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2.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 32(6): 577-583, 2020 Nov 23.
Artigo em Chinês | MEDLINE | ID: mdl-33325191

RESUMO

OBJECTIVE: To investigate the prevalence and risk factors of Blastocystis hominis infections among AIDS patients in Nanchang City. METHODS: A cross-sectional questionnaire survey was conducted among AIDS patients in Nanchang City during the period between May and September, 2016. B. hominis infection was detected in patients'stool samples using a PCR assay, and the CD4+ T cell count was measured in subjects'blood samples. In addition, the risk factors of B. hominis infection in AIDS patients were identified using univariate and multivariate logistic regression analyses. RESULTS: A survey was conducted in Nanchang City from May to September 2016. A total of 505 AIDS patients were investigated, and the prevalence of B. hominis infection was 4.16%. Univariate analysis revealed that B. hominis infection correlated with the occupation (χ2 = 8.595, P = 0.049), education level (χ2 = 14.494, P = 0.001), type of daily drinking water (χ2 = 10.750, P = 0.020), root of HIV infections (χ2 = 8.755, P = 0.026) and receiving anti-HIV therapy (χ2 = 23.083, P = 0.001) among AIDS patients, and multivariate logistic regression analysis identified daily direct drinking of tap water as a risk factor of B. hominis infections [odds ratio (OR) = 7.988, 95% confidential interval (CI): (1.160, 55.004)] and anti-HIV therapy as a protective factor of B. hominis infection [OR = 0.183, 95% CI: (0.049, 0.685)]. CONCLUSIONS: The prevalence of B. hominis is 4.16% among AIDS patients in Nanchang City. Daily direct drinking of tap water is a risk factor, and anti-HIV therapy is a protective factor of B. hominis infection among AIDS patients living in Nanchang City.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS , Síndrome de Imunodeficiência Adquirida , Infecções por Blastocystis , Infecções por HIV , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Síndrome de Imunodeficiência Adquirida/complicações , Síndrome de Imunodeficiência Adquirida/epidemiologia , Infecções por Blastocystis/epidemiologia , Blastocystis hominis , China , Cidades , Estudos Transversais , Fezes/parasitologia , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Humanos , Prevalência , Fatores de Risco
3.
BMC Infect Dis ; 20(1): 836, 2020 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-33176715

RESUMO

BACKGROUND: The KwaZulu-Natal (KZN) province of South Africa has the highest prevalence of HIV infection in the world. Viral load (VL) testing is a crucial tool for clinical and programmatic monitoring. Within uMkhanyakude district, VL suppression rates were 91% among patients with VL data; however, VL performance rates averaged only 38·7%. The objective of this study was to determine if enhanced clinic processes and community outreach could improve VL monitoring within this district. METHODS: A packaged intervention was implemented at three rural clinics in the setting of the KZN HIV AIDS Drug Resistance Surveillance Study. This included file hygiene, outreach, a VL register and documentation revisions. Chart audits were used to assess fidelity. Outcome measures included percentage VL performed and suppressed. Each rural clinic was matched with a peri-urban clinic for comparison before and after the start of each phase of the intervention. Monthly sample proportions were modelled using quasi-likelihood regression methods for over-dispersed binomial data. RESULTS: Mkuze and Jozini clinics increased VL performance overall from 33·9% and 35·3% to 75·8% and 72·4%, respectively which was significantly greater than the increases in the comparison clinics (RR 1·86 and 1·68, p < 0·01). VL suppression rates similarly increased overall by 39·3% and 36·2% (RR 1·84 and 1·70, p < 0·01). The Chart Intervention phase showed significant increases in fidelity 16 months after implementation. CONCLUSIONS: The packaged intervention improved VL performance and suppression rates overall but was significant in Mkuze and Jozini. Larger sustained efforts will be needed to have a similar impact throughout the province.


