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Sample records for african antiretroviral programme

  1. Renal impairment in a rural African antiretroviral programme

    Directory of Open Access Journals (Sweden)

    Lessells Richard J

    2009-08-01

    Full Text Available Abstract Background There is little knowledge regarding the prevalence and nature of renal impairment in African populations initiating antiretroviral treatment, nor evidence to inform the most cost effective methods of screening for renal impairment. With the increasing availability of the potentially nephrotixic drug, tenofovir, such information is important for the planning of antiretroviral programmes Methods (i Retrospective review of the prevalence and risk factors for impaired renal function in 2189 individuals initiating antiretroviral treatment in a rural African setting between 2004 and 2007 (ii A prospective study of 149 consecutive patients initiating antiretrovirals to assess the utility of urine analysis for the detection of impaired renal function. Severe renal and moderately impaired renal function were defined as an estimated GFR of ≤ 30 mls/min/1.73 m2 and 30–60 mls/min/1.73 m2 respectively. Logistic regression was used to determine odds ratio (OR of significantly impaired renal function (combining severe and moderate impairment. Co-variates for analysis were age, sex and CD4 count at initiation. Results (i There was a low prevalence of severe renal impairment (29/2189, 1.3% 95% C.I. 0.8–1.8 whereas moderate renal impairment was more frequent (287/2189, 13.1% 95% C.I. 11.6–14.5 with many patients having advanced immunosuppression at treatment initiation (median CD4 120 cells/μl. In multivariable logistic regression age over 40 (aOR 4.65, 95% C.I. 3.54–6.1, male gender (aOR 1.89, 95% C.I. 1.39–2.56 and CD4 Conclusion In this rural African setting, significant renal impairment is uncommon in patients initiating antiretrovirals. Urine analysis alone may be inadequate for identification of those with impaired renal function where resources for biochemistry are limited.

  2. Factors influencing retention in care after starting antiretroviral therapy in a rural South African programme.

    Directory of Open Access Journals (Sweden)

    Tom H Boyles

    2011-05-01

    Full Text Available The prognosis of patients with HIV in Africa has improved with the widespread use of antiretroviral therapy (ART but these successes are threatened by low rates of long-term retention in care. There are limited data on predictors of retention in care, particularly from rural sites.Prospective cohort analysis of outcome measures in adults from a rural HIV care programme in Madwaleni, Eastern Cape, South Africa. The ART programme operates from Madwaleni hospital and seven primary care feeder clinics with full integration between inpatient and outpatient services. Outreach workers conducted home visits for defaulters.1803 adults initiated ART from June 2005 to May 2009. At the end of the study period 82.4% were in active care or had transferred elsewhere, 11.1% had died and 6.5% were lost to follow-up (LTFU. Independent predictors associated with an increased risk of LTFU were CD4 nadir >200, initiating ART as an inpatient or while pregnant, and younger age, while being in care for >6 months before initiating ART was associated with a reduced risk. Independent factors associated with an increased risk of mortality were baseline CD4 count 6 months before initiating ART and initiating ART while pregnant were associated with a reduced risk.Serving a socioeconomically deprived rural population is not a barrier to successful ART delivery. Patients initiating ART while pregnant and inpatients may require additional counselling and support to reduce LTFU. Providing HIV care for patients not yet eligible for ART may be protective against being LTFU and dying after ART initiation.

  3. Patterns of disclosure and antiretroviral treatment adherence in a South African mining workplace programme and implications for HIV prevention.

    Science.gov (United States)

    Bhagwanjee, Anil; Govender, Kaymarlin; Akintola, Olagoke; Petersen, Inge; George, Gavin; Johnstone, Leigh; Naidoo, Kerisha

    2011-01-01

    Social and psychological barriers to the disclosure of one's seropositive HIV status to significant others and poor adherence to taking medications pose significant challenges to the scaling-up of access to antiretroviral treatment (ART) in the workplace. Such barriers are predictive of sub-optimal treatment outcomes and bedevil HIV-prevention interventions at a societal level. Against this background, this article explores the lived experiences of 19 HIV-positive male participants, between the ages of 33 and 57 years, who were enrolled in an ART programme managed at an occupational health clinic at a mining company in South Africa. The majority of these mineworkers had been aware of their HIV status for between 5 and 7 years. The study explored psychological and relational factors, as aspects of these participants lived experiences, which had a bearing on their adherence to their ART regimen and the disclosure choices that they made regarding their HIV status. In our sample, those participants who were adherent demonstrated higher levels of control and acceptance of their HIV infection and were more confident in their ability to manage their treatment, while the group who were non-adherent presented with lower levels of adherence motivation and self-efficacy, difficulties in maintaining a healthy lifestyle and significant challenges in maintaining control over their lives. While most of the men favoured disclosing their HIV status to their partners for the sake of treatment support, they were less sure about disclosing to family members and non-family members, respectively, because of their need to protect these persons and due to their fear of being stigmatised. It was evident that treatment adherence choices and behaviours were impacted by psychological and relational factors, including disclosure decisions. We conclude with a bivariate model for understanding the adherence behaviours that influenced different patterns of ART adherence among the sample, and

  4. Antiretroviral therapy programme on control of HIV transmission in ...

    African Journals Online (AJOL)

    Antiretroviral therapy programme on control of HIV transmission in Morogoro municipality, Tanzania: A challenge for development. ... The government and partners should improve access to ART services to enable many PLHIV to access the services. Key words: Antiretroviral Therapy, Highly Active Antiretroviral Treatment, ...

  5. Antiretroviral therapy programme outcomes in Tshwane district ...

    African Journals Online (AJOL)

    Objectives. To ascertain patient retention on ART after 5 years on treatment in one district of Gauteng Province, SA, establish the number of patients ... A retrospective cohort study of patients initiated on highly active antiretroviral therapy (HAART) between January and March .... ferred-out patients from the total of 381 leaves.

  6. South African southern ocean research programme

    CSIR Research Space (South Africa)

    SASCAR

    1987-01-01

    Full Text Available This document describes the South African National Antarctic Research Programme's (SANARP) physical, chemical and biological Southern Ocean research programme. The programme has three main components: ecological studies of the Prince Edward Islands...

  7. Cutting the cost of South African antiretroviral therapy using newer, safer drugs

    Directory of Open Access Journals (Sweden)

    W F Venter

    2017-01-01

    Full Text Available Antiretrovirals are a significant cost driver for HIV programmes. Current first-line regimens have performed well in real-life programmes, but have a low barrier to virological resistance and still carry toxicity that limits adherence. New drug developments may mean that we have access to safer, more robust and cheaper regimens, but only if the appropriate clinical trials are conducted. We briefly discuss these trials, and demonstrate the large cost savings to the South African HIV programme if these are successful.

  8. An information system to manage the rollout of the antiretroviral treatment programme in the Free State

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    J.E. Kotzé

    2010-09-01

    Full Text Available The Acquired Immune Deficiency Syndrome epidemic, caused by the Human Immunodeficiency Virus, is a global crisis which threatens development gains, economies, and societies. Within sub-Saharan Africa, where the epidemic began the earliest and the HIV prevalence is the highest, African countries have death rates not seen before. In South Africa the epidemic has a devastating impact which creates profound suffering on individuals and their families, and the impact on the socio-economic level is of great concern. The eradication of HIV/AIDS represents one of humanity’s greatest challenges, which requires co-operation and comprehensive collaboration between many different role players. In this endeavour clinical information plays a major role. To combat the effect of the disease, the Free State Department of Health started with the provisioning of antiretroviral therapy in the public health sector. The objective of this paper was to address the challenges they faced in order to develop and implement an information system to manage the rollout of antiretroviral treatment effectively. They started with a paper-based system to collect vital information. It was followed by a palm computer project that was initiated to electronically capture the data collected by the paper-based system. This system was then replaced by a comprehensive Hospital and Clinic Information System which was acquired and customised for the antiretroviral data collection process. Research partners developed a standalone antiretroviral data warehouse for collecting information associated with the monitoring and evaluation of the Free State antiretroviral and HIV/ AIDS treatment programme. The data warehouse successfully produced several management information reports to the antiretroviral management team. A need was identified to design a comprehensive antiretroviral data warehouse that will integrate data from several operational sources which are all associated with HIV/AIDS.

  9. Antiretroviral drug resistance: A guide for the southern African clinician

    African Journals Online (AJOL)

    Both private and public sector see a bewildering clinical array of patients taking failing antiretroviral (ARV) regimens. We intend this article to provide a practical guide to help clinicians understand and manage ARV drug resistance in an African context. ARV resistance is a rapidly evolving field, requiring expertise in dealing ...

  10. South African Antarctic earth science research programme

    CSIR Research Space (South Africa)

    SASCAR

    1984-02-01

    Full Text Available This document describes the past, current and planned future South African earth science research programme in the Antarctic, Southern Ocean and subantarctic regions. The scientific programme comprises five components into which present and future...

  11. Southern African HIV Clinicians Society adult antiretroviral therapy guidelines: Update on when to initiate antiretroviral therapy

    Directory of Open Access Journals (Sweden)

    Graeme Meintjes

    2015-12-01

    Full Text Available The most recent version of the Southern African HIV Clinicians Society’s adult antiretroviral therapy (ART guidelines was published in December 2014. In the 27 August 2015 edition of the New England Journal of Medicine, two seminal randomised controlled trials that addressed the optimal timing of ART in HIV-infected patients with high CD4 counts were published: Strategic timing of antiretroviral therapy (START and TEMPRANO ANRS 12136 (Early antiretroviral treatment and/or early isoniazid prophylaxis against tuberculosis in HIV-infected adults. The findings of these two trials were consistent: there was significant individual clinical benefit from starting ART immediately in patients with CD4 counts higher than 500 cells/μL rather than deferring until a certain lower CD4 threshold or clinical indication was met. The findings add to prior evidence showing that ART reduces the risk of onward HIV transmission. Therefore, early ART initiation has the public health benefits of potentially reducing both HIV incidence and morbidity. Given this new and important evidence, the Society took the decision to provide a specific update on the section of the adult ART guidelines relating to when ART should be initiated.

  12. Differences in antiretroviral scale up in three South African provinces: the role of implementation management

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    Van Rensburg Dingie

    2010-07-01

    Full Text Available Abstract Background South Africa’s antiretroviral programme is governed by defined national plans, establishing treatment targets and providing funding through ring-fenced conditional grants. However, in terms of the country’s quasi-federal constitution, provincial governments bear the main responsibility for provision of health care, and have a certain amount of autonomy and therefore choice in the way their HIV/AIDS programmes are implemented. Methods The paper is a comparative case study of the early management of ART scale up in three South African provincial governments – Western Cape, Gauteng and Free State – focusing on both operational and strategic dimensions. Drawing on surveys of models of ART care and analyses of the policy process conducted in the three provinces between 2005 and 2007, as well as a considerable body of grey and indexed literature on ART scale up in South Africa, it draws links between implementation processes and variations in provincial ART coverage (low, medium and high achieved in the three provinces. Results While they adopted similar chronic disease care approaches, the provinces differed with respect to political and managerial leadership of the programme, programme design, the balance between central standardisation and local flexibility, the effectiveness of monitoring and evaluation systems, and the nature and extent of external support and programme partnerships. Conclusions This case study points to the importance of sub-national programme processes and the influence of factors other than financing or human resource capacity, in understanding intervention scale up.

  13. South African antarctic biological research programme

    CSIR Research Space (South Africa)

    SASCAR

    1981-07-01

    Full Text Available This document provides a description of the past, current and planned South African biological research activities in the sub-Antarctic and Antarctic regions. Future activities will fall under one of the five components of the research programme...

  14. The intersection of antiretroviral therapy, peer support programmes ...

    African Journals Online (AJOL)

    Evidence suggests that interventions for people living with HIV infection that include, in combination, antiretroviral therapy (ART), peer support and economic empowerment are likely to be more effective than if used alone. We report a qualitative study in West Nile Uganda that explored perceptions of HIV stigma among ...

  15. New targets and novel antiretrovirals | Wood | Southern African ...

    African Journals Online (AJOL)

    Highly active antiretroviral therapy (HAART) has to date been based on use of a triple combination of drugs chosen from three classes of antiretrovirals (ARVs), nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs) and protease inhibitors (PIs). These ARV classes ...

  16. Acceptability of Early Antiretroviral Therapy Among South African Women.

    Science.gov (United States)

    Garrett, Nigel; Norman, Emily; Leask, Kerry; Naicker, Nivashnee; Asari, Villeshni; Majola, Nelisile; Karim, Quarraisha Abdool; Karim, Salim S Abdool

    2018-03-01

    WHO guidelines recommend immediate initiation of antiretroviral therapy (ART) for all individuals at HIV diagnosis regardless of CD4 count, but concerns remain about potential low uptake or poor adherence among healthy patients with high CD4 counts, especially in resource-limited settings. This study assessed the acceptability of earlier treatment among HIV-positive South African women, median age at enrollment 25 (IQR 22-30), in a 10 year prospective cohort study by (i) describing temporal CD4 count trends at initiation in relation to WHO guidance, (ii) virological suppression rates post-ART initiation at different CD4 count thresholds, and (iii) administration of a standardized questionnaire. 158/232 (68.1%) participants initiated ART between 2006 and 2015. Mean CD4 count at initiation was 217 cells/µl (range 135-372) before 2010, and increased to 531 cells/µl (range 272-1095) by 2015 (p suppression rates at 3, 6, 12 and 18 months were consistently above 85% with no statistically significant differences for participants starting ART at different CD4 count thresholds. A questionnaire assessing uptake of early ART amongst ART-naïve women, median age 28 (IQR 24-33), revealed that 40/51 (78.4%) were willing to start ART at CD4 ≥500. Of those unwilling, 6/11 (54.5%) started ART within 6 months of questionnaire administration. Temporal increases in CD4 counts, comparable virological suppression rates, and positive patient perceptions confirm high acceptability of earlier ART initiation for the majority of patients.

  17. Default from Anti-Retroviral Treatment Programme in Sagamu, Nigeria

    African Journals Online (AJOL)

    For those who were not met at home proxy interviewees such as a neighbour or a family member were asked if they were available. Of the 100 patients who had enrolled in the ART treatment programme during the study period, 36% of the study population defaulted treatment, 18% had died while 46% were alive and well.

  18. Age in antiretroviral therapy programmes in South Africa: a multi-centre observational cohort study

    Science.gov (United States)

    Cornell, Morna; Johnson, Leigh F; Schomaker, Michael; Tanser, Frank; Maskew, Mhairi; Wood, Robin; Prozesky, Hans; Giddy, Janet; Stinson, Kathryn; Egger, Matthias; Boulle, Andrew; Myer, Landon

    2015-01-01

    Background As access to antiretroviral therapy (ART) expands, increasing numbers of older patients will start treatment and require specialised long-term care. However the impact of age in ART programs in resource-constrained settings is poorly understood. South Africa has the second largest population of older (≥50 years) people in sub-Saharan Africa. The HIV epidemic is also ageing rapidly and the country has one of the highest HIV population prevalences worldwide. This study explored the effect of age on mortality on ART in South Africa and whether this effect was mediated by baseline immunologic status. Methods IeDEA-SA is a regional collaboration which combines routine observational data from large ART programmes across Southern Africa. This study was a retrospective cohort analysis of adults starting ART from 2004-2013 in six large South African cohorts: two primary care clinics, three hospitals and a large rural cohort. The primary outcome was mortality; secondary outcomes were loss to follow-up (LTF), immunologic and virologic responses. Patients' vital status was ascertained through linkage to the National Population Register. Inverse probability weighting was used to correct mortality for LTF. Mortality was estimated using Cox's proportional hazards and competing risks regression. The interaction between baseline CD4+ cell count and age was tested. Immunologic responses were graphed by age and duration on ART. Findings 83 566 patients were followed for 174 640 patient-years. Patients were predominantly female, especially in the younger age groups: 81% (18 819/23 258) of patients 16-29 years and 66% (12 812/19 372) of those aged 30-34. Mortality increased with age in a dose response, mediated by baseline immunologic status. Patients with CD4 counts <50 cells/μL were a particularly high risk group, comprising 14% of all older patients starting ART. The percentage of older patients enrolling increased with successive calendar years from 6% (290/4 999) in

  19. African Primary Care Research: Performing a programme evaluation

    OpenAIRE

    Dudley, Lilian

    2014-01-01

    Abstract This article is part of a series on Primary Care Research in the African context and focuses on programme evaluation. Different types of programme evaluation are outlined: developmental, process, outcome and impact. Eight steps to follow in designing your programme evaluation are then described in some detail: engage stakeholders; establish what is known; describe the programme; define the evaluation and select a study design; define the indicators; plan and manage data collection an...

  20. A clinical assessment of antiretroviral-treated patients Referred from ...

    African Journals Online (AJOL)

    HAART) on the immunological, virological and clinical status of two groups of patients in the South African government antiretroviral (ARV) programme in KwaZulu-Natal, viz. patients previously treated with ARVs in the private sector and then ...

  1. Delivery of antiretroviral treatment services in India: Estimated costs incurred under the National AIDS Control Programme.

    Science.gov (United States)

    Agarwal, Reshu; Rewari, Bharat Bhushan; Shastri, Suresh; Nagaraja, Sharath Burugina; Rathore, Abhilakh Singh

    2017-04-01

    Competing domestic health priorities and shrinking financial support from external agencies necessitates that India's National AIDS Control Programme (NACP) brings in cost efficiencies to sustain the programme. In addition, current plans to expand the criteria for eligibility for antiretroviral therapy (ART) in India will have significant financial implications in the near future. ART centres in India provide comprehensive services to people living with HIV (PLHIV): those fulfilling national eligibility criteria and receiving ART and those on pre-ART care, i.e. not on ART. ART centres are financially supported (i) directly by the NACP; and (ii) indirectly by general health systems. This study was conducted to determine (i) the cost incurred per patient per year of pre-ART and ART services at ART centres; and (ii) the proportion of this cost incurred by the NACP and by general health systems. The study used national data from April 2013 to March 2014, on ART costs and non-ART costs (human resources, laboratory tests, training, prophylaxis and management of opportunistic infections, hospitalization, operational, and programme management). Data were extracted from procurement records and reports, statements of expenditure at national and state level, records and reports from ART centres, databases of the National AIDS Control Organisation, and reports on use of antiretroviral drugs. The analysis estimates the cost for ART services as US$ 133.89 (?8032) per patient per year, of which 66% (US$ 88.66, ?5320) is for antiretroviral drugs and 34% (US$ 45.23, ?2712) is for non-ART recurrent expenditure, while the cost for pre-ART care is US$ 33.05 (?1983) per patient per year. The low costs incurred for patients in ART and pre-ART care services can be attributed mainly to the low costs of generic drugs. However, further integration with general health systems may facilitate additional cost saving, such as in human resources.

  2. Age in antiretroviral therapy programmes in South Africa: a retrospective, multicentre, observational cohort study.

    Science.gov (United States)

    Cornell, Morna; Johnson, Leigh F; Schomaker, Michael; Tanser, Frank; Maskew, Mhairi; Wood, Robin; Prozesky, Hans; Giddy, Janet; Stinson, Kathryn; Egger, Matthias; Boulle, Andrew; Myer, Landon

    2015-09-01

    As access to antiretroviral therapy (ART) expands, increasing numbers of older patients will start treatment and need specialised long-term care. However, the effect of age in ART programmes in resource-constrained settings is poorly understood. The HIV epidemic is ageing rapidly and South Africa has one of the highest HIV population prevalences worldwide. We explored the effect of age on mortality of patients on ART in South Africa and whether this effect is mediated by baseline immunological status. In this retrospective cohort analysis, we studied HIV-positive patients aged 16-80 years who started ART for the first time in six large South African cohorts of the International Epidemiologic Databases to Evaluate AIDS-Southern Africa collaboration, in KwaZulu-Natal, Gauteng, and Western Cape (two primary care clinics, three hospitals, and a large rural cohort). The primary outcome was mortality. We ascertained patients' vital status through linkage to the National Population Register. We used inverse probability weighting to correct mortality for loss to follow-up. We estimated mortality using Cox's proportional hazards and competing risks regression. We tested the interaction between baseline CD4 cell count and age. Between Jan 1, 2004, and Dec 31, 2013, 84,078 eligible adults started ART. Of these, we followed up 83,566 patients for 174,640 patient-years. 8% (1817 of 23,258) of patients aged 16-29 years died compared with 19% (93 of 492) of patients aged 65 years or older. The age adjusted mortality hazard ratio was 2·52 (95% CI 2·01-3·17) for people aged 65 years or older compared with those 16-29 years of age. In patients starting ART with a CD4 count of less than 50 cells per μL, the adjusted mortality hazard ratio was 2·52 (2·04-3·11) for people aged 50 years or older compared with those 16-39 years old. Mortality was highest in patients with CD4 counts of less than 50 cells per μL, and 15% (1103 of 7295) of all patients aged 50 years or older

  3. Starting infants on antiretroviral therapy | Clayden | Southern African ...

    African Journals Online (AJOL)

    Southern African Journal of HIV Medicine. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 9, No 4 (2008) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected ...

  4. Who is accessing public-sector anti-retroviral treatment in the Free State, South Africa? An exploratory study of the first three years of programme implementation

    Directory of Open Access Journals (Sweden)

    Booysen Frederik

    2010-07-01

    Full Text Available Abstract Background Although South Africa has the largest public-sector anti-retroviral treatment (ART programme in the world, anti-retroviral coverage in adults was only 40.2% in 2008. However, longitudinal studies of who is accessing the South African public-sector ART programme are scarce. This study therefore had one main research question: who is accessing public-sector ART in the Free State Province, South Africa? The study aimed to extend the current literature by investigating, in a quantitative manner and using a longitudinal study design, the participants enrolled in the public-sector ART programme in the period 2004-2006 in the Free State Province of South Africa. Methods Differences in the demographic (age, sex, population group and marital status socio-economic (education, income, neo-material indicators, geographic (travel costs, relocation for ART, and medical characteristics (CD4, viral load, time since first diagnosis, treatment status among 912 patients enrolled in the Free State public-sector ART programme between 2004 and 2006 were assessed with one-way analysis of variance, Bonferroni post-hoc analysis, and cross tabulations with the chi square test. Results The patients accessing treatment tended to be female (71.1% and unemployed (83.4%. However, although relatively poor, those most likely to access ART services were not the most impoverished patients. The proportion of female patients increased (P P P P P Conclusions Our analysis showed significant changes in the demographic, socio-economic, geographic, and medical characteristics of the patients during the first three years of the programme. Knowledge of the characteristics of these patients can assist policy makers in developing measures to retain them in care. The information reported here can also be usefully applied to target patient groups that are currently not reached in the implementation of the ART programme.

  5. Southern Ocean - South African cooperative research programme.

    CSIR Research Space (South Africa)

    SANCOR

    1979-05-01

    Full Text Available and elsewhere- and to ensure the most efficient possible utilization of limited manpower and facilities, a national programme had to be formulated to achieve the required coordination and cooperation. Such a programme is presented in this report, compiled...

  6. Psychosocial and behavioural correlates of attitudes towards antiretroviral therapy (ART) in a sample of South African mineworkers.

    Science.gov (United States)

    Govender, Kaymarlin; Akintola, Olagoke; George, Gavin; Petersen, Inge; Bhagwanjee, Anil; Reardon, Candice

    2011-01-01

    Despite being one of the worst affected sectors in South Africa, the mining sector has proven to be one of the most active in intervention efforts in the fight against HIV and AIDS (Ellis, 2007). Owing to low uptake rates of antiretroviral therapy (ART) in mining companies in recent years (Connelly & Rosen, 2006) and the positive relationship between attitudes towards ART and ART uptake (Cooper et al., 2002; Horne, Cooper, Gellaitry, Leake, & Fisher, 2007), this study sought to describe and investigate the psychosocial and behavioural correlates of attitudes towards ART in a sample of South African mineworkers. A total of 806 mineworkers from a large South African mine participated in this quantitative study. Despite a high rate of HIV testing behaviour (83.0%) as well as favourable attitudes towards ART, analysis indicated that temporary employees and contractors were more vulnerable in terms of HIV risk, HIV testing behaviours and ART knowledge and attitudes. Employees who had more positive attitudes towards ART were more knowledgeable of ART and, importantly, had a more favourable attitude towards the mine's HIV/AIDS treatment programme. These findings are discussed in relation to the low ART uptake rates in this context and recommendations for the improvement of ART uptake amongst employees at this mining site.

  7. Are routine tuberculosis programme data suitable to report on antiretroviral therapy use of HIV-infected tuberculosis patients?

    NARCIS (Netherlands)

    Brouwer, Miranda; Gudo, Paula Samo; Simbe, Chalice Mage; Perdigão, Paula; van Leth, Frank

    2013-01-01

    Antiretroviral therapy (ART) is lifesaving for HIV-infected tuberculosis (TB) patients. ART-use by these patients lag behind compared to HIV-testing and co-trimoxazole preventive therapy. TB programmes provide the data on ART-use by HIV-infected TB patients, however often the HIV services provide

  8. South African Antarctic research programme 1978-1982

    CSIR Research Space (South Africa)

    SASCAR

    1978-12-01

    Full Text Available This document provides a comprehensive review of the planned South African scientific activities in Antarctica and on the sub-Antarctic islands in the five year period starting in 1978. The scientific programmes are classified under five headings...

  9. WEST AFRICAN JOURNAL OF MEDICINE African Programme for ...

    African Journals Online (AJOL)

    user1

    there has been a vertical Ivermectin treatment programme, supported by the. Christoffel Blindenmission (CBM) ... is traversed by many streams which drain into Lakes Edward, George and other lakes in the area. ... computer with vertical moving oscillating targets as described by Wu et al.11 Each point was tested either six ...

  10. Retention and mortality on antiretroviral therapy in sub-Saharan Africa: collaborative analyses of HIV treatment programmes.

    Science.gov (United States)

    Haas, Andreas D; Zaniewski, Elizabeth; Anderegg, Nanina; Ford, Nathan; Fox, Matthew P; Vinikoor, Michael; Dabis, François; Nash, Denis; Sinayobye, Jean d'Amour; Niyongabo, Thêodore; Tanon, Aristophane; Poda, Armel; Adedimeji, Adebola A; Edmonds, Andrew; Davies, Mary-Ann; Egger, Matthias

    2018-02-01

    By 2020, 90% of all people diagnosed with HIV should receive long-term combination antiretroviral therapy (ART). In sub-Saharan Africa, this target is threatened by loss to follow-up in ART programmes. The proportion of people retained on ART long-term cannot be easily determined, because individuals classified as lost to follow-up, may have self-transferred to another HIV treatment programme, or may have died. We describe retention on ART in sub-Saharan Africa, first based on observed data as recorded in the clinic databases, and second adjusted for undocumented deaths and self-transfers. We analysed data from HIV-infected adults and children initiating ART between 2009 and 2014 at a sub-Saharan African HIV treatment programme participating in the International epidemiology Databases to Evaluate AIDS (IeDEA). We used the Kaplan-Meier method to calculate the cumulative incidence of retention on ART and the Aalen-Johansen method to calculate the cumulative incidences of death, loss to follow-up, and stopping ART. We used inverse probability weighting to adjust clinic data for undocumented mortality and self-transfer, based on estimates from a recent systematic review and meta-analysis. We included 505,634 patients: 12,848 (2.5%) from Central Africa, 109,233 (21.6%) from East Africa, 347,343 (68.7%) from Southern Africa and 36,210 (7.2%) from West Africa. In crude analyses of observed clinic data, 52.1% of patients were retained on ART, 41.8% were lost to follow-up and 6.0% had died 5 years after ART initiation. After accounting for undocumented deaths and self-transfers, we estimated that 66.6% of patients were retained on ART, 18.8% had stopped ART and 14.7% had died at 5 years. Improving long-term retention on ART will be crucial to attaining the 90% on ART target. Naïve analyses of HIV cohort studies, which do not account for undocumented mortality and self-transfer of patients, may severely underestimate both mortality and retention on ART. © 2018 The

  11. The South African nuclear programme in a strategic perspective

    International Nuclear Information System (INIS)

    Zelinka, Martin; Sůsa, Tomáš

    2017-01-01

    The main idea behind the article is that the strategic aspects of the South African nuclear proliferation programme might be seen from a different point of view. The goal is to gain a perspective by looking into South African history, politics and international status, using these factors as the context for the nuclear programme. First, the authors define the necessary theoretical background, emphasizing the various motivations behind nuclear proliferation. The main focus of the article is on South Africa's motivation – where it came from and which factors influenced it. Among the examined aspects are: historical development and emergence of the regime, internal and external opposition (enemies), international status and the nature of the local political system. The various options South Africa had for actual usage of its nuclear weapons are also considered, The questions as to the motivation, results of nuclear proliferation (whether or not it was successful) and practical use of weapons developed are answered in the conclusion. (orig.)

  12. The South African National Accelerator Centre and its research programme

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, Y. [Kyushu Univ., Fukuoka (Japan)

    1997-03-01

    An overview of the South African National Accelerator Centre and its research activities is given with emphasis on medium energy nuclear physics and nuclear data measurements for medical use. Also presented is a preliminary result of {sup 40}Ca(p,p`x) spectrum measurement for 392 MeV which has been carried out at RCNP, Osaka University, under the South Africa-Japan collaborative programme. (author)

  13. A comparison of death recording by health centres and civil registration in South Africans receiving antiretroviral treatment.

    Science.gov (United States)

    Johnson, Leigh F; Dorrington, Rob E; Laubscher, Ria; Hoffmann, Christopher J; Wood, Robin; Fox, Matthew P; Cornell, Morna; Schomaker, Michael; Prozesky, Hans; Tanser, Frank; Davies, Mary-Ann; Boulle, Andrew

    2015-01-01

    There is uncertainty regarding the completeness of death recording by civil registration and by health centres in South Africa. This paper aims to compare death recording by the two systems, in cohorts of South African patients receiving antiretroviral treatment (ART). Completeness of death recording was estimated using a capture-recapture approach. Six ART programmes linked their patient record systems to the vital registration system using civil identity document (ID) numbers and provided data comparing the outcomes recorded in patient files and in the vital registration. Patients were excluded if they had missing/invalid IDs or had transferred to other ART programmes. After exclusions, 91,548 patient records were included. Of deaths recorded in patients files after 2003, 94.0% (95% CI: 93.3-94.6%) were recorded by civil registration, with completeness being significantly higher in urban areas, older adults and females. Of deaths recorded by civil registration after 2003, only 35.0% (95% CI: 34.2-35.8%) were recorded in patient files, with this proportion dropping from 60% in 2004-2005 to 30% in 2010 and subsequent years. Recording of deaths in patient files was significantly higher in children and in locations within 50 km of the health centre. When the information from the two systems was combined, an estimated 96.2% of all deaths were recorded (93.5% in children and 96.2% in adults). South Africa's civil registration system has achieved a high level of completeness in the recording of mortality. However, the fraction of deaths recorded by health centres is low and information from patient records is insufficient by itself to evaluate levels and predictors of ART patient mortality. Previously documented improvements in ART mortality over time may be biased if based only on data from patient records.

  14. Rotavirus vaccination within the South African Expanded Programme on Immunisation.

    Science.gov (United States)

    Seheri, L Mapaseka; Page, Nicola A; Mawela, Mothahadini P B; Mphahlele, M Jeffrey; Steele, A Duncan

    2012-09-07

    Diarrhoeal diseases are ranked the third major cause of childhood mortality in South African children less than 5 years, where the majority of deaths are among black children. Acute severe dehydrating rotavirus diarrhoea remains an important contributor towards childhood mortality and morbidity and has been well documented in South Africa. As the preventive strategy to control rotavirus diarrhoea, South Africa became the first country in the WHO African Region to adopt the rotavirus vaccine in the national childhood immunisation programme in August 2009. The rotavirus vaccine in use, Rotarix, GSK Biologicals, is given at 6 and 14 weeks of age, along with other vaccines as part of Expanded Programme on Immunisation (EPI). Studies which facilitated the introduction of rotavirus vaccine in South Africa included the burden of rotavirus disease and strain surveillance, economic burden of rotavirus infection and clinical trials to assess the safety and efficacy of vaccine candidates. This paper reviews the epidemiology of rotavirus in South Africa, outlines some of the steps followed to introduce rotavirus vaccine in the EPI, and highlights the early positive impact of vaccination in reducing the rotavirus burden of disease based on the post-marketing surveillance studies at Dr George Mukhari hospital, a sentinel site at University of Limpopo teaching hospital in Pretoria, South Africa, which has conducted rotavirus surveillance for >20 years. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. Association of pol diversity with antiretroviral treatment outcomes among HIV-infected African children.

    Directory of Open Access Journals (Sweden)

    Iris Chen

    Full Text Available In HIV-infected children, viral diversity tends to increase with age in the absence of antiretroviral treatment (ART. We measured HIV diversity in African children (ages 6-36 months enrolled in a randomized clinical trial comparing two ART regimens (Cohort I of the P1060 trial. Children in this cohort were exposed to single dose nevirapine (sdNVP at birth.HIV diversity was measured retrospectively using a high resolution melting (HRM diversity assay. Samples were obtained from 139 children at the enrollment visit prior to ART initiation. Six regions of the HIV genome were analyzed: two in gag, one in pol, and three in env. A single numeric HRM score that reflects HIV diversity was generated for each region; composite HRM scores were also calculated (mean and median for all six regions.In multivariable median regression models using backwards selection that started with demographic and clinical variables, older age was associated with higher HRM scores (higher HIV diversity in pol (P = 0.005 and with higher mean (P = 0.014 and median (P<0.001 HRM scores. In multivariable models adjusted for age, pre-treatment HIV viral load, pre-treatment CD4%, and randomized treatment regimen, higher HRM scores in pol were associated with shorter time to virologic suppression (P = 0.016 and longer time to study endpoints (virologic failure [VF], VF/death, and VF/off study treatment; P<0.001 for all measures.In this cohort of sdNVP-exposed, ART-naïve African children, higher levels of HIV diversity in the HIV pol region prior to ART initiation were associated with better treatment outcomes.

  16. Potential pharmacokinetic interactions between antiretrovirals and medicinal plants used as complementary and African traditional medicines.

    Science.gov (United States)

    Müller, Adrienne C; Kanfer, Isadore

    2011-11-01

    The use of traditional/complementary/alternate medicines (TCAMs) in HIV/AIDS patients who reside in Southern Africa is quite common. Those who use TCAMs in addition to antiretroviral (ARV) treatment may be at risk of experiencing clinically significant pharmacokinetic (PK) interactions, particularly between the TCAMs and the protease inhibitors (PIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs). Mechanisms of PK interactions include alterations to the normal functioning of drug efflux transporters, such as P-gp and/or CYP isoenzymes, such a CYP3A4 that mediate the absorption and elimination of drugs in the small intestine and liver. Specific mechanisms include inhibition and activation of these proteins and induction via the pregnane X receptor (PXR). Several clinical studies and case reports involving ARV-herb PK interactions have been reported. St John's Wort, Garlic and Cat's Claw exhibited potentially significant interactions, each with a PI or NNRTI. The potential for these herbs to induce PK interactions with drugs was first identified in reports of in vitro studies. Other in vitro studies have shown that several African traditional medicinal (ATM) plants and extracts may also demonstrate PK interactions with ARVs, through effects on CYP3A4, P-gp and PXR. The most complex effects were exhibited by Hypoxis hemerocallidea, Sutherlandia frutescens, Cyphostemma hildebrandtii, Acacia nilotica, Agauria salicifolia and Elaeodendron buchananii. Despite a high incidence of HIV/AIDs in the African region, only one clinical study, between efavirenz and Hypoxis hemerocallidea has been conducted. However, several issues/concerns still remain to be addressed and thus more studies on ATMs are warranted in order for more meaningful data to be generated and the true potential for such interactions to be determined. Copyright © 2011 John Wiley & Sons, Ltd.

  17. Do national drug policies influence antiretroviral drug prices? Evidence from the Southern African Development community.

    Science.gov (United States)

    Liu, Yao; Galárraga, Omar

    2017-03-01

    The efficacy of low- and middle-income countries’ (LMIC) national drug policies in managing antiretroviral (ARV) pharmaceutical prices is not well understood. Though ARV drug prices have been declining in LMIC over the past decade, little research has been done on the role of their national drug policies. This study aims to (i) analyse global ARV prices from 2004 to 2013 and (ii) examine the relationship of national drug policies to ARV prices. Analysis of ARV drug prices utilized data from the Global Price Reporting Mechanism from the World Health Organization (WHO). Ten of the most common ARV drugs (first-line and second-line) were selected. National drug policies were also assessed for 12 countries in the South African Development Community (SADC), which self-reported their policies through WHO surveys. The best predictor of ARV drug price was generic status—the generic versions of 8 out of 10 ARV drugs were priced lower than branded versions. However, other factors such as transaction volume, HIV prevalence, national drug policies and PEPFAR/CHAI involvement were either not associated with ARV drug price or were not consistent predictors of price across different ARV drugs. In the context of emerging international trade agreements, which aim to strengthen patent protections internationally and potentially delay the sale of generic drugs in LMIC, this study shines a spotlight on the importance of generic drugs in controlling ARV prices. Further research is needed to understand the impact of national drug policies on ARV prices.

  18. Risk factors for death in HIV-infected adult African patients receiving anti-retroviral therapy.

    Science.gov (United States)

    Siika, A M; Wools-Kaloustian, K; Mwangi, A W; Kimaiyo, S N; Diero, L O; Ayuo, P O; Owino-Ong'or, W D; Sidle, J E; Einterz, R M; Yiannoutsos, C T; Musick, B; Tierney, W M

    2010-11-01

    To determine risk factors for death in HIV-infected African patients on anti-retroviral therapy (ART). Retrospective Case-control study. The MOH-USAID-AMPATH Partnership ambulatory HIV-care clinics in western Kenya. Between November 2001 and December 2005 demographic, clinical and laboratory data from 527 deceased and 1054 living patients receiving ART were compared to determine independent risk factors for death. Median age at ART initiation was 38 versus 36 years for the deceased and living patients respectively (p100/mm3 (HR=1.553. 95% CI (1.156, 2.087), p<0.003). Patients attending rural clinics had threefold higher risk of dying compared to patients attending clinic at a tertiary referral hospital (p<0.0001). Two years after initiating treatment fifty percent of non-adherent patients were alive compared to 75% of adherent patients. Male gender, WHO Stage and haemoglobin level <10 grams% were associated with time to death while age, marital status, educational level, employment status and weight were not. Profoundly immunosuppressed patients were more likely to die early in the course of treatment. Also, patients receiving care in rural clinics were at greater risk of dying than those receiving care in the tertiary referral hospital.

  19. Early severe morbidity and resource utilization in South African adults on antiretroviral therapy

    Directory of Open Access Journals (Sweden)

    Meintjes Graeme A

    2009-12-01

    Full Text Available Abstract Background High rates of mortality and morbidity have been described in sub-Saharan African patients within the first few months of starting highly active antiretroviral therapy (HAART. There is limited data on the causes of early morbidity on HAART and the associated resource utilization. Methods A cross-sectional study was conducted of medical admissions at a secondary-level hospital in Cape Town, South Africa. Patients on HAART were identified from a register and HIV-infected patients not on HAART were matched by gender, month of admission, and age group to correspond with the first admission of each case. Primary reasons for admission were determined by chart review. Direct health care costs were determined from the provider's perspective. Results There were 53 in the HAART group with 70 admissions and 53 in the no-HAART group with 60 admissions. The median duration of HAART was 1 month (interquartile range 1-3 months. Median baseline CD4 count in the HAART group was 57 × 106 cells/L (IQR 15-115. The primary reasons for admission in the HAART group were more likely to be due to adverse drug reactions and less likely to be due to AIDS events than the no-HAART group (34% versus 7%; p Conclusions Causes of early morbidity are different and more complex in HIV-infected patients on HAART. This results in greater resource utilization of diagnostic and therapeutic services.

  20. Life expectancies of South African adults starting antiretroviral treatment: collaborative analysis of cohort studies.

    Science.gov (United States)

    Johnson, Leigh F; Mossong, Joel; Dorrington, Rob E; Schomaker, Michael; Hoffmann, Christopher J; Keiser, Olivia; Fox, Matthew P; Wood, Robin; Prozesky, Hans; Giddy, Janet; Garone, Daniela Belen; Cornell, Morna; Egger, Matthias; Boulle, Andrew

    2013-01-01

    Few estimates exist of the life expectancy of HIV-positive adults receiving antiretroviral treatment (ART) in low- and middle-income countries. We aimed to estimate the life expectancy of patients starting ART in South Africa and compare it with that of HIV-negative adults. Data were collected from six South African ART cohorts. Analysis was restricted to 37,740 HIV-positive adults starting ART for the first time. Estimates of mortality were obtained by linking patient records to the national population register. Relative survival models were used to estimate the excess mortality attributable to HIV by age, for different baseline CD4 categories and different durations. Non-HIV mortality was estimated using a South African demographic model. The average life expectancy of men starting ART varied between 27.6 y (95% CI: 25.2-30.2) at age 20 y and 10.1 y (95% CI: 9.3-10.8) at age 60 y, while estimates for women at the same ages were substantially higher, at 36.8 y (95% CI: 34.0-39.7) and 14.4 y (95% CI: 13.3-15.3), respectively. The life expectancy of a 20-y-old woman was 43.1 y (95% CI: 40.1-46.0) if her baseline CD4 count was ≥ 200 cells/µl, compared to 29.5 y (95% CI: 26.2-33.0) if her baseline CD4 count was <50 cells/µl. Life expectancies of patients with baseline CD4 counts ≥ 200 cells/µl were between 70% and 86% of those in HIV-negative adults of the same age and sex, and life expectancies were increased by 15%-20% in patients who had survived 2 y after starting ART. However, the analysis was limited by a lack of mortality data at longer durations. South African HIV-positive adults can have a near-normal life expectancy, provided that they start ART before their CD4 count drops below 200 cells/µl. These findings demonstrate that the near-normal life expectancies of HIV-positive individuals receiving ART in high-income countries can apply to low- and middle-income countries as well. Please see later in the article for the Editors' Summary.

  1. Life expectancies of South African adults starting antiretroviral treatment: collaborative analysis of cohort studies.

    Directory of Open Access Journals (Sweden)

    Leigh F Johnson

    Full Text Available Few estimates exist of the life expectancy of HIV-positive adults receiving antiretroviral treatment (ART in low- and middle-income countries. We aimed to estimate the life expectancy of patients starting ART in South Africa and compare it with that of HIV-negative adults.Data were collected from six South African ART cohorts. Analysis was restricted to 37,740 HIV-positive adults starting ART for the first time. Estimates of mortality were obtained by linking patient records to the national population register. Relative survival models were used to estimate the excess mortality attributable to HIV by age, for different baseline CD4 categories and different durations. Non-HIV mortality was estimated using a South African demographic model. The average life expectancy of men starting ART varied between 27.6 y (95% CI: 25.2-30.2 at age 20 y and 10.1 y (95% CI: 9.3-10.8 at age 60 y, while estimates for women at the same ages were substantially higher, at 36.8 y (95% CI: 34.0-39.7 and 14.4 y (95% CI: 13.3-15.3, respectively. The life expectancy of a 20-y-old woman was 43.1 y (95% CI: 40.1-46.0 if her baseline CD4 count was ≥ 200 cells/µl, compared to 29.5 y (95% CI: 26.2-33.0 if her baseline CD4 count was <50 cells/µl. Life expectancies of patients with baseline CD4 counts ≥ 200 cells/µl were between 70% and 86% of those in HIV-negative adults of the same age and sex, and life expectancies were increased by 15%-20% in patients who had survived 2 y after starting ART. However, the analysis was limited by a lack of mortality data at longer durations.South African HIV-positive adults can have a near-normal life expectancy, provided that they start ART before their CD4 count drops below 200 cells/µl. These findings demonstrate that the near-normal life expectancies of HIV-positive individuals receiving ART in high-income countries can apply to low- and middle-income countries as well. Please see later in the article for the Editors' Summary.

  2. Interplay between air passengers' service quality, satisfaction, loyalty and loyalty programmes in South African owned airlines

    OpenAIRE

    Mantey, Nicholas O.; Naidoo, Vannie

    2017-01-01

    Orientation: Delivering service quality is crucial for the continuous operation and sustainability of South African owned airlines. The term ‘South African owned airlines’ refers to six South African owned registered airlines, and is used for purpose of anonymity and confidentiality. Research purpose: The main aim of this study was to examine the interplay between service quality delivery, satisfaction, loyalty programmes and passengers’ loyalty to South African owned airlines. Motivati...

  3. Incidence of pregnancy following antiretroviral therapy initiation and associated factors in eight West African countries

    Science.gov (United States)

    Burgos-Soto, Juan; Balestre, Eric; Minga, Albert; Ajayi, Samuel; Sawadogo, Adrien; Zannou, Marcel D.; Leroy, Valériane; Ekouevi, Didier K.; Dabis, François; Becquet, Renaud

    2014-01-01

    Introduction This study aimed at estimating the incidence of pregnancy after antiretroviral therapy (ART) initiation in eight West African countries over a 10-year period. Methods A retrospective analysis was conducted within the international database of the IeDEA West Africa Collaboration. All HIV-infected women aged Pregnancy after ART initiation was the main outcome and was based on clinical reporting. Poisson regression analysis accounting for country heterogeneity was computed to estimate first pregnancy incidence post-ART and to identify its associated factors. Pregnancy incidence rate ratios were adjusted on country, baseline CD4 count and clinical stage, haemoglobin, age, first ART regimen and calendar year. Results Overall 29,425 HIV-infected women aged 33 years in median [Inter Quartile Range: 28–38] contributed for 84,870 women-years of follow-up to this analysis. The crude incidence of first pregnancy (2,304 events) was 2.9 per 100 women-years [95% confidence interval [CI]: 2.7–3.0], the highest rate being reported among women aged 25–29 years: 4.7 per 100 women-years; 95% CI: 4.3–5.1. The overall Kaplan-Meier probability of pregnancy occurrence by the fourth year on ART was 10.9% (95% CI: 10.4–11.4) and as high as 28.4% (95% CI: 26.3–30.6) among women aged 20–29 years at ART initiation. Conclusion The rate of pregnancy occurrence after ART initiation among HIV-infected women living in the West Africa region was high. Family planning services tailored to procreation needs should be provided to all HIV-infected women initiating ART and health consequences carefully monitored in this part of the world. PMID:25216079

  4. Correcting Mortality for Loss to Follow-Up: A Nomogram Applied to Antiretroviral Treatment Programmes in Sub-Saharan Africa

    Science.gov (United States)

    Egger, Matthias; Spycher, Ben D.; Sidle, John; Weigel, Ralf; Geng, Elvin H.; Fox, Matthew P.; MacPhail, Patrick; van Cutsem, Gilles; Messou, Eugène; Wood, Robin; Nash, Denis; Pascoe, Margaret; Dickinson, Diana; Etard, Jean-François; McIntyre, James A.; Brinkhof, Martin W. G.

    2011-01-01

    Background The World Health Organization estimates that in sub-Saharan Africa about 4 million HIV-infected patients had started antiretroviral therapy (ART) by the end of 2008. Loss of patients to follow-up and care is an important problem for treatment programmes in this region. As mortality is high in these patients compared to patients remaining in care, ART programmes with high rates of loss to follow-up may substantially underestimate mortality of all patients starting ART. Methods and Findings We developed a nomogram to correct mortality estimates for loss to follow-up, based on the fact that mortality of all patients starting ART in a treatment programme is a weighted average of mortality among patients lost to follow-up and patients remaining in care. The nomogram gives a correction factor based on the percentage of patients lost to follow-up at a given point in time, and the estimated ratio of mortality between patients lost and not lost to follow-up. The mortality observed among patients retained in care is then multiplied by the correction factor to obtain an estimate of programme-level mortality that takes all deaths into account. A web calculator directly calculates the corrected, programme-level mortality with 95% confidence intervals (CIs). We applied the method to 11 ART programmes in sub-Saharan Africa. Patients retained in care had a mortality at 1 year of 1.4% to 12.0%; loss to follow-up ranged from 2.8% to 28.7%; and the correction factor from 1.2 to 8.0. The absolute difference between uncorrected and corrected mortality at 1 year ranged from 1.6% to 9.8%, and was above 5% in four programmes. The largest difference in mortality was in a programme with 28.7% of patients lost to follow-up at 1 year. Conclusions The amount of bias in mortality estimates can be large in ART programmes with substantial loss to follow-up. Programmes should routinely report mortality among patients retained in care and the proportion of patients lost. A simple

  5. The FAO programme for the control of African animal trypanosomiasis and related development

    Energy Technology Data Exchange (ETDEWEB)

    Hursey, B S [FAO, Rome (Italy)

    1990-04-01

    The FAO proposal for a long-term Programme for the Control of African Animal Trypanosomiasis and Related Development was presented to the World Food Conference in November 1974. A recommendation was adopted that the programme should be implemented as a matter of urgency and should receive high priority in the FAO programme of work and budget. Following recommendations of support by FAO statutory bodies the preparatory phase, which led to implementation of a large-scale programme, was launched in 1980.

  6. The FAO programme for the control of African animal trypanosomiasis and related development

    International Nuclear Information System (INIS)

    Hursey, B.S.

    1990-01-01

    The FAO proposal for a long-term Programme for the Control of African Animal Trypanosomiasis and Related Development was presented to the World Food Conference in November 1974. A recommendation was adopted that the programme should be implemented as a matter of urgency and should receive high priority in the FAO programme of work and budget. Following recommendations of support by FAO statutory bodies the preparatory phase, which led to implementation of a large-scale programme, was launched in 1980

  7. Four African Nations Agree to Water Management Programme

    International Nuclear Information System (INIS)

    2013-01-01

    Full text: Seeking to improve their management of water resources, four northeast African nations today agreed at the International Atomic Energy Agency (IAEA) to establish a long-term framework for utlizing a key underground water system. Chad, Egypt, Libya and Sudan signed a Strategic Action Programme (SAP) that aims to optimize the equitable use of the Nubian Sandstone Aquifer System, a huge water resource that lies beneath the four nations. The SAP also commits the countries to strengthen and build upon a previously existing regional coordination mechanism, in part by establishing a new Joint Authority for the Nubian Aquifer System. The Programme lays the groundwork for improving cooperation among the four arid nations and for strengthening their capacity to monitor and manage the aquifer effectively. With growing populations and decreasing water availability from other sources in the region, the aquifer is under mounting pressure. Removing water without a clear understanding of transboundary and other implications threatens water quality and has the potential to harm biodiversity and accelerate land degradation. The agreement resulted from a joint Technical Cooperation project of the United Nations Development Programme (UNDP) and the Global Environment Facility (GEF), the United Nations Educational, Scientific and Cultural Organization (UNESCO) and the IAEA. ''I congratulate all involved on this significant achievement,'' said IAEA Director General Yukiya Amano. ''Water is a key resource, and effective management and use of such water resources is essential for the future. The agreement of the Strategic Action Programme is the result of real cooperation between the four States, the Agency and UNDP-GEF. I am confident that this Programme will be a success and will benefit the people of the region. This positive project experience benefits strengthened and expanded cooperation between the IAEA and the UNDP-GEF.'' ''UNDP would like to congratulate the

  8. Manual of methods for use in the South African Marine Pollution Monitoring Programme

    CSIR Research Space (South Africa)

    Watling, RJ

    1981-07-01

    Full Text Available Methods used in the South African Marine Pollution Monitoring Programme for the analysis of toxic metals, nutrients, oxygen absorbed, chlorophyll, pesticides and bacteria are described. Sample types include biological material, sediments, estuarine...

  9. African Ancestry Influences CCR5 –2459G>A Genotype-Associated Virologic Success of Highly Active Antiretroviral Therapy

    Science.gov (United States)

    Cheruvu, Vinay K.; Igo, Robert P.; Jurevic, Richard J.; Serre, David; Zimmerman, Peter A.; Rodriguez, Benigno; Mehlotra, Rajeev K.

    2014-01-01

    Introduction In a North American, HIV-positive, highly active antiretroviral therapy (HAART)-treated, adherent cohort of self-identified white and black patients, we previously observed that chemokine (C-C motif) receptor 5 (CCR5) –2459G>A genotype had a strong association with time to achieve virologic success (TVLS) in black but not in white patients. Methods Using 128 genome-wide ancestry informative markers, we performed a quantitative assessment of ancestry in these patients (n = 310) to determine (1) whether CCR5 –2459G>A genotype is still associated with TVLS of HAART when ancestry, not self-identified race, is considered and (2) whether this association is influenced by varying African ancestry. Results We found that the interaction between CCR5 –2459G>A genotype and African ancestry (≤0.125 vs. ≥0.425 and A genotype and TVLS was stronger in patients with African ancestry ≥0.71 than in patients with African ancestry ≥0.452, in both Kaplan-Meier (log-rank P = 0.039 and 0.057, respectively, for AA, GA, and GG) and Cox proportional hazards regression (relative hazard for GG compared with AA 2.59 [95% CI, 1.27–5.22; P = 0.01] and 2.26 [95% CI, 1.18–4.32; P = 0.01], respectively) analyses. Conclusions We observed that the association between CCR5 –2459G>A genotype and TVLS of HAART increased with stronger African ancestry. Understanding the genomic mechanisms by which African ancestry influences this association is critical, and requires further studies. PMID:24714069

  10. Patterns of HIV-1 Drug Resistance After First-Line Antiretroviral Therapy (ART) Failure in 6 Sub-Saharan African Countries: Implications for Second-Line ART Strategies

    NARCIS (Netherlands)

    Hamers, Raph L.; Sigaloff, Kim C. E.; Wensing, Annemarie M.; Wallis, Carole L.; Kityo, Cissy; Siwale, Margaret; Mandaliya, Kishor; Ive, Prudence; Botes, Mariette E.; Wellington, Maureen; Osibogun, Akin; Stevens, Wendy S.; Rinke de Wit, Tobias F.; Schuurman, Rob; Siwale, M.; Njovu, C.; Labib, M.; Menke, J.; Botes, M. E.; Conradie, F.; Ive, P.; Sanne, I.; Wallis, C. L.; Letsoalo, E.; Stevens, W. S.; Hardman, M.; Wellington, M.; Luthy, R.; Mandaliya, K.; Abdallah, S.; Jao, I.; Dolan, M.; Namayanja, G.; Nakatudde, L.; Nankya, I.; Kiconco, M.; Abwola, M.; Mugyenyi, P.; Osibogun, A.; Akanmu, S.; Schuurman, R.; Wensing, A. M.; Straatsma, E.; Wit, F. W.; Dekker, J.; van Vugt, M.; Lange, J. M.

    2012-01-01

    Background. Human immunodeficiency virus type 1 (HIV-1) drug resistance may limit the benefits of antiretroviral therapy (ART). This cohort study examined patterns of drug-resistance mutations (DRMs) in individuals with virological failure on first-line ART at 13 clinical sites in 6 African

  11. Alarming Default Rates in South African Children with Moderate Malnutrition on Targeted Supplementary Feeding Programmes

    International Nuclear Information System (INIS)

    Steenkamp, Juliana; Lategan, Ronette

    2014-01-01

    Full text: In 2008, 4.7% South African children under five years suffered from moderate wasting and 23.9% from moderate stunting. Intervention strategies in the public health care system allow for targeted supplementation of children with moderate malnutrition and/or growth failure for three to six months or less if catch-up growth is established. Earlier research among HIV-infected adults on antiretroviral therapy showed that only about 50% of adults could be retained in a nutrition supplementation programme. The aim of this research was to determine default rates of children with moderate malnutrition on a targeted supplementary feeding programme, using Ready-to-use Supplementary Food (RUSF) as home treatment and to explore possible associations between socio-demographic and nutritional factors and defaulting. Between September 2012 and August 2013, a prospective controlled trial was performed in three provinces of South Africa. Children between 12 and 60 months, classified as moderately malnourished, were purposefully selected by dieticians for inclusion in the study, after informed consent was obtained from the legal guardian. Ethical approval was obtained from the Research Ethics Committee, NNMU. In this study defaulting refers to failure to return to the programme after admission, or more than two consecutive absences. Participants had to attend five follow-up sessions, during which children were weighed, measured and data collected in a structured questionnaire. At each visit participants received RUSF as treatment for moderate malnutrition. Parents received a stipend to encourage return. Data were analyzed using PASW (Predictive Analytics SoftWare) by SPSS (Version 21). Frequencies and percentages were used to describe categorical data. Comparisons of means were performed using t-tests. Chi-square tests and two-tailed Pearson correlations were used to describe and test associations and correlations between variables. A p-level ≤0.05 was considered

  12. Mobile phones to support adherence to antiretroviral therapy: what would it cost the Indian National AIDS Control Programme?

    Science.gov (United States)

    Rodrigues, Rashmi; Bogg, Lennart; Shet, Anita; Kumar, Dodderi Sunil; De Costa, Ayesha

    2014-01-01

    Adherence to antiretroviral treatment (ART) is critical to maintaining health and good clinical outcomes in people living with HIV/AIDS. To address poor treatment adherence, low-cost interventions using mobile communication technology are being studied. While there are some studies that show an effect of mobile phone reminders on adherence to ART, none has reported on the costs of such reminders for national AIDS programmes. This paper aims to study the costs of mobile phone reminder strategies (mHealth interventions) to support adherence in the context of India's National AIDS Control Program (NACP). The study was undertaken at two tertiary level teaching hospitals that implement the NACP in Karnataka state, South India. Costs for a mobile phone reminder application to support adherence, implemented at these sites (i.e. weekly calls, messages or both) were studied. Costs were collected based on the concept of avoidable costs specific to the application. The costs that were assessed were one-time costs and recurrent costs that included fixed and variable costs. A sequential procedure for costing was used. Costs were calculated at national-programme level, individual ART-centre level and individual patient level from the NACP's perspective. The assessed costs were pooled to obtain an annual cost per patient. The type of application, number of ART centres and number of patients on ART were varied in a sensitivity analysis of costs. The Indian NACP would incur a cost of between 79 and 110 INR (USD 1.27-1.77) per patient per year, based on the type of reminder, the number of patients on ART and the number of functioning ART centres. The total programme costs for a scale-up of the mHealth intervention to reach the one million patients expected to be on treatment by 2017 is estimated to be 0.36% of the total five-year national-programme budget. The cost of the mHealth intervention for ART-adherence support in the context of the Indian NACP is low and is facilitated by

  13. A Linguistic Research Programme for Reading in African ...

    African Journals Online (AJOL)

    Although ANAs show language conditioned problems in reading comprehension and decoding ability, most South African research focuses disproportionately on ... Obviously African languages are structurally and typologically different to English and Afrikaans; reading strategies required for the mechanics of reading are ...

  14. HIV drug resistance following a decade of the free antiretroviral therapy programme in India: A review.

    Science.gov (United States)

    Karade, Santosh; Chaturbhuj, Devidas N; Sen, Sourav; Joshi, Rajneesh K; Kulkarni, Smita S; Shankar, Subramanian; Gangakhedkar, Raman R

    2018-01-01

    The objective of this review was to assess the burden of HIV drug resistance mutations (DRM) in Indian adults exposed to first-line antiretroviral therapy (ART) as per national guidelines. An advanced search of the published literature on HIV drug resistance in India was performed in the PubMed and Scopus databases. Data pertaining to age, sex, CD4 count, viral load, and prevalence of nucleoside reverse transcriptase inhibitor (NRTI)/non-nucleoside reverse transcriptase inhibitor (NNRTI) DRM were extracted from each publication. Year-wise Indian HIV-1 reverse transcriptase (RT) sequences were retrieved from the Los Alamos HIV database and mutation analyses were performed. A time trend analysis of the proportion of sequences showing NRTI resistance mutations among individuals exposed to first-line ART was conducted. Overall, 23 studies (1046 unique RT sequences) were identified indicating a prevalence of drug resistance to NRTI and NNRTI. The proportion of RT sequences with any DRM, any NRTI DRM, and any NNRTI DRM was 78.39%, 68.83%, and 73.13%, respectively. The temporal trend analysis of individual DRM from sequences retrieved during 2004-2014 indicated a rising trend in K65R mutations (p=0.013). Although the overall burden of resistance against first-line ART agents remained steady over the study decade, periodic monitoring is essential. There is the need to develop an HIV-1 subtype C-specific resistance database in India. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  15. A pharmacogenetic study of CD4 recovery in response to HIV antiretroviral therapy in two South African population groups.

    Science.gov (United States)

    Parathyras, John; Gebhardt, Stefan; Hillermann-Rebello, Renate; Grobbelaar, Nelis; Venter, Mauritz; Warnich, Louise

    2009-05-01

    South Africa, like many other Southern African countries, has one of the highest HIV infection rates in the world and many individuals consequently receive antiretroviral therapy (ART). However, knowledge regarding (i) the prevalence of functional single nucleotide polymorphisms (SNPs) in pharmacologically relevant genes, and (ii) variance in pharmacotherapy both within and between different populations and ethnic groups is limited. The aim of this study was to determine whether selected polymorphisms in cytochrome P450 (CYP) genes (CYP2B6 and CYP3A4) and the multidrug-resistance 1 (ABCB1) gene underlie altered antiretroviral (ARV) drug response in two South African populations. DNA samples from 182 HIV-positive individuals of Mixed-Ancestry and Xhosa ethnicity on ART were genotyped for the A-392G SNP in CYP3A4, the G516T and A785G SNPs in CYP2B6, and the T-129C, C1236T, G2677T/A and C3435T SNPs in ABCB1. Univariate two-way analysis of variance (ANOVA) testing revealed no apparent effect of ethnicity on immune recovery (in terms of CD4-cell count) in response to ART. Univariate one-way ANOVA testing revealed a discernible effect of genotype on immune recovery in the cases of the T-129C (P=0.03) and G2677A (P<0.01) polymorphisms in the ABCB1 gene. This study serves as a basis for better understanding and possible prediction of pharmacogenetic risk profiles and drug response in individuals and ethnic groups in South Africa.

