• 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; et al. (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.
    • The journey to antiretroviral therapy in Karnataka, India: who was lost on the road?

      Shastri, S; Sathyanarayna, S; Nagaraja, S B; Kumar, A M V; Rewari, B; Harries, A D; Zachariah, R (International AIDS Society, 2013)
      One important operational challenge facing antiretroviral treatment (ART) programmes in low- and middle-income countries is the loss to follow-up between diagnosis of human immunodeficiency virus (HIV) and initiation of ART. This is a major obstacle to achieving universal access to ART. This study from Karnataka, India, tried to measure such losses by determining the number of HIV-positive individuals diagnosed, the number of them reaching ART centres, the number initiated on ART and the reasons for non-initiation of ART.
    • A 'one-stop shop' approach in antenatal care: does this improve antiretroviral treatment uptake in Zimbabwe?

      Gunguwo, H; Zachariah, R; Bissell, K; Ndebele, W; Moyo, J; Mutasa-Apollo, T (International Union Against Tuberculosis and Lung Disease, 2014-03-25)
    • 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; et al. (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.