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47 ud af 47 tidsskrifter valgt, søgeord (aids) valgt, emner højest 180 dage gamle, sorteret efter nyeste først.
135 emner vises.
Reis, Karl; Wolf, Allison; Perumal, Rubeshan; Seepamore, Boitumelo; Guzman, Kevin; Ross, Jesse; Cheung, Ken; Amico, K. Rivet; Brust, James C.M.; Padayatchi, Nesri; Friedland, Gerald; Naidoo, Kogieleum; Daftary, Amrita; Zelnick, Jennifer; O’Donnell, Max
Journal of Acquired Immune Deficiency Syndromes, 15.02.2024
Tilføjet 15.02.2024
Introduction For people living with HIV/AIDS, care is commonly delivered through Differentiated Service Delivery (DSD). Although people with multidrug-resistant tuberculosis (MDR-TB) and HIV/AIDS experience severe treatment associated challenges, there is no DSD model to support their treatment. In this study, we defined patterns of medication adherence and characterized longitudinal barriers to inform development of an MDR-TB/HIV DSD framework. Methods Adults with MDR-TB and HIV initiating bedaquiline (BDQ) and receiving antiretroviral therapy (ART) in KwaZulu-Natal, South Africa, were enrolled and followed through the end of MDR-TB treatment. Electronic dose monitoring devices (EDM) measured BDQ and ART adherence. Longitudinal focus groups were conducted and transcripts analyzed thematically to describe discrete treatment stage-specific and cross-cutting treatment challenges. Results 283 participants were enrolled and followed through treatment completion (median 17.8 months [IQR 16.5–20.2]). Thirteen focus groups were conducted. Most participants (82.7%, 234/283) maintained high adherence (mean BDQ adherence 95.3%; mean ART adherence 85.5%), but an adherence-challenged subpopulation with
Læs mere Tjek på PubMedNjoki, Carolyne; Simiyu, Nabukwangwa; Kaddu, Ronnie; Mwangi, Wambui; Sulemanji, Demet; Oduor, Peter; Dona, Dilanthi Gamage; Otieno, Dorothy; Abonyo, Teddy Thaddeus; Wangeci, Patricia; Kabanya, Thomas; Mutuku, Selina; Kioko, Annastacia; Muthoni, Joy; Kamau, Peter Mburu; Beane, Abigail; Haniffa, Rashan; Dondorp, Arjen; Misango, David; Pisani, Luigi; Waweru-Siika, Wangari
Critical Care Explorations, 11.02.2024
Tilføjet 11.02.2024
OBJECTIVES: To describe clinical, management, and outcome features of critically ill patients admitted to ICUs and high-dependency units (HDUs) in Kenya. DESIGN: Prospective registry-based observational study. SETTING: Three HDUs and eight ICUs in Kenya. PATIENTS: Consecutive adult patients admitted between January 2021 and June 2022. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Data were entered in a cloud-based platform using a common data model. Study endpoints included case-mix variables, management features, and patient-centered outcomes. Patients with COVID-19 were reported separately. Of the 3892 of 4546 patients without COVID-19, 2445 patients (62.8%) were from HDUs, and 1447 patients (37.2%) were from ICUs. Patients had a median age of 53 years (interquartile range [IQR] 38–68), with HDU patients being older but with a lower severity (Acute Physiology and Chronic Health Evaluation II 6 [3–9] in HDUs vs. 12 [7–17] in ICUs; p < 0.001). One in four patients was postoperative with 604 (63.4%) receiving emergency surgery. Readmission rate was 4.8%. Hypertension and diabetes were prevalent comorbidities, with a 4.0% HIV/AIDS rate. Invasive mechanical ventilation was applied in 3.4% in HDUs versus 47.6% in ICUs (p < 0.001), with a duration of 7 days (IQR 3–21). There was a similar use of renal replacement therapy (4.0% vs. 4.7%; p < 0.001). Vasopressor use was infrequent while half of patients received antibiotics. Average length of stay was 2 days (IQR 1–5). Crude HDU mortality rate was 6.5% in HDUs versus 30.5% in the ICUs (p < 0.001). Of the 654 COVID-19 admissions, most were admitted in ICUs (72.3%) with a 33.2% mortality. CONCLUSIONS: We provide the first multicenter observational cohort study from an African ICU National Registry. Distinct management features and outcomes characterize HDU from ICU patients.
Læs mere Tjek på PubMedClemente, T., Galli, L., Lolatto, R., Gagliardini, R., Lagi, F., Ferrara, M., Cattelan, A. M., Foca, E., Di Biagio, A., Cervo, A., Calza, L., Maggiolo, F., Marchetti, G., Cenderello, G., Rusconi, S., Zazzi, M., Santoro, M. M., Spagnuolo, V., Castagna, A., On behalf of PRESTIGIO Study Group
BMJ Open, 10.02.2024
Tilføjet 10.02.2024
PurposeThe PRESTIGIO Registry was established in 2017 to collect clinical, virological and immunological monitoring data from people living with HIV (PLWH) with documented four-class drug resistance (4DR). Key research purposes include the evaluation of residual susceptibility to specific antiretrovirals and the validation of treatment and monitoring strategies in this population. ParticipantsThe PRESTIGIO Registry collects annual plasma and peripheral blood mononuclear cell samples and demographic, clinical, virological, treatment and laboratory data from PLWH followed at 39 Italian clinical centres and characterised by intermediate-to-high genotypic resistance to ≥1 nucleoside reverse transcriptase inhibitors, ≥1 non-nucleoside reverse transcriptase inhibitors, ≥1 protease inhibitors, plus either intermediate-to-high genotypic resistance to ≥1 integrase strand transfer inhibitors (INSTIs) or history of virological failure to an INSTI-containing regimen. To date, 229 people have been recorded in the cohort. Most of the data are collected from the date of the first evidence of 4DR (baseline), with some prebaseline information obtained retrospectively. Samples are collected from the date of enrollment in the registry. Findings to dateThe open-ended cohort has been used to assess (1) prognosis in terms of survival or development of AIDS-related or non-AIDS-related clinical events; (2) long-term efficacy and safety of different antiretroviral regimens and (3) virological and immunological factors predictive of clinical outcome and treatment efficacy, especially through analysis of plasma and cell samples. Future plansThe registry can provide new knowledge on how to implement an integrated approach to study PLWH with documented resistance to the four main antiretroviral classes, a population with a limited number of individuals characterised by a high degree of frailty and complexity in therapeutic management. Given the scheduled annual updates of PLWH data, the researchers who collaborate in the registry can send study proposals at any time to the steering committee of the registry, which evaluates every 3 months whether the research studies can be conducted on data and biosamples from the registry and whether they are aimed at a better understanding of a specific health condition, the emergence of comorbidities or the effect of potential treatments or experimental drugs that may have an impact on disease progression and quality of life. Finally, the research studies should aim to be inclusive, innovative and in touch with the communities and society as a whole. Trial registration numberNCT04098315.
Læs mere Tjek på PubMedClinical Infectious Diseases, 10.02.2024
Tilføjet 10.02.2024
Abstract Background Pre-diabetes is associated with proteinuria, a risk factor for chronic kidney disease. While people living with HIV (PWH) have a higher risk of proteinuria than people without HIV (PWOH), it is unknown whether incident proteinuria differs by HIV serostatus among pre-diabetic persons.Methods Urine protein-to-creatinine ratio (PCR) was measured at semi-annual visits among men in the Multicenter AIDS Cohort Study since April 2006. Men with pre-DM on or after April 2006 and no prevalent proteinuria or use of anti-diabetic medications were included. Pre-diabetes was defined as fasting glucose (FG) of 100-125 mg/dL confirmed within a year by a repeat FG or hemoglobin A1c 5.7–6.4%. Incident proteinuria was defined as PCR > 200 mg/g, confirmed within a year. We used Poisson regression models to determine whether incident proteinuria in participants with pre-diabetes differed by HIV serostatus and, among PWH, whether HIV-specific factors were related to incident proteinuria.Results Between 2006 and 2019, among 1276 men with pre-diabetes, 128/613 PWH (21%) and 50/663 PWOH (8%) developed proteinuria over a median 10-year follow-up. After multivariable adjustment, the incidence of proteinuria in PWH with pre-diabetes was 3.3 times [95% CI: 2.3–4.8 times] greater than in PWOH (p
Læs mere Tjek på PubMedThi Vu, Jasmine Manalel, Kate Nyhan, Katie Wang, Joan Monin
PLoS One Infectious Diseases, 9.02.2024
Tilføjet 9.02.2024
by Thi Vu, Jasmine Manalel, Kate Nyhan, Katie Wang, Joan Monin Introduction The population of women aged 50 years and older living with HIV is increasing. Older women face unique challenges in the prevention and management of HIV; however, they are often under engaged in HIV/AIDS research. One such challenge is gender-based stigma, which can be manifested through harmful gendered stereotypes, discrimination, prejudice, and sexism that could potentially hinder HIV care engagement among this population. We propose a scoping review to identify and synthesize evidence pertaining to how experiences of gender-based stigma impacts HIV prevention and care among older women. Materials and methods We will use the framework by Arksey and O’Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) to conduct this scoping review. We will search MEDLINE/PubMed, Web of Science, PsycINFO, CINAHL and Scopus for empirical literature published between January 1981 and the date of search commencement. Supplementary screening will be conducted using backwards citation chaining of the final list of included full-text articles. Two reviewers will independently screen all titles and abstracts for articles that meet the predetermined inclusion criteria. Two reviewers will also screen full-text articles and chart data using a standardized data collection form. Results We will synthesize the findings through tables, charts, and narrative summaries. We will also identify gaps in the current literature and provide recommendations for future research. Findings will be shared at conferences and submitted to a peer-reviewed publication. Discussion To our knowledge, this will be the first scoping review to examine gender-based stigma in relation to HIV prevention and care among older women. We anticipate that our results will be of interest to older women living with HIV, healthcare providers, policy makers, and community activists working to improve quality of life and care experiences for older women living with HIV.