  16. The South African rainfall enhancement programme: 1997-2001 ...

    African Journals Online (AJOL)

    SAREP included an operational cloud-seeding campaign based on the South African developed hygroscopic flare-seeding technology which ran from December 1997 to the end of ... This would have considerable socio-economic benefits.

  17. Outcomes of antiretroviral treatment programmes in rural Lesotho: health centres and hospitals compared.

    Science.gov (United States)

    Labhardt, Niklaus Daniel; Keiser, Olivia; Sello, Motlalepula; Lejone, Thabo Ishmael; Pfeiffer, Karolin; Davies, Mary-Ann; Egger, Matthias; Ehmer, Jochen; Wandeler, Gilles

    2013-11-21

    Lesotho was among the first countries to adopt decentralization of care from hospitals to nurse-led health centres (HCs) to scale up the provision of antiretroviral therapy (ART). We compared outcomes between patients who started ART at HCs and hospitals in two rural catchment areas in Lesotho. The two catchment areas comprise two hospitals and 12 HCs. Patients ≥16 years starting ART at a hospital or HC between 2008 and 2011 were included. Loss to follow-up (LTFU) was defined as not returning to the facility for ≥180 days after the last visit, no follow-up (no FUP) as not returning after starting ART, and retention in care as alive and on ART at the facility. The data were analysed using logistic regression, competing risk regression and Kaplan-Meier methods. Multivariable analyses were adjusted for sex, age, CD4 cell count, World Health Organization stage, catchment area and type of ART. All analyses were stratified by gender. Of 3747 patients, 2042 (54.5%) started ART at HCs. Both women and men at hospitals had more advanced clinical and immunological stages of disease than those at HCs. Over 5445 patient-years, 420 died and 475 were LTFU. Kaplan-Meier estimates for three-year retention were 68.7 and 69.7% at HCs and hospitals, respectively, among women (p=0.81) and 68.8% at HCs versus 54.7% at hospitals among men (phospitals among women (odds ratio (OR): 0.89, 95% confidence interval (CI): 0.73-1.09) and higher retention at HCs among men (OR: 1.53, 95% CI: 1.20-1.96). The latter result was mainly driven by a lower proportion of patients LTFU at HCs (OR: 0.68, 95% CI: 0.51-0.93). In rural Lesotho, overall retention in care did not differ significantly between nurse-led HCs and hospitals. However, men seemed to benefit most from starting ART at HCs, as they were more likely to remain in care in these facilities compared to hospitals.

  18. The role of small satellites in the development of the South African space programme

    Science.gov (United States)

    Martinez, Peter

    In the 1990s a team of scientists and engineers at Stellenbosch University built the first South African satellite to fly in space, the 64-kg Sunsat. This university-based satellite programme took advantage of the skills and facilities developed in the previous South African space programme of the 1980s and early 1990s, which had developed a much larger satellite (Greensat), but was cancelled in the mid-1990s prior to launch. Sunsat incorporated a number of novel capabilities for a microsatellite platform, and interest was shown in these technologies by other groups developing similar satellites. As the University was not the ideal environment to develop the commercial potential of these microsatellite technologies, a company called Sunspace was later established, thus creating industrial capacity in South Africa in a niche area of space technology. This new industrial capability, together with the infrastructure from the previous space programme, have created a foundation upon which to build the new South African space programme. This paper discusses the historical, current and possible future roles of small satellites in the development of the South African space programme.

  19. Abandoning weight-loss programmes | Van Staden | South African ...

    African Journals Online (AJOL)

    South African Medical Journal. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 79, No 5 (1991) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should load here if your ...

  20. Equity development programmes for academic staff at South African ...

    African Journals Online (AJOL)

    The current academic staff profile in South African Higher Education reflects much of the skewdness of the past. The central dilemma faced by these institutions is how to achieve an equitable ratio in the short and medium terms. In response to government concerns expressed through the National Plan on Higher Education, ...

  1. Programme for the control of African animal trypanosomiasis and related development

    International Nuclear Information System (INIS)

    Finelle, P.

    1980-01-01

    After a statement on the problems raised by African animal trypanosomiasis and its control, and the development of currently affected areas, the Programme is outlined describing the methodology for tsetse and trypanosomiasis control operations and the basic approach for implementation of related development. The activities carried out during the five-year preliminary phase are summarized. The operational phase of the Programme is now being launched. The possible use of the sterile male technique is mentioned marginally. No details of research programmes envisaged are presented. A series of Preliminary Assistance Missions to Governments for the evaluation and preparation of control schemes, development strategies and projects is being mounted

  2. From transmission to transition: lessons learnt from the Thai paediatric antiretroviral programme.

    Directory of Open Access Journals (Sweden)

    Olivia Tulloch

    Full Text Available BACKGROUND: The Thai HIV programme is a leader in the public health approach to HIV treatment. Starting at transmission of HIV and ending with transition to adult services this paper assesses the paediatric HIV treatment continuum from three perspectives: service-user, provider and policy maker, to understand what works well and why. METHODS: A qualitative research design was used to assess and triangulate the stakeholder perspectives. Semi-structured interviews were conducted with ART service-users (n = 35, policy actors (n = 20; telephone interviews with prior caregivers of orphans (n = 10; and three focus group discussions with service-providers (hospital staff and volunteers from a district, provincial and a university hospital. FINDINGS: Children accessing HIV care were often orphaned, cared for by elderly relatives and experiencing multiple vulnerabilities. Services were divided into three stages, 1. Diagnosis and linkage: Despite strong policies there were supply and demand-side gaps in the prevention of mother-to-child transmission 'cascade' preventing early diagnosis and/or treatment. 2. Maintenance on ART - Children did well on treatment; caregivers took adherence seriously and valued the quality of services. Drug resistance, adherence and psychosocial issues were important concerns from all perspectives. 3. Adolescents and transition: Adolescent service-users faced greater complexity in their physical and emotional lives for which providers lacked skills; transition from the security of paediatric clinic was a daunting prospect. Dedicated healthcare providers felt they struggled to deliver services that met service-users' diverse needs at all stages. Child- and adolescent-specific elements of HIV policy were considered low priority. CONCLUSIONS: Using the notion of the continuum of care a number of strengths and weaknesses were identified. Features of paediatric services need to evolve alongside the changing needs of service users

  3. African Programme for Onchocerciasis Control 1995-2015: Model-Estimated Health Impact and Cost

    NARCIS (Netherlands)

    L.E. Coffeng (Luc); W.A. Stolk (Wilma); H.G.M. Zouré (Honorat G.); J.L. Veerman (Lennert); K.B. Agblewonu (Koffi); M.E. Murdoch (Michele); M. Noma (Mounkaila); G. Fobi (Grace); J.H. Richardus (Jan Hendrik); D.A.P. Bundy (Donald A.); J.D.F. Habbema (Dik); S.J. de Vlas (Sake); U.V. Amazigo (Uche)

    2013-01-01

    textabstractBackground: Onchocerciasis causes a considerable disease burden in Africa, mainly through skin and eye disease. Since 1995, the African Programme for Onchocerciasis Control (APOC) has coordinated annual mass treatment with ivermectin in 16 countries. In this study, we estimate the health

  4. The Lifecycle of a South African Non-governmental Organisation: Primary Science Programme, 1983-1999.

    Science.gov (United States)

    Harvey, Stephen; Peacock, Alan

    2001-01-01

    Traces the lifecycle of the Primary Science Programme (PSP), 1983-99, a representative South African nongovernmental organization. Shows how the social and economic environment shaped PSP development and demise. Highlights tensions between quality versus quantity, subject versus holistic focus, and participatory versus authoritarian management…

  5. "Views from the Nano Edge": Women on Doctoral Preparation Programmes in Selected African Contexts

    Science.gov (United States)

    Williamson, Charmaine

    2016-01-01

    The study explored the conceptual views of "critical mass", alongside micro experiences, of women, at a practice level, on a doctoral preparation programme which was implemented within the South African Development Community (SADC) and Ethiopian contexts. At the strategising level of policies, insufficient attention has been paid to the…

  6. Mitochondrial genomics and antiretroviral therapy-associated metabolic complications in HIV-infected Black South Africans: a pilot study.

    Science.gov (United States)

    Sinxadi, Phumla Z; Dave, Joel A; Samuels, David C; Heckmann, Jeannine M; Maartens, Gary; Levitt, Naomi S; Wester, C William; Haas, David W; Hulgan, Todd

    2013-07-01

    Studies suggest that mitochondrial DNA (mtDNA) haplogroups are associated with antiretroviral therapy (ART)-related metabolic complications and distal sensory polyneuropathy (DSP), but there have been few studies in persons of African descent. We explored such associations in South African adults. Clinical and laboratory data and DNA specimens from a cross-sectional study were used. Sequencing and Phylotree determined African mtDNA subhaplogroups. Wilcoxon and regression analyses determined associations between mtDNA subhaplogroups and ART-related complications. The 171 participants represented six major haplogroups: L0 (n=78), L1 (n=3), L2 (n=30), L3 (n=53), L4 (n=1), and L5 (n=6). Analyses were restricted to 161 participants representing L0, L2, and L3: 78% were female; the median age was 36 years. All had been exposed to thymidine analogues, 42% were on lopinavir/ritonavir (lopinavir/r), and 58% were on either efavirenz or nevirapine. Median (IQR) ART duration was 22 (14-36) months. Median fasting triglycerides were 1.60 (1.13-1.75) and 1.04 (0.83-1.45) mmol/liter among L3e1 (n=22) and other subhaplogroups, respectively (p=0.003). Subhaplogroup L3e1 [adjusted OR (aOR) 3.16 (95% CI: 1.11-8.96); p=0.03] and exposure to lopinavir/r [aOR 2.98 (95% CI: 1.02-8.96); p=0.05] were independently associated with hypertriglyceridemia, after adjusting for age, sex, and ART duration. There were no significant associations between mtDNA haplogroups and cholesterol, dysglycemia, hyperlactatemia, or lipoatrophy, or DSP. Subhaplogroup L3e1 and lopinavir/r exposure were independently associated with hypertriglyceridemia in black South Africans on ART. This is the first report to link an African mtDNA variant with hypertriglyceridemia. If replicated, these findings may provide new insights into host factors affecting metabolic complications.

  7. The intersection of antiretroviral therapy, peer support programmes, and economic empowerment with HIV stigma among HIV-positive women in West Nile Uganda.

    Science.gov (United States)

    Kellett, Nicole Coffey; Gnauck, Katherine

    2016-12-01

    HIV stigma remains a major problem of the AIDS epidemic in sub-Saharan Africa. Women fear impending social stigma including blame, isolation and abuse. HIV infection and HIV stigma interact cyclically, creating and reinforcing economic and social exclusion for individuals living with HIV. Evidence suggests that interventions for people living with HIV infection that include, in combination, antiretroviral therapy (ART), peer support and economic empowerment are likely to be more effective than if used alone. We report a qualitative study in West Nile Uganda that explored perceptions of HIV stigma among fifty-four HIV-positive women who had similar access to ART and HIV peer support programmes, but varying levels of participation (full-time, intermittent, none) in economic empowerment programmes. Our study found that access to ART, peer support groups, and economic empowerment programmes helped to curb perceptions of deep-seated HIV stigma for participants. More expressions of usefulness, hope and psychological well-being prevailed with participants who had increased participation in economic empowerment programmes. Our findings underscore the value of HIV outreach programmes which combine ART, peer support and economic empowerment to alleviate HIV stigma. Further research to quantify the interaction of these factors is warranted.

  8. Evaluation of a school-based intervention programme for South African children of divorce.

    Science.gov (United States)

    Botha, Cornelius J; Wild, Lauren G

    2013-01-01

    Parental divorce affects approximately 30 000 South African children annually. This pilot study aimed to evaluate the effectiveness of the Children of Divorce Intervention Programme (CODIP) at two South African schools. CODIP is a preventively oriented group programme which was developed to foster resilience by helping children cope more effectively with possible academic, behavioural, and emotional problems brought about by their parents' divorce. Twenty-five 10- to 14-year-old boys from two primary schools were randomly assigned to 2 experimental groups and 1 delayed intervention control group. The experimental groups attended 12 one-hour weekly sessions; the control group received no intervention until after the study was completed. Children's understanding of divorce related events and social, emotional and behavioural adjustment was assessed one week before the intervention and three months thereafter using a battery of self-rated, teacher-rated and parent-rated questionnaires. One-way ANOVAs indicated no statistically significant decline in children's self-reported problematic beliefs about divorce or total difficulties. However, teachers' and parents' ratings indicated that compared to the control group, the combined experimental groups showed significant improvement in their general behavioural, emotional and social adjustment after programme participation. The results suggest that South African children who experience parental divorce may benefit from participation in CODIP.

  9. Tobacco use and its determinants in HIV-infected patients on antiretroviral therapy in West African countries

    Science.gov (United States)

    Jaquet, Antoine; Ekouevi, Didier-Koumavi; Aboubakrine, Maiga; Bashi, Jules; Messou, Eugène; Maiga, Moussa; Traore, Hamar-Alassane; Zannou, Marcel; Guehi, Calixte; Ba-Gomis, Franck-Olivier; Minga, Albert; Allou, Gérard; Eholie, Serge-Paul; Dabis, Francois; Bissagnene, Emmanuel; Sasco, Annie-Jeanne

    2009-01-01

    INTRODUCTION Tobacco smoking is common in HIV-infected patients from industrialized countries. In West Africa, few data exist concerning tobacco consumption. METHODS A cross-sectional survey was conducted within the International epidemiological Database to Evaluate AIDS (IeDEA) network in West Africa. Health workers administered to patients receiving antiretroviral treatment a questionnaire assessing tobacco and cannabis consumption. Regular smokers were defined as present smokers who smoked >1 cigarette per day for ≥1 year. RESULTS Overall, 2920 patients were enrolled in three countries. The prevalence of ever smokers and present smokers were 46.2% (95% CI 42.8–49.5) and 15.6% (95% CI 13.2–18.0) in men and 3.7% (95% CI 2.9–4.5) and 0.6% (95% CI 0.3–0.9) in women, respectively. Regular smoking was associated being from Côte d’Ivoire or Mali compared to Benin (OR 4.6; 95% CI 2.9–7.3 and 7.7; 95% CI 4.4–13.6), a severely impaired immunological status at HAART initiation (OR 1.5; 95% CI 1.1–2.2) and a history of tuberculosis (OR 1.8; 95% CI 1.1–3.0). CONCLUSION Marked differences of smoking prevalence exist between these West African countries. This survey approach also provides evidences concerning the association between cigarette smoking and tuberculosis in HIV-infected patients, a major public health issue in this part of the world. PMID:19861019

  10. Effect of Pregnancy on Response to Antiretroviral Therapy in HIV-Infected African Women.

    Science.gov (United States)

    Kourtis, Athena P; Wiener, Jeffrey; King, Caroline C; Heffron, Renee; Mugo, Nelly R; Nanda, Kavita; Pyra, Maria; Donnell, Deborah; Celum, Connie; Lingappa, Jairam R; Baeten, Jared M

    2017-01-01

    While most recent evidence does not support a role for pregnancy in accelerating HIV disease progression, very little information is available on the effects of incident pregnancy in response to antiretroviral therapy (ART). Hormonal, immune, and behavioral changes during pregnancy may influence response to ART. We sought to explore the effects of incident pregnancy (after ART initiation) on virologic, immunologic, and clinical response to ART. Data were collected from HIV-infected women participating in 3 prospective studies (Partners in Prevention Herpes simplex virus/HIV Transmission Study, Couples Observational Study, and Partners Preexposure Prophylaxis Study) from 7 countries in Africa from 2004 to 2012. Women were included in this analysis if they were ≤45 years of age, were started on ART during the study and were not pregnant at ART initiation. Pregnancy was treated as a time-dependent exposure variable covering the duration of pregnancy, including all pregnancies occurring after ART initiation. Virologic failure was defined as a viral load (VL) greater than 400 copies per milliliter ≥6 months after ART initiation and viral suppression was defined as VL ≤400 copies per milliliter. Multivariable Cox proportional hazards models were used to assess the association between pregnancy and time to viral suppression, virologic failure, World Health Organization clinical stage III/IV, and death. Linear mixed-effects models were used to assess the association between pregnancy and CD4 count and VL. All analyses were adjusted for confounders, including pre-ART CD4 count and plasma VL. A total of 1041 women were followed, contributing 1196.1 person-years of follow-up. Median CD4 count before ART initiation was 276 cells per cubic millimeter (interquartile range, 209-375); median pre-ART VL was 17,511 copies per milliliter (interquartile range, 2480-69,286). One hundred ten women became pregnant after ART initiation. Pregnancy was not associated with time to

  11. Developing and implementing an anti-corruption ethics and compliance programme in the African environment

    Directory of Open Access Journals (Sweden)

    Alain Ndedi

    2015-12-01

    Full Text Available This article discusses the development and implementation of anti-corruption ethics and compliance programme in the African business environment. In the past decade, an international legal framework has been developed to tackle corruption both in public and private sectors. This framework includes the United Nations Convention against Corruption (UNCAC, which entered into force in 2005, and the Convention on Combating Bribery of Foreign Public Officials in International Business Transactions, which entered into force in 1999. These instruments mandate that State Parties must criminalise and punish a variety of corrupt practices. Relevant domestic laws have a direct impact on business, especially in States Parties instruments that require the establishment of liability of legal persons for corrupt acts. The African Union Convention also requires States Parties to establish mechanisms to encourage participation by the private sector in the fight against unfair competition, respect of the tender procedures and property rights. The paper details various steps needed to efficiently and effectively implement anti-corruption ethics and compliance programme in the African context. The first part of the paper develops the primary objective of the corruption risk assessment which is to better understand the risk exposure so that informed risk management decisions may be taken. A structured approach for how enterprises could conduct an anti-corruption risk assessment will be outlined in this first section. The author argued in this same first section that each enterprise’s own risk assessment exercise is unique, depending on that enterprise’s industry, size, location, and other factors inherent to that organisation. The second part of the paper drafts the development and the implementation of an anti-corruption programme. The paper concludes by stating that an anti-corruption and compliance programme is not a panacea for fighting all the ills on

  12. Do hernia operations in african international cooperation programmes provide good quality?

    Science.gov (United States)

    Gil, J; Rodríguez, J M; Hernández, Q; Gil, E; Balsalobre, M D; González, M; Torregrosa, N; Verdú, T; Alcaráz, M; Parrilla, P

    2012-12-01

    Hernia is especially prevalent in developing countries where the population is obliged to undertake strenuous work in order to survive, and International Cooperation Programmes are helping to solve this problem. However, the quality of surgical interventions is unknown. The objective of the present study was to evaluate the quality of hernia repair processes carried out by the Surgical Solidarity Charity in Central African States. A total of 524 cases of inguinal hernia repair carried out in Cameroon and Mali during 2005 to 2009 were compared with 386 cases treated in a Multicentre Spanish Study (2003). General data (clinical, demographic, etc.), type of surgery, complications, and effectiveness and efficiency indicators were collected. Preoperative studies in the Spanish group were greater in number than in the African group. The use of local anesthesia was similar. Antibiotic prophylaxis was higher in the African group (100% to 75.4%). The use of mesh was similar. The incidence of hematomas was higher in the Spanish group (11.61% to 4.61%), but the incidence of infection of the wound and of hernia recurrence was similar, although follow-up was only carried out in 20.97% in the African group (70% in the Spanish group). Hospital stay of more than 24 h was higher in the Spanish group. The standard quality of surgery for the treatment of hernia in developing countries with few instrumental means, and in sub-optimal surgical conditions is similar to that provided in Spain.

  13. Balancing the need to rapidly scale-up and improve clinical outcomes in antiretroviral programmes in developing countries: lessons from an Indian programmatic cohort study.

    Science.gov (United States)

    Bock, Peter; Beyers, Nulda; Fidler, Sarah

    2014-10-01

    Antiretroviral treatment (ART) is highly effective reducing mortality and AIDS-related morbidity in HIV-infected people and at preventing transmission of HIV between individuals. The article reviewed for this commentary reported on data from an Indian ART cohort that showed low median baseline CD4 counts and high rates of mortality and loss to follow-up. Programme implementers in developing regions need to balance the need for rapid scale-up and simultaneous improvement in clinical outcomes. Challenges outlined support HIV treatment strategies that combine improved HIV diagnosis, linkage to care and provision of ART with a strong community-based component. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. Active tuberculosis is associated with worse clinical outcomes in HIV-infected African patients on antiretroviral therapy.

    Directory of Open Access Journals (Sweden)

    Abraham M Siika

    Full Text Available This cohort study utilized data from a large HIV treatment program in western Kenya to describe the impact of active tuberculosis (TB on clinical outcomes among African patients on antiretroviral therapy (ART.We included all patients initiating ART between March 2004 and November 2007. Clinical (signs and symptoms, radiological (chest radiographs and laboratory (mycobacterial smears, culture and tissue histology criteria were used to record the diagnosis of TB disease in the program's electronic medical record system.We assessed the impact of TB disease on mortality, loss to follow-up (LTFU and incident AIDS-defining events (ADEs through Cox models and CD4 cell and weight response to ART by non-linear mixed models.We studied 21,242 patients initiating ART-5,186 (24% with TB; 62% female; median age 37 years. There were proportionately more men in the active TB (46% than in the non-TB (35% group. Adjusting for baseline HIV-disease severity, TB patients were more likely to die (hazard ratio--HR = 1.32, 95% CI 1.18-1.47 or have incident ADEs (HR = 1.31, 95% CI: 1.19-1.45. They had lower median CD4 cell counts (77 versus 109, weight (52.5 versus 55.0 kg and higher ADE risk at baseline (CD4-adjusted odds ratio = 1.55, 95% CI: 1.31-1.85. ART adherence was similarly good in both groups. Adjusting for gender and baseline CD4 cell count, TB patients experienced virtually identical rise in CD4 counts after ART initiation as those without. However, the overall CD4 count at one year was lower among patients with TB (251 versus 269 cells/µl.Clinically detected TB disease is associated with greater mortality and morbidity despite salutary response to ART. Data suggest that identifying HIV patients co-infected with TB earlier in the HIV-disease trajectory may not fully address TB-related morbidity and mortality.

  15. Access to antiretroviral drugs and AIDS management in Senegal.

    Science.gov (United States)

    Desclaux, Alice; Ciss, Mounirou; Taverne, Bernard; Sow, Papa S; Egrot, Marc; Faye, Mame A; Lanièce, Isabelle; Sylla, Omar; Delaporte, Eric; Ndoye, Ibrahima

    2003-07-01

    Description and analysis of the Senegalese Antiretroviral Drug Access Initiative (ISAARV), the first governmental highly active antiretroviral therapy (HAART) treatment programme in Africa, launched in 1998. ISAARV was initially an experimental project designed to evaluate the feasibility, efficacy and acceptability of HAART in an African context. It was based on four principles: collective definition of the strategy, with involvement of the health professionals who would be called on to execute the programme; matching the objectives to available means (gradual enrollment according to drug availability); monitoring by several research programmes; and ongoing adaptation of treatment and follow-up according to the latest international recommendations. Persons qualifying for antiretroviral (ARV) therapy are selected on the basis of immunological and clinical criteria, regardless of economic and social considerations. A system of subsidies was created to favor access to ARV. Following the ARV price reductions that occurred in November 2000, 100% subsidies were created for the poorest participants. Optimal adherence was ensured by monthly follow-up by pharmacists and support groups held by social workers and patient associations. The chosen supply and distribution system allowed drug dispensing to be strictly controlled. The ISAARV programme demonstrates that HAART can be successfully prescribed in Africa. This experience has served as the basis for the creation of a national treatment programme in Senegal planned to treat 7000 patients by 2006.

  16. Effect of Age at Antiretroviral Therapy Initiation on Catch-up Growth Within the First 24 Months Among HIV-infected Children in the IeDEA West African Pediatric Cohort

    DEFF Research Database (Denmark)

    Jesson, Julie; Koumakpaï, Sikiratou; Diagne, Ndeye R

    2015-01-01

    BACKGROUND: We described malnutrition and the effect of age at antiretroviral therapy (ART) initiation on catch-up growth over 24 months among HIV-infected children enrolled in the International epidemiologic Databases to Evaluate Aids West African paediatric cohort. METHODS: Malnutrition...

  17. Prices of second-line antiretroviral treatment for middle-income countries inside versus outside sub-Saharan Africa.

    Science.gov (United States)

    Simmons, Bryony; Hill, Andrew; Ford, Nathan; Ruxrungtham, Kiat; Ananworanich, Jintanat

    2014-01-01

    Antiretrovirals are available at low prices in sub-Saharan Africa, but these prices may not be consistently available for middle-income countries in other regions with large HIV epidemics. Over 30% of HIV infected people live in countries outside sub-Saharan Africa. Several key antiretrovirals are still on patent, with generic production restricted. We assessed price variations for key antiretroviral drugs inside versus outside sub-Saharan Africa. HIV drug prices used in national programmes (2010-2014) were extracted from the WHO Global Price Reporting Mechanism database for all reporting middle-income countries as classified by the World Bank. Treatment costs (branded and generic) were compared for countries inside sub-Saharan Africa versus those outside. Five key second-line antiretrovirals were analysed: abacavir, atazanavir, darunavir, lopinavir/ritonavir, raltegravir. Prices of branded antiretrovirals were significantly higher outside sub-Saharan Africa (psub-Saharan Africa versus $4689 (IQR $4075-5717) in non-African middle-income countries, an increase of 541%. However, when supplied by generic companies, most antiretrovirals were similarly priced between countries in sub-Saharan Africa and other regions. Pharmaceutical companies are selling antiretrovirals to non-African middle-income countries at prices 74-541% higher than African countries with similar gross national incomes. However, generic companies are selling most of these drugs at similar prices across regions. Mechanisms to ensure fair pricing for patented antiretrovirals across both African and non-African middle-income countries need to be improved, to ensure sustainable treatment access.

  18. Evaluation of three sampling methods to monitor outcomes of antiretroviral treatment programmes in low- and middle-income countries.

    Science.gov (United States)

    Tassie, Jean-Michel; Malateste, Karen; Pujades-Rodríguez, Mar; Poulet, Elisabeth; Bennett, Diane; Harries, Anthony; Mahy, Mary; Schechter, Mauro; Souteyrand, Yves; Dabis, François

    2010-11-10

    Retention of patients on antiretroviral therapy (ART) over time is a proxy for quality of care and an outcome indicator to monitor ART programs. Using existing databases (Antiretroviral in Lower Income Countries of the International Databases to Evaluate AIDS and Médecins Sans Frontières), we evaluated three sampling approaches to simplify the generation of outcome indicators. We used individual patient data from 27 ART sites and included 27,201 ART-naive adults (≥15 years) who initiated ART in 2005. For each site, we generated two outcome indicators at 12 months, retention on ART and proportion of patients lost to follow-up (LFU), first using all patient data and then within a smaller group of patients selected using three sampling methods (random, systematic and consecutive sampling). For each method and each site, 500 samples were generated, and the average result was compared with the unsampled value. The 95% sampling distribution (SD) was expressed as the 2.5(th) and 97.5(th) percentile values from the 500 samples. Overall, retention on ART was 76.5% (range 58.9-88.6) and the proportion of patients LFU, 13.5% (range 0.8-31.9). Estimates of retention from sampling (n = 5696) were 76.5% (SD 75.4-77.7) for random, 76.5% (75.3-77.5) for systematic and 76.0% (74.1-78.2) for the consecutive method. Estimates for the proportion of patients LFU were 13.5% (12.6-14.5), 13.5% (12.6-14.3) and 14.0% (12.5-15.5), respectively. With consecutive sampling, 50% of sites had SD within ±5% of the unsampled site value. Our results suggest that random, systematic or consecutive sampling methods are feasible for monitoring ART indicators at national level. However, sampling may not produce precise estimates in some sites.

  19. Survival of patients with Kaposi's sarcoma in the South African ...

    African Journals Online (AJOL)

    When the South African (SA) antiretroviral therapy (ART) programme was rolled out in 2004, the treatment model for HIV- ... context of ART and affordable standard-of-care cancer regimens, KS ... for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, Faculty of Health Sciences,.

  20. Cost-savings accruable to removing value added tax from antiretrovirals in the South African private health sector

    Directory of Open Access Journals (Sweden)

    Varsha Bangalee

    2017-10-01

    Full Text Available Background: Despite the important and essential role that medicines play in any society, all medicines, including those identified as essential, are uniformly subjected to 14% value added tax (VAT, regardless of their therapeutic value in the private healthcare sector of South Africa. The aim of this article is to demonstrate the potential cost-saving attained from the removal of VAT from the private sector pricing of essential medicines, using antiretroviral treatment as an example. Methods: An empirical analysis was undertaken to illustrate the potential cost-saving achieved by removing VAT from the Single Exit Price and the dispensing fee of essential medicines. This outcome was demonstrated by applying the methodology to an adult fixed dose combination 1st line antiretroviral regimen as well as to a group of 3rd line antiretroviral medicines. Results: The potential saving for the lowest priced generic and originator 1st line antiviral regimen accrued to ZAR 693.84 and ZAR 1085.04 over a year respectively. Regarding the 3rd line antiretroviral drugs, results yielded an annual saving of ZAR 1678.68 (darunavir, ZAR5741.04 (maraviroc and ZAR 159.48 (rilpivirine. Conclusions: Lobbying for the removal of VAT from the supply chain of medicines should be intensified. Policy development to monitor and recover lost government revenue through the removal of taxes should be explored.

  1. HIV-Related Medical Admissions to a South African District Hospital Remain Frequent Despite Effective Antiretroviral Therapy Scale-Up

    NARCIS (Netherlands)

    Meintjes, Graeme; Kerkhoff, Andrew D.; Burton, Rosie; Schutz, Charlotte; Boulle, Andrew; van Wyk, Gavin; Blumenthal, Liz; Nicol, Mark P.; Lawn, Stephen D.

    2015-01-01

    The public sector scale-up of antiretroviral therapy (ART) in South Africa commenced in 2004. We aimed to describe the hospital-level disease burden and factors contributing to morbidity and mortality among hospitalized HIV-positive patients in the era of widespread ART availability. Between June

  2. Cost Effective Ways of Implementing Nuclear Power Programme in African Countries

    International Nuclear Information System (INIS)

    Aderojua, Abraham; Choi, Kwang Sik

    2011-01-01

    still growing fast and hence are characterized by a foreseeable increase in electricity demand to drive the factors of production. 1.3 Objective of this Paper The purpose of this paper is to explore the efficient means of building nuclear power plants and associated infra structure in African countries. The concept adopted in this paper to achieve efficient allocation of resources is sharing of infrastructural items. The paper lists examples of sharing arrangement on the African continent for other purposes other than nuclear power programme. This is an attempt to justify the workability of the concept for nuclear power programme. Mention has also been made of similar sharing arrangement in other countries for the purpose of nuclear power programme. The factors that will enhance the success of sharing concept in African countries have also been highlighted

  3. Understanding HIV Transmission Risk Behavior Among HIV-Infected South Africans Receiving Antiretroviral Therapy: An Information—Motivation—Behavioral Skills Model Analysis

    Science.gov (United States)

    Kiene, Susan M.; Fisher, William A.; Shuper, Paul A.; Cornman, Deborah H.; Christie, Sarah; MacDonald, Susan; Pillay, Sandy; Mahlase, Gethwana; Fisher, Jeffrey D.

    2014-01-01

    The current study applied the Information—Motivation—Behavioral Skills (IMB) model (J. D. Fisher & Fisher, 1992; W. A. Fisher & Fisher, 1993) to identify factors associated with HIV transmission risk behavior among HIV-infected South Africans receiving antiretroviral therapy (ART), a population of considerable significance for curtailing, or maintaining, South Africa’s generalized HIV epidemic. HIV prevention information, HIV prevention motivation, HIV prevention behavioral skills, and HIV transmission risk behavior were assessed in a sample of 1,388 South Africans infected with HIV and receiving ART in 16 clinics in KwaZulu-Natal, South Africa. Results confirmed the assumptions of the IMB model and demonstrated that HIV prevention information and HIV prevention motivation work through HIV prevention behavioral skills to affect HIV transmission risk behavior in this population. Subanalyses confirmed these relationships for HIV transmission risk behavior overall and for HIV transmission risk behavior with partners perceived to be HIV-negative or HIV-status unknown. A consistent pattern of gender differences showed that for men, HIV prevention information and HIV prevention motivation may have direct links with HIV preventive behavior, while for women, the effects of HIV prevention information and HIV prevention motivation work through HIV prevention behavioral skills to affect HIV preventive behavior. These IMB model-based findings suggest directions for HIV prevention interventions with South African men and women living with HIV and on ART as an important component of overall strategies to contain South Africa’s generalized HIV epidemic. PMID:23477576

  4. Understanding HIV transmission risk behavior among HIV-infected South Africans receiving antiretroviral therapy: an information--motivation--behavioral skills model analysis.

    Science.gov (United States)

    Kiene, Susan M; Fisher, William A; Shuper, Paul A; Cornman, Deborah H; Christie, Sarah; Macdonald, Susan; Pillay, Sandy; Mahlase, Gethwana; Fisher, Jeffrey D

    2013-08-01

    The current study applied the Information-Motivation-Behavioral Skills (IMB) model (Fisher & Fisher, 1992; Fisher & Fisher, 1993) to identify factors associated with human immunodeficiency virus (HIV) transmission risk behavior among HIV-infected South Africans receiving antiretroviral therapy (ART), a population of considerable significance for curtailing, or maintaining, South Africa's generalized HIV epidemic. HIV prevention information, HIV prevention motivation, HIV prevention behavioral skills, and HIV transmission risk behavior were assessed in a sample of 1,388 South Africans infected with HIV and receiving ART in 16 clinics in KwaZulu-Natal, South Africa. Findings confirmed the assumptions of the IMB model and demonstrated that HIV prevention information and HIV prevention motivation work through HIV prevention behavioral skills to affect HIV transmission risk behavior in this population. Subanalyses confirmed these relationships for HIV transmission risk behavior overall and for HIV transmission risk behavior with partners perceived to be HIV-negative or HIV-status unknown. A consistent pattern of gender differences showed that for men, HIV prevention information and HIV prevention motivation may have direct links with HIV preventive behavior, whereas for women, the effect of HIV prevention motivation works through HIV prevention behavioral skills to affect HIV preventive behavior. These IMB model-based findings suggest directions for HIV prevention interventions with South African men and women living with HIV and on ART as an important component of overall strategies to contain South Africa's generalized HIV epidemic. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  5. Impact of community-based support services on antiretroviral treatment programme delivery and outcomes in resource-limited countries: a synthetic review

    Directory of Open Access Journals (Sweden)

    Wouters Edwin

    2012-07-01

    Full Text Available Abstract Background Task-shifting to lay community health providers is increasingly suggested as a potential strategy to overcome the barriers to sustainable antiretroviral treatment (ART scale-up in high-HIV-prevalence, resource-limited settings. The dearth of systematic scientific evidence on the contributory role and function of these forms of community mobilisation has rendered a formal evaluation of the published results of existing community support programmes a research priority. Methods We reviewed the relevant published work for the period from November 2003 to December 2011 in accordance with the guidelines for a synthetic review. ISI Web of Knowledge, Science Direct, BioMed Central, OVID Medline, PubMed, Social Services Abstracts, and Sociological Abstracts and a number of relevant websites were searched. Results The reviewed literature reported an unambiguous positive impact of community support on a wide range of aspects, including access, coverage, adherence, virological and immunological outcomes, patient retention and survival. Looking at the mechanisms through which community support can impact ART programmes, the review indicates that community support initiatives are a promising strategy to address five often cited challenges to ART scale-up, namely (1 the lack of integration of ART services into the general health system; (2 the growing need for comprehensive care, (3 patient empowerment, (4 and defaulter tracing; and (5 the crippling shortage in human resources for health. The literature indicates that by linking HIV/AIDS-care to other primary health care programmes, by providing psychosocial care in addition to the technical-medical care from nurses and doctors, by empowering patients towards self-management and by tracing defaulters, well-organised community support initiatives are a vital part of any sustainable public-sector ART programme. Conclusions The review demonstrates that community support initiatives are a

  6. Longitudinal relationships between antiretroviral treatment adherence and discrimination due to HIV-serostatus, race, and sexual orientation among African-American men with HIV.

    Science.gov (United States)

    Bogart, Laura M; Wagner, Glenn J; Galvan, Frank H; Klein, David J

    2010-10-01

    African-Americans show worse HIV disease outcomes compared to Whites. Health disparities may be aggravated by discrimination, which is associated with worse health and maladaptive health behaviors. We examined longitudinal effects of discrimination on antiretroviral treatment adherence among 152 HIV-positive Black men who have sex with men. We measured adherence and discrimination due to HIV-serostatus, race/ethnicity, and sexual orientation at baseline and monthly for 6 months. Hierarchical repeated-measures models tested longitudinal effects of each discrimination type on adherence. Over 6 months, participants took 60% of prescribed medications on average; substantial percentages experienced discrimination (HIV-serostatus, 38%; race/ethnicity, 40%; and sexual orientation, 33%). Greater discrimination due to all three characteristics was significantly bivariately associated with lower adherence (all p's discrimination was significant (p < 0.05). Efforts to improve HIV treatment adherence should consider the context of multiple stigmas, especially racism.

  7. Concurrent use of Antiretroviral and African traditional medicines amongst people living with HIV/AIDS (PLWA) in the eThekwini Metropolitan area of KwaZulu Natal.

    Science.gov (United States)

    Mncengeli, Sibanda; Manimbulu, Nlooto M; Panjasaram, Naidoo

    2016-12-01

    People living with HIV/AIDS (PLWA) often use African Traditional Medicines (ATM) either alone or in combination with Western medicines including Antiretrovirals (ARV). To explore the prevalence of concurrent Antiretrovirals (ARV) and African Traditional medicines (ATM) use and determine the effects of any concurrent use on the CD4+ Lymphocyte count and Viral Load (VL) of PLWA in the eThekwini Metropolitan area. A descriptive and exploratory study was carried out on 360 patients. Information was gathered on patients socioeconomic characteristics, ATM usage, outcome measures of HIV disease progression (CD4+ Count, VL). The data was analysed using descriptive statistics, univariate and multivariate analyses. 4.98% (14/281) of the patients used ATM and ARV concurrently during the study period. Over 65% (185/281) reported ATM use before diagnosis with HIV whilst 77.6% (218/281) reported previous ATM use after their HIV diagnosis but before initiation with ARV. Place of residence (p=0.004), age (p<0.001) and education level (P=0.041) were found to be significantly and positively correlated with ATM use. There were no statistically significant changes in mean plasma CD4+ Count and inconclusive effects on VL during the period of the study in the group taking ARV alone when compared with the group using ARV and ATM concomitantly. Concurrent ARV and ATM use is quite low (4.98%) when compared to ATM use before HIV diagnosis and after HIV diagnosis but before initiation with ARV. This may point to efficient pre-counselling efforts before ARV initiation by health care professionals. This study also demonstrated that there were no significant differences in the CD4+ and inconclusive effects on VL, between patients taking both ARV and ATM concomitantly and those using ARV alone.

  8. Patterns of HIV-1 drug resistance after first-line antiretroviral therapy (ART) failure in 6 sub-Saharan African countries: implications for second-line ART strategies.

    Science.gov (United States)

    Hamers, Raph L; Sigaloff, Kim C E; Wensing, Annemarie M; Wallis, Carole L; Kityo, Cissy; Siwale, Margaret; Mandaliya, Kishor; Ive, Prudence; Botes, Mariette E; Wellington, Maureen; Osibogun, Akin; Stevens, Wendy S; Rinke de Wit, Tobias F; Schuurman, Rob

    2012-06-01

    Human immunodeficiency virus type 1 (HIV-1) drug resistance may limit the benefits of antiretroviral therapy (ART). This cohort study examined patterns of drug-resistance mutations (DRMs) in individuals with virological failure on first-line ART at 13 clinical sites in 6 African countries and predicted their impact on second-line drug susceptibility. A total of 2588 antiretroviral-naive individuals initiated ART consisting of different nucleoside reverse transcriptase inhibitor (NRTI) backbones (zidovudine, stavudine, tenofovir, or abacavir, plus lamivudine or emtricitabine) with either efavirenz or nevirapine. Population sequencing after 12 months of ART was retrospectively performed if HIV RNA was >1000 copies/mL. The 2010 International Antiviral Society-USA list was used to score major DRMs. The Stanford algorithm was used to predict drug susceptibility. HIV-1 sequences were generated for 142 participants who virologically failed ART, of whom 70% carried ≥1 DRM and 49% had dual-class resistance, with an average of 2.4 DRMs per sequence (range, 1-8). The most common DRMs were M184V (53.5%), K103N (28.9%), Y181C (15.5%), and G190A (14.1%). Thymidine analogue mutations were present in 8.5%. K65R was frequently selected by stavudine (15.0%) or tenofovir (27.7%). Among participants with ≥1 DRM, HIV-1 susceptibility was reduced in 93% for efavirenz/nevirapine, in 81% for lamivudine/emtricitabine, in 59% for etravirine/rilpivirine, in 27% for tenofovir, in 18% for stavudine, and in 10% for zidovudine. Early failure detection limited the accumulation of resistance. After stavudine failure in African populations, zidovudine rather than tenofovir may be preferred in second-line ART. Strategies to prevent HIV-1 resistance are a global priority.

  9. Service Quality and Students' Satisfaction with the Professional Teacher Development Programmes by Distance Mode in a South African University

    Science.gov (United States)

    Oduaran, A. B.

    2011-01-01

    This article reports on the relationship between seven factors that described dimensions of education service quality and overall service quality on one hand, and students' satisfaction with the professional teacher development programmes by distance mode in a South African University on the other. We sought to find out whether students enrolled…

  10. Programme

    OpenAIRE

    Hobday, E, fl. 1905, artist

    2003-01-01

    A photograph of an illustrated programme listing dances. The illustration shows a snake charmer playing to a snake while another man watches. Buildings and trees can be seen behind a wall in the distance. In the lower right-hand corner of the programme is the signature 'E. Hobday'. The programme is almost certainly related to the Punjab Ball, Lahore. It is placed next to the Punjab Ball Menu in the album and the Menu is also illustrated by 'E. Hobday'.

  11. Mortality and loss to programme before antiretroviral therapy among HIV-infected children eligible for treatment in The Gambia, West Africa

    Directory of Open Access Journals (Sweden)

    Okomo Uduak

    2012-10-01

    Full Text Available Abstract Background HIV infection among children, particularly those under 24 months of age, is often rapidly progressive; as a result guidelines recommend earlier access to combination antiretroviral therapy (cART for HIV infected children. Losses to follow-up (LTFU and death in the interval between diagnosis and initiation of ART profoundly limit this strategy. This study explores correlates of LTFU and death prior to ART initiation among children. Methods The study is based on 337 HIV-infected children enrolled into care at an urban centre in The Gambia, including those alive and in care when antiretroviral therapy became available and those who enrolled later. Children were followed until they started ART, died, transferred to another facility, or were LTFU. Cox proportional hazards regression models were used to determine the hazard of death or LTFU according to the baseline characteristics of the children. Results Overall, 223 children were assessed as eligible for ART based on their clinical and/or immunological status among whom 73 (32.7% started treatment, 15 (6.7% requested transfer to another health facility, 105 (47.1% and 30 (13.5% were lost to follow-up and died respectively without starting ART. The median survival following eligibility for children who died without starting treatment was 2.8 months (IQR: 0.9 - 5.8 with over half (60% of all deaths occurring at home. ART-eligible children less than 2 years of age and those in WHO stage 3 or 4 were significantly more likely to be LTFU when compared with their respective comparison groups. The overall pre-treatment mortality rate was 25.7 per 100 child-years of follow-up (95% CI 19.9 - 36.8 and the loss to programme rate was 115.7 per 100 child-years of follow-up (95% CI 98.8 - 137. In the multivariable Cox proportional hazard model, significant independent predictors of loss to programme were being less than 2 years of age and WHO stage 3 or 4. The Adjusted Hazard Ratio

  12. High-levels of acquired drug resistance in adult patients failing first-line antiretroviral therapy in a rural HIV treatment programme in KwaZulu-Natal, South Africa.

    Directory of Open Access Journals (Sweden)

    Justen Manasa

    Full Text Available To determine the frequency and patterns of acquired antiretroviral drug resistance in a rural primary health care programme in South Africa.Cross-sectional study nested within HIV treatment programme.Adult (≥ 18 years HIV-infected individuals initially treated with a first-line stavudine- or zidovudine-based antiretroviral therapy (ART regimen and with evidence of virological failure (one viral load >1000 copies/ml were enrolled from 17 rural primary health care clinics. Genotypic resistance testing was performed using the in-house SATuRN/Life Technologies system. Sequences were analysed and genotypic susceptibility scores (GSS for standard second-line regimens were calculated using the Stanford HIVDB 6.0.5 algorithms.A total of 222 adults were successfully genotyped for HIV drug resistance between December 2010 and March 2012. The most common regimens at time of genotype were stavudine, lamivudine and efavirenz (51%; and stavudine, lamivudine and nevirapine (24%. Median duration of ART was 42 months (interquartile range (IQR 32-53 and median duration of antiretroviral failure was 27 months (IQR 17-40. One hundred and ninety one (86% had at least one drug resistance mutation. For 34 individuals (15%, the GSS for the standard second-line regimen was <2, suggesting a significantly compromised regimen. In univariate analysis, individuals with a prior nucleoside reverse-transcriptase inhibitor (NRTI substitution were more likely to have a GSS <2 than those on the same NRTIs throughout (odds ratio (OR 5.70, 95% confidence interval (CI 2.60-12.49.There are high levels of drug resistance in adults with failure of first-line antiretroviral therapy in this rural primary health care programme. Standard second-line regimens could potentially have had reduced efficacy in about one in seven adults involved.

  13. The Efficacy of "Catch-Up Programmes" in South African High Schools: A Legal Jinx

    Science.gov (United States)

    Nyoni, Jabulani

    2013-01-01

    The South African State is mandated by Sections 28(2) and 29(1) of the South African Constitution to make provision for the education of a South African child in fulfilment of the child's constitutional rights. Teacher Unions (TUs) and provincial Departments of Basic Education (DBEs) have often promised South African high school student body, in…

  14. South African teachers’ conceptualisations of gradient: A study of historically disadvantaged teachers in an Advanced Certificate in Education programme

    OpenAIRE

    Vimolan Mudaly; Deborah Moore-Russo

    2011-01-01

    This study looked at how a group of South African secondary school mathematics teachers regarded the concept of gradient (slope). Results are reported from nine free-response items on a paper-and-pencil test administered to practising teachers who were pursuing qualifications to teach Grades 10–12 mathematics through an Advanced Certificate in Education (ACE) programme. The findings suggest that teachers’ understanding of gradient varies greatly. A number of teachers in the study demonstrated...

  15. Associations between alcohol use, other psychosocial factors, structural factors and antiretroviral therapy (ART) adherence among South African ART recipients.

    Science.gov (United States)

    Morojele, Neo K; Kekwaletswe, Connie T; Nkosi, Sebenzile

    2014-03-01

    We examined whether alcohol use is associated with antiretroviral therapy (ART) adherence independently of structural and psychosocial factors among 304 male and female ART recipients in ART sites in Tshwane, South Africa. ART adherence was assessed by the CASE Adherence Index. Independent variables were demographic, structural, psycho-social, and alcohol use (AUDIT score) factors. In hierarchical multiple regression, demographic variables (Step 1) explained 4 % of variance in ART adherence (p ≤ 0.01). Variance explained increased to 16 % (p ≤ 0.001) after entering structural variables (Step 2); 19 % (p ≤ 0.001) after entering psychosocial variables (Step 3); and 24 % (p ≤ 0.001) after entering AUDIT score (Step 4). Alcohol use is independently associated with ART adherence.

  16. Improving skills and institutional capacity to strengthen adolescent immunisation programmes and health systems in African countries through HPV vaccine introduction

    Directory of Open Access Journals (Sweden)

    Carine Dochez

    2017-12-01

    Full Text Available Several African countries have recently introduced or are currently introducing the HPV vaccine, either nationwide or through demonstration projects, while some countries are planning for introduction. A collaborative project was developed to strengthen country adolescent immunisation programmes and health systems in the African Region, addressing unique public health considerations of HPV vaccination: adolescents as the primary target group, delivery platforms (e.g. school-based and facility based, socio-behavioural issues, and the opportunity to deliver other health interventions alongside HPV vaccination.Following a successful “taking-stock” meeting, a training programme was drafted to assist countries to strengthen the integration of adolescent health interventions using HPV vaccination as an entry point. Two workshops were conducted in the Eastern and Southern African Regions. All countries reported on progress made during a final joint symposium.Of the 20 countries invited to participate in either of the workshops and/or final symposium, 17 countries participated: Angola, Botswana, Ethiopia, Kenya, Malawi, Mauritius, Mozambique, Namibia, Rwanda, Seychelles, South Africa, South Sudan, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe. Countries that are currently implementing HPV vaccination programmes, either nationally or through demonstration projects, reported varying degrees of integration with other adolescent health interventions. The most commonly reported adolescent health interventions alongside HPV vaccination include health education (including sexually transmitted infections, deworming and delivering of other vaccines like tetanus toxoid (TT or tetanus diphtheria (Td.The project has successfully (a established an African-based network that will advocate for incorporating the HPV vaccine into national immunisation programmes; (b created a platform for experience exchange and thereby contributed to novel ideas of

  17. Using an innovative mixed method methodology to investigate the appropriateness of a quantitative instrument in an African context: Antiretroviral treatment and quality of life.

    Science.gov (United States)

    Greeff, Minrie; Chepuka, Lignet M; Chilemba, Winnie; Chimwaza, Angela F; Kululanga, Lucy I; Kgositau, Mabedi; Manyedi, Eva; Shaibu, Sheila; Wright, Susan C D

    2014-01-01

    The relationship between quality of life (QoL) and antiretroviral treatment (ART) has mainly been studied using quantitative scales often not appropriate for use in other contexts and without taking peoples' lived experiences into consideration. Sub-Saharan Africa has the highest incidence of HIV and AIDS yet there is paucity in research done on QoL. This research report is intended to give an account of the use of a mixed method convergent parallel design as a novice approach to evaluate an instrument's context specificity, appropriateness and usefulness in another context for which it was designed. Data were collected through a qualitative exploration of the experiences of QoL of people living with HIV or AIDS (PLHA) in Africa since being on ART, as well as the quantitative measurements obtained from the HIV/AIDS-targeted quality of life (HAT-QoL) instrument. This study was conducted in three African countries. Permission and ethical approval to conduct the study were obtained. Purposive voluntary sampling was used to recruit PLHA through mediators working in community-based HIV/AIDS organisations and health clinics. Interviews were analysed through open coding and the quantitative data through descriptive statistics and the Cronbach's alpha coefficient. A much wider range and richness of experiences were expressed than measured by the HAT-QoL instrument. Although an effective instrument for use in the USA, it was found not to be sensitive, appropriate and useful in an African context in its present form. The recommendations focus on adapting the instrument using the data from the in-depth interviews or to develop a context-sensitive instrument that could measure QoL of PLHA in Africa.

  18. The important role of food composition in policies and programmes for better public health: A South African case study.

    Science.gov (United States)

    Schönfeldt, Hettie C; Hall, Nicolette; Pretorius, B

    2018-01-01

    Most governments have committed to the set of Sustainable Development Goals established by the United Nations (UN) to be achieved by 2030. Subsequently the governments have drafted, or are in process of drafting, policies and programmes which aim to answer to these global requests. South Africa provides a unique case study: despite economic growth, undernutrition has not improved when compared to other industrialised nations, while at the same time, diet-related non-communicable diseases and obesity have exponentially increased. Access to healthy food is a constitutional right of all South Africans, and towards increasing food security and improving population health, various policies, programmes and regulations have been developed and implemented by the government to rectify the situation. The paper presents an overview of food composition within these public health policies, programmes and regulations and unpacks the important role of accurate food composition data. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. 'I told her this is your life': relationship dynamics, partner support and adherence to antiretroviral therapy among South African couples.

    Science.gov (United States)

    Conroy, Amy; Leddy, Anna; Johnson, Mallory; Ngubane, Thulani; van Rooyen, Heidi; Darbes, Lynae

    2017-11-01

    Despite the important role of social relationships for health and wellbeing, little is known about how primary partners affect adherence to HIV care and treatment. We qualitatively explored how relationship dynamics and partner support influence adherence among couples from KwaZulu-Natal, South Africa. Twenty-four heterosexual couples with at least one HIV-positive partner completed semi-structured interviews on topics including relationship dynamics (intimacy or emotional closeness, communication, violence), experiences with HIV care and treatment and HIV-related social support. The majority of couples were seroconcordant HIV-positive (92%) and both on antiretroviral therapy (ART) (63%). Participants described how primary partners both interfered with and supported adherence. Negative forms of influence included relationship conflict, which resulted in forgetfulness to take pills, and men's attempt to control use of ART. However, participants were more likely to highlight positive forms of influence on adherence, which included social support (instrumental, informational and emotional), intimacy and commitment. The findings also suggest a reciprocal relationship between ART and relationships such that couple ART use may enhance relationship quality. Primary partners are important pillars of support for ART adherence, especially in contexts of high unemployment and poverty. Future interventions that encourage and leverage these supportive relationships could improve ART adherence among heterosexual couples in similar settings.

  20. African Programme for Onchocerciasis Control 1995–2015: Model-Estimated Health Impact and Cost

    Science.gov (United States)

    Coffeng, Luc E.; Stolk, Wilma A.; Zouré, Honorat G. M.; Veerman, J. Lennert; Agblewonu, Koffi B.; Murdoch, Michele E.; Noma, Mounkaila; Fobi, Grace; Richardus, Jan Hendrik; Bundy, Donald A. P.; Habbema, Dik; de Vlas, Sake J.; Amazigo, Uche V.

    2013-01-01

    Background Onchocerciasis causes a considerable disease burden in Africa, mainly through skin and eye disease. Since 1995, the African Programme for Onchocerciasis Control (APOC) has coordinated annual mass treatment with ivermectin in 16 countries. In this study, we estimate the health impact of APOC and the associated costs from a program perspective up to 2010 and provide expected trends up to 2015. Methods and Findings With data on pre-control prevalence of infection and population coverage of mass treatment, we simulated trends in infection, blindness, visual impairment, and severe itch using the micro-simulation model ONCHOSIM, and estimated disability-adjusted life years (DALYs) lost due to onchocerciasis. We assessed financial costs for APOC, beneficiary governments, and non-governmental development organizations, excluding cost of donated drugs. We estimated that between 1995 and 2010, mass treatment with ivermectin averted 8.2 million DALYs due to onchocerciasis in APOC areas, at a nominal cost of about US$257 million. We expect that APOC will avert another 9.2 million DALYs between 2011 and 2015, at a nominal cost of US$221 million. Conclusions Our simulations suggest that APOC has had a remarkable impact on population health in Africa between 1995 and 2010. This health impact is predicted to double during the subsequent five years of the program, through to 2015. APOC is a highly cost-effective public health program. Given the anticipated elimination of onchocerciasis from some APOC areas, we expect even more health gains and a more favorable cost-effectiveness of mass treatment with ivermectin in the near future. PMID:23383355

  1. African Programme For Onchocerciasis Control 1995-2015: model-estimated health impact and cost.

    Science.gov (United States)

    Coffeng, Luc E; Stolk, Wilma A; Zouré, Honorat G M; Veerman, J Lennert; Agblewonu, Koffi B; Murdoch, Michele E; Noma, Mounkaila; Fobi, Grace; Richardus, Jan Hendrik; Bundy, Donald A P; Habbema, Dik; de Vlas, Sake J; Amazigo, Uche V

    2013-01-01

    Onchocerciasis causes a considerable disease burden in Africa, mainly through skin and eye disease. Since 1995, the African Programme for Onchocerciasis Control (APOC) has coordinated annual mass treatment with ivermectin in 16 countries. In this study, we estimate the health impact of APOC and the associated costs from a program perspective up to 2010 and provide expected trends up to 2015. With data on pre-control prevalence of infection and population coverage of mass treatment, we simulated trends in infection, blindness, visual impairment, and severe itch using the micro-simulation model ONCHOSIM, and estimated disability-adjusted life years (DALYs) lost due to onchocerciasis. We assessed financial costs for APOC, beneficiary governments, and non-governmental development organizations, excluding cost of donated drugs. We estimated that between 1995 and 2010, mass treatment with ivermectin averted 8.2 million DALYs due to onchocerciasis in APOC areas, at a nominal cost of about US$257 million. We expect that APOC will avert another 9.2 million DALYs between 2011 and 2015, at a nominal cost of US$221 million. Our simulations suggest that APOC has had a remarkable impact on population health in Africa between 1995 and 2010. This health impact is predicted to double during the subsequent five years of the program, through to 2015. APOC is a highly cost-effective public health program. Given the anticipated elimination of onchocerciasis from some APOC areas, we expect even more health gains and a more favorable cost-effectiveness of mass treatment with ivermectin in the near future.

  2. African Programme For Onchocerciasis Control 1995-2015: model-estimated health impact and cost.

    Directory of Open Access Journals (Sweden)

    Luc E Coffeng

    Full Text Available Onchocerciasis causes a considerable disease burden in Africa, mainly through skin and eye disease. Since 1995, the African Programme for Onchocerciasis Control (APOC has coordinated annual mass treatment with ivermectin in 16 countries. In this study, we estimate the health impact of APOC and the associated costs from a program perspective up to 2010 and provide expected trends up to 2015.With data on pre-control prevalence of infection and population coverage of mass treatment, we simulated trends in infection, blindness, visual impairment, and severe itch using the micro-simulation model ONCHOSIM, and estimated disability-adjusted life years (DALYs lost due to onchocerciasis. We assessed financial costs for APOC, beneficiary governments, and non-governmental development organizations, excluding cost of donated drugs. We estimated that between 1995 and 2010, mass treatment with ivermectin averted 8.2 million DALYs due to onchocerciasis in APOC areas, at a nominal cost of about US$257 million. We expect that APOC will avert another 9.2 million DALYs between 2011 and 2015, at a nominal cost of US$221 million.Our simulations suggest that APOC has had a remarkable impact on population health in Africa between 1995 and 2010. This health impact is predicted to double during the subsequent five years of the program, through to 2015. APOC is a highly cost-effective public health program. Given the anticipated elimination of onchocerciasis from some APOC areas, we expect even more health gains and a more favorable cost-effectiveness of mass treatment with ivermectin in the near future.

  3. Patient retention, clinical outcomes and attrition-associated factors of HIV-infected patients enrolled in Zimbabwe's National Antiretroviral Therapy Programme, 2007-2010.

    Directory of Open Access Journals (Sweden)

    Tsitsi Mutasa-Apollo

    Full Text Available Since establishment of Zimbabwe's National Antiretroviral Therapy (ART Programme in 2004, ART provision has expanded from <5,000 to 369,431 adults by 2011. However, patient outcomes are unexplored.To determine improvement in health status, retention and factors associated with attrition among HIV-infected patients on ART.A retrospective review of abstracted patient records of adults ≥ 15 years who initiated ART from 2007 to 2009 was done. Frequencies and medians were calculated for rates of retention in care and changes in key health status outcomes at 6, 12, 24 and 36 months respectively. Cox proportional hazards models were used to determine factors associated with attrition.Of the 3,919 patients, 64% were female, 86% were either WHO clinical stage III or IV. Rates of patient retention at 6, 12, 24 and 36 months were 90.7%, 78.1%, 68.8% and 64.4%, respectively. After ART initiation, median weight gains at 6, 12, and 24 months were 3, 4.5, and 5.0 kgs whilst median CD4+ cell count gains at 6, 12 and 24 months were 122, 157 and 279 cells/µL respectively. Factors associated with an increased risk of attrition included male gender (AHR 1.2; 95% CI, 1.1-1.4, baseline WHO stage IV (AHR 1.7; 95% CI, 1.1-2.6, lower baseline body weight (AHR 2.0; 95% CI, 1.4-2. 8 and accessing care from higher level healthcare facilities (AHR 3.5; 95% 1.1-11.2.Our findings with regard to retention as well as clinical and immunological improvements following uptake of ART, are similar to what has been found in other settings. Factors influencing attrition also mirror those found in other parts of sub-Saharan Africa. These findings suggest the need to strengthen earlier diagnosis and treatment to further improve treatment outcomes. Whilst decentralisation improves ART coverage it should be coupled with strategies aimed at improving patient retention.

  4. Growth, immune and viral responses in HIV infected African children receiving highly active antiretroviral therapy: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Bagenda Danstan

    2010-08-01

    Full Text Available Abstract Background Scale up of paediatric antiretroviral therapy in resource limited settings continues despite limited access to routine laboratory monitoring. We documented the weight and height responses in HIV infected Ugandan children on highly active antiretroviral therapy and determined clinical factors associated with successful treatment outcomes. Methods A prospective cohort of HIV infected children were initiated on HAART and followed for 48 weeks. Body mass index for age z scores(BAZ, weight and height-for-age z scores (WAZ & HAZ were calculated: CD4 cell % and HIV-1 RNA were measured at baseline and every 12 weeks. Treatment outcomes were classified according to; both virological and immunological success (VS/IS, virological failure and immunological success (VF/IS. virological success and immunological failure (VS/IF and both virological and immunological failure (VF/IF. Results From March 2004 until May 2006, 124 HIV infected children were initiated on HAART. The median age (IQR was 5.0 years (2.1 - 7.0 and 49% (61/124 were female. The median [95% confidence interval (CI] BAZ, WAZ and HAZ at baseline were 0.29 (-2.9, -1.2, -1.2 (-2.1, -0.5 and -2.06 (-2.9, -1.2 respectively. Baseline median CD4 cell % and log10 HIV-1 RNA were; 11.8% (7.5-18.0 and 5.6 (5.2-5.8 copies/ml. By 48 weeks, mean WAZ and HAZ in the VF/IS group, which was younger, increased from - 0.98 (SD 1.7 to + 1.22 (SD 1.2 and from -1.99 (1.7 to + 0.76 (2.4 respectively. Mean increase in WAZ and HAZ in the VS/IF group, an older group was modest, from -1.84 (1.3 to - 0.41 (1.2 and -2.25 (1.2 to -1.16 (1.3 respectively. Baseline CD4 cell % [OR 6.97 95% CI (2.6 -18.6], age [OR 4.6 95% CI (1.14 -19.1] and WHO clinical stage [OR 3.5 95%CI (1.05 -12.7] were associated with successful treatment outcome. Conclusions HIV infected Ugandan children demonstrated a robust increase in height and weight z scores during the first 48 weeks of HAART, including those who failed to

  5. High Prevalence of Dyslipidemia and Insulin Resistance in HIV-infected Prepubertal African Children on Antiretroviral Therapy.

