Last data update: Jun 17, 2024. (Total: 47034 publications since 2009)
Records 1-2 (of 2 Records) |
Query Trace: Kalata N [original query] |
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Characteristics of TPT initiation and completion among people living with HIV
Gunde L , Wang A , Payne D , O'Connor S , Kabaghe A , Kalata N , Maida A , Kayira D , Buie V , Tauzi L , Sankhani A , Thawani A , Rambiki E , Ahimbisibwe A , Maphosa T , Kudiabor K , Nyirenda R , Mpunga J , Mbendera K , Nyasulu P , Kayigamba F , Farahani M , Voetsch AC , Brown K , Jahn A , Girma B , Mirkovic K . IJTLD Open 2024 1 (1) 11-19 BACKGROUND: TB preventive treatment (TPT) reduces morbidity and mortality among people living with HIV (PLHIV). Despite the successful scale-up of TPT in Malawi, monitoring and evaluation have been suboptimal. We utilized the Malawi Population-Based HIV Impact Assessment (MPHIA) 2020-2021 survey data to estimate TPT uptake and completion among self-reported HIV-positive persons. METHODS: We estimated the proportion of HIV-positive respondents who had ever undergone TPT, and determined the percentage of those currently on TPT who had completed more than 6 months of treatment. Bivariate and multivariable logistic regression were performed to calculate the odds ratios for factors associated with ever-taking TPT. All variables were self-reported, and the analysis was weighted and accounted for in the survey design. RESULTS: Of the HIV+ respondents, 38.8% (95% CI 36.4-41.3) had ever taken TPT. The adjusted odds of ever taking TPT were 8.0 and 5.2 times as high in the Central and Southern regions, respectively, compared to the Northern region; 1.9 times higher among those in the highest wealth quintile, and 2.1 times higher for those on antiretroviral therapy >10 years. Of those currently taking TPT, 56.2% completed >6 months of TPT. CONCLUSION: These results suggest low TPT uptake and >6 months' completion rates among self-reported HIV+ persons. Initiatives to create demand and strengthen adherence would improve TPT uptake. |
Leave no one behind: response to new evidence and guidelines for the management of cryptococcal meningitis in low-income and middle-income countries
Loyse A , Burry J , Cohn J , Ford N , Chiller T , Ribeiro I , Koulla-Shiro S , Mghamba J , Ramadhani A , Nyirenda R , Aliyu SH , Wilson D , Le T , Oladele R , Lesikari S , Muzoora C , Kalata N , Temfack E , Mapoure Y , Sini V , Chanda D , Shimwela M , Lakhi S , Ngoma J , Gondwe-Chunda L , Perfect C , Shroufi A , Andrieux-Meyer I , Chan A , Schutz C , Hosseinipour M , Van der Horst C , Klausner JD , Boulware DR , Heyderman R , Lalloo D , Day J , Jarvis JN , Rodrigues M , Jaffar S , Denning D , Migone C , Doherty M , Lortholary O , Dromer F , Stack M , Molloy SF , Bicanic T , van Oosterhout J , Mwaba P , Kanyama C , Kouanfack C , Mfinanga S , Govender N , Harrison TS . Lancet Infect Dis 2018 19 (4) e143-e147 In 2018, WHO issued guidelines for the diagnosis, prevention, and management of HIV-related cryptococcal disease. Two strategies are recommended to reduce the high mortality associated with HIV-related cryptococcal meningitis in low-income and middle-income countries (LMICs): optimised combination therapies for confirmed meningitis cases and cryptococcal antigen screening programmes for ambulatory people living with HIV who access care. WHO's preferred therapy for the treatment of HIV-related cryptococcal meningitis in LMICs is 1 week of amphotericin B plus flucytosine, and the alternative therapy is 2 weeks of fluconazole plus flucytosine. In the ACTA trial, 1-week (short course) amphotericin B plus flucytosine resulted in a 10-week mortality of 24% (95% CI -16 to 32) and 2 weeks of fluconazole and flucytosine resulted in a 10-week mortality of 35% (95% CI -29 to 41). However, with widely used fluconazole monotherapy, mortality because of HIV-related cryptococcal meningitis is approximately 70% in many African LMIC settings. Therefore, the potential to transform the management of HIV-related cryptococcal meningitis in resource-limited settings is substantial. Sustainable access to essential medicines, including flucytosine and amphotericin B, in LMICs is paramount and the focus of this Personal View. |
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