Læs mere Tjek på PubMedYang, X., Olatosi, B., Weissman, S., Li, X., Zhang, J.
BMJ Open, 8.02.2024
Tilføjet 8.02.2024
IntroductionThe measure of sexual orientation and gender identity (SOGI) data in electronic health records (EHR) has been critical for addressing health disparities and inequalities, especially for HIV care. Given that gender and sexual minorities (eg, transgender, men who have sex with men and intersex) are key groups in people living with HIV (PLWH), SOGI data can facilitate a more accurate understanding about the HIV outcomes (eg, viral suppression) among this key group and then lead to tailored therapeutic services. The two-step SOGI collection method as an emerging gender measurement can be used to measure SOGI status in medical settings. Using the statewide cohort of PLWH in South Carolina (SC), this project aims to: (1) integrate statewide PLWH cohort data with their birth certificate data to evaluate SOGI measurements from multiple EHR sources; and (2) examine differences in viral suppression based on SOGI measurements. Methods and analysisOur EHR database includes several HIV data sources with patients’ gender information, such as SC Department of Health and Environmental Control Centre (DHEC), Health Sciences South Carolina (HSSC) and Prisma as well as birth certificate data to retrieve the sex at birth. The SC Enhanced HIV/AIDS Reporting System (e-HARS) from DHEC will provide longitudinal viral load information to define a variety of viral suppression status. Datasources like the SC office of Revenue and Fiscal Affairs (RFA) will extract longitudinal EHR clinical data of all PLWH in SC from multiple health systems; obtain data from other state agencies and link the patient-level data with county-level data from multiple publicly available data sources. Ethics and disseminationThe study was approved by the Institutional Review Board at the University of South Carolina (Pro00129906) as a Non-Human Subject study. The study’s findings will be published in peer-reviewed journals and disseminated at national and international conferences and through social media.
Læs mere Tjek på PubMedWeiping Liu, Lin Li, Minggang Yin, Chengjian Cao, Yaohui Song, Xia Long
Journal of Medical Virology, 7.02.2024
Tilføjet 7.02.2024
Riley M. HorvathZabrina L. BrummeIvan Sadowski1Department of Biochemistry and Molecular Biology Molecular Epigenetics Group, LSI, University of British Columbia, Vancouver, British Columbia, Canada2Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada3British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada, Miguel Angel Martinez
Antimicrobial Agents And Chemotherapy, 6.02.2024
Tilføjet 6.02.2024
Fu Feifei
PLoS One Infectious Diseases, 3.02.2024
Tilføjet 3.02.2024
by Fu Feifei Drawing on Critical Metaphor Analysis, this study investigates major metaphors of the COVID-19 pandemic used by the Chinese government in the specific genre of news picture. It examines patterns of metaphor use in the first year of the pandemic in China and explains how and why the government employs the identified metaphors in the Chinese political context. Results reveal that pandemic metaphors (45%) are not as widely used in news pictures as presumed, the vast majority (95%) are rendered in verbal mode, and the most salient metaphors used in news pictures are the UP/DOWN (spatial), WAR, FAMILY, and COMPETITION metaphors. This study then addresses how COVID-19 metaphors are used in the Chinese political context and claims that the Chinese government uses specific metaphors with persuasive and ideological functions. The WAR metaphor aids comprehension of abstract concepts of the pandemic treatment, the FAMILY metaphor fosters empathy among Chinese individuals to counter blame and discrimination in society, UP/DOWN (spatial) and COMPETITION metaphors stimulate action to overcome the common “enemy.” WAR and FAMILY metaphors also contribute to the construction of a greater sense of collectivism and play a crucial role in fostering a positive national identity. Implications, limitations and some directions for future research are suggested.
Læs mere Tjek på PubMedRodrigo Volmir Anderle, Robson Bruniera de Oliveira, Felipe Alves Rubio, James Macinko, Ines Dourado, Davide Rasella
PLoS One Infectious Diseases, 3.02.2024
Tilføjet 3.02.2024
by Rodrigo Volmir Anderle, Robson Bruniera de Oliveira, Felipe Alves Rubio, James Macinko, Ines Dourado, Davide Rasella Objective To end the AIDS epidemic by 2030, despite the increasing poverty and inequalities, policies should be designed to deal with population heterogeneity and environmental changes. Bottom-up designs, such as the Agent-Based Model (ABM), can model these features, dealing with such complexity. HIV/AIDS has a complex dynamic of structural factors, risk behaviors, biomedical characteristics and interventions. All embedded in unequal, stigmatized and heterogeneous social structure. To understand how ABMs can model this complexity, we performed a scoping review of HIV applications, highlighting their potentialities. Methods We searched on PubMed, Web of Science, and Scopus repositories following the PRISMA extension for scoping reviews. Our inclusion criteria were HIV/AIDS studies with an ABM application. We identified the main articles using a local co-citation analysis and categorized the overall literature aims, (sub)populations, regions, and if the papers declared the use of ODD protocol and limitations. Results We found 154 articles. We identified eleven main papers, and discussed them using the overall category results. Most studies model Transmission Dynamics (37/154), about Men who have sex with Men (MSM) (41/154), or individuals living in the US or South Africa (84/154). Recent studies applied ABM to model PrEP interventions (17/154) and Racial Disparities (12/154). Only six papers declared the use of ODD Protocol (6/154), and 34/154 didn’t mention the study limitations. Conclusions While ABM is among the most sophisticated techniques available to model HIV/AIDS complexity. Their applications are still restricted to some realities. However, researchers are challenged to think about social structure due model characteristics, the inclusion of these features is still restricted to case-specific. Data and computational power availability can enhance this feature providing insightful results.
Læs mere Tjek på PubMedBMC Infectious Diseases, 2.02.2024
Tilføjet 2.02.2024
Abstract Background objective This study aimed to understand the basic situation of adults with human immunodeficiency virus (HIV) receiving antiretroviral therapy (ART) in Meigu County, Liangshan Yi Autonomous Prefecture. The information of patients who had been on ART for more than 6 months, the effect of ART, the possible reasons for ART failure, knowledge of drug resistance among patients with ART failure and the possible reasons for the emergence of drug resistance were analyzed. Methods A total of 2753 people living with HIV (PLWH) were collected for HIV-1 RNA virus nucleic acid testing. Plasma specimens with HIV-1 RNA ≥ 1000 copies/mL were sent to the laboratory for nucleic acid extraction, PCR, electrophoresis and sequencing, and the sequencing results were submitted to the HIV drug resistance database of Stanford University for subtyping to determine the drug resistance mutation sites and drug sensitivity levels. Results A total of 2753 patients were enrolled in this study. Antiviral therapy failed in 288 patients and was successfully amplified in 245, of which 111 had resistance genes. The resistance rate to failure of viral suppression was 45.3% (111/245). The highest rates of resistance to NNRTIs were found for efavirenz (EFV) and nevirapine (NVP) (42.9%), and the highest rates of resistance to NRTIs were found for 3TC and emtricitabine (FTC) (15.9%). The most common NNRTI resistance mutation site was K103N (20.8%), followed by V179D (9.4%) and V106M (7.8%); the most common NRTI resistance mutation site was M184V/I/MV (14.3%), followed by K65R (6.9%); three PI-associated resistance mutation sites were identified. The subtype of the resistant strain was CRF07-BC in almost all patients (98.9%). Conclusions Compared with the previous low ART efficacy in the county, this study showed that the overall virological failure (VF) resistance rate in the county is still low, dominated by resistance to EFV, NVP, 3TC, FTC, and didanosine (DDI). Due to economic constraints, the core regimen is still 3TC + TDF, but before initiating ART, testing for HIV-1 subtypes and resistance should be conducted to avoid resistance that can lead to VF, especially for patients with high risk factors for resistance as shown by epidemiologic investigations.
Læs mere Tjek på PubMedMichal JuraskaHongjun BaiAllan C. deCampCraig A. MagaretLi LiKevin GillespieLindsay N. CarppElena E. GiorgiJames LudwigCindy MolitorAaron HudsonBrian D. WilliamsonNicole EspyBrian SimpkinsErika RudnickiDanica ShaoRaabya RossenkhanPaul T. EdlefsenDylan H. WestfallWenjie DengLennie ChenHong ZhaoTanmoy BhattacharyaAlec PankowBen MurrellAnna YsselDavid MattenTalita YorkNicolas BeaumeAsanda Gwashu-NyangiweNonkululeko NdabambiRuwayhida ThebusShelly T. KarunaLynn MorrisDavid C. MontefioriJohn A. HuralMyron S. CohenLawrence CoreyMorgane RollandPeter B. GilbertCarolyn WilliamsonJames I. MullinsaVaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA 98109bU.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910cHenry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817dBiostatistics Division, Kaiser Permanente Washington Health Research Institute, Seattle, WA 98101eScience and Technology Policy Fellowships, American Association for the Advancement of Science, Washington, DC 20005fDepartment of Computer Science, Pitzer College, Claremont, CA 91711gDepartment of Microbiology, University of Washington School of Medicine, Seattle, WA 98195hTheoretical Division, Los Alamos National Laboratory, Los Alamos, NM 87544iDepartment of Microbiology, Tumor, and Cell Biology, Karolinska Institutet, Solna 171 77, SwedenjInstitute of Infectious Disease and Molecular Medicine, and Wellcome Centre for Infectious Diseases Research in Africa, Department of Pathology, Faculty of Health Sciences, University of Cape Town and National Health Laboratory Service, Cape Town 7701, South AfricakHIV Virology Section, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg 2192, South AfricalAntibody Immunity Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South AfricamCentre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Durban 4041, South AfricanDepartment of Surgery, Duke University Medical Center, Durham, NC 27710oInstitute of Global Health and Infectious Diseases, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599pDepartment of Medicine, University of Washington, Seattle, WA 98195qDepartment of Laboratory Medicine, University of Washington, Seattle, WA 98195rPublic Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109sDepartment of Biostatistics, University of Washington, Seattle, WA 98195tDepartment of Global Health, University of Washington, Seattle, WA 98195uDepartment of Microbiology, University of Washington, Seattle, WA 98109
Proceedings of the National Academy of Sciences, 24.01.2024
Tilføjet 24.01.2024
Proceedings of the National Academy of Sciences, Volume 121, Issue 4, January 2024.
