Current Issue : October - December Volume : 2018 Issue Number : 4 Articles : 7 Articles
With many countries experiencing high prevalence rates of HIV scaling up\nART, it is vital to assess quality assurance in health facilities accredited to provide\nthese HIV and AIDS-related services. Reviewed literature indicates that\nthere are limited studies in Zambia on the capacity of accredited health care\nfacilities to provide effective HIV/AIDS related services. Using data from a\nlarge ethnographic qualitative study in a resource poor rural setting in Zambia,\nthis paper assesses quality assurance in health facilities to providing\nHIV/AIDS services in a remote rural setting. Findings show that although\nHIV and AIDS related services were available at the remote rural health facility\nof Chivuna, the services provided did not meet the WHO minimum guidelines/\nstandards on the provision of such services. Therefore, there is need for\nsuch facilities to be adequately equipped in all the departments of ART delivery\nso as to ensure effective delivery of these services and universal access....
Background: Bone diseases are common complications in HIV infected patients with increased fracture rates. Factors, calcium and Vitamin D deficiency, depression and smoking are contributed to increased prevalence of this disease. Some studies reported that antiretroviral therapy may also relate to bone diseases in HIV patients.\n\nAim of the study: To assess plasma levels of bone metabolism biomarkers in HIV infected patients before and after ART treatment.\n\nMaterials and methods: Leftover blood samples from advanced clinical monitoring project were used for this study. 156 individuals with HIV infection before and after ART at different stages of treatment (0, 6 and 12 months) were investigated. Plasma level of bone metabolism biomarkers like PTH, phosphate, Vitamin D and Osteocalcin were measured using Cobas 6000 chemistry machine. Data analysis was carried out by means of statistical package for social science version 16.\n\nResults: The mean level of PTH and Osteocalcin increased significantly in HIV infected patients taking ART compared to HIV patients not taking ART (p value<0.05). Viral load was negatively correlated with PTH, Osteocalcin, Vitamin D and Phosphate.\n\nConclusions: As the duration of treatment with ART extended, further increase of the higher rate of bone turnover in HIVinfected patients was observed....
Background: The biological profile of HIV-positive patients is essential for\ndiagnosing treatment failure and the prognosis of infection. We determined\nthe virological and immunological profiles and biological anomalies of\nHIV-positive people on antiretroviral therapy (ART) in Bangui, Central African\nRepublic. Methods: We conducted an analytical, descriptive study between\n4 April and 30 September 2017 of all patients who had received ART\nfor more than 12 months and who attended the Medical Analysis Laboratory\nof the Institut Pasteur in Bangui for a complete biological work-up, including\nviral load. A blood sample was taken for quantification of RNA HIV-1, CD4\nlymphocytes and blood count in two tubes containing ethylenediamine tetraacetic\nacid, and another sample was taken in a dry tube for measurement of\ncreatinine and transaminases. Results: The total population comprised 1748\npatients, with a mean age of 38.7 years (�±14.3; median, 41 years; range, 2 - 79\nyears); 33.3% of patients were between 40 and 49 years old. Females predominated\n(71.3%), for a sex ratio of 0.4. Immunological failure was observed in\n20.2% of patients (CD4 < 200 cells/�¼L), and 44.5% of patients had a load of\nRNA HIV-1 â�¥ 1000 copies/mL. The main haematological anomalies were\nanaemia (28.0%), leukopenia (26.7%), neutropenia (42.1%) and lymphopenia\n(27.2%). Blood creatinine was abnormal in 61.0% of patients, ALAT in 57.0%\nand ASAT in 66.9%. Conclusion: The abnormalities observed in this study\nconcerned the haematopoietic system, the liver and the kidneys. As other organs\nand systems may be affected, periodic multidisciplinary biological and\nclinical follow-up is necessary for people living with HIV in order to improve\ntheir management....
