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 Tuberculosis screening coverage and isoniazid preventive therapy among people living with HIV at Gambella Hospital, southwest Ethiopia: a retrospective study design

2021 ◽  
Vol 49 (9) ◽  
pp. 030006052110461
Author(s):  
Mecha Aboma ◽  
Nagasa Dida
Keyword(s):  
Retrospective Study ◽  
Complete Information ◽  
Preventive Therapy ◽  
Isoniazid Preventive Therapy ◽  
World Health ◽  
People Living With Hiv ◽  
African Countries ◽  
Tuberculosis Screening ◽  
Southwest Ethiopia ◽  
Health Organization

Objective We aimed to assess the coverage of tuberculosis screening and isoniazid preventive therapy (IPT) among people living with human immunodeficiency virus (PLHIV) at Gambella Hospital, southwest Ethiopia. Methods We conducted a 5-year retrospective study of PLHIV receiving care in an antiretroviral therapy clinic from 1 January 2011 to 30 December 2015. We reviewed a total of 900 medical records of patients with complete information. Result Of the total, 897 (99.7%) PLHIV were screened for tuberculosis, among which 77 (8.6%) were found to be positive for active tuberculosis. Among 820 (91.4%) individuals eligible for IPT, only 545 (66.5%) were provided IPT; 275 (33.5%) eligible PLHIV were not provided IPT. Male sex (adjusted odds ratio [AOR] 1.63) and ages 18–29 years (AOR 0.33) and 30–44 years (AOR 0.31) were significantly associated with the likelihood of tuberculosis infection. Conclusion The present study findings demonstrated that tuberculosis screening for PLHIV at Gambella Hospital was improved in comparison with reports from many African countries and other parts of Ethiopia. Despite this improvement, the implementation rate of IPT was below national and World Health Organization recommendations. Overall, tuberculosis diagnostic approaches and available preventive measures should be strengthened in the study area.

scholarly journals Two diseases, same person: moving toward a combined HIV and tuberculosis continuum of care

2018 ◽  
Vol 29 (9) ◽  
pp. 873-883 ◽  
Author(s):  
Reuben Granich ◽  
Somya Gupta
Keyword(s):  
Public Health ◽  
Disease Control ◽  
Treatment Success ◽  
World Health ◽  
People Living With Hiv ◽  
Global Public Health ◽  
Tb Treatment ◽  
Immunodeficiency Virus ◽  
Health Organization ◽  
Living With Hiv

The human immunodeficiency virus (HIV) and Mycobacterium tuberculosis syndemic remains a global public health threat. Separate HIV and tuberculosis (TB) global targets have been set; however, success will depend on achieving combined disease control objectives and care continua. The objective of this study was to review available policy, budgets, and data to reconceptualize TB and HIV disease control objectives by combining HIV and TB care continua. For 22 World Health Organization (WHO) TB and TB/HIV priority countries, we used 2015 data from the HIV90–90–90watch website, UNAIDS AIDSinfo, and WHO 2016 and 2017 Global TB Reports. Global resources available in TB and HIV/TB activities for 2003–2017 were collected from publicly available sources. In 22 high-burden countries, people living with HIV on antiretroviral therapy ranged from 9 to 70%; viral suppression was 38–63%. TB treatment success ranged from 71 to 94% with 14 (81% HIV/TB burden) countries above 80% TB treatment success. From 2003 to 2017, reported global international and domestic resources for HIV-associated TB and TB averaged $2.85 billion per year; the total for 2003–2017 was 43 billion dollars. Reviewing combined HIV and TB targets demonstrate disease control progress and challenges. Using an integrated HIV and TB continuum supports HIV and TB disease control efforts focused on improving both individual and public health.

scholarly journals QUANTITATIVE REAL-TIME PCR (Q-PCR) FOR SPUTUM SMEAR DIAGNOSIS OF PULMONARY TUBERCULOSIS AMONG PEOPLE WITH HIV/AIDS