Læs mere Tjek på PubMedEden Ashenafi, Getahun Beyene Guluma, Dirshaye Argaw, Habtamu Endashaw Hareru, Nagasa Eshete Soboksa
PLoS One Infectious Diseases, 24.01.2024
Tilføjet 24.01.2024
by Eden Ashenafi, Getahun Beyene Guluma, Dirshaye Argaw, Habtamu Endashaw Hareru, Nagasa Eshete Soboksa Background For those living with HIV/AIDS, malnutrition is a significant issue everywhere, but it is particularly prevalent in Sub-Saharan Africa. A nutritional support program is becoming a more and more common strategy to prevent malnutrition in HIV-positive persons. Thus, this study aimed to assess nutritional treatment outcomes and their predictors among adult HIV-positive undernourished individuals in West Guji Zone healthcare facilities. Method A facility-based retrospective cohort study was conducted among 348 randomly selected adult HIV- positive patients in the West Guji Zone healthcare facilities between January 2018 and December 2022. Data were collected using the data extraction tool. Entered into Epi Data version 3.1 and exported to SPSS version 26 for analysis. The Kaplan-Meier survival curve and log-rank test were used to predict the time to recovery and to compare survival curves across categorical variables. A Cox proportional hazard regression model was fitted to identify an independent predictor of the recovery rate. Statistical significance was declared at a p-value of < 0.05. Results In the final analysis 348 undernourished HIV-positive persons were included. Based on preset exit criteria, approximately 198, 56.9% of patients enrolled in the RUTF program were able to recovered, with an incidence of 9.83 (95% CI: 3.12, 13.44) per 100 person-month observations. Being divorced (AHR = 0.21; 95% CI: 0.06, 0.69) and being in the WHO advanced stage (AHR = 0.42; 95% CI: 0.23, 0.79) was a negative predictor. Being in the age range of 18–29 and 30–39 and having a working functional status (AHR = 2; 95% CI: 1.25, 3.23) were positive predictors. Conclusion Nutritional recovery in this study lower than WHO Sphere requirements. Age between 18 and 39 and working functional status were good indicators of nutritional recovery, whereas advanced WHO clinical stage and divorced marital status were negative predictors.
Læs mere Tjek på PubMedJohn E. Moore, Beverley C. Millar
Clinical Microbiology and Infection, 23.01.2024
Tilføjet 23.01.2024
Tuberculosis (TB) is 13th leading cause of death globally and the second leading cause of death from an infectious disease after COVID-19 (above HIV and AIDS).1 In 2021, it is estimated that 10.6 million people worldwide developed TB, including six million men, 3.4 million women and 1.2 million children, and in that year, approximately 1.6 million people died from TB, including 187 000 people with HIV.1
Læs mere Tjek på PubMedMinjuan LiYangyi ZhangZheyuan WuYuan JiangRuoyao SunJinghui YangJing LiHonghua LinRui ZhangQi JiangLili WangXiaocui WuFangyou YuJianhui YuanChongguang YangXin Shena School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Guangdong, People’s Republic of Chinab Division of TB and HIV/AIDS Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People’s Republic of Chinac Shanghai Institutes of Preventive Medicine, Shanghai, People’s Republic of Chinad Department of Epidemiology, School of Public Health and Key Laboratory of Public Health Safety, Fudan University, Shanghai, People’s Republic of Chinae Department of Clinical Laboratory, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of Chinaf Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, People’s Republic of Chinag Nanshan District Center for Disease Control and Prevention, Shenzhen, People’s Republic of China
Emerg Microbes Infect, 23.01.2024
Tilføjet 23.01.2024
Minh-Anh Le-Dang, Hai-Yen Nguyen-Thi, Luyen Pham Dinh, Danh Le Ngoc, Nguyen Dang Tu Le, Hien Pham Thu, Dinh Thanh Le
PLoS One Infectious Diseases, 19.01.2024
Tilføjet 19.01.2024
by Minh-Anh Le-Dang, Hai-Yen Nguyen-Thi, Luyen Pham Dinh, Danh Le Ngoc, Nguyen Dang Tu Le, Hien Pham Thu, Dinh Thanh Le Background The Coronavirus disease of 2019 (COVID-19) pandemic and the corresponding mitigation measures have had a discernible impact on drug utilization among outpatients. However, limited research exists on the prescription trends in the elderly population during the pandemic period in Viet Nam. Objectives This study aims to analyze the effects of COVID-19 on outpatient drug utilization patterns at a national geriatric hospital in Ho Chi Minh City before and after the early onset of the pandemic. Methods Data was collected from the prescriptions and administration claims, encompassing the period from January 2016 to December 2022. The dataset was divided into two periods: Period 1: January 2016 to December 2020 and Period 2: January 2021 to December 2022. The drug utilization was measured using DDD/1000P (defined daily doses–DDD per 1000 prescriptions) on a monthly basis. The analysis employed interrupted time series using Autoregressive Integrated Moving Average (ARIMA) to detect changes in drug use levels and rates. Results A total of 1,060,507 and 644,944 outpatient prescriptions from Thong Nhat Hospital were included in Period 1 and Period 2, respectively. The median age of the patients were 58 in Period 1 and 67 years old in Period 2. The most common comorbidities were dyslipidemia, hypertension, and diabetes mellitus. In terms of medication utilization, cardiovascular drugs were the most frequently prescribed, followed by drugs active on the digestive and hormonal systems. The study observed significant surges in the number of prescriptions and the average number of drugs per prescription. However, there were no significant changes in the overall consumption of all drugs. Among the drug groups related to the cardiovascular system, three subgroups experienced a sudden and significant increase: cardiac therapy, beta-blocking agents, and antihypertensives, with increasing consumption levels of 1,177.73 [CI 95%: 79.29; 2,276.16], 73.32 [CI 95%: 28.18; 118.46], and 36.70 [CI 95%: 6.74; 66.66] DDD/1000P, respectively. On the other hand, there was a significant monthly decrease of -31.36 [CI 95%: -57.02; -5.70] DDD/1000P in the consumption of anti-inflammatory and antirheumatic products. Interestingly, there was a significant increase of 74.62 [CI 95%: -0.36; 149.60] DDD/1000P in the use of antigout preparations. Conclusion COVID-19 resulted in a sudden, non-significant increase in overall drug consumption levels among outpatients. Notably, our findings highlight significant increases in the utilization of three drug groups related to the cardiovascular system, specifically cardiac therapy, beta-blocking agents, and antihypertensives. Intriguingly, there was a statistically significant increase in the consumption of antigout preparations, despite a decline in the monthly consumption rate of non-steroidal anti-flammatory drugs (NSAIDs). Further studies in the following years are necessary to provide a more comprehensive understanding of the impact of COVID-19 on outpatient drug utilization patterns.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 17.01.2024
Tilføjet 17.01.2024
Abstract Background Torque Teno Virus (TTV) is a non-enveloped, circular single-strand DNA virus and part of the human virome. The replication of TTV was related to the immune status in patients treated with immunosuppressive drugs after organ transplantation. We hypothesize that TTV load could be an additional marker for immune function in people living with HIV (PLWH).Methods In this analysis serum samples of PLWH from the RESINA multicenter cohort were reanalysed for TTV. Investigated clinical and epidemiological parameters included Pegivirus (HPgV) load, age, sex, HIV load, CD4+ cell count (CDC 1, 2, 3) and CDC clinical stages (1993 CDC classification system, A, B, C) before initiation of antiretroviral treatment. Regression analysis was used to detect possible associations among parameters.Results Our analysis confirmed TTV as a strong predictor of CD4+ cell count and CDC class 3. This relationship was used to propose a first classification of TTV load in regard to clinical stage. We found no association with clinical CDC stages A, B and C. HPgV load was inversely correlated with HIV load but not TTV load.Conclusions TTV load was associated with immunodeficiency in PLWH. Neither TTV- nor HIV load were predictive for the clinical categories of HIV infection.