    Science.gov (United States)

    Innes, Steve; Abdullah, Kameelah L; Haubrich, Richard; Cotton, Mark F; Browne, Sara H

    2016-01-01

    Data describing the true extent of antiretroviral therapy (ART)-induced dyslipidemia and insulin resistance in perinatally infected children on ART in Africa are sparse. Fasting total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, insulin and glucose were performed on the first 100 of 190 pediatric ART clinic attendees. Diet assessment was performed by a trained dietician. Lipoatrophy was formally graded by consensus between 2 expert HIV pediatricians. Durations of previous ART exposures, clinical stage, pre-ART viral load, nadir and current CD4 were recorded. Dual-energy X-ray absorptiometry was performed on a subset of 42 patients selected semi-randomly. Prevalences of insulin resistance, abnormal total cholesterol, LDL, HDL and triglyceride were 10%, 13%, 12%, 13% and 9%, respectively. Overall, 40% had at least 1 lipid abnormality or insulin resistance. Adjusted mean LDL cholesterol increased by 0.24 mmol/L for each additional year of cumulative lopinavir/r exposure (P = 0.03) after correcting for age, gender, body mass index, previous stavudine exposure, age at ART initiation, dietary fat and refined carbohydrate, whereas adjusted mean LDL cholesterol was 0.9 mmol/L higher in children exposed to efavirenz within the previous 6 months (P = 0.02). Adjusting for age, gender and ethnicity, dual-energy X-ray absorptiometry revealed that greater trunk fat and lower peripheral subcutaneous fat were associated with elevated triglycerides but not with total cholesterol, LDL, HDL or homeostatic model assessment. Similarly, the presence of visually obvious lipoatrophy was associated with elevated triglycerides but not with total cholesterol, LDL, HDL, homeostatic model assessment or lactate. Prevalences of insulin resistance and dyslipidemia were high. Cumulative lopinavir is an independent risk factor for dyslipidemia, with efavirenz exposure having only transitory effect.

  6. "Not easy at all but I am trying": barriers and facilitators to physical activity in a South African cohort of people living with HIV participating in a home-based pedometer walking programme.

    Science.gov (United States)

    Roos, Ronel; Myezwa, Hellen; van Aswegen, Helena

    2015-01-01

    The promotion of physical activity is encouraged in people living with HIV and AIDS (PLWHA) as a means of promoting wellness and health. Adherence to programmes that promote exercise is often reduced, and home-based programmes are suggested to improve adherence. This study investigated the personal and environmental factors that cause barriers and facilitators of physical activity in a home-based pedometer walking programme as a means of highlighting adherence challenges. An observational study nested in a randomised controlled trial was conducted in a cohort of South African PLWHA on antiretroviral therapy over a six-month period. Descriptive analysis and qualitative content analysis of 42 participants who underwent physical activity modification assisted with data review. The mean age of the sample was 38.7 (±8.9) years, consisted mostly of women (n = 35; 83.3%) who were employed (n = 19; 45.2%) but earning very little (less than R500 per month) and often single or widowed (n = 23; 54.8%). Barriers to physical activity identified included physical complaints, e.g., low-energy levels; psychological complaints, e.g., stress levels; family responsibility, e.g., being primary caregivers; the physical environment, e.g., adverse weather conditions; social environment, e.g., domestic abuse and crime; and workplace, e.g., being in a sedentary job. Facilitators of physical activity included support and encouragement from friends and family, religious practices during worship and community environment, e.g., having access to parks and sport fields. The study is of benefit as it highlights personal and environmental factors that need to be considered when developing or implementing a home-based walking programme in PLWHA.

  7. Research Protocol: Development, implementation and evaluation of a cognitive behavioural therapy-based intervention programme for the management of anxiety symptoms in South African children with visual impairments

    Directory of Open Access Journals (Sweden)

    Lisa Visagie

    2015-07-01

    Objectives: The main aim of this study is to develop, implement and evaluate a specifically tailored anxiety intervention programme for use with South African children with visual impairments. Method: A specifically tailored cognitive-behavioural therapy-based anxiety intervention, for 9–13 year old South African children with visual impairments, will be evaluated in two special schools. The study will employ a randomised wait-list control group design with pre- postand follow-up intervention measures, with two groups each receiving a 10 session anxiety intervention programme. The main outcome measure relates to the participants’ symptoms of anxiety as indicated on the Revised Child Anxiety and Depression Scale. Conclusion: If the anxiety intervention programme is found to be effective in reducing symptoms of anxiety, this universal intervention will lay down the foundation upon which future contextually sensitive (South African anxiety intervention programmes can be built.

  8. Ethical, legal and social issues in the context of the planning stages of the Southern African Human Genome Programme.

    Science.gov (United States)

    de Vries, Jantina; Slabbert, Melodie; Pepper, Michael S

    2012-03-01

    As the focus on the origin of modern man appears to be moving from eastern to southern Africa, it is recognised that indigenous populations in southern Africa may be the most genetically diverse on the planet and hence a valuable resource for human genetic diversity studies. In order to build regional capacity for the generation, analysis and application of genomic data, the Southern African Human Genome Programme was recently launched with the aid of seed funding from the national Department of Science and Technology in South Africa. The purpose of the article is to investigate pertinent ethical, legal and social issues that have emerged during the planning stages of the Southern African Human Genome Programme. A careful consideration of key issues such as public perception of genomic research, issues relating to genetic and genomic discrimination and stigmatisation, informed consent, privacy and data protection, and the concept of genomic sovereignty, is of paramount importance in the early stages of the Programme. This article will also consider the present legal framework governing genomic research in South Africa and will conclude with proposals regarding such a framework for the future.

  9. Nutritional status is the major factor affecting grip strength of African HIV patients before and during antiretroviral treatment

    DEFF Research Database (Denmark)

    Filteau, Suzanne; PrayGod, G; Woodd, Susannah L

    2017-01-01

    OBJECTIVES: Low grip strength is a marker of frailty and a risk factor for mortality among HIV patients and other populations. We investigated factors associated with grip strength in malnourished HIV patients at referral to ART, and at 12 weeks and 2-3 years after starting ART. METHODS: The study...... involved HIV-infected Zambian and Tanzanian participants recruited to the NUSTART trial when malnourished (body mass index .... CONCLUSIONS: In this population of originally malnourished HIV patients, poor grip strength was more strongly and independently associated with nutritional than with infection and inflammation variables. Programmes to improve health and survival of HIV patients should incorporate nutritional assessment...

  10. ORIGINAL ARTICLES Estimation of adult antiretroviral treatment ...

    African Journals Online (AJOL)

    workplace treatment programmes (WPTPs) and NGO ..... Our analysis also demonstrates significant inequality .... paying for their own treatment outside of DMPs,15 which may ... of antiretroviral coverage in men and women and to develop.

  11. Measuring the Impact of Antiretroviral Therapy Roll-Out on Population Level Fertility in Three African Countries.

    Directory of Open Access Journals (Sweden)

    Milly Marston

    Full Text Available UNAIDS official estimates of national HIV prevalence are based on trends observed in antenatal clinic surveillance, after adjustment for the reduced fertility of HIV positive women. Uptake of ART may impact on the fertility of HIV positive women, implying a need to re-estimate the adjustment factors used in these calculations. We analyse the effect of antiretroviral therapy (ART provision on population-level fertility in Southern and East Africa, comparing trends in HIV infected women against the secular trends observed in uninfected women.We used fertility data from four community-based demographic and HIV surveillance sites: Kisesa (Tanzania, Masaka and Rakai (Uganda and uMkhanyakude (South Africa. All births to women aged 15-44 years old were included in the analysis, classified by mother's age and HIV status at time of birth, and ART availability in the community. Calendar time period of data availability relative to ART Introduction varied across the sites, from 5 years prior to ART roll-out, to 9 years after. Calendar time was classified according to ART availability, grouped into pre ART, ART introduction (available in at least one health facility serving study site and ART available (available in all designated health facilities serving study site. We used Poisson regression to calculate age adjusted fertility rate ratios over time by HIV status, and investigated the interaction between ART period and HIV status to ascertain whether trends over time were different for HIV positive and negative women.Age-adjusted fertility rates declined significantly over time for HIV negative women in all four studies. However HIV positives either had no change in fertility (Masaka, Rakai or experienced a significant increase over the same period (Kisesa, uMkhanyakude. HIV positive fertility was significantly lower than negative in both the pre ART period (age adjusted fertility rate ratio (FRR range 0.51 95%CI 0.42-0.61 to 0.73 95%CI 0.64-0.83 and when

  12. Antiretroviral therapy enrollment characteristics and outcomes among HIV-infected adolescents and young adults compared with older adults--seven African countries, 2004-2013.

    Science.gov (United States)

    Auld, Andrew F; Agolory, Simon G; Shiraishi, Ray W; Wabwire-Mangen, Fred; Kwesigabo, Gideon; Mulenga, Modest; Hachizovu, Sebastian; Asadu, Emeka; Tuho, Moise Zanga; Ettiegne-Traore, Virginie; Mbofana, Francisco; Okello, Velephi; Azih, Charles; Denison, Julie A; Tsui, Sharon; Koole, Olivier; Kamiru, Harrison; Nuwagaba-Biribonwoha, Harriet; Alfredo, Charity; Jobarteh, Kebba; Odafe, Solomon; Onotu, Dennis; Ekra, Kunomboa A; Kouakou, Joseph S; Ehrenkranz, Peter; Bicego, George; Torpey, Kwasi; Mukadi, Ya Diul; van Praag, Eric; Menten, Joris; Mastro, Timothy; Dukes Hamilton, Carol; Swaminathan, Mahesh; Dokubo, E Kainne; Baughman, Andrew L; Spira, Thomas; Colebunders, Robert; Bangsberg, David; Marlink, Richard; Zee, Aaron; Kaplan, Jonathan; Ellerbrock, Tedd V

    2014-11-28

    Although scale-up of antiretroviral therapy (ART) since 2005 has contributed to declines of about 30% in the global annual number of human immunodeficiency (HIV)-related deaths and declines in global HIV incidence, estimated annual HIV-related deaths among adolescents have increased by about 50% and estimated adolescent HIV incidence has been relatively stable. In 2012, an estimated 2,500 (40%) of all 6,300 daily new HIV infections occurred among persons aged 15-24 years. Difficulty enrolling adolescents and young adults in ART and high rates of loss to follow-up (LTFU) after ART initiation might be contributing to mortality and HIV incidence in this age group, but data are limited. To evaluate age-related ART retention challenges, data from retrospective cohort studies conducted in seven African countries among 16,421 patients, aged ≥15 years at enrollment, who initiated ART during 2004-2012 were analyzed. ART enrollment and outcome data were compared among three groups defined by age at enrollment: adolescents and young adults (aged 15-24 years), middle-aged adults (aged 25-49 years), and older adults (aged ≥50 years). Enrollees aged 15-24 years were predominantly female (81%-92%), commonly pregnant (3%-32% of females), unmarried (54%-73%), and, in four countries with employment data, unemployed (53%-86%). In comparison, older adults were more likely to be male (padults, adolescents and young adults had higher LTFU rates in all seven countries, reaching statistical significance in three countries in crude and multivariable analyses. Evidence-based interventions to reduce LTFU for adolescent and young adult ART enrollees could help reduce mortality and HIV incidence in this age group.

  13. High T-cell immune activation and immune exhaustion among individuals with suboptimal CD4 recovery after 4 years of antiretroviral therapy in an African cohort

    Directory of Open Access Journals (Sweden)

    Colebunders Robert

    2011-02-01

    Full Text Available Abstract Background Antiretroviral therapy (ART partially corrects immune dysfunction associated with HIV infection. The levels of T-cell immune activation and exhaustion after long-term, suppressive ART and their correlation with CD4 T-cell count reconstitution among ART-treated patients in African cohorts have not been extensively evaluated. Methods T-cell activation (CD38+HLA-DR+ and immune exhaustion (PD-1+ were measured in a prospective cohort of patients initiated on ART; 128 patient samples were evaluated and subcategorized by CD4 reconstitution after long-term suppressive treatment: Suboptimal [median CD4 count increase 129 (-43-199 cells/μl], N = 34 ], optimal [282 (200-415 cells/μl, N = 64] and super-optimal [528 (416-878 cells/μl, N = 30]. Results Both CD4+ and CD8 T-cell activation was significantly higher among suboptimal CD4 T-cell responders compared to super-optimal responders. In a multivariate model, CD4+CD38+HLADR+ T-cells were associated with suboptimal CD4 reconstitution [AOR, 5.7 (95% CI, 1.4-23, P = 0.014]. T-cell exhaustion (CD4+PD1+ and CD8+PD1+ was higher among suboptimal relative to optimal (P P = 0.022]. Conclusion T-cell activation and exhaustion persist among HIV-infected patients despite long-term, sustained HIV-RNA viral suppression. These immune abnormalities were associated with suboptimal CD4 reconstitution and their regulation may modify immune recovery among suboptimal responders to ART.

  14. Key indicators for the monitoring and evaluation of control programmes of human African trypanosomiasis due to Trypanosoma brucei gambiense.

    Science.gov (United States)

    Bouchet, B; Legros, D; Lee, E

    1998-06-01

    Very little research has been devoted to the design of epidemiological tools for the monitoring and evaluation of National Human African Trypanosomiasis (HAT) Control Programmes and daily management decisions are made in the absence of accurate knowledge of the situation. This paper identifies key indicators necessary to make decisions in the field and constantly adjust control activities to changing situations. Examples are derived from the Médecins Sans Frontières (MSF) HAT Control Programme in Adjumani, Uganda. Based on the principles of quality assurance, the focus is placed on process indicators. A conceptual framework derived from a system view/planning cycle perspective is also described for the construction of indicators. Finally, some specific challenging aspects of the epidemiology of HAT are presented and the limitations of the interpretation of the indicators discussed.

  15. Focus on CSIR research in pollution waste: The South African river health programme

    CSIR Research Space (South Africa)

    Hill, Liesl

    2007-08-01

    Full Text Available the design of the River Health Programme (RHP) to monitor the health of rivers in South Africa. The RHP forms part of a bigger initiative, the National Aquatic Ecosystem Health Monitoring Programme which will eventually cover all surface water resources...

  16. Nutritional status is the major factor affecting grip strength of African HIV patients before and during antiretroviral treatment.

    Science.gov (United States)

    Filteau, S; PrayGod, G; Woodd, S L; Friis, H; Heimburger, D C; Koethe, J R; Kelly, P; Kasonka, L; Rehman, A M

    2017-10-01

    Low grip strength is a marker of frailty and a risk factor for mortality among HIV patients and other populations. We investigated factors associated with grip strength in malnourished HIV patients at referral to ART, and at 12 weeks and 2-3 years after starting ART. The study involved HIV-infected Zambian and Tanzanian participants recruited to the NUSTART trial when malnourished (body mass index <18.5 kg/m 2 ) and requiring ART. The relationship of grip strength to nutritional, infectious and demographic factors was assessed by multivariable linear regression at referral for ART (n = 1742) and after 12 weeks (n = 778) and 2-3 years of ART (n = 273). In analyses controlled only for sex, age and height, most nutrition and infection-related variables were associated with grip strength. However, in multivariable analyses, consistent associations were seen for fat-free mass index, mid-upper arm circumference, haemoglobin and systolic blood pressure, and a variable association with fat mass index in men. C-reactive protein and CD4 count had limited independent effects on grip strength, while receiving tuberculosis treatment was associated with weaker grip strength. In this population of originally malnourished HIV patients, poor grip strength was more strongly and independently associated with nutritional than with infection and inflammation variables. Programmes to improve health and survival of HIV patients should incorporate nutritional assessment and management and could use grip strength as a functional indicator of improving nutrition. © 2017 John Wiley & Sons Ltd.

  17. The West African monsoon: Contribution of the AMMA multidisciplinary programme to the study of a regional climate system.

    Science.gov (United States)

    Lebel, T.; Janicot, S.; Redelsperger, J. L.; Parker, D. J.; Thorncroft, C. D.

    2015-12-01

    The AMMA international project aims at improving our knowledge and understanding of the West African monsoon and its variability with an emphasis on daily-to-interannual timescales. AMMA is motivated by an interest in fundamental scientific issues and by the societal need for improved prediction of the WAM and its impacts on water resources, health and food security for West African nations. The West African monsoon (WAM) has a distinctive annual cycle in rainfall that remains a challenge to understand and predict. The location of peak rainfall, which resides in the Northern Hemisphere throughout the year, moves from the ocean to the land in boreal spring. Around the end of June there is a rapid shift in the location of peak rainfall between the coast and around 10°N where it remains until about the end of August. In September the peak rainfall returns equatorward at a relatively steady pace and is located over the ocean again by November. The fact that the peak rainfall migrates irregularly compared to the peak solar heating is due to the interactions that occur between the land, the atmosphere and the ocean. To gain a better understanding of this complex climate system, a large international research programme was launched in 2002, the biggest of its kind into environment and climate ever attempted in Africa. AMMA has involved a comprehensive field experiment bringing together ocean, land and atmospheric measurements, on timescales ranging from hourly and daily variability up to the changes in seasonal activity over a number of years. This presentation will focus on the description of the field programme and its accomplishments, and address some key questions that have been recently identified to form the core of AMMA-Phase 2.

  18. The potential and reality of the solar water heater programme in South African townships: Lessons from the City of Tshwane

    International Nuclear Information System (INIS)

    Curry, Claire; Cherni, Judith A.; Mapako, Maxwell

    2017-01-01

    The South African solar water heater (SWH) programme is part of national policy to improve the country's electricity security, an innovative strategy to provide indigent households with free solar water heaters. The study assesses the effects of the government programme for poor townships on reduction of household electricity consumption, decline in energy poverty, and reduction in CO2 emissions; and estimates the impact of SWH on reducing electricity demand nationwide. It reports results from fieldwork carried out in the City of Tshwane to measure both quantitatively and qualitatively the success of the project's deployment in townships. Although households register average savings of 27% on their monthly electricity bills and off-peak electricity demand has reduced significantly in the area, a variety of problems prevented the project from attaining the desired level of impact. Difficulties encountered include technical faults with the heaters combined with nonavailability of maintenance; a rise in water consumption; lack of community engagement leading to apathy; and dearth of owner training leading to underuse. The gap between inflated estimates and real savings is discussed. Expanding the programme could generate jobs but significant challenges remain. - Highlights: • The government's aim of saving electricity and reducing utility bills partly achieved. • Savings of electricity are estimated at about 25% less than the potential saving. • Wrong assumption that peak time is only 1 h produced savings 5 times larger. • ESKOM & government overlooked providing Information on the SWH to the householders. • No maintenance led to abandonment by many or water leaking increasing utility bills.

  19. Evaluation of an HIV/AIDS peer education programme South African ...

    African Journals Online (AJOL)

    HIV I AIDS peer-education programme for its employees aimed at addressing the growing ..... m:JI education intervention in a mining community reports essentially no effect.17 ... yet to be determined. Such data are crucial for the development.

  20. Nylsvley - South African Savanna ecosystem project: objectives, organisation and research programme

    CSIR Research Space (South Africa)

    Huntley, BJ

    1978-03-01

    Full Text Available A description of the objectives, organization and research programme of the Savanna Ecosystem Project being undertaken at Nylsvley in the northern Transvaal is presented. The project is a cooperative multi-disciplinary study of the structure...

  1. South African programme for the SCOPE project on the ecology of biological invasions

    CSIR Research Space (South Africa)

    Ferrar, AA

    1983-07-01

    Full Text Available A description of the aims of the international SCOPE programme on biological invasions is provided, together with a proposed four year time table of international activities. This is followed by a brief account of the history, organization...

  2. Better antiretroviral therapy outcomes at primary healthcare facilities: an evaluation of three tiers of ART services in four South African provinces.

    Science.gov (United States)

    Fatti, Geoffrey; Grimwood, Ashraf; Bock, Peter

    2010-09-21

    There are conflicting reports of antiretroviral therapy (ART) effectiveness comparisons between primary healthcare (PHC) facilities and hospitals in low-income settings. This comparison has not been evaluated on a broad scale in South Africa. A retrospective cohort study was conducted including ART-naïve adults from 59 facilities in four provinces in South Africa, enrolled between 2004 and 2007. Kaplan-Meier estimates, competing-risks Cox regression, generalised estimating equation population-averaged models and logistic regression were used to compare death, loss to follow-up (LTFU) and virological suppression (VS) between PHC, district and regional hospitals. 29 203 adults from 47 PHC facilities, nine district hospitals and three regional hospitals were included. Patients at PHC facilities had more advanced WHO stage disease when starting ART. Retention in care was 80.1% (95% CI: 79.3%-80.8%), 71.5% (95% CI: 69.1%-73.8%) and 68.7% (95% CI: 67.0%-69.7%) at PHC, district and regional hospitals respectively, after 24 months of treatment (Phospitals (aHR 2.19; 95% CI: 1.94-2.47) and mortality was independently elevated at district hospitals (aHR 1.60; 95% CI: 1.30-1.99) compared to PHC facilities after 12 months of ART. District and regional hospital patients had independently reduced probabilities of VS, aOR 0.76 (95% CI: 0.59-0.97) and 0.64 (95% CI: 0.56-0.75) respectively compared to PHC facilities over 24 months of treatment. ART outcomes were superior at PHC facilities, despite PHC patients having more advanced clinical stage disease when starting ART, suggesting that ART can be adequately provided at this level and supporting the South African government's call for rapid up-scaling of ART at the primary level of care. Further prospective research is required to determine the degree to which outcome differences are attributable to either facility level characteristics or patient co-morbidity at hospital level.

  3. Better antiretroviral therapy outcomes at primary healthcare facilities: an evaluation of three tiers of ART services in four South African provinces.

    Directory of Open Access Journals (Sweden)

    Geoffrey Fatti

    Full Text Available BACKGROUND: There are conflicting reports of antiretroviral therapy (ART effectiveness comparisons between primary healthcare (PHC facilities and hospitals in low-income settings. This comparison has not been evaluated on a broad scale in South Africa. METHODOLOGY/PRINCIPAL FINDINGS: A retrospective cohort study was conducted including ART-naïve adults from 59 facilities in four provinces in South Africa, enrolled between 2004 and 2007. Kaplan-Meier estimates, competing-risks Cox regression, generalised estimating equation population-averaged models and logistic regression were used to compare death, loss to follow-up (LTFU and virological suppression (VS between PHC, district and regional hospitals. 29 203 adults from 47 PHC facilities, nine district hospitals and three regional hospitals were included. Patients at PHC facilities had more advanced WHO stage disease when starting ART. Retention in care was 80.1% (95% CI: 79.3%-80.8%, 71.5% (95% CI: 69.1%-73.8% and 68.7% (95% CI: 67.0%-69.7% at PHC, district and regional hospitals respectively, after 24 months of treatment (P<0.0001. In adjusted regression analyses, LTFU was independently increased at regional hospitals (aHR 2.19; 95% CI: 1.94-2.47 and mortality was independently elevated at district hospitals (aHR 1.60; 95% CI: 1.30-1.99 compared to PHC facilities after 12 months of ART. District and regional hospital patients had independently reduced probabilities of VS, aOR 0.76 (95% CI: 0.59-0.97 and 0.64 (95% CI: 0.56-0.75 respectively compared to PHC facilities over 24 months of treatment. CONCLUSIONS/SIGNIFICANCE: ART outcomes were superior at PHC facilities, despite PHC patients having more advanced clinical stage disease when starting ART, suggesting that ART can be adequately provided at this level and supporting the South African government's call for rapid up-scaling of ART at the primary level of care. Further prospective research is required to determine the degree to which

  4. A retrospective case-cohort study comparing treatment outcomes in abacavir versus stavudine containing first line antiretroviral treatment regimens in children <3yrs old, at a paediatric programme based in Soweto, South Africa

    Science.gov (United States)

    Otwombe, Kennedy; Lazarus, Erica; Liberty, Afaaf; Gray, Glenda E.; Greeff, Oppel B. W.; Violari, Avy

    2017-01-01

    Introduction The current World Health Organization guideline for first line antiretroviral therapy (ART) in HIV-infected children recommends the use of abacavir and lamivudine as nucleoside backbones and no longer includes stavudine. We compared treatment outcomes with abacavir (ABC) versus stavudine (d4T) in a cohort of HIV-1 infected children 6 and 12 months after antiretroviral therapy was initiated. Methods This was a retrospective case-cohort study, using programmatic data from children enrolled in the Paediatric Wellness Programme at the Perinatal HIV Research Unit in Soweto, South Africa between 2005 and 2013. Children on abacavir/stavudine who had initiated ART at age 90% for ABC and d4T were similar too (95% in ABC vs. 86% in d4T, p = 0.10). The proportion of children who died over 12 months was 3.5% in the ABC and 7.9% in the d4T group (p = 0.27). Similarly, the anthropometric measures were comparable. Conclusions It is reassuring that in the short term, in this group of patients, the treatment outcomes were similar. PMID:28686654

  5. Bridging programmes: gain, pain or all in vain | Hay | South African ...

    African Journals Online (AJOL)

    South African higher education institutions find it increasingly difficult to deal with school-leavers who are ill-prepared for higher education. Institutions are obliged to meet national goals in terms of access and increased pass rates. However, the hard realities of educational backloop are difficult to deal with. In this article an ...

  6. South African teachers’ conceptualisations of gradient: A study of historically disadvantaged teachers in an Advanced Certificate in Education programme

    Directory of Open Access Journals (Sweden)

    Vimolan Mudaly

    2011-09-01

    Full Text Available This study looked at how a group of South African secondary school mathematics teachers regarded the concept of gradient (slope. Results are reported from nine free-response items on a paper-and-pencil test administered to practising teachers who were pursuing qualifications to teach Grades 10–12 mathematics through an Advanced Certificate in Education (ACE programme. The findings suggest that teachers’ understanding of gradient varies greatly. A number of teachers in the study demonstrated very little to no understanding of this important concept, whilst others demonstrated a strong understanding of gradient and were able to conceptualise it in many different ways. Implications for teacher professional development are considered.

  7. Part-Time Post Graduate Certificate in Education Teacher-Students: What Do They Bring to and Expect from a Formal South African Teaching Programme?

    Science.gov (United States)

    Mukeredzi, Tabitha Grace; Sibanda, Doras

    2016-01-01

    The purpose of this study was to understand the nature and extent of subject content and curriculum knowledge that part-time Post Graduate Certificate in Education students in one South African university, brought to the classroom, and the kind and level of knowledge that they expected and sought from the programme. The study employed a…

  8. Productivity assessments in small ruminant improvement programmes : a case study of the West African dwarf goat

    NARCIS (Netherlands)

    Bosman, H.G.

    1995-01-01

    Livestock production in the tropics is characterised by a high degree of variability in terms of composition, setting and aims. A good understanding of these characteristics is a prerequisite for the planning of a successful improvement programme. A frequently used criterion to assess the

  9. South African programme for the SCOPE mid-term project on the ecological effects of fire.

    CSIR Research Space (South Africa)

    Huntley, BJ

    1978-09-01

    Full Text Available involve limited research activities on selected topics within eight main review themes. The emphasis will fall on the analysis and interpretation of the results of existing long-term burning trials in savanna, grassland and fynbos biomes. The programme...

  10. Eleventh congress of the South African Society of Nuclear Medicine : programme and abstracts

    International Nuclear Information System (INIS)

    2004-10-01

    The volume contains the abstracts of papers and poster sessions presented at the eleventh biennial congress of the South African Society of Nuclear Medicine that was held at the CSIR Conference Centre in Pretoria from 1-4 October 2004, and was preceded by a workshop on nuclear medicine in endocrinology and molecular imaging. The workshop papers are not included. Forty-nine presentations are indexed. One presentation was excluded.

  11. Energy, growth and sustainable development - An African equation. The Sub-Saharan Africa programme

    International Nuclear Information System (INIS)

    Heuraux, Christine; Guinebault, Alain; Auge, Benjamin; Ouedraogo, Lassane; Keita, Seydou; Gemenne, Francois

    2010-01-01

    A first contribution comments the situation of the African electricity sector by notably highlighting its paradoxes (huge available reserves but very low production capacities). The author proposes a brief overview and discussion of the present production capacities and supply, outlines production shortfalls and their main reasons, comments the situation of demand, consumption and markets by distinguishing three main geographical areas (Northern Africa, Southern Africa, and Central Africa) and indicating some data related to urban and rural electrification in different parts of Africa. He also addresses the issue of prices and costs. After having outlined these paradoxes and differences, he notices the weight of history, the fact that markets are too narrow and supported by too fragile economies, and the negative influence of political and economic failures. He proposes perspectives to introduce a sustainable growth of the African electricity sector. The second contribution proposes an analysis of the present situation in Sub-Saharan Africa and possibilities of action in the field of biomass. The author notably reports the case study of Bamako. The third contribution addresses the possibility of transformation of the African gas into electricity. He notably comments the leading and innovating projects in West-Africa: the West African Gas Pipeline (the first African gas project with a regional importance), the Mauritanian gas potential which could be a chance for the mining industry of this country and for neighbouring countries, the developments in Ivory Coast and Senegal. He gives an overview of projects in Central and Southern Africa: the Logbaba deposit in Cameroon, slow advances in the Republic of Congo, the challenge of methane development by the Kivu Lake, investments in Mozambique and Tanzania. The fourth contribution discusses challenges to be faced for energy projects (energy planning, hydrocarbons, renewable energies, electric energy) and for energy

  12. South African CSP projects under the REIPPP programme - Requirements, challenges and opportunities

    Science.gov (United States)

    Relancio, Javier; Cuellar, Alberto; Walker, Gregg; Ettmayr, Chris

    2016-05-01

    Thus far seven Concentrated Solar Power (CSP) projects have been awarded under the Renewable Energy Independent Power Producer Procurement Programme (REIPPPP), totalling 600MW: one project is in operation, four under construction and two on their way to financial close. This provides an excellent opportunity for analysis of key features of the projects that have contributed to or detracted from the programme's success. The paper draws from Mott MacDonald's involvement as Technical Advisor on the seven CSP projects that have been successful under the REIPPPP to date as well as other global CSP developments. It presents how various programme requirements have affected the implementation of projects, such as the technical requirements, time of day tariff structure, economic development requirements and the renewable energy grid code. The increasingly competitive tariffs offered have encouraged developers to investigate efficiency maximising project configurations and cost saving mechanisms, as well as featuring state of the art technology in their proposals. The paper assesses the role of the project participants (developers, lenders and government) with regards to these innovative technologies and solutions. In our paper we discuss the status of projects and the SA market, analysing the main challenges and opportunities that in turn have influenced various aspects such as technology choice, operational regimes and supply chain arrangements.

  13. Acceptability and feasibility of mHealth and community-based directly observed antiretroviral therapy to prevent mother-to-child HIV transmission in South African pregnant women under Option B+: an exploratory study

    Science.gov (United States)

    Nachega, Jean B; Skinner, Donald; Jennings, Larissa; Magidson, Jessica F; Altice, Frederick L; Burke, Jessica G; Lester, Richard T; Uthman, Olalekan A; Knowlton, Amy R; Cotton, Mark F; Anderson, Jean R; Theron, Gerhard B

    2016-01-01

    Objective To examine the acceptability and feasibility of mobile health (mHealth)/short message service (SMS) and community-based directly observed antiretroviral therapy (cDOT) as interventions to improve antiretroviral therapy (ART) adherence for preventing mother-to-child human immunodeficiency virus (HIV) transmission (PMTCT). Design and methods A mixed-method approach was used. Two qualitative focus group discussions with HIV-infected pregnant women (n=20) examined the acceptability and feasibility of two ART adherence interventions for PMTCT: 1) SMS text messaging and 2) patient-nominated cDOT supporters. Additionally, 109 HIV-infected, pregnant South African women (18–30 years old) receiving PMTCT services under single-tablet antiretroviral therapy regimen during pregnancy and breastfeeding and continuing for life (“Option B+”) were interviewed about mobile phone access, SMS use, and potential treatment supporters. Setting A community primary care clinic in Cape Town, South Africa. Participants HIV-infected pregnant women. Main outcomes Acceptability and feasibility of mHealth and cDOT interventions. Results Among the 109 women interviewed, individual mobile phone access and SMS use were high (>90%), and 88.1% of women were interested in receiving SMS ART adherence support messages such as reminders, motivation, and medication updates. Nearly all women (95%) identified at least one person close to them to whom they had disclosed their HIV status and would nominate as a cDOT supporter. Focus group discussions revealed that cDOT supporters and adherence text messages were valued, but some concerns regarding supporter time availability and risk of unintended HIV status disclosure were expressed. Conclusion mHealth and/or cDOT supporter as interventions to improve ART adherence are feasible in this setting. However, safe HIV status disclosure to treatment supporters and confidentiality of text messaging content about HIV and ART were deemed crucial. PMID

  14. First-line antiretroviral drug discontinuations in children.

    Directory of Open Access Journals (Sweden)

    Melony Fortuin-de Smidt

    Full Text Available There are a limited number of paediatric antiretroviral drug options. Characterising the long term safety and durability of different antiretrovirals in children is important to optimise management of HIV infected children and to determine the estimated need for alternative drugs in paediatric regimens. We describe first-line antiretroviral therapy (ART durability and reasons for discontinuations in children at two South African ART programmes, where lopinavir/ritonavir has been recommended for children <3 years old since 2004, and abacavir replaced stavudine as the preferred nucleoside reverse transcriptase inhibitor in 2010.We included children (<16 years at ART initiation who initiated ≥3 antiretrovirals between 2004-2014 with ≥1 follow-up visit on ART. We estimated the incidence of first antiretroviral discontinuation using Kaplan-Meier analysis. We determined the reasons for antiretroviral discontinuations using competing risks analysis. We used Cox regression to identify factors associated with treatment-limiting toxicity.We included 3579 children with median follow-up duration of 41 months (IQR 14-72. At ART initiation, median age was 44 months (IQR 13-89 and median CD4 percent was 15% (IQR 9-21%. At three and five years on ART, 72% and 26% of children respectively remained on their initial regimen. By five years on ART, the most common reasons for discontinuations were toxicity (32%, treatment failure (18%, treatment simplification (5%, drug interactions (3%, and other or unspecified reasons (18%. The incidences of treatment limiting toxicity were 50.6 (95% CI 46.2-55.4, 1.6 (0.5-4.8, 2.0 (1.2-3.3, and 1.3 (0.6-2.8 per 1000 patient years for stavudine, abacavir, efavirenz and lopinavir/ritonavir respectively.While stavudine was associated with a high risk of treatment-limiting toxicity, abacavir, lopinavir/ritonavir and efavirenz were well-tolerated. This supports the World Health Organization recommendation to replace stavudine with

  15. Anti-retroviral therapy induced diabetes in a Nigerian | Bakari ...

    African Journals Online (AJOL)

    African Health Sciences ... Background:Anti-retroviral therapy (ART) using Highly Active Anti-retroviral Therapy (HAART) has led to ... HIV infected individuals on one hand, and side effects of chronic administration of these drugs on the other.

  16. Effect of Age at Antiretroviral Therapy Initiation on Catch-Up Growth within the First 24 Months among HIV-Infected Children in the IeDEA West African Pediatric Cohort

    Science.gov (United States)

    Jesson, Julie; Koumakpaï, Sikiratou; Diagne, Ndeye R.; Amorissani-Folquet, Madeleine; Kouéta, Fla; Aka, Addi; Lawson-Evi, Koko; Dicko, Fatoumata; Kouakou, Kouadio; Pety, Touré; Renner, Lorna; Eboua, Tanoh; Coffie, Patrick A.; Desmonde, Sophie; Leroy, Valériane

    2015-01-01

    Background We described malnutrition and the effect of age at antiretroviral therapy (ART) initiation on catch-up growth over 24 months among HIV-infected children enrolled in the IeDEA West African paediatric cohort (pWADA). Methods Malnutrition was defined at ART initiation (baseline) by a Z-score malnutrition at ART initiation, ART regimen, time period and country, were compared by age at ART initiation. Cox proportional hazards regression models determined predictors of catch-up growth on ART over 24 months. Results Between 2001 and 2012, 2004 HIV-infected children Malnutrition among these children is an additional burden that has to be urgently managed. Despite a significant growth improvement after 24 months on ART, especially in children <5 years, a substantial proportion of children still never achieved catch-up growth. Nutritional care should be part of the global healthcare of HIV-infected children in sub-Saharan Africa. PMID:25955835

  17. Nurse educators’ experiences of case-based education in a South African nursing programme

    Directory of Open Access Journals (Sweden)

    Felicity M. Daniels

    2015-12-01

    Full Text Available Background: A school of nursing at a university in the Western Cape experienced an increase in student enrolments from an intake of 150 students to 300 students in the space of one year. This required a review of the teaching and learning approach to ensure that it was appropriate for effective facilitation of large classes. The case-based education (CBE approach was adopted for the delivery of the Bachelor of Nursing programme in 2005. Aim: The aim of the study was to explore nurse educators’ experiences, current practices and possible improvements to inform best practice of CBE at the nursing school in the Western Cape. Methods: A participatory action research method was applied in a two day workshop conducted with nurse educators in the undergraduate nursing programme. The nominal group technique was used to collect the data. Results: Three themes emerged from the final synthesis of the findings, namely: teaching and learning related issues, student issues and teacher issues. Amongst other aspects, theory and practice integration, as well as the need for peer support in facilitation of CBE, were identified as requiring strengthening. Conclusion: It was concluded that case-based education should continue to be used in the school, however, more workshops should be arranged to keep educators updated and new staff orientated in respect of this teaching and learning approach.

  18. Self-care practices and experiences of people living with HIV not receiving antiretroviral therapy in an urban community of Lusaka, Zambia: implications for HIV treatment programmes

    Science.gov (United States)

    2013-01-01

    Background Despite the increasingly wider availability of antiretroviral therapy (ART), some people living with HIV (PLHIV) and eligible for treatment have opted to adopt self-care practices thereby risking early AIDS-related mortality. Methods A qualitative study was conducted in urban Zambia to gain insights into PLHIV self-care practices and experiences and explore the implications for successful delivery of ART care. Between March 2010 and September 2011, in-depth interviews were conducted with PLHIV who had dropped out of treatment (n=25) and those that had opted not to initiate medication (n=37). Data was entered into and managed using Atlas ti, and analysed inductively using latent content analysis. Results PHIV used therapeutic and physical health maintenance, psychological well-being and healthy lifestyle self-care practices to maintain physical health and mitigate HIV-related symptoms. Herbal remedies, faith healing and self-prescription of antibiotics and other conventional medicines to treat HIV-related ailments were used for therapeutic and physical health maintenance purposes. Psychological well-being self-care practices used were religiosity/spirituality and positive attitudes towards HIV infection. These practices were modulated by close social network relationships with other PLHIV, family members and peers, who acted as sources of emotional, material and financial support. Cessations of sexual relationships, adoption of safe sex to avoid re-infections and uptake of nutritional supplements were the commonly used risk reduction and healthy lifestyle practices respectively. Conclusions While these self-care practices may promote physical and psychosocial well-being and mitigate AIDS-related symptoms, at least in the short term, they however undermine PLHIV access to ART care thereby putting PLHIV at risk of early AIDS-related mortality. The use of scientifically unproven herbal remedies raises health and safety concerns; faith healing may create

  19. Natural convection solar crop dryers in Kenya: Theory and practical application. African Energy Programme research report series no. 3

    International Nuclear Information System (INIS)

    Othieno, H.

    1987-01-01

    The African Energy Programme (AEP) was established by the Commonwealth Science Council (CSC) to strengthen Africa's scientific and technical capabilities to develop and utilise the continent's enormous renewable energy resources to assist its socio-economic development. The AEP was conceived at a regional workshop held at Arusha, Tanzania in 1979, at which African researchers met to share their experiences of and explored the feasibility of establishing a collaborative regional R and D programme to develop and adapt technologies appropriate to the specific needs of the participating countries. The AEP researchers accorded the highest priority to seeking solutions to the energy problems of Africa's predominantly rural populations and identified eight project areas as the nodes for regional collaborative research and development: 1. Biogas for rural development; 2. Wood/Charcoal production and utilisation; 3. Solar crop drying; 4. Solar thermal heating and cooling; 5. Wind electricity generation; 6. Wind water pumping; 7. Resources Assessments; 8. Energy policy and planning. The primary goal of the AEP activities were to develop indigenous national capabilities to enable the examination and application of technological solutions appropriate to the unique problems and socio-cultural environments of each country. However, the severe limitations on expertise and the broad similarity of many of the critical problems favoured regional R and D cooperation around common techniques and methodologies in each project area. This work has made a significant contribution to Science and Technology. Prior to this work there was no detailed information in natural convection solar dryers. This work has exposed a number of critical design factors which must be considered in order to design an efficient dryer. Buoyancy-induced pressure inside the dryer, problems of multiple radiative heat exchange in the heater and cooling effects of wind have been studied in detail. The final dryer

  20. Natural convection solar crop dryers in Kenya: Theory and practical application. African Energy Programme research report series no. 3

    Energy Technology Data Exchange (ETDEWEB)

    Othieno, H [Kenyatta University, Nairobi (Kenya)

    1987-07-01

    The African Energy Programme (AEP) was established by the Commonwealth Science Council (CSC) to strengthen Africa's scientific and technical capabilities to develop and utilise the continent's enormous renewable energy resources to assist its socio-economic development. The AEP was conceived at a regional workshop held at Arusha, Tanzania in 1979, at which African researchers met to share their experiences of and explored the feasibility of establishing a collaborative regional R and D programme to develop and adapt technologies appropriate to the specific needs of the participating countries. The AEP researchers accorded the highest priority to seeking solutions to the energy problems of Africa's predominantly rural populations and identified eight project areas as the nodes for regional collaborative research and development: 1. Biogas for rural development; 2. Wood/Charcoal production and utilisation; 3. Solar crop drying; 4. Solar thermal heating and cooling; 5. Wind electricity generation; 6. Wind water pumping; 7. Resources Assessments; 8. Energy policy and planning. The primary goal of the AEP activities were to develop indigenous national capabilities to enable the examination and application of technological solutions appropriate to the unique problems and socio-cultural environments of each country. However, the severe limitations on expertise and the broad similarity of many of the critical problems favoured regional R and D cooperation around common techniques and methodologies in each project area. This work has made a significant contribution to Science and Technology. Prior to this work there was no detailed information in natural convection solar dryers. This work has exposed a number of critical design factors which must be considered in order to design an efficient dryer. Buoyancy-induced pressure inside the dryer, problems of multiple radiative heat exchange in the heater and cooling effects of wind have been studied in detail. The final dryer

  1. Anxiety and depression amongst patients enrolled in a public sector antiretroviral treatment programme in South Africa: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Pappin Michele

    2012-03-01

    Full Text Available Abstract Background HIV/AIDS and depression are projected to be the two leading causes of disability by 2030. HIV/AIDS and anxiety/depression are interlinked. People suffering from depression may be more likely to engage in risky sexual behaviour, and therefore at greater risk of contracting HIV. An HIV + diagnosis may trigger symptoms of anxiety and depression, which may in turn result in risky sexual behaviour and the spread of HIV. This study explores correlates of anxiety and depression in patients enrolled in a public sector ART programme in South Africa. Methods Interviews were conducted with 716 patients initiating ART at twelve public health care facilities in the Free State. Symptoms of anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS. An 8+ cut-off was used to identify possible cases of anxiety and depression. Multivariate logistic regression analysis, using STATA Version 11, was performed to identify correlates of anxiety and depression. Results The prevalence of symptoms of respectively anxiety and depression amongst this study population in the Free State was 30.6% and 25.4%. The multivariate logistic regression analyses identified five correlates of symptoms of anxiety and depression. Disruptive side effects (OR = 3.62, CI 1.95-6.74 and avoidant coping (OR = 1.42, CI 1.22-1.65 were associated with a greater number of symptoms of anxiety. Stigma was associated with an increase in symptoms of anxiety (OR = 1.14, CI 1.07-1.21 and of depression (OR = 1.13, CI 1.06-1.20, while being a widow (OR = 0.30, CI 0.13-0.69 and participating in a support group (OR = 0.21, CI 0.05-0.99 were associated with decreased symptoms of depression. Conclusions The findings from the study provide valuable insights into the psychosocial aspects of the Free State public-sector ART programme. Combined with the literature on the intricate link between mental health problems and treatment outcomes our results emphasise

  2. "If She is Drunk, I Don't Want Her to Take it": Partner Beliefs and Influence on Use of Alcohol and Antiretroviral Therapy in South African Couples.

    Science.gov (United States)

    Conroy, Amy A; McKenna, Stacey A; Leddy, Anna; Johnson, Mallory O; Ngubane, Thulani; Darbes, Lynae A; van Rooyen, Heidi

    2017-07-01

    Alcohol consumption and beliefs about mixing alcohol and ART are associated with decreased adherence to antiretroviral therapy (ART). In this study, we examined how romantic partners influence alcohol and ART use. We conducted semi-structured interviews with 24 HIV-positive individuals and their primary partners (48 individuals) in KwaZulu-Natal, South Africa. Almost 17% of participants spontaneously expressed beliefs that alcohol and ART should not be mixed. Participants who held these beliefs influenced their partners' behaviors by either discouraging the mixing of alcohol and ART, which sometimes resulted in missed pills when drinking, or by helping partners manage their medications when drinking. Other participants encouraged partners to take ART no matter what. Messages on alcohol and ART may need to be refined for ART patients who cannot abstain from alcohol. Primary partners should be included in these education efforts and their influence could be leveraged to help reduce alcohol consumption and maintain adherence.

  3. Determinants of the risk of dying of HIV/AIDS in a rural South African community over the period of the decentralised roll-out of antiretroviral therapy: a longitudinal study

    Directory of Open Access Journals (Sweden)

    Paul Mee

    2014-11-01

    Full Text Available Background: Antiretroviral treatment (ART has significantly reduced HIV mortality in South Africa. The benefits have not been experienced by all groups. Here we investigate the factors associated with these inequities. Design: This study was located in a rural South African setting and used data collected from 2007 to 2010, the period when decentralised ART became available. Approximately one-third of the population were of Mozambican origin. There was a pattern of repeated circular migration between urban areas and this community. Survival analysis models were developed to identify demographic, socioeconomic, and spatial risk factors for HIV mortality. Results: Among the study population of 105,149 individuals, there were 2,890 deaths. The HIV/TB mortality rate decreased by 27% between 2007–2008 and 2009–2010. For other causes of death, the reduction was 10%. Bivariate analysis found that the HIV/TB mortality risk was lower for: those living within 5 km of the Bhubezi Community Health Centre; women; young adults; in-migrants with a longer period of residence; permanent residents; and members of households owning motorised transport, holding higher socioeconomic positions, and with higher levels of education. Multivariate modelling showed, in addition, that those with South Africa as their country of origin had an increased risk of HIV/TB mortality compared to those with Mozambican origins. For males, those of South African origin, and recent in-migrants, the risk of death associated with HIV/TB was significantly greater than that due to other causes. Conclusions: In this community, a combination of factors was associated with an increased risk of dying of HIV/TB over the period of the roll-out of ART. There is evidence for the presence of barriers to successful treatment for particular sub-groups in the population, which must be addressed if the recent improvements in population-level mortality are to be maintained.

  4. Determinants of the risk of dying of HIV/AIDS in a rural South African community over the period of the decentralised roll-out of antiretroviral therapy: a longitudinal study

    Science.gov (United States)

    Mee, Paul; Collinson, Mark A.; Madhavan, Sangeetha; Kabudula, Chodziwadziwa; Gómez-Olivé, Francesc Xavier; Kahn, Kathleen; Tollman, Stephen M.; Hargreaves, James; Byass, Peter

    2014-01-01

    Background Antiretroviral treatment (ART) has significantly reduced HIV mortality in South Africa. The benefits have not been experienced by all groups. Here we investigate the factors associated with these inequities. Design This study was located in a rural South African setting and used data collected from 2007 to 2010, the period when decentralised ART became available. Approximately one-third of the population were of Mozambican origin. There was a pattern of repeated circular migration between urban areas and this community. Survival analysis models were developed to identify demographic, socioeconomic, and spatial risk factors for HIV mortality. Results Among the study population of 105,149 individuals, there were 2,890 deaths. The HIV/TB mortality rate decreased by 27% between 2007–2008 and 2009–2010. For other causes of death, the reduction was 10%. Bivariate analysis found that the HIV/TB mortality risk was lower for: those living within 5 km of the Bhubezi Community Health Centre; women; young adults; in-migrants with a longer period of residence; permanent residents; and members of households owning motorised transport, holding higher socioeconomic positions, and with higher levels of education. Multivariate modelling showed, in addition, that those with South Africa as their country of origin had an increased risk of HIV/TB mortality compared to those with Mozambican origins. For males, those of South African origin, and recent in-migrants, the risk of death associated with HIV/TB was significantly greater than that due to other causes. Conclusions In this community, a combination of factors was associated with an increased risk of dying of HIV/TB over the period of the roll-out of ART. There is evidence for the presence of barriers to successful treatment for particular sub-groups in the population, which must be addressed if the recent improvements in population-level mortality are to be maintained. PMID:25416322

  5. Radiobiology 2000: advances in fundamental and clinical radiobiology. Programme and abstracts: 1st international congress of the South African Radiobiology Society (SARS) in conjunction with the South African Association of Physicists in Medicine and Biology (SAAPMB) and the University of Stellenbosch, 10-13 December 2000, Music Conservatoire, University of Stellenbosch

    International Nuclear Information System (INIS)

    2000-12-01

    Programme and abstracts of the 1st international congress of the South African Radiobiology Society, held in conjunction with the South African Association of Physicists in Medicine and Biology and the University of Stellenbosch, from 10-13 December 2000. This publication contain the abstracts of the forty-four papers and posters that were presented

  6. Association of Adolescent- and Caregiver-Reported Antiretroviral Therapy Adherence with HIV Viral Load Among Perinatally-infected South African Adolescents.

    Science.gov (United States)

    Brittain, Kirsty; Asafu-Agyei, Nana Akua; Hoare, Jacqueline; Bekker, Linda-Gail; Rabie, Helena; Nuttall, James; Roux, Paul; Stein, Dan J; Zar, Heather J; Myer, Landon

    2018-03-01

    Accurate measurement of antiretroviral therapy (ART) adherence remains challenging and there are few data assessing the validity of self-reported adherence among perinatally HIV-infected adolescents. We examined adolescent and caregiver reports of adolescent adherence among perinatally-infected adolescents aged 9-14 years in Cape Town, South Africa, and explored factors that may modify associations between reported adherence and elevated viral load (VL). Among 474 adolescents (median age 12.0 years; median duration of ART use 7.5 years), elevated VL and caregiver- and adolescent-report of missed ART doses were common. Elevated VL was particularly prevalent among older, male adolescents. Low-moderate concordance was observed between caregiver and adolescent report. Among adolescents aged ≥ 12 years, caregiver- and adolescent-reported adherence was associated with elevated VL across most items assessed, but few significant associations were observed among adolescents adolescents who require adherence interventions are needed in this context.

  7. Individualised motivational counselling to enhance adherence to antiretroviral therapy is not superior to didactic counselling in South African patients: findings of the CAPRISA 058 randomised controlled trial.

    Science.gov (United States)

    van Loggerenberg, Francois; Grant, Alison D; Naidoo, Kogieleum; Murrman, Marita; Gengiah, Santhanalakshmi; Gengiah, Tanuja N; Fielding, Katherine; Abdool Karim, Salim S

    2015-01-01

    Concerns that standard didactic adherence counselling may be inadequate to maximise antiretroviral therapy (ART) adherence led us to evaluate more intensive individualised motivational adherence counselling. We randomised 297 HIV-positive ART-naïve patients in Durban, South Africa, to receive either didactic counselling, prior to ART initiation (n = 150), or an intensive motivational adherence intervention after initiating ART (n = 147). Study arms were similar for age (mean 35.8 years), sex (43.1 % male), CD4+ cell count (median 121.5 cells/μl) and viral load (median 119,000 copies/ml). Virologic suppression at 9 months was achieved in 89.8 % of didactic and 87.9 % of motivational counselling participants (risk ratio [RR] 0.98, 95 % confidence interval [CI] 0.90-1.07, p = 0.62). 82.9 % of didactic and 79.5 % of motivational counselling participants achieved >95 % adherence by pill count at 6 months (RR 0.96, 95 % CI 0.85-1.09, p = 0.51). Participants receiving intensive motivational counselling did not achieve higher treatment adherence or virological suppression than those receiving routinely provided didactic adherence counselling. These data are reassuring that less resource intensive didactic counselling was adequate for excellent treatment outcomes in this setting.

  8. High pregnancy intentions and missed opportunities for patient-provider communication about fertility in a South African cohort of HIV-positive women on antiretroviral therapy.

    Science.gov (United States)

    Schwartz, Sheree R; Mehta, Shruti H; Taha, Taha E; Rees, Helen V; Venter, Francois; Black, Vivian

    2012-01-01

    High fertility intentions amongst HIV-positive women have been reported elsewhere. Less is known about how clinical and HIV treatment characteristics correlate with fertility intentions. We use cross-sectional baseline data from a prospective cohort study to assess pregnancy intentions and patient-provider communication around fertility. Non-pregnant, HIV-positive women aged 18-35 on ART were recruited through convenience sampling at Johannesburg antiretroviral (ART) treatment facilities. Among the 850 women in this analysis, those on efavirenz had similar fertility intentions over the next year as women on nevirapine-based regimens (33% vs. 38%). In multivariate analysis, recent ART initiation was associated with higher current fertility intentions; there was no association with CD4 cell count. Forty-one percent of women had communicated with providers about future pregnancy options. Women on ART may choose to conceive at times that are sub-optimal for maternal, child and partner health outcomes and should be routinely counseled around safer pregnancy options.

  9. 'Side effects' are 'central effects' that challenge retention on antiretroviral therapy in HIV treatment programmes in six sub-Saharan African countries

    DEFF Research Database (Denmark)

    Renju, Jenny; Moshabela, Mosa; McLean, Estelle

    2017-01-01

    PLHIV who were lost to follow-up and 53 healthcare workers (HCWs) in Kenya, Uganda, Tanzania, Malawi, Zimbabwe and South Africa. PLHIV were purposely selected to include a range of HIV treatment histories. Deductive and inductive analysis was guided by aspects of practice theory; retention in HIV care...... following ART initiation was the practice of interest. Results: PLHIV who were engaged in HIV care took ART every day, attended clinic appointments and ate as well as possible. For PLHIV, biomedical markers acted as reassurance for their positive treatment progression. However, many described ART side...... effects ranging from dizziness to conditions severe enough to prevent them from leaving home or caring for themselves or others. In all settings, the primary concern of HCW was ensuring patients achieved viral suppression, with management of side effects seen as a lower priority. Where PLHIV tolerated...

  10. Prevalence of malnutrition among HIV-infected children in Central and West-African HIV-care programmes supported by the Growing Up Programme in 2011: a cross-sectional study.

    Science.gov (United States)

    Jesson, Julie; Masson, David; Adonon, Arsène; Tran, Caroline; Habarugira, Capitoline; Zio, Réjane; Nicimpaye, Léoncie; Desmonde, Sophie; Serurakuba, Goreth; Kwayep, Rosine; Sare, Edith; Konate, Tiefing; Nimaga, Abdoulaye; Saina, Philemon; Kpade, Akossiwa; Bassuka, Andrée; Gougouyor, Gustave; Leroy, Valériane

    2015-05-26

    The burden of malnutrition among HIV-infected children is not well described in sub-Saharan Africa, even though it is an important problem to take into account to guarantee appropriate healthcare for these children. We assessed the prevalence of malnutrition and its associated factors among HIV-infected children in HIV care programmes in Central and West-Africa. A cross-sectional study was conducted from September to December 2011 among the active files of HIV-infected children aged 2-19 years old, enrolled in HIV-care programmes supported by the Sidaction Growing Up Programme in Benin, Burundi, Cameroon, Côte d'Ivoire, Mali, Chad and Togo. Socio-demographics characteristics, anthropometric, clinical data, and nutritional support were collected. Anthropometric indicators, expressed in Z-scores, were used to define malnutrition: Height-for-age (HAZ), Weight-for-Height (WHZ) for children children ≥5 years. Three types of malnutrition were defined: acute malnutrition (WHZ/BAZ malnutrition (HAZ malnutrition (WHZ/BAZ malnutrition. Overall, 1350 HIV-infected children were included; their median age was 10 years (interquartile range [IQR]: 7-13 years), 49 % were girls. 80 % were on antiretroviral treatment (ART), for a median time of 36 months. The prevalence of malnutrition was 42 % (95 % confidence interval [95% CI]: 40-44 %) with acute, chronic and mixed malnutrition at 9 % (95% CI: 6-12 %), 26 % (95% CI: 23-28 %), and 7 % (95% CI: 5-10 %), respectively. Among those malnourished, more than half of children didn't receive any nutritional support at the time of the survey. Acute malnutrition was associated with male gender, severe immunodeficiency, and the absence of ART; chronic malnutrition with male gender and age (malnutrition with male gender, age (malnutrition. The prevalence of malnutrition in HIV-infected children even on ART remains high in HIV care programmes. Anthropometric measurements and appropriate nutritional care of malnourished HIV

  11. Bioethics training programmes for Africa: evaluating professional and bioethics-related achievements of African trainees after a decade of Fogarty NIH investment.

    Science.gov (United States)

    Kass, Nancy E; Ali, Joseph; Hallez, Kristina; Hyder, Adnan A

    2016-09-15

    Our primary aim was to evaluate the impact of US National Institutes of Health (NIH)-funded bioethics training programmes (Fogarty bioethics training programmes, FBTPs) that trained individuals from Africa over the programme's first 10 years to examine changes between pretraining and post-training in individual achievement and to document any associations between individual, training programme and post-training accomplishments. We surveyed trainees from the 10 bioethics programmes funded by NIH Fogarty International Center from 2000 to 2011 that included African trainees. McNemar's and Wilcoxon signed rank-sum tests were used to analyse pre-post levels of general and bioethics-related professional achievement. Likelihood of specific post-training achievement outcomes was measured using logistic regression including demographic, pretraining and intratraining variables. 10 different FBTPs that trained individuals from Africa from 2000 to 2011. Of 253 eligible respondents, 171 completed the survey (response rate 67.6%). Pre-post comparisons of professional achievement indicators (eg, serving in leadership roles, teaching, publishing manuscripts); likelihood of specific post-training achievement outcomes. Post-training, respondents were significantly more likely to report serving in a leadership role, being an investigator on a research grant, serving on international committees, serving as a mentor, and publishing manuscripts than at pretraining. Post-training, significantly greater numbers of respondents reported bioethics-related achievements including being a bioethics instructor, serving on an Institutional Review Board (IRB), being an investigator on a bioethics grant and publishing bioethics-related manuscripts than pretraining. Controlling for other factors, there were no significant differences by gender in the post-training success of these participants in terms of leadership roles, being instructors, investigators on grants and holding IRB roles. African

  12. Highly active antiretroviral treatment and health related quality of life in South African adults with human immunodeficiency virus infection: A cross-sectional analytical study

    Directory of Open Access Journals (Sweden)

    Fairall Lara R

    2007-09-01

    Full Text Available Abstract Background Health Related Quality of Life (HRQoL is an important outcome in times of Highly Active Antiretroviral Treatment (HAART. We compared the HRQoL of HIV positive patients receiving HAART with those awaiting treatment in public sector facilities in the Free State province in South Africa. Methods A stratified random sample of 371 patients receiving or awaiting HAART were interviewed and the EuroQol-profile, EuroQol-index and Visual Analogue Scale (VAS were compared. Independent associations between these outcomes and HAART, socio-demographic, clinical and health service variables were estimated using linear and ordinal logistic regression, adjusted for intra-clinic clustering of outcomes. Results Patients receiving HAART reported better HRQoL for 3 of the 5 EuroQol-dimensions, for the VAS score and for the EuroQol index in bivariable analysis. They had a higher mean EuroQol index (0.11 difference, 95% confidence interval [CI] 0.04; 0.23, and were more likely to have a higher index (odds ratio 1.9, 95% CI 1.1; 1.3, compared to those awaiting HAART, in multivariate analysis. Higher mean VAS scores were reported for patients who were receiving HAART (6.5 difference, 95% CI 1.3; 11.7, were employed (9.1, 95% CI 4.3; 13.7 or were female (4.7, 95% CI 0.79; 8.5. Conclusion HAART was associated with improved HRQoL in patients enrolled in a public sector treatment program in South Africa. Our finding that the EuroQol instrument was sensitive to HAART supports its use in future evaluation of HIV/AIDS care in South Africa. Longitudinal studies are needed to evaluate changes in individuals' HRQoL.

  13. Highly active antiretroviral treatment and health related quality of life in South African adults with human immunodeficiency virus infection: A cross-sectional analytical study.

