• Clinical screening for HIV in a health centre setting in urban Kenya: an entry point for voluntary counselling, HIV testing and early diagnosis of HIV infection?

      Arendt, V; Mossong, J; Zachariah, R; Inwani, C; Farah, B; Robert, I; Waelbrouck, A; Fonck, K; Médecins Sans Frontières, Mission Kenya, Brussels Operational Centre, Brussels, Belgium. (2007-01)
      A study was conducted among patients attending a public health centre in Nairobi, Kenya in order to (a) verify the prevalence of HIV, (b) identify clinical risk factors associated with HIV and (c) determine clinical markers for clinical screening of HIV infection at the health centre level. Of 304 individuals involved in the study,107(35%) were HIV positive. A clinical screening algorithm based on four clinical markers, namely oral thrush, past or present TB, past or present herpes zoster and prurigo would pick out 61 (57%) of the 107 HIV-positive individuals. In a resource-poor setting, introducing a clinical screening algorithm for HIV at the health centre level could provide an opportunity for targeting voluntary counselling and HIV testing, and early access to a range of prevention and care interventions.
    • Correcting mortality for loss to follow-up: a nomogram applied to antiretroviral treatment programmes in sub-Saharan Africa.

      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; Institute of Social and Preventive Medicine (ISPM), University of Bern, Switzerland; Moi University School of Medicine, Eldoret, Kenya; Lighthouse Trust, Kamuzu Hospital, Lilongew, Malawi; Divison of HIV/AIDS, Department of Medicine, University of California, San Franciso, California, USA; Center for Global Health and Development, Boston University, Boston, Massachusetts, USA; Right to Care, Thema Leftu Clinic, Joseph Hospital, Johannesburg, South Africa; Khayelitsha Medecins sans Frontieres programme, University of Cape Town, Cape Town, South Africa; Centre de Prise en Charge, de Recherche et de Formation sur le VH/SIDA, Abidjan, Cote d'Ivoire; Desmond Tutu Hiv Centre, Cape Town, South Africa, Mailman School, Columbia University, NY, NY, USA; Newlands Clinic, Harare, Zimbabwe; Independent Surgery, Gaborone, Botswana; Institut de Recherece pour le Developpement/UMR 145, Montpeller, France; Perinatal Hiv Research Unit, Soweto, South Africa. (2011-01)
      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.
    • Viral Load Monitoring of Antiretroviral Therapy, cohort viral load and HIV transmission in Southern Africa: A Mathematical Modelling Analysis

      Estill, Janne; Aubrière, Cindy; Egger, Matthias; Johnson, Leigh; Wood, Robin; Garone, Daniela; Gsponer, Thomas; Wandeler, Gilles; Boulle, Andrew; Davies, Mary-Ann; Hallett, Timothy B; Keiser, Olivia; Institute of Social and Preventive Medicine, University of Bern, Switzerland. (2012-03-20)
      In low-income settings, treatment failure is often identified using CD4 cell count monitoring. Consequently, patients remain on a failing regimen, resulting in a higher risk of transmission. We investigated the benefit of routine viral load monitoring for reducing HIV transmission.