Læs mere Tjek på PubMedGoyal, Ravi; Hotchkiss, John; Gilman, Boyd; Klein, Pamela W.; Mills, Robert J.; Starling, Jennifer; Martin, Natasha K.; Patton, Thomas; Cohen, Stacy M.; Cheever, Laura
AIDS, 17.01.2024
Tilføjet 17.01.2024
Objective: Investigate the role of the Ryan White HIV/AIDS Program (RWHAP) – which funds services for vulnerable and historically disadvantaged populations with HIV – in reducing health inequities among people with HIV over a 10-year horizon. Design: We use an agent-based microsimulation model to incorporate the complexity of the program and long-time horizon. Methods: We use a composite measure (the Theil index) to evaluate the health equity implications of the RWHAP for each of four subgroups (based on race and ethnicity, age, gender, and HIV transmission category) and two outcomes (probability of being in care and treatment and probability of being virally suppressed). We compare results with the RWHAP fully funded versus a counterfactual scenario, in which the medical and support services funded by the RWHAP are not available. Results: The model indicates the RWHAP will improve health equity across all demographic subgroups and outcomes over a 10-year horizon. In Year 10, the Theil index for race and ethnicity is 99% lower for both outcomes under the RWHAP compared to the non-RWHAP scenario; 71–93% lower across HIV transmission categories; 31–44% lower for age; and 73–75% lower for gender. Conclusion: Given the large number of people served by the RWHAP and our findings on its impact on equity, the RWHAP represents an important vehicle for achieving the health equity goals of the National HIV/AIDS Strategy (2022–2025) and the Ending the HIV Epidemic Initiative goal of reducing new infections by 90% by 2030. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedLi, Na; Zheng, Hong-Yi; He, Wen-Qiang; He, Xiao-Yan; Li, Rui; Cui, Wen-Bo; Yang, Wei-Lin; Dong, Xing-Qi; Shen, Zhi-Qiang; Zheng, Yong-Tang
AIDS, 17.01.2024
Tilføjet 17.01.2024
Objectives: There is conflicting data regarding the response of older people with HIV (PWH) to antiretroviral therapy (ART). The objective of this study was to evaluate the long-term immunological and virological responses, changes in regimen, and adverse drug reactions (ADRs) in older participants (50+ years) compared with younger (18–34 years) and middle-aged (35–49 years) PWH. Methods: A retrospective review of medical records was conducted on 1622 participants who received ART in Yunnan Province, China, from 2010 to 2019. The study compared CD4+ T-cell counts, CD4+/CD8+ ratio, and relative numbers between different groups using the Kruskal–Wallis test. Cox proportional hazards regression models were used to identify variables associated with the occurrence of immune reconstitution insufficiency. The rates of immune reconstitution, incidence of ADRs, and rates of treatment change were analyzed using the chi-squared test or Fisher\'s exact test. Results: Over 95% achieved viral load 200 copies/ml or less, with no age-related difference. However, older participants exhibited significantly lower CD4+ T-cell counts and CD4+/CD8+ recovery post-ART (P
Læs mere Tjek på PubMedHarikrishnan Vijayakumar Sreelatha, Hamza Palekkodan, Ansar Fasaludeen, Lissy K. Krishnan, Klas S. P. Abelson
PLoS One Infectious Diseases, 17.01.2024
Tilføjet 17.01.2024
by Harikrishnan Vijayakumar Sreelatha, Hamza Palekkodan, Ansar Fasaludeen, Lissy K. Krishnan, Klas S. P. Abelson Usage and reporting of analgesia in animal models of spinal cord injury (SCI) have been sparse and requires proper attention. The majority of experimental SCI research uses rats as an animal model. This study aimed to probe into the effects of some commonly used regimens with NSAIDs and opioids on well-being of the rats as well as on the functional outcome of the model. This eight-week study used forty-two female Wistar rats (Crl: WI), randomly and equally divided into 6 treatment groups, viz. I) tramadol (5mg/kg) and buprenorphine (0.05mg/kg); II) carprofen (5mg/kg) and buprenorphine (0.05mg/kg); III) carprofen (5mg/kg); IV) meloxicam (1mg/kg) and buprenorphine (0.05mg/kg); V) meloxicam (1mg/kg); and VI) no analgesia (0.5 ml sterile saline). Buprenorphine was administered twice daily whereas other treatments were given once daily for five days post-operatively. Injections were given subcutaneously. All animals underwent dental burr-assisted laminectomy at the T10-T11 vertebra level. A custom-built calibrated spring-loaded 200 kilodynes force deliverer was used to induce severe SCI. Weekly body weight scores, Rat Grimace Scale (RGS), and dark-phase home cage activity were used as markers for well-being. Weekly Basso Beattie and Bresnahan (BBB) scores served as markers for functionality together with Novel Object Recognition test (NOR) at week 8 and terminal histopathology using area of vacuolisation and live neuronal count from the ventral horns of spinal cord. It was concluded that the usage of analgesia improved animal wellbeing while having no effects on the functional aspects of the animal model in comparison to the animals that received no analgesics.
Læs mere Tjek på PubMedJournal of the American Medical Association, 16.01.2024
Tilføjet 16.01.2024
To the Editor Deficits in nonverbal communicative behaviors used for social interaction are manifested by absent, reduced, or atypical use of eye contact. The study by Jones et al is an important step toward the development of reliable diagnostic aids for autism spectrum disorders. My concern relates to the formulation of expert clinician diagnosis, which is central to the determination of the sensitivity and specificity of the eye-tracking measurement of social visual engagement for autism diagnoses.
Læs mere Tjek på PubMedBMC Infectious Diseases, 15.01.2024
Tilføjet 15.01.2024
Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has disrupted multiple health services, including human immunodeficiency virus (HIV) testing, care, and treatment services, jeopardizing the achievement of the Joint United Nations Programme on HIV/AIDS 90-90-90 global target. While there are limited studies assessing the impact of the COVID-19 pandemic on people living with HIV (PLHIV) in Latin America, there are none, to our knowledge, in Venezuela. This study aims to assess the impact of the COVID-19 pandemic among PLHIV seen at the outpatient clinic of a reference hospital in Venezuela. Methods We conducted a cross-sectional study among PLHIV aged 18 years and over seen at the Infectious Diseases Department of the University Hospital of Caracas, Venezuela between March 2021 and February 2022. Results A total of 238 PLHIV were included in the study. The median age was 43 (IQR 31–55) years, and the majority were male (68.9%). Most patients (88.2%, n = 210) came for routine check-ups, while 28 (11.3%) were newly diagnosed. The majority of patients (96.1%) were on antiretroviral therapy (ART), but only 67.8% had a viral load test, with almost all (95.6%) being undetectable. Among those who attended regular appointments, 11.9% reported missing at least one medical consultation, and 3.3% reported an interruption in their ART refill. More than half of the patients (55.5%) had received at least one dose of the COVID-19 vaccine, while the rest expressed hesitancy to get vaccinated. Most patients with COVID-19 vaccine hesitancy were male (65.1%), younger than 44 years (57.5%), employed (47.2%), and had been diagnosed with HIV for less than one year (33%). However, no statistically significant differences were found between vaccinated patients and those with COVID-19 vaccine hesitancy. Older age was a risk factor for missing consultations, while not having an alcoholic habit was identified as a protective factor against missing consultations. Conclusion This study found that the COVID-19 pandemic had a limited impact on adherence to medical consultations and interruptions in ART among PLHIV seen at the University Hospital of Caracas, Venezuela.
Læs mere Tjek på PubMedClinical Infectious Diseases, 13.01.2024
Tilføjet 13.01.2024
Abstract Background Advancements in access to antiretroviral therapy (ART) and human immunodeficiency virus (HIV) care have led to a decline in acquired immunodeficiency syndrome (AIDS)-related deaths among people with HIV (PWH) in Switzerland. However, data on the ongoing changes in causes of death among PWH over the past 15 years is scarce.Methods We investigated all reported deaths in the Swiss HIV Cohort Study between 2005-2022. Causes of death were categorized using the Coding Causes of Death in HIV protocol. The statistical analysis included demographic stratification to identify time trends and logistic regression models to determine associated factors for the underlying cause of death.Results In total, 1630 deaths were reported, with 23.7% of individuals assigned female at birth. Out of these deaths, 147 (9.0%) were HIV/AIDS-related, 373 (22.9%) due to non-AIDS, non-hepatic (NANH) cancers, 166 (10.2%) liver-related, and 158 (9.7%) cardiovascular-related. The median age at death increased from 45.0 [40.0,53.0] years in 2005-2007 to 61.0 [56.0,69.5] years in 2020-2022. HIV/AIDS and liver-related causes of death decreased, whereas deaths from NANH cancers increased, and cardiovascular-related deaths remained relatively stable.Conclusion The proportionally decreasing HIV/AIDS and liver-related deaths showcase the effectiveness of ART, comprehensive HIV patient care, and interventions targeting hepatitis C virus co-infection. Future research should focus on managing cancer and cardiovascular-related conditions as the new leading causes of death among PWH. Comprehensive healthcare strategies focusing on non-AIDS-related comorbidities, cancer management, and sustaining liver and cardiovascular health are needed to bridge the ongoing health disparities between PWH and the general population.