2014 ◽  
Vol 56 (2) ◽  
pp. 139-142 ◽  
Author(s):  
Yvana Maria Maia de Albuquerque ◽  
Ana Luiza Magalhães de Andrade Lima ◽  
Ana Kelly Lins ◽  
Marcelo Magalhães ◽  
Vera Magalhães
Keyword(s):  
Pulmonary Tuberculosis ◽  
Real Time ◽  
Clinical Suspicion ◽  
Sputum Smear ◽  
People Living With Hiv ◽  
Lowenstein Jensen ◽  
Sensitivity Specificity ◽  
A Prospective Study ◽  
Living With Hiv ◽  
Hiv Aids

Objective: To assess quantitative real-time polymerase chain reaction (q-PCR) for the sputum smear diagnosis of pulmonary tuberculosis (PTB) in patients living with HIV/AIDS with a clinical suspicion of PTB.Method: This is a prospective study to assess the accuracy of a diagnostic test, conducted on 140 sputum specimens from 140 patients living with HIV/AIDS with a clinical suspicion of PTB, attended at two referral hospitals for people living with HIV/AIDS in the city of Recife, Pernambuco, Brazil. A Löwenstein-Jensen medium culture and 7H9 broth were used as gold standard.Results: Of the 140 sputum samples, 47 (33.6%) were positive with the gold standard. q-PCR was positive in 42 (30%) of the 140 patients. Only one (0.71%) did not correspond to the culture. The sensitivity, specificity and accuracy of the q-PCR were 87.2%, 98.9% and 95% respectively. In 39 (93%) of the 42 q-PCR positive cases, the CT (threshold cycle) was equal to or less than 37.Conclusion: q-PCR performed on sputum smears from patients living with HIV/AIDS demonstrated satisfactory sensitivity, specificity and accuracy, and may therefore be recommended as a method for diagnosing PTB.

scholarly journals Repurposing of Chloroquine and Its Derivative, Hydroxychloroquine for COVID-19: Implications for People Living with HIV in Africa

2020 ◽  
Author(s):  
Chiagoziem Otuechere
Keyword(s):  
Immune System ◽  
Antiviral Agents ◽  
World Health ◽  
People Living With Hiv ◽  
Short Term ◽  
Confounding Variables ◽  
Immunodeficiency Virus ◽  
Proven Efficacy ◽  
Health Organization ◽  
Living With Hiv

The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2, has been declared by the World Health Organization (WHO) as a pandemic. Unfortunately, finding a vaccine or developing drugs from the scratch is a time-consuming luxury given the widespread and high fatality rates of the virus. In the short term, repurposing of drugs already in use seem to be the most rational step to quickly and effectively curb the virus. Several antiviral agents had been proposed as possible remedies, but the 4-aminoquinolines, Chloroquine (CHQ) and hydroxychloroquine (HCHQ) appear to be generating more interest. They are generic, cheaply available and have proven efficacy against malaria parasites in Africa. The human immunodeficiency virus (HIV), on the other hand, targets the immune system thereby reducing the patient’s ability to fight infections. Sadly, 68% of the global HIV burden occur in Africa. It is therefore anticipated that incidence of severe forms of COVID-19 could occur in Africa because of associated endemic conditions that compromise the immune system. With CHQ and HCHQ being considered for clinical use against COVID-19, there is a need to highlight their potential merits and confounding variables in the subgroup of patients with or without HIV.

scholarly journals Kondisi Psikologi, Sosial, dan Spiritual pada Orang dengan HIV/AIDS Selama Pengobatan Antiretroviral di Komisi Penanggulangan AIDS Kota Bogor Tahun 2019

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Ervan Meidan Ariatama ◽  
Titik Respati ◽  
Eka Nurhayati
Keyword(s):  
Aids Prevention ◽  
World Health ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
World Health Organization Quality ◽  
Organization Quality ◽  
Health Organization ◽  
Living With Hiv ◽  
Hiv Aids

Penyakit HIV/AIDS selain mengakibatkan dampak kesehatan dapat juga mengakibatkan dampak negatif terhadap psikologi, sosial, dan spiritual pada kualitas hidup orang dengan HIV/AIDS (ODHA). Antiretroviral (ARV) merupakan obat penghambat proses replikasi HIV yang merupakan solusi untuk meningkatkan kualitas hidup dan harapan hidup penderita. Tujuan penelitian ini adalah menggambarkan kondisi psikologi, sosial, dan spiritual ODHA selama menjalani pengobatan ARV di Komisi Penanggulangan AIDS (KPA) Kota Bogor periode bulan Agustus–September 2019. Penelitian ini dilakukan menggunakan metode observasi analitik dengan pendekatan cross sectional. Data diambil menggunakan kuesioner World Health Organization Quality of Life-HIV Instrument (WHOQOL-HIV Instrument) yang terdiri atas 120 pertanyaan dan terbagi menjadi 6 domain (psikologi, sosial, spiritual, fisik, lingkungan hidup, dan tingkat kebebasan). Pada penelitian ini hanya diambil 3 domain, yaitu psikologi, sosial, dan spiritual dengan jumlah pertanyaan 52 butir yang dibagikan kepada 80 responden dan dilaksanakan selama bulan Agustus sampai bulan September 2019. Teknik pengambilan sampel menggunakan non-probability sampling jenis consecutive sampling berdasar atas rumus besar estimasi proporsi dengan presisi absolut. Hasil menunjukkan mayoritas kondisi psikologi, sosial, dan spiritual ODHA selama pengobatan antiretroviral di KPA Kota Bogor tahun 2019 dalam kondisi baik dengan persentase kondisi psikologi 96%, sosial 99%, dan spiritual 70%. Simpulan penelitian ini adalah kondisi psikologi, sosial, dan spiritual pada ODHA di Komisi Penanggulangan AIDS Kota Bogor tahun 2019 mayoritas dalam kondisi baik, walaupun kondisi spiritual ODHA masih terdapat hasil kurang baik. PSYCHOLOGICAL, SOCIAL, AND SPIRITUAL CONDITIONS IN PEOPLE LIVING WITH HIV/AIDS DURING ANTIRETROVIRAL TREATMENT AT THE AIDS PREVENTION COMMISSION AT BOGOR CITY IN 2019Apart from having an impact on health, HIV/AIDS can also have a negative psychological, social, and spiritual impact on people living with HIV/AIDS (PLWHA). Antiretroviral (ARV) as drugs that inhibits the process of replication of HIV, which is a solution to improve the quality of life and life expectancy of patients. The purpose of this study was to describe the psychological, social, and spiritual conditions of PLWHA during ARV treatment at the AIDS Prevention Commission in Bogor City in August to September 2019. The study was a cross-sectional study. The research material consisted of primary data taken using the World Health Organization-Quality Instrument HIV questionnaire (WHOQOL-HIV Instrument) consisting of 120 questions and divided into six domains (psychological, social, spiritual, physical, environment, degree of freedom). However, in this study, only three domains studied, which are psychological, social, and spiritual, with 52 questions and then distributed to 80 respondents and carried out from August to September. The sampling technique uses non-probability sampling type consecutive sampling based on large formula of proportion estimation with absolute precision. Results showed the psychological, social, and spiritual condition of PLWHA during antiretroviral treatment at the Bogor City AIDS Commission in 2019 shows a good condition. The majority of good psychological, social, and spiritual domain experienced by 96%, 99%, and 70% of respondents, respectively. The conclusion of this research is the psychological, social, and spiritual conditions of PLWHA in the Bogor AIDS prevention commission in 2019 in the good conditions, even though there was a spiritual condition of ODHA that was still not good.

scholarly journals INH preventive pherapy (IPT) for HIV-infected South African children

2011 ◽  
Vol 12 (2) ◽  
pp. 27-30
Author(s):  
Mark F Cotton
Keyword(s):  
South African ◽  
Preventive Therapy ◽  
World Health ◽  
Who Guidelines ◽  
Hiv Status ◽  
Source Case ◽  
Adults And Children ◽  
Health Organization ◽  
Living With Hiv

HIV-infected children have a high risk of acquiring tuberculosis. The World Health Organization (WHO) has released isoniazid preventive therapy (IPT) recommendations for adults and children living with HIV, based on efficacy studies, mainly in adults. Data from children appear conflicting. IPT guidelines for children were developed in response to WHO guidelines at a local meeting, followed by discussions. IPT should be given to all HIV-infected children after exposure to a source case if treatment for active disease is not required. For children whose mothers’ HIV status was known antentally, when tuberculosis has been actively excluded in mothers and at infant follow-up, and when infants have commenced antiretroviral therapy in the first 3 months of life, IPT is not required. Otherwise, all infants and children should be given IPT for 6 months once active tuberculosis has been excluded.

scholarly journals Mixed methods systematic review and metasummary about barriers and facilitators for the implementation of cotrimoxazole and isoniazid - preventive therapies for people living with HIV.

2021 ◽  
Author(s):  
Pia Muller ◽  
Luis Velez Lapao
Keyword(s):  
Health System ◽  
Opportunistic Infections ◽  
Stakeholder Involvement ◽  
Preventive Therapy ◽  
Health System Strengthening ◽  
World Health ◽  
People Living With Hiv ◽  
Therapy Regimen ◽  
Similarities And Differences ◽  
Health Organization

Background: Cotrimoxazole and isoniazid preventive therapy (CPT, IPT) have been shown to be efficacious therapies for the prevention of opportunistic infections and tuberculosis (TB) among people living with human immunodeficiency virus (HIV). Despite governments' efforts to translate World Health Organization recommendations into practice, implementation remains challenging. This review aimed to explore and compare CPT and IPT with respect to similarities and differences of barriers identified across high TB/HIV burden countries. A secondary objective was to identify facilitators for implementing both preventive therapies. Methods: We searched MEDLINE, Web of Science and SCOPUS databases for peer-reviewed literature published before September 2020. We extracted and synthesized our findings using Maxqda software. We applied framework synthesis in conjunction with metasummary to compare both therapies with respect to similarities and differences of barriers identified across seven health system components (in line with the modified WHO's Framework for action). Protocol registration: PROSPERO (CRD42019137778). Findings: We identified four hundred and eighty-two papers, of which we included forty for review. Although most barrier themes were identical for both preventive therapies, we identified seven intervention-specific themes. Like for CPT, barriers identified for IPT were most frequently classified as 'service delivery-related barriers' and 'patient & community-related barriers'. 'Health provider-related barriers' played an additional important role for implementing of IPT. Most facilitators identified referred to health system strengthening activities. Conclusions: For researchers with limited working experience in high TB/HIV burden countries, this review can provide valuable insights about barriers that may arise at different levels of the health system. For policymakers in high TB/HIV burden countries, this review offers strategies for improving the delivery of IPT (or any newer therapy regimen) for the prevention of TB. Based on our findings, we suggest initial and continuous stakeholder involvement, a focus on the efficient use and reinforcement of existing resources for health.

scholarly journals Adherence to Isoniazid Preventive Therapy among Under-Five Children in Contact with Adult Bacteriologically Confirmed Pulmonary Tuberculosis Patients: A Mixed-Method Study

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Getachew Seid ◽  
Tsegaye Tsedalu ◽  
Marta Ayele ◽  
Faham Khamesipour
Keyword(s):  
Pulmonary Tuberculosis ◽  
World Health Organization ◽  
Study Design ◽  
Addis Ababa ◽  
Preventive Treatment ◽  
Preventive Therapy ◽  
World Health ◽  
Tuberculosis Patients ◽  
The World ◽  
Health Organization

Background. The World Health Organization recommends that all children below the age of five who have household contact with an infectious tuberculosis case should receive isoniazid preventive treatment for at least six months after the active tuberculosis disease has been ruled out. This research aims to determine the adherence of children, eligible for isoniazid preventive treatment, to the treatment who had contact with pulmonary tuberculosis patients. Methods. A mixed study design was used to prospectively assess the adherence to IPT among children under the age of 5 in contact with pulmonary TB patients through the quantitative study design and barriers of adherence in view of health care professionals and the family of children through a descriptive qualitative study. The study was conducted from July 2019 to December 2019 in Addis Ababa. Data were collected by a structured datasheet from the selected health center registration book. Data were entered into Epi Data software and analyzed by using SPSS version 20. Descriptive statistical methods were used to summarize the sociodemographic characteristics of the study participants. Result. The ratio of the total number of pulmonary tuberculosis index cases recruited into the study to the number of child contacts aged less than 5 years was 1 : 1.32. The total isoniazid preventive treatment uptake in this study was 75.2%; one-fifth (21.3%) of the children who started IPT did not complete the full course of six-month isoniazid preventive treatment. Except for HIV not to be tested ( P < 0.001 ), there was no significant association of the listed risk factors in default to complete the full six months of preventive treatment. Conclusion. Enrolment of eligible children for isoniazid preventive treatment in the urban city Addis Ababa was still below the target of the World Health Organization End tuberculosis strategy by 2030. The treatment adherence rate also needs a great deal of effort to achieve the strategy. Child default after the first visit indicates a lack of understanding about the benefit and safety of preventive therapy in young children among families of TB patients, and awareness-creating efforts by health extension workers will help to improve the outcomes.

Self-Reported Disability in Persons With HIV-Related Neuropathy Is Mediated by Pain Interference and Depression

2020 ◽  
Vol 100 (12) ◽  
pp. 2174-2185
Author(s):  
David M Kietrys ◽  
James Scott Parrott ◽  
Mary Lou Galantino ◽  
Tracy Davis ◽  
Todd Levin ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Pain Interference ◽  
World Health ◽  
Depression Symptoms ◽  
People Living With Hiv ◽  
Disability Assessment ◽  
Painful Neuropathy ◽  
Health Organization ◽  
Living With Hiv ◽  
The Relationship

Abstract Objective The purpose of this study was to compare disability in people with HIV and peripheral neuropathy with those without neuropathy and explore how neuropathy and other relevant factors are associated with disability. Methods In this cross-sectional study, participants completed the Brief pain inventory, Beck Depression Inventory II, World Health Organization Disability Assessment Schedule (WHODAS 2.0), and a health and demographic questionnaire. Additional data were extracted from the medical record. A raw score of ≥1 on the Subjective Peripheral Neuropathy Screen questions about lower extremity numbness or paresthesia was used to identify peripheral neuropathy. Predictors of disability (as determined by association with World Health Organization Disability Assessment Schedule 2.0 scores) were evaluated bivariately and in a multivariable model. Path modeling was used to identify a parsimonious model to elucidate the mediated effects of peripheral neuropathy on disability. Results Participants with peripheral neuropathy had more depression symptoms, more pain (severity and interference), and higher disability scores compared with participants without neuropathy. The relationship between neuropathy and disability was mediated by pain interference and depression (standardized root mean residual = .056). Conclusion In this sample of people with HIV, those with lower extremity peripheral neuropathy reported more severe disability, worse pain, and more depression symptoms than those without neuropathy. The relationship between peripheral neuropathy and disability may be mediated though pain interference and depression. Impact Distal sensory polyneuropathy is a common comorbidity experienced by people living with HIV and frequently causes pain. This study can help providers direct care toward lessening disability experienced among people with HIV and peripheral neuropathy by targeting interventions for treatment of pain and depression. Lay Summary People living with HIV may experience disabling painful neuropathy. Treatment for pain and depression may help reduce the disability associated with painful neuropathy.

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