
Living With Hiv ◽  
East Asia Region

In September 2018, all countries made a commitment at the first ever United Nations High‐Level Meeting (UNHLM) on TB, to provide TB preventive treatment (TPT) to at least 30 million people at high‐risk of TB disease between 2018 and 2022. In the WHO South‐East Asia Region (SEA Region), which accounts for 44% of the global TB burden, only 1.2 million high‐risk individuals (household contacts and people living with HIV) were provided TPT (11% of the 10.8 million regional UNHLM TPT target) in 2018 and 2019. By 2020, almost all 11 countries of the SEA Region had revised their policies on TPT target groups and criteria to assess TPT eligibility, and had adopted at least one shorter TPT regimen recommended in the latest WHO TPT guidelines. The major challenges for TPT scale‐up in the SEA Region are resource shortages, knowledge and service delivery/uptake gaps among providers and service recipients, and the lack of adequate quantities of rifapentine for use in shorter TPT regimens. There are several regional opportunities to address these gaps and countries of the SEA Region must make use of these opportunities to scale up TPT services rapidly to reduce the TB burden in the SEA Region.

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