Læs mere Tjek på PubMedAlexandre Perret, Marion Le Marechal, Raphaele Germi, Daniele Maubon, Cécile Garnaud, Johan Noble, Aude Boignard, Loïc Falque, Mathieu Meunier, Théophile Gerster, Olivier Epaulard
PLoS One Infectious Diseases, 11.01.2024
Tilføjet 11.01.2024
by Alexandre Perret, Marion Le Marechal, Raphaele Germi, Daniele Maubon, Cécile Garnaud, Johan Noble, Aude Boignard, Loïc Falque, Mathieu Meunier, Théophile Gerster, Olivier Epaulard Objectives Cytomegalovirus (CMV) is frequently detected in lung and/or blood samples of patients with Pneumocystis jirovecii pneumonia (PJP), although this co-detection is not precisely understood. We aimed to determine whether PJP was more severe in case of CMV detection. Methods We retrospectively included all patients with a diagnosis of PJP between 2009 and 2020 in our centre and with a measure of CMV viral load in blood and/or bronchoalveolar lavage (BAL). PJP severity was assessed by the requirement for intensive care unit (ICU) admission. Results The median age of the 249 patients was 63 [IQR: 53–73] years. The main conditions were haematological malignancies (44.2%), solid organ transplantations (16.5%), and solid organ cancers (8.8%). Overall, 36.5% patients were admitted to ICU. CMV was detected in BAL in 57/227 patients; the 37 patients with viral load ≥3 log copies/mL were more frequently admitted to ICU (78.4% vs 28.4%, p
Læs mere Tjek på PubMedMargaux Louchet, Mathis Collier, Nathanaël Beeker, Laurent Mandelbrot, Jeanne Sibiude, Laurent Chouchana, Jean Marc Treluyer
PLoS One Infectious Diseases, 11.01.2024
Tilføjet 11.01.2024
by Margaux Louchet, Mathis Collier, Nathanaël Beeker, Laurent Mandelbrot, Jeanne Sibiude, Laurent Chouchana, Jean Marc Treluyer Objective Describe the trends of exposure to harmful drugs during pregnancy over recent years in France. Design Nationwide cohort study. Setting The French National administrative health Data System (SNDS). Population Pregnancies starting between 2013 and 2019 and outcomes corresponding to live births, medical terminations of pregnancy, and stillbirths. Methods Each pregnancy was divided into a preconceptional period of 90 days before conception and three trimesters from conception to birth. Harmful drugs were defined according to their risks to the fetus: teratogenicity or fetotoxicity. Exposure was defined using the critical period during pregnancy for each type of harmful drug: preconceptional period or first trimester for teratogenic drugs and second or third trimesters for fetotoxic drugs. Main outcome measures Prevalence of pregnancies exposed to at least one harmful drug. Results Among 5,253,284 pregnancies, 204,402 (389 per 10,000) pregnancies were exposed to at least one harmful drug during the critical periods: 48,326 (92 per 10,000) pregnancies were exposed to teratogenic drugs during the preconceptional period or the first trimester, and 155,514 (299 per 10,000) pregnancies were exposed to fetotoxic drugs during the second or third trimesters. Teratogenic drugs were mainly retinoids for topical use (44 per 10,000 pregnancies), antiepileptics (13 per 10,000 pregnancies) and statins (13 per 10,000 pregnancies). Fetotoxic drugs were mainly non-steroidal anti-inflammatory drugs (NSAIDs), for systemic (128 per 10,000 pregnancies) and topical use (122 per 10,000 pregnancies). Exposure to teratogenic drugs decreased from the preconceptional period to the first trimester. Exposure to fetotoxic drugs decreased from the second to the third trimester. Between 2013 and 2019, we found a decrease in harmful drug exposure overall, mainly for topical and systemic NSAIDs and for topical retinoids. Conclusions In this nationwide study, about one in 25 pregnancies was exposed to at least one harmful drug, mainly NSAIDs and topical retinoids. Although the prevalence of harmful drug exposure decreased over the study period, NSAID exposure in the second and third trimester remains of concern.
Læs mere Tjek på PubMedEnane, L. A., Duda, S. N., Chanyachukul, T., Bolton-Moore, C., Navuluri, N., Messou, E., Mbonze, N., McDade, L. R., Figueiredo, M. C., Ross, J., Evans, D., Diero, L., Akpata, R., Zotova, N., Freeman, A., Pierre, M. F., Rupasinghe, D., Ballif, M., Byakwaga, H., de Castro, N., Tabala, M., Sterling, T. R., Sohn, A. H., Fenner, L., Wools-Kaloustian, K., Poda, A., Yotebieng, M., Huebner, R., Marcy, O., on behalf of the International epidemiology Databases to Evaluate AIDS
BMJ Open, 9.01.2024
Tilføjet 9.01.2024
IntroductionTuberculosis (TB) is a leading infectious cause of death globally. It is the most common opportunistic infection in people living with HIV, and the most common cause of their morbidity and mortality. Following TB treatment, surviving individuals may be at risk for post-TB lung disease. The TB Sentinel Research Network (TB-SRN) provides a platform for coordinated observational TB research within the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. Methods and analysisThis prospective, observational cohort study will assess treatment and post-treatment outcomes of pulmonary TB (microbiologically confirmed or clinically diagnosed) among 2600 people aged ≥15 years, with and without HIV coinfection, consecutively enrolled at 16 sites in 11 countries, across 6 of IeDEA’s global regions. Data regarding clinical and sociodemographic factors, mental health, health-related quality of life, pulmonary function, and laboratory and radiographic findings will be collected using standardised questionnaires and data collection tools, beginning from the initiation of TB treatment and through 12 months after the end of treatment. Data will be aggregated for proposed analyses. Ethics and disseminationEthics approval was obtained at all implementing study sites, including the Vanderbilt University Medical Center Human Research Protections Programme. Participants will provide informed consent; for minors, this includes both adolescent assent and the consent of their parent or primary caregiver. Protections for vulnerable groups are included, in alignment with local standards and considerations at sites. Procedures for requesting use and analysis of TB-SRN data are publicly available. Findings from TB-SRN analyses will be shared with national TB programmes to inform TB programming and policy, and disseminated at regional and global conferences and other venues.
Læs mere Tjek på PubMedBMC Infectious Diseases, 7.01.2024
Tilføjet 7.01.2024
Abstract Background Misconceptions and myths are still the bottlenecks for the prevention of HIV/AIDS transmission in developing countries. This study aimed to assess the prevalence and associated factors of misconception about HIV transmission among reproductive age groups using the most recently available Ethiopian Demographic and Health Surveydata. Methods A cross-sectional study design was done using the Ethiopian Demographic and Health Survey 2016 data set. The data analysis was conducted using Statistical Package for Social Sciences version 25. Multivariable logistic regression analysis was done to identify associated factors of misconception about HIV/AIDS transmission. A p-value of
Læs mere Tjek på PubMedTony Kirby
Lancet, 5.01.2024
Tilføjet 5.01.2024
An eclectic mix of countries have already reached the UNAIDS 95-95-95 targets, but others including Russia, Ukraine, and the USA remain off track. Tony Kirby reports.
Læs mere Tjek på PubMedTony Kirby
Lancet, 5.01.2024
Tilføjet 5.01.2024
“Being gay meant facing the loss and terror of HIV/AIDS”, says global health advocate Bruce Richman when speaking about his formative years during the 1980s and 1990s in the New England region of the USA. It was a time when HIV/AIDS began extending its dark shadow worldwide and Richman was navigating his own sexuality while seeing news about healthy young men suddenly succumbing to this new disease. His early experiences shaped the role he has today as founder of the Prevention Access Campaign (PAC), a non-profit organisation that launched, with partners, the Undetectable=Untransmittable (U=U) movement to build a scientific consensus on the fact that people living with HIV who are on antiretroviral therapy and have an undetectable viral load cannot sexually transmit HIV.
Læs mere Tjek på PubMedBMC Infectious Diseases, 4.01.2024
Tilføjet 4.01.2024
Abstract Introduction The dynamic HIV/AIDS epidemic significantly impacts China, particularly affecting injection drug users (IDUs), former plasma donors (FPDs), men who have sex with men (MSM), and those engaging in high-risk heterosexual behavior (HRHB). This study specifically focuses on identifying the risk factors and influences that drive the spread of HIV among these population groups by performing a comprehensive analysis of contact histories of individuals diagnosed with HIV. Methods Data for this research were gathered from China’s HIV/AIDS Comprehensive Response Information Management System (CRIMS). Contact histories were described using bar and venn diagram. Trend in engaging in HBRB among MSM were identify potential change using the Cochran-Armitage test. Logistic regression was employed to analyze the factors influencing HBRB in MSM. Results From 1989 through to 2022, a total of 1,457,218 individuals aged 15 years or older in China, who reported being infected with HIV, indicated they had one or more types of contact histories including injecting drug use, male homosexual behavior, commercial plasma donation, and high-risk heterosexual behavior. Among these, 97.0% reported a single type of contact history, while 3.0% reported having multiple contact histories. Of those with multiple contact histories, 98.0% (42,258 individuals) had engaged in HRHB. Among all HIV-infected IDUs, MSM, and FPDs, their respective proportions of engagement in HRHB were 11.8%, 5.7% and 6.2%. Prior to 2012, most were reported to be IDUs; however, subsequent to this, most reported being MSM. Factors that heightened the risk of engaging in HRHB among HIV-infected MSM included being of age between 25–34 years [adjusted odds ratio (AOR) = 1.29] or 35–44 years (AOR = 1.22), marital status such as being married (AOR = 1.23) or being divorced/widowed (AOR = 1.17), belonging to an ethnic minority (AOR = 1.29), receiving diagnosis in hospitals (AOR = 1.81), residing in rural areas (AOR = 1.12), among others. However, the risk of HRHB decreased when age ≥ 55 years (55–64 years: AOR = 0.82; ≥ 65 years: AOR = 0.64). Conclusion The potential for HIV transmission among diverse populations is substantial. As such, it is imperative that strategies are implemented to mitigate the propagation of HIV to the general populace via heterosexual intercourse.
Læs mere Tjek på PubMedStuart, B., Venekamp, R., Hounkpatin, H., Wilding, S., Moore, M., Little, P., Gulliford, M. C.
BMJ Open, 3.01.2024
Tilføjet 3.01.2024
ObjectivesInfections in primary care are often treated with non-steroidal anti-inflammatory drugs (NSAIDs). This study evaluates whether NSAID prescribing is associated with adverse outcomes for respiratory (RTIs) or urinary track (UTI) infections. ObjectivesTo determine whether there is an association between NSAID prescribing and the rate of adverse outcomes for infections for individual consulting in primary care. DesignCohort study of electronic health records. Setting87 general practices in the UK Clinical Practice Research Datalink GOLD. Participants142 925 patients consulting with RTI or UTI. Primary and secondary outcome measuresRepeat consultations, hospitalisation or death within 30 days of the initial consultation for RTI or UTI. Poisson models estimated the associations between NSAID exposure and outcome. Rate ratios were adjusted for gender, age, ethnicity, deprivation, antibiotic use, seasonal influenza vaccination status, comorbidities and general practice. Since prescribing variations by practice are not explained by case mix—hence, less impacted by confounding by indication—both individual-level and practice-level analyses are included. ResultsThere was an increase in hospital admission/death for acute NSAID prescriptions (RR 2.73, 95% CI 2.10 to 3.56) and repeated NSAID prescriptions (6.47, 4.46–9.39) in RTI patients, and for acute NSAID prescriptions for UTI (RR 3.03; 1.92 to 4.76). Practice-level analysis, controlling for practice population characteristics, found that for each percentage point increase in NSAID prescription, the percentages of hospital admission/death within 30 days increased by 0.32 percentage points (95% CI 0.16 to 0.47). ConclusionsIn this non-randomised study, prescription of NSAIDs at consultations for RTI or UTIs in primary care is infrequent but may be associated with increased risk of hospital admission. This supports other observational and limited trial data that NSAID prescribing might be associated with worse outcomes following acute infection and should be prescribed with caution.
Læs mere Tjek på PubMedKebede, Samuel; Brazier, Ellen; Freeman, Aimee M.; Muwonge, Timothy R.; Choi, Jun Yong; de Waal, Renee; Poda, Armel; Cesar, Carina; Munyaneza, Athanase; Kasozi, Charles; Pasayan, Mark Kristoffer U.; Althoff, Keri N.; Shongo, Alisho; Low, Nicola; Ekouevi, Didier; Veloso, Valdiléa G.; Ross, Jonathan
AIDS, 2.01.2024
Tilføjet 2.01.2024
Background: While recognized as a key HIV prevention strategy, preexposure prophylaxis (PrEP) availability and accessibility are not well documented globally. We aimed to describe PrEP drug registration status and the availability of PrEP services across HIV care sites participating in the International epidemiology Databases to Evaluate AIDS (IeDEA) research consortium. Methods: We used country-level PrEP drug registration status from the AIDS Vaccine Advocacy Coalition and data from IeDEA surveys conducted in 2014, 2017 and 2020 among participating HIV clinics in seven global regions. We used descriptive statistics to assess PrEP availability across IeDEA sites serving adult patients in 2020 and examined trends in PrEP availability among sites that responded to all three surveys. Results: Of 199 sites that completed the 2020 survey, PrEP was available in 161 (81%). PrEP availability was highest at sites in North America (29/30; 97%) and East Africa (70/74; 95%) and lowest at sites in Central (10/20; 50%) and West Africa (1/6; 17%). PrEP availability was higher among sites in countries where PrEP was officially registered (146/161; 91%) than where it was not (14/32; 44%). Availability was higher at health centers (109/120; 90%) and district hospitals (14/16; 88%) compared to regional/teaching hospitals (36/63). Among the 94 sites that responded to all three surveys, PrEP availability increased from 47% in 2014 to 60% in 2017 and 76% in 2020. Conclusion: PrEP availability has substantially increased since 2014 and is now available at most IeDEA sites. However, PrEP service provision varies markedly across global regions. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedRamírez-Ortiz, Daisy; Jean-Gilles, Michele; Sheehan, Diana M.; Ladner, Robert; Li, Tan; Trepka, Mary Jo
Journal of Acquired Immune Deficiency Syndromes, 2.01.2024
Tilføjet 2.01.2024
Background: Racial/ethnic minority groups with HIV in the United States are particularly vulnerable to COVID-19 consequences and can significantly benefit from increased uptake of COVID-19 vaccines. This study identified factors associated with full COVID-19 vaccination among people with HIV. Setting: Ryan White HIV/AIDS Program (RWP) in Miami-Dade County, Florida. Methods: Data were collected from 299 RWP adult clients during January–March 2022 using a cross-sectional phone survey. Multivariable logistic regression was used to estimate adjusted odds ratios (aORs) with 95% confidence intervals (CIs). All analyses were weighted to be representative of the race/ethnicity and sex distribution of clients in the RWP. Results: Eighty-four percent of participants were fully vaccinated with a primary vaccine series; stratified by race/ethnicity, the percentages were 88.9% of Hispanic, 72.0% of Black/African American, and 67.5% of Haitian participants. Fully vaccinated participants were less likely to be Black/African American than Hispanic (aOR=0.18; 95% CI=0.05-0.67) and more likely to not endorse any misconceptions about COVID-19 vaccines (aOR=8.26; 95% CI=1.38-49.64), to report encouragement to get vaccinated from sources of information (aOR=20.82; 95% CI=5.84-74.14), and to perceive that more than 50% of their social network was vaccinated (aOR=3.35; 95% CI=1.04-10.71). Experiences of healthcare discrimination, structural barriers to access vaccines, and recommendations from HIV providers were not associated with full vaccination. Conclusions: These findings highlight the importance of delivering accurate and positive messages about vaccines and engaging social networks to promote COVID-19 vaccination among PWH. This information can be leveraged to promote uptake of subsequent boosters and other recommended vaccines. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedYi-Chia Huang, Chia-Jui Yang, Hsin-Yun Sun, Chen-Hsiang Lee, Po-Liang Lu, Hung-Jen Tang, Chun-Eng Liu, Yuan-Ti Lee, Chin-Shiang Tsai, Nan-Yao Lee, Bo-Huang Liou, Tung-Che Hung, Mei-Hui Lee, Miao-Hui Huang, Ning-Chi Wang, Chi-Ying Lin, Yi-Chien Lee, Shu-Hsing Cheng, Chien-Ching Hung
International Journal of Infectious Diseases, 30.12.2023
Tilføjet 30.12.2023
According to the latest statistics from UNAIDS, the case number of people newly diagnosed with HIV has declined by 32% in the past decade; however, 1.3 million new infections occurred in 2022, which was almost three times higher than the 2020 target of 500,000 [1,2]. To reduce the risk of human immunodeficiency virus (HIV) transmission, the treat-all policy was implemented under the “treatment-as-prevention” concept and the services of pre-exposure prophylaxis against HIV infection are scaling up globally.
Læs mere Tjek på PubMedNguyen, H. L. T., Bui, T. M., Dam, V. A. T., Nguyen, T. T., Nguyen, H. T., Zeng, G. M., Bradley, D., Nguyen, Q. N., Ngo, T. V., Latkin, C. A., Ho, R. C., Ho, C. S.
BMJ Open, 30.12.2023
Tilføjet 30.12.2023
ObjectiveThe prevention of HIV/AIDS is not making sufficient progress. The slow reduction of HIV/AIDS infections needs to prioritise hesitancy towards service utilisation, including treatment duration, social support and social stigma. This study investigates HIV-positive patients’ avoidance of healthcare services and its correlates. DesignA cross-sectional study. SettingThe secondary data analysis used cross-sectional data from a randomised controlled intervention, examining the effectiveness of HIV-assisted smartphone applications in the treatment of HIV/AIDS patients in the Bach Mai and Ha Dong clinics in Hanoi. MethodsSimple random sampling was used to identify 495 eligible patients. Two-tailed 2, Mann-Whitney, multivariate logistic and ordered logistic regression models were performed. Primary and secondary outcome measuresThe main study outcome was the patients’ healthcare avoidance and frequency of healthcare avoidance. The association of individual characteristics, social and behavioural determinants of HIV patients’ usage of health services was also determined based on the collected data using structured questionnaires. ResultsNearly half of the participants avoid health service use (47.3%), while 30.7% rarely avoid health service use. Duration of antiretroviral therapy and initial CD4 cell count were negatively associated with avoidance of health services and frequency of health service avoidance. Similarly, those with the middle and highest income were more likely to avoid health services compared with those with the lowest income. People having health problems avoided health service use more frequently (OR 1.47, 95% CI 1.35 to 1.61). ConclusionsOur study’s findings identify characteristics of significance in relation to health service avoidance and utilisation among HIV-positive patients. The results highlighted the need to improve satisfaction, adherence and utilisation of treatment. Moreover, identifying ways to address or incorporate those social determinants in new policy may also help the treatment of HIV/AIDS and strategically allocate funding in the changing financial and political climate of Vietnam. Trial registration numberThai Clinical Trials Registry TCTR20220928003.
Læs mere Tjek på PubMedYueyang YuYi FengZehua ZhouKang LiXiaoyan HuLingjie LiaoHui XingYimig Shaoa School of Medicine, Nankai University, Tianjin, People’s Republic of Chinab State Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of Chinac Changping Laboratory, Beijing, People’s Republic of China
Emerg Microbes Infect, 30.12.2023
Tilføjet 30.12.2023
You GeYing ZhouYahong LiuJing LuTao QiuLing-En ShiZhi ZhangHaiyang HuPingmin WeiGengfeng Fua Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, People’s Republic of Chinab Institute of HIV/AIDS/STI Prevention and Control, Jiangsu Provincial Center for Diseases Control and Prevention, Nanjing, People’s Republic of Chinac Jiangsu Cancer Hospital, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
Emerg Microbes Infect, 30.12.2023
Tilføjet 30.12.2023
Mengxiao LuoBiao ZhouEswar R. ReddemBingjie TangBohao ChenRunhong ZhouHang LiuLihong LiuPhinikoula S. KatsambaKa-Kit AuHiu-On ManKelvin Kai-Wang ToKwok-Yung YuenLawrence ShapiroShangyu DangDavid D. HoZhiwei Chena AIDS Institute, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People’s Republic of Chinab Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People’s Republic of Chinac Zuckerman Mind Brain Behaviour Institute, New York, NY, USAd Division of Life Science, Center of Systems Biology and Human Health, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong Special Administrative Region, People’s Republic of Chinae Aaron Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USAf State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People’s Republic of Chinag Centre for Virology, Vaccinology and Therapeutics, Health@InnoHK, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People’s Republic of Chinah Department of Clinical Microbiology and Infection Control, The University of Hong Kong-Shenzhen Hospital, Shenzhen, People’s Republic of Chinai Department of Microbiology, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, People’s Republic of Chinaj Southern Marine Science and Engineering Guangdong Laboratory (Guangzhou), Guangzhou, People’s Republic of Chinak HKUST-Shenzhen Research Institute, Nanshan, People’s Republic of China
Emerg Microbes Infect, 30.12.2023
Tilføjet 30.12.2023
Qian WangAndre Yanchen YehYicheng GuoHiroshi MohriJian YuDavid D. HoLihong Liua Aaron Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, USAb School of Medicine, National Taiwan University, Taipei, Taiwanc Department of Microbiology and Immunology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USAd Division of Infectious Diseases, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
Emerg Microbes Infect, 30.12.2023
Tilføjet 30.12.2023
Agus Widarjono, Rifai Afin, Gita Kusnadi, Muhammad Zulfiqar Firdaus, Olivia Herlinda
PLoS One Infectious Diseases, 30.12.2023
Tilføjet 30.12.2023
by Agus Widarjono, Rifai Afin, Gita Kusnadi, Muhammad Zulfiqar Firdaus, Olivia Herlinda The global trend of diets high in sugar sweetened beverages (SSB) is associated with a high risk of obesity and non-communicable diseases (NCDs). To reduce SSB consumption on a population level, SSB taxes have become a popular policy solution. In Indonesia, although the prevalence of obesity has doubled in the past decade (11.7% in 2010 to 21.8% in 2018), SSB taxes have not yet been implemented. Utilizing the 2021 Indonesian household socioeconomic survey (SUSENAS), this study estimated price elasticities and projected the plausible effects of implementing an SSB tax on consumers’ demand for SSBs and the associated government revenue using the Quadratic Almost Ideal Demand System (QUAIDS) model. Five SSB groups were studied: 1) manufactured liquid milk; 2) sweetened condense milk; 3) instant coffee; 4) tea drinks and fizzy drinks with CO2; 5) fruit juices, “health” drinks, and energy drinks. The overall results showed that the non-milk SSB groups were price elastic. Probing deeper into the substitutions for SSB across categories, we found both substitutionary and complementary effects. Our analysis revealed that increasing SSB prices by 20% would reduce the demand for SSBs on average by 17.5% (14.3%-18.6% for each SSB group) and generate additional state revenue up to IDR 3,628.3 billion per year (approximately US$ 238.5 million or 0.2% of total tax revenue in 2022). Considering the health and economic impacts of high consumption of SSBs, this study provides empirical evidence that imposing taxes on SSBs could be an effective measure to reduce public consumption and to generate tax revenue for financing health programs that address obesity and NCDs in Indonesia.
Læs mere Tjek på PubMedFuchten, D., Smit, A. L., Huenges Wajer, I. M. C., Rhebergen, K. S., Stegeman, I.
BMJ Open, 27.12.2023
Tilføjet 27.12.2023
IntroductionHearing loss is one of the leading potentially modifiable risk factors for dementia. There is growing evidence suggesting that treating hearing loss with hearing aids could be a relatively low-cost intervention in reducing cognitive decline and the risk of dementia in the long term. However, given the current constraints of the limited evidence, it is premature to draw definitive conclusions about the effect of hearing aids on cognitive functioning. More long-term randomised studies examining this effect would be recommended. Prior to embarking on large-scale lengthy randomised controlled trials (RCTs), it is imperative to determine the viability of such studies. Therefore, the purpose of the current study is to assess the feasibility of a RCT that investigates the effect of hearing aids on cognitive functioning in elderly hearing impaired individuals. Methods and analysisIn this randomised controlled feasibility trial, 24 individuals aged 65 years or older with mild to moderate hearing loss (≥35–
Læs mere Tjek på PubMedSafura-Luise Heidari, Malene Hove-Skovsgaard, Nicoline Stender Arentoft, Anne-Sophie W. Svartstein, Dina Leth Møller, Christian Salgård Jensen, Thomas Benfield, Jens-Ulrik Stæhr Jensen, Rebekka Faber Thudium, Susanne D. Nielsen
International Journal of Infectious Diseases, 27.12.2023
Tilføjet 27.12.2023
Respiratory infections, including pneumonia, are common causes of hospital admission in people with HIV (PWH) [1]. A multicenter study including 10,851 PWH found that pneumonia was the most frequently observed severe bacterial non-AIDS-defining infection in PWH [2]. Prior to the introduction of combination antiretroviral therapy (cART), incidence rates of pneumonia up to 90 cases per 1000 person-years were reported in USA, Europe, and Africa, corresponding to a 25-fold higher risk of bacterial pneumonia in PWH compared to the general population [3], [4].
Læs mere Tjek på PubMedClinical Infectious Diseases, 26.12.2023
Tilføjet 26.12.2023
Abstract Background Older people with HIV (PWH) are prone to using multiple medications due to higher rates of medical comorbidities and the use of antiretroviral therapy (ART). We assessed the prevalence and clinical impact of polypharmacy among PWH.Methods We leveraged clinical data from the AIDS Clinical Trials Group (ACTG) A5322 (HAILO) cohort of PWH aged 40 or older with plasma HIV RNA levels below 200 copies/µL. We assessed the relationship between polypharmacy (defined as the use of 5 or more prescription medications, excluding ART) and hyperpolypharmacy (defined as the use of 10 or more prescription medications) with slow gait speed (less than 1 meter/second) and falls, including recurrent falls.Results Excluding ART, 24% of study participants had polypharmacy and 4% had hyperpolypharmacy. Polypharmacy was more common in women (30%) than men (23%). Participants with polypharmacy had a higher risk of slow gait speed (Odds ratio (OR) = 1.78 [95% CI=1.27, 2.50]) and increased risk of recurrent falls (OR= 2.12 [95% CI=1.06, 4.23]). The risk for recurrent falls was further increased in those with hyperpolypharmacy compared to those without polypharmacy (OR = 3.46 [95% CI=1.32, 9.12]).Conclusions In this large, mixed-sex cohort of PWH aged over 40, polypharmacy was associated with slow gait speed and recurrent falls, even after accounting for medical comorbidities, alcohol use, substance use, and other factors. These results highlight the need for increased focus on identifying and managing polypharmacy and hyperpolypharmacy in PWH.
Læs mere Tjek på PubMedHimelhoch, Seth; Kelly, Deana; deFilippi, Chris; Taylor, Gregory; Bennett, Melanie; Medoff, Deborah; Li, Lan; Christiansen, Robert; Potts, Wendy; Shuter, Jonathan
AIDS, 26.12.2023
Tilføjet 26.12.2023
Background: People living with HIV/AIDS (PWH) smoke at nearly three times the rate of the general population. Interventions to promote sustained quitting among PWH are urgently needed. Methods: Our study used a randomized factorial design to evaluate the effects of varenicline, compared to placebo, and behavioral cessation therapy, Positively Smoke Free (PSF), compared to Standard of Care (SOC) among PWH who smoke. The study was designed with power to detect a small effect (Cohen\'s h of .28-.36) with 240 participants. The primary outcome was the 7-day point prevalence abstinence (PPA) confirmed by exhaled carbon monoxide
Læs mere Tjek på PubMedGaumer, G., Crown, W. H., Kates, J., Luan, Y., Hariharan, D., Jordan, M., Hurley, C. L., Nandakumar, A.
BMJ Open, 22.12.2023
Tilføjet 22.12.2023
ObjectivesThis study examined whether the US President’s Emergency Plan for AIDS Relief (PEPFAR) funding had effects beyond HIV, specifically on several measures of maternal and child health in low-income and middle-income countries (LMICs). The results of previous research on the question of PEPFAR health spillovers have been inconsistent. This study, using a large, multicountry panel data set of 157 LMICs including 90 recipient countries, adds to the literature. DesignSeven indicators including child and maternal mortality, several child vaccination rates and anaemia among childbearing-age women are important population health indicators. Panel data and difference-in-differences estimators (DID) were used to estimate the impact of the PEPFAR programme from inception in 2004 to 2018 using a comparison group of 67 LMICs. Several different models of baseline (2004) covariates were used to help balance the comparison and treatment groups. Staggered DID was used to estimate impacts since all countries did not start receiving aid at PEPFAR’s inception. SettingAll 157 LMICs from 1990 to 2018. Participants90 LMICs receiving PEPFAR aid and cohorts of those countries, including those required to submit annual country operational plans (COP), other recipient countries (non-COP), and three groupings of countries based on cumulative amount of per capita aid received (high, medium, low). InterventionsPEPFAR aid to combat the HIV epidemic. Primary outcome measuresMaternal mortality and child mortality rates, vaccination rates to protect children for diphtheria, whooping cough and tetanus, measles, HepB3, and tetanus, and prevalence of anaemia in women of childbearing age. ResultsAcross PEPFAR recipient countries, large, favourable PEPFAR health effects were found for rates of childhood immunisation, child mortality and maternal mortality. These beneficial health effects were large and significant in all segments of PEPFAR recipient countries studied. We also found significant and favourable programme effects on the prevalence of anaemia in women of childbearing age in PEPFAR recipient countries receiving the most intensive financial support from the PEPFAR programme. Other recipient countries did not demonstrate significant effects on anaemia. ConclusionsThis study demonstrated that important health indicators, beyond HIV, have been consistently and favourably influenced by PEPFAR presence. Child and maternal mortality have been substantially reduced, and childhood immunisation rates increased. We also found no evidence of ‘crowding out’ or negative spillovers in these resource-poor countries. These findings add to the body of evidence that PEPFAR has had favourable health effects beyond HIV. The implications of these findings are that foreign aid for health in one area may have favourable health effects in other areas in recipient countries. More research is needed on the influence of the mechanisms at work that create these spillover health effects of PEPFAR.