    Science.gov (United States)

    Louwagie, Goedele M; Bachmann, Max O; Meyer, Kobus; Booysen, Frikkie le R; Fairall, Lara R; Heunis, Christo

    2007-09-14

    Health Related Quality of Life (HRQoL) is an important outcome in times of Highly Active Antiretroviral Treatment (HAART). We compared the HRQoL of HIV positive patients receiving HAART with those awaiting treatment in public sector facilities in the Free State province in South Africa. A stratified random sample of 371 patients receiving or awaiting HAART were interviewed and the EuroQol-profile, EuroQol-index and Visual Analogue Scale (VAS) were compared. Independent associations between these outcomes and HAART, socio-demographic, clinical and health service variables were estimated using linear and ordinal logistic regression, adjusted for intra-clinic clustering of outcomes. Patients receiving HAART reported better HRQoL for 3 of the 5 EuroQol-dimensions, for the VAS score and for the EuroQol index in bivariable analysis. They had a higher mean EuroQol index (0.11 difference, 95% confidence interval [CI] 0.04; 0.23), and were more likely to have a higher index (odds ratio 1.9, 95% CI 1.1; 1.3), compared to those awaiting HAART, in multivariate analysis. Higher mean VAS scores were reported for patients who were receiving HAART (6.5 difference, 95% CI 1.3; 11.7), were employed (9.1, 95% CI 4.3; 13.7) or were female (4.7, 95% CI 0.79; 8.5). HAART was associated with improved HRQoL in patients enrolled in a public sector treatment program in South Africa. Our finding that the EuroQol instrument was sensitive to HAART supports its use in future evaluation of HIV/AIDS care in South Africa. Longitudinal studies are needed to evaluate changes in individuals' HRQoL.

  14. Maternal anaemia and duration of zidovudine in antiretroviral regimens for preventing mother-to-child transmission: a randomized trial in three African countries.

    Science.gov (United States)

    Sartorius, Benn K D; Chersich, Matthew F; Mwaura, Mary; Meda, Nicolas; Temmerman, Marleen; Newell, Marie Louise; Farley, Timothy M M; Luchters, Stanley

    2013-11-06

    Although substantiated by little evidence, concerns about zidovudine-related anaemia in pregnancy have influenced antiretroviral (ARV) regimen choice for preventing mother-to-child transmission of HIV-1, especially in settings where anaemia is common. Eligible HIV-infected pregnant women in Burkina Faso, Kenya and South Africa were followed from 28 weeks of pregnancy until 12-24 months after delivery (n = 1070). Women with a CD4 count of 200-500 cells/mm(3) and gestational age 28-36 weeks were randomly assigned to zidovudine-containing triple-ARV prophylaxis continued during breastfeeding up to 6-months, or to zidovudine during pregnancy plus single-dose nevirapine (sd-NVP) at labour. Additionally, two cohorts were established, women with CD4 counts: 500 cells/mm(3) received zidovudine during pregnancy plus sd-NVP at labour. Mild (haemoglobin 8.0-10.9 g/dl) and severe anaemia (haemoglobin anaemia occurred subsequently in 194 (18.1%) women, mostly in those with low baseline haemoglobin, lowest socio-economic category, advanced HIV disease, prolonged breastfeeding (≥ 6 months) and shorter ARV exposure. Severe anaemia incidence was similar in the randomized arms (equivalence P-value = 0.32). After 1-2 months of ARV's, severe anaemia was significantly reduced in all groups, though remained highest in the low CD4 cohort. Severe anaemia occurs at a similar rate in women receiving longer triple zidovudine-containing regimens or shorter prophylaxis. Pregnant women with pre-existing anaemia and advanced HIV disease require close monitoring. ISRCTN71468401.

  15. Antiretroviral therapy: current drugs.

    Science.gov (United States)

    Pau, Alice K; George, Jomy M

    2014-09-01

    The rapid advances in drug discovery and the development of antiretroviral therapy is unprecedented in the history of modern medicine. The administration of chronic combination antiretroviral therapy targeting different stages of the human immunodeficiency virus' replicative life cycle allows for durable and maximal suppression of plasma viremia. This suppression has resulted in dramatic improvement of patient survival. This article reviews the history of antiretroviral drug development and discusses the clinical pharmacology, efficacy, and toxicities of the antiretroviral agents most commonly used in clinical practice to date. Published by Elsevier Inc.

  16. Acceptability and feasibility of mHealth and community-based directly observed antiretroviral therapy to prevent mother-to-child HIV transmission in South African pregnant women under Option B+: an exploratory study

    Directory of Open Access Journals (Sweden)

    Nachega JB

    2016-04-01

    University, Cape Town, South Africa Objective: To examine the acceptability and feasibility of mobile health (mHealth/short message service (SMS and community-based directly observed antiretroviral therapy (cDOT as interventions to improve antiretroviral therapy (ART adherence for preventing mother-to-child human immunodeficiency virus (HIV transmission (PMTCT. Design and methods: A mixed-method approach was used. Two qualitative focus group discussions with HIV-infected pregnant women (n=20 examined the acceptability and feasibility of two ART adherence interventions for PMTCT: 1 SMS text messaging and 2 patient-nominated cDOT supporters. Additionally, 109 HIV-infected, pregnant South African women (18–30 years old receiving PMTCT services under single-tablet antiretroviral therapy regimen during pregnancy and breastfeeding and continuing for life (“Option B+” were interviewed about mobile phone access, SMS use, and potential treatment supporters. Setting: A community primary care clinic in Cape Town, South Africa. Participants: HIV-infected pregnant women. Main outcomes: Acceptability and feasibility of mHealth and cDOT interventions. Results: Among the 109 women interviewed, individual mobile phone access and SMS use were high (>90%, and 88.1% of women were interested in receiving SMS ART adherence support messages such as reminders, motivation, and medication updates. Nearly all women (95% identified at least one person close to them to whom they had disclosed their HIV status and would nominate as a cDOT supporter. Focus group discussions revealed that cDOT supporters and adherence text messages were valued, but some concerns regarding supporter time availability and risk of unintended HIV status disclosure were expressed. Conclusion: mHealth and/or cDOT supporter as interventions to improve ART adherence are feasible in this setting. However, safe HIV status disclosure to treatment supporters and confidentiality of text messaging content about HIV and ART were

  17. Migrant women’s knowledge and perceived sociocultural barriers to cervical cancer screening programme: a qualitative study of African women in Poland

    Directory of Open Access Journals (Sweden)

    Omoye Mary Akhagba

    2017-01-01

    Full Text Available This article explores both the knowledge and perception of African women about the importance of screening as a recommended health action to counter the growing rate of cervical cancer in women. The theoretical framework is influenced by the postulations of behavioural theories, sociology of health and the health belief model (HBM on how people perceive health issues such as cervical cancer and its screening measures. In addition, this study tries to explore the acculturation challenges involved in migration, which adversely affects health knowledge and behaviour of African women. To achieve this, one focus group discussion was conducted with twelve women between the ages of 25 and 54 years old from Egypt, Eritrea, Kenya and Nigeria to share their knowledge of cervical cancer screening programmes in Poland. They constituted a mixture of women from different parts of Africa with cultural differences and different belief systems. Little or no in-depth understanding of Polish language, lack of information about the disease and its screening methods, lack of understanding of the Polish health care systems and social economic factors were issues discussed by these women as socio-cultural barriers to their non-participation in the organised cervical cancer screening programme in Poland. Based on this study, migrant women lack adequate information about cervical cancer, its causes, risk factors and its screening methods. Therefore, this study proposes that good understanding of health care systems, language translation support in the health care system, health awareness campaigns and social relationships are important motivating factors that could encourage migrant women to participate in the cancer screening programmes in Poland.

  18. "That is why I stopped the ART": patients' & providers' perspectives on barriers to and enablers of HIV treatment adherence in a South African workplace programme.

    Science.gov (United States)

    Dahab, Mison; Charalambous, Salome; Hamilton, Robin; Fielding, Katherine; Kielmann, Karina; Churchyard, Gavin J; Grant, Alison D

    2008-02-18

    As ART programmes in African settings expand beyond the pilot stages, adherence to treatment may become an increasing challenge. This qualitative study examines potential barriers to, and facilitators of, adherence to ART in a workplace programme in South Africa. We conducted key informant interviews with 12 participants: six ART patients, five health service providers (HSPs) and one human resources manager. The main reported barriers were denial of existence of HIV or of one's own positive status, use of traditional medicines, speaking a different language from the HSP, alcohol use, being away from home, perceived severity of side-effects, feeling better on treatment and long waiting times at the clinic. The key facilitators were social support, belief in the value of treatment, belief in the importance of one's own life to the survival of one's family, and the ability to fit ART into daily life schedules. Given the reported uncertainty about the existence of HIV disease and the use of traditional medicines while on ART, despite a programme emphasising ART counselling, there is a need to find effective ways to support adherence to ART even if the individual does not accept biomedical concepts of HIV disease or decides to use traditional medicines. Additionally, providers should identify ways to minimize barriers in communication with patients with whom they have no common language. Finally, dissatisfaction with clinical services, due to long waiting times, should be addressed.

  19. "That is why I stopped the ART": Patients' & providers' perspectives on barriers to and enablers of HIV treatment adherence in a South African workplace programme

    Directory of Open Access Journals (Sweden)

    Kielmann Karina

    2008-02-01

    Full Text Available Abstract Background As ART programmes in African settings expand beyond the pilot stages, adherence to treatment may become an increasing challenge. This qualitative study examines potential barriers to, and facilitators of, adherence to ART in a workplace programme in South Africa. Methods We conducted key informant interviews with 12 participants: six ART patients, five health service providers (HSPs and one human resources manager. Results The main reported barriers were denial of existence of HIV or of one's own positive status, use of traditional medicines, speaking a different language from the HSP, alcohol use, being away from home, perceived severity of side-effects, feeling better on treatment and long waiting times at the clinic. The key facilitators were social support, belief in the value of treatment, belief in the importance of one's own life to the survival of one's family, and the ability to fit ART into daily life schedules. Conclusion Given the reported uncertainty about the existence of HIV disease and the use of traditional medicines while on ART, despite a programme emphasising ART counselling, there is a need to find effective ways to support adherence to ART even if the individual does not accept biomedical concepts of HIV disease or decides to use traditional medicines. Additionally, providers should identify ways to minimize barriers in communication with patients with whom they have no common language. Finally, dissatisfaction with clinical services, due to long waiting times, should be addressed.

  20. The status of HIV-1 resistance to antiretroviral drugs in sub-Saharan Africa

    NARCIS (Netherlands)

    Hamers, Raph L.; Derdelinckx, Inge; van Vugt, Michèle; Stevens, Wendy; Rinke de Wit, Tobias F.; Schuurman, Rob

    2008-01-01

    Access to highly active antiretroviral therapy (HAART) for persons infected with HIV in sub-Saharan Africa has greatly improved over the past few years. However, data on long-term clinical outcomes of Africans receiving HAART, patterns of HIV resistance to antiretroviral drugs and implications of

  1. Effect of Antiretroviral Drug (arved) on the Kidney in Albino Rat ...

    African Journals Online (AJOL)

    African studies on effect of antiretroviral drugs on the kidney are limited resulting to scanty information on the safety of these drugs. This study was therefore designed to evaluate the effects of antiretroviral drugs arved®, on creatinine, urea, potassium and sodium ions as well as histological effect on the kidney. A total of fifty ...

  2. Peer Review and the Dilemmas of Quality Control in Programme Accreditation in South African Higher Education: Challenges and Possibilities

    Science.gov (United States)

    Cross, Michael; Naidoo, Devika

    2011-01-01

    The paper scrutinises the dynamics and the nature of peer review in the programme evaluation and accreditation process within the context of diverse individual and institutional legacies in South Africa. It analyses the peer review process and highlights the contestation at political, policy and epistemological levels. The paper argues that,…

  3. Structural adjustment programmes on the African continent : the theoretical foundations of IMF/World Bank reform policies

    NARCIS (Netherlands)

    Meilink, H.A.

    2003-01-01

    Since the early 1980s the majority of countries in sub-Saharan Africa embarked on the implementation of IMF/World Bank designed 'structural adjustment programmes' (SAPs). This paper examines the theoretical underpinnings of the SAPs. It shows that IMF policies are based on a theoretical framework

  4. Equity Development Programmes: Does Mentoring Make a Difference in Individual and Social Transformation for South African WonderWomen?

    Science.gov (United States)

    Geber, Hilary

    2010-01-01

    The equity and transformation challenge for women and black academics at universities in Post-Apartheid South Africa is enormous. Despite a marked increase in equity development programmes since the 1996 Employment Equity legislation, fewer women than expected have advanced through the academic ranks. An indigenous mentoring model for…

  5. Improving access to antiretrovirals in rural South Africa – a call to ...

    African Journals Online (AJOL)

    Improving access to antiretrovirals in rural South Africa – a call to action. South Africa (SA) already has the world's biggest antiretroviral (ARV) programme. With the introduction of extended criteria for initiating ARVs, the National Department of Health (NDoH) wishes to increase the number of people on ARVs by around.

  6. Prevalence of oral candidiasis in HIV/AIDS children in highly active antiretroviral therapy era. A literature analysis.

    Science.gov (United States)

    Gaitán-Cepeda, Luis Alberto; Sánchez-Vargas, Octavio; Castillo, Nydia

    2015-08-01

    SummaryHighly active antiretroviral therapy has decreased the morbidity and mortality related to HIV infection, including oral opportunistic infections. This paper offers an analysis of the scientific literature on the epidemiological aspects of oral candidiasis in HIV-positive children in the combination antiretroviral therapy era. An electronic databases search was made covering the highly active antiretroviral therapy era (1998 onwards). The terms used were oral lesions, oral candidiasis and their combination with highly active antiretroviral therapy and HIV/AIDS children. The following data were collected from each paper: year and country in which the investigation was conducted, antiretroviral treatment, oral candidiasis prevalence and diagnostic parameters (clinical or microbiological). Prevalence of oral candidiasis varied from 2.9% in American HIV-positive children undergoing highly active antiretroviral therapy to 88% in Chilean HIV-positive children without antiretroviral therapy. With respect to geographical location and antiretroviral treatment, higher oral candidiasis prevalence in HIV-positive children on combination antiretroviral therapy/antiretroviral therapy was reported in African children (79.1%) followed by 45.9% reported in Hindu children. In HIV-positive Chilean children on no antiretroviral therapy, high oral candidiasis prevalence was reported (88%) followed by Nigerian children (80%). Oral candidiasis is still frequent in HIV-positive children in the highly active antiretroviral therapy era irrespective of geographical location, race and use of antiretroviral therapy. © The Author(s) 2014.

  7. Accessibility of antiretroviral therapy in Ghana: Convenience of access

    African Journals Online (AJOL)

    Joyce Addo-Atuah * Joyce Addo-Atuah, BPharm, MSc, PhD, Assistant Professor, Touro College of Pharmacy, New York, USA. She was a PhD candidate at the University of Tennessee (UT), Memphis, USA, when the study was undertaken in Ghana. joyce.addo-atuah@touro.edu, Dick Gourley Dick Gourley, PharmD, Professor and Dean, UT College of Pharmacy during the study and major research advisor. , Greta Gourley Greta Gourley, PharmD/PhD, retired Associate Professor of Pharmaceutical Sciences at UT College of Pharmacy and research advisor. , Shelley I. White-Means Shelley I. White-Means, PhD, Professor and Chair, Health Outcomes and Policy Research Division of UT College of Pharmacy at time of the study and research advisor. , Robin J. Womeodu Robin J. Womeodu, MD, F.A.C.P., Associate Professor of Internal Medicine and Preventive Medicine at UT College of Medicine at time of study and research advisor. , Richard J. Faris Richard J. Faris, Assistant Professor at UT College of Pharmacy at time of study and research advisor. &

    2012-05-30

    May 30, 2012 ... The accuracy of any instructions, formulae, and drug doses ... The convenience of accessing antiretroviral therapy (ART) is ...... tious diseases, paediatrics, chest diseases, dermatology, public .... CD4 count, (2) a full blood count, (3) a liver function test, (4) ..... America: measures of the African brain drain.

  8. Guidelines for antiretroviral therapy in adults

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    G Meintjes

    2012-08-01

    Full Text Available These guidelines are intended as an update to those published in the Southern African Journal of HIV Medicine in January 2008. Since the release of the previous guidelines, the scale-up of antiretroviral therapy (ART in Southern Africa has continued to grow. Cohort studies from the region show excellent clinical outcomes; however, ART is still being started late (in advanced disease, resulting in relatively high early mortality rates. New data on antiretroviral (ARV tolerability in the region and several new ARV drugs have become available. Although currently few in number, some patients in the region are failing protease inhibitor (PI-based second-line regimens. To address this, guidelines on third-line (or ‘salvage’ therapy have been expanded.

  9. Pharmacoepidemiology of antiretroviral drugs in a teaching hospital ...

    African Journals Online (AJOL)

    Objective: Prescribing, adherence, and adverse drug events to HAART in a large antiretroviral programme in Lagos was evaluated. Design: A retrospective 5 year open cohort study. Setting: The AIDS Prevention Initiative in Nigeria (APIN) clinic at LUTH is one of the United States Presidential Emergency Plan for AIDS ...

  10. Differences in access and patient outcomes across antiretroviral ...

    African Journals Online (AJOL)

    Objective. To assess differences in access to antiretroviral treatment (ART) and patient outcomes across public sector treatment facilities in the Free State province, South Africa. Design. Prospective cohort study with retrospective database linkage. We analysed data on patients enrolled in the treatment programme across ...

  11. Delays in switching patients onto second-line antiretroviral treatment ...

    African Journals Online (AJOL)

    Background: South Africa has one of the largest antiretroviral treatment (ART) programmes globally. In addition to increasing access to ART, it is important that the health system also focuses on the appropriate management of patients who fail first-line ART. Delays in switching patients onto second-line ART can adversely ...

  12. Influence of highly active antiretroviral therapy (HAART) on the ...

    African Journals Online (AJOL)

    This report is part of the ongoing highly active antiretroviral therapy (HAART) trial, 167 patients were enlisted, but current analysis was restricted to 107 patients that were about a year old on the programme. The baseline weight, CD4+ cell count and serum albumin of 59 males and 48 females age 15-60 years, were ...

  13. WHEN RELEVANCE DECENTERS CRITICALITY: THE CASE OF THE SOUTH AFRICAN NATIONAL CRIME, VIOLENCE AND INJURY LEAD PROGRAMME

    Directory of Open Access Journals (Sweden)

    Mohamed Seedat

    2010-11-01

    Full Text Available Following the formal demise of political apartheid in SouthAfrica in 1994, critical and community-centred psychologistshave tended to obtain relevance through alignment with thetenets of social justice and the larger democratic project. Thisarticle draws on the experiences of the Crime, Violence andInjury Lead Programme (CVI to illustrate how particularformulations of scientific and social relevance function tomarginalize criticality and critical scholarship. The authorsuggests that relevance without criticality produces forms ofintellectual activity that privilege empiricist traditions, perpetrate a binary between research and research translation, andreproduce the myth that intervention work is atheoretical.The review of the CVI serves as a reminder of the challengesinherent in enactments of critical psychology. Among themany issues that critical psychology oriented initiatives likeCVI have to contend with is the task of developing theoreticaland other resources to move between co-operation and critiquein the service of democratic development.

  14. Infrastructure and Other Considerations to Launch Nuclear Power Programme: The Case of Sub-Sahara African Developing Countries like Ethiopia

    International Nuclear Information System (INIS)

    Meshesha, Atnatiwos Zeleke

    2011-01-01

    Trends in the world's population and energy use during the past decades show dramatic increases; and the demand for electricity, mainly from developing countries, is expected to increase more rapidly than the demand for other forms of energy. Besides, concern of climate change led to the need for production of significant amount of 'safe and clean' energy which in turn favours to nuclear option. Other alternative renewable sources like solar and wind can assist but currently they are short of supplying the required high energy demand either economically or/and in substantial amount. Nuclear option therefore remains a possible (developed) technology to fill this energy gap; and many countries including developing one show interest to make use of this energy source. In this paper the economic situations and energy production of six East Africa Sub-Saharan developing countries, with total population of 240 million were assessed, and 6.8% and 2.9% average GDP and population growth respectively registered in the last four years; however, their energy production in 2008 (est.) was 17.662 billion kWh, which is the least in the world. The contribution of inadequate energy and its poor coverage in hampering development, increase poverty and unstability were also analyzed. To come out of this cyclic challenge; it is recommended that countries based on regional economic cooperation should interconnect their electricity grid like EAPP and cooperate to invest commonly or unilaterally to launch Nuclear Power Programmes in relatively stable countries. Candid support of the international community is crucial, and IAEA should support and encourage such arrangements. It is also noted that the best candidate to start NP programme in these countries would be the worldwide dominant water cooled reactors. However, for countries with low grid capacity and to carry out projects in remote areas which are far-away from national grid systems or to desalinate water, considerations for smaller

  15. African Journal of Food, Agriculture, Nutrition and Development ...

    African Journals Online (AJOL)

    African Journal of Food, Agriculture, Nutrition and Development. ... and African public institutions working towards solving food and nutrition problems through sound policies, ... Ecosystems Division, United Nations Environment Programme.

  16. Potential use and performance studies of solar crop driers in Mauritius. African Energy Programme research report series no. 2

    International Nuclear Information System (INIS)

    Yu Wai Man, Y.K.L.

    1987-01-01

    Monoculture has in the past, been the norm in agriculture in Mauritius. However under a recent policy of self reliance, there has been a move to multi-crop culture. Under this policy it has been decided to release, in the first instance, 800 hectares of the best arable land for the production of food crops. This decision, coupled with further increase in intense cultivation of crops in the interrow space of the 80,000 hectares of sugar cane fields, will make the need for crop drying more and more indispensable. As the present oil bill of MuR 25 million in precious foreign exchange, for crop drying only is already too much the country could afford, the need for solar drying remains the only other alternative. The Government's Plan of Action calls for immediate action on at least 10 major crops, among which maize is the single most important. The major land holders who will participate in the programme of agricultural diversification will normally use the established artificial drying process. However the 1200 small scale farmers who will also be called upon to contribute their share will obviously not be able to afford such an expensive process and open air or sun drying remains the only resort for them. However sun drying methods have several major constraints not least of which is the inability to dry down to the safe moisture content for subsequent storage. For example, sun-dried maize will only reach a minimum of 15 to 16% moisture and must be further dried artificially at a cost of about MuR 200 per tonne to attain the 12% moisture for storage. It is apparent that the use of solar driers would generate a higher income, through a reduction in post-harvest losses and a saving in drying cost, to these small scale farmers. This, in turn, would act as an impetus to grow more food for self-reliance, if not for export. This research work was, therefore, undertaken with the aim of fulfilling the needs of small-scale farmers. The objectives of the project were to

  17. Patterns of disclosure and antiretroviral treatment adherence in a ...

    African Journals Online (AJOL)

    ... South African mining workplace programme and implications for HIV prevention. ... the lived experiences of 19 HIV-positive male participants, between the ages of ... infection and were more confident in their ability to manage their treatment, ...

  18. Clinician perceptions and patient experiences of antiretroviral treatment integration in primary health care clinics, Tshwane, South Africa

    Directory of Open Access Journals (Sweden)

    Maphuthego D. Mathibe

    2015-10-01

    Full Text Available Background: Primary Health Care (PHC clinicians and patients are major role players in the South African antiretroviral treatment programme. Understanding their perceptions and experiences of integrated care and the management of people living with HIV and AIDS in PHC facilities is necessary for successful implementation and sustainability of integration. Objective: This study explored clinician perceptions and patient experiences of integration of antiretroviral treatment in PHC clinics. Method: An exploratory, qualitative study was conducted in four city of Tshwane PHC facilities. Two urban and two rural facilities following different models of integration were included. A self-administered questionnaire with open-ended items was completed by 35 clinicians and four focus group interviews were conducted with HIV-positive patients. The data were coded and categories were grouped into sub-themes and themes. Results: Workload, staff development and support for integration affected clinicians’ performance and viewpoints. They perceived promotion of privacy, reduced discrimination and increased access to comprehensive care as benefits of service integration. Delays, poor patient care and patient dissatisfaction were viewed as negative aspects of integration. In three facilities patients were satisfied with integration or semi-integration and felt common queues prevented stigma and discrimination, whilst the reverse was true in the facility with separate services. Single-month issuance of antiretroviral drugs and clinic schedule organisation was viewed negatively, as well as poor staff attitudes, poor communication and long waiting times. Conclusion: Although a fully integrated service model is preferable, aspects that need further attention are management support from health authorities for health facilities, improved working conditions and appropriate staff development opportunities.

  19. Clinician perceptions and patient experiences of antiretroviral treatment integration in primary health care clinics, Tshwane, South Africa.

    Science.gov (United States)

    Mathibe, Maphuthego D; Hendricks, Stephen J H; Bergh, Anne-Marie

    2015-10-02

    Primary Health Care (PHC) clinicians and patients are major role players in the South African antiretroviral treatment programme. Understanding their perceptions and experiences of integrated care and the management of people living with HIV and AIDS in PHC facilities is necessary for successful implementation and sustainability of integration. This study explored clinician perceptions and patient experiences of integration of antiretroviral treatment in PHC clinics. An exploratory, qualitative study was conducted in four city of Tshwane PHC facilities. Two urban and two rural facilities following different models of integration were included. A self-administered questionnaire with open-ended items was completed by 35 clinicians and four focus group interviews were conducted with HIV-positive patients. The data were coded and categories were grouped into sub-themes and themes. Workload, staff development and support for integration affected clinicians' performance and viewpoints. They perceived promotion of privacy, reduced discrimination and increased access to comprehensive care as benefits of service integration. Delays, poor patient care and patient dissatisfaction were viewed as negative aspects of integration. In three facilities patients were satisfied with integration or semi-integration and felt common queues prevented stigma and discrimination, whilst the reverse was true in the facility with separate services. Single-month issuance of antiretroviral drugs and clinic schedule organisation was viewed negatively, as well as poor staff attitudes, poor communication and long waiting times. Although a fully integrated service model is preferable, aspects that need further attention are management support from health authorities for health facilities, improved working conditions and appropriate staff development opportunities.

  20. Diagnosis, antiretroviral therapy, and emergence of resistance to antiretroviral agents in HIV-2 infection: a review

    Directory of Open Access Journals (Sweden)

    Maia Hightower

    Full Text Available Human immunodeficiency virus type 1 (HIV-1 and type 2 (HIV-2 are the causative agents of AIDS. HIV-2 is prevalent at moderate to high rates in West African countries, such as Senegal, Guinea, Gambia, and Cape Verde. Diagnosis of HIV-2 is made with a positive HIV-1/HIV-2 ELISA or simple/rapid assay, followed by one or two confirmatory tests specific for HIV-2. Following CD4+ T cell counts, HIV-2 viral burden and clinical signs and symptoms of immunodeficiency are beneficial in monitoring HIV-2 disease progression. Although non-nucleoside reverse transcriptase inhibitors are ineffective in treating HIV-2, nucleoside reverse transcriptase inhibitors and protease inhibitors can be effective in dual and triple antiretroviral regimens. Their use can decrease HIV-2 viral load, increase CD4+ T cell counts and improve AIDS-related symptoms. HIV-2 resistance to various nucleoside reverse transcriptase inhibitors and protease inhibitors, including zidovudine, lamivudine, ritonavir and indinavir, has been identified in some HIV-2 infected patients on antiretroviral therapy. The knowledge of HIV-2 peculiarities, when compared to HIV-1, is crucial to helping diagnose and guide the clinician in the choice of the initial antiretroviral regimen and for monitoring therapy success.

  1. Changes in serum phosphate and potassium and their effects on mortality in malnourished African HIV-infected adults starting antiretroviral therapy and given vitamins and minerals in lipid-based nutritional supplements

    DEFF Research Database (Denmark)

    Rehman, Andrea Mary; Woodd, Susannah Louise; Heimburger, Douglas Corbett

    2017-01-01

    Malnourished HIV-infected patients starting antiretroviral therapy (ART) are at high risk of early mortality, some of which may be attributed to altered electrolyte metabolism. We used data from a randomised controlled trial of electrolyte-enriched lipid-based nutritional supplements to assess...... that changes in serum electrolytes, largely irrespective of the starting point and the direction of change, were more strongly associated with mortality than were absolute electrolyte levels. Although K and phosphate are required for tissue deposition during recovery from malnutrition, further studies...... are needed to determine whether specific supplements exacerbate physiologically adverse shifts in electrolyte levels during nutritional rehabilitation of ill malnourished HIV patients....

  2. Individualization of antiretroviral therapy

    Directory of Open Access Journals (Sweden)

    Pavlos R

    2011-12-01

    Full Text Available Rebecca Pavlos, Elizabeth J PhillipsInstitute for Immunology and Infectious Diseases, Murdoch University, Murdoch, Western Australia, AustraliaAbstract: Antiretroviral therapy (ART has evolved considerably over the last three decades. From the early days of monotherapy with high toxicities and pill burdens, through to larger pill burdens and more potent combination therapies, and finally, from 2005 and beyond where we now have the choice of low pill burdens and once-daily therapies. More convenient and less toxic regimens are also becoming available, even in resource-poor settings. An understanding of the individual variation in response to ART, both efficacy and toxicity, has evolved over this time. The strong association of the major histocompatibility class I allele HLA-B*5701 and abacavir hypersensitivity, and its translation and use in routine HIV clinical practice as a predictive marker with 100% negative predictive value, has been a success story and a notable example of the challenges and triumphs in bringing pharmacogenetics to the clinic. In real clinical practice, however, it is going to be the exception rather than the rule that individual biomarkers will definitively guide patient therapy. The need for individualized approaches to ART has been further increased by the importance of non-AIDS comorbidities in HIV clinical practice. In the future, the ideal utilization of the individualized approach to ART will likely consist of a combined approach using a combination of knowledge of drug, virus, and host (pharmacogenetic and pharmacoecologic [factors in the individual's environment that may be dynamic over time] information to guide the truly personalized prescription. This review will focus on our knowledge of the pharmacogenetics of the efficacy and toxicity of currently available antiretroviral agents and the current and potential utility of such information and approaches in present and future HIV clinical care.Keywords: HIV

  3. Marine line fish research programme

    CSIR Research Space (South Africa)

    SANCOR

    1979-04-01

    Full Text Available This report outlines the framework for a marine line fish programme under the aegis of the South African National Committee for Oceanographic Research (SANCOR). An attempt is made to assess the state of knowledge about South African marine line...

  4. African Heath Sciences Vol 7 No 3.p65

    African Journals Online (AJOL)

    FOMCS2

    Conclusion: The burden of HIV infection in the medical emergency unit is high and majority of the patients who ... Key words:HIV/AIDS, Eligibility for antiretroviral therapy, Hospitals, Africa. African ... National Council of Science and Technology.

  5. The Incorporation of the USA "Science Made Sensible" Programme in South African Primary Schools: A Cross-Cultural Approach to Science Education

    Science.gov (United States)

    de Villiers, Rian; Plantan, Tiffany; Gaines, Michael

    2016-01-01

    The Science Made Sensible (SMS) programme began as a partnership between the University of Miami (UM), Florida, USA, and some public schools in Miami. In this programme, postgraduate students from UM work with primary school science teachers to engage learners in science through the use of inquiry-based, hands-on activities. Due to the success of…

  6. “If she is drunk, I don’t want her to take it”: Partner beliefs and influence on use of alcohol and antiretroviral therapy in South African couples

    Science.gov (United States)

    Conroy, Amy A.; McKenna, Stacey A.; Leddy, Anna; Johnson, Mallory O.; Ngubane, Thulani; Darbes, Lynae A.; van Rooyen, Heidi

    2017-01-01

    Alcohol consumption and beliefs about mixing alcohol and ART are associated with decreased adherence to antiretroviral therapy (ART). In this study, we examined how romantic partners influence alcohol and ART use. We conducted semi-structured interviews with 24 HIV-positive individuals and their primary partners (48 individuals) in KwaZulu-Natal, South Africa. Almost 17% of participants spontaneously expressed beliefs that alcohol and ART should not be mixed. Participants who held these beliefs influenced their partners’ behaviors by either discouraging the mixing of alcohol and ART, which sometimes resulted in missed pills when drinking, or by helping partners manage their medications when drinking. Other participants encouraged partners to take ART no matter what. Messages on alcohol and ART may need to be refined for ART patients who cannot abstain from alcohol. Primary partners should be included in these education efforts and their influence could be leveraged to help reduce alcohol consumption and maintain adherence. PMID:28150121

  7. 12-month mortality and loss-to-program in antiretroviral-treated children: The IeDEA pediatric West African Database to evaluate AIDS (pWADA, 2000-2008

    Directory of Open Access Journals (Sweden)

    Peterson Kevin

    2011-06-01

    Full Text Available Abstract Background The IeDEA West Africa Pediatric Working Group (pWADA was established in January 2007 to study the care and treatment of HIV-infected children in this region. We describe here the characteristics at antiretroviral treatment (ART initiation and study the 12-month mortality and loss-to-program of HIV-infected children followed in ART programs in West Africa. Methods Standardized data from HIV-infected children followed-up in ART programs were included. Nine clinical centers from six countries contributed to the dataset (Benin, Côte d'Ivoire, Gambia, Ghana, Mali and Senegal. Inclusion criteria were the followings: age 0-15 years and initiated triple antiretroviral drug regimens. Baseline time was the date of ART initiation. WHO criteria was used to define severe immunosuppression based on CD4 count by age or CD4 percent 6 months after ART initiation and factors associated with these two outcomes. Results Between June 2000 and December 2007, 2170 children were included. Characteristics at ART initiation were the following: median age of 5 years (Interquartile range (IQR: 2-9 and median CD4 percentage of 13% (IQR: 7-19. The most frequent drug regimen consisted of two nucleoside reverse transcriptase inhibitors and one non-nucleoside reverse transcriptase inhibitors (62%. During the first 12 months, 169 (7.8% children died and 461(21.2% were lost-to-program. Overall, in HIV-infected children on ART, the 12-month probability of death was 8.3% (95% Confidence Interval (CI: 7.2-9.6%, and of loss-to-program was 23.1% (95% CI: 21.3-25.0%. Both mortality and loss-to program were associated with advanced clinical stage, CD4 percentage 2005 of ART initiation. Conclusion Innovative and sustainable approaches are needed to better document causes of death and increase retention in HIV pediatric clinics in West Africa.

  8. The Heart of the Matter: Methodological Challenges in Developing a Contemporary 257-269 Reading Programme for Monolingual Lexicography, from the Perspective of the Dictionary Unit for South African English

    Directory of Open Access Journals (Sweden)

    Leela Pienaar

    2011-10-01

    Full Text Available

    Abstract: This article argues the importance of the reading programme as the pivotal issue inthe lexicographic process. It is essentially a practical article which outlines strategies for developingand implementing a reading programme for monolingual lexicography. The arguments are informedby theory, together with an examination of the data-collection procedures followed by theDictionary Unit for South African English (DSAE and a survey of current practice in major Englishdictionary units around the world, namely the Oxford English Dictionary, the Canadian OxfordDictionary, the Australian National Dictionary Centre and the New Zealand Dictionary Centre.The reading programme for the DSAE is first defined and contextualized within its mission statement.The article then explores the challenges inherent in sampling contemporary written and spokenEnglish in the South African multilingual context. It is intended to inform the DSAE's intakepolicy, in terms of the following critical issues:

    — the definition of South African English,

    — the monitoring and selection of print, oral and electronic sources,

    — the excerpting of citations and relevant bibliographic information, and

    — the recruiting and training of readers.

    These interlinked aspects of the reading programme have crucial implications for the quality andauthority of the monolingual dictionary on historical principles.

    Keywords: READING PROGRAMME, MONOLINGUAL DICTIONARY, HISTORICAL PRINCIPLES, CONTEMPORARY, INTAKE, CITATIONS, STRATEGIES

    Opsomming: Die kern van die saak: Metodologiese uitdagings by die ontwikkelingvan 'n eietydse leesprogram vir eentalige leksikografie, uit dieperspektief van die Dictionary Unit for South African English. Hierdie artikelbepleit die belangrikheid van die leesprogram as die kernsaak in die leksikografiese proses. Dit ishoofsaaklik 'n praktiese artikel wat stategieë vir die ontwikkeling en implementering van 'n

  9. Accessing antiretroviral therapy for children: Caregivers' voices

    Directory of Open Access Journals (Sweden)

    Margaret (Maggie Williams

    2016-10-01

    Full Text Available Despite efforts to scale up access to antiretroviral therapy (ART, particularly at primary health care (PHC facilities, antiretroviral therapy (ART continues to be out of reach formany human immunodeficiency virus (HIV-positive children in sub-Saharan Africa. In resource limited settings decentralisation of ART is required to scale up access to essential medication. Traditionally, paediatric HIV care has been provided in tertiary care facilities which have better human and material resources, but limited accessibility in terms of distance for caregivers of HIV-positive children. The focus of this article is on the experiences of caregivers whilst accessing ART for HIV-positive children at PHC (decentralised care facilities in Nelson Mandela Bay (NMB in the Eastern Cape, South Africa. A qualitative, explorative, descriptive and contextual research design was used. The target population comprised caregivers of HIV-positive children. Data were collected by means of indepth individual interviews, which were thematically analysed. Guba's model was usedto ensure trustworthiness. Barriers to accessing ART at PHC clinics for HIV-positive children included personal issues, negative experiences, lack of support and finance, stigma and discrimination. The researchers recommend standardised programmes be developed and implemented in PHC clinics to assist in providing treatment, care and support for HIV positive children.

  10. Accessing antiretroviral therapy for children: Caregivers' voices

    Directory of Open Access Journals (Sweden)

    Margaret (Maggie Williams

    2016-12-01

    Full Text Available Despite efforts to scale up access to antiretroviral therapy (ART, particularly at primary health care (PHC facilities, antiretroviral therapy (ART continues to be out of reach for many human immunodeficiency virus (HIV-positive children in sub-Saharan Africa. In resource limited settings decentralisation of ART is required to scale up access to essential medication. Traditionally, paediatric HIV care has been provided in tertiary care facilities which have better human and material resources, but limited accessibility in terms of distance for caregivers of HIV-positive children. The focus of this article is on the experiences of caregivers whilst accessing ART for HIV-positive children at PHC (decentralised care facilities in Nelson Mandela Bay (NMB in the Eastern Cape, South Africa. A qualitative, explorative, descriptive and contextual research design was used. The target population comprised caregivers of HIV-positive children. Data were collected by means of in-depth individual interviews, which were thematically analysed. Guba's model was used to ensure trustworthiness. Barriers to accessing ART at PHC clinics for HIV-positive children included personal issues, negative experiences, lack of support and finance, stigma and discrimination. The researchers recommend standardised programmes be developed and implemented in PHC clinics to assist in providing treatment, care and support for HIV-positive children.

  11. Equity in the use of antiretroviral treatment in the public health care system in urban South Africa.

    Science.gov (United States)

    Cleary, Susan; Silal, Sheetal; Birch, Stephen; Carrara, Henri; Pillay-van Wyk, Victoria; Rehle, Thomas; Schneider, Helen

    2011-03-01

    The scaling up of antiretroviral treatment (ART) for HIV-infected adults requires a sizeable investment of resources in the South African public health care system. It is important that these resources are used productively and in ways that reach those in need, irrespective of social status or personal characteristics. In this study we evaluate whether the distribution of ART services in the public system reflects the distribution of need among adults in the urban population. Data from a 2008 national survey were used to estimate the distribution of socioeconomic status (SES) and sex in HIV-positive adults in urban areas. These findings were compared to SES and sex distributions in 635 ART users within 6 urban public ART facilities. Close to 40% of those with HIV are in the lowest SES quintile, while 67% are women. The distributions in users of ART are similar to these distributions in HIV-positive people. Patterns of ART use in study settings correspond to patterns of HIV in the urban population at the national level. This suggests that the South African ART programme is on track to ensure equitable delivery of treatment services in urban settings. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  12. GEOTHERM programme supports geothermal energy world-wide. Geothermal energy, a chance for East African countries; GEOTHERM: BGR foerdert weltweit Nutzung geothermischer Energie. Geothermie - eine Chance fuer ostafrikanische Laender

    Energy Technology Data Exchange (ETDEWEB)

    Kraml, M.; Kessels, K.; Kalberkamp, U.; Ochmann, N.; Stadtler, C. [Bundesanstalt fuer Geowissenschaften und Rohstoffe (BGR), Hannover (Germany)

    2007-02-15

    The high geothermal potential of East Africa, especially of the Eastern Rift, is known for a long time. Since these pioneer studies, geothermal plants have been constructed at three sites in East Africa. Nevertheless, up to now geothermal has been a success story only in Kenya. The steam power plant Olkaria I in Kenya is running reliability since 25 years. Today, the country produces more than 12% of its electricity from geothermal. Now, Eritrea, Djibouti, Uganda, Tanzania and Ethiopia which are also situated along the East African Rift, are planning similar projects. The countries need to develop new energy sources because oil prices have reached a critical level. In the past, hydro power was regarded to be a reliable source of energy, but increased droughts changed the situation. Thus, the african states are searching for alternatives to be able to stabilise their energy supply and to cover the growing energy demand. There is much hope that the success of the Kenyan geothermal power plants will be repeated in the neighbouring countries. The East African countries have joined their forces to give impetus to the use of the regional geothermal resources. On behalf of the Federal Ministry for Economic Cooperation and Development, the Federal Institute for Geosciences and Natural Resources supports the countries in realising their plans as part of the GEOTHERM Programme. Together with further donors (Iceland, France, USA, Global Environment Facility) the path will be paved for geothermal power plants in the above mentioned six East African countries. The following main steps are necessary: - Awareness raising of political decision makers about the advantages of including geothermal into the national power plans - Improvement of knowledge about potentials geothermal sites - Development of a regional equipment pool including the necessary geophysical equipment, laboratories, etc. - Training in geothermal exploration and plant maintenance, to minimise risks of site

  13. An inventory of programmes, capacity and interventions available at ...

    African Journals Online (AJOL)

    to providing management and introduce antiretroviral treatment programmes is welcomed by all, including civil society, employers and local government. This exploratory study was undertaken to establish an inventory of programmes, capacity and interventions available within the. Emfuleni Local Municipality, which is one ...

  14. Benefits of adherence to psychotropic medications on depressive symptoms and antiretroviral medication adherence among men and women living with HIV/AIDS.

    Science.gov (United States)

    Cruess, Dean G; Kalichman, Seth C; Amaral, Christine; Swetzes, Connie; Cherry, Chauncey; Kalichman, Moira O

    2012-04-01

    Psychotropic medications are commonly used for depressive symptoms among people living with HIV/AIDS. We examined the relationships between adherence to psychotropic medications, depressive symptoms, and antiretroviral adherence. We assessed depressive symptoms among 324 people living with HIV/AIDS across a 3-month period (70% men; mean age 45 years; 90% African-American). Psychotropic and antiretroviral adherence was assessed using monthly, unannounced telephone pill counts. Multiple-regression and mediation analyses were utilized to examine associations under investigation. Greater depressive symptoms were associated with lower antiretroviral and psychotropic medication adherence. Greater adherence to psychotropic medications regardless of medication class was positively related to higher antiretroviral adherence. Greater adherence to psychotropic medications also significantly mediated the association between depressive symptoms and antiretroviral adherence. This study demonstrates the benefits of adherence to psychotropic medications on both depressive symptoms and antiretroviral adherence. Future work examining psychotropic medication adherence on disease outcomes in people living with HIV/AIDS is warranted.

  15. Investing in African research training institutions creates sustainable capacity for Africa: the case of the University of the Witwatersrand School of Public Health masters programme in epidemiology and biostatistics

    Science.gov (United States)

    2012-01-01

    Background Improving health in Africa is a high priority internationally. Inadequate research capacity to produce local, relevant research has been identified as a limitation to improved population health. Increasing attention is being paid to the higher education sector in Africa as a method of addressing this; evidence that such investment is having the desired impact is required. A 1998 3-year investment by the Special Programme for Research and Training in Tropical Diseases (TDR) in research training at the School of Public Health, University of the Witwatersrand, South Africa was reviewed to assess its' impact. Methods A descriptive cross-sectional survey of the 70 students registered for the masters programme in epidemiology & biostatistics from 2000-2005 was conducted. Data were collected from self-administered questionnaires. Results Sixty percent (42/70) of students responded. At the time of the survey 19% of respondents changed their country of residence after completion of the masters course, 14% migrated within Africa and 5% migrated out of Africa. Approximately half (47%) were employed as researchers and 38% worked in research institutions. Sixty percent reported research output, and four graduates were pursuing PhD studies. Government subsidy to higher education institutions, investments of the University of the Witwatersrand in successful programmes and ongoing bursaries for students to cover tuition fees were important for sustainability. Conclusions Investing in African institutions to improve research training capacity resulted in the retention of graduates in Africa in research positions and produced research output. Training programmes can be sustained when national governments invest in higher education and where that funding is judiciously applied. Challenges remain if funding for students bursaries is not available. PMID:22475629

  16. Selecting students for a South African mathematics and science foundation programme: effectiveness and fairness of school-leaving examinations and aptitude tests.

    NARCIS (Netherlands)

    van der Flier, H.; Thijs, G.D.; Zaaiman, H.

    2003-01-01

    The identification of students with the potential to succeed in mathematics- and science-based study despite previous educational disadvantage is a critical issue currently facing many South African higher education institutions. The possible use of school-leaving examination (Matric) results and/or

  17. What happens to patients on antiretroviral therapy who transfer out to another facility?

    Directory of Open Access Journals (Sweden)

    Joseph Kwong-Leung Yu

    Full Text Available BACKGROUND: Long term retention of patients on antiretroviral therapy (ART in Africa's rapidly expanding programmes is said to be 60% at 2 years. Many reports from African ART programmes make little mention of patients who are transferred out to another facility, yet Malawi's national figures show a transfer out of 9%. There is no published information about what happens to patients who transfer-out, but this is important because if they transfer-in and stay alive in these other facilities then national retention figures will be better than previously reported. METHODOLOGY/PRINCIPAL FINDINGS: Of all patients started on ART over a three year period in Mzuzu Central Hospital, North Region, Malawi, those who transferred out were identified from the ART register and master cards. Clinic staff attempted to trace these patients to determine whether they had transferred in to a new ART facility and their outcome status. There were 805 patients (19% of the total cohort who transferred out, of whom 737 (92% were traced as having transferred in to a new ART facility, with a median time of 1.3 months between transferring-out and transferring-in. Survival probability was superior and deaths were lower in the transfer-out patients compared with those who did not transfer. CONCLUSION/SIGNIFICANCE: In Mzuzu Central Hospital, patients who transfer-out constitute a large proportion of patients not retained on ART at their original clinic of registration. Good documentation of transfer-outs and transfer-ins are needed to keep track of national outcomes. Furthermore, the current practice of regarding transfer-outs as being double counted in national cohorts and subtracting this number from the total national registrations to get the number of new patients started on ART is correct.

  18. Bioanalysis, metabolism & clinical pharmacology of antiretroviral drugs

    NARCIS (Netherlands)

    Heine, R. ter

    2009-01-01

    The aims of all studies described in this thesis were to develop new bioanalytical and more patient friendly methods for studying the clinical pharmacology of antiretroviral drugs and to ultimately improve antiretroviral treatment.

  19. Developing Programmes to Promote Participation in Sport among Adolescents with Disabilities: Perceptions Expressed by a Group of South African Adolescents with Cerebral Palsy

    Science.gov (United States)

    Bantjes, Jason; Swartz, Leslie; Conchar, Lauren; Derman, Wayne

    2015-01-01

    Adolescents with disabilities in developing countries frequently have limited access to sporting opportunities and comparatively little is known of their lived experiences and preferences. We set out to understand what a group of adolescents with cerebral palsy (CP) living in South Africa perceive to be important components of programmes developed…

  20. Population uptake of antiretroviral treatment through primary care in rural South Africa

    Directory of Open Access Journals (Sweden)

    Bärnighausen Till W

    2010-09-01

    Full Text Available Abstract Background KwaZulu-Natal is the South African province worst affected by HIV and the focus of early modeling studies investigating strategies of antiretroviral treatment (ART delivery. The reality of antiretroviral roll-out through primary care has differed from that anticipated and real world data are needed to inform the planning of further scaling up of services. We investigated the factors associated with uptake of antiretroviral treatment through a primary healthcare system in rural South Africa. Methods Detailed demographic, HIV surveillance and geographic information system (GIS data were used to estimate the proportion of HIV positive adults accessing antiretroviral treatment within northern KwaZulu-Natal, South Africa in the period from initiation of antiretroviral roll-out until the end of 2008. Demographic, spatial and socioeconomic factors influencing the likelihood of individuals accessing antiretroviral treatment were explored using multivariable analysis. Results Mean uptake of ART among HIV positive resident adults was 21.0% (95%CI 20.1-21.9. Uptake among HIV positive men (19.2% was slightly lower than women (21.8%, P = 0.011. An individual's likelihood of accessing ART was not associated with level of education, household assets or urban/rural locale. ART uptake was strongly negatively associated with distance from the nearest primary healthcare facility (aOR = 0.728 per square-root transformed km, 95%CI 0.658-0.963, P = 0.002. Conclusions Despite concerns about the equitable nature of antiretroviral treatment rollout, we find very few differences in ART uptake across a range of socio-demographic variables in a rural South African population. However, even when socio-demographic factors were taken into account, individuals living further away from primary healthcare clinics were still significantly less likely to be accessing ART

  1. WEST AFRICAN JOURNAL OF MEDICINE

    African Journals Online (AJOL)

    user1

    African Programme for Onchocerciasis Control: Ophthalmological Findings in Bushenyi, Uganda ... In a cross-sectional study, 367 persons aged 10 years or older from seven selected .... down posture, and evidence of acute or torpid uveitis.

  2. Evolution of HIV and AIDS Programmes in an African Institution of Higher Learning: The Case of the Copperbelt University in Zambia

    Science.gov (United States)

    Sanjobo, Nawa; Lukwesa, Matilda; Kaziya, Charity; Tepa, Cornwell; Puta, Bernard

    2016-01-01

    Background: Universities present the foundation for socio-economic and political development. Without structures and processes to fight HIV, there is no prospect of enhancing treatment, prevention, care and support services. Copperbelt University HIV and AIDS response was initiated in 2003 with the aim of building capacity of students and employees in HIV and AIDS. Objectives: The main objective of this paper is to demonstrate how the CBU HIV response has evolved over time and provide a timeline of important milestones in the development process. Method: Peer educators and counsellors conduct sensitization campaigns through one on one discussion, workshops, and drama performances, distribution of Information, Education and Communication (IEC) materials. Results: HIV Programme has been set up with players from policy, programme and community levels. Strategic processes, collaborations, funding, medical insurance schemes, prevention, treatment, care and support services, training of peer educators and counsellors have been established. Conclusion: Copperbelt University HIV initiative has demonstrated potential to reduce new infections in the university, and is currently expanding her programme to encompass wellness and also spearhead the integration of HIV in the university curriculum. PMID:27347269

  3. Evolution of HIV and AIDS Programmes in an African Institution of Higher Learning: The Case of the Copperbelt University in Zambia.

    Science.gov (United States)

    Sanjobo, Nawa; Lukwesa, Matilda; Kaziya, Charity; Tepa, Cornwell; Puta, Bernard

    2016-01-01

    Universities present the foundation for socio-economic and political development. Without structures and processes to fight HIV, there is no prospect of enhancing treatment, prevention, care and support services. Copperbelt University HIV and AIDS response was initiated in 2003 with the aim of building capacity of students and employees in HIV and AIDS. The main objective of this paper is to demonstrate how the CBU HIV response has evolved over time and provide a timeline of important milestones in the development process. Peer educators and counsellors conduct sensitization campaigns through one on one discussion, workshops, and drama performances, distribution of Information, Education and Communication (IEC) materials. HIV Programme has been set up with players from policy, programme and community levels. Strategic processes, collaborations, funding, medical insurance schemes, prevention, treatment, care and support services, training of peer educators and counsellors have been established. Copperbelt University HIV initiative has demonstrated potential to reduce new infections in the university, and is currently expanding her programme to encompass wellness and also spearhead the integration of HIV in the university curriculum.

  4. When to start antiretroviral therapy

    DEFF Research Database (Denmark)

    Lundgren, Jens D; Babiker, Abdel G; Gordin, Fred M

    2013-01-01

    Strategies for use of antiretroviral therapy (ART) have traditionally focused on providing treatment to persons who stand to benefit immediately from initiating the therapy. There is global consensus that any HIV+ person with CD4 counts less than 350 cells/μl should initiate ART. However, it rema...

  5. Twelve-year mortality in adults initiating antiretroviral therapy in South Africa.

    Science.gov (United States)

    Cornell, Morna; Johnson, Leigh F; Wood, Robin; Tanser, Frank; Fox, Matthew P; Prozesky, Hans; Schomaker, Michael; Egger, Matthias; Davies, Mary-Ann; Boulle, Andrew

    2017-09-25

    South Africa has the largest number of individuals living with HIV and the largest antiretroviral therapy (ART) programme worldwide. In September 2016, ART eligibility was extended to all 7.1 million HIV-positive South Africans. To ensure that further expansion of services does not compromise quality of care, long-term outcomes must be monitored. Few studies have reported long-term mortality in resource-constrained settings, where mortality ascertainment is challenging. Combining site records with data linked to the national vital registration system, sites in the International Epidemiology Databases to Evaluate AIDS Southern Africa collaboration can identify >95% of deaths in patients with civil identification numbers (IDs). This study used linked data to explore long-term mortality and viral suppression among adults starting ART in South Africa. The study was a cohort analysis of routine data on adults with IDs starting ART 2004-2015 in five large ART cohorts. Mortality was estimated overall and by gender using the Kaplan-Meier estimator and Cox's proportional hazards regression. Standardized mortality ratios (SMRs) were calculated by dividing observed numbers of deaths by numbers expected if patients had been HIV-negative. Viral suppression in patients with viral loads (VLs) in their last year of follow-up was the secondary outcome. Among 72,812 adults followed for 350,376 person years (pyrs), the crude mortality rate was 3.08 (95% CI 3.02-3.14)/100 pyrs. Patients were predominantly female (67%) and the percentage of men initiating ART did not increase. Cumulative mortality 12 years after ART initiation was 23.9% (33.4% male and 19.4% female). Mortality peaked in patients enrolling in 2007-2009 and was higher in men than women at all durations. Observed mortality rates were higher than HIV-negative mortality, decreasing with duration. By 48 months, observed mortality was close to that in the HIV-negative population, and SMRs were similar for all baseline CD4

  6. Evaluation of a school-based intervention programme for South ...

    African Journals Online (AJOL)

    Objective: Parental divorce affects approximately 30 000 South African children annually. This pilot study aimed to evaluate the effectiveness of the Children of Divorce Intervention Programme (CODIP) at two South African schools. CODIP is a preventively oriented group programme which was developed to foster resilience ...

  7. Simplified clinical algorithm for identifying patients eligible for immediate initiation of antiretroviral therapy for HIV (SLATE): protocol for a randomised evaluation

    OpenAIRE

    Rosen, Sydney; Fox, Matthew P; Larson, Bruce A; Brennan, Alana T; Maskew, Mhairi; Tsikhutsu, Isaac; Bii, Margaret; Ehrenkranz, Peter D; Venter, WD Francois

    2017-01-01

    Introduction African countries are rapidly adopting guidelines to offer antiretroviral therapy (ART) to all HIV-infected individuals, regardless of CD4 count. For this policy of ‘treat all’ to succeed, millions of new patients must be initiated on ART as efficiently as possible. Studies have documented high losses of treatment-eligible patients from care before they receive their first dose of antiretrovirals (ARVs), due in part to a cumbersome, resource-intensive process for treatment initia...

  8. Clinical mentorship of nurse initiated antiretroviral therapy in Khayelitsha, South Africa: a quality of care assessment.

    Directory of Open Access Journals (Sweden)

    Ann Green

    Full Text Available INTRODUCTION: To combat the AIDS epidemic and increase HIV treatment access, the South African government implemented a nurse-based, doctor-supported model of care that decentralizes administration of antiretroviral treatment (ART for HIV positive patients through nurse initiated and managed ART. Médecins Sans Frontières (MSF implemented a mentorship programme to ensure successful task-shifting, subsequently assessing the quality of clinical care provided by nurses. METHODS: A before-after cross-sectional study was conducted on nurses completing the mentorship programme in Khayelitsha, South Africa, from February 2011-September 2012. Routine clinical data from 229 patient folders and 21 self-assessment questionnaires was collected to determine the number of patients initiated on ART by nurses; quality of ART management before-after mentorship; patient characteristics for doctor and nurse ART initiations; and nurse self-assessments after mentorship. RESULTS: Twenty one nurses were authorized by one nurse mentor with one part-time medical officer's support, resulting in nurses initiating 77% of ART eligible patients. Improvements in ART management were found for drawing required bloods (91% vs 99%, p = 0.03, assessing adherence (50% vs 78%, p<0.001 and WHO staging (63% vs 91%, p<0.001. Nurse ART initiation indicators were successfully completed at 95-100% for 11 of 16 indicators: clinical presentation; patient weight; baseline blood work (CD4, creatinine, haemoglobin; STI screening; WHO stage, correlating medical history; medications prescribed appropriately; ART start date; and documented return date. Doctors initiated more patients with TB/HIV co-infection and WHO Stage 3 and 4 disease than nurses. Nurse confidence improved for managing HIV-infected children and pregnant women, blood result interpretation and long-term side effects. CONCLUSIONS: Implementation of a clinical mentorship programme in Khayelitsha led to nurse initiation of a

  9. Students' Perception of West African Agricultural Productivity ...

    African Journals Online (AJOL)

    More than half (55.6%) of them were favourably disposed to the programme while respondents' farming background (r=3.740, p ≤ 0.05) was significantly related to their perception of the programme. It was recommended that West African Agricultural Productivity Programme officials should focus more attention on ...

  10. Scaling-up antiretroviral therapy in Malawi.

    Science.gov (United States)

    Jahn, Andreas; Harries, Anthony D; Schouten, Erik J; Libamba, Edwin; Ford, Nathan; Maher, Dermot; Chimbwandira, Frank

    2016-10-01

    In Malawi, health-system constraints meant that only a fraction of people infected with human immunodeficiency virus (HIV) and in immediate need of antiretroviral treatment (ART) received treatment. In 2004, the Malawian Ministry of Health launched plans to scale-up ART nationwide, adhering to the principle of equity to ensure fair geographical access to therapy. A public health approach was used with standardized training and treatment and regular supervision and monitoring of the programme. Before the scale-up, an estimated 930 000 people in Malawi were HIV-infected, with 170 000 in immediate need of ART. About 3000 patients were on ART in nine clinics. By December 2015, cumulatively 872 567 patients had been started on ART from 716 clinics, following national treatment protocols and using the standard monitoring system. Strong national leadership allowed the ministry of health to implement a uniform system for scaling-up ART and provided benchmarks for implementation on the ground. New systems of training staff and accrediting health facilities enabled task-sharing and decentralization to peripheral health centres and a standardized approach to starting and monitoring ART. A system of quarterly supervision and monitoring, into which operational research was embedded, ensured stocks of drug supplies at facilities and adherence to national treatment guidelines.

  11. The use of immunoassay method to improve the diagnosis of African trypanosomosis and its application to monitor disease control programmes: A summary

    International Nuclear Information System (INIS)

    Dwinger, R.H.

    1997-01-01

    The traditional diagnostic techniques for detecting trypanosomes in animals have been the microscopic examination of wet blood films or of thin and thick bloodsmears following fixation and Giemsa staining. The development of concentration methods such as the microhaematocrit centrifuge technique (MHCT) or the buffy coat technique (BCT) using a phase contrast/darkground microscope has improved diagnosis considerably. All these parasitological techniques are very specific (a positive result indicates the true presence of a trypanosome and few false positives are encountered), but generally lack sensitivity. However, in chronically infected animals low parasitaemias often occur, which could not be detected by the most sensitive technique, the BCT method. In 1971 the enzyme-linked immunosorbent assay (ELISA) was developed and various applications of the technique soon proved to be highly sensitive and specific as well as reliable and flexible methods for screening large number of samples. The technique was modified for the detection of trypanosomal antigens and applied for the diagnosis of T. vivax, T. congolense and T. brucei infections in cattle. In experimental infections the test proved to be a sensitive technique for the diagnosis of animal trypanosomosis. Moreover, indications were that the test was well suited for application in developing countries. Consequently, the ELISA was transferred to the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture for distribution to various African research institutes for extensive validation under tropical conditions. 17 refs, 2 tabs

  12. The use of immunoassay method to improve the diagnosis of African trypanosomosis and its application to monitor disease control programmes: A summary

    Energy Technology Data Exchange (ETDEWEB)

    Dwinger, R H [Joint FAO/IAEA Div. of Nuclear Techniques in Food and Agriculture, Vienna (Austria). Animal Production and Health Section

    1997-02-01

    The traditional diagnostic techniques for detecting trypanosomes in animals have been the microscopic examination of wet blood films or of thin and thick bloodsmears following fixation and Giemsa staining. The development of concentration methods such as the microhaematocrit centrifuge technique (MHCT) or the buffy coat technique (BCT) using a phase contrast/darkground microscope has improved diagnosis considerably. All these parasitological techniques are very specific (a positive result indicates the true presence of a trypanosome and few false positives are encountered), but generally lack sensitivity. However, in chronically infected animals low parasitaemias often occur, which could not be detected by the most sensitive technique, the BCT method. In 1971 the enzyme-linked immunosorbent assay (ELISA) was developed and various applications of the technique soon proved to be highly sensitive and specific as well as reliable and flexible methods for screening large number of samples. The technique was modified for the detection of trypanosomal antigens and applied for the diagnosis of T. vivax, T. congolense and T. brucei infections in cattle. In experimental infections the test proved to be a sensitive technique for the diagnosis of animal trypanosomosis. Moreover, indications were that the test was well suited for application in developing countries. Consequently, the ELISA was transferred to the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture for distribution to various African research institutes for extensive validation under tropical conditions. 17 refs, 2 tabs.