Assuntos
Síndrome de Imunodeficiência Adquirida/epidemiologia , Monitoramento Epidemiológico , HIV-1/genética , Saúde da População Rural , Carga Viral/métodos , Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Síndrome de Imunodeficiência Adquirida/virologia , Adulto , Antirretrovirais/uso terapêutico , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , População Rural , África do Sul/epidemiologia , Resposta Viral Sustentada , Carga Viral/efeitos dos fármacos
4.
PLoS One ; 15(11): e0242491, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33201934

RESUMO

We formulate a sex-structured deterministic model to study the effects of varying HIV testing rates, condom use rates and ART adherence rates among Adolescent Girls and Young Women (AGYW) and, Adolescent Boys and Young Men (ABYM) populations in Kenya. Attitudes influencing the Kenyan youth HIV/AIDS control measures both positively and negatively were considered. Using the 2012 Kenya AIDS Indicator Survey (KAIS) microdata we constructed our model, which we fitted to the UNAIDS-Kenya youth prevalence estimates to understand factors influencing Kenyan youth HIV/AIDS prevalence trends. While highly efficacious combination control approach significantly reduces HIV/AIDS prevalence rates among the youth, the disease remains endemic provided infected unaware sexual interactions persist. Disproportional gender-wise attitudes towards HIV/AIDS control measures play a key role in reducing the Kenyan youth HIV/AIDS prevalence trends. The female youth HIV/AIDS prevalence trend seems to be directly linked to increased male infectivity with decreased female infectivity while the male youth prevalence trend seems to be directly associated with increased female infectivity and reduced male infectivity.


Assuntos
Infecções por HIV/epidemiologia , Adesão à Medicação/psicologia , Cooperação do Paciente/psicologia , Síndrome de Imunodeficiência Adquirida/epidemiologia , Adolescente , Atitude Frente a Saúde , Criança , Feminino , HIV/patogenicidade , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Quênia/epidemiologia , Masculino , Programas de Rastreamento/métodos , Programas de Rastreamento/tendências , Adesão à Medicação/estatística & dados numéricos , Cooperação do Paciente/estatística & dados numéricos , Prevalência , Fatores de Risco , Sexo Seguro/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
5.
PLoS One ; 15(11): e0242701, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33237965

RESUMO

INTRODUCTION: Data on the sexual behavior among people living with human immunodeficiency virus (PLHIV) dwelling at HIV prevalent setting located at the periphery of Ethiopia is lacking. Therefore, this study was designed to investigate sexual practice of patients following their antiretroviral therapy (ART) service and factors affecting their behavior. MATERIALS AND METHODS: A facility based cross-sectional study design was employed to assess risky sexual practice and associated factors among HIV positive adults attending ART clinics in Gambella town, Southwest Ethiopia. Risky sexual practice is defined as a custom of getting in at least one of the following practices such as condom-unprotected sex with any partner, having two or more sexual partners and practicing casual sex in the last three months. A total of 352 randomly selected clients were interviewed by using a structured questionnaire. The multivariable logistic regression model was used to examine the association between covariates and the outcome variable. RESULTS: Majority of the study participants were engaged at least in one of the risky sexual practices (79.8% confidence interval (CI): 75.3% - 83.9%). The multivariable analysis found that the odds of risky sexual practice were higher among individuals who use substances ('khat' users (AOR: 3.82, 95%CI:1.30-11.22), smoke cigarette (AOR:4.90, 95%CI:1.19-12.60), consume alcohol (AOR: 2.59, 95%CI:1.28-5.21)); those who never discuss about safe sex with their partner/s (AOR: 2.21, 95%CI:1.16-4.21); those who have been in attachment for longer duration (more than four years) with their partner (AOR: 3.56, 95%CI: 1.32-9.62); and groups who desire to bear children in their future life (AOR: 3.15, 95%CI:1.40-7.04) as compared to their respective comparison groups. CONCLUSIONS: A significant number of participants were engaged at least in one of the risky sexual practices which potentially result in super infection by a new or/and drug resistant viral strain/s, and onward transmission of the virus. Thus, an HIV intervention program which focuses on the identified factors has to be implemented to mitigate risk of unsafe sexual behavior of this population group and move towards ending the HIV/Acquired Immunodeficiency Syndrome (AIDS) epidemic.


Assuntos
Síndrome de Imunodeficiência Adquirida/epidemiologia , HIV-1 , Comