scholarly journals Declining tuberculosis case notification rates with the scale-up of antiretroviral therapy in Zimbabwe

2016 ◽  
Vol 6 (3) ◽  
pp. 164-168 ◽  
Author(s):  
K. C. Takarinda ◽  
A. D. Harries ◽  
C. Sandy ◽  
T. Mutasa-Apollo ◽  
C. Zishiri
Keyword(s):  
Antiretroviral Therapy ◽  
Scale Up ◽  
Tuberculosis Case ◽  
Case Notification

scholarly journals Trend analysis of tuberculosis case notifications with scale-up of antiretroviral therapy and roll-out of isoniazid preventive therapy in Zimbabwe, 2000–2018

BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e034721
Author(s):  
Kudakwashe C Takarinda ◽  
Anthony D Harries ◽  
Tsitsi Mutasa-Apollo ◽  
Charles Sandy ◽  
Regis C Choto ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Scale Up ◽  
Population Level ◽  
Preventive Therapy ◽  
Isoniazid Preventive Therapy ◽  
People Living With Hiv ◽  
National Data ◽  
Tuberculosis Case ◽  
Case Notification ◽  
Roll Out

ObjectivesAntiretroviral therapy (ART) and isoniazid preventive therapy (IPT) are known to have a tuberculosis (TB) protective effect at the individual level among people living with HIV (PLHIV). In Zimbabwe where TB is driven by HIV infection, we have assessed whether there is a population-level association between IPT and ART scale-up and annual TB case notification rates (CNRs) from 2000 to 2018.DesignEcological study using aggregate national data.SettingAnnual aggregate national data on TB case notification rates (stratified by TB category and type of disease), numbers (and proportions) of PLHIV in ART care and of these, numbers (and proportions) ever commenced on IPT.ResultsART coverage in the public sector increased from <1% (8400 PLHIV) in 2004 to ~88% (>1.1 million PLHIV patients) by December 2018, while IPT coverage among PLHIV in ART care increased from <1% (98 PLHIV) in 2012 to ~33% (373 917 PLHIV) by December 2018. These HIV-related interventions were associated with significant declines in TB CNRs: between the highest CNR prior to national roll-out of ART (in 2004) to the lowest recorded CNR after national IPT roll-out from 2012, these were (1) for all TB case (510 to 173 cases/100 000 population; 66% decline, p<0.001); (2) for those with new TB (501 to 159 cases/100 000 population; 68% decline, p<0.001) and (3) for those with new clinically diagnosed PTB (284 to 63 cases/100 000 population; 77.8% decline, p<0.001).ConclusionsThis study shows the population-level impact of the continued scale-up of ART among PLHIV and the national roll-out of IPT among those in ART care in reducing TB, particularly clinically diagnosed TB which is largely associated with HIV. There are further opportunities for continued mitigation of TB with increasing coverage of ART and in particular IPT which still has a low coverage.

scholarly journals Community-based model for the delivery of antiretroviral therapy in Cambodia: a quasi-experimental study protocol

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sovannary Tuot ◽  
Alvin Kuo Jing Teo ◽  
Kiesha Prem ◽  
Pheak Chhoun ◽  
Chamroen Pall ◽  
...  
Keyword(s):  
Experimental Study ◽  
Antiretroviral Therapy ◽  
Scale Up ◽  
Economic Evaluations ◽  
People Living With Hiv ◽  
Cad Model ◽  
Community Based ◽  
Quasi Experimental ◽  
Living With Hiv ◽  
Art Delivery

Abstract Background Multi-month dispensing (MMD) is the mainstay mechanism for clinically stable people living with HIV in Cambodia to refill antiretroviral therapy (ART) every 3-6 months. However, less frequent ART dispensing through the community-based ART delivery (CAD) model could further reduce the clients’ and health facilities’ burden. While community-based services have been recognized as an integral component of HIV response in Cambodia, their role and effectiveness in ART delivery have yet to be systematically assessed. This study aims to evaluate the CAD model’s effectiveness on the continuum of care and treatment outcomes for stable people living with HIV in Cambodia. Methods We will conduct this quasi-experimental study in 20 ART clinics across the capital city and nine provinces between May 2021 and April 2023. Study sites were purposively selected based on the availability of implementing partners, the number of people living with HIV each clinic serves, and the accessibility of the clinics. In the intervention arm, approximately 2000 stable people living with HIV will receive ART and services from the CAD model. Another 2000 stable people living with HIV in the control arm will receive MMD—a standard care model for stable people living with HIV. The primary outcomes will be retention in care, viral load suppression, and adherence to ART. The secondary endpoints will include health providers’ work burden, the model’s cost-effectiveness, quality of life, mental health, social support, stigma, and discrimination. We will compare the outcome indicators within each arm at baseline, midline, and endline using descriptive and inferential statistics. We will evaluate the differences between the intervention and control arms using the difference-in-differences method. We will perform economic evaluations to determine if the intervention is cost-effective. Discussion This study will build the evidence base for future implementation and scale-up of CAD model in Cambodia and other similar settings. Furthermore, it will strengthen engagements with community stakeholders and further improve community mobilization, a vital pillar of the Cambodian HIV response. Trial registration ClinicalTrials.gov, NCT04766710. Registered 23 February 2021, Version 1.

Improving antiretroviral therapy scale-up and effectiveness through service integration and decentralization

AIDS ◽  
2014 ◽  
Vol 28 ◽  
pp. S175-S185 ◽  
Author(s):  
Amitabh B. Suthar ◽  
George W. Rutherford ◽  
Tara Horvath ◽  
Meg C. Doherty ◽  
Eyerusalem K. Negussie
Keyword(s):  
Antiretroviral Therapy ◽  
Scale Up ◽  
Service Integration

scholarly journals Accelerating access and scale-up of optimized antiretroviral therapy in low-income and middle-income countries: results of a coordinated end-to-end approach

AIDS ◽  
2021 ◽  
Vol 35 (Supplement 2) ◽  
pp. S165-S171
Author(s):  
Emily Lark Harris ◽  
Katherine Blumer ◽  
Carmen Perez Casas ◽  
Danielle Ferris ◽  
Carolyn Amole ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Low Income ◽  
Scale Up ◽  
Middle Income ◽  
Middle Income Countries ◽  
End To End

Trends in tuberculosis case notification and treatment outcomes after interventions in 10 zones of Ethiopia

2016 ◽  
Vol 20 (9) ◽  
pp. 1192-1198 ◽  
Author(s):  
Z. G. Dememew ◽  
D. Habte ◽  
M. Melese ◽  
S. D. Hamusse ◽  
G. Nigussie ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Tuberculosis Case ◽  
Case Notification

scholarly journals The shift in tuberculosis timing among people living with HIV in the course of antiretroviral therapy scale‐up in Malawi

2019 ◽  
Vol 22 (4) ◽  
pp. e25240 ◽  
Author(s):  
Hannock Tweya ◽  
Caryl Feldacker ◽  
James Mpunga ◽  
Henry Kanyerere ◽  
Tom Heller ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Scale Up ◽  
People Living With Hiv ◽  
Living With Hiv
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