  13. Convergent ethical issues in HIV/AIDS, tuberculosis and malaria vaccine trials in Africa: Report from the WHO/UNAIDS African AIDS Vaccine Programme's Ethics, Law and Human Rights Collaborating Centre consultation, 10-11 February 2009, Durban, South Africa

    Directory of Open Access Journals (Sweden)

    Essack Zaynab

    2010-03-01

    Full Text Available Abstract Background Africa continues to bear a disproportionate share of the global HIV/AIDS, tuberculosis (TB and malaria burden. The development and distribution of safe, effective and affordable vaccines is critical to reduce these epidemics. However, conducting HIV/AIDS, TB, and/or malaria vaccine trials simultaneously in developing countries, or in populations affected by all three diseases, is likely to result in numerous ethical challenges. Methods In order to explore convergent ethical issues in HIV/AIDS, TB and malaria vaccine trials in Africa, the Ethics, Law and Human Rights Collaborating Centre of the WHO/UNAIDS African AIDS Vaccine Programme hosted a consultation on the Convergent Ethical Issues in HIV/AIDS, TB and Malaria Vaccine Trials in Africa in Durban, South Africa on the 10-11 February 2009. Results Key cross cutting ethical issues were prioritized during the consultation as community engagement; ancillary care obligations; care and treatment; informed consent; and resource sharing. Conclusion The consultation revealed that while there have been few attempts to find convergence on ethical issues between HIV/AIDS, TB and malaria vaccine trial fields to date, there is much common ground and scope for convergence work between stakeholders in the three fields.

  14. Convergent ethical issues in HIV/AIDS, tuberculosis and malaria vaccine trials in Africa: Report from the WHO/UNAIDS African AIDS Vaccine Programme's Ethics, Law and Human Rights Collaborating Centre consultation, 10-11 February 2009, Durban, South Africa.

    Science.gov (United States)

    Mamotte, Nicole; Wassenaar, Douglas; Koen, Jennifer; Essack, Zaynab

    2010-03-09

    Africa continues to bear a disproportionate share of the global HIV/AIDS, tuberculosis (TB) and malaria burden. The development and distribution of safe, effective and affordable vaccines is critical to reduce these epidemics. However, conducting HIV/AIDS, TB, and/or malaria vaccine trials simultaneously in developing countries, or in populations affected by all three diseases, is likely to result in numerous ethical challenges. In order to explore convergent ethical issues in HIV/AIDS, TB and malaria vaccine trials in Africa, the Ethics, Law and Human Rights Collaborating Centre of the WHO/UNAIDS African AIDS Vaccine Programme hosted a consultation on the Convergent Ethical Issues in HIV/AIDS, TB and Malaria Vaccine Trials in Africa in Durban, South Africa on the 10-11 February 2009. Key cross cutting ethical issues were prioritized during the consultation as community engagement; ancillary care obligations; care and treatment; informed consent; and resource sharing. The consultation revealed that while there have been few attempts to find convergence on ethical issues between HIV/AIDS, TB and malaria vaccine trial fields to date, there is much common ground and scope for convergence work between stakeholders in the three fields.

  15. Understanding the Influence of Socioeconomic Environment on Paediatric Antiretroviral Treatment Coverage: Towards Closing Treatment Gaps in Sub-Saharan Africa.

    Science.gov (United States)

    Adeyinka, Daniel A; Evans, Meirion R; Ozigbu, Chamberline E; van Woerden, Hugo; Adeyinka, Esther F; Oladimeji, Olanrewaju; Aimakhu, Chris; Odoh, Deborah; Chamla, Dick

    2017-03-01

    Many sub-Saharan African countries have massively scaled-up their antiretroviral treatment (ART) programmes, but many national programmes still show large gaps in paediatric ART coverage making it challenging to reduce AIDS-related deaths among HIV-infected children. We sought to identify enablers of paediatric ART coverage in Africa by examining the relationship between paediatric ART coverage and socioeconomic parameters measured at the population level so as to accelerate reaching the 90-90-90 targets. Ecological analyses of paediatric ART coverage and socioeconomic indicators were performed. The data were obtained from the United Nations agencies and Forum for a new World Governance reports for the 21 Global Plan priority countries in Africa with highest burden of mother-to-child HIV transmission. Spearman's correlation and median regression were utilized to explore possible enablers of paediatric ART coverage. Factors associated with paediatric ART coverage included adult literacy (r=0.6, p=0.004), effective governance (r=0.6, p=0.003), virology testing by 2 months of age (r=0.9, p=0.001), density of healthcare workers per 10,000 population (r=0.6, p=0.007), and government expenditure on health (r=0.5, p=0.046). The paediatric ART coverage had a significant inverse relationship with the national mother-to-child transmission (MTCT) rate (r=-0.9, pgender inequality index (r=-0.6, p=0.006). Paediatric ART coverage had no relationship with poverty and HIV stigma indices. Low paediatric ART coverage continues to hamper progress towards eliminating AIDS-related deaths in HIV-infected children. Achieving this requires full commitment to a broad range of socioeconomic development goals. Copyright© by the National Institute of Public Health, Prague 2017

  16. Good treatment outcomes among foreigners receiving antiretroviral therapy in Johannesburg, South Africa.

    Science.gov (United States)

    McCarthy, K; Chersich, M F; Vearey, J; Meyer-Rath, G; Jaffer, A; Simpwalo, S; Venter, W D F

    2009-12-01

    Foreigners, including displaced persons, often have limited health-care access, especially to HIV services. Outcomes of antiretroviral therapy (ART) in South Africans and foreigners were compared at a Johannesburg non-governmental clinic. Records were reviewed of 1297 adults enrolled between April 2004 and March 2007 (568 self-identified foreigners, 431 South Africans citizens and 298 with unknown origin). Compared with citizens, foreigners had fewer hospital admissions (39%, 90/303 versus 51%, 126/244; P fail ART than citizens (95% CI = 0.23-0.87). These findings support United Nations High Commissioner for Refugees recommendations that ART should not be withheld from displaced persons.

  17. Global trends in antiretroviral resistance in treatment-naive individuals with HIV after rollout of antiretroviral treatment in resource-limited settings: a global collaborative study and meta-regression analysis

    NARCIS (Netherlands)

    Gupta, Ravindra K.; Jordan, Michael R.; Sultan, Binta J.; Hill, Andrew; Davis, Daniel H. J.; Gregson, John; Sawyer, Anthony W.; Hamers, Raph L.; Ndembi, Nicaise; Pillay, Deenan; Bertagnolio, Silvia

    2012-01-01

    Background The emergence and spread of high levels of HIV-1 drug resistance in resource-limited settings where combination antiretroviral treatment has been scaled up could compromise the effectiveness of national HIV treatment programmes. We aimed to estimate changes in the prevalence of HIV-1 drug

  18. Male students’ perceptions about gender imbalances in a speech-language pathology and audiology training programme of a South African institution of higher education

    Directory of Open Access Journals (Sweden)

    Sandra du Plessis

    2018-05-01

    Full Text Available Background: The professions of speech-language pathology and audiology (SLPA are characterised by occupational gender segregation. Reasons given by men are a lack of awareness of SLPA; a perception of poor salaries; a perception of poor working conditions; a stereotype that the profession is a female occupation; and a perception that working with children is feminine.   Objectives: The aim of this study was to describe the perceptions of male students in a specific SLPA training programme regarding gender imbalances. The objectives were to describe the influences of gender on the career orientation of students, the factors shaping students’ career choices and the experiences of students during their undergraduate training.   Method: This study followed a quantitative descriptive survey design. Thirty-one conveniently sampled male SLPA students, across different years of study, completed a self-administered questionnaire.   Results: Participants indicated that they did not believe in the gendered nature of occupations and that SLPA are not ‘female only’ professions. They (65% recorded that they considered salary and career prospects for choosing a career, and 74% specified that they chose SLPA because of a desire to help people. The perception of male students regarding their training appears to be positive as participants are comfortable with the clinical (71% and learning (77% activities. However, barriers were reported and some lecture information may be more obvious or applicable to female students. A need was identified to address the issue of working alone with paediatric clients and pertains to the societal awareness regarding sexual harassment of children, which may impact spontaneity in engagements.   Conclusion: The recruitment of male students should be prioritised to better reflect the client population served by the professions. Recommendations include career counselling in rural schools, recruitment campaigns to

  19. The elimination of the onchocerciasis vector from the island of Bioko as a result of larviciding by the WHO African Programme for Onchocerciasis Control.

    Science.gov (United States)

    Traoré, S; Wilson, M D; Sima, A; Barro, T; Diallo, A; Aké, A; Coulibaly, S; Cheke, R A; Meyer, R R F; Mas, J; McCall, P J; Post, R J; Zouré, H; Noma, M; Yaméogo, L; Sékétéli, A V; Amazigo, U V

    2009-09-01

    The island of Bioko is part of the Republic of Equatorial Guinea and is the only island in the World to have endemic onchocerciasis. The disease is hyperendemic and shows a forest-type epidemiology with low levels of blindness and high levels of skin disease, and the whole population of 68,000 is estimated to be at risk. Control of onchocerciasis began in 1990 using ivermectin and this yielded significant clinical benefits but transmission was not interrupted. Feasibility and preparatory studies carried out between 1995 and 2002 confirmed the probable isolation of the vector on the island, the high vectorial efficiency of the Bioko form of Simulium yahense, the seasonality of river flow, blackfly breeding and biting densities, and the distribution of the vector breeding sites. It was proposed that larviciding should be carried out from January to April, when most of the island's rivers were dry or too low to support Simulium damnosum s.l., and that most rivers would not need to be treated above 500 m altitude because they were too small to support the breeding of S. damnosum s.l. Larviciding (with temephos) would need to be carried out by helicopter (because of problems of access by land), supplemented by ground-based delivery. Insecticide susceptibility trials showed that the Bioko form was highly susceptible to temephos, and insecticide carry was tested in the rivers by assessing the length of river in which S. damnosum s.l. larvae were killed below a temephos dosing point. Regular fly catching points were established in 1999 to provide pre-control biting densities, and to act as monitoring points for control efforts. An environmental impact assessment concluded that the proposed control programme could be expected to do little damage, and a large-scale larviciding trial using ground-based applications of temephos (Abate 20EC) throughout the northern (accessible) part of the island was carried out for five weeks from 12 February 2001. Following this, a first

  20. Combined antiretroviral and anti- tuberculosis drug resistance ...

    African Journals Online (AJOL)

    these epidemics, many challenges remain.[3] Antiretroviral and anti-TB drug resistance pose considerable threats to the control of these epidemics.[4,5]. The breakdown in HIV/TB control within prisons is another emerging threat.[6,7] We describe one of the first reports of combined antiretroviral and anti-TB drug resistance ...

  1. Preliminary investigation of adherence to antiretroviral therapy ...

    African Journals Online (AJOL)

    Treatment of HIV with highly active antiretroviral therapy (HAART) has resulted in declining morbidity and mortality rates from HIV-associated diseases, but concerns regarding access and adherence are growing. To determine the adherence level and the reasons for non-adhering to antiretroviral therapy (ART) among ...

  2. NEW DRUGS NEW TARGETS AND NOVEL ANTIRETROVIRALS

    African Journals Online (AJOL)

    2005-11-02

    Nov 2, 2005 ... Highly active antiretroviral therapy (HAART) has to date been based on use of a triple combination of drugs chosen from three classes of antiretrovirals (ARVs), nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs) and protease inhibitors (PIs).

  3. Nurse led, primary care based antiretroviral treatment versus hospital care: a controlled prospective study in Swaziland

    Directory of Open Access Journals (Sweden)

    Bailey Kerry A

    2010-08-01

    Full Text Available Abstract Background Antiretroviral treatment services delivered in hospital settings in Africa increasingly lack capacity to meet demand and are difficult to access by patients. We evaluate the effectiveness of nurse led primary care based antiretroviral treatment by comparison with usual hospital care in a typical rural sub Saharan African setting. Methods We undertook a prospective, controlled evaluation of planned service change in Lubombo, Swaziland. Clinically stable adults with a CD4 count > 100 and on antiretroviral treatment for at least four weeks at the district hospital were assigned to either nurse led primary care based antiretroviral treatment care or usual hospital care. Assignment depended on the location of the nearest primary care clinic. The main outcome measures were clinic attendance and patient experience. Results Those receiving primary care based treatment were less likely to miss an appointment compared with those continuing to receive hospital care (RR 0·37, p p = 0·001. Those receiving primary care based, nurse led care were more likely to be satisfied in the ability of staff to manage their condition (RR 1·23, p = 0·003. There was no significant difference in loss to follow-up or other health related outcomes in modified intention to treat analysis. Multilevel, multivariable regression identified little inter-cluster variation. Conclusions Clinic attendance and patient experience are better with nurse led primary care based antiretroviral treatment care than with hospital care; health related outcomes appear equally good. This evidence supports efforts of the WHO to scale-up universal access to antiretroviral treatment in sub Saharan Africa.

  4. Starting infants on antiretroviral therapy | Clayden | Southern African ...

    African Journals Online (AJOL)

    5 years or more, that most start at a late stage of the disease, and that mortality in the first few months of treatment remains high.5,6 A recent study shows that starting treatment in early infancy can be lifesaving, and this has informed revisions in World Health Organization (WHO) guidelines7,8 (see WHO 'Dear Health Care ...

  5. Concurrent use of Antiretroviral and African traditional medicines ...

    African Journals Online (AJOL)

    drug in the human body affecting the entire pharmaco- kinetic profile .... combining all independent and controlling factors, for predicting ..... •The use of population pharmacokinetic approach in or- .... Performance of immunologic responses in.

  6. Outcomes of the South African National Antiretroviral Treatment ...

    African Journals Online (AJOL)

    The median (interquartile range) age of 6 078 children with 9 368 child-years of follow-up was 43 (15 - 83) months, with 29% being <18 months. Most were severely ill at ART initiation. More than 75% of children were appropriately monitored at 6-monthly intervals with viral load suppression (<400 copies/ml) being 80% or ...

  7. Students' Perception of West African Agricultural Productivity ...

    African Journals Online (AJOL)

    E M IGBOKWE

    recommended that West African Agricultural Productivity Programme officials ... The agricultural sector in the 1960s provided the main source of employment, .... their fathers and mothers' occupation were majorly trading (43.3%) and trading.

  8. Crispv programme

    International Nuclear Information System (INIS)

    Marinkovicj, N.

    CRISPV (Criticality and Spectrum code) is a multigroup neutron spectrum code for homogeneous reactor cores and is actually a somewhat modified version of the original CRISP programme. It is a combination of DATAPREP-II and BIGG-II programmes. It is assumed that the reactor cell is a cylindrical fuel rod in the light or heavy water moderator. DATEPREP-II CODE forms the multigroup data for homogeneous reactor and prepares the input parameters for the BIGG-II code. It has its own nuclear data library on a separate tape in binary mode. BIGG-II code is a multigroup neutron spectrum and criticality code for a homogenized medium. It has as well its own separate data library. In the CRISPV programme the overlay structure enables automatic handling of data calculated in the DATAPREP-II programme and needed in the BIGG-II core. Both programmes are written in FORTRAN for CDC 3600. Using the programme is very efficient and simple

  9. Leadership in the African context

    Directory of Open Access Journals (Sweden)

    M. Masango

    2002-08-01

    Full Text Available The Western world has always viewed the African continent as plagued by corruption; dictatorship; military coups; rebellious leaders; greediness; misuse of power; and incompetent, politically unstable leaders - in effect, suspicious leaders who undermine their own democracies. This paper analyzes African leadership and its impact by concentrating on three historical eras, namely; the African Religious era; the Christian era, and the era of Globalization. These affected African leadership. In addition, many brilliant minds left the continent in search of greener pastures. A review of these three eras will help us understand how leadership shifted from African values into Western concepts. The role of missionaries lead African people to live with both an African and a Western concept of life. In spite of the above problems, our past leaders did their best in addressing the difficulties they faced during the three eras. African concepts of leadership were often regarded as barbaric and uncultured. Structures were evaluated by Western standards. Due to globalisation, African leaders, through programmes like NEPAD, are going back to basics, drawing on African concepts of unity among its leadership. Effectiveness or life-giving leadership is emerging and empowering villagers/communities in the continent. This type of leadership is innovative and has brought new hope for the continent.

  10. Examining the production costs of antiretroviral drugs.

    Science.gov (United States)

    Pinheiro, Eloan; Vasan, Ashwin; Kim, Jim Yong; Lee, Evan; Guimier, Jean Marc; Perriens, Joseph

    2006-08-22

    To present direct manufacturing costs and price calculations of individual antiretroviral drugs, enabling those responsible for their procurement to have a better understanding of the cost structure of their production, and to indicate the prices at which these antiretroviral drugs could be offered in developing country markets. Direct manufacturing costs and factory prices for selected first and second-line antiretroviral drugs were calculated based on cost structure data from a state-owned company in Brazil. Prices for the active pharmaceutical ingredients (API) were taken from a recent survey by the World Health Organization (WHO). The calculated prices for antiretroviral drugs are compared with quoted prices offered by privately-owned, for-profit manufacturers. The API represents the largest component of direct manufacturing costs (55-99%), while other inputs, such as salaries, equipment costs, and scale of production, have a minimal impact. The calculated prices for most of the antiretroviral drugs studied fall within the lower quartile of the range of quoted prices in developing country markets. The exceptions are those drugs, primarily for second-line therapy, for which the API is either under patent, in short supply, or in limited use in developing countries (e.g. abacavir, lopinavir/ritonavir, nelfinavir, saquinavir). The availability of data on the cost of antiretroviral drug production and calculation of factory prices under a sustainable business model provide benchmarks that bulk purchasers of antiretroviral drugs could use to negotiate lower prices. While truly significant price decreases for antiretroviral drugs will depend largely on the future evolution of API prices, the present study demonstrates that for several antiretroviral drugs price reduction is currently possible. Whether or not these reductions materialize will depend on the magnitude of indirect cost and profit added by each supplier over the direct production costs. The ability to

  11. Nonadherence as 4-day Antiretroviral Therapy Interruptions: Do Depression and Race/Ethnicity Matter as Much in the Modern Antiretroviral Therapy Era?

    Science.gov (United States)

    Sauceda, John A; Johnson, Mallory O; Saberi, Parya

    2016-11-01

    HIV + White, Latino, and African Americans (N = 1131) completed a survey advertised on social media to re-examine the effect of depressive symptoms (via the Patient Health Questionnaire; PHQ-9) and race/ethnicity on antiretroviral therapy nonadherence (defined as past 3-month, 4-day treatment interruption). An adjusted logistic regression showed a 15 % increase in odds for a treatment interruption per 1-unit increase on the PHQ-9. The effect of depressive symptoms on nonadherence was greater for Latinos (OR = 1.80, p depressive symptomatology.

  12. ORIGINAL ARTICLES Antiretroviral treatment for children

    African Journals Online (AJOL)

    Kaplan-Meier survival estimate for 407 children at 1 year was. 84% (95% ... highly active antiretroviral therapy (HAART) to 3 million people living with HIV I AIDS in ... 5 Furthermore, improvements in growth and body composition parameters,.

  13. Characteristics of HIV-2 and HIV-1/HIV-2 Dually Seropositive Adults in West Africa Presenting for Care and Antiretroviral Therapy

    DEFF Research Database (Denmark)

    Ekouevi, Didier K; Balestre, Eric; Coffie, Patrick A

    2013-01-01

    HIV-2 is endemic in West Africa. There is a lack of evidence-based guidelines on the diagnosis, management and antiretroviral therapy (ART) for HIV-2 or HIV-1/HIV-2 dual infections. Because of these issues, we designed a West African collaborative cohort for HIV-2 infection within the framework o...... of the International epidemiological Databases to Evaluate AIDS (IeDEA)....

  14. The predictive value of current haemoglobin levels for incident tuberculosis and/or mortality during long-term antiretroviral therapy in South Africa: a cohort study

    NARCIS (Netherlands)

    Kerkhoff, Andrew D.; Wood, Robin; Cobelens, Frank G.; Gupta-Wright, Ankur; Bekker, Linda-Gail; Lawn, Stephen D.

    2015-01-01

    Low haemoglobin concentrations may be predictive of incident tuberculosis (TB) and death in HIV-infected patients receiving antiretroviral therapy (ART), but data are limited and inconsistent. We examined these relationships retrospectively in a long-term South African ART cohort with multiple

  15. Realities of a foundation programme implemented as a vehicle to ...

    African Journals Online (AJOL)

    Realities of a foundation programme implemented as a vehicle to align learners cognitively for ... South African Journal of Higher Education ... indeed widened while the added curriculum had a positive impact on the learners' cognitive skills.

  16. African Programme for Onchocerciasis Control: Ophthalmological ...

    African Journals Online (AJOL)

    Methods: The study site was in Bushenyi, Western Uganda. In a cross-sectional study, 367 persons aged 10 years or older from seven selected villages received eye examination using a standardised protocol and Wu-Jones Motion Sensitivity Testing (MSST). Besides MSST, other information sought included visual acuity, ...

  17. Monitoring programme

    International Nuclear Information System (INIS)

    1994-06-01

    Her Majesty's Inspectorate of Pollution's 1992 report on its programme of monitoring radioactive substances is presented. Site operators' returns are verified and the report provides independent data on the environmental impact of authorized disposal of radioactive wastes. Radiation doses which may have been received by members of the public, fall well below the International Commission for Radiological Protection's (ICRP) recommended annual doses. (UK)

  18. The African Hospitalist Fellowship | Daniels | South African Medical ...

    African Journals Online (AJOL)

    The African Paediatric Fellowship Programme is rolling out a training course for newly qualified paediatricians to equip them with the leadership skills to function in complex general paediatric settings. The care of children in Africa carries its own unique demands, from the layering effects of multiple conditions through to ...

  19. Effects on mortality of a nutritional intervention for malnourished HIV-infected adults referred for antiretroviral therapy

    DEFF Research Database (Denmark)

    Filteau, Suzanne; PrayGod, George; Kasonka, Lackson

    2015-01-01

    BACKGROUND: Malnourished HIV-infected African adults are at high risk of early mortality after starting antiretroviral therapy (ART). We hypothesized that short-course, high-dose vitamin and mineral supplementation in lipid nutritional supplements would decrease mortality. METHODS: The study...... was an individually-randomised phase III trial conducted in ART clinics in Mwanza, Tanzania, and Lusaka, Zambia. Participants were 1,815 ART-naïve non-pregnant adults with body mass index (BMI)

  20. Maternal and infant health is protected by antiretroviral drug strategies that preserve breastfeeding by HIV-positive women

    Directory of Open Access Journals (Sweden)

    Louise Kuhn

    2012-03-01

    Full Text Available The South African Department of Health is justified in withdrawing support for free infant formula. By so doing, it recognises that any intervention that might detract from breast feeding poses a serious threat to infant survival. Since evidence is now strong that antiretroviral drugs used during lactation prevent transmission of infection from a seropositive mother, strategies that promote breastfeeding can now be recommended for enhancing the health of mothers and infants.

  1. Improving adherence to antiretroviral therapy

    Directory of Open Access Journals (Sweden)

    Nischal K

    2005-01-01

    Full Text Available Antiretroviral therapy (ART has transformed HIV infection into a treatable, chronic condition. However, the need to continue treatment for decades rather than years, calls for a long-term perspective of ART. Adherence to the regimen is essential for successful treatment and sustained viral control. Studies have indicated that at least 95% adherence to ART regimens is optimal. It has been demonstrated that a 10% higher level of adherence results in a 21% reduction in disease progression. The various factors affecting success of ART are social aspects like motivation to begin therapy, ability to adhere to therapy, lifestyle pattern, financial support, family support, pros and cons of starting therapy and pharmacological aspects like tolerability of the regimen, availability of the drugs. Also, the regimen′s pill burden, dosing frequency, food requirements, convenience, toxicity and drug interaction profile compared with other regimens are to be considered before starting ART. The lack of trust between clinician and patient, active drug and alcohol use, active mental illness (e.g. depression, lack of patient education and inability of patients to identify their medications, lack of reliable access to primary medical care or medication are considered to be predictors of inadequate adherence. Interventions at various levels, viz. patient level, medication level, healthcare level and community level, boost adherence and overall outcome of ART.

  2. Gender Differences in Survival among Adult Patients Starting Antiretroviral Therapy in South Africa: A Multicentre Cohort Study

    Science.gov (United States)

    Cornell, Morna; Schomaker, Michael; Garone, Daniela Belen; Giddy, Janet; Hoffmann, Christopher J.; Lessells, Richard; Maskew, Mhairi; Prozesky, Hans; Wood, Robin; Johnson, Leigh F.; Egger, Matthias; Boulle, Andrew; Myer, Landon

    2012-01-01

    Background Increased mortality among men on antiretroviral therapy (ART) has been documented but remains poorly understood. We examined the magnitude of and risk factors for gender differences in mortality on ART. Methods and Findings Analyses included 46,201 ART-naïve adults starting ART between January 2002 and December 2009 in eight ART programmes across South Africa (SA). Patients were followed from initiation of ART to outcome or analysis closure. The primary outcome was mortality; secondary outcomes were loss to follow-up (LTF), virologic suppression, and CD4+ cell count responses. Survival analyses were used to examine the hazard of death on ART by gender. Sensitivity analyses were limited to patients who were virologically suppressed and patients whose CD4+ cell count reached >200 cells/µl. We compared gender differences in mortality among HIV+ patients on ART with mortality in an age-standardised HIV-negative population. Among 46,201 adults (65% female, median age 35 years), during 77,578 person-years of follow-up, men had lower median CD4+ cell counts than women (85 versus 110 cells/µl, p<0.001), were more likely to be classified WHO stage III/IV (86 versus 77%, p<0.001), and had higher mortality in crude (8.5 versus 5.7 deaths/100 person-years, p<0.001) and adjusted analyses (adjusted hazard ratio [AHR] 1.31, 95% CI 1.22–1.41). After 36 months on ART, men were more likely than women to be truly LTF (AHR 1.20, 95% CI 1.12–1.28) but not to die after LTF (AHR 1.04, 95% CI 0.86–1.25). Findings were consistent across all eight programmes. Virologic suppression was similar by gender; women had slightly better immunologic responses than men. Notably, the observed gender differences in mortality on ART were smaller than gender differences in age-standardised death rates in the HIV-negative South African population. Over time, non-HIV mortality appeared to account for an increasing proportion of observed mortality. The analysis was limited by missing

  3. Gender differences in survival among adult patients starting antiretroviral therapy in South Africa: a multicentre cohort study.

    Directory of Open Access Journals (Sweden)

    Morna Cornell

    Full Text Available Increased mortality among men on antiretroviral therapy (ART has been documented but remains poorly understood. We examined the magnitude of and risk factors for gender differences in mortality on ART.Analyses included 46,201 ART-naïve adults starting ART between January 2002 and December 2009 in eight ART programmes across South Africa (SA. Patients were followed from initiation of ART to outcome or analysis closure. The primary outcome was mortality; secondary outcomes were loss to follow-up (LTF, virologic suppression, and CD4+ cell count responses. Survival analyses were used to examine the hazard of death on ART by gender. Sensitivity analyses were limited to patients who were virologically suppressed and patients whose CD4+ cell count reached >200 cells/µl. We compared gender differences in mortality among HIV+ patients on ART with mortality in an age-standardised HIV-negative population. Among 46,201 adults (65% female, median age 35 years, during 77,578 person-years of follow-up, men had lower median CD4+ cell counts than women (85 versus 110 cells/µl, p<0.001, were more likely to be classified WHO stage III/IV (86 versus 77%, p<0.001, and had higher mortality in crude (8.5 versus 5.7 deaths/100 person-years, p<0.001 and adjusted analyses (adjusted hazard ratio [AHR] 1.31, 95% CI 1.22-1.41. After 36 months on ART, men were more likely than women to be truly LTF (AHR 1.20, 95% CI 1.12-1.28 but not to die after LTF (AHR 1.04, 95% CI 0.86-1.25. Findings were consistent across all eight programmes. Virologic suppression was similar by gender; women had slightly better immunologic responses than men. Notably, the observed gender differences in mortality on ART were smaller than gender differences in age-standardised death rates in the HIV-negative South African population. Over time, non-HIV mortality appeared to account for an increasing proportion of observed mortality. The analysis was limited by missing data on baseline HIV disease

  4. African Journal of Economic Policy

    African Journals Online (AJOL)

    The primary aim of this journal, an offshoot of the Trade Policy Research and Training Programme in Economics Department, University of Ibadan, is to provide a forum for development and equity on the African continent. Vol 20, No 2 (2013). DOWNLOAD FULL TEXT Open Access DOWNLOAD FULL TEXT Subscription or ...

  5. African Journal of AIDS Research - Vol 15, No 4 (2016)

    African Journals Online (AJOL)

    The intersection of antiretroviral therapy, peer support programmes, and economic empowerment with HIV stigma among HIV-positive women in West Nile Uganda · EMAIL FULL TEXT EMAIL FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Nicole Coffey Kellett, Katherine Gnauck.

  6. Cost of a dedicated ART clinic | Harling | South African Medical ...

    African Journals Online (AJOL)

    Abstract. Background. The provision of antiretroviral therapy (ART) is being rolled out across South Africa. Little evidence exists on the cost of running clinics for ART provision. Objectives. To determine the cost per patient-month enrolled in an ART programme and per patient-visit for a dedicated, public-sector ART clinic in a ...

  7. South African Medical Journal - Vol 92, No 10 (2002)

    African Journals Online (AJOL)

    Exploring the costs of a limited public sector antiretroviral treatment programme in South Africa · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Andrew Boulle, Christopher Kenyon, Jolene Skordis, Robin Wood, 811-817 ...

  8. Factors associated with high rates of antiretroviral medication adherence among youth living with perinatal HIV in Thailand.

    Science.gov (United States)

    Kang, Ezer; Delzell, Darcie A P; Chhabra, Manik; Oberdorfer, Peninnah

    2015-07-01

    Antiretroviral medication adherence behaviour among Thai youth with perinatal HIV in Thailand has received growing attention. However, few studies have examined individual predictors of antiretroviral adherence using multiple self-reports. A convenience sample of 89 Thai youth (interquartile range 14-16 years) with perinatal HIV at three paediatric programmes in Chiang Mai completed a structured questionnaire and reported their antiretroviral adherence in the past one, seven and 30 days using count-based recall and a visual analog scale. Mean self-reported adherence rates ranged from 83.5% (past 30 days) to 99.8% (yesterday) of the time. One-inflated beta regression models were used to examine the associations between antiretroviral adherence outcomes, treatment self-efficacy, depression, anxiety, social support and beliefs/attitudes about medications. Higher percentage of medications taken in the past 30 days was independently associated with higher treatment self-efficacy and fewer symptoms of depression. Adherence monitoring would benefit from focal assessment of youth depression and perceived capacity to follow their antiretroviral regimen. © The Author(s) 2014.

  9. African Anthropologist

    African Journals Online (AJOL)

    PROMOTING ACCESS TO AFRICAN RESEARCH ... It provides a forum for African and Africanist anthropologists to publish research reports, articles, book ... A Qualitative Exploration · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT

  10. The Female Genital Tract Microbiome Is Associated With Vaginal Antiretroviral Drug Concentrations in Human Immunodeficiency Virus-Infected Women on Antiretroviral Therapy.

    Science.gov (United States)

    Donahue Carlson, Renee; Sheth, Anandi N; Read, Timothy D; Frisch, Michael B; Mehta, C Christina; Martin, Amy; Haaland, Richard E; Patel, Anar S; Pau, Chou-Pong; Kraft, Colleen S; Ofotokun, Igho

    2017-11-15

    The female genital tract (FGT) microbiome may affect vaginal pH and other factors that influence drug movement into the vagina. We examined the relationship between the microbiome and antiretroviral concentrations in the FGT. Over one menstrual cycle, 20 human immunodeficiency virus (HIV)-infected women virologically suppressed on tenofovir (TFV) disoproxil fumarate/emtricitabine and ritonavir-boosted atazanavir (ATV) underwent serial paired cervicovaginal and plasma sampling for antiretroviral concentrations using high-performance liquid chromatography-tandem mass spectrometry. Analysis of 16S ribosomal RNA gene sequencing of cervicovaginal lavage clustered each participant visit into a unique microbiome community type (mCT). Participants were predominantly African American (95%), with a median age of 38 years. Cervicovaginal lavage sequencing (n = 109) resulted in a low-diversity mCT dominated by Lactobacillus (n = 40), and intermediate-diversity (n = 28) and high-diversity (n = 41) mCTs with abundance of anaerobic taxa. In multivariable models, geometric mean FGT:plasma ratios varied significantly by mCT for all 3 drugs. For both ATV and TFV, FGT:plasma was significantly lower in participant visits with high- and low-diversity mCT groups (all P < .02). For emtricitabine, FGT:plasma was significantly lower in participant visits with low- vs intermediate-diversity mCT groups (P = .002). Certain FGT mCTs are associated with decreased FGT antiretroviral concentrations. These findings are relevant for optimizing antiretrovirals used for biomedical HIV prevention in women. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  11. Traditional, complementary and alternative medicine use by HIV patients a decade after public sector antiretroviral therapy roll out in South Africa: a cross sectional study.

    Science.gov (United States)

    Nlooto, Manimbulu; Naidoo, Panjasaram

    2016-05-17

    The roll out of antiretroviral therapy in the South African public health sector in 2004 was preceded by the politicisation of HIV-infection which was used to promote traditional medicine for the management of HIV/AIDS. One decade has passed since; however, questions remain on the extent of the use of traditional, complementary and alternative medicine (TCAM) by HIV-infected patients. This study therefore aimed at investigating the prevalence of the use of African traditional medicine (ATM), complementary and alternative medicines (CAM) by adult patients in the eThekwini and UThukela Health Districts, South Africa. A cross- sectional study was carried out at 8 public health sector antiretroviral clinics using interviewer-administered semi-structured questionnaires. These were completed from April to October 2014 by adult patients who had been on antiretroviral therapy (ART) for at least three months. Use of TCAM by patients was analysed by descriptive statistics using frequency and percentages with standard error. Where the associated relative error was equal or greater to 0.50, the percentage was rejected as unstable. A p-value public health sector, the use of TCAM is still prevalent amongst a small percentage of HIV infected patients attending public healthcare sector antiretroviral clinics. Further research is needed to explore reasons for use and health benefits or risks experienced by the minority that uses both conventional antiretroviral therapy with TCAM.

  12. Technology Programme

    Energy Technology Data Exchange (ETDEWEB)

    Batistoni, Paola; De Marco, Francesco; Pieroni, Leonardo [ed.

    2005-07-01

    The technology activities carried out by the Euratom-ENEA Association in the framework of the European Fusion Development Agreement concern the Next Step (International Thermonuclear Experimental Reactor - ITER), the Long-Term Programme (breeder blanket, materials, International Fusion Materials Irradiation Facility - IFMIF), Power Plant Conceptual Studies and Socio-Economic Studies. The Underlying Technology Programme was set up to complement the fusion activities as well to develop technologies with a wider range of interest. The Technology Programme mainly involves staff from the Frascati laboratories of the Fusion Technical and Scientific Unit and from the Brasimone laboratories of the Advanced Physics Technologies Unit. Other ENEA units also provide valuable contributions to the programme. ENEA is heavily engaged in component development/testing and in design and safety activities for the European Fusion Technology Programme. Although the work documented in the following covers a large range of topics that differ considerably because they concern the development of extremely complex systems, the high level of integration and coordination ensures the capability to cover the fusion system as a whole. In 2004 the most significant testing activities concerned the ITER primary beryllium-coated first wall. In the field of high-heat-flux components, an important achievement was the qualification of the process for depositing a copper liner on carbon fibre composite (CFC) hollow tiles. This new process, pre-brazed casting (PBC), allows the hot radial pressing (HRP) joining procedure to be used also for CFC-based armour monoblock divertor components. The PBC and HRP processes are candidates for the construction of the ITER divertor. In the materials field an important milestone was the commissioning of a new facility for chemical vapour infiltration/deposition, used for optimising silicon carbide composite (SiCf/SiC) components. Eight patents were deposited during 2004

  13. Technology Programme

    International Nuclear Information System (INIS)

    Batistoni, Paola; De Marco, Francesco; Pieroni, Leonardo

    2005-01-01

    The technology activities carried out by the Euratom-ENEA Association in the framework of the European Fusion Development Agreement concern the Next Step (International Thermonuclear Experimental Reactor - ITER), the Long-Term Programme (breeder blanket, materials, International Fusion Materials Irradiation Facility - IFMIF), Power Plant Conceptual Studies and Socio-Economic Studies. The Underlying Technology Programme was set up to complement the fusion activities as well to develop technologies with a wider range of interest. The Technology Programme mainly involves staff from the Frascati laboratories of the Fusion Technical and Scientific Unit and from the Brasimone laboratories of the Advanced Physics Technologies Unit. Other ENEA units also provide valuable contributions to the programme. ENEA is heavily engaged in component development/testing and in design and safety activities for the European Fusion Technology Programme. Although the work documented in the following covers a large range of topics that differ considerably because they concern the development of extremely complex systems, the high level of integration and coordination ensures the capability to cover the fusion system as a whole. In 2004 the most significant testing activities concerned the ITER primary beryllium-coated first wall. In the field of high-heat-flux components, an important achievement was the qualification of the process for depositing a copper liner on carbon fibre composite (CFC) hollow tiles. This new process, pre-brazed casting (PBC), allows the hot radial pressing (HRP) joining procedure to be used also for CFC-based armour monoblock divertor components. The PBC and HRP processes are candidates for the construction of the ITER divertor. In the materials field an important milestone was the commissioning of a new facility for chemical vapour infiltration/deposition, used for optimising silicon carbide composite (SiCf/SiC) components. Eight patents were deposited during 2004

  14. Payment for antiretroviral drugs is associated with a higher rate of patients lost to follow-up than those offered free-of-charge therapy in Nairobi, Kenya

    NARCIS (Netherlands)

    Zachariah, R.; van Engelgem, I.; Massaquoi, M.; Kocholla, L.; Manzi, M.; Suleh, A.; Phillips, M.; Borgdorff, M.

    2008-01-01

    This retrospective analysis of routine programme data from Mbagathi District Hospital, Nairobi, Kenya shows the difference in rates of loss to follow-up between a cohort that paid 500 shillings/month (approximately US$7) for antiretroviral drugs (ART) and one that received medication free of charge.

  15. Instructional Television Programmes and Academic Performance of ...

    African Journals Online (AJOL)

    This study investigated instructional Television (ITV) programmes and Academic performance of Senior Secondary School students in Anambra state-Nigeria. The need for the study arose from the problem of the declining nature of West African school certificate examination results of senior secondary school students in ...

  16. Graduates\\' Perception of University Programmes and Their ...

    African Journals Online (AJOL)

    Graduates\\' Perception of University Programmes and Their Relevance to Employment: A study of University of Nairobi Graduates (1991-1998). Gerald N Kimani. Abstract. No Abstract Available Africa Development Vol. XXX (1&2) 2005: 68-85. http://dx.doi.org/10.4314/ad.v30i1.22213 · AJOL African Journals Online.

  17. Description of the Wetlands Research Programme

    CSIR Research Space (South Africa)

    Walmsley, RD

    1988-01-01

    Full Text Available This report presents a rationale to the development of a multidisciplinary South African Wetland Research Programme. A definition of what is meant by the term wetland is given along with a general description of what types of wetland occur in South...

  18. Platelet count kinetics following interruption of antiretroviral treatment

    DEFF Research Database (Denmark)

    Zetterberg, Eva; Neuhaus, Jacqueline; Baker, Jason V

    2013-01-01

    To investigate the mechanisms of platelet kinetics in the Strategies for Management of Antiretroviral Therapy (SMART) study that demonstrated excess mortality with CD4 guided episodic antiretroviral therapy (ART) drug conservation compared with continuous treatment viral suppression. Follow...

  19. The association between HIV, antiretroviral therapy, and gestational diabetes mellitus

    NARCIS (Netherlands)

    Soepnel, Larske M; Norris, Shane A; Schrier, Verena J M M; Browne, Joyce L; Rijken, Marcus J; Gray, Glenda; Klipstein-Grobusch, Kerstin

    2017-01-01

    OBJECTIVES: The widespread, chronic use of antiretroviral therapy raises questions concerning the metabolic consequences of HIV infection and treatment. Antiretroviral therapy, and specifically protease inhibitors, has been associated with hyperglycemia. As pregnant women are vulnerable to

  20. Estimating health workforce needs for antiretroviral therapy in resource-limited settings

    Directory of Open Access Journals (Sweden)

    Fullem Andrew

    2006-01-01

    Full Text Available Abstract Background Efforts to increase access to life-saving treatment, including antiretroviral therapy (ART, for people living with HIV/AIDS in resource-limited settings has been the growing focus of international efforts. One of the greatest challenges to scaling up will be the limited supply of adequately trained human resources for health, including doctors, nurses, pharmacists and other skilled providers. As national treatment programmes are planned, better estimates of human resource needs and improved approaches to assessing the impact of different staffing models are critically needed. However there have been few systematic assessments of staffing patterns in existing programmes or of the estimates being used in planning larger programmes. Methods We reviewed the published literature and selected plans and scaling-up proposals, interviewed experts and collected data on staffing patterns at existing treatment sites through a structured survey and site visits. Results We found a wide range of staffing patterns and patient-provider ratios in existing and planned treatment programmes. Many factors influenced health workforce needs, including task assignments, delivery models, other staff responsibilities and programme size. Overall, the number of health care workers required to provide ART to 1000 patients included 1–2 physicians, 2–7 nurses, Discussion These data are consistent with other estimates of human resource requirements for antiretroviral therapy, but highlight the considerable variability of current staffing models and the importance of a broad range of factors in determining personnel needs. Few outcome or cost data are currently available to assess the effectiveness and efficiency of different staffing models, and it will be important to develop improved methods for gathering this information as treatment programmes are scaled up.

  1. African Journals Online: African Studies

    African Journals Online (AJOL)

    Items 51 - 56 of 56 ... Research Review of the Institute of African Studies. Please note: As of 2013 the Research Review of the Institute of African Studies is now publishing under the title Contemporary Journal of African Studies. You can view the CJAS pages on AJOL here: http://www.ajol.info/index.php/contjas/index.

  2. The discovery and development of antiretroviral agents

    NARCIS (Netherlands)

    Lange, Joep M. A.; Ananworanich, Jintanat

    2014-01-01

    Since the discovery of HIV as the causative agent of AIDS in 1983/1984, remarkable progress has been made in finding antiretroviral drugs (ARVs) that are effective against it. A major breakthrough occurred in 1996 when it was found that triple drug therapy (HAART) could durably suppress viral

  3. Perceived stigma and highly active antiretroviral treatment ...

    African Journals Online (AJOL)

    Perceived stigma and highly active antiretroviral treatment adherence among persons living with HIV/AIDS in the University of Port Harcourt Teaching Hospital. ... Data on socio-demographic characteristics, stigma and adherence to drug regimen were collected using a validated self-administered questionnaire. Data were ...

  4. Dual antiretroviral therapy for HIV infection.

    Science.gov (United States)

    Soriano, Vicente; Fernandez-Montero, Jose Vicente; Benitez-Gutierrez, Laura; Mendoza, Carmen de; Arias, Ana; Barreiro, Pablo; Peña, José M; Labarga, Pablo

    2017-08-01

    For two decades, triple combinations of antiretrovirals have been the standard treatment for HIV infection. The challenges of such lifelong therapy include long-term side effects, high costs and reduced drug adherence. The recent advent of more potent and safer antiretrovirals has renewed the interest for simpler HIV regimens. Areas covered: We discuss the pros and cons of dual antiretroviral therapies in both drug-naïve and in treatment-experienced patients with viral suppression (switch strategy). Expert opinion: Some dual antiretroviral regimens are safe and efficacious, particularly as maintenance therapy. At this time, combinations of dolutegravir plus rilpivirine represent the best dual regimen. Longer follow-up and larger study populations are needed before supporting dolutegravir plus lamivudine. In contrast, dual therapy based on maraviroc is less effective. Although dual regimens with boosted protease inhibitors plus either lamivudine or raltegravir may be effective, they are penalized by metabolic side effects and risk for drug interactions. The newest dual regimens could save money, reduce toxicity and spare drug options for the future. For the first time in HIV therapeutics, less can be more. Dual therapy switching has set up a new paradigm in HIV treatment that uses induction-maintenance.

  5. Insulin resistance induced by antiretroviral drugs: Current ...

    African Journals Online (AJOL)

    Treatment with highly active antiretroviral therapy (HAART) has improved the prognosis of patients with AIDS, but it has also increased the incidence of various metabolic disorders, in particular insulin resistance accompanied by dyslipidaemia, hyperglycaemia and lipodystrophy. This is often accompanied by frank type 2 ...

  6. CROI 2016: Advances in Antiretroviral Therapy.

    Science.gov (United States)

    Taylor, Barbara S; Olender, Susan A; Tieu, Hong-Van; Wilkin, Timothy J

    2016-01-01

    The 2016 Conference on Retroviruses and Opportunistic Infections highlighted exciting advances in antiretroviral therapy, including important data on investigational antiretroviral drugs and clinical trials. Clinical trials demonstrated benefits from a long-acting injectable coformulation given as maintenance therapy, examined intravenous and subcutaneous administration of a monoclonal antibody directed at the CD4 binding site of HIV-1, and provided novel data on tenofovir alafenamide. Several studies focused on the role of HIV drug resistance, including the significance of minority variants, transmitted drug resistance, use of resistance testing, and drug class-related resistance. Novel data on the HIV care continuum in low- and middle-income settings concentrated on differentiated HIV care delivery models and outcomes. Data on progress toward reaching World Health Organization 90-90-90 targets as well as outcomes related to expedited initiation of HIV treatment and adherence strategies were presented. Results from a trial in Malawi showed reduced rates of mother-to-child transmission among HIV-infected women who initiated antiretroviral therapy prior to pregnancy, and several studies highlighted the effect of antiretroviral therapy in pediatric populations. A special session was dedicated to the findings of studies of Ebola virus disease and treatment during the outbreak in West Africa.

  7. ISOLDE PROGRAMME

    CERN Multimedia

    Fedosseev, V; Herfurth, F; Scheidenberger, C; Geppert, C; Gorges, C; Ratajczyk, T; Wiederhold, J C; Vogel, S; Munch, M K; Nieminen, P; Pakarinen, J J A; Lecesne, N; Bouzomita, H; Grinyer, J; Marques moreno, F M; Parlog, M; Blank, B A; Pedroza, J; Ghetta, V; Lozeva, R; Zacarias, S M; Guillemaud mueller, D S; Cottereau, E; Cheikh mhamed, M; Tusseau nenez, S; Tungate, G; Walker, P M; Smith, A G; Fitzpatrick, C; Dominik, W M; Karny, M; Ciemny, A A; Nyman, G H; Thies, R M A; Lindberg, S K G; Langouche, G F; Velten, P; Araujo escalona, V I; Boudreau, M; Domnanich, K A; Richter, D; Lutter, R J; Javaji, A; Engel, R Y; Wiehr, S; Nacher gonzalez, E; Jungclaus, A; Ribeiro jimenez, G; Marroquin alonso, I; Cal gonzalez, J; Paziy, V; Salsac, M; Murphy, C; Podolyak, Z F; Bajoga, A D; Butler, P; Pritchard, A; Colosimo, S J; Steer, A N; Fox, S P; Wadsworth, B A; Truesdale, V L; Al monthery, M; Bracco, A; Guttormsen, M S; Badea, M N; Calinescu, S; Ujeniuc, S; Cederkall, J A; Zemlyanoy, S; Donets, E D; Golovkov, M; Schweitzer, D K; Vranicar, A; Harrichunder, S; Ncube, M; Nannini, A; Strisovska, J; Wolf, E; Gerten, R F; Lehnert, J; Rainovski, G I; Pospisil, S; Datta pramanik, U; Benzoni, G; Fedorov, D; Maier, F M; Bonanni, A; Pfeiffer, B; Griesel, T; Wehner, L W; Mikkelsen, M; Recchia, F; Lenzi, S M; Smith, J F; Kelly, C M; Acosta sanchez, L A; Chavez lomeli, E R; De melo bandeira tavares, P M; Vieira, J M; Martins da silva, M A; Lima lopes, A M; Lopes leal, T J; Mader, J; Kessler, P; Laurent, B G; Schweikhard, L C; Marx, G H; Kulczycka, E; Komorowska, M; Da silva, M F; Goncalves marques, C P; Baptista peres, M A; Welander, J E; Reiter, P; Miller, C; Martin sanchez-cano, D; Wiens, A; Blazhev, A A; Braun, N; Cappellazzo, M V; Birkenbach, B; Gerst, R; Dannhoff, M F; Sithole, M J; Bilgier, B; Nardelli, S; Araujo mendes, C M; Agramunt ros, J; Valencia marin, E; Pantea, E; Hessberger, F P; Leduc, A J; Mitsuoka, S; Carbonari, A W; Buchegger, F J; Garzon camacho, A; Dapo, H; Papka, P; Stachura, M K; Stora, T; Marsh, B A; Thiboud, J A; Heylen, H; Antalic, S; Stahl, C; Bauer, C; Thurauf, M; Maass, B; Sturm, S; Boehm, C; Wolf, N R; Ways, M; Steinsberger, T P; Riisager, K; Ruotsalainen, P A; Bastin, B; Duval, F T; Penessot, G; Flechard, X D; Desrues, P; Giovinazzo, J; Kurtukian nieto, T; Ascher, P E L; Roccia, S; Matea, I; Croizet, H A G; Bonnin, C M; Morfouace, P; Smith, A J; Guin, R; Banerjee, D; Gunnlaugsson, H P; Ohtsubo, T; Zhukov, M V; Tengborn, E A; Welker, A; Giannopoulos, E; Dessagne, P; Juscamaita vivanco, Y; Da costa pereira, L M; Hustings, J; Yu, H; Kruecken, R; Nowak, A K; Jankowski, M; Cano ott, D; Galve lahoz, P; Murphy, A S J; Shand, C M; Jones, G D; Herzberg, R; Ikin, P; Revill, J P; Everett, C; Napoli, D R; Scarel, G; Larsen, A; Tornyi, T G; Pascu, S G; Stroe, L; Toma, S; Jansson, K; Dronjak fahlander, M; Krupko, S; Hurst, A M; Veskovic, M; Nikolov, J; Masenda, H; Sibanda, W N; Rocchini, M; Klimo, J; Deicher, M; Wichert, T; Kronenberg, J; Helmke, A; Meliani, Z; Ivanov, V S; Green, B L; Keatings, J M; Kuti, I; Halasz, Z; Henry, M O; Bras de sequeira amaral, V; Espirito santo, F; Da silva, D J; Rosendahl, S; Vianden, R J; Speidel, K; Agarwal, I; Faul, T; Kownacki, J M; Martins correia, J G; Lorenz, K; Costa miranda, S M; Granadeiro costa, A R; Zyabkin, D; Kotthaus, T; Pfeiffer, M; Gironi, L; Jensen, A; Romstedt, F; Constantino silva furtado, I; Heredia cardona, J A; Jordan martin, M D; Montaner piza, A; Zacate, M O; Plewinski, F; Mesli, A; Akakpo, E H; Pichard, A; Hergemoller, F; Neu, W; Fallis starhunter, J P; Voulot, D; Mrazek, J; Ugryumov, V; Savreux, R P; Kojouharov, I M; Kern, R O; Papst, O; Fitting, J; Lauer, M; Kirsebom, O S; Jensen, K L; Jokinen, A; Rahkila, P J; Hager, U D K; Konki, J P; Dubois, M; Orr, N A; Fabian, X; Huikari, J E; Goigoux, T; Magron, C; Zakari, A A; Maietta, M; Bachelet, C E M; Roussiere, B; Li, R; Canavan, R L; Lorfing, C; Foster, R M; Gislason, H P; Shayestehaminzadeh, S; Qi, B; Mukai, M; Watanabe, Y; Willmann, L; Kurcewicz, W; Wimmer, K; Meisel, Z P; Dorvaux, O; Nowacki, F; Koudriavtsev, I; Lievens, P; Delaure, B J P; Neyens, G; Ceruti, S; Bunka, M; Vermeulen, C; Umbricht, C A; De boer, J; Podadera aliseda, I; Alcorta moreno, M; Pesudo fortes, V; Zielinska, M; Korten, W; Wang, C H; Lotay, G J; Mason, P; Rice, S J; Regan, P H; Willenegger, L M; Andreev, A; Yavuzkanat, N; Hass, M; Kumar, V; Valiente dobon, J J; Crespo campo, L; Zamfir, N - V; Deleanu, D; Clisu, C; Jeppesen, H B; Wu, C; Pain, S D; Stracener, D W; Wuosmaa, A H; Szilner, S; Colovic, P; Matousek, V; Venhart, M; Birova, M; Li, X; Stuchbery, A E; Lellep, G M; Chakraborty, S; Leoni, S; Chupp, T; Yilmaz, C; Severin, G; Garcia ramos, J E; Newton, M E; Hadinia, B; Mc glynn, E; Monteiro de sena silvares de carvalho, I; Friedag, P; Figuera, P; Koos, V; Meot, V H; Pauwels, D B; Jancso, A; Srebrny, J; Alves, E J; David bosne, E; Bengtsson, L; Kalkuehler, M; Albers, M; Bharuth-ram, K; Akkus, B; Hemmingsen, L B S; Pedersen, J T; Dos santos redondo, L M; Rubio barroso, B; Algora, A; Kozlov, V; Mavela, D L; Mokhles gerami, A; Keeley, N; Bernardo da silva, E; Unzueta solozabal, I; Schell, J; Szybowicz, M; Yang, X; Plavec, J; Lassen, J; Johnston, K; Coquard, L; Bloch, T P; Bonig, E S; Stegmann, R; Ignatov, A; Paschalis, S; Fernandez martinez, G; Schilling, M; Habermann, T; Von hahn, R; Minaya ramirez, E E; Moore, I D; Wang, Y; Saastamoinen, A J; Grahn, T; Herzan, A; Stolze, S M; Clement, E; Dijon, A; Shornikov, A; Lienard, E; Gibelin, J D; Pain, C; Canchel, G; Simpson, G S; Latrasse, L P; Huang, W; Forest, D H; Billowes, J; Flanagan, K; Strashnov, I; Binnersley, C L; Sanchez poncela, M; Simpson, J; Morrall, P S; Grant, A F; Charisopoulos, S; Lagogiannis, A; Bhattacharya, C; Olafsson, S; Stepaniuk, M; Tornqvist, H T; Heinz, A M; White iv, E R; Courtin, S; Marechal, F; Da silva fenta, A E; De lemos lima, T A; Stryjczyk, M; Dockx, K; Haller, S; Rizzi, M; Reichert, S B; Bonn, J; Thirolf, P G; Garcia rios, A R; Gugliermina, V M; Cubero campos, M A; Sanchez tembleque, V; Benito garcia, J; Senoville, M; Mountford, D J; Gelletly, W; Alharbi, T S T; Wilson, E; Rigby, S V; Andreoiu, C; Paul, E S; Harkness, L J; Judson, D S; Wraith, C; Van esbroeck, K; Wadsworth, R; Cubiss, J G; Harding, R D; Vaintraub, S; Mandal, S K; Scarpa, D; Hoff, P; Syed naeemul, H; Borcea, R; Balabanski, D L; Marginean, R; Rotaru, F; Rudolph, D; Fahlander, C H; Chudoba, V; Kay, B P; Soic, N; Naidoo, D; Veselsky, M; Kliman, J; Raisanen, J A; Dietrich, M; Maung maung than, M M T; Reed, M W; Danchev, M T; Ray, J; Roy, M; Hammen, M; Capponi, L; Veghne csatlos, M M; Fryar, J; Mirzadeh vaghefi, S P; Trindade pereira, A M; De pinho oliveira, G N; Bakenecker, A; Tramm, C; Germic, V; Morel, P A; Kowalczyk, M; Matejska-minda, M; Wolinska-cichocka, M; Ringvall moberg, A; Mantovan, R; Fransen, C H; Radeck, F; Schneiders, D W; Steinbach, T; Vibenholt, J E; Magnussen, M J; Stevnhoved, H M; Comas lijachev, V; Dasenbrock-gammon, N M; Perkowski, J; O'neill, G G; Matveev, Y; Wegner, M; Liu, Z; Perez alvarez, T; Cerato, L; Radchenko, V; Molholt, T E; Tabares giraldo, J A; Srnka, D; Dlouhy, Z; Beck, D; Werner, V R; Homm, I; Eliseev, S; Blaum, K; Probst, M B; Kaiser, C J; Martin, J A; Refsgaard, J; Peura, P J; Greenlees, P T; Auranen, K; Delahaye, P; Traykov, E K; Perez loureiro, D; Mery, A A; Couratin, C; Tsekhanovich, I; Lunney, D; Gaulard, C V; Mottram, A D; Cullen, D M; Das, S K; Van de walle, J; Mazzocchi, C; Jonson, B N G; Woehr, A; Lesher, S R; Zuber, K T; Filippin, L; De witte, H J; Van den bergh, P A M; Raabe, R; Dirkx, D; Parnefjord gustafsson, F O A; Dunlop, R A; Tarasava, K; Gernhaeuser, R A; Weinzierl, W; Berger, C; Wendt, K; Achtzehn, T; Gottwald, T; Schug, M; Rossel, R E; Dominguez reyes, R R; Fraile prieto, L M; Briz monago, J A; Koester, U H; Bunce, M R; Bowry, M D; Nakhostin, M; Shearman, R; Cresswell, J R; Joss, D T; Gredley, A; Groombridge, D; Laird, A M; Aslanoglou, X; Siem, S; Weterings, J A; Renstrom, T; Szpak, B T; Luczkowski, M J; Ghita, D; Bezbakh, A; Soltz, R A; Bollmann, J; Bhattacharya, P; Roy, S; Rahaman, M A; Wlodarski, T; Carvalho soares, J; Barzakh, A; Schertz, F; Froemmgen, N E; Liberati, V; Foy, B E; Baptista barbosa, M; Weinheimer, C P; Zboril, M; Simon, R E; Popescu, L A; Czosnyka, T; Miranda jana, P A; Leimbach, D; Naskrecki, R; Plociennik, W A; Ruchowska, E E; Chiara, C J; Walters, W; Eberth, J H; Thomas, T; Thole, P; Queiser, M T; Lo bianco, G; D'amico, F; Muller, S; Sanchez alarcon, R M; Tain enriquez, J L; Orrigo, S E A; Orlandi, R; Masango, S; Plazaola muguruza, F C; Lepareur, N G; Fiebig, J M; Ceylan, N; Wildner, E; Kowalska, M; Malbrunot, S; Garcia ruiz, R F; Pallada, S; Slezak, M; Roeckl, E; Schrieder, G H; Ilieva, S K; Koenig, K L; Amoretti, M A; Lommen, J M; Fynbo, H O U; Weyer, G O P; Koldste, G T; Madsboll, K; Jensen, J H; Nieminen, A M; Reponen, M; Villari, A; Thomas, J; Saint-laurent, M; Sorlin, O H; Carniol, B; Pereira lopez, J; Grevy, S; Plaisir, C; Marie-jeanne, M J; Georgiev, G P; Etile, A M; Le blanc, F M; Verney, D; Stefan, G I; Assie, M; Suzuki, D; Guillot, J; Vazquez rodriguez, L; Campbell, P; Deacon, A N; Ware, T; Flueras, A; Xie, L; Banerjee, K; Piersa, M; Galaviz redondo, D; Johansson, H T; Schwarz, S; Toysa, A S; Aumont, J; Van duppen, P L E; Atanasov, D; Zadvornaya, A; Renaud, M A; Xu, Z; Garrett, P E; Rapisarda, E; Reber, J A; Mattolat, C F; Raeder, S; Habs, D; Vidal, M; Perez liva, M; Calvo portela, P; Ulla pedrera, F J; Wood, R T; Lalkovski, S; Page, R; Petri, M; Barton, C J; Nichols, A J; Vermeulen, M J; Bloor, D M; Henderson, J; Wilson, G L; De angelis, G; Buerger, A; Modamio hoybjor, V; Klintefjord, M L; Ingeberg, V W; Fornal, B A; Marginean, R; Sava, T; Kusoglu, A; Suvaila, R; Lica, R; Costache, C; Mihai, R; Ionescu, A; Baeck, T M; Hoffman, C R; Sedlak, M; Koskelo, O K; Kyaw myat, K M; Gladnishki, K A; Ganguly, B; Goncalves marques, J; Cardoso, S; Seliverstov, M; Niessen, B D; Gutt, L E; Chapman, R; Spagnoletti, P N; Lopes, C; De oliveira amorim, C; Batista lopes, C M; Araujo, J; Schielke, S J; Daugas, J R; Gaudefroy, L; Chevrier, R; Szunyogh, D M; Napiorkowski, P J; Wrzosek-lipska, K; Wahl, U; Catarino, N; Pereira carvalho alves de sequeira, M; Hess, H E; Holler, A; Bettermann, L; Geibel, K; Taprogge, J; Lewandowski, L T N; Manchado de sola, F; Cakirli mutlu, R B; Das gupta, S; Thulstrup, P W; Heinz, U; Nogwanya, T; Neidherr, D M; Morales lopez, A I; Gumenyuk, O; Peaker, A R; Wakabayashi, Y; Abrahams, K J; Martin montes, E J; Mach, H A; Souza ribeiro junior, I; He, J; Chalil, A; Xing, R; Dos santos augusto, R M; Giles, T J; Dorsival, A; Trujillo hernandez, J S; Kalaninova, Z; Andel, B; Venos, D; Kraemer, J; Saha, S; Neugart, R; Eronen, T O; Kreim, K D; Heck, M K; Goncharov, M; Karthein, J; Julin, R J; Eleon, C; Achouri, N L; Grinyer, G F; Fontbonne, C M; Alfaurt, P; Lynch, K M; Wilkins, S G; Brown, A R; Imai, N; Pomorski, M J; Janiak, L; Nilsson, T; Stroke, H H; Stanja, J; Dangelser, E; Heenen, P; Godefroid, M; Mallion, S N; Gins, W A M; Stegemann, S T; Koszorus, A; Mcnulty, J F; Lin, P; Ohlert, C M; Schwerdtfeger, W; Tengblad, O; Becerril reyes, A D; Perea martinez, A; Martinez perez, M C; Margerin, V; Rudigier, M; Alexander, T D; Patel, Z V; Hammond, N; Wearing, F; Patel, A; Jenkins, D G; Corradi, L; Galtarossa, F; Debernardi, A; Giacoppo, F; Tveten, G M; Malatji, K L; Krolas, W A; Stanoiu, M A; Rickert, E U; Ter-akopian, G; Cline, D; Riihimaeki, I A; Simon, K D; Wagner, F E; Turker, M; Neef, M H; Coombes, B J; Jakubek, J; Vagena, E; Bottoni, S; Nishimura, K; Correia, J; Rodrigues valdrez, C J; Molkanov, P; Adhikari, R; Ostrowski, A N; Hallmann, O; Scheck, M; Wady, P T; Lane, J; Krasznahorkay, A J; Kunne sohler, D; Meaney, A J; Hochschulz, F; Roig, O; Behan, C C; Kargoll, S; Kemnitz, S; Carvalho teixeira, R C; Redondo cubero, A; Tallarida, G; Kaczarowski, R; Finke, F; Linnemann, A; Altenkirch, R; Saed-samii, N; Ansari, S H; Dlamini, W B; Adoons, V N; Ronning, C R; Wiedeking, M; Herlert, A J; Mehl, C V; Judge, S M; Gaertner, D; Divinskyi, S; Karabasov, M O; Zagoraios, G; Boztosun, I; Van zyl, J J; Catherall, R; Lettry, J; Wenander, F J C; Zakoucky, D; Catchen, G L; Noertershaeuser, W; Kroell, T; Leske, J; Shubina, D; Murray, I M; Pancin, J; Delaunay, F; Poincheval, J J L; Audirac, L L; Gerbaux, M T; Aouadi, M; Sole, P G P; Fallot, M P; Onillon, A; Duchemin, C; Formento cavaier, R; Audi, G; Boukhari, A; Lau, C; Martin, J A; Barre, N H; Berry, T A; Procter, T J; Bladen, L K; Axiotis, M; Muto, S; Jeong, S C; Hirayama, Y; Korgul, A B; Minamisono, K; Bingham, C R; Aprahamian, A; Bucher, B M; Severijns, N; Huyse, M L; Ferrer garcia, R; Verlinde, M N S; Romano, N; Maugeri, E A; Klupp, S C; Dehn, M H; Heinke, R M; Naubereit, P; Maira vidal, A; Vedia fernandez, M V; Ibanez garcia, P B; Bruyneel, B J E; Materna, T; Hadynska-klek, K; Al-dahan, N; Alazemi, N; Carroll, R J; Babcock, C; Patronis, N; Eleme, Z; Dhal, A; Sahin, E; Goergen, A; Maj, A; Bednarczyk, P A; Borcea, C; Negoita, F; Suliman, G; Marginean, N M; Sotty, C O; Negret, A L; Nae, S A; Nita, C; Golubev, P I; Knyazev, A; Jost, C U; Petrik, K; Vaeyrynen, S A; Dracoulis, G D; Uher, J; Fernandez dominguez, B; Chakraborty, P; Avigo, R; Falahat, S; Lekovic, F; Dorrer, H J; Mengoni, D; Derkx, X; Angus, L J; Sandhu, K S; Gregor, E; Kelly, N A; Byrne, D J; Haas, H; Lourenco, A A; Sousa pereira, S M; Sousa, J B; De melo mendonca, T M; Tavares de sousa, C; Guerreiro dos santos oliveira custodio, L M; Da rocha rodrigues, P M; Yamaguchi, T; Thompson, P C; Rosenbusch, M; Wienholtz, F; Fischer, P; Iwanicki, J S; Rusek, K M; Hanstorp, D; Vetter, U; Wolak, J M; Park, S H; Warr, N V; Doornenbal, P C; Imig, A; Seidlitz, M; Moschner, K; Vogt, A; Kaya, L; Martel bravo, I; Orduz, A K; Serot, O; Majola, S N; Litvinov, Y; Bommert, M; Hensel, S; Markevich, V; Nishio, K; Ota, S; Matos, I; Zenkevich, A; Picado sandi, E; Forstner, O; Hu, B; Ntshangase, S S; Sanchez-segovia, J

    2002-01-01

    The experiments aim at a broad exploration of the properties of atomic nuclei far away from the region of beta stability. Furthermore, the unique radioactive beams of over 60~elements produced at the on-line isotope separators ISOLDE-2 and ISOLDE-3 are used in a wide programme of atomic, solid state and surface physics. Around 300 scientists are involved in the project, coming from about 70 laboratories. \\\\ \\\\ The electromagnetic isotope separators are connected on-line with their production targets in the extracted 600 MeV proton or 910~MeV Helium-3 beam of the Synchro-Cyclotron. Secondary beams of radioactive isotopes are available at the facility in intensities of 10$^1

  8. Use of antiretroviral therapy in households and risk of HIV acquisition in rural KwaZulu-Natal, South Africa, 2004–12: a prospective cohort study

    Science.gov (United States)

    Vandormael, Alain; Newell, Marie-Louise; Bärnighausen, Till; Tanser, Frank

    2014-01-01

    Summary Background Studies of HIV-serodiscordant couples in stable sexual relationships have provided convincing evidence that antiretroviral therapy can prevent the transmission of HIV. We aimed to quantify the preventive effect of a public-sector HIV treatment and care programme based in a community with poor knowledge and disclosure of HIV status, frequent migration, late marriage, and multiple partnerships. Specifically, we assessed whether an individual's hazard of HIV acquisition was associated with antiretroviral therapy coverage among household members of the opposite sex. Methods In this prospective cohort study, we linked patients' records from a public-sector HIV treatment programme in rural KwaZulu-Natal, South Africa, with population-based HIV surveillance data collected between 2004 and 2012. We used information about coresidence to construct estimates of HIV prevalence and antiretroviral therapy coverage for each household. We then regressed the time to HIV seroconversion for 14 505 individuals, who were HIV-uninfected at baseline and individually followed up over time regarding their HIV status, on opposite-sex household antiretroviral therapy coverage, controlling for household HIV prevalence and a range of other potential confounders. Findings 2037 individual HIV seroconversions were recorded during 54 845 person-years of follow-up. For each increase of ten percentage points in opposite-sex household antiretroviral therapy coverage, the HIV acquisition hazard was reduced by 6% (95% CI 2–9), after controlling for other factors. This effect size translates into large reductions in HIV acquisition hazards when household antiretroviral therapy coverage is substantially increased. For example, an increase of 50 percentage points in household antiretroviral therapy coverage (eg, from 20% to 70%) reduced the hazard of HIV acquisition by 26% (95% CI 9–39). Interpretation Our findings provide further evidence that antiretroviral therapy

  9. The need for second-line antiretroviral therapy in adults in sub-Saharan Africa up to 2030: a mathematical modelling study.