Læs mere Tjek på PubMedCaterina Casalini, Yema D’Almeida, Moussa Ariziki Nassam, Essopha Kokoloko, Souley Wade, Jean Paul Tchupo, Messan Damarly, Justin Mandala, Michele Lanham, Natasha Mack, Chris Akolo, Vincent Polakinam Pitche, Hugues Guidigbi, Claver Anoumou Dagnra
PLoS One Infectious Diseases, 22.12.2023
Tilføjet 22.12.2023
by Caterina Casalini, Yema D’Almeida, Moussa Ariziki Nassam, Essopha Kokoloko, Souley Wade, Jean Paul Tchupo, Messan Damarly, Justin Mandala, Michele Lanham, Natasha Mack, Chris Akolo, Vincent Polakinam Pitche, Hugues Guidigbi, Claver Anoumou Dagnra Background According to UNAIDS, Togo halved AIDS-related deaths among children ages 0–14 from 2010 to 2020. However, available data show low dolutegravir (DTG)-containing antiretroviral therapy (ART) coverage and low viral load suppression (VLS) among children living with HIV (CLHIV). We analyzed routine facility data before and after implementation of root-cause-based solutions for improving DTG coverage, viral load (VL) testing coverage, and VLS among CLHIV. Description We analyzed routine data for CLHIV ≤14 years from October 2019 through September 2022. We assessed proportion of CLHIV on ART receiving DTG, VL testing coverage (CLHIV on ART with documented VL test result), and VLS (CLHIV with documented VL test result of
Læs mere Tjek på PubMedBMC Infectious Diseases, 21.12.2023
Tilføjet 21.12.2023
Abstract Background Periods of droughts can lead to decreased food security, and altered behaviours, potentially affecting outcomes on antiretroviral therapy (ART) among persons with HIV (PWH). We investigated whether decreased rainfall is associated with adverse outcomes among PWH on ART in Southern Africa. Methods Data were combined from 11 clinical cohorts of PWH in Lesotho, Malawi, Mozambique, South Africa, Zambia, and Zimbabwe, participating in the International epidemiology Databases to Evaluate AIDS Southern Africa (IeDEA-SA) collaboration. Adult PWH who had started ART prior to 01/06/2016 and were in follow-up in the year prior to 01/06/2016 were included. Two-year rainfall from June 2014 to May 2016 at the location of each HIV centre was summed and ranked against historical 2-year rainfall amounts (1981–2016) to give an empirical relative percentile rainfall estimate. The IeDEA-SA and rainfall data were combined using each HIV centre’s latitude/longitude. In individual-level analyses, multivariable Cox or generalized estimating equation regression models (GEEs) assessed associations between decreased rainfall versus historical levels and four separate outcomes (mortality, CD4 counts 400 copies/mL, and > 12-month gaps in follow-up) in the two years following the rainfall period. GEEs were used to investigate the association between relative rainfall and monthly numbers of unique visitors per HIV centre. Results Among 270,708 PWH across 386 HIV centres (67% female, median age 39 [IQR: 32–46]), lower rainfall than usual was associated with higher mortality (adjusted Hazard Ratio: 1.18 [95%CI: 1.07–1.32] per 10 percentile rainfall rank decrease) and unsuppressed viral loads (adjusted Odds Ratio: 1.05 [1.01–1.09]). Levels of rainfall were not strongly associated with CD4 counts 12-month gaps in care. HIV centres in areas with less rainfall than usual had lower numbers of PWH visiting them (adjusted Rate Ratio: 0.80 [0.66–0.98] per 10 percentile rainfall rank decrease). Conclusions Decreased rainfall could negatively impact on HIV treatment behaviours and outcomes. Further research is needed to explore the reasons for these effects. Interventions to mitigate the health impact of severe weather events are required.
Læs mere Tjek på PubMedBMC Infectious Diseases, 20.12.2023
Tilføjet 20.12.2023
Abstract Background Periods of droughts can lead to decreased food security, and altered behaviours, potentially affecting outcomes on antiretroviral therapy (ART) among persons with HIV (PWH). We investigated whether decreased rainfall is associated with adverse outcomes among PWH on ART in Southern Africa. Methods Data were combined from 11 clinical cohorts of PWH in Lesotho, Malawi, Mozambique, South Africa, Zambia, and Zimbabwe, participating in the International epidemiology Databases to Evaluate AIDS Southern Africa (IeDEA-SA) collaboration. Adult PWH who had started ART prior to 01/06/2016 and were in follow-up in the year prior to 01/06/2016 were included. Two-year rainfall from June 2014 to May 2016 at the location of each HIV centre was summed and ranked against historical 2-year rainfall amounts (1981–2016) to give an empirical relative percentile rainfall estimate. The IeDEA-SA and rainfall data were combined using each HIV centre’s latitude/longitude. In individual-level analyses, multivariable Cox or generalized estimating equation regression models (GEEs) assessed associations between decreased rainfall versus historical levels and four separate outcomes (mortality, CD4 counts 400 copies/mL, and > 12-month gaps in follow-up) in the two years following the rainfall period. GEEs were used to investigate the association between relative rainfall and monthly numbers of unique visitors per HIV centre. Results Among 270,708 PWH across 386 HIV centres (67% female, median age 39 [IQR: 32–46]), lower rainfall than usual was associated with higher mortality (adjusted Hazard Ratio: 1.18 [95%CI: 1.07–1.32] per 10 percentile rainfall rank decrease) and unsuppressed viral loads (adjusted Odds Ratio: 1.05 [1.01–1.09]). Levels of rainfall were not strongly associated with CD4 counts 12-month gaps in care. HIV centres in areas with less rainfall than usual had lower numbers of PWH visiting them (adjusted Rate Ratio: 0.80 [0.66–0.98] per 10 percentile rainfall rank decrease). Conclusions Decreased rainfall could negatively impact on HIV treatment behaviours and outcomes. Further research is needed to explore the reasons for these effects. Interventions to mitigate the health impact of severe weather events are required.
Læs mere Tjek på PubMedIsabelle Holland-Lulewicz, Jacob Holland-Lulewicz
PLoS One Infectious Diseases, 19.12.2023
Tilføjet 19.12.2023
by Isabelle Holland-Lulewicz, Jacob Holland-Lulewicz Zooarchaeological datasets are often large, complex, and difficult to visualize and communicate. Many visual aids and summaries often limit the patterns that can be identified and mask interpretations of relationships between contexts, species, and environmental information. The most commonly used of these often include bar charts, pie charts, and other such graphs that aid in categorizing data and highlighting the differences or similarities between categories. While such simplification is often necessary for effective communication, it can also obscure the full range of complexity of zooarchaeological datasets and the human-environment dynamics they reflect. In this paper, we demonstrate the utility of formal network graphs to capturing the complexity of zooarchaeological datasets and to effectively highlighting the kinds of relationships between contexts, time, and faunal assemblages in which zooarchaeologists are primarily interested. Using a case study from southwestern Florida (USA), we argue that network graphs provide a quick solution to visualizing the structure of zooarchaeological datasets and serve as a useful aid in interpreting patterns that represent fundamental reflections of human-centered ecosystems.
Læs mere Tjek på PubMedLesego, A., Tsegaye, T., Were, L. P. O., Sakvarelidze, G., Garg, S., Morrison, L., Nigussie, S., Githendu, P., Achoki, T.
BMJ Open, 15.12.2023
Tilføjet 15.12.2023
ObjectiveThe Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) partnered with the Ethiopian Pharmaceutical Supply Agency (EPSA) in 2018–2019 to reform procurement and supply chain management (PSCM) procedures within the Ethiopian healthcare system. This assessment sought to determine the impact of the reforms and document the lessons learnt. DesignMixed-methods study incorporating qualitative and quantitative analysis. Purposive and snowballing sampling techniques were applied for the qualitative methods, and the data collected was transcribed in full and subjected to thematic content analysis. Descriptive analysis was applied to quantitative data. SettingThe study was based in Ethiopia and focused on the EPSA operations nationally between 2017 and 2021. ParticipantsTwenty-five Ethiopian healthcare decision-makers and health workers. InterventionGlobal Fund training programme for health workers and infrastructural improvements OutcomesOperational and financial measures for healthcare PSCM. ResultsThe availability of antiretrovirals, tuberculosis and malaria medicines, and other related commodities, remained consistently high. Line fill rate and forecast accuracy were average. Between 2018 and 2021, procurement lead times for HIV and malaria-related orders reduced by 43.0% relative to other commodities that reported an increase. Many interview respondents recognised the important role of the Global Fund support in improving the performance of EPSA and provided specific attributions to the observed successes. However, they were also clear that more needs to be done in specific critical areas such as financing, strategic reorganisation, data and information management systems. ConclusionThe Global Fund-supported initiatives led to improvements in the EPSA performance, despite several persistent challenges. To sustain and secure the gains achieved so far through Global Fund support and make progress, it is important that various stakeholders, including the government and the donor community, work together to support EPSA in delivering on its core mandate within the Ethiopian health system.
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