• Access to CD4 Testing for Rural HIV Patients: Findings from a Cohort Study in Zimbabwe

      Vogt, Florian; Tayler-Smith, Katie; Bernasconi, Andrea; Makondo, Eliphas; Taziwa, Fabian; Moyo, Buhlebenkosi; Havazvidi, Liberty; Satyanarayana, Srinath; Manzi, Marcel; Khogali, Mohammed; et al. (Public Library of Science, 2015-06-17)
      CD4 cell count measurement remains an important diagnostic tool for HIV care in developing countries. Insufficient laboratory capacity in rural Sub-Saharan Africa is frequently mentioned but data on the impact at an individual patient level are lacking. Urban-rural discrepancies in CD4 testing have not been quantified to date. Such evidence is crucial for public health planning and to justify new yet more expensive diagnostic procedures that could circumvent access constraints in rural areas.
    • The contribution of Ebola viral load at admission and other patient characteristics to mortality in a Médecins Sans Frontières (MSF) Ebola Case Management Centre (CMC), Kailahun, Sierra Leone, June -October, 2014

      Fitzpatrick, Gabriel; Vogt, Florian; Gbabai, Osman B Moi; Decroo, Tom; Keane, Marian; De Clerck, Hilde; Grolla, Allen; Brechard, Raphael; Stinson, Kathryn; Van Herp, Michel (Oxford University Press, 2015-05-22)
      This paper describes patient characteristics, including Ebola viral load, associated with mortality in an MSF Ebola case management centre. Out of 780 admissions between June and October 2014, 525 (67%) were positive for Ebola with a known outcome. The crude mortality rate was 51% (270/525). Ebola viral load (whole blood sample) data was available on 76% (397/525) of patients. Univariate analysis indicated viral load at admission, age, symptom duration prior to admission and distance travelled to the CMC were associated with mortality (p value<0.05). The multivariable model predicted mortality in those with a viral load at admission greater than 10 million copies per millilitre (p value<0.05, Odds Ratio>10), aged 50 years or more (p value=0.08, Odds Ratio=2) and symptom duration prior to admission less than 5 days (p value=0.14). The presence of confusion, diarrhoea and conjunctivitis were significantly higher (p value<0.05) in Ebola patients who died. These findings highlight the importance viral load at admission has on mortality outcomes and could be used to cohort cases with viral loads greater than 10 million copies into dedicated wards with more intensive medical support to further reduce mortality.
    • Tracing defaulters in HIV prevention of mother-to-child transmission programmes through community health workers: results from a rural setting in Zimbabwe.

      Vogt, Florian; Ferreyra, Cecilia; Bernasconi, Andrea; Ncube, Lewis; Taziwa, Fabian; Marange, Winnie; Wachi, David; Becher, Heiko (International AIDS Society, 2015-10)
      High retention in care is paramount to reduce vertical human immunodeficiency virus (HIV) infections in prevention of mother-to-child transmission (PMTCT) programmes but remains low in many sub-Saharan African countries. We aimed to assess the effects of community health worker-based defaulter tracing (CHW-DT) on retention in care and mother-to-child HIV transmission, an innovative approach that has not been evaluated to date.
    • Using BD Vacutainer CD4 Stabilization Tubes for Absolute Cluster of Differentiation Type 4 Cell Count Measurement on BD FacsCount and Partec Cyflow Cytometers: A Method Comparison Study from Zimbabwe

      Vogt, Florian; Van den Bergh, Rafael; Bernasconi, Andrea; Moyo, Buhlebenkosi; Havazvidi, Liberty; Bastard, Mathieu; Flevaud, Laurence; Taziwa, Fabian; Makondo, Eliphas; Mtapuri-Zinyowera, Sekesai (Public Library of Science, 2015-08-21)
      Blood collected in conventional EDTA tubes requires laboratory analysis within 48 hours to provide valid CD4 cell count results. This restricts access to HIV care for patients from rural areas in resource-constraint settings due to sample transportation problems. Stabilization Tubes with extended storage duration have been developed but not yet evaluated comprehensively.
    • Using BD Vacutainer CD4 Stabilization Tubes for Absolute Cluster of Differentiation Type 4 Cell Count Measurement on BD FacsCount and Partec Cyflow Cytometers: A Method Comparison Study from Zimbabwe.

      Vogt, Florian; Van den Bergh, Rafael; Bernasconi, Andrea; Moyo, Buhlebenkosi; Havazvidi, Liberty; Bastard, Mathieu; Flevaud, Laurence; Taziwa, Fabian; Makondo, Eliphas; Mtapuri-Zinyowera, Sekesai; et al. (2015-08)
      Blood collected in conventional EDTA tubes requires laboratory analysis within 48 hours to provide valid CD4 cell count results. This restricts access to HIV care for patients from rural areas in resource-constraint settings due to sample transportation problems. Stabilization Tubes with extended storage duration have been developed but not yet evaluated comprehensively.