    Science.gov (United States)

    Estill, Janne; Ford, Nathan; Salazar-Vizcaya, Luisa; Haas, Andreas D; Blaser, Nello; Habiyambere, Vincent; Keiser, Olivia

    2016-03-01

    The number of patients in need of second-line antiretroviral drugs is increasing in sub-Saharan Africa. We aimed to project the need of second-line antiretroviral therapy in adults in sub-Saharan Africa up to 2030. We developed a simulation model for HIV and applied it to each sub-Saharan African country. We used the WHO country intelligence database to estimate the number of adult patients receiving antiretroviral therapy from 2005 to 2014. We fitted the number of adult patients receiving antiretroviral therapy to observed estimates, and predicted first-line and second-line needs between 2015 and 2030. We present results for sub-Saharan Africa, and eight selected countries. We present 18 scenarios, combining the availability of viral load monitoring, speed of antiretroviral scale-up, and rates of retention and switching to second-line. HIV transmission was not included. Depending on the scenario, 8·7-25·6 million people are expected to receive antiretroviral therapy in 2020, of whom 0·5-3·0 million will be receiving second-line antiretroviral therapy. The proportion of patients on treatment receiving second-line therapy was highest (15·6%) in the scenario with perfect retention and immediate switching, no further scale-up, and universal routine viral load monitoring. In 2030, the estimated range of patients receiving antiretroviral therapy will remain constant, but the number of patients receiving second-line antiretroviral therapy will increase to 0·8-4·6 million (6·6-19·6%). The need for second-line antiretroviral therapy was two to three times higher if routine viral load monitoring was implemented throughout the region, compared with a scenario of no further viral load monitoring scale-up. For each monitoring strategy, the future proportion of patients receiving second-line antiretroviral therapy differed only minimally between countries. Donors and countries in sub-Saharan Africa should prepare for a substantial increase in the need for second

  10. Barriers to initiation of antiretrovirals during antituberculosis therapy in Africa.

    Directory of Open Access Journals (Sweden)

    Dominique J Pepper

    2011-05-01

    Full Text Available In the developing world, the principal cause of death among HIV-infected patients is tuberculosis (TB. The initiation of antiretroviral therapy (ART during TB therapy significantly improves survival, however it is not known which barriers prevent eligible TB patients from initiating life-saving ART.Setting. A South African township clinic with integrated tuberculosis and HIV services. Design. Logistic regression analyses of a prospective cohort of HIV-1 infected adults (≥18 years who commenced TB therapy, were eligible for ART, and were followed for 6 months.Of 100 HIV-1 infected adults eligible for ART during TB therapy, 90 TB patients presented to an ART clinic for assessment, 66 TB patients initiated ART, and 15 TB patients died. 34% of eligible TB patients (95%CI: 25-43% did not initiate ART. Male gender and younger age (<36 years were associated with failure to initiate ART (adjusted odds ratios of 3.7 [95%CI: 1.25-10.95] and 3.3 [95%CI: 1.12-9.69], respectively. Death during TB therapy was associated with a CD4+ count <100 cells/µL.In a clinic with integrated services for tuberculosis and HIV, one-third of eligible TB patients--particularly young men--did not initiate ART. Strategies are needed to promote ART initiation during TB therapy, especially among young men.

  11. Technology programme

    International Nuclear Information System (INIS)

    2007-01-01

    The technology activities carried out by the EURATOM-ENEA Association concern the continuation of the European Fusion Development Agreement (EFDA) as well as the ITER activities coordinated by the ITER International Office and Fusion for Energy. Also included in the activities are design and RD under the Broader Approach Agreement between the EU and Japan. In order to better contribute to the programme a number of consortium agreements among the Associations are being signed. Collaboration with industries in view of their participation in the construction of ITER was further strengthened, mainly in the field of magnet and divertor components. The new European Test Blanket Facility at ENEA Brasimone was completed; the design of the ITER radial neutron camera was optimised and the performance achievable with the in-vessel viewing system was further assessed by experimental trials. Design activities for the JT-60SA magnet and power supply system as well as the design and experimental activities related to the target of the International Fusion Materials Irradiation Facility were continued. Significant work was done to define quality assurance for neutronics analyses. Mockups of the ITER pre-compression ring made in glass fibre epoxy were tested. The activities and results documented in the following illustrate ENEA's efforts to support fusion development

  12. Advertising effectiveness of South African newspapers in the higher ...

    African Journals Online (AJOL)

    The article reports on the advertising effectiveness of the press media in the RSA with regard to the ... a frame of reference that could be applied to future marketing campaigns in educational programmes. ... AJOL African Journals Online.

  13. Epidemiology of Injuries in Elite South African Netball players ...

    African Journals Online (AJOL)

    ... structured programme to enhance core stability, neuromuscular control, and proprioception and to optimise biomechanical execution of functional movement patterns. Keywords: Netball; Epidemiology; Injury prevention; Sports injuries. South African Journal for Research in Sport, Physical Education and Recreation, 2012, ...

  14. African Journal for Physical Activity and Health Sciences - Vol 17 ...

    African Journals Online (AJOL)

    Factors influencing the implementation of soccer injury prevention strategies in ... Contradictions and responses concerning the South African sport colour bar with ... Impact of a nutrition education programme on the nutrition knowledge of ...

  15. Health education on diabetes at a South African national science ...

    African Journals Online (AJOL)

    ... with a major negative impact on the health and development of South Africans. ... To determine the effects of a health education programme on increasing ... models, word-search games, information leaflets and a computer-based quiz ...

  16. African Zoology

    African Journals Online (AJOL)

    African Zoology, a peer-reviewed research journal, publishes original scientific contributions and critical reviews that focus principally on African fauna in terrestrial, freshwater, and marine ecosystems. Research from other regions that advances practical and theoretical aspects of zoology will be considered. Rigorous ...

  17. Generic substitution of antiretrovirals: patients' and health care providers' opinions.

    Science.gov (United States)

    Kieran, Jennifer A; O'Reilly, Eimear; O'Dea, Siobhan; Bergin, Colm; O'Leary, Aisling

    2017-10-01

    There is interest in introducing generic antiretroviral drugs (ARVs) into high-income countries in order to maximise efficiency in health care budgets. Studies examining patients' and providers' knowledge and attitudes to generic substitution in HIV are few. This was a cross-sectional, observational study with a convenience sample of adult HIV-infected patients and health care providers (HCPs). Data on demographics, knowledge of generic medicine and facilitators of generic substitution were collected. Descriptive and univariate analysis was performed using SPSS V.23™. Questionnaires were completed by 66 patients. Seventy-one per cent would have no concerns with the introduction of generic ARVs. An increase in frequency of administration (61%) or pill burden (53%) would make patients less likely to accept generic ARVs. There were 30 respondents to the HCP survey. Concerns included the supply chain of generics, loss of fixed dose combinations, adherence and use of older medications. An increase in dosing frequency (76%) or an increase in pill burden (50%) would make HCPs less likely to prescribe a generic ARV. The main perceived advantage was financial. Generic substitution of ARVs would be acceptable to the majority of patients and HCPs. Reinvesting savings back into HIV services would facilitate the success of such a programme.

  18. Antiretroviral Resistance in HIV/AIDS Patients

    Science.gov (United States)

    Manosuthi, W.; MD

    2018-03-01

    The higher prevalence of HIV drug resistance was observed in areas with greater ART coverage. The HIV resistance-associated mutations occur when people have inadequate levels of antiretroviral drugs as well as inadequate potency, inadequate adherence, and preexisting resistance. The degree to drug cross-resistance is observed depends on the specific mutations and number of mutation accumulation. In the Southeast Asia region, the challenging of people with treatment failure is the availability and accessibility to subsequent new antiretroviral drugs to construct he second and salvage regimen. Genotypic resistance testing is a useful tool because it can identify the existing drug resistance-associated mutations under the selective drug pressure. Thus, understanding the basic interpretation of HIV drug resistance- associated mutation is useful in guiding clinical decisions for treatment-experienced people living with HIV.

  19. Antiretroviral treatment response of HIV-infected children after prevention of mother-to-child transmission in West Africa

    DEFF Research Database (Denmark)

    Ndondoki, Camille; Dicko, Fatoumata; Ahuatchi Coffie, Patrick

    2014-01-01

    INTRODUCTION: We assessed the rate of treatment failure of HIV-infected children after 12 months on antiretroviral treatment (ART) in the Paediatric IeDEA West African Collaboration according to their perinatal exposure to antiretroviral drugs for preventing mother-to-child transmission (PMTCT......). METHODS: A retrospective cohort study in children younger than five years at ART initiation between 2004 and 2009 was nested within the pWADA cohort, in Bamako-Mali and Abidjan-Côte d'Ivoire. Data on PMTCT exposure were collected through a direct review of children's medical records. The 12-month Kaplan....... Immunological failure was defined according to the 2006 World Health Organization age-related immunological thresholds for severe immunodeficiency. RESULTS: Among the 1035 eligible children, PMTCT exposure was only documented for 353 children (34.1%) and remained unknown for 682 (65.9%). Among children...

  20. Strengthening African Union for African Integration: An African ...

    African Journals Online (AJOL)

    Log in or Register to get access to full text downloads. ... in the international state system and seek for African initiative in solving African problems. ... of the African Union by examining the efforts of African Leaders towards African integration, ...

  1. Complications of HIV Disease and Antiretroviral Therapy

    OpenAIRE

    Luetkemeyer, Anne F.; Havlir, Diane V.; Currier, Judith S.

    2010-01-01

    There is growing interest in the pathogenesis, treatment, and prevention of long-term complications of HIV disease and its therapies. Specifically, studies focused on cardiovascular, renal, bone, and fat abnormalities were prominent at the 17th Conference on Retroviruses and Opportunistic Infections. Although enthusiasm about the effectiveness of current antiretroviral therapy remains strong, collectively, the ongoing work in the area of HIV disease and treatment complications appears to refl...

  2. Adipocytes Impair Efficacy of Antiretroviral Therapy

    Science.gov (United States)

    Couturier, Jacob; Winchester, Lee C.; Suliburk, James W.; Wilkerson, Gregory K.; Podany, Anthony T.; Agarwal, Neeti; Chua, Corrine Ying Xuan; Nehete, Pramod N.; Nehete, Bharti P.; Grattoni, Alessandro; Sastry, K. Jagannadha; Fletcher, Courtney V.; Lake, Jordan E.; Balasubramanyan, Ashok; Lewis, Dorothy E.

    2018-01-01

    Adequate distribution of antiretroviral drugs to infected cells in HIV patients is critical for viral suppression. In humans and primates, HIV- and SIV-infected CD4 T cells in adipose tissues have recently been identified as reservoirs for infectious virus. To better characterize adipose tissue as a pharmacological sanctuary for HIV-infected cells, in vitro experiments were conducted to assess antiretroviral drug efficacy in the presence of adipocytes, and drug penetration in adipose tissue cells (stromal-vascular-fraction cells and mature adipocytes) was examined in treated humans and monkeys. Co-culture experiments between HIV-1-infected CD4 T cells and primary human adipocytes showed that adipocytes consistently reduced the antiviral efficacy of the nucleotide reverse transcriptase inhibitor tenofovir and its prodrug forms tenofovir disoproxil fumarate (TDF) and tenofovir alafenamide (TAF). In HIV-infected persons, LC-MS/MS analysis of intracellular lysates derived from adipose tissue stromal-vascular-fraction cells or mature adipocytes suggested that integrase inhibitors penetrate adipose tissue, whereas penetration of nucleoside/nucleotide reverse transcriptase inhibitors such as TDF, emtricitabine, abacavir, and lamivudine is restricted. The limited distribution and functions of key antiretroviral drugs within fat depots may contribute to viral persistence in adipose tissue. PMID:29630975

  3. Challenges in Initiating Antiretroviral Therapy in 2010

    Directory of Open Access Journals (Sweden)

    Cécile L Tremblay

    2010-01-01

    Full Text Available Many clinical trials have shown that initiating antiretroviral therapy (ART at higher rather than lower CD4 T cell-positive counts results in survival benefit. Early treatment can help prevent end-organ damage associated with HIV replication and can decrease infectivity. The mainstay of treatment is either a non-nucleoside reverse transcriptase inhibitor or a ritonavir-boosted protease inhibitor in combination with two nucleoside reverse transcriptase inhibitors. While effective at combating HIV, ART can produce adverse alterations of lipid parameters, with some studies suggesting a relationship between some anti-retroviral agents and cardiovascular disease. As the HIV-positive population ages, issues such as hypertension and diabetes must be taken into account when initiating ART. Adhering to ART can be difficult; however, nonoptimal adherence to ART can result in the development of resistance; thus, drug characteristics and the patient’s preparedness to begin therapy must be considered. Reducing the pill burden through the use of fixed-dose antiretroviral drug combinations can facilitate adherence.

  4. Efavirenz poisoning in a 12 year old HIV negative African boy ...

    African Journals Online (AJOL)

    Efavirenz is an oral antiretroviral drug in the class of non nucleoside reverse transcriptase inhibitors. Toxicity at therapeutic doses has been documented but there is scarcity of data on presentation and management of Efavirenz overdose. We describe a case of Efavirenz poisoning in a 12-year old HIV Negative African boy ...

  5. Building South African women's leadership: A cohort model for the ...

    African Journals Online (AJOL)

    the University of the Western Cape (UWC) and California State University, Fullerton's ... limited representation of women in positions of academic leadership in African ... There was a need and interest from South African higher education faculty and ... of five black women and their experiences in this pilot PhD programme.

  6. The African Institutions Initiative: Insights from the First Four Years

    Science.gov (United States)

    Cochrane, Gavin; Robin, Enora; Marjanovic, Sonja; Diepeveen, Stephanie; Hanlin, Rebecca; Kryl, David; Muchova, Lucia; Yaqub, Ohid; Chataway, Joanna

    2014-01-01

    In 2009, the Wellcome Trust launched a research capacity strengthening programme known as the "African Institutions Initiative" (AII). The AII is innovative in its methods and organization. The Initiative funded networked consortia (7 consortia involving 54 institutions in 18 African countries, and Northern partners). RAND Europe was…

  7. Mobile phone use for a social strategy to improve antiretroviral refill experience at a low-resource HIV clinic: patient responses from Nigeria.

    Science.gov (United States)

    Adetunji, Adedotun A; Muyibi, Sufiyan A; Imhansoloeva, Martins; Ibraheem, Olusola M; Sunmola, Adegbenga; Kolawole, Olubunmi O; Akinrinsola, Oluwasina O; Ojo-Osagie, James O; Mosuro, Olusola A; Abiolu, Josephine O; Irabor, Achiaka E; Okonkwo, Prosper; Adewole, Isaac F; Taiwo, Babafemi O

    2017-05-01

    In sub-Saharan African areas where antiretroviral (ARV) drugs are not available through community pharmacies, clinic-based pharmacies are often the primary source of ARV drug refills. Social pressure is mounting on treatment providers to adjust ARV refill services towards user-friendly approaches which prioritize patients' convenience and engage their resourcefulness. By this demand, patients may be signalling dissatisfaction with the current provider-led model of monthly visits to facility-based pharmacies for ARV refill. Mobile phones are increasingly popular in sub-Saharan Africa, and have been used to support ARV treatment goals in this setting. A patient-centred response to on-going social pressure requires treatment providers to view ARV refill activities through the eyes of patients who are negotiating the challenges of day-to-day life while contemplating their next refill appointment. Using focus groups of five categories of adult patients receiving combination ARV therapy, we conducted this cross-sectional qualitative study to provide insight into modifiable gaps between patients' expectations and experiences of the use of mobile phones in facility-based ARV refill service at a public HIV clinic in Nigeria. A notable finding was patients' preference for harnessing informal social support (through intermediaries with mobile phones) to maintain adherence to ARV refill appointments when they could not present in person. This evolving social support strategy also has the potential to enhance defaulter tracking. Our study findings may inform the development of ARV refill strategies and the design of future qualitative studies on client-provider communication by mobile phones in under-resourced HIV treatment programmes.

  8. Las personas que viven con VIH/SIDA y su vínculo con los antirretrovirales provistos por el Programa Nacional en Argentina People living with HIV/AIDS and their link with the antiretrovirals provided by the National Programme in Argentina

    Directory of Open Access Journals (Sweden)

    Marisel Andrea Colautti

    2012-05-01

    Full Text Available El Estado argentino se compromete, mediante la Ley Nacional de SIDA, a suministrar gratuitamente los ARV. Reconociendo la complejidad que envuelve el proceso de gestión de ARV desde Programa Nacional y dando por sentado que las PVVS son el fin último del mismo, se piensa que es fundamental indagar en sus opiniones. El objetivo es explorar el suministro de ARV desde la perspectiva de las PVVS, en un hospital público de Rosario, respecto a: 1 valoración del Programa y de la información recibida, 2 tiempos de espera, 3 la provisión en relación con la disponibilidad de ARV para sostener el tratamiento. Estudio de abordaje cualitativo, con entrevistas durante enero y febrero de 2007, se realizan en presencia de una psicóloga. Se definen criterios de selección de los entrevistados y ejes para las entrevistas. Las PVVS entrevistadas son 15 y opinan con autoridad respecto al Programa, señalando problemas en el suministro de ARV. Reconocen dificultades del sostenimiento en el tiempo en la toma de ARV y sus consecuencias en relación a la muerte y a la calidad de vida. El Programa se caracteriza por convivencia de rasgos que responden a políticas garantizadas por el Estado y a programas que responden a la emergencia. Aparece la necesidad de repensar el Programa como política de salud genuina, considerando a los ARV como medicamentos esenciales.In accordance with the National AIDS Law, the Argentinian State is committed to supply antiretroviral medication (ARV free of charge. Due to the complexity of the National ARV Program management process, and the fact that people with HIV/AIDS (PLHA are the beneficiaries of the Program, it is considered relevant to ascertain their opinion. The aim of this work is to examine the supply of ARV by the National HIV/AIDS Program, from the perspective of PLHA, in a public hospital of the city of Rosario, in relation to: 1 value of the Program and the information received from it; 2 waiting times; 3 availability

  9. A longitudinal study of systemic inflammation and recovery of lean body mass among malnourished HIV-infected adults starting antiretroviral therapy in Tanzania and Zambia

    DEFF Research Database (Denmark)

    PrayGod, George; Blevins, M; Woodd, Susannah

    2016-01-01

    BACKGROUND/OBJECTIVES: The effects of inflammation on nutritional rehabilitation after starting antiretroviral therapy (ART) are not well understood. We assessed the relationship between inflammation and body composition among patients enrolled in the Nutritional Support for African Adults Starting...... gains. Further studies are warranted to determine whether interventions to reduce systemic inflammation will enhance gains in fat-free mass.European Journal of Clinical Nutrition advance online publication, 20 January 2016; doi:10.1038/ejcn.2015.221....

  10. National programme: Finland

    International Nuclear Information System (INIS)

    Forsten, J.

    1986-01-01

    Finland's programmes in the field of reactor pressure components are presented in this paper. The following information on each of these programmes is given: the brief description of the programme; the programme's schedule and duration; the name of the project manager

  11. morphological characterization and variability study of african yam ...

    African Journals Online (AJOL)

    abc

    Characterisation of Sphenostylis stenocarpa (Hochst ex A. Rich) Harms (African yam bean) was carried out to determine the degree ... the differences in the accessions of S.stenocarpa could be explored in breeding programme for improved crop. KEYWORDS: ... programme for AYB would depend on the genetic variability ...

  12. Human resource development and antiretroviral treatment in Free State province, South Africa

    Directory of Open Access Journals (Sweden)

    Schneider Helen

    2008-07-01

    Full Text Available Abstract Background In common with other developing countries, South Africa's public health system is characterised by human resource shortfalls. These are likely to be exacerbated by the escalating demand for HIV care and a large-scale antiretroviral therapy (ART programme. Focusing on professional nurses, the main front-line providers of primary health care in South Africa, we studied patterns of planning, recruitment, training and task allocation associated with an expanding ART programme in the districts of one province, the Free State. Methods Data collection included an audit of professional nurse posts created and filled following the introduction of the ART programme, repeated surveys of facilities providing ART over two years to assess the deployment of staff, and secondary data analysis of government personnel databases to track broader patterns of recruitment and training. Results Although a substantial number of new professional nurse posts were established for the ART programme in the Free State, nearly 80% of these posts were filled by nurses transferring from other programmes within the same facility or from facilities within the same district, rather than by new recruits. From the beginning, ART nurse posts tended to be graded at a senior level, and later, in an effort to recruit professional nurses for the ART programme, the majority (54.6% of nurses entering the programme were promoted to a senior level. The vacancy rate of nurse ART posts was significantly lower than that of other posts in the primary health care (PHC system (15.7% vs 37.1%. Nursing posts in urban ART facilities were more easily filled than those in rural areas, exacerbating existing imbalances. The shift of nurses into the ART programme was partially compensated for by the appointment of additional support staff, task shifting to community health workers, and a large investment in training of PHC workers. However, the use of less-trained, mid-level enrolled

  13. Determinants of durability of first-line antiretroviral therapy regimen and time from first-line failure to second-line antiretroviral therapy initiation

    DEFF Research Database (Denmark)

    Desmonde, Sophie; Eboua, François T; Malateste, Karen

    2015-01-01

    BACKGROUND: We described reasons for switching to second-line antiretroviral treatment (ART) and time to switch in HIV-infected children failing first-line ART in West Africa. METHODS: We included all children aged 15 years or less, starting ART (at least three drugs) in the paediatric Ie...... post-ART initiation, 188 (7%) had switched to second-line. The most frequent reasons were drug stock outs (20%), toxicity (18%), treatment failure (16%) and poor adherence (8%). Over the 24-month follow-up period, 322 (12%) children failed first-line ART after a median time of 7 months...... rare and switches after an immunological failure were insufficient. These gaps reveal that it is crucial to advocate for both sustainable access to first-line and alternative regimens to provide adequate roll-out of paediatric ART programmes....

  14. African Journals Online (AJOL)

    African Journals Online (AJOL)

    African Journals OnLine (AJOL) is the world's largest online library of ... AJOL works to change this, so that African-origin research output is available to Africans ... South African Medical Journal ... Global Journal of Pure and Applied Sciences.

  15. Immunizations and African Americans

    Science.gov (United States)

    ... Data > Minority Population Profiles > Black/African American > Immunizations Immunizations and African Americans African American adults are less ... 19 to 35 months had comparable rates of immunization. African American women are as likely to have ...

  16. Cost effectiveness analysis of clinically driven versus routine laboratory monitoring of antiretroviral therapy in Uganda and Zimbabwe.

    Directory of Open Access Journals (Sweden)

    Antonieta Medina Lara

    Full Text Available Despite funding constraints for treatment programmes in Africa, the costs and economic consequences of routine laboratory monitoring for efficacy and toxicity of antiretroviral therapy (ART have rarely been evaluated.Cost-effectiveness analysis was conducted in the DART trial (ISRCTN13968779. Adults in Uganda/Zimbabwe starting ART were randomised to clinically-driven monitoring (CDM or laboratory and clinical monitoring (LCM; individual patient data on healthcare resource utilisation and outcomes were valued with primary economic costs and utilities. Total costs of first/second-line ART, routine 12-weekly CD4 and biochemistry/haematology tests, additional diagnostic investigations, clinic visits, concomitant medications and hospitalisations were considered from the public healthcare sector perspective. A Markov model was used to extrapolate costs and benefits 20 years beyond the trial.3316 (1660LCM;1656CDM symptomatic, immunosuppressed ART-naive adults (median (IQR age 37 (32,42; CD4 86 (31,139 cells/mm(3 were followed for median 4.9 years. LCM had a mean 0.112 year (41 days survival benefit at an additional mean cost of $765 [95%CI:685,845], translating into an adjusted incremental cost of $7386 [3277,dominated] per life-year gained and $7793 [4442,39179] per quality-adjusted life year gained. Routine toxicity tests were prominent cost-drivers and had no benefit. With 12-weekly CD4 monitoring from year 2 on ART, low-cost second-line ART, but without toxicity monitoring, CD4 test costs need to fall below $3.78 to become cost-effective (<3xper-capita GDP, following WHO benchmarks. CD4 monitoring at current costs as undertaken in DART was not cost-effective in the long-term.There is no rationale for routine toxicity monitoring, which did not affect outcomes and was costly. Even though beneficial, there is little justification for routine 12-weekly CD4 monitoring of ART at current test costs in low-income African countries. CD4 monitoring

  17. Public health lessons from a pilot programme to reduce mother-to ...

    African Journals Online (AJOL)

    Public health lessons from a pilot programme to reduce mother-to-child transmission of HIV-1 in Khayelitsha. ... PROMOTING ACCESS TO AFRICAN RESEARCH ... took blood for HIV enzyme-linked imrnunosorbent assay (EUSA) testing.

  18. Influence of students in other programmes on the self-esteem of ...

    African Journals Online (AJOL)

    Influence of students in other programmes on the self-esteem of agricultural education students in ... The findings showed, inter alia, that Agricultural students possess positive self-esteem against all odds. ... AJOL African Journals Online.

  19. Antiretroviral Therapy during the Neonatal Period | Nuttall | Southern ...

    African Journals Online (AJOL)

    Initiation of combination antiretroviral therapy (cART) at 6–9 weeks of age has been shown to reduce early infant mortality by 76% and HIV progression by 75% compared with cART deferred until clinical or CD4 criteria were met. In the landmark Children with HIV Early Antiretroviral Therapy (CHER) trial, although the ...

  20. Class of Antiretroviral Drugs and the Risk of Myocardial Infarction

    DEFF Research Database (Denmark)

    Friis-Møller, Nina; Reiss, P; Sabin, CA

    2007-01-01

    BACKGROUND: We have previously demonstrated an association between combination antiretroviral therapy and the risk of myocardial infarction. It is not clear whether this association differs according to the class of antiretroviral drugs. We conducted a study to investigate the association of cumu...

  1. Nurses' perceptions about Botswana patients' anti-retroviral therapy ...

    African Journals Online (AJOL)

    Anti-retroviral drugs(ARVs) are supplied free of charge in Botswana. Lifelong adherence to antiretroviral therapy (ART) is vital to improve the patient's state of well-being and to prevent the development of strains of the human immunodefi ciency virus (HIV) that are resistant to ART. Persons with ART-resistant strains of HIV ...

  2. Exploration of pain in children on antiretroviral treatment in a ...

    African Journals Online (AJOL)

    Exploration of pain in children on antiretroviral treatment in a regional hospital in South Africa. M Azam, L Campbell, A Ross. Abstract. Background: Patients with human immunodeficiency virus (HIV) disease on antiretroviral therapy (ART) may experience pain for a variety of reasons, including the effects of the virus itself, ...

  3. Provision of antiretroviral treatment in conflict settings: the experience of Médecins Sans Frontières.

    Science.gov (United States)

    O'Brien, Daniel P; Venis, Sarah; Greig, Jane; Shanks, Leslie; Ellman, Tom; Sabapathy, Kalpana; Frigati, Lisa; Mills, Clair

    2010-06-17

    Many countries ravaged by conflict have substantial morbidity and mortality attributed to HIV/AIDS yet HIV treatment is uncommonly available. Universal access to HIV care cannot be achieved unless the needs of populations in conflict-affected areas are addressed. From 2003 Médecins Sans Frontières introduced HIV care, including antiretroviral therapy, into 24 programmes in conflict or post-conflict settings, mainly in sub-Saharan Africa. HIV care and treatment activities were usually integrated within other medical activities. Project data collected in the Fuchia software system were analysed and outcomes compared with ART-LINC data. Programme reports and other relevant documents and interviews with local and headquarters staff were used to develop lessons learned. In the 22 programmes where ART was initiated, more than 10,500 people were diagnosed with HIV and received medical care, and 4555 commenced antiretroviral therapy, including 348 children. Complete data were available for adults in 20 programmes (n = 4145). At analysis, 2645 (64%) remained on ART, 422 (10%) had died, 466 (11%) lost to follow-up, 417 (10%) transferred to another programme, and 195 (5%) had an unclear outcome. Median 12-month mortality and loss to follow-up were 9% and 11% respectively, and median 6-month CD4 gain was 129 cells/mm 3.Patient outcomes on treatment were comparable to those in stable resource-limited settings, and individuals and communities obtained significant benefits from access to HIV treatment. Programme disruption through instability was uncommon with only one program experiencing interruption to services, and programs were adapted to allow for disruption and population movements. Integration of HIV activities strengthened other health activities contributing to health benefits for all victims of conflict and increasing the potential sustainability for implemented activities. With commitment, simplified treatment and monitoring, and adaptations for potential

  4. Provision of antiretroviral treatment in conflict settings: the experience of Médecins Sans Frontières

    Directory of Open Access Journals (Sweden)

    Ellman Tom

    2010-06-01

    Full Text Available Abstract Introduction Many countries ravaged by conflict have substantial morbidity and mortality attributed to HIV/AIDS yet HIV treatment is uncommonly available. Universal access to HIV care cannot be achieved unless the needs of populations in conflict-affected areas are addressed. Methods From 2003 Médecins Sans Frontières introduced HIV care, including antiretroviral therapy, into 24 programmes in conflict or post-conflict settings, mainly in sub-Saharan Africa. HIV care and treatment activities were usually integrated within other medical activities. Project data collected in the Fuchia software system were analysed and outcomes compared with ART-LINC data. Programme reports and other relevant documents and interviews with local and headquarters staff were used to develop lessons learned. Results In the 22 programmes where ART was initiated, more than 10,500 people were diagnosed with HIV and received medical care, and 4555 commenced antiretroviral therapy, including 348 children. Complete data were available for adults in 20 programmes (n = 4145. At analysis, 2645 (64% remained on ART, 422 (10% had died, 466 (11% lost to follow-up, 417 (10% transferred to another programme, and 195 (5% had an unclear outcome. Median 12-month mortality and loss to follow-up were 9% and 11% respectively, and median 6-month CD4 gain was 129 cells/mm 3. Patient outcomes on treatment were comparable to those in stable resource-limited settings, and individuals and communities obtained significant benefits from access to HIV treatment. Programme disruption through instability was uncommon with only one program experiencing interruption to services, and programs were adapted to allow for disruption and population movements. Integration of HIV activities strengthened other health activities contributing to health benefits for all victims of conflict and increasing the potential sustainability for implemented activities. Conclusions With commitment, simplified

  5. The HIV epidemic and sexual and reproductive health policy integration: views of South African policymakers.

    Science.gov (United States)

    Cooper, Diane; Mantell, Joanne E; Moodley, Jennifer; Mall, Sumaya

    2015-03-04

    Integration of sexual and reproductive health (SRH) and HIV policies and services delivered by the same provider is prioritised worldwide, especially in sub-Saharan Africa where HIV prevalence is highest. South Africa has the largest antiretroviral treatment (ART) programme in the world, with an estimated 2.7 million people on ART, elevating South Africa's prominence as a global leader in HIV treatment. In 2011, the Southern African HIV Clinicians Society published safer conception guidelines for people living with HIV (PLWH) and in 2013, the South African government published contraceptive guidelines highlighting the importance of SRH and fertility planning services for people living with HIV. Addressing unintended pregnancies, safer conception and maternal health issues is crucial for improving PLWH's SRH and combatting the global HIV epidemic. This paper explores South African policymakers' perspectives on public sector SRH-HIV policy integration, with a special focus on the need for national and regional policies on safer conception for PLWH and contraceptive guidelines implementation. It draws on 42 in-depth interviews with national, provincial and civil society policymakers conducted between 2008-2009 and 2011-2012, as the number of people on ART escalated. Interviews focused on three key domains: opinions on PLWH's childbearing; the status of SRH-HIV integration policies and services; and thoughts and suggestions on SRH-HIV integration within the restructuring of South African primary care services. Data were coded and analysed according to themes. Participants supported SRH-HIV integrated policy and services. However, integration challenges identified included a lack of policy and guidelines, inadequately trained providers, vertical programming, provider work overload, and a weak health system. Participants acknowledged that SRH-HIV integration policies, particularly for safer conception, contraception and cervical cancer, had been neglected. Policymakers

  6. Mapping Criminal Governance in African Cities | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Mapping Criminal Governance in African Cities. This grant will allow the Institute for Security Studies (ISS), through its Organized Crime and Money Laundering Programme (OCML), to explore the causal links between weak state authority and the emergence of criminal governance ... Profile of crime markets in Dakar.

  7. African Journal of Economic Policy: Editorial Policies

    African Journals Online (AJOL)

    Focus and Scope. The primary aim of this journal, an offshoot of the Trade Policy Research and Training Programme in Economics Department, University of Ibadan, is to provide a forum for development and equity on the African continent. It, therefore, welcomes well researched papers on the implications of a specific ...

  8. Multitype violence exposures and adolescent antiretroviral nonadherence in South Africa.

    Science.gov (United States)

    Cluver, Lucie; Meinck, Franziska; Toska, Elona; Orkin, F Mark; Hodes, Rebecca; Sherr, Lorraine

    2018-05-15

    HIV-positive adolescents have low-ART adherence, with consequent increased risks of mortality, morbidity, and viral resistance. Despite high rates of violence against children in the Africa region, no known studies have tested impacts on HIV-positive adolescents. We examine associations of ART adherence with adolescent violence victimization by caregivers, teachers, peers, community members, and healthcare providers. HIV-positive adolescents were interviewed (n = 1060), and clinic biomarker data collected. We sampled all 10-19-year olds ever ART-initiated within 53 clinics in 180 South African communities (90.1% reached). Analyses examined associations between nonadherence and nine violence types using sequential multivariate logistic regressions. Interactive and additive effects were tested with regression and marginal effects. Past-week self-reported ART nonadherence was 36%. Nonadherence correlated strongly with virologic failure (OR 2.3, CI 1.4-3.8) and symptomatic pulmonary tuberculosis (OR 1.49, CI 1.18-2.05). Four violence types were independently associated with nonadherence: physical abuse by caregivers (OR 1.5, CI 1.1-2.1); witnessing domestic violence (OR 1.8, CI 1.22-2.66); teacher violence (OR 1.51, CI 1.16-1.96,) and verbal victimization by healthcare staff (OR 2.15, CI 1.59-2.93). Past-week nonadherence rose from 25% with no violence to 73.5% with four types of violence exposure. Violence exposures at home, school, and clinic are major and cumulating risks for adolescent antiretroviral nonadherence. Prevention, mitigation, and protection services may be essential for the health and survival of HIV-positive adolescents.

  9. Sex Differences in Antiretroviral Therapy Initiation in Pediatric HIV Infection.

    Directory of Open Access Journals (Sweden)

    Masahiko Mori

    Full Text Available The incidence and severity of infections in childhood is typically greater in males. The basis for these observed sex differences is not well understood, and potentially may facilitate novel approaches to reducing disease from a range of conditions. We here investigated sex differences in HIV-infected children in relation to antiretroviral therapy (ART initiation and post-treatment outcome. In a South African cohort of 2,101 HIV-infected children, we observed that absolute CD4+ count and CD4% were significantly higher in ART-naïve female, compared to age-matched male, HIV-infected children. Absolute CD4 count and CD4% were also significantly higher in HIV-uninfected female versus male neonates. We next showed that significantly more male than female children were initiated on ART (47% female; and children not meeting criteria to start ART by >5 yrs were more frequently female (59%; p<0.001. Among ART-treated children, immune reconstitution of CD4 T-cells was more rapid and more complete in female children, even after adjustment for pre-ART absolute CD4 count or CD4% (p=0.011, p=0.030, respectively. However, while ART was initiated as a result of meeting CD4 criteria less often in females (45%, ART initiation as a result of clinical disease in children whose CD4 counts were above treatment thresholds occurred more often in females (57%, p<0.001. The main sex difference in morbidity observed in children initiating ART above CD4 thresholds, above that of TB disease, was as a result of wasting and stunting observed in females with above-threshold CD4 counts (p=0.002. These findings suggest the possibility that optimal treatment of HIV-infected children might incorporate differential CD4 treatment thresholds for ART initiation according to sex.

  10. Exploring ‘generative mechanisms’ of the antiretroviral adherence club intervention using the realist approach: a scoping review of research-based antiretroviral treatment adherence theories

    Directory of Open Access Journals (Sweden)

    Ferdinand C. Mukumbang

    2017-05-01

    Full Text Available Abstract Background Poor retention in care and non-adherence to antiretroviral therapy (ART continue to undermine the success of HIV treatment and care programmes across the world. There is a growing recognition that multifaceted interventions – application of two or more adherence-enhancing strategies – may be useful to improve ART adherence and retention in care among people living with HIV/AIDS. Empirical evidence shows that multifaceted interventions produce better results than interventions based on a singular perspective. Nevertheless, the bundle of mechanisms by which multifaceted interventions promote ART adherence are poorly understood. In this paper, we reviewed theories on ART adherence to identify candidate/potential mechanisms by which the adherence club intervention works. Methods We searched five electronic databases (PubMed, EBSCOhost, CINAHL, PsycARTICLES and Google Scholar using Medical Subject Headings (MeSH terms. A manual search of citations from the reference list of the studies identified from the electronic databases was also done. Twenty-six articles that adopted a theory-guided inquiry of antiretroviral adherence behaviour were included for the review. Eleven cognitive and behavioural theories underpinning these studies were explored. We examined each theory for possible ‘generative causality’ using the realist evaluation heuristic (Context-Mechanism-Outcome configuration, then, we selected candidate mechanisms thematically. Results We identified three major sets of theories: Information-Motivation-Behaviour, Social Action Theory and Health Behaviour Model, which explain ART adherence. Although they show potential in explaining adherence bebahiours, they fall short in explaining exactly why and how the various elements they outline combine to explain positive or negative outcomes. Candidate mechanisms indentified were motivation, self-efficacy, perceived social support, empowerment, perceived threat, perceived

  11. Exploring 'generative mechanisms' of the antiretroviral adherence club intervention using the realist approach: a scoping review of research-based antiretroviral treatment adherence theories.

    Science.gov (United States)

    Mukumbang, Ferdinand C; Van Belle, Sara; Marchal, Bruno; van Wyk, Brian

    2017-05-04

    Poor retention in care and non-adherence to antiretroviral therapy (ART) continue to undermine the success of HIV treatment and care programmes across the world. There is a growing recognition that multifaceted interventions - application of two or more adherence-enhancing strategies - may be useful to improve ART adherence and retention in care among people living with HIV/AIDS. Empirical evidence shows that multifaceted interventions produce better results than interventions based on a singular perspective. Nevertheless, the bundle of mechanisms by which multifaceted interventions promote ART adherence are poorly understood. In this paper, we reviewed theories on ART adherence to identify candidate/potential mechanisms by which the adherence club intervention works. We searched five electronic databases (PubMed, EBSCOhost, CINAHL, PsycARTICLES and Google Scholar) using Medical Subject Headings (MeSH) terms. A manual search of citations from the reference list of the studies identified from the electronic databases was also done. Twenty-six articles that adopted a theory-guided inquiry of antiretroviral adherence behaviour were included for the review. Eleven cognitive and behavioural theories underpinning these studies were explored. We examined each theory for possible 'generative causality' using the realist evaluation heuristic (Context-Mechanism-Outcome) configuration, then, we selected candidate mechanisms thematically. We identified three major sets of theories: Information-Motivation-Behaviour, Social Action Theory and Health Behaviour Model, which explain ART adherence. Although they show potential in explaining adherence bebahiours, they fall short in explaining exactly why and how the various elements they outline combine to explain positive or negative outcomes. Candidate mechanisms indentified were motivation, self-efficacy, perceived social support, empowerment, perceived threat, perceived benefits and perceived barriers. Although these candidate

  12. Combination antiretroviral therapy and cancer risk

    DEFF Research Database (Denmark)

    Borges, Álvaro H

    2017-01-01

    PURPOSE OF REVIEW: To review the newest research about the effects of combination antiretroviral therapy (cART) on cancer risk. RECENT FINDINGS: HIV+ persons are at increased risk of cancer. As this risk is higher for malignancies driven by viral and bacterial coinfections, classifying malignanci......ART initiation in reducing cancer risk, understand the relationship between long-term cART exposure and cancer incidence and assess whether adjuvant anti-inflammatory therapies can reduce cancer risk during treated HIV infection.......PURPOSE OF REVIEW: To review the newest research about the effects of combination antiretroviral therapy (cART) on cancer risk. RECENT FINDINGS: HIV+ persons are at increased risk of cancer. As this risk is higher for malignancies driven by viral and bacterial coinfections, classifying malignancies...... into infection-related and infection-unrelated has been an emerging trend. Cohorts have detected major reductions in the incidence of Kaposi sarcoma and non-Hodgkin lymphoma (NHL) following cART initiation among immunosuppressed HIV+ persons. However, recent randomized data indicate that cART reduces risk...

  13. Ghana's nuclear programme

    International Nuclear Information System (INIS)

    Ahafia, Albert K.

    1988-01-01

    The Paper gives the purpose of Ghana's Nuclear Programme and describes some specific research activities and peaceful applications of atomic energy in agriculture, medicine and industry. A discussion of some of the problem facing the programme concludes the Paper. (author)

  14. Comprehension and acceptability of a patient information leaflet (pil for antiretroviral therapy

    Directory of Open Access Journals (Sweden)

    Betty Mwingira

    2006-11-01

    Full Text Available The patient information leaflet (PIL is recognised as playing a key role in informing patients about their medicines. The objectives of this research were to evaluate the readability and understanding of a PIL for the first-line ARV (antiretroviral regimen available in the South African public health sector, and investigate its acceptability in the target Xhosa population. Opsomming Daar word algemeen aanvaar dat die pasiëntinligtingsblaadjie (PIB ‘n sleutelrol speel in die oordra van inligting ten opsigte van medikasie aan pasiënte. Die doelwitte van hierdie navorsing was om die leesbaarheid en begrip van ‘n PIB vir die eerste-linie antiretrovirale (ARV regimen wat in die Suid-Afrikaanse openbare gesondheidsektor beskikbaar is, te evalueer, en om die aanvaarbaarheid daarvan in ‘n teiken-Xhosabevolking te ondersoek. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

  15. Determinants of Adherence to Antiretroviral Therapy among HIV-Infected Patients in Africa

    Directory of Open Access Journals (Sweden)

    Ayalu A. Reda

    2012-01-01

    Full Text Available Background. There are only a few comprehensive studies of adherence to ART and its challenges in Africa. This paper aims to assess the evidence on the challenges and prospects of ART adherence in sub-Saharan Africa. Methods. The authors reviewed original and review articles involving HIV-positive individuals that measured adherence to ART and its predictors in the past decade. Findings. Against expectations, sub-Saharan Africa patients have similar or higher adherence levels compared to those of developed countries. The challenges to ART adherence include factors related to patients and their families, socioeconomic factors, medication, and healthcare systems. Conclusion. Despite good adherence and program-related findings, antiretroviral treatment is challenged by a range of hierarchical and interrelated factors. There is substantial room for improvement of ART programs in sub-Sahara African countries.

  16. Intestinal Integrity Biomarkers in Early Antiretroviral-Treated Perinatally HIV-1-Infected Infants.

    Science.gov (United States)

    Koay, Wei Li A; Lindsey, Jane C; Uprety, Priyanka; Bwakura-Dangarembizi, Mutsa; Weinberg, Adriana; Levin, Myron J; Persaud, Deborah

    2018-05-12

    Biomarkers of intestinal integrity (intestinal fatty acid binding protein (iFABP) and zonulin), were compared in early antiretroviral-treated, HIV-1-infected (HIV+; n=56) African infants and HIV-exposed but uninfected (HEU; n=53) controls. Despite heightened inflammation and immune activation in HIV+ infants, iFABP and zonulin levels at three months of age were not different from those in HEU infants, and largely not correlated with inflammatory and immune activation biomarkers. However, zonulin levels increased, and became significantly higher in HIV+ compared to HEU infants by five months of age despite ART-suppression. These findings have implications for intestinal integrity biomarker profiling in perinatal HIV-1 infection.

  17. The Winfrith DSN programme

    International Nuclear Information System (INIS)

    Francescon, S.

    1963-05-01

    The programme, which is written in the Fortran language, solves the Carlson discrete S n approximation to the Boltzmann transport equation in cylindrical geometry. This report describes the input and output facilities of the WINFRITH DSN programme and the associated editing programme WED. (author)

  18. The Winfrith DSN programme

    Energy Technology Data Exchange (ETDEWEB)

    Francescon, S [General Reactor Physics Division, Atomic Energy Establishment, Winfrith, Dorchester, Dorset (United Kingdom)

    1963-05-15

    The programme, which is written in the Fortran language, solves the Carlson discrete S{sub n} approximation to the Boltzmann transport equation in cylindrical geometry. This report describes the input and output facilities of the WINFRITH DSN programme and the associated editing programme WED. (author)

  19. UNESCO's Ethics Education Programme.

    NARCIS (Netherlands)

    Have, H.A.M.J. ten

    2008-01-01

    Unesco initiated the Ethics Education Programme in 2004 at the request of member states to reinforce and increase the capacities in the area of ethics teaching. The programme is focused on providing detailed information about existing teaching programmes. It also develops and promotes teaching

  20. Ritonavir-boosted darunavir combined with raltegravir or tenofovir-emtricitabine in antiretroviral-naive adults infected with HIV-1

    DEFF Research Database (Denmark)

    Raffi, François; Babiker, Abdel G; Richert, Laura

    2014-01-01

    BACKGROUND: Standard first-line antiretroviral therapy for HIV-1 infection includes two nucleoside or nucleotide reverse transcriptase inhibitors (NtRTIs), but these drugs have limitations. We assessed the 96 week efficacy and safety of an NtRTI-sparing regimen. METHODS: Between August, 2010......-inferior to standard treatment and represents a treatment option for patients with CD4 cell counts higher than 200 cells per μL. FUNDING: European Union Sixth Framework Programme, Inserm-ANRS, Gilead Sciences, Janssen Pharmaceuticals, Merck Laboratories....

  1. African Environment

    African Journals Online (AJOL)

    Environmental Studies and Regional Planning Bulletin African Environment is published in French and English, and for some issues, in Arabic. (only the issue below has been received by AJOL). Vol 10, No 3 (1999). DOWNLOAD FULL TEXT Open Access DOWNLOAD FULL TEXT Subscription or Fee Access. Table of ...

  2. African Journals Online: Central African Republic

    African Journals Online (AJOL)

    African Journals Online: Central African Republic. Home > African Journals Online: Central African Republic. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Browse By Category · Browse Alphabetically · Browse By Country · List All Titles · Free to read Titles This ...

  3. The effectiveness of the Expanded Public Works Programme on job ...

    African Journals Online (AJOL)

    The effectiveness of the Expanded Public Works Programme on job creation: a look at a South African ... Open Access DOWNLOAD FULL TEXT ... This paper reports of a study that examined how the eThekwini Municipality's EPWP has been ...

  4. The struggle for textual conventions in a language support programme

    African Journals Online (AJOL)

    In this article, the writer explores the experience of a group of South African learners with regard to a language support course that aims to facilitate their struggle to master English textual conventions in discipline specific contexts. The academic context of this study was that of a nursing science degree programme where ...

  5. Structural challenges of holiday placement programmes for children ...

    African Journals Online (AJOL)

    Structural challenges of holiday placement programmes for children in SOS's Children Village, Zimbabwe. ... African Journal of Social Work ... Response to child protection crisis has essentially seen the placement of orphans and other vulnerable children in residential care institutions, particularly children' homes modelled ...

  6. Evaluating Development Projects and Programmes in Africa: The ...

    African Journals Online (AJOL)

    evaluation. It is indicated that NEPAD has not prescribed any internal or external monitoring and evaluation of its projects and programmes, and therefore calls into doubt the level of professional competence in its delivery strategies. The article also examines selected monitoring and evaluation strategies such as the African

  7. HIV antiretroviral medication stock-outs in Ghana: contributors and consequences.

    Science.gov (United States)

    Poku, Rebecca A; Owusu, Adobea Yaa; Mullen, Patricia Dolan; Markham, Christine; McCurdy, Sheryl A

    2017-09-01

    Drug stock-outs are an unfortunate yet common reality for patients living in low and middle income countries, particularly in sub-Saharan Africa where trouble with consistent stock of antiretroviral medications (ARVs) continues. Our study takes a snapshot of this problem in Ghana. Although the country launched its antiretroviral therapy (ART) programme in 2003, progress toward realising the full benefit of ART for treated individuals has been limited, in part, because of stock-outs. In Ghana's Greater Accra region, we conducted semi-structured interviews with 40 women living with HIV (WLHIV) and 15 individuals with a history of HIV-related work in government or non-governmental organisations, or healthcare facilities. We used repeated review with coding and mapping techniques to analyse the transcripts and identify common themes. Stock-outs of ARVs result in inconsistent administration of therapy, increased indirect medical costs for WLHIV, and negative labelling of patients. Inefficiencies in drug supply, poor coordination with port authorities, inadequate government funding and dependence on international aid contribute to the stock-outs experienced in Ghana. Although using ARVs produced in-country could reduce supply problems, the domestically-manufactured product currently does not meet World Health Organization (WHO) standards. We recommend focused efforts to produce WHO standard ARVs in Ghana, and a review of current supply chain management to identify and mend pitfalls in the system.

  8. Exploring the use of role play in a school-based programme to ...

    African Journals Online (AJOL)

    Exploring the use of role play in a school-based programme to reduce teenage pregnancy. ... South African Journal of Education ... study was undertaken of the use of role plays by Grade 8 learners, at eight urban and rural KwaZulu-Natal high schools, as part of a programme to reduce the prevalence of teenage pregnancy.

  9. Current status of topical antiretroviral chemoprophylaxis.

    Science.gov (United States)

    Van Damme, Lut; Szpir, Michael

    2012-11-01

    Recent studies suggest that the vaginal delivery of antiretroviral (ARV) agents - such as tenofovir, dapivirine and UC781 - may be a promising way to reduce the high rates of HIV infection among women in developing countries. This review examines these developments. The Microbicide Trials Network 003 study, a large phase IIb trial, was unable to show that daily dosing with 1% tenofovir vaginal gel was effective for HIV prevention. Nevertheless, preclinical and early-phase clinical trials suggest that ARV drugs - formulated in vaginal gels, rings, films, tablets and diaphragms - could be effective for HIV chemoprophylaxis. Investigations of topical chemoprophylaxis methods have seen mixed results in the past 12-18 months. Product adherence may prove to be one of the field's greatest challenges. Phase II and III trials continue to explore different dosing strategies for topical products that contain one or more ARV agents.

  10. African Journals Online: African Studies

    African Journals Online (AJOL)

    Items 1 - 50 of 56 ... Africa Development is the quarterly bilingual journal of CODESRIA. .... relationship in the family, workplace, schools and organisations. .... activities, and personalities driving the democracy and development agenda in the region; 4. Conflict .... with preference for the results of African and Africanist studies.

  11. The programme benefits of improving project team communication through a contact centre

    Directory of Open Access Journals (Sweden)

    Bond-Barnard, T. J.

    2013-08-01

    Full Text Available A South African national programme to repair government infrastructure uses a contact centre (or call centre to facilitate and manage communication. An important question is: How does the contact centre benefit the programme and its projects? This study discusses the findings of a survey that quantified the benefits of the programme when the communication between team members in the programme was improved by using a contact centre. The results show that, by using a contact centre to improve the communication between project team members, their perception of communication effectiveness, quality of project deliverables, service delivery, and customer satisfaction of the programme dramatically increases.

  12. The cost of antiretroviral therapy in Haiti

    Directory of Open Access Journals (Sweden)

    Fitzgerald Daniel W

    2008-02-01

    Full Text Available Abstract Background We determined direct medical costs, overhead costs, societal costs, and personnel requirements for the provision of antiretroviral therapy (ART to patients with AIDS in Haiti. Methods We examined data from 218 treatment-naïve adults who were consecutively initiated on ART at the GHESKIO Center in Port-au-Prince, Haiti between December 23, 2003 and May 20, 2004 and calculated costs and personnel requirements for the first year of ART. Results The mean total cost of treatment per patient was $US 982 including $US 846 in direct costs, $US 114 for overhead, and $US 22 for societal costs. The direct cost per patient included generic ART medications $US 355, lab tests $US 130, nutrition $US 117, hospitalizations $US 62, pre-ART evaluation $US 58, labor $US 51, non-ART medications $US 39, outside referrals $US 31, and telephone cards for patient retention $US 3. Higher treatment costs were associated with hospitalization, change in ART regimen, TB treatment, and survival for one year. We estimate that 1.5 doctors and 2.5 nurses are required to treat 1000 patients in the first year after initiating ART. Conclusion Initial ART treatment in Haiti costs approximately $US 1,000 per patient per year. With generic first-line antiretroviral drugs, only 36% of the cost is for medications. Patients who change regimens are significantly more expensive to treat, highlighting the need for less-expensive second-line drugs. There may be sufficient health care personnel to treat all HIV-infected patients in urban areas of Haiti, but not in rural areas. New models of HIV care are needed for rural areas using assistant medical officers and community health workers.

  13. African Journals Online (AJOL)

    African Journals Online (AJOL)

    It has also been difficult for African researchers to access the work of other African academics. In partnership with hundreds of journals from all over the continent, AJOL works to change this, so that African-origin research output is available to Africans and to the rest of the world. AJOL is ... African Journal of AIDS Research.

  14. Manifestações otoneurológicas associadas à terapia anti-retroviral Otoneurological manifestations associated with antiretroviral therapy

    Directory of Open Access Journals (Sweden)

    Andrêza Batista Cheloni Vieira

    2008-02-01

    Full Text Available Ototoxicidade e terapia anti-retroviral parecem estar associadas. O objetivo desse estudo foi avaliar essa possível correlação. Foram avaliados 779 prontuários médicos de pacientes infectados pelo HIV e regularmente acompanhados, sendo 162 tratados com terapia anti-retroviral e 122 não tratados (controle. Pacientes em tratamento eram mais velhos (média 42 anos, com maior tempo de confirmação sorológica (80 meses e com menor carga viral (p=0,00. CD4+ foi semelhante entre os grupos (P=0,60. No grupo tratado, três (1,8% casos de perda auditiva idiopática e dois (1,3% de perda auditiva relacionada a otosclerose foram observadas e ambas iniciadas após terapia anti-retroviral. Nenhuma diferença estatística relacionada à perda auditiva idiopática foi encontrada entre os grupos. Enquanto estudos descritivos consideram possível ototoxidade associada à terapia anti-retroviral, esse possível efeito adverso não foi relacionado à terapia anti-retroviral neste estudo. Contrariamente, otosclerose poderia estar correlacionada à terapia anti-retroviral. Este assunto merece ser estudado.Ototoxicity and antiretroviral therapy seem to be associated. The aim of this study was to evaluate this possible correlation. Evaluations were carried out on 779 medical records from HIV-infected patients who were being regularly followed up, of whom 162 were being treated with antiretroviral therapy and 122 were untreated (controls. The patients undergoing treatment were older (mean: 42 years, had had serological confirmation for longer times (80 months and had smaller viral loads (P = 0.00. CD4+ was similar between the groups (P = 0.60. In the treated group, three cases (1.8% of idiopathic hearing loss and two (1.3% of otosclerosis-related hearing loss were observed, which both started after antiretroviral therapy. No statistical difference relating to idiopathic hearing loss was found between the groups. While descriptive studies consider possible

  15. Severe morbidity after antiretroviral (ART) initiation

    DEFF Research Database (Denmark)

    Abo, Yao; Zannou Djimon, Marcel; Messou, Eugène

    2015-01-01

    system established within a network of specialized care facilities in West African cities. METHODS: Within the International epidemiological Database to Evaluate AIDS (IeDEA)--West Africa collaboration, we conducted a prospective, multicenter data collection that involved two facilities in Abidjan, Côte...

  16. HIV/AIDS National Strategic Plans of Sub-Saharan African countries: an analysis for gender equality and sex-disaggregated HIV targets

    Science.gov (United States)

    Sherwood, Jennifer; Sharp, Alana; Cooper, Bergen; Roose-Snyder, Beirne; Blumenthal, Susan

    2017-01-01

    Abstract National Strategic Plans (NSPs) for HIV/AIDS are country planning documents that set priorities for programmes and services, including a set of targets to quantify progress toward national and international goals. The inclusion of sex-disaggregated targets and targets to combat gender inequality is important given the high disease burden among young women and adolescent girls in Sub-Saharan Africa, yet no comprehensive gender-focused analysis of NSP targets has been performed. This analysis quantitatively evaluates national HIV targets, included in NSPs from eighteen Sub-Saharan African countries, for sex-disaggregation. Additionally, NSP targets aimed at reducing gender-based inequality in health outcomes are compiled and inductively coded to report common themes. On average, in the eighteen countries included in this analysis, 31% of NSP targets include sex-disaggregation (range 0–92%). Three countries disaggregated a majority (>50%) of their targets by sex. Sex-disaggregation in data reporting was more common for targets related to the early phases of the HIV care continuum: 83% of countries included any sex-disaggregated targets for HIV prevention, 56% for testing and linkage to care, 22% for improving antiretroviral treatment coverage, and 11% for retention in treatment. The most common target to reduce gender inequality was to prevent gender-based violence (present in 50% of countries). Other commonly incorporated target areas related to improving women’s access to family planning, human and legal rights, and decision-making power. The inclusion of sex-disaggregated targets in national planning is vital to ensure that programmes make progress for all population groups. Improving the availability and quality of indicators to measure gender inequality, as well as evaluating programme outcomes by sex, is critical to tracking this progress. This analysis reveals an urgent need to set specific and separate targets for men and women in order to achieve

  17. Factors affecting adherence to antiretroviral therapy among pregnant women in the Eastern Cape, South Africa.

    Science.gov (United States)

    Adeniyi, Oladele Vincent; Ajayi, Anthony Idowu; Ter Goon, Daniel; Owolabi, Eyitayo Omolara; Eboh, Alfred; Lambert, John

    2018-04-13

    Context-specific factors influence adherence to antiretroviral therapy (ART) among pregnant women living with HIV. Gaps exist in the understanding of the reasons for the variable outcomes of the prevention of mother-to-child transmission (PMTCT) programme at the health facility level in South Africa. This study examined adherence levels and reasons for non-adherence during pregnancy in a cohort of parturient women enrolled in the PMTCT programme in the Eastern Cape, South Africa. This was a mixed-methods study involving 1709 parturient women in the Eastern Cape, South Africa. We conducted a multi-centre retrospective analysis of the mother-infant pair in the PMTCT electronic database in 2016. Semi-structured interviews of purposively selected parturient women with self-reported poor adherence (n = 177) were conducted to gain understanding of the main barriers to adherence. Binary logistic regression was used to determine the independent predictors of ART non-adherence. A high proportion (69.0%) of women reported perfect adherence. In the logistic regression analysis, after adjusting for confounding factors, marital status, cigarette smoking, alcohol use and non-disclosure to a family member were the independent predictors of non-adherence. Analysis of the qualitative data revealed that drug-related side-effects, being away from home, forgetfulness, non-disclosure, stigma and work-related demand were among the main reasons for non-adherence to ART. Non-adherence to the antiretroviral therapy among pregnant women in this setting is associated with lifestyle behaviours, HIV-related stigma and ART side-effects. In order to eliminate mother-to-child transmission of HIV, clinicians need to screen for these factors at every antenatal clinic visit.

  18. The effects of enhanced access to antiretroviral therapy: a qualitative ...

    African Journals Online (AJOL)

    The effects of enhanced access to antiretroviral therapy: a qualitative study of community perceptions in ... Twenty FGDs comprising of 190 participants and 12 KI interviews were conducted. ... All data was tape recorded with consent from

  19. Short-term treatment outcomes of children starting antiretroviral ...

    African Journals Online (AJOL)

    Short-term treatment outcomes of children starting antiretroviral therapy in the intensive care unit, general medical wards and outpatient HIV clinics at Red Cross War Memorial Children's Hospital, Cape Town, South Africa: A retrospective cohort study.

  20. Adherence to antiretrovirals in refugees and asylum seekers.

    Science.gov (United States)

    Nwoguh, Francisca

    Adherence to antiretroviral regimes is essential in effective management of HIV. The cultural, social, religious and immigration status of refugees and asylum seekers can have an impact on their understanding of their care needs and maintenance of their treatment regimen.

  1. Roles of family dynamics on adherence to highly active antiretroviral ...

    African Journals Online (AJOL)

    EB

    Background: Adherence to highly active antiretroviral therapy (HAART) has been proven .... Table 1: Relationship between socio-demographic characteristics and HAART adherence among ... constraints (44%), stigma (15%), travel/migration.

  2. Determination of eligibility to antiretroviral therapy in resource ...

    African Journals Online (AJOL)

    admin

    Objective: This study was to determine eligibility for antiretroviral therapy in resource-limited settings using total lymphocyte .... ART until CD4+ T cell counts fall below 200 cells/mm3 ... (Abbott Cell Dyne Operators manual) were checked for.

  3. Antiretroviral Drug Resistance- implications for HIV/AIDS reduction ...

    African Journals Online (AJOL)

    Saharan Africa and other developing countries. ... Abstract: Background: The introduction of the highly active antiretroviral therapy in the mid-1990s has significantly reduced morbidities and prolonged the lifespan of people living with HIV. However ...

  4. Why HIV Positive Patients on Antiretroviral Treatment and/or ...

    African Journals Online (AJOL)

    Why HIV Positive Patients on Antiretroviral Treatment and/or Cotrimoxazole Prophylaxis Use Traditional Medicine: Perceptions of Health Workers, Traditional Healers and Patients: A Study in Two Provinces of South Africa.

  5. Antiretroviral therapy in a community clinic - early lessons from a ...

    African Journals Online (AJOL)

    Antiretroviral therapy in a community clinic - early lessons from a pilot project. ... The HIV Research Unit, University of Cape Town, supplied training and ... Attention must be given to the diagnosis of tuberculosis during screening and early ART ...

  6. Long-Acting Antiretrovirals: Where Are We now?

    Science.gov (United States)

    Nyaku, Amesika N; Kelly, Sean G; Taiwo, Babafemi O

    2017-04-01

    Current HIV treatment options require daily use of combination antiretroviral drugs. Many persons living with HIV experience treatment fatigue and suboptimal adherence as a result. Long-acting antiretroviral drugs are being developed to expand options for HIV treatment. Here, we review the agents in development, and evaluate data from recent clinical trials. In addition, we anticipate challenges to successful widespread use of long-acting antiretrovirals. Parenteral nanosuspensions of cabotegravir and rilpivirine, and dapivirine vaginal ring are the farthest in clinical development. Long-acting modalities in earlier development stages employ drug-loaded implants, microparticles, or targeted mutagenesis, among other innovations. Long-acting antiretroviral drugs promise new options for HIV prevention and treatment, and ways to address poor adherence and treatment fatigue. Further studies will identify the long-acting agents or combinations that are suitable for routine use. Creative solutions will be needed for anticipated implementation challenges.

  7. Antiretroviral Drugs Used in the Treatment of HIV Infection

    Science.gov (United States)

    ... HIV/AIDS Treatment Antiretroviral drugs used in the treatment of HIV infection Share Tweet Linkedin Pin it More sharing ... Pin it Email Print Drugs Used in the Treatment of HIV Infection All FDA-approved medicines used in the ...

  8. Obesity and African Americans

    Science.gov (United States)

    ... Data > Minority Population Profiles > Black/African American > Obesity Obesity and African Americans African American women have the ... youthonline . [Accessed 08/18/2017] HEALTH IMPACT OF OBESITY People who are overweight are more likely to ...

  9. African Journals Online: Kenya

    African Journals Online (AJOL)

    Items 1 - 29 of 29 ... African Journal of Food, Agriculture, Nutrition and Development ... African and international non-governmental organizations (NGOs); African and .... for scholars and practitioners in all spheres of biological sciences to publish ...

  10. Retraction | Simon | African Zoology

    African Journals Online (AJOL)

    Panthera leo) ina. West African national park”. African Zoology is publishing an Editorial Expression of Concern regarding the following article: “New records of a threatened lion population (Panthera leo) in a West African national park” by ...

  11. The Epidemiology of Meningitis among Adults in a South African Province with a High HIV Prevalence, 2009-2012

    Science.gov (United States)

    Britz, Erika; Perovic, Olga; von Mollendorf, Claire; von Gottberg, Anne; Iyaloo, Samantha; Quan, Vanessa; Chetty, Verushka; Sriruttan, Charlotte; Ismail, Nazir A.; Nanoo, Ananta; Musekiwa, Alfred; Reddy, Carl; Viljoen, Karien; Cohen, Cheryl; Govender, Nelesh P.

    2016-01-01

    Introduction Meningitis is a major cause of mortality in southern Africa. We aimed to describe the aetiologies and frequencies of laboratory-confirmed fungal and bacterial meningitis among adults in a South African province with an 11% HIV prevalence, over 4 years. Methods We conducted a retrospective, observational study of secondary laboratory data, extracted on all cerebrospinal fluid (CSF) specimens submitted to public-sector laboratories in Gauteng province from 2009 through 2012. We calculated cause-specific incidence rates in the general and HIV-infected populations and used Poisson regression to determine if trends were significant. Results We identified 11,891 (10.7%) incident cases of meningitis from 110,885 CSF specimens. Cryptococcal meningitis, tuberculous meningitis and pneumococcal meningitis accounted for 62.3% (n = 7,406), 24.6% (n = 2,928) and 10.1% (n = 1,197) of cases over the four-year period. The overall incidence (cases per 100,000 persons) of cryptococcal meningitis declined by 23% from 24.4 in 2009 to 18.7 in 2012 (p meningitis decreased by 40% from 11.3 in 2009 to 6.8 in 2012 (p meningitis decreased by 41% from 4.2 in 2009 to 2.5 in 2012 (p meningitis (248/11,891, 2.1%), Neisseria meningitidis (n = 93), Escherichia coli (n = 72) and Haemophilus influenzae (n = 20) were the most common organisms identified. Conclusions In this high HIV-prevalence province, cryptococcal meningitis was the leading cause of laboratory-confirmed meningitis among adults. Over a 4-year period, there was a significant decrease in incidence of cryptococcal, tuberculous and pneumococcal meningitis. This coincided with expansion of the national antiretroviral treatment programme, enhanced tuberculosis control programme and routine childhood immunisation with pneumococcal conjugate vaccines. PMID:27669564

  12. Scientific Production about the Adherence to Antiretroviral Therapy

    Directory of Open Access Journals (Sweden)

    Regina Célia De Oliveira

    2017-09-01

    Full Text Available Objective: To identify the elite of authors about the subject adherence to antiretroviral therapy; to identify the journals turned to publishing articles about adherence to antiretroviral therapy; and to identify and analyze the most commonly used words in abstracts of articles about adherence to antiretroviral therapy. Method: A bibliometric study conducted through the Scopus base. We used articles published between 1996 and 2014, after application of the eligibility criteria, there were composed the sample with 24 articles. The data were analyzed descriptively. Were used the laws of bibliometric (Lotka, Bradford and Zipf and the conceptual cloud map of words, through the program Cmap tools. Results: Lotka's Law identified the 5 authors more productive (46% of the total published. Bradford is impaired in this study. Concerning Zipf, 3 zones were determined, 31.47% of the words with in the first zone, 26.46% in the second and 42.06% in the third. In the conceptual map, the words/factors that positively and negatively influence adherence were emphasized, among them the need for more research in the health services. Conclusion: There are few publications about the accession to antiretroviral therapy, and the scientific production is in the process of maturation. One can infer that the theme researched is not yet an obsolete topic. It should be noted that the Bibliometric was a relevant statistic tool to generate information about the publications about the antiretroviral therapy. Descriptors: Antiretroviral Therapy, Highly Active; Medication Adherence; Bibliometric; HIV; Acquired Immunodeficiency Syndrome

  13. Dyslipidemia in HIV Infected Children Receiving Highly Active Antiretroviral Therapy.

    Science.gov (United States)

    Mandal, Anirban; Mukherjee, Aparna; Lakshmy, R; Kabra, Sushil K; Lodha, Rakesh

    2016-03-01

    To assess the prevalence of dyslipidemia and lipodystrophy in Indian children receiving non-nucleoside reverse transcriptase inhibitor (NNRTI) based highly active antiretroviral therapy (HAART) and to determine the associated risk factors for the same. The present cross-sectional study was conducted at a Pediatric Clinic of a tertiary care teaching center in India, from May 2011 through December 2012. HIV infected children aged 5-15 y were enrolled if they did not have any severe disease or hospital admission within last 3 mo or receive any medications known to affect the lipid profile. Eighty-one children were on highly active antiretroviral therapy (HAART) for at least 6 mo and 16 were receiving no antiretroviral therapy (ART). Participants' sociodemographic, nutritional, clinical, and laboratory data were recorded in addition to anthropometry and evidence of lipodystrophy. Fasting lipid profile, apolipoprotein A1 and B levels were done for all the children. Among the children on highly active antiretroviral therapy (HAART), 38.3 % had dyslipidemia and 80.2 % had lipodystrophy, while 25 % antiretroviral therapy (ART) naïve HIV infected children had dyslipidemia. No clinically significant risk factors could be identified that increased the risk of dyslipidemia or lipodystrophy in children on highly active antiretroviral therapy (HAART). There is a high prevalence of dyslipidemia and lipodystrophy in Indian children with HIV infection with an imminent need to establish facilities for testing and treatment of these children for metabolic abnormalities.

  14. CD4+ Count-Guided Interruption of Antiretroviral Treatment. The Strategies for Mangement of Antiretroviral Therapy (SMART) Study Group

    DEFF Research Database (Denmark)

    El-Sadr, WM; Lundgren, Jens Dilling; Neaton, JD

    2006-01-01

    had a CD4+ cell count of more than 350 per cubic millimeter to the continuous use of antiretroviral therapy (the viral suppression group) or the episodic use of antiretroviral therapy (the drug conservation group). Episodic use involved the deferral of therapy until the CD4+ count decreased to less......BACKGROUND: Despite declines in morbidity and mortality with the use of combination antiretroviral therapy, its effectiveness is limited by adverse events, problems with adherence, and resistance of the human immunodeficiency virus (HIV). METHODS: We randomly assigned persons infected with HIV who...... the risk of adverse events that have been associated with antiretroviral therapy. (ClinicalTrials.gov number, NCT00027352 [ClinicalTrials.gov].). Copyright 2006 Massachusetts Medical Society....

  15. Finnish bioenergy research programme

    Energy Technology Data Exchange (ETDEWEB)

    Asplund, D. [VTT Energy, Jyvaeskylae (Finland)

    1996-12-31

    Finland is a leading country in the use of biofuels and has excellent opportunities to increase the use of biofuels by up to 25-30 %. The Finnish Government has set an objective for the promotion of bioenergy. The aim is to increase the use of bioenergy by about 25 % from the present level by 2005, and the increment corresponds to 1.5 million tonnes of oil equivalent (toe) per year. The R and D work has been considered as an important factor to achieve this ambitious goal. Energy research was organised into a series of research programmes in 1988 in accordance with the proposal of Finnish Energy Research Committee. The object of the research programmes is to enhance research activities and to bundle individual projects together into larger research packages. The common target of the Finnish energy research programmes is to proceed from basic and applied research to product development and pilot operation, and after that to the first commercial applications, e.g. demonstrations. As the organisation of energy research to programmes has led to good results, the Finnish Ministry of Trade and Industry decided to go on with this practice by launching new six-year programmes in 1993-1998. One of these programmes is the Bioenergy Research Programme and the co-ordination of this programme is carried out by VTT Energy. Besides VTT Energy the Finnish Forest Research Institute, Work Efficiency Institute, Metsaeteho and University of Joensuu are participating in the programme 7 refs.

  16. Finnish bioenergy research programme

    Energy Technology Data Exchange (ETDEWEB)

    Asplund, D [VTT Energy, Jyvaeskylae (Finland)

    1997-12-31

    Finland is a leading country in the use of biofuels and has excellent opportunities to increase the use of biofuels by up to 25-30 %. The Finnish Government has set an objective for the promotion of bioenergy. The aim is to increase the use of bioenergy by about 25 % from the present level by 2005, and the increment corresponds to 1.5 million tonnes of oil equivalent (toe) per year. The R and D work has been considered as an important factor to achieve this ambitious goal. Energy research was organised into a series of research programmes in 1988 in accordance with the proposal of Finnish Energy Research Committee. The object of the research programmes is to enhance research activities and to bundle individual projects together into larger research packages. The common target of the Finnish energy research programmes is to proceed from basic and applied research to product development and pilot operation, and after that to the first commercial applications, e.g. demonstrations. As the organisation of energy research to programmes has led to good results, the Finnish Ministry of Trade and Industry decided to go on with this practice by launching new six-year programmes in 1993-1998. One of these programmes is the Bioenergy Research Programme and the co-ordination of this programme is carried out by VTT Energy. Besides VTT Energy the Finnish Forest Research Institute, Work Efficiency Institute, Metsaeteho and University of Joensuu are participating in the programme 7 refs.

  17. Effects on anthropometry and appetite of vitamins and minerals given in lipid nutritional supplements for malnourished HIV-infected adults referred for antiretroviral therapy

    DEFF Research Database (Denmark)

    Rehman, Andrea M; Woodd, Susannah; PrayGod, George

    2015-01-01

    in malnourished patients starting ART and that vitamin and mineral supplementation would improve appetite and permit nutritional recovery. DESIGN:: The randomised controlled Nutritional Support for Africans Starting Antiretroviral Therapy (NUSTART) trial was conducted in Mwanza, Tanzania and Lusaka, Zambia. ART......-upper-arm circumference. CONCLUSIONS:: Provision of high levels of vitamins and minerals to patients referred for ART, delivered with substantial macronutrients, increased nutritional recovery but did not appear to act through treatment group differences in appetite.This is an open access article distributed under......BACKGROUND:: The evidence base for effects of nutritional interventions for malnourished HIV-infected patients starting antiretroviral therapy (ART) is limited and inconclusive. OBJECTIVE:: We hypothesised that both vitamin and mineral deficiencies and poor appetite limit weight gain...

  18. Designing equitable antiretroviral allocation strategies in resource-constrained countries.

    Directory of Open Access Journals (Sweden)

    David P Wilson

    2005-02-01

    Full Text Available Recently, a global commitment has been made to expand access to antiretrovirals (ARVs in the developing world. However, in many resource-constrained countries the number of individuals infected with HIV in need of treatment will far exceed the supply of ARVs, and only a limited number of health-care facilities (HCFs will be available for ARV distribution. Deciding how to allocate the limited supply of ARVs among HCFs will be extremely difficult. Resource allocation decisions can be made on the basis of many epidemiological, ethical, or preferential treatment priority criteria.Here we use operations research techniques, and we show how to determine the optimal strategy for allocating ARVs among HCFs in order to satisfy the equitable criterion that each individual infected with HIV has an equal chance of receiving ARVs. We present a novel spatial mathematical model that includes heterogeneity in treatment accessibility. We show how to use our theoretical framework, in conjunction with an equity objective function, to determine an optimal equitable allocation strategy (OEAS for ARVs in resource-constrained regions. Our equity objective function enables us to apply the egalitarian principle of equity with respect to access to health care. We use data from the detailed ARV rollout plan designed by the government of South Africa to determine an OEAS for the province of KwaZulu-Natal. We determine the OEAS for KwaZulu-Natal, and we then compare this OEAS with two other ARV allocation strategies: (i allocating ARVs only to Durban (the largest urban city in KwaZulu-Natal province and (ii allocating ARVs equally to all available HCFs. In addition, we compare the OEAS to the current allocation plan of the South African government (which is based upon allocating ARVs to 17 HCFs. We show that our OEAS significantly improves equity in treatment accessibility in comparison with these three ARV allocation strategies. We also quantify how the size of the

  19. Influence of the number of daily pills and doses on adherence to antiretroviral treatment: a 7-year study.

    Science.gov (United States)

    Hernández Arroyo, M J; Cabrera Figueroa, S E; Sepúlveda Correa, R; Valverde Merino, M P; Luna Rodrigo, G; Domínguez-Gil Hurlé, A

    2016-02-01

    Antiretroviral treatment (ART) is hampered by complicated regimens, high pill burden, drug-drug interactions, and frequent short- and long-term adverse effects, leading to decreased adherence. Over recent years, considerable effort has been directed at developing regimens that are less burdening. We undertook a 7-year retrospective study of the records of 264 HIV-infected subjects enrolled in a pharmaceutical care programme to document the progress made and to study the influence of the number of ART pills and doses on the level of treatment adherence. Antiretroviral dispensing records were analysed for the number of pills and doses administered and the ART adherence rate estimated. In 2005, the patients took a mean of 6·2 pills daily (CI 95%: 5·9-6·6), and 92·9% of them were on a twice-a-day (BID) dosage regimen. By 2012, the mean number of pills was reduced to 4·1 (CI 95%: 3·8-4·4), and only 50·9% were on a BID regimen. No statistically significant relation was observed between number of daily pills and doses and ART adherence reached by the patients in any of the analyses performed. There has been a continuous reduction in the number of pills and doses of antiretrovirals taken by individual patients over the last 7 years due largely to the introduction of improved treatments and regimens. More daily pills or doses was not associated with worse ART adherence in our pharmaceutical care programme. © 2015 John Wiley & Sons Ltd.

  20. Interactions between recreational drugs and antiretroviral agents.

    Science.gov (United States)

    Antoniou, Tony; Tseng, Alice Lin-In

    2002-10-01

    To summarize existing data regarding potential interactions between recreational drugs and drugs commonly used in the management of HIV-positive patients. Information was obtained via a MEDLINE search (1966-August 2002) using the MeSH headings human immunodeficiency virus, drug interactions, cytochrome P450, medication names commonly prescribed for the management of HIV and related opportunistic infections, and names of commonly used recreational drugs. Abstracts of national and international conferences, review articles, textbooks, and references of all articles were also reviewed. Literature on pharmacokinetic interactions was considered for inclusion. Pertinent information was selected and summarized for discussion. In the absence of specific data, prediction of potential clinically significant interactions was based on pharmacokinetic and pharmacodynamic properties. All protease inhibitors (PIs) and nonnucleoside reverse transcriptase inhibitors are substrates and potent inhibitors or inducers of the cytochrome P450 system. Many classes of recreational drugs, including benzodiazepines, amphetamines, and opioids, are also metabolized by the liver and can potentially interact with antiretrovirals. Controlled interaction studies are often not available, but clinically significant interactions have been observed in a number of case reports. Overdoses secondary to interactions between the "rave" drugs methylenedioxymethamphetamine (MDMA) or gamma-hydroxybutyrate (GHB) and PIs have been reported. PIs, particularly ritonavir, may also inhibit metabolism of amphetamines, ketamine, lysergic acid diethylmide (LSD), and phencyclidine (PCP). Case series and pharmacokinetic studies suggest that nevirapine and efavirenz induce methadone metabolism, which may lead to symptoms of opiate withdrawal. A similar interaction may exist between methadone and the PIs ritonavir and nelfinavir, although the data are less consistent. Opiate metabolism can be inhibited or induced by

  1. HIV drug resistance following a decade of the free antiretroviral therapy programme in India: A review

    Directory of Open Access Journals (Sweden)

    Santosh Karade

    2018-01-01

    Conclusions: Although the overall burden of resistance against first-line ART agents remained steady over the study decade, periodic monitoring is essential. There is the need to develop an HIV-1 subtype C-specific resistance database in India.

  2. African Journal of AIDS Research - Vol 10, No 3-Sup (2011)

    African Journals Online (AJOL)

    Gendered perceptions of HIV risk among young women and men in a ... Employment discrimination and HIV stigma: survey results from civil society ... treatment adherence in a South African mining workplace programme and implications for ...

  3. Self-sampling kits to increase HIV testing among black Africans in the UK: the HAUS mixed-methods study.

    Science.gov (United States)

    Seguin, Maureen; Dodds, Catherine; Mugweni, Esther; McDaid, Lisa; Flowers, Paul; Wayal, Sonali; Zomer, Ella; Weatherburn, Peter; Fakoya, Ibidun; Hartney, Thomas; McDonagh, Lorraine; Hunter, Rachael; Young, Ingrid; Khan, Shabana; Freemantle, Nick; Chwaula, Jabulani; Sachikonye, Memory; Anderson, Jane; Singh, Surinder; Nastouli, Eleni; Rait, Greta; Burns, Fiona

    2018-04-01

    Timely diagnosis of human immunodeficiency virus (HIV) enables access to antiretroviral treatment, which reduces mortality, morbidity and further transmission in people living with HIV. In the UK, late diagnosis among black African people persists. Novel methods to enhance HIV testing in this population are needed. To develop a self-sampling kit (SSK) intervention to increase HIV testing among black Africans, using existing community and health-care settings (stage 1) and to assess the feasibility for a Phase III evaluation (stage 2). A two-stage, mixed-methods design. Stage 1 involved a systematic literature review, focus groups and interviews with key stakeholders and black Africans. Data obtained provided the theoretical base for intervention development and operationalisation. Stage 2 was a prospective, non-randomised study of a provider-initiated, HIV SSK distribution intervention targeted at black Africans. The intervention was assessed for cost-effectiveness. A process evaluation explored feasibility, acceptability and fidelity. Twelve general practices and three community settings in London. HIV SSK return rate. Stage 1 - the systematic review revealed support for HIV SSKs, but with scant evidence on their use and clinical effectiveness among black Africans. Although the qualitative findings supported SSK distribution in settings already used by black Africans, concerns were raised about the complexity of the SSK and the acceptability of targeting. These findings were used to develop a theoretically informed intervention. Stage 2 - of the 349 eligible people approached, 125 (35.8%) agreed to participate. Data from 119 were included in the analysis; 54.5% (65/119) of those who took a kit returned a sample; 83.1% of tests returned were HIV negative; and 16.9% were not processed, because of insufficient samples. Process evaluation showed the time pressures of the research process to be a significant barrier to feasibility. Other major barriers were

  4. Cerebrospinal Fluid HIV Escape from Antiretroviral Therapy.

    Science.gov (United States)

    Ferretti, Francesca; Gisslen, Magnus; Cinque, Paola; Price, Richard W

    2015-06-01

    CNS infection is a nearly constant facet of systemic CNS infection and is generally well controlled by suppressive systemic antiretroviral therapy (ART). However, there are instances when HIV can be detected in the cerebrospinal fluid (CSF) despite suppression of plasma viruses below the clinical limits of measurement. We review three types of CSF viral escape: asymptomatic, neuro-symptomatic, and secondary. The first, asymptomatic CSF escape, is seemingly benign and characterized by lack of discernable neurological deterioration or subsequent CNS disease progression. Neuro-symptomatic CSF escape is an uncommon, but important, entity characterized by new or progressive CNS disease that is critical to recognize clinically because of its management implications. Finally, secondary CSF escape, which may be even more uncommon, is defined by an increase of CSF HIV replication in association with a concomitant non-HIV infection, as a consequence of the local inflammatory response. Understanding these CSF escape settings not only is important for clinical diagnosis and management but also may provide insight into the CNS HIV reservoir.

  5. Antiretroviral procurement and supply chain management.

    Science.gov (United States)

    Ripin, David J; Jamieson, David; Meyers, Amy; Warty, Umesh; Dain, Mary; Khamsi, Cyril

    2014-01-01

    Procurement, the country-level process of ordering antiretrovirals (ARVs), and supply chain management, the mechanism by which they are delivered to health-care facilities, are critical processes required to move ARVs from manufacturers to patients. To provide a glimpse into the ARV procurement and supply chain, the following pages provide an overview of the primary stakeholders, principal operating models, and policies and regulations involved in ARV procurement. Also presented are key challenges that need to be addressed to ensure that the supply chain is not a barrier to the goal of universal coverage. This article will cover the steps necessary to order and distribute ARVs, including different models of delivery, key stakeholders involved, strategic considerations that vary depending on context and policies affecting them. The single drug examples given illustrate the complications inherent in fragmented supply and demand-driven models of procurement and supply chain management, and suggest tools for navigating these hurdles that will ultimately result in more secure and reliable ARV provision. Understanding the dynamics of ARV supply chain is important for the global health community, both to ensure full and efficient treatment of persons living with HIV as well as to inform the supply chain decisions for other public health products.

  6. Accessibility of antiretroviral therapy in Ghana: convenience of access.

    Science.gov (United States)

    Addo-Atuah, Joyce; Gourley, Dick; Gourley, Greta; White-Means, Shelley I; Womeodu, Robin J; Faris, Richard J; Addo, Nii Akwei

    2012-01-01

    The convenience of accessing antiretroviral therapy (ART) is important for initial access to care and subsequent adherence to ART. We conducted a qualitative study of people living with HIV/AIDS (PLWHA) and ART healthcare providers in Ghana in 2005. The objective of this study was to explore the participants' perceived convenience of accessing ART by PLWHA in Ghana. The convenience of accessing ART was evaluated from the reported travel and waiting times to receive care, the availability, or otherwise, of special considerations, with respect to the waiting time to receive care, for those PLWHA who were in active employment in the formal sector, the frequency of clinic visits before and after initiating ART, and whether the PLWHA saw the same or different providers at each clinic visit (continuity of care). This qualitative study used in-depth interviews based on Yin's case-study research design to collect data from 20 PLWHA and 24 ART healthcare providers as study participants. • Reported travel time to receive ART services ranged from 2 to 12 h for 30% of the PLWHA. • Waiting time to receive care was from 4 to 9 h. • While known government workers, such as teachers, were attended to earlier in some of the centres, this was not a consistent practice in all the four ART centres studied. • The PLWHA corroborated the providers' description of the procedure for initiating and monitoring ART in Ghana. • PLWHA did not see the same provider every time, but they were assured that this did not compromise the continuity of their care. Our study suggests that convenience of accessing ART is important to both PLWHA and ART healthcare providers, but the participants alluded to other factors, including open provider-patient communication, which might explain the PLWHA's understanding of the constraints under which they were receiving care. The current nation-wide coverage of the ART programme in Ghana, however, calls for the replication of this study to identify

  7. Factors associated with suboptimal adherence to antiretroviral therapy in Asia

    Science.gov (United States)

    Jiamsakul, Awachana; Kumarasamy, Nagalingeswaran; Ditangco, Rossana; Li, Patrick CK; Phanuphak, Praphan; Sirisanthana, Thira; Sungkanuparph, Somnuek; Kantipong, Pacharee; Lee, Christopher KC; Mustafa, Mahiran; Merati, Tuti; Kamarulzaman, Adeeba; Singtoroj, Thida; Law, Matthew

    2014-01-01

    Introduction Adherence to antiretroviral therapy (ART) plays an important role in treatment outcomes. It is crucial to identify factors influencing adherence in order to optimize treatment responses. The aim of this study was to assess the rates of, and factors associated with, suboptimal adherence (SubAdh) in the first 24 months of ART in an Asian HIV cohort. Methods As part of a prospective resistance monitoring study, the TREAT Asia Studies to Evaluate Resistance Monitoring Study (TASER-M) collected patients’ adherence based on the World Health Organization-validated Adherence Visual Analogue Scale. SubAdh was defined in two ways: (i) 14 days. Time was divided into four intervals: 0–6, 6–12, 12–18 and 18–24 months. Factors associated with SubAdh were analysed using generalized estimating equations. Results Out of 1316 patients, 32% ever reported 2 assessments per patient per year had an odds ratio (OR)=0.7 (95% confidence interval (CI) (0.55 to 0.90), p=0.006), compared to sites with ≤2 assessments per patient per year. Compared to heterosexual exposure, SubAdh was higher in injecting drug users (IDUs) (OR=1.92, 95% CI (1.23 to 3.00), p=0.004) and lower in homosexual exposure (OR=0.52, 95% CI (0.38 to 0.71), p<0.001). Patients taking a nucleoside transcriptase inhibitor and protease inhibitor (NRTI+PI) combination were less likely to report adherence <100% (OR=0.36, 95% CI (0.20 to 0.67), p=0.001) compared to patients taking an NRTI and non-nucleoside transcriptase inhibitor (NRTI+NNRTI) combination. SubAdh decreased with increasing time on ART (all p<0.001). Similar associations were found with adherence <95% as the outcome. Conclusions We found that SubAdh, defined as either <100% and <95%, was associated with mode of HIV exposure, ART regimen, time on ART and frequency of adherence measurement. The more frequently sites assessed patients, the lower the SubAdh, possibly reflecting site resourcing for patient counselling. Although social

  8. Fixed-dose combination for adults accessing antiretroviral therapy

    Directory of Open Access Journals (Sweden)

    SA HIV Clinicians Society

    2013-02-01

    Full Text Available This document serves to guide clinicians and programme managers on how to switch from 3 separate antiretroviral (ARV drugs to the new, single, fixed-dose combination (FDC tablet containing tenofovir (TDF, emtricitabine (FTC and efavirenz (EFV. Summary Transitioning from individual drugs to an FDC tablet needs to be managed carefully, particularly regarding stock management, ordering processes, supply-chain integrity and comprehensive patient counselling. Priority groups • Initially, FDC supply will be insufficient to provide for all FDC-suitable patients • Therefore, the National Department of Health (NDoH has recommended that the following patient groups be prioritized for FDC initiation/switch: • Priority group 1: All HIV-positive patients newly initiating ART – adults, adolescents and pregnant women (regardless of CD4 count (amendment to the guidelines for the prevention of mother-to-child transmission of HIV (PMTCT anticipated in April 2013 – and who do not have contra-indications to the FDC component drugs • Priority group 2: HIV-positive pregnant women and breastfeeding mothers currently stable on lamivudine (3TC, TDF and EFV • Priority group 3: Virologically suppressed patients on a stavudine (d4T-based regimen and who have normal renal function • Priority group 4: Stable patients receiving individual TDF, 3TC and EFV and who have tuberculosis (TB co-infection • Priority group 5: Stable patients receiving individual TDF, 3TC and EFV and who have other co-morbidites (e.g. hypertension, diabetes • Priority group 6: Patients receiving individual TDF, 3TC and EFV and who request to switch to the FDC treatment • Priority group 7: Patients receiving individual TDF, 3TC and EFV and who, after counselling, agree to switch to the FDC treatment. Important: Clinic staff must co-ordinate this process and only switch as many patients to the FDC tablet as stock allows. This should avoid patients being switched back and forth

  9. Fusion technology programme

    International Nuclear Information System (INIS)

    Finken, D.

    1984-04-01

    KfK participates to the Fusion Technology Programme of the European Community. Most of the work in progress addresses the Next European Torus (NET) and the long term technology aspects as defined in the 82/86 programme. A minor part serves to preparation of future contributions and to design studies on fusion concepts in a wider perspective. The Fusion Technology Programme of Euratom covers mainly aspects of nuclear engineering. Plasma engineering, heating, refueling and vacuum technology are at present part of the Physics Programme. In view of NET, integration of the different areas of work will be mandatory. KfK is therefore prepared to address technical aspects beyond the actual scope of the physics experiments. The technology tasks are reported project wise under title and code of the Euratom programme. Most of the projects described here are shared with other European fusion laboratories as indicated in the table annexed to this report. (orig./GG)

  10. Factors predicting discordant virological and immunological responses to antiretroviral therapy in HIV-1 clade C infected Zulu/Xhosa in South Africa.

    Directory of Open Access Journals (Sweden)

    Boris Julg

    Full Text Available Factors predicting suboptimal CD4 cell recovery have been studied in HIV clade-B infected US and European populations. It is, however, uncertain to what extent these results are applicable to HIV clade-C infected African populations. Multivariate analysis using logistic regression and longitudinal analyses using mixed models were employed to assess the impact of age, gender, baseline CD4 cell count, hemoglobin, body mass index (BMI, tuberculosis and other opportunistic co-infections, and frequencies of regimen change on CD4 cell recovery at 12 and 30 months and on overtime change in CD4 cells among 442 virologically suppressed South Africans. Despite adequate virological response 37% (95% CI:32%-42% and 83% (95% CI:79%-86% of patients on antiretroviral therapy failed to restore CD4 cell counts ≥ 200 cells/mm(3 after 12 and ≥ 500 cells/mm(3 after 30 months, respectively, in this South African cohort. Critical risk factors for inadequate recovery were older age (p = 0.001 and nadir CD4 cell count at ART initiation (p<0.0001, while concurrent TB co-infection, BMI, baseline hemoglobin, gender and antiretroviral regimen were not significant risk factors. These data suggest that greater efforts are needed to identify and treat HAART-eligible patients prior to severe CD4 cell decline or achievement of advanced age.

  11. Factors predicting discordant virological and immunological responses to antiretroviral therapy in HIV-1 clade C infected Zulu/Xhosa in South Africa.

    Science.gov (United States)

    Julg, Boris; Poole, Danielle; Ghebremichael, Musie; Castilla, Carmen; Altfeld, Marcus; Sunpath, Henry; Murphy, Richard A; Walker, Bruce D

    2012-01-01

    Factors predicting suboptimal CD4 cell recovery have been studied in HIV clade-B infected US and European populations. It is, however, uncertain to what extent these results are applicable to HIV clade-C infected African populations. Multivariate analysis using logistic regression and longitudinal analyses using mixed models were employed to assess the impact of age, gender, baseline CD4 cell count, hemoglobin, body mass index (BMI), tuberculosis and other opportunistic co-infections, and frequencies of regimen change on CD4 cell recovery at 12 and 30 months and on overtime change in CD4 cells among 442 virologically suppressed South Africans. Despite adequate virological response 37% (95% CI:32%-42%) and 83% (95% CI:79%-86%) of patients on antiretroviral therapy failed to restore CD4 cell counts ≥ 200 cells/mm(3) after 12 and ≥ 500 cells/mm(3) after 30 months, respectively, in this South African cohort. Critical risk factors for inadequate recovery were older age (p = 0.001) and nadir CD4 cell count at ART initiation (p<0.0001), while concurrent TB co-infection, BMI, baseline hemoglobin, gender and antiretroviral regimen were not significant risk factors. These data suggest that greater efforts are needed to identify and treat HAART-eligible patients prior to severe CD4 cell decline or achievement of advanced age.

  12. Young Africans Tackle Their Continent's Environmental Issues

    Science.gov (United States)

    Olwoch, Jane Mukarugwiza

    2008-11-01

    Young African Scientists Session at the Fourth International Geosphere-Biosphere Programme Congress; Cape Town, South Africa, 7 May 2008; Africa is often described as a unique and diverse continent. This is reflected in its biodiversity, economic and social circumstances, and diversity in culture and environment. The Young African Scientists (YAS) session at the International Geosphere-Biosphere Programme Congress was one of the congress's highlights. Global environmental change research in Africa was presented to an audience that included visiting international and national scientists, policy makers, and a group of schoolchildren. From the uniqueness of Africa's paleoclimate to the diversity and complexity of current and future impacts of environmental change on Africa, the session not only provided an overview of current projects but also highlighted the problems that are intertwined with poverty. This session was sponsored by the Global Change System for Analysis, Research, and Training (START).

  13. African Solutions to African Problems?

    DEFF Research Database (Denmark)

    Emmanuel, Nikolas G.; Schwartz, Brendan

    2017-01-01

    . The emergence of Déby’s Chad depends both on its ability to accomplish sub-imperial tasks encouraged by these actors, while obfuscating undemocratic governance and human rights abuses at home. Nonetheless, Déby’s role in regional security has helped him achieve a certain degree of agency in his relationship...... and maintain control of the state. These range from “liberal” desires to help control the region’s trouble spots in places like Mali, to clearly illiberal medaling in the domestic affairs of neighbors like the Central African Republic, with the fight against Boko Haram somewhere in the middle. This paper seeks...

  14. The impact of alcohol on HIV prevention and treatment for South Africans in primary healthcare

    Directory of Open Access Journals (Sweden)

    Michelle Schneider

    2014-02-01

    Full Text Available Background: Antiretroviral treatment (ART has substantially reduced morbidity and mortality for HIV patients. In South Africa, with the largest ART programme globally, attention is needed not only on the further expansion of ART coverage, but also on factors which undermine its effectiveness, such as alcohol use.Objective: Given the decentralised approach of nurse-initiated and -sustained ART in the South African primary health sector, it is important to document key aspects of alcohol use to be conveyed to HIV-positive individuals and those at risk for HIV.Method: This study comprised a narrative review of relevant literature.Results: Alcohol acts through both behavioural and physiological pathways to impact on the acquisition, further transmission and then progression of HIV disease. Besides links to risky sex, alcohol undermines the immune system, raising susceptibility to contracting and then countering HIV and other infections. There are important drug interactions between alcohol and ART, or therapies for opportunistic infections and other co-morbidities. Moreover, alcohol undermines adherence to the medication which is essential for effective ART.Conclusion: Primary healthcare clinic attendees need evidence-based information on the detrimental effects of alcohol consumption on HIV infection, which ensue throughout the clinical course of HIV. This spans the role of alcohol consumption as a risk factor for HIV infection, HIV replication in infected individuals, a person’s response to HIV infection and HIV treatment. Primary healthcare workers, especially nurses and HIV counsellors, require training in order to screen for and provide appropriate interventions for HIV-positive patients, those on treatment and treatment-naïve patients, who will benefit from reduced alcohol consumption or the cessation thereof.

  15. African Journals Online (AJOL)

    African Journals Online (AJOL)

    It has also been difficult for African researchers to access the work of other African academics. In partnership with hundreds of journals from all over the continent, AJOL works to change this, so that African-origin research output is available to Africans and to the rest of the ... Egyptian Journal of Medical Human Genetics.

  16. African Journals Online (AJOL)

    African Journals Online (AJOL)

    African Journals OnLine (AJOL) is the world's largest and pre-eminent collection of peer-reviewed, African-published scholarly journals. Historically, scholarly information has flowed from North to South and from West to East. It has also been difficult for African researchers to access the work of other African academics.

  17. Trends in African philosophy

    African Journals Online (AJOL)

    JONATHAN

    In the contention of Oladipo (2006), the debate on the idea of. African philosophy which has been divided into trends or schools, dates back to the 1960's and 70's, which constitute the modern epoch of African philosophy, when some African thinkers began to question the perspective that traditional African beliefs and.

  18. African Journals Online (AJOL)

    African Journals Online (AJOL)

    It has also been difficult for African researchers to access the work of other African ... search for an article by title, author/s or keywords,; and find other information sources ... Southern African Business Review; The role played by the South African ... The Basis of Distinction Between Qualitative and Quantitative Research in ...

  19. African Journals Online (AJOL)

    African Journals Online (AJOL)

    It has also been difficult for African researchers to access the work of other African academics. In partnership with hundreds of journals from all over the continent, AJOL works to change this, so that African-origin research output is available to Africans and ... Featured Country: South Africa, Featured Journal: Ergonomics SA ...

  20. Mycobacterium sherrisii visceral disseminated infection in an African HIV-infected adolescent

    Directory of Open Access Journals (Sweden)

    Francesco Santoro

    2016-04-01

    Full Text Available A case of visceral disseminated infection by Mycobacterium sherrisii in an African HIV-infected adolescent with multiple abdominal abscesses is reported. Despite multiple drug resistance to first-line antibiotics in vitro, long-term treatment with clarithromycin, moxifloxacin, and clindamycin, together with appropriate antiretroviral treatment, resulted in clinical and radiological cure after 19 months of therapy and follow-up.

  1. [Sustainability of Brazilian policy for access to antiretroviral drugs].

    Science.gov (United States)

    Grangeiro, Alexandre; Teixeira, Luciana; Bastos, Francisco I; Teixeira, Paulo

    2006-04-01

    The expense of acquiring antiretroviral drugs in Brazil has given rise to debate about the sustainability of the policy of universal access to AIDS medications, despite the evident benefits. The objective of this study was to analyze the evolution of the Ministry of Health's spending on acquiring antiretroviral drugs from 1998 to 2005, the determining factors and the medium-term sustainability of this policy (2006-2008). The study on the evolution of spending on antiretrovirals included analysis of their prices, the year-by-year expenditure, the number of patients utilizing the medication, the mean expenditure per patient and the strategies for reducing the prices maintained during this period. To analyze the sustainability of the policy for access to antiretrovirals, the cost of acquiring the drugs over the period from 2006 to 2008 was estimated, along with the proportion of gross domestic product and federal health expenditure represented by this spending. The data were collected from the Ministry of Health, the Brazilian Institute for Geography and Statistics (IBGE) and the Ministry of Planning. The expenditure on antiretrovirals increased by 66% in 2005, breaking the declining trend observed over the period from 2000 to 2004. The main factors associated with this increase were the weakening of the national generics industry and the unsatisfactory results from the process of negotiating with pharmaceutical companies. The Brazilian policy for universal access is unsustainable at the present growth rates of the gross domestic product, unless the country compromises its investments in other fields.

  2. Global trends in antiretroviral resistance in treatment-naive individuals with HIV after rollout of antiretroviral treatment in resource-limited settings: a global collaborative study and meta-regression analysis.

    Science.gov (United States)

    Gupta, Ravindra K; Jordan, Michael R; Sultan, Binta J; Hill, Andrew; Davis, Daniel H J; Gregson, John; Sawyer, Anthony W; Hamers, Raph L; Ndembi, Nicaise; Pillay, Deenan; Bertagnolio, Silvia

    2012-10-06

    The emergence and spread of high levels of HIV-1 drug resistance in resource-limited settings where combination antiretroviral treatment has been scaled up could compromise the effectiveness of national HIV treatment programmes. We aimed to estimate changes in the prevalence of HIV-1 drug resistance in treatment-naive individuals with HIV since initiation of rollout in resource-limited settings. We did a systematic search for studies and conference abstracts published between January, 2001, and July, 2011, and included additional data from the WHO HIV drug resistance surveillance programme. We assessed the prevalence of drug-resistance mutations in untreated individuals with respect to time since rollout in a series of random-effects meta-regression models. Study-level data were available for 26,102 patients from sub-Saharan Africa, Asia, and Latin America. We recorded no difference between chronic and recent infection on the prevalence of one or more drug-resistance mutations for any region. East Africa had the highest estimated rate of increase at 29% per year (95% CI 15 to 45; p=0·0001) since rollout, with an estimated prevalence of HIV-1 drug resistance at 8 years after rollout of 7·4% (4·3 to 12·7). We recorded an annual increase of 14% (0% to 29%; p=0·054) in southern Africa and a non-significant increase of 3% (-0·9 to 16; p=0·618) in west and central Africa. There was no change in resistance over time in Latin America, and because of much country-level heterogeneity the meta-regression analysis was not appropriate for Asia. With respect to class of antiretroviral, there were substantial increases in resistance to non-nucleoside reverse transcriptase inhibitors (NNRTI) in east Africa (36% per year [21 to 52]; pAfrica (23% per year [7 to 42]; p=0·0049). No increase was noted for the other drug classes in any region. Our findings suggest a significant increase in prevalence of drug resistance over time since antiretroviral rollout in regions of sub

  3. Islamic perspectives on HIV/AIDS and antiretroviral treatment: the case of Nigeria.

    Science.gov (United States)

    Balogun, Amusa Saheed

    2010-12-01

    Some religious reactions to the HIV epidemic in Africa unwittingly contributed to the expansion of the epidemic in its early years. This was because many religious people regarded the emergence of HIV and AIDS as divine punishment for man's sins as a result of people's sexual promiscuity. Some also opposed public promotion of the use of condoms for HIV prevention. However, religious bodies have made positive contributions to HIV/AIDS responses in many African countries in recent times. Though Christian bodies are taking the lead in faith-based responses to HIV and AIDS in Africa, Islamic bodies have also been major partners in HIV/AIDS interventions in several countries. Against this background, this article examines some Islamic perceptions of HIV and AIDS, and especially the impact of antiretroviral treatment (ART) for people living with HIV in Africa, with particular emphasis on Nigeria. In spite of the emergence of antiretroviral (ARV) drugs in Africa, Islam still emphasises the prevention of new infections and care for people living with HIV or AIDS. The article discusses basic issues associated with ARVs, such as health, sickness, life-prolongation and death, from an Islamic viewpoint, as well as some Islamic measures to prevent HIV-risk-taking behaviours in an era of ARVs. It also looks at the nature and extent of Islamic involvement in the national HIV/AIDS response in Nigeria. The paper concludes that while Islam sees HIV and AIDS and other diseases as 'tests' from Allah, the religion is not opposed to ART. Thus, efforts need to be intensified by Islamic bodies and Muslim leaders in Nigeria for an improved response to HIV and AIDS in the country.

  4. Human resource aspects of antiretroviral treatment delivery models: current practices and recommendations.

    Science.gov (United States)

    Assefa, Yibeltal; Van Damme, Wim; Hermann, Katharina

    2010-01-01

    PURPOSE OF VIEW: To illustrate and critically assess what is currently being published on the human resources for health dimension of antiretroviral therapy (ART) delivery models. The use of human resources for health can have an effect on two crucial aspects of successful ART programmes, namely the scale-up capacity and the long-term retention in care. Task shifting as the delegation of tasks from higher qualified to lower qualified cadres has become a widespread practice in ART delivery models in low-income countries in recent years. It is increasingly shown to effectively reduce the workload for scarce medical doctors without compromising the quality of care. At the same time, it becomes clear that task shifting can only be successful when accompanied by intensive training, supervision and support from existing health system structures. Although a number of recent publications have focussed on task shifting in ART delivery models, there is a lack of accessible information on the link between task shifting and patient outcomes. Current ART delivery models do not focus sufficiently on retention in care as arguably one of the most important issues for the long-term success of ART programmes. There is a need for context-specific re-designing of current ART delivery models in order to increase access to ART and improve long-term retention.

  5. Optical programmable metamaterials

    Science.gov (United States)

    Gong, Cheng; Zhang, Nan; Dai, Zijie; Liu, Weiwei

    2018-02-01

    We suggest and demonstrate the concept of optical programmable metamaterials which can configure the device's electromagnetic parameters by the programmable optical stimuli. In such metamaterials, the optical stimuli produced by a FPGA controlled light emitting diode array can switch or combine the resonance modes which are coupled in. As an example, an optical programmable metamaterial terahertz absorber is proposed. Each cell of the absorber integrates four meta-rings (asymmetric 1/4 rings) with photo-resistors connecting the critical gaps. The principle and design of the metamaterials are illustrated and the simulation results demonstrate the functionalities for programming the metamaterial absorber to change its bandwidth and resonance frequency.

  6. NNP Life Management Programmes

    International Nuclear Information System (INIS)

    Hervia Ruperez, F.

    1996-01-01

    Around the world, power station owners are increasingly concerned to optimise Plant Life Management. In response, they are setting up Life Management programmes, of more or less ambitious scope and depth. Strategic, economic and security concerns and the close link between life extension work and the improved maintenance practices that are so important today, will increase and global these programmes for monitoring and conservation or mitigation of ageing. These programmes are all based on knowledge of the precise condition of all components and population with the greatest effect on the economics and safety of the plant, and trends in changes in their condition. (Author)

  7. The European Fusion Programme

    International Nuclear Information System (INIS)

    Palumbo, D.

    1983-01-01

    The European Fusion Programme is coordinated by Euratom and represents a long term cooperative project of Member States of the European Communities in the field of fusion, designed to lead to the joint construction of prototypes. The main lines of the programme proposed for 1982 to 1986 are: (1) the continuation of a strong effort on tokamaks with emphasis on JET construction, operation and upgrading, (2) conceptual design of NET and development of the related technology, and (3) further work on two alternative magnetic confinement systems. The current status and future plans for this programme are discussed in the paper. (author)

  8. HIV INFECTION, ANTIRETROVIRAL THERAPY AND CARDIOVASCULAR RISK

    Directory of Open Access Journals (Sweden)

    Katleen de Gaetano Donati

    2010-11-01

    Full Text Available In the last 15 years, highly active antiretroviral therapy (HAART has determined a dramatic reduction of both morbidity and mortality in human immunodeficiency virus (HIV-infected subjects, transforming this infection in a chronic and manageable disease. Patients surviving with HIV in the developed world, in larger number men,  are becoming aged. As it would be expected for a population of comparable age, many HIV-infected individuals report a family history of cardiovascular disease, a small proportion have already experienced a cardiovascular event and an increasing proportion has diabetes mellitus. Smoking rate is very high while an increasing proportion of HIV-infected individuals have dyslipidaemia. Studies suggest that these traditional risk factors could play an important  role in the development of cardiovascular disease in these patients as they do in the general population. Thus, whilst the predicted 10-year cardiovascular disease risk remains relatively low at present, it will likely increase in relation to the progressive aging of  this patient population. Thus, the long-term follow-up of HIV infected patients has to include co-morbidity management such as cardiovascular disease prevention and treatment. Two intriguing aspects related to the cardiovascular risk in patients with HIV infection are the matter of current investigation: 1 while these subjects share many cardiovascular risk factors with the general population, HIV infection itself increases cardiovascular risk; 2 some HAART regimens too influence atherosclerotic profile, partly due to lipid changes. Although the mechanisms involved in the development of cardiovascular complications in HIV-infected patients remain to be fully elucidated, treatment guidelines recommending interventions to prevent cardiovascular disease in these individuals are already available; however, their application is still limited.

  9. Factors influencing global antiretroviral procurement prices.

    Science.gov (United States)

    Wirtz, Veronika J; Forsythe, Steven; Valencia-Mendoza, Atanacio; Bautista-Arredondo, Sergio

    2009-11-18

    Antiretroviral medicines (ARVs) are one of the most costly parts of HIV/AIDS treatment. Many countries are struggling to provide universal access to ARVs for all people living with HIV and AIDS. Although substantial price reductions of ARVs have occurred, especially between 2002 and 2008, achieving sustainable access for the next several decades remains a major challenge for most low- and middle-income countries. The objectives of the present study were twofold: first, to analyze global ARV prices between 2005 and 2008 and associated factors, particularly procurement methods and key donor policies on ARV procurement efficiency; second, to discuss the options of procurement processes and policies that should be considered when implementing or reforming access to ARV programs. An ARV-medicines price-analysis was carried out using the Global Price Reporting Mechanism from the World Health Organization. For a selection of 12 ARVs, global median prices and price variation were calculated. Linear regression models for each ARV were used to identify factors that were associated with lower procurement prices. Logistic regression models were used to identify the characteristics of those countries which procure below the highest and lowest direct manufactured costs. Three key factors appear to have an influence on a country's ARV prices: (a) whether the product is generic or not; (b) the socioeconomic status of the country; (c) whether the country is a member of the Clinton HIV/AIDS Initiative. Factors which did not influence procurement below the highest direct manufactured costs were HIV prevalence, procurement volume, whether the country belongs to the least developed countries or a focus country of the United States President's Emergency Plan For AIDS Relief. One of the principal mechanisms that can help to lower prices for ARV over the next several decades is increasing procurement efficiency. Benchmarking prices could be one useful tool to achieve this.

  10. Response to combination antiretroviral therapy: variation by age

    DEFF Research Database (Denmark)

    Lundgren, Jens

    2008-01-01

    -naive individuals starting combination antiretroviral therapy from 1998 to 2006. OUTCOME MEASURES: Time from combination antiretroviral therapy initiation to HIV RNA less than 50 copies/ml (virological response), CD4 increase of more than 100 cells/microl (immunological response) and new AIDS/death were analysed...... response. The probability of virological response was lower in those aged 6-12 (adjusted hazard ratio: 0.87) and 13-17 (0.78) years, but was higher in those aged 50-54 (1.24), 55-59 (1.24) and at least 60 (1.18) years. The probability of immunological response was higher in children and younger adults...... and reduced in those 60 years or older. Those aged 55-59 and 60 years or older had poorer clinical outcomes after adjusting for the latest CD4 cell count. CONCLUSION: Better virological responses but poorer immunological responses in older individuals, together with low precombination antiretroviral therapy...

  11.  The potential nephrotoxicity of antiretroviral drugs

    Directory of Open Access Journals (Sweden)

    Zofia Marchewka

    2012-09-01

    Full Text Available  The intensive studies carried out in many scientific laboratories and the efforts of numerous pharmaceutical companies have led to the development of drugs which are able to effectively inhibitHIV proliferation. At present, a number of antiretroviral agents with different mechanisms of actionare available. Unfortunately, long-term use of antiretroviral drugs, however, does not remainindifferent to the patient and can cause significant side effects.In the present work, the antiretroviral drugs with a nephrotoxicity potential most commonly usedin clinical practice are described. In the review attention has also been focused on the nephropathyresulting from the HIV infection alone and the influence of genetic factors on the occurrenceof pathological changes in the kidney.

  12. A 10-year cohort analysis of routine paediatric ART data in a rural South African setting.

    Science.gov (United States)

    Lilian, R R; Mutasa, B; Railton, J; Mongwe, W; McINTYRE, J A; Struthers, H E; Peters, R P H

    2017-01-01

    South Africa's paediatric antiretroviral therapy (ART) programme is managed using a monitoring and evaluation tool known as TIER.Net. This electronic system has several advantages over paper-based systems, allowing profiling of the paediatric ART programme over time. We analysed anonymized TIER.Net data for HIV-infected children aged ART in a rural district of South Africa between 2005 and 2014. We performed Kaplan-Meier survival analysis to assess outcomes over time. Records of 5461 children were available for analysis; 3593 (66%) children were retained in care. Losses from the programme were higher in children initiated on treatment in more recent years (P ART programme and highlights interventions to improve programme performance.

  13. Adherence to anti-retroviral drugs in pregnant and lactating HIV ...

    African Journals Online (AJOL)

    Background: Anti-retroviral drugs reduce morbidity and mortality due to HIV and prevent transmission from mother to child. But compliance on anti-retroviral treatment is an essential element for the success of therapeutic goals. Objective: To assess the level of compliance of anti-retroviral treatment in pregnant and lactating ...

  14. Fellows, Associates & Students Programmes

    CERN Document Server

    2005-01-01

    The present document reviews the CERN Fellows, Associates and Students Programmes emphasizing the developments since 2000, when the previous review was presented to the Scientific Policy Committee, Finance Committee and Council (CERN/2325), and makes proposals for the coming five years. In summary, it is proposed to â?¢ Simplify the payment scheme for the Paid Scientific Associates Programme, which will no longer depend on candidateâ??s home support and age; â?¢ Broaden the scope of the Fellowship Programme, in order to facilitate the recruitment of young graduates in computing and engineering. Age-related eligibility conditions and payment levels will be replaced with experience-based criteria; â?¢ Modify subsistence rates for the Doctoral and Technical Student Programme in order to harmonize CERNâ??s payment levels with those offered by other research establishments. This document is presented for discussion and recommendation by the Scientific Policy Committee and approval by the Council. Additiona...

  15. (ARV) treatment training programme

    African Journals Online (AJOL)

    Winnie

    Keywords:ARV, training, evaluation, HIV, health care provider. RÉSUMÉ .... workers, adequate laboratory facilities for measuring viral load and .... questionnaire guide, the head of unit of the ART ...... begins its scale-up programme. Some of ...

  16. The French nuclear programme

    International Nuclear Information System (INIS)

    Bacher, Pierre

    1987-01-01

    France has a civil nuclear power generation programme second only to the USA with 49 nuclear units in operation and 13 under construction. The units in service are described. These include 33 PWR 900 MW and 9 PWR 1300 MW units. The electricity consumption and generation in France is illustrated. The absence of a powerful anti-nuclear lobby and two main technical options have contributed to the success of the French nuclear programme. These are the PWR design and the plant standardization policy which allows the setting up of an effective industrial complex (eg for analysis of operating conditions and of safety and reliability information). The programme and the reasons for its success are reviewed. Research programmes and future plans are also discussed. (UK)

  17. Elukestva õppe programm : Erasmus+

    Index Scriptorium Estoniae

    2014-01-01

    Erasmus+ programm liidab senised koostööprogrammid „Euroopa elukestva õppe programm“, „Euroopa Noored“ ning Euroopa komisjoni rahvusvahelised kõrgharidusprogrammid. Elukestva õppe programmi 2013 kokkuvõte

  18. Greek Teachers Programme 2015

    CERN Multimedia

    Hoch, Michael

    2015-01-01

    The 3rd edition of this year's Greek Teachers Programme was co-organized by CERN Education Group and the Hellenic Physical Society and took place from 8 to 12 November 2015. The programme targets physics high-school teachers from all over Greece. It aims to help teachers inspire the next generation of scientists and engineers by motivating their students to understand and appreciate how science works at the world's largest physics laboratory, whereby increasing their interest in pursuing studies in STEM fields in secondary and post-secondary education. 33 teachers took part in this programme which comprised lectures by Greek members of the CERN scientific community, with visits to experimental facilities, hands-on activities and dedicated sessions on effective and creative ways through which participants may bring physics, particle physics and CERN closer to their school classroom. In 2015, more than 100 teachers took part in the three editions of the Greek Teachers Programme.

  19. The French energy programme

    International Nuclear Information System (INIS)

    Bohnen, U.

    1980-01-01

    The challenge of the oil crisis made French energy policy react chiefly by means of a programme for the rapid expansion of nuclear energy which has become unparalleled because of its systematic realization. The following article gives a survey of this programme and its political preconditions. The French energy programme deserves special attention as the utilization of nuclear energy in France including all related activities has reached a more advanced stage than in most other countries. The effects and requirements connected with such an extensive programme which can therefore be investigated with the help of the French example migth be of importance also for other countries in a similar way. (orig./UA) [de

  20. The Gold Standard Programme

    DEFF Research Database (Denmark)

    Neumann, Tim; Rasmussen, Mette; Ghith, Nermin

    2013-01-01

    To evaluate the real-life effect of an evidence-based Gold Standard Programme (GSP) for smoking cessation interventions in disadvantaged patients and to identify modifiable factors that consistently produce the highest abstinence rates.......To evaluate the real-life effect of an evidence-based Gold Standard Programme (GSP) for smoking cessation interventions in disadvantaged patients and to identify modifiable factors that consistently produce the highest abstinence rates....

  1. Motivation programmes of organizations

    OpenAIRE

    Pízová, Tereza

    2008-01-01

    The Bachelor Thesis "'Motivation Programmes of Organizations" focuses on an extremely important area within personnel management. Employee motivation is crucial to the effective operation of businesses. Motivation programmes assist in increasing and maintaining employee motivation and demonstrate an organization's interest in its employees. This piece is on one hand concerned with theoretical foundations of motivation, describing theories and concepts important to the area of human behaviour ...

  2. In vivo assessment of antiretroviral therapy-associated side effects

    Directory of Open Access Journals (Sweden)

    Eduardo Milton Ramos-Sanchez

    2014-07-01

    Full Text Available Antiretroviral therapy has been associated with side effects, either from the drug itself or in conjunction with the effects of human immunodeficiency virus infection. Here, we evaluated the side effects of the protease inhibitor (PI indinavir in hamsters consuming a normal or high-fat diet. Indinavir treatment increased the hamster death rate and resulted in an increase in triglyceride, cholesterol and glucose serum levels and a reduction in anti-oxLDL auto-antibodies. The treatment led to histopathological alterations of the kidney and the heart. These results suggest that hamsters are an interesting model for the study of the side effects of antiretroviral drugs, such as PIs.

  3. Antiretroviral activity of protease inhibitors against Toxoplasma gondii

    Directory of Open Access Journals (Sweden)

    Lianet Monzote

    2013-02-01

    Full Text Available The introduction of highly active antiretroviral therapy (HAART has caused a marked reduction in the occurrence and severity of parasitic infections, including the toxoplasmic encephalitis (TE. These changes have been attributed to the restoration of cell-mediated immunity. This study was developed to examine the activity of six antiretroviral protease inhibitors (API on Toxoplasma gondii tachyzoites. The six API showed anti-Toxoplasma activity, with IC50 value between 1.4 and 6.6 µg/mL. Further studies at the molecular level should be performed to clarify if the use of API could be beneficial or not for AIDS patients with TE.

  4. Avances recientes en VIH/SIDA: Terapia antiretroviral.

    Directory of Open Access Journals (Sweden)

    Ernesto Scerpella

    1997-01-01

    Full Text Available Recent advances in our understanding of HIV infection in patients with the acquired immunodeficiency syndrome (AIDS are leading us to explore new treatment strategies, including the use of combination antiretroviral therapy. In this review, we present information from recently completed clinical trials explore the use of combination therapy, including ACTG 175, the Delta studies, and the NUCA studies. In addition, we present preliminary about use of protease inhibitors, the newest class of antiretrovirals. (Rev Med Hered 1997; 8: 23-31.

  5. The African interpretations of a set of values in a value-based HIV ...

    African Journals Online (AJOL)

    This article focuses on a qualitative exploration of six core values embedded in the Choose Life Training Programme (CLTP), a value-based HIV and AIDS prevention programme. The article is based on a study that explored the possibility that the African interpretations of these values are different to the Western definitions.

  6. Antiretroviral drug supply challenges in the era of scaling up ART in Malawi.

    Science.gov (United States)

    Schouten, Erik J; Jahn, Andreas; Ben-Smith, Anne; Makombe, Simon D; Harries, Anthony D; Aboagye-Nyame, Francis; Chimbwandira, Frank

    2011-07-06

    The number of people receiving antiretroviral treatment (ART) has increased considerably in recent years and is expected to continue to grow in the coming years. A major challenge is to maintain uninterrupted supplies of antiretroviral (ARV) drugs and prevent stock outs. This article discusses issues around the management of ARVs and prevention of stock outs in Malawi, a low-income country with a high HIV/AIDS burden, and a weak procurement and supply chain management system. This system for ARVs, paid for by the Global Fund to Fight AIDS, Tuberculosis and Malaria, and bypassing the government Central Medical Stores, is in place, using the United Nations Children's Fund's (UNICEF's) procurement services. The system, managed by a handful of people who spend limited time on supply management, is characterized by a centrally coordinated quantification based on verified data from all national ART clinics, parallel procurement through UNICEF, and direct distribution to ART clinics. The model worked well in the first years of the ART programme with a single first-line ARV regimen, but with more regimens becoming available (e.g., alternative first-line, second-line and paediatric regimens), it has become more difficult to administer. Managing supplies through a parallel system has the advantage that weaknesses in the national system have limited influence on the ARV procurement and supply chain management system. However, as the current system operates without a central warehouse and national buffer stock capacity, it diminishes the ability to prevent ARV stock outs. The process of ordering ARVs, from the time that estimates are made to the arrival of supplies in health facilities, takes approximately one year. Addressing the challenges involved in maintaining ARVs through an efficient procurement and supply chain management system that prevents ARV stock outs through the establishment of a dedicated procurement team, a central warehouse and/or national buffer stock is a

  7. An outcome evaluation of a perinatal education programme

    Directory of Open Access Journals (Sweden)

    Alfeous Rundare

    2012-07-01

    Research purpose: The Perinatal Education Programme (PEP has been introduced in the Western Cape in South Africa, and the main aim of this evaluation was to provide information regarding the effectiveness of perinatal training in a single maternity hospital in this province. Motivation for the study: There are a few evaluation studies of the PEP in different South African contexts. These evaluations have shown that the programme was effective in improving the knowledge of midwives. The current evaluation was motivated by the need for more research on the programme’s effectiveness. Research design, approach and method: A quasi-experimental design was used to determine knowledge and skills acquisition of midwives. The sample consisted of 42 midwives. Programme records and questionnaire results were used as data. Main findings: This evaluation showed that the PEP is an effective programme endorsed by participants and supervisors alike. Practical/managerial implications: This specific hospital added group facilitation to the self-study mode of the programme. This mode of study produced additional increases in knowledge, skills and group work. Contributions/value-add: The evaluation has provided sound evidence for programme managers to increase programme coverage and continue the good work already evident from the results.

  8. Using cost-effectiveness analyses to inform policy: the case of antiretroviral therapy in Thailand

    Directory of Open Access Journals (Sweden)

    Walt Gill

    2006-12-01

    Full Text Available Abstract Background: Much emphasis is put on providing evidence to assist policymakers in priority setting and investment decisions. Assessing the cost-effectiveness of interventions is one technique used by policymakers in their decisions around the allocation of scarce resources. However, even where such evidence is available, other considerations may also be taken into account, and even over-ride technical evidence. Antiretroviral therapy (ART is the most effective intervention to reduce HIV-related morbidity and prolong mortality. However, treatment provision in the developing world has been hindered by the high costs of services and drugs, casting doubts on its cost-effectiveness. This paper looks at Thailand's publicly-funded antiretroviral initiative which was first introduced in 1992, and explores the extent to which cost-effectiveness evidence influenced policy. Methods: This article reviews the development of the national ART programme in Thailand between 1992 and 2004. It examines the roles of cost-effectiveness information in treatment policy decisions. Qualitative approaches including document analysis and interview of key informants were employed. Results: Two significant policy shifts have been observed in government-organised ART provision. In 1996, service-based therapy for a few was replaced by a research network to support clinical assessments of antiretroviral medication in public hospitals. This decision was taken after a domestic study illustrated the unaffordable fiscal burden and inefficient use of resources in provision of ART. The numbers of treatment recipients was maintained at 2,000 per year throughout the 1990s. It was not until 2001 that a new government pledged to extend the numbers receiving the service, as part of its commitment to universal coverage. Several elements played a role in this decision: new groups of dominant actors, drug price reductions, a pro-active civil society movement, lessons from experience

  9. Speaking to experts and patients: Recommendations for improving antiretroviral therapy (ART adherence

    Directory of Open Access Journals (Sweden)

    Janice Frank

    2009-06-01

    Full Text Available This article reports on the findings of a study that aimed to explore experts’ and patients’ opinions and recommendations regarding adherence to antiretroviral medication. This study was prompted firstly by the lack of existing local research on adherence to antiretroviral therapy (ART and secondly by the importance of adherence, given the recent introduction of ART to the public health sector. Four experts and seven patients were interviewed. The experts had worked within the HIV/AIDS field for at least two years while the patients (chosen from public antiretroviral roll-out programmes had been on ART for at least six months. These interviews were transcribed and analysed using thematic content analysis. This article focuses specifically on the recommendations for improving adherence that emerged from the experts' and patients' interviews. While the experts and patients generated two fairly distinct sets of recommendations (clearly informed by their different experiences and knowledge, both groups emphasised the importance of the mediating effects of social support and the healthcare provider–patient relationship in adherence to ART medication. Opsomming Gesprekke met kundiges en pasiënte: Aanbevelings ter verbetering van ART-nakoming. Hierdie artikel doen verslag oor die bevindinge van ’n studie wat kundiges en pasiënte se menings en aanbevelings ten opsigte van die nakoming van antiretrovirale medikasievoorskrifte ondersoek het. Die studie is in die eerste plek uitgevoer na aanleiding van die gebrek aan bestaande plaaslike navorsing oor die nakoming van antiretrovirale terapie (ART en in die tweede plek na aanleiding van die belangrikheid van nakoming in die lig van die onlangse bekendstelling van ART in die openbaregesondheidsektor. Onderhoude is met vier kundiges en sewe pasiënte gevoer. Die kundiges het vir ten minste twee jaar binne die MIV/Vigs-omgewing gewerk en die pasiënte (wat uit die openbare antiretrovirale

  10. Risk factors, barriers and facilitators for linkage to antiretroviral therapy care: a systematic review.

    Science.gov (United States)

    Govindasamy, Darshini; Ford, Nathan; Kranzer, Katharina

    2012-10-23

    To characterize patient and programmatic factors associated with retention in care during the pre-antiretroviral therapy (ART) period and linkage to ART care. Systematic literature review. An electronic search was conducted on MEDLINE, Global Health, Google Scholar and conference databases to identify studies reporting on predictors, barriers and facilitators of retention in care in the pre-ART period, and linkage to care at three steps: ART-eligibility assessment, pre-ART care and ART initiation. Factors associated with attrition were then divided into areas for intervention. Seven hundred and sixty-eight citations were identified. Forty-two studies from 12 countries were included for review, with the majority from South Africa (16). The most commonly cited category of factors was transport costs and distance. Stigma and fear of disclosure comprised the second most commonly cited category of factors followed by staff shortages, long waiting times, fear of drug side effects, male sex, younger age and the need to take time off work. This review highlights the importance of investigating interventions that could reduce transport difficulties. Decentralization, task-shifting and integration of services need to be expedited to alleviate health system barriers. Patient support groups and strategic posttest counselling are essential to assist patients deal with stigma and disclosure. Moreover, well tolerated first-line drugs and treatment literacy programmes are needed to improve acceptance of ART. This review suggests a combination of interventions to retain specific groups at risk for attrition such as workplace programmes for employed patients, dedicated clinic and support programmes for men and younger individuals.

  11. Heart Disease and African Americans

    Science.gov (United States)

    ... Minority Population Profiles > Black/African American > Heart Disease Heart Disease and African Americans Although African American adults are ... were 30 percent more likely to die from heart disease than non-Hispanic whites. African American women are ...

  12. The INTEGRAL Core Observing Programme

    DEFF Research Database (Denmark)

    Winkler, C.; Gehrels, N.; Lund, Niels

    1999-01-01

    The Core Programme of the INTEGRAL mission is defined as the portion of the scientific programme covering the guaranteed time observations for the INTEGRAL Science Working Team. This paper describes the current status of the Core Programme preparations and summarizes the key elements...... of the observing programme....

  13. South African marine pollution monitoring programme 1979-1982

    CSIR Research Space (South Africa)

    Cloete, CE

    1981-07-01

    Full Text Available A national marine pollution survey was initiated in 1974 to determine and assess the levels and effects of pollutant discharges to the marine environment of South Africa. During the period 1974-1979 impact area surveys, coastal and estuarine...

  14. South African perspective on conservation behaviour - a programme description

    CSIR Research Space (South Africa)

    Ferrar, AA

    1983-12-01

    Full Text Available In South Africa there is a serious lack of understanding of the relationship between human behaviour and environmental conservation. A multidisciplinary field of study is described dealing with the causes and effects of people's attitudes...

  15. Abandoning weight-loss programmes | Van Staden | South African ...

    African Journals Online (AJOL)

    "ies in maintaining weight loss. A study of unsuccessful dieters focused on a group of 50 obese subjects who had previously joined a slimming organisation, but who had dropped out. They were interviewed with emphasis on factors relating to ...

  16. "Gender-specific HIV policies and programmes at South African ...

    African Journals Online (AJOL)

    HP27975994114

    2004-06-07

    Jun 7, 2004 ... will discuss employers' duties in the fight against HIV/AIDS with ..... The breach of the duty of care can also take the form of an omission.26 Brassey states: ... responsibility to the employer for the consequences of a negligent ...

  17. The tuberculosis challenge in a rural South African HIV programme

    Directory of Open Access Journals (Sweden)

    Cooke Graham S

    2010-02-01

    Full Text Available Abstract Background South Africa remains the country with the greatest burden of HIV-infected individuals and the second highest estimated TB incidence per capita worldwide. Within South Africa, KwaZulu-Natal has one of the highest rates of TB incidence and an emerging epidemic of drug-resistant tuberculosis. Methods Review of records of consecutive HIV-infected people initiated onto ART between 1st January 2005 and 31st March 2006. Patients were screened for TB at initiation and incident episodes recorded. CD4 counts, viral loads and follow-up status were recorded; data was censored on 5th August 2008. Geographic cluster analysis was performed using spatial scanning. Results 801 patients were initiated. TB prevalence was 25.3%, associated with lower CD4 (AHR 2.61 p = 0.01 for CD4 25 copies/ml (OR 1.75 p = 0.11. A low-risk cluster for incident TB was identified for patients living near the local hospital in the geospatial analysis. Conclusion There is a large burden of TB in this population. Rate of incident TB stabilises at a rate higher than that of the overall population. These data highlight the need for greater research on strategies for active case finding in rural settings and the need to focus on strengthening primary health care.

  18. Spectrum of female commercial sex work in Bangui, Central African ...

    African Journals Online (AJOL)

    Classification of professional and non-professional female sex workers (FSWs) into different categories, never previously reported in the Central African Republic (CAR), may be useful to assess the dynamics of the human immunodeficiency virus (HIV) epidemic, design operational intervention programmes to combat HIV ...

  19. Sea level monitoring in Africa | Woodworth | African Journal of ...

    African Journals Online (AJOL)

    Information Network for Africa (ODINAfrica) programme are described and a survey of currently existing and planned sea level stations in Africa is presented, together with information on where data for existing stations may be found. Keywords: sea level data applications, sea level data telemetry, sea level networks. African ...

  20. ORIGINAL ARTICLES Roll back malaria - an African success story in ...

    African Journals Online (AJOL)

    infections, water-borne diseases and sexually transmitted diseases? ... J Mufunda, MB ChB, PhD, MBA. P Nyarango ... community protective measures such as insecticide-treated nets. (ITNs), and ... vector control and case management was integral to the programme. ..... major infectious disease in this small African country.

  1. Adherence to antiretroviral therapy and clinical outcomes among young adults reporting high-risk sexual behavior, including men who have sex with men, in coastal Kenya.

    Science.gov (United States)

    Graham, Susan M; Mugo, Peter; Gichuru, Evanson; Thiong'o, Alexander; Macharia, Michael; Okuku, Haile S; van der Elst, Elise; Price, Matthew A; Muraguri, Nicholas; Sanders, Eduard J

    2013-05-01

    African men who have sex with men (MSM) face significant stigma and barriers to care. We investigated antiretroviral therapy (ART) adherence among high-risk adults, including MSM, participating in a clinic-based cohort. Survival analysis was used to compare attrition across patient groups. Differences in adherence, weight gain, and CD4 counts after ART initiation were assessed. Among 250 HIV-1-seropositive adults, including 108 MSM, 15 heterosexual men, and 127 women, patient group was not associated with attrition. Among 58 participants who were followed on ART, 40 % of MSM had less than 95 % adherence, versus 28.6 % of heterosexual men and 11.5 % of women. Although MSM gained less weight after ART initiation than women (adjusted difference -3.5 kg/year), CD4 counts did not differ. More data are needed on barriers to adherence and clinical outcomes among African MSM, to ensure that MSM can access care and derive treatment and prevention benefits from ART.

  2. Benefits and Risks of Antiretroviral Therapy for Perinatal HIV Prevention.

    Science.gov (United States)

    Fowler, Mary G; Qin, Min; Fiscus, Susan A; Currier, Judith S; Flynn, Patricia M; Chipato, Tsungai; McIntyre, James; Gnanashanmugam, Devasena; Siberry, George K; Coletti, Anne S; Taha, Taha E; Klingman, Karin L; Martinson, Francis E; Owor, Maxensia; Violari, Avy; Moodley, Dhayendre; Theron, Gerhard B; Bhosale, Ramesh; Bobat, Raziya; Chi, Benjamin H; Strehlau, Renate; Mlay, Pendo; Loftis, Amy J; Browning, Renee; Fenton, Terence; Purdue, Lynette; Basar, Michael; Shapiro, David E; Mofenson, Lynne M

    2016-11-03

    Randomized-trial data on the risks and benefits of antiretroviral therapy (ART) as compared with zidovudine and single-dose nevirapine to prevent transmission of the human immunodeficiency virus (HIV) in HIV-infected pregnant women with high CD4 counts are lacking. We randomly assigned HIV-infected women at 14 or more weeks of gestation with CD4 counts of at least 350 cells per cubic millimeter to zidovudine and single-dose nevirapine plus a 1-to-2-week postpartum "tail" of tenofovir and emtricitabine (zidovudine alone); zidovudine, lamivudine, and lopinavir-ritonavir (zidovudine-based ART); or tenofovir, emtricitabine, and lopinavir-ritonavir (tenofovir-based ART). The primary outcomes were HIV transmission at 1 week of age in the infant and maternal and infant safety. The median CD4 count was 530 cells per cubic millimeter among 3490 primarily black African HIV-infected women enrolled at a median of 26 weeks of gestation (interquartile range, 21 to 30). The rate of transmission was significantly lower with ART than with zidovudine alone (0.5% in the combined ART groups vs. 1.8%; difference, -1.3 percentage points; repeated confidence interval, -2.1 to -0.4). However, the rate of maternal grade 2 to 4 adverse events was significantly higher with zidovudine-based ART than with zidovudine alone (21.1% vs. 17.3%, P=0.008), and the rate of grade 2 to 4 abnormal blood chemical values was higher with tenofovir-based ART than with zidovudine alone (2.9% vs. 0.8%, P=0.03). Adverse events did not differ significantly between the ART groups (P>0.99). A birth weight of less than 2500 g was more frequent with zidovudine-based ART than with zidovudine alone (23.0% vs. 12.0%, P<0.001) and was more frequent with tenofovir-based ART than with zidovudine alone (16.9% vs. 8.9%, P=0.004); preterm delivery before 37 weeks was more frequent with zidovudine-based ART than with zidovudine alone (20.5% vs. 13.1%, P<0.001). Tenofovir-based ART was associated with higher rates than

  3. Personal barriers to antiretroviral therapy adherence: Case studies ...

    African Journals Online (AJOL)

    Personal barriers to antiretroviral therapy adherence: Case studies from a rural Uganda prospective clinical cohort. ... Journal Home > Vol 13, No 2 (2013) > ... should target specific personal barriers to ART adherence like: lack of family support, health and sexual life concerns, desire to have children and family instability.

  4. Case Report: A man on antiretroviral therapy with painful thighs

    African Journals Online (AJOL)

    A 54 year old man presented with increasing pain in both thighs for three months during a follow up visit at the antiretroviral therapy (ART) clinic of Queen Elizabeth. Central Hospital. He was first seen at the same clinic three years and eight months before the current presentation, when he started. ART with ...

  5. Effect Of Acess To Antiretroviral Therapy On Stigma, Jimma

    African Journals Online (AJOL)

    JU

    with HIV/AIDS was low 45 (16.6%) when compared with the fear of being stigmatized (perceived stigma) which was195 (72.2%). ... attitudinal change on stigma with access to antiretroviral treatment. There was a statistically significant association ..... All other ethnicities and nationalities. § PLWHA on follow up but not started ...

  6. Providing insecticide treated bed nets in antiretroviral treatment ...

    African Journals Online (AJOL)

    HIV-replication.5-13 Mathematical models show that repeated ... antiretroviral treatment clinics in Malawi: a pilot ... related disease or AIDS.3 In addition, there are between 300 - ... and growing evidence of interactive pathology.1,2. HIV ..... by the HIV Unit and its partners. ... procurement and supply chain systems developed.

  7. Efficacy and durability of nevirapine in antiretroviral drug naive patients

    NARCIS (Netherlands)

    Lange, Joep M. A.

    2003-01-01

    Nevirapine is a non-nucleoside reverse transcriptase inhibitor (NNRTI) that was first reported in the scientific literature in 1990. Varying doses of nevirapine (NVP) and a number of regimens containing this NNRTI have been studied in antiretroviral (ARV) naive patients. Four key studies have

  8. When to start antiretroviral therapy in infants and children | Cotton ...

    African Journals Online (AJOL)

    We review the background and key studies that inform decisions on when to initiate antiretroviral therapy (ART) in infants and children. The World Health Organization staging system from 2006 was based on conditions commonly seen in Africa and provided an impetus for advancing ART in children. Because of poor ...

  9. Quality of Life and Adherence to Antiretroviral Drugs

    African Journals Online (AJOL)

    Sitwala

    Department of Nursing Sciences, School of Medicine, University of Zambia, Lusaka, Zambia. ABSTRACT ... it is individually, socially and culturally determined. .... concept that is a semantic representation which .... antiretroviral drugs enhances quality of life and is clearly in keeping with the philosophy of palliative. 19 care .

  10. When to start antiretroviral therapy in infants and children

    Directory of Open Access Journals (Sweden)

    Mark F Cotton

    2009-12-01

    Full Text Available This articles provides a background for antiretroviral therapy in infants and children, incorporating both old and new data. There is increasing data favouring early therapy for all age groups. Below a year of age, all HIV-infected infants should commence therapy and thereafter at higher CD4 thresholds than previous recommendations

  11. HIV Testing and Antiretroviral Therapy Initiation at Birth: Views from ...

    African Journals Online (AJOL)

    HIV Testing and Antiretroviral Therapy Initiation at Birth: Views from a Primary Care Setting in Khayelitsha. A Nelson, J Maritz, J Giddy, L Frigati, H Rabie, G van Cutsem, T Mutseyekwa, N Jange, J Bernheimer, M Cotton, V Cox ...

  12. Religion, authority and their interplay in the shaping of antiretroviral ...

    African Journals Online (AJOL)

    The article explores how religious actors have increasingly shaped the nature of antiretroviral treatment (ART) services in Kabarole district, western Uganda. As have the regular health services, Christian donors, non-governmental organisations (NGOs), and churches in the district have also stepped up to provide money for ...

  13. Abuse of antiretroviral drugs combined with addictive drugs by ...

    African Journals Online (AJOL)

    Reports of the use of antiretroviral drugs (ARVs) to produce a highly addictive drug called nyaope or whoonga are of major concern as ARVs are easily accessible in sub-Saharan Africa, including to pregnant women. Use of illicit drugs by pregnant women may result in serious adverse effects in their infants. We have ...

  14. Spirituality and adherence to antiretroviral drugs among HIV positive ...

    African Journals Online (AJOL)

    Method: It was an observational, longitudinal study in which 215 consenting HIV positive patients aged 18 to 65 years who were on antiretroviral drugs were recruited through systematic random sampling technique. Socio-demographic characteristics, clinical history and physical examination findings were documented for ...

  15. HIV-related symptoms and management in HIV and antiretroviral ...

    African Journals Online (AJOL)

    Karl Peltzer

    2014-01-03

    Jan 3, 2014 ... To cite this article: Karl Peltzer (2013) HIV-related symptoms and management in HIV and antiretroviral therapy patients ...... Fear/worry. 14.2. 22. 2.5. 20 ..... Internalized Stigma, Discrimination, and Depression among Men and.

  16. The influence of antiretroviral treatment on willingness to test: a ...

    African Journals Online (AJOL)

    Previous quantitative studies suggest a mutually reinforcing relationship between HIV counselling and testing (HCT) and antiretroviral treatment (ART). HCT is the entry into ART, and access to ART appears to increase HIV-testing uptake in settings with historically low uptake. Adopting a qualitative approach, this study ...

  17. Assessment of antiretroviral treatment outcome in public hospitals ...

    African Journals Online (AJOL)

    Bernt Lindtjørn

    2009-01-31

    Jan 31, 2009 ... CD4 cell count is less than 350 and all WHO stage IV and CD4 cell count ..... Katherine H, et al: Antiretroviral therapy and early mortality in South ... Evan W, Robert S, Benita Y, Richard H, Michael V. Julio SG. ... Kara W, Silvester K, Lameck D, Abraham S, John S,. Constantin T ... Janet G, et al. Predicators of ...

  18. End-user centeredness in antiretroviral therapy services in Nigerian ...

    African Journals Online (AJOL)

    Objective: To describe the perception of end users with regard to end-user centeredness in antiretroviral therapy (ART) service provision in Nigerian public health facilities. Design: A qualitative design was followed. Subjects and setting: Unstructured focus group discussions were conducted with end users (n = 64) in six ...

  19. Christian identity and men's attitudes to antiretroviral therapy in ...

    African Journals Online (AJOL)

    Increasing access to antiretroviral therapy (ART), especially in urban areas in Zambia, has transformed the landscape of the HIV epidemic to include hope. Drawing upon long-term ethnographic research, this article briefly describes the religious ideas of a cohort of former students of a Catholic mission boarding school for ...

  20. Correlates of highly active antiretroviral therapy adherence among ...

    African Journals Online (AJOL)

    Correlates of highly active antiretroviral therapy adherence among urban Ethiopian clients. ... clients' self-reported adherence to HAART medication, a descriptive, comparative cross-sectional study was carried out among adults receiving HAART medication at the Zewditu Memorial Hospital ART clinic in Addis Ababa.

  1. Timing of antiretroviral therapy initiation in adults with HIV ...

    African Journals Online (AJOL)

    Timing of antiretroviral therapy initiation in adults with HIV-associated tuberculosis: Outcomes of therapy in an urban hospital in KwaZulu-Natal. ... We aimed to compare clinical outcomes of patients with HIV-associated TB who commenced ART at different stages of TB therapy. Methods. A retrospective chart review was ...

  2. Malarial infection among HIV Patients on Antiretroviral Therapy (ART)

    African Journals Online (AJOL)

    Malarial infection among patients on antiretroviral therapy (ART) attending Federal Medical Centre, Makurdi, Benue State was investigated between April and August 2008 to determine the level of malaria infection in HIV/AIDS patients on ART and those not on ART with respect to CD4+ counts, age and gender. A total of ...

  3. Patients' perceptions of a rural decentralised anti-retroviral therapy ...

    African Journals Online (AJOL)

    Background: Geographical and financial barriers hamper accessibility to HIV services for rural communities. The government has introduced the nurse initiated management of anti-retroviral therapy at primary health care level, in an effort to improve patient access and reduce patient loads on facilities further up the system.

  4. Modelling the relationship between antiretroviral treatment and HIV ...

    African Journals Online (AJOL)

    This paper shows how two publicly available epidemiological modelling packages, namely the Spectrum AIDS Impact Model and the ASSA2003 AIDS and Demographic Model, predict very different impacts from rolling out highly active antiretroviral treatment (HAART) on new HIV infections. Using South Africa as a case ...

  5. Estimates of eligibility for antiretroviral treatment (ART) and ...

    African Journals Online (AJOL)

    The study assessed the proportion of HIV-infected educators that need antiretroviral treatment (ART) according to current criteria, and estimated the impact of ART on AIDS mortality by modelling scenarios with and without access to ART. Specimens for HIV testing were obtained from 17 088 educators and a sub-sample of ...

  6. adherence to antiretroviral treatment in Zambia: a qualitative study

    African Journals Online (AJOL)

    Patients\\' adherence to antiretroviral therapy (ART) is important for effective medical treatment of HIV/AIDS. We conducted a qualitative interview study in the Copperbelt Province of Zambia in 2006. The aim of the study was to explore patients\\' and health care professionals\\' perceived barriers and facilitators to patients\\' ...

  7. Implementation and effectiveness of antiretroviral therapy in Greenland

    DEFF Research Database (Denmark)

    Lohse, N.; Ladefoged, K.; Obel, N.

    2008-01-01

    Analyses from the Danish HIV Cohort Study showed that, despite comparable economic means and general education of healthcare personnel, antiretroviral treatment of HIV in Greenland began later and has been implemented at a slower pace with lower therapeutic effectiveness than in Denmark. However...

  8. Roles of family dynamics on adherence to highly active antiretroviral ...

    African Journals Online (AJOL)

    Background: Adherence to highly active antiretroviral therapy (HAART) has been proven to be the only effective treatment for HIV/AIDS worldwide. Good adherence to HAART might require good family support. Objective: To determine the family dynamics and social support of people living with HIV/AIDS (PLWHA) and its ...

  9. Malaria in immuno-suppressed individuals on antiretroviral therapy ...

    African Journals Online (AJOL)

    Malaria in immuno-suppressed individuals on antiretroviral therapy (ART) in north-central Nigeria. C.R. Pam, B.T. Abubakar, G.O. Inwang, G.A. Amuga. Abstract. The immune deficiency caused by HIV infection reduces the immune response to malaria parasitaemia and therefore leads to an increased frequency of clinical ...

  10. Estimation of adult antiretroviral treatment coverage in South Africa ...

    African Journals Online (AJOL)

    The unmet need for treatment in adults is estimated using a Markov model of HIV progression in adults, combined with estimates of annual new HIV infections from a national AIDS and demographic model. Results. By the middle of 2008, 568 000 adults and children were receiving antiretroviral treatment in South Africa, ...

  11. Antiretrovirals, Fractures, and Osteonecrosis in a Large International HIV Cohort

    DEFF Research Database (Denmark)

    Borges, Álvaro H; Hoy, Jennifer; Florence, Eric

    2017-01-01

    Background: Antiretrovirals (ARVs) affect bone density and turnover, but their effect on risk of fractures and osteonecrosis of the femoral head is less understood. We investigated if exposure to ARVs increases the risk of both bone outcomes. Methods: EuroSIDA participants were followed to assess...

  12. A qualitative analysis of the barriers to antiretroviral therapy initiation ...

    African Journals Online (AJOL)

    A qualitative analysis of the barriers to antiretroviral therapy initiation among children 2 to 18 months of age in Swaziland. Charisse V Ahmed, Pauline Jolly, Luz Padilla, Musa Malinga, Chantal Harris, Nobuhle Mthethwa, Inessa Ba, Amy Styles, Sarah Perry, Raina Brooks, Florence Naluyinda-Kitabire, Makhosini Mamba, ...

  13. among People Receiving Antiretroviral Treatment in Western Uganda

    African Journals Online (AJOL)

    In this paper, we use survey (n=87) and interview (n=30) data to investigate orientations towards future childbearing among people receiving antiretroviral treatment and their family members in western Uganda. We investigate how reproductive options are perceived, by those receiving treatment and those closest to them, ...

  14. Quality of Life and Adherence to Antiretroviral Drugs | Mweemba ...

    African Journals Online (AJOL)

    Efficacy of antiretroviral treatment in HIV/AIDS is showing inhibition of viral replication and reduction of viral load to a point where viral particles are undetectable in the blood of infected individuals. ... Quality of life is a complex broad ranging multidimensional concept defined in terms of individual's subjective experiences.

  15. Can measuring immunity to HIV during antiretroviral therapy (ART ...

    African Journals Online (AJOL)

    The vexing issue of whether the immune system can be reconstituted during HIV infection by supplying antiretroviral therapy (ART) has been a question asked about HIV-infected adults and children receiving therapy.1-9 Knowing that the immune system is sufficiently plastic in adults to show restoration of specific and ...

  16. Antiretroviral treatment uptake in patients with HIV associated TB ...

    African Journals Online (AJOL)

    Background. Delivery of integrated care for patients with HIV-associated TB is challenging. We assessed the uptake and timing of antiretroviral treatment (ART) among eligible patients attending a primary care service with co-located ART and TB clinics. Methods. In a retrospective cohort study, all HIV-associated TB patients ...

  17. Determinants of Adherence to Antiretroviral Treatment among HIV ...

    African Journals Online (AJOL)

    This study investigated factors of adherence to Antiretroviral Treatment (ART), factors or variables that can discriminate between adherent and non-adherent patients on ART were selected. Simple structured questionnaire was employed. The study sample consisted of 145 HIV patients who received ART in the Shashemene ...

  18. South African Medical Journal

    African Journals Online (AJOL)

    The South African Medical Journal is published by the South African Medical Association, which represents ... G Watermeyer, S Thomson, 399-402 ... Assessing the value of Western Cape Provincial Government health administrative data and ...

  19. African Crop Science Journal

    African Journals Online (AJOL)

    AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search · USING AJOL ... The African Crop Science Journal, a quarterly publication, publishes original ... interactions, information science, environmental science and soil science.

  20. African Journals Online (AJOL)

    African Journals Online (AJOL)

    Lwati: A Journal of Contemporary Research. Vol 14, No 3 (2017) ... Journal of Business and Administrative Studies. Vol 6, No 2 (2014) ... Vol 11 (2015): African Journal of Educational Studies in Mathematics and Sciences Vol. 11, 2015. African ...

  1. South African Music Studies

    African Journals Online (AJOL)

    SAMUS: South African Music Studies is the official organ for the South African ... Shifty Records in Apartheid South Africa: Innovations in Independent Record ... Experiences of Belonging and Exclusion in the Production and Reception of ...

  2. Liberalism and African Culture.

    Science.gov (United States)

    Sindima, Harvey

    1990-01-01

    Discusses the effect of liberalism on the African understanding of education, community, and religion. Describes ways in which the European intrusion, that is, colonial governments, schools, and churches, undermined traditional African life and thought. (DM)

  3. African Studies Monographs

    African Journals Online (AJOL)

    The African Studies Monographs is a serial that promotes research and scholarship on the African perspective worldwide. This includes matters of philosophy, history, literature, arts and culture, environment, gender, politics, administration crisis management, etc.

  4. Dilemmas and paradoxes of capacity building in African higher education

    DEFF Research Database (Denmark)

    Madsen, Lene Møller; Jensen, Stig; Adriansen, Hanne Kirstine

    2015-01-01

    This chapter discusses and reflects on the dilemmas and paradoxes of capacity building in African higher education by drawing on the findings of the case-based chapters in the book. The collection confirms the importance of using geography of knowledge as an approach for understanding how capacity...... building influences and affects African academics, institutions and degree programmes. The chapters also illustrate how reflexivity and positionality can be important tools for highlighting the power relations inherent in capacity building. In this chapter we discuss the three interwoven dilemmas...... neo-imperial effects of internationalisation. We finally argue that capacity building programmes can be a means to assist African universities to ‘find their own feet’ if they are based on long terms partnerships, a close understanding of historical, political and geographical context, and not least...

  5. 'We are left in the cold': nurses' perceptions and responses to antiretroviral treatment roll-out in the Free State, South Africa.

    Science.gov (United States)

    de Wet, Katinka; du Plooy, Shirley

    2012-01-01

    The unprecedented roll-out of antiretroviral therapy (ART) in South Africa is a complex process where no previous endeavour exists that can measure, predict, or direct an intervention of this scale. In the Free State province, unique characteristics and problems distinguish its ART programme, although countrywide problems also occur within the province. The Free State province faces high vacancy rates among its health-care workers, the programme has lower patient enrolment rates because of an obsession with quality to the detriment of quantity, and various incidents of ART shortages have also shook the province. The ART roll-out intervention thus far has been largely nurse-driven (however not nurse initiated), and they form what many refer to as the 'backbone' of the programme. In order to respond to the challenges faced by these front-line ART providers, continuous transformations inevitably take place to respond to new needs associated with the roll-out programme, but also to strengthen the primary health-care system in general. The objective of this article is to present a typology of contradictory contextual factors in the antiretroviral programme as identified through group interviews that were conducted with PNs at public health-care clinics in the five districts of the Free State province during 2005 and 2006. We intend to show that transformations often have contradictory and problematic outcomes as expressed and perceived by the nurses themselves. This unprecedented endeavour of ART roll-out inevitably has to treasure and support its most valued implementers, i.e. the front-line providers who are not only professionals in the health-care setting, but also social agents in a wider contextual framework.

  6. The French nuclear programme

    International Nuclear Information System (INIS)

    Feger, M.

    1990-01-01

    EDF has long been interested in the use of nuclear energy for thermal power generation. After a period of apprenticeship and experiments, EDF launched a major PWR plant programme so as to reduce France's energy dependence and master generation costs. This programme, based on standardization, has achieved the desired results. It must now be adapted to suit the needs of the 21st century. For this programme, all those involved (Governmental authorities, EDF, manufacturers) were mobilized to an unprecedented extent and rigorous working methods were imposed. Experience feedback has been used to make improvements both to the installations themselves and to procedures. Results have proved satisfactory as regards nuclear safety but vigilance must be maintained. Public opinion on nuclear power is reserved we are sentenced to achieving a 'fault-free' track record, all the while mastering costs, so as to ensure the continuing use of nuclear energy. (author)

  7. The French nuclear programme

    Energy Technology Data Exchange (ETDEWEB)

    Feger, M [Ecole Nationale Superieure d' Electrotechnique de Grenoble, Institute National des Sciences et Techniques Nucleaires (Saclay), Gif-sur-Yvette, Electricite de France (France)

    1990-06-01

    EDF has long been interested in the use of nuclear energy for thermal power generation. After a period of apprenticeship and experiments, EDF launched a major PWR plant programme so as to reduce France's energy dependence and master generation costs. This programme, based on standardization, has achieved the desired results. It must now be adapted to suit the needs of the 21st century. For this programme, all those involved (Governmental authorities, EDF, manufacturers) were mobilized to an unprecedented extent and rigorous working methods were imposed. Experience feedback has been used to make improvements both to the installations themselves and to procedures. Results have proved satisfactory as regards nuclear safety but vigilance must be maintained. Public opinion on nuclear power is reserved we are sentenced to achieving a 'fault-free' track record, all the while mastering costs, so as to ensure the continuing use of nuclear energy. (author)

  8. External Mobility Programme

    CERN Multimedia

    HR Department

    2007-01-01

    Every year, a significant number of highly-skilled staff members leave the Organization and offer their talents on the European job market. CERN is launching a programme aiming to help staff members to whom the Organization cannot offer an indefinite contract in the transition towards their next employment. The programme, which is based on the establishment of a number of partnerships with potential employers in the private sector, will run on a voluntary basis. Staff members who have received confirmation that they will not be offered an indefinite contract and who are interested in availing themselves of the opportunities offered by the programme, are invited to enrol by following the procedure described at: https://ert.cern.ch/browse_intranet/wd_pds?p_web_page_id=5841 Applications will be processed in the strictest confidence by the Human Resources Department and eligible profiles will then be made available to partner companies for recruitment purposes. Any subsequent ...

  9. Characteristics of HIV antiretroviral regimen and treatment adherence

    Directory of Open Access Journals (Sweden)

    Vera Lúcia da Silveira

    Full Text Available The relationship between characteristics of HIV antiretroviral regimens and treatment adherence was studied in adolescent and adult patients who underwent antiretroviral therapy from January 1998 to September 2000, at the Service for Specialized Assistance in Pelotas. The patients were interviewed on two occasions, and the use of antiretrovirals during the previous 48 hours was investigated by a self-report. Adherence was defined as use of 95% or more of the prescribed medication. Social-demographic variables were collected through direct questionnaires. The antiretroviral regimen and clinical data were copied from the patients' records. Associations between the independent variables and adherence were analyzed by means of logistic regression. The multivariate analysis included characteristics of the antiretroviral regimens, social-demographic variables, as well as perception of negative effects, negative physiological states, and adverse effects of the treatment. Among the 224 selected patients, 194 participated in our study. Their ages varied from 17 to 67 years; most patients were men, with few years of schooling and a low family income. Only 49% adhered to the treatment. Adherence to treatment regimens was reduced when more daily doses were indicated: three to four doses (odds ratio of adherence to treatment (OR=0.47, 95% confidence interval (CI 0.22-1.01 and five to six (OR=0.24, 95% CI 0.09-0.62; two or more doses taken in a fasting state (OR=0.59, 95% CI 0.11-0.68, and for patients who reported adverse effects to the treatment (OR=0.39, 95% CI 0.19-0.77. Most of the regimens with more than two daily doses of medication included at least one dose apart from mealtimes. The results suggest that, if possible, regimens with a reduced number of doses should be chosen, with no compulsory fasting, and with few adverse effects. Strategies to minimize these effects should be discussed with the patients.

  10. Evaluating 5 years' NIMART mentoring in South Africa's HIV treatment programme: Successes, challenges and future needs.

    Science.gov (United States)

    Jones, M; Cameron, D

    2017-09-22

    Task shifting has enabled South Africa (SA) to rapidly expand its HIV treatment programme. This has been achieved by training and mentoring primary-care nurses in nurse initiation and management of antiretroviral therapy (NIMART). Five years into its clinical mentoring programme, the Foundation for Professional Development conducted an evaluation that identified improved knowledge, attitudes and confidence perceived by nurses who received NIMART mentoring. Low completion rates for the Department of Health (DoH) NIMART training process were identified and therefore targeted mentoring was introduced; this increased the percentage of primary nurses eligible for DoH certificates of clinical competence in NIMART from 12%, adding a further 30%. There remain a large number of primary nurses who require mentoring in order to complete the NIMART process. For those who have completed the process, there remains a need for ongoing mentoring as SA's HIV programme evolves, complex cases emerge and primary care undergoes change.

  11. An implementation evaluation of a voluntary counselling and testing programme for the human immunodeficiency virus (HIV and acquired immunodeficiency syndrome (AIDS

    Directory of Open Access Journals (Sweden)

    Tarryn N. Anderson

    2012-07-01

    Research purpose: The purpose of this evaluation was to assess whether or not a Voluntary Counselling and Testing (VCT programme for HIV and AIDS, at a South African university, was implemented as intended. Motivation for the study: The evaluators were motivated to explore indications in the existing literature about these programmes that participants in VCT programmes are often not the intended target population who live a high risk lifestyle. Research design, approach and method: A descriptive design was used to evaluate service utlisation, service delivery and organisational support. Questionnaire data from 285 respondents who participated in the programme and programme records supplied by the programme staff were consulted to answer the evaluation questions. Main findings: The evaluation showed that the highest uptake for the programme occurred amongst female students. The low uptake amongst men was a concern. It was found that the programme was delivered as intended and that there were enough resources to implement it according to standards set. Practical/managerial implications: The systematic report on the programme process provided the programme managers with practical suggestions for programme improvement. Contribution/value-add: This was the first implementation evaluation of a VCT programme in a South African university context. As such it aimed to educate programme managers to think evaluatively about introducing new or continuing existing programmes.

  12. Probabilistic programmable quantum processors

    International Nuclear Information System (INIS)

    Buzek, V.; Ziman, M.; Hillery, M.

    2004-01-01

    We analyze how to improve performance of probabilistic programmable quantum processors. We show how the probability of success of the probabilistic processor can be enhanced by using the processor in loops. In addition, we show that an arbitrary SU(2) transformations of qubits can be encoded in program state of a universal programmable probabilistic quantum processor. The probability of success of this processor can be enhanced by a systematic correction of errors via conditional loops. Finally, we show that all our results can be generalized also for qudits. (Abstract Copyright [2004], Wiley Periodicals, Inc.)

  13. A programme in transition

    International Nuclear Information System (INIS)

    Dean, S.O.

    1992-01-01

    Fusion is beginning its transition from a scientific research programme to that of an engineering development programme aimed at practical applications. This transition is likely to last a decade or more because many scientific questions remain and because of the magnitude and cost of the engineering issues. This article reviews briefly the encouraging results produced at the Joint European Torus (JET) where 1.7 MW of fusion power was generated for 2 seconds in experiments in November 1991, the remaining scientific issues, the role of near-term experimental reactors like the International Thermonuclear Experimental reactor (ITER) and other approaches to a demonstration power plant. (author)

  14. Computer mathematics for programmers

    CERN Document Server

    Abney, Darrell H; Sibrel, Donald W

    1985-01-01

    Computer Mathematics for Programmers presents the Mathematics that is essential to the computer programmer.The book is comprised of 10 chapters. The first chapter introduces several computer number systems. Chapter 2 shows how to perform arithmetic operations using the number systems introduced in Chapter 1. The third chapter covers the way numbers are stored in computers, how the computer performs arithmetic on real numbers and integers, and how round-off errors are generated in computer programs. Chapter 4 details the use of algorithms and flowcharting as problem-solving tools for computer p

  15. CD4+ Count-Guided Interruption of Antiretroviral Treatment. The Strategies for Mangement of Antiretroviral Therapy (SMART) Study Group

    DEFF Research Database (Denmark)

    El-Sadr, WM; Lundgren, Jens Dilling; Neaton, JD

    2006-01-01

    BACKGROUND: Despite declines in morbidity and mortality with the use of combination antiretroviral therapy, its effectiveness is limited by adverse events, problems with adherence, and resistance of the human immunodeficiency virus (HIV). METHODS: We randomly assigned persons infected with HIV wh...

  16. The UCAR Africa Initiative: Enabling African Solutions to African Needs

    Science.gov (United States)

    Pandya, R.; Bruintjes, R.; Foote, B.; Heck, S.; Hermann, S.; Hoswell, L.; Konate, M.; Kucera, P.; Laing, A.; Lamptey, B.; Moncrieff, M.; Ramamurthy, M.; Roberts, R.; Spangler, T.; Traoré, A.; Yoksas, T.; Warner, T.

    2007-12-01

    The University Corporation for Atmospheric Research (UCAR) Africa Initiative (AI) is a coordinated effort aimed at building sustainable partnerships between UCAR and African institutions in order to pursue research and applications for the benefit of the African people. The initiative is based on four fundamental operating principles, concisely summarized by the overall philosophy of enabling African solutions to African needs. The four principles are: • Collaborate with African institutions • Focus on institutional capacity building and research support • Explore science research themes critical to Africa and important for the world • Leverage the research infrastructure in UCAR to add value These principles are realized in a set of pilot activities, chosen for their high probability of short-term results and ability to set the stage for longer-term collaboration. The three pilot activities are listed below. 1. A modest radar network and data-distribution system in Mali and Burkina Faso, including a data-sharing MOU between the Mail and Burkina Faso Weather Services. 2. A partnership among UCAR, the Ghana Meteorological Agency, and the Ghana university community to develop an operational Weather Research and Forecasting (WRF) model for West Africa. The output is used by researchers and operational forecasters in Africa. Model output is also part of a demonstration project that aims to allow humanitarian agencies to share geo-referenced information in Africa via a web portal. 3. A workshop in Ouagadougou, Burkina Faso from April 2-6, 2007, with the theme Improving Lives by Understanding Weather. The workshop, co-organized with Programme SAAGA and the Commité Permanent Inter-Etats de Lutte Contre la Sécheresse dans le Sahel (CILSS), included over 80 participants from 18 countries, and produced a set of recommendations for continued collaboration. Our presentation will provide an update of these pilot activities and point to future directions. Recognizing

  17. African Anthropologist: Submissions

    African Journals Online (AJOL)

    Author Guidelines. The African Anthropologist is a biannual journal of the Pan African Anthropological Association. It provides a forum for African and Africanist anthropologists to publish articles, research reports, review articles, and book reviews. The views expressed in any published material are those of the authors and ...

  18. African Journals Online (AJOL)

    African Journals Online (AJOL)

    African Journals OnLine (AJOL) is the world's largest and pre-eminent collection of peer-reviewed, African-published scholarly journals. Historically ... African Research Review; The Roles of Information Communication Technologies in Education: Review Article with Emphasis to the Computer and Internet Ethiopian Journal ...

  19. African Journals Online (AJOL)

    African Journals Online (AJOL)

    reviewed, African-published scholarly journals. Historically, scholarly information has flowed from North to South and from West to East. It has also been difficult for African researchers to access the work of other African academics. In partnership with ...

  20. African Journals Online (AJOL)

    African Journals Online (AJOL)

    It has also been difficult for African researchers to access the work of other African academics. ... search for an article by title, author/s or keywords,; and find other information ... Southern African Business Review; Project Work by Students for First ... The Basis of Distinction Between Qualitative and Quantitative Research in ...

  1. African Journals Online (AJOL)

    African Journals Online (AJOL)

    It has also been difficult for African researchers to access the work of other African ... search for an article by title, author/s or keywords,; and find other information ... Southern African Business Review; Effect of Globalization on Sovereignty of States ... The Basis of Distinction Between Qualitative and Quantitative Research in ...

  2. African Journals Online (AJOL)

    African Journals Online (AJOL)

    It has also been difficult for African researchers to access the work of other African ... search for an article by title, author/s or keywords,; and find other information sources ... Southern African Business Review; Conflicts in Africa: Meaning, Causes, ... The Basis of Distinction Between Qualitative and Quantitative Research in ...

  3. African Journals Online: Health

    African Journals Online (AJOL)

    Items 1 - 50 of 167 ... African Journal of AIDS Research (AJAR) is a peer-reviewed ... The African Journal of Drug & Alcohol Studies is an international ... The Journal has been produced through the efforts of Kenya Medical Research Institute (KEMRI) and the African .... in basic and clinical medical sciences as well as dentistry.

  4. African Journals Online (AJOL)

    African Journals Online (AJOL)

    South African Journal for Research in Sport, Physical Education and Recreation. Vol 17, No 4 (2017). African Health Sciences. Vol 6, No 1 (2015). Nigeria Journal of Pure and Applied Physics. Vol 5, No 2 (2017). Journal of Student Affairs in Africa. Vol 14, No 1 (2017). Annals of African Surgery. Vol 63, No 7-9 (2018).

  5. African Journals Online (AJOL)

    African Journals Online (AJOL)

    reviewed, African-published scholarly journals. Historically ... It has also been difficult for African researchers to access the work of other African academics. In partnership with ... Vol 15, No 1 (2018). SAHARA-J: Journal of Social Aspects of HIV/AIDS.

  6. African Journals Online (AJOL)

    African Journals Online (AJOL)

    West African Journal of Applied Ecology. Vol 6, No 2 (2017). Filosofia Theoretica: Journal of African Philosophy, Culture and Religions. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use · Contact AJOL ...

  7. African Journals Online (AJOL)

    African Journals Online (AJOL)

    In partnership with hundreds of journals from all over the continent, AJOL works to change this, so that African-origin research output is available to Africans and to ... African Journal of AIDS Research. Vol 35, No 2 (2017). Zimbabwe Veterinary Journal. Vol 34, No 1 (2018). Eastern Africa Social Science Research Review.

  8. Perceptions of the benefits and affordability of antiretrovirals among ...

    African Journals Online (AJOL)

    US$73). One hundred and eleven respondents (72.1%) had sought care ... their accessibility and treatment compliance, especially among lower-income patients. ... national AIDS programmes, perception, programme planning, treatment cost

  9. Should HIV and AIDS workplace programmes still be advocated in the automotive industry?

    OpenAIRE

    Liana Steenkamp; Jill von der Marwitz; Friederike Baasner-Weihs; Jacques Pietersen

    2015-01-01

    Orientation: In light of the human immunodeficiency virus (HIV) pandemic, and in order to improve competitiveness in the South African private sector, many structures have implemented subsidised workplace programmes. Research purpose: The aim of this study was to collect baseline data regarding the knowledge, attitudes, practices and belief (KAPB) of employees in the automotive industry in relation to HIV and AIDS, in order to assess the need for HIV and AIDS workplace programmes. Mot...

  10. Clinical differences between younger and older adults with HIV/AIDS starting antiretroviral therapy in Uganda and Zimbabwe: a secondary analysis of the DART trial.

    Directory of Open Access Journals (Sweden)

    Sujal M Parikh

    Full Text Available Clinical and immunological data about HIV in older adults from low and middle income countries is scarce. We aimed to describe differences between younger and older adults with HIV starting antiretroviral therapy in two low-income African countries.HIV clinics in Uganda and Zimbabwe.Secondary exploratory cross-sectional analysis of the DART randomized controlled trial.Clinical and laboratory characteristics were compared between adults aged 18-49 years (younger and ≥ 50 years (older, using two exploratory multivariable logistic regression models, one with HIV viral load (measured in a subset pre-ART and one without.A total of 3316 eligible participants enrolled in DART were available for analysis; 219 (7% were ≥ 50 years and 1160 (35% were male. Across the two adjusted regression models, older adults had significantly higher systolic blood pressure, lower creatinine clearance and were consistently less likely to be females compared to younger adults with HIV. Paradoxically, the models separately suggested that older adults had statistically significant (but not clinically important higher CD4+ cell counts and higher plasma HIV-1 viral copies at initiation. Crude associations between older age and higher baseline hemoglobin, body mass index, diastolic blood pressure and lower WHO clinical stage were not sustained in the adjusted analysis.Our study found clinical and immunological differences between younger and older adults, in a cohort of Africans starting antiretroviral therapy. Further investigations should explore how these differences could be used to ensure equity in service delivery and affect outcomes of antiretroviral therapy.

  11. Examining the interplay between depression, motivation, and antiretroviral therapy adherence: a social cognitive approach.

    Science.gov (United States)

    Tatum, A K; Houston, E

    2017-03-01

    A large body of research identifies depressive symptoms as a barrier to optimal antiretroviral therapy (ART) adherence, whereas treatment motivation has been characterized as a facilitator. There is evidence, however, that these patterns may not hold for some ART patients despite the widespread use of motivational techniques aimed at promoting adherence. Little is known about how the interplay between different levels of depressive symptoms and variations in the types and levels of motivation may influence ART adherence. The purpose of this study was to examine the relationship between depressive symptoms, two types of motivation, and adherence, with self-efficacy as a mediator. The sample consisted of 121 ART patients who reported various levels of depressive symptoms (mean age = 41 years; 84% African-American; and 68% female). Path analysis revealed that self-efficacy fully mediated the relationship between the three predictor variables (depressive symptoms, intrinsic motivation, and extrinsic motivation) and adherence, χ 2 (3, N = 121) = .78, RMSEA = .00, SRMR = .02, CFI = 1.00, NNFI = 1.06. Findings suggest that interventions using motivational techniques to build adherence among patients with varying levels of depressive symptoms should address the role of treatment self-efficacy to improve their effectiveness.

  12. Increased Persistence of Initial Treatment for HIV Infection With Modern Antiretroviral Therapy.

    Science.gov (United States)

    Davy-Mendez, Thibaut; Eron, Joseph J; Zakharova, Oksana; Wohl, David A; Napravnik, Sonia

    2017-10-01

    Initiating antiretroviral therapy (ART) early improves clinical outcomes and prevents transmission. Guidelines for first-line therapy have changed with the availability of newer ART agents. In this study, we compared persistence and virologic responses with initial ART according to the class of anchor agent used. An observational clinical cohort study in the Southeastern United States. All HIV-infected patients participating in the UNC Center for AIDS Research Clinical Cohort (UCHCC) and initiating ART between 1996 and 2014 were included. Separate time-to-event analyses with regimen discontinuation and virologic failure as outcomes were used, including Kaplan-Meier survival curves and adjusted Cox proportional hazards models. One thousand six hundred twenty-four patients were included (median age of 37 years at baseline, 28% women, 60% African American, and 28% white). Eleven percent initiated integrase strand transfer inhibitor (INSTI), 33% non-nucleoside reverse transcriptase inhibitor (NNRTI), 20% boosted protease inhibitor, 27% other, and 9% NRTI only regimens. Compared with NNRTI-containing regimens, INSTI-containing regimens had an adjusted hazard ratio of 0.49 (95% confidence interval, 0.35 to 0.69) for discontinuation and 0.70 (95% confidence interval, 0.46 to 1.06) for virologic failure. All other regimen types were associated with increased rates of discontinuation and failure compared with NNRTI. Initiating ART with an INSTI-containing regimen was associated with lower rates of regimen discontinuation and virologic failure.

  13. Systematic review of antiretroviral-associated lipodystrophy: lipoatrophy, but not central fat gain, is an antiretroviral adverse drug reaction.

    Directory of Open Access Journals (Sweden)

    Reneé de Waal

    Full Text Available BACKGROUND: Lipoatrophy and/or central fat gain are observed frequently in patients on antiretroviral therapy (ART. Both are assumed to be antiretroviral adverse drug reactions. METHODS: We conducted a systematic review to determine whether fat loss or gain was more common in HIV-infected patients on ART than in uninfected controls; was associated with specific antiretrovirals; and would reverse after switching antiretrovirals. RESULTS: Twenty-seven studies met our inclusion criteria. One cohort study reported more lipoatrophy, less subcutaneous fat gain, but no difference in central fat gain in HIV-infected patients on ART than in controls. Randomised controlled trials (RCTs showed more limb fat loss (or less fat gain with the following regimens: stavudine (versus other nucleoside reverse transcriptase inhibitors (NRTIs; efavirenz (versus protease inhibitors (PIs; and NRTI-containing (versus NRTI-sparing. RCTs showed increased subcutaneous fat after switching to NRTI-sparing regimens or from stavudine/zidovudine to abacavir/tenofovir. There were no significant between-group differences in trunk and/or visceral fat gain in RCTs of various regimens, but results from efavirenz versus PI regimens were inconsistent. There was no significant between-group differences in central fat gain in RCTs switched to NRTI-sparing regimens, or from PI-containing regimens. CONCLUSIONS: There is clear evidence of a causal relationship between NRTIs (especially thymidine analogues and lipoatrophy, with concomitant PIs possibly having an ameliorating effect or efavirenz causing additive toxicity. By contrast, central fat gain appears to be a consequence of treating HIV infection, because it is not different from controls, is not linked to any antiretroviral class, and doesn't improve on switching.

  14. Strengthening African Union for African Integration: An African ...

    African Journals Online (AJOL)

    Toshiba

    to secure African continent, speed up development process, and strengthen our survival ... Regional integration generally involves a somewhat complex web of cooperation ... networking of various government institutions to provide and shape.

  15. Mexican medfly programme

    International Nuclear Information System (INIS)

    1980-01-01

    This film tells the story of the fight against and final extinction of the Mediterranean fruit-fly (Ceratitis capitata) in Mexico. By producing billions of high quality sterile flies in the Medfly reproduction and sterilization laboratory in the province of Chiapas and releasing them over infested areas, the Moscamed Programme succeeded in eradicating this pest from Mexico in 1982

  16. Nuclear safety. Improvement programme

    International Nuclear Information System (INIS)

    2000-01-01

    In this brochure the improvement programme of nuclear safety of the Mochovce NPP is presented in detail. In 1996, a 'Mochovce NPP Nuclear Safety Improvement Programme' was developed in the frame of unit 1 and 2 completion project. The programme has been compiled as a continuous one, with the aim to reach the highest possible safety level at the time of commissioning and to establish good preconditions for permanent safety improvement in future. Such an approach is in compliance with the world's trends of safety improvement, life-time extension, modernisation and nuclear station power increase. The basic document for development of the 'Programme' is the one titled 'Safety Issues and their Ranking for WWER 440/213 NPP' developed by a group of IAEA experts. The following organisations were selected for solution of the safety measures: EUCOM (Consortium of FRAMATOME, France, and SIEMENS, Germany); SKODA Prague, a.s.; ENERGOPROJEKT Prague, a.s. (EGP); Russian organisations associated in ATOMENERGOEXPORT; VUJE Trnava, a.s

  17. Progressive Retirement Programme

    CERN Document Server

    HR Department

    2009-01-01

    Following the Standing Concertation Committee meeting of 2 December 2008, please note that the Progressive Retirement Programme has been extended by one year, i.e. until 31 March 2010. Further information is available on : https://hr-services.web.cern.ch/hr-services/services-Ben/prp/prp.asp HR Department, tel. 73903

  18. Fusion technology programme

    International Nuclear Information System (INIS)

    Finken, D.

    1985-10-01

    KfK is involved in the European Fusion Programme predominantly in the NET and Fusion Technology part. The following fields of activity are covered: Studies for NET, alternative confinement concepts, and needs and issues of integral testing. Research on structural materials. Development of superconducting magnets. Gyrotron development (part of the Physics Programme). Nuclear technology (breeding materials, blanket design, tritium technology, safety and environmental aspects of fusion, remote maintenance). Reported here are status and results of work under contracts with the CEC within the NET and Technology Programme. The aim of the major part of this R and D work is the support of NET, some areas (e.g. materials, safety and environmental impact, blanket design) have a wider scope and address problems of a demonstration reactor. In the current working period, several new proposals have been elaborated to be implemented into the 85/89 Euratom Fusion Programme. New KfK contributions relate to materials research (dual beam and fast reactor irradiations, ferritic steels), to blanket engineering (MHD-effects) and to safety studies (e.g. magnet safety). (orig./GG)

  19. SET-Routes programme

    CERN Multimedia

    Marietta Schupp, EMBL Photolab

    2008-01-01

    Dr Sabine Hentze, specialist in human genetics, giving an Insight Lecture entitled "Human Genetics – Diagnostics, Indications and Ethical Issues" on 23 September 2008 at EMBL Heidelberg. Activities in a achool in Budapest during a visit of Angela Bekesi, Ambassadors for the SET-Routes programme.

  20. Programmable dc motor controller

    Science.gov (United States)

    Hopwood, J. E.

    1982-11-01

    A portable programmable dc motor controller, with features not available on commercial instruments was developed for controlling fixtures during welding processes. The controller can be used to drive any dc motor having tachometer feedback and motor requirements not exceeding 30 volts, 3 amperes. Among the controller's features are delayed start time, upslope time, speed, and downslope time.