Objective. HIV and tuberculosis represent diseases of major public health importance worldwide. Very little is known about HIVTB\ncoinfection among pregnant women, especially fromindustrialized settings. In this study, we examined the association between\nTB, HIV, and HIV-TB coinfection among pregnant mothers and obstetric complications, alcohol use, drug abuse, and depression.\nMethod. We examined inpatient hospital discharges in the United States from January 1, 2002, through December 31, 2014. We\nemployed multivariable survey logistic regression to generate adjusted estimates for the association between infection status and\nstudy outcomes. Results. We analyzed approximately 57 million records of pregnant women and their delivery information. HIVTB\ncoinfection was associated with the highest risks for several obstetric complications, alcohol use, and drug abuse. The risk\nfor alcohol abuse was more than twice as high among HIV-monoinfected as compared to TB-monoinfected mothers. That risk\ngap more than doubled with HIV-TB coinfection. Both HIV-monoinfected and HIV-TB coinfected mothers experienced similarly\nincreased risks for depression. Conclusions.Mothers with HIV-TB coinfection experienced relatively heightened risks for obstetric\ncomplications, alcohol use, and drug abuse. The findings of this study underscore the importance of augmenting and enhancing\nsocial and structural support systems for HIV-TB coinfected pregnant women....
Background. People with disabilities are vulnerable group to be infected with HIV/AIDS and are challenged to utilize HIV/AIDS\nservices. Hence, this study assessed knowledge, attitude, and practice about HIV/AIDS among disabled people in Hawassa city.\nMethods. A community-based cross-sectional study was conducted among 250 disabled people. All disabled people residing in\nHawassa city during the study period were included. Pretested and structured questionnaire was used for data collection. Logistic\nregression analyses were used to identify the associated factors. Results. A high percentage (197 (79.8%)) of disabled people were\nknowledgeable about HIV/AIDS. Similarly, 190 (76%) of the respondents had a favorable attitude towards HIV/AIDS. In addition,\nbeing married (AOR = 2.20; 95% CI: 1.14, 4.27) and being employed (AOR = 2.85; 95% CI: 1.19, 6.81) were positively associated with\nknowledge about HIV/AIDS. Moreover, being a male (AOR = 2.83; 95% CI: 1.61, 2.90) and being married (AOR = 2.13; 95% CI:\n2.25, 3.26) were also positively associated with having a favorable attitude towards HIV/AIDS. Conclusions. Significant numbers of\ndisabled people were knowledgeable and had a favorable attitude towards HIV/AIDS....
People living with HIV (PLWH) have distinct needs when it comes to reproductive health, specifically regarding fertility, family\nplanning, and pregnancy, and these needs are often complicated by HIV status. While there is ample research that focuses on\nreproductive health inPLWHthrough a quantitative lens, there is a lack of research using qualitativemethods, namely, thenarrative\ninterview model. We searched PubMed and relevant abstracts to identify 72 articles published from 1997 to 2016 that described a\nqualitative framework for exploring the behaviors and perceptions regarding family planning, abortion, pregnancy, parenthood,\nfertility, and forced sterility in PLWH. The inclusion criteria initially showed 147 articles, which were further screened to exclude\nthose that did not address fertility and family planning specifically.Our final sample of articles included articles related to qualitative\nresearch on reproductive attitudes, beliefs, and behaviors of PLWH. Several of these articles were mixed-methods analyses, but\nour focus was on the qualitative portion only. Further qualitative works in this area will not only contribute to gaps quantitative\nresearch in the field cannot capture by design, but also inform clinical practice, policy, and interventions through systematic, indepth\nevaluation....
Background. Low retention of HIV-positive adolescents in care is a major problem across HIV programs. Approximately 70% of\nadolescents were nonretained in care at Katooke Health Center, Mid-Western Uganda. Consequently, a quality improvement (QI)\nproject was started to increase retention from 29.3% in May 2016 to 90% in May 2017. Methods. In May 2016, we analyzed data\nfor retention, prioritized gaps with theme-matrix selection, analyzed root causes with fishbone diagram, developed site-specific\nimprovement changes and prioritized with countermeasures matrix, and implemented improvement changes with Plan-Do-Study-\nAct (PDSA). Identified root causes were missing follow-up strategy, stigma and discrimination, difficult health facility access, and\nmissing scheduled appointments. Interventions tested included generating list of adolescents who missed scheduled appointments,\nuse of mobile phone technology, and linkage of adolescents to nearest health facilities (PDSA 1), Adolescent Only Clinic (PDSA\n2), and monthly meetings to address care and treatment challenges (PDSA 3). Results. Retention increased from 17 (29.3%) in\nMay 2016 to 60 (96.7%) in August 2016 and was maintained above 90% until May 2017 (with exception of February and May 2017\nrecording 100% retention levels). Conclusion. Context specific, integrated, adolescent-centered interventions implemented using\nQI significantly improved retention in Mid-Western Uganda....
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