• Caring for patients with surgically resectable cancers: experience from a specialised centre in rural Rwanda

      Mubiligi, J M; Hedt-Gauthier, B; Mpunga, T; Tapela, N; Okao, P; Harries, A D; Edginton, M E; Driscoll, C; Mugabo, L; Riviello, R; Shulman, L N (The Union, 2014-06-21)
    • Childhood immunization in Bungoma County, Kenya, from 2008 to 2011: need for improved uptake

      Mbuthia, G W; Harries, A D; Obala, A A; Nyamogoba, H D N; Simiyu, C; Edginton, M E; Khogali, M; Hedt-Gauthier, B L; Otsyla, B K (International Union Against Tuberculosis and Lung Disease, 2014-03)
      Uptake of immunisations in children aged 1–2 years in Bungoma County, Kenya, was determined as part of the 6-monthly Health and Demographic Surveillance System surveys. A total of 2699 children were assessed between 2008 and 2011. During this time period, full immunisation declined significantly from 84% to 58%,and measles vaccine declined uptake from 89% to 60%(P<0.001). Each year there was a significant fall-off for the third doses of the oral polio and pentavalent vaccines(P<0.001). These findings are of concern, as low immunisation coverage may lead to vaccine-preventable disease outbreaks. Further investigations into the reasons for declining immunisation trends are required.
    • Intensified Tuberculosis Case Finding among Malnourished Children in Nutritional Rehabilitation Centres of Karnataka, India: Missed Opportunities

      Bhat, P G; Kumar, A M V; Naik, B; Satyanarayana, S; Kg, D; Nair, S A; MD, S; Heldal, E; Enarson, D A; Reid, A J (Public Library of Science, 2013)
      Severe acute malnutrition (SAM) is the most serious form of malnutrition affecting children under-five and is associated with many infectious diseases including Tuberculosis (TB). In India, nutritional rehabilitation centres (NRCs) have been recently established for the management of SAM including TB. The National TB Programme (NTP) in India has introduced a revised algorithm for diagnosing paediatric TB. We aimed to examine whether NRCs adhered to these guidelines in diagnosing TB among SAM children.
    • Intensive-Phase Treatment Outcomes among Hospitalized Multidrug-Resistant Tuberculosis Patients: Results from a Nationwide Cohort in Nigeria

      Oladimeji, O; Isaakidis, P; Obasanya, O J; Eltayeb, O; Khogali, M; Van den Bergh, R; Kumar, A M V; Hinderaker, S G; Abdurrahman, S T; Lawson, L; Cuevas, L E (Public Library of Science, 2014-04)
      Nigeria is faced with a high burden of Human Immunodeficiency Virus (HIV) infection and multidrug-resistant tuberculosis (MDR-TB). Treatment outcomes among MDR-TB patients registered across the globe have been poor, partly due to high loss-to-follow-up. To address this challenge, MDR-TB patients in Nigeria are hospitalized during the intensive-phase(IP) of treatment (first 6-8 months) and are provided with a package of care including standardized MDR-TB treatment regimen, antiretroviral therapy (ART) and cotrimoxazole prophylaxis (CPT) for HIV-infected patients, nutritional and psychosocial support. In this study, we report the end-IP treatment outcomes among them.
    • Management of previously treated tuberculosis patients in Kalutara district, Sri Lanka: how are we faring?

      Abeygunawardena, S C; Sharath, B N; Van den Bergh, R; Naik, B; Pallewatte, N; Masaima, M N N (The Union, 2014-06-21)
    • Provider-initiated HIV testing and counselling for TB in low HIV prevalence settings: is it worthwhile?

      Nagai, S; Robinson, R; Rahamefy, J R; Randriambeloson, S J; Ranaivomanana, D A; Razafindranaivo, T; Rakotobe, L; Ranaivo, A; Hinderaker, S G; Harries, A D; Zachariah, R (Oxford University Press, 2014-01-23)
      We assessed the HIV-positive yield of offering provider-initiated HIV testing and counselling (PITC) for TB and the costs, in Madagascar, which has a low HIV prevalence and a high TB burden.
    • Providing a gateway to prevention and care for the most at-risk populations in Bhutan: is this being achieved?

      Khandu, L; Zachariah, R; Van den Bergh, R; Wangchuk, D; Tshering, N; Wangmo, D; Ananthakrishnan, R; Dorji, T; Satyanarayana, S (International Union Against Tuberculosis and Lung Disease, 2014-03)
      Setting: Two free-standing urban human immunodeficiency virus (HIV) testing and counselling (HCT) centres in Bhutan offering services to the general population and targeting the most at-risk populations (MARPs). Objectives: To assess the trend in testing for HIV, hepatitis B and syphilis in both the general population and MARPs, and to determine if sociodemographic and risk behaviour characteristics are associated with HIV, hepatitis B and syphilis seropositivity. Design: Cross-sectional study using client records, 2009–2012. Results: Of 7894 clients, 3009 (38%) were from the general population, while 4885 (62%) were from MARPs. Over the 4-year period, testing declined progressively among the general population, while it increased or remained static for MARPs. Of 4885 MARPs, seropositivity was respectively 0.7%, 1.3% and 1.2% for HIV, hepatitis B and syphilis. Female sex workers (FSWs) (relative risk[RR] 4.4, P=0.03) and partners of person living with HIV(RR 25.9, P<0.001) had a higher risk of being HIV-positive. FSWs had also a greater risk of being syphilis-positive(RR 9.1, P<0.001). Conclusion: The increase in uptake of HCT services by MARPs is a welcome finding; however, the relatively static trends call for the introduction of community outreach approaches. The critical gateway being provided to MARPs is an ‘opportunity’ for the expansion of the current service package.
    • Sex, drugs and prisons: HIV prevention strategies for over 190000 clients in Ukraine

      Denisiuk, O; Smyrnov, P; Kumar, A M V; Achanta, S; Boyko, K; Khogali, M; Naik, B; Zachariah, R (The Union, 2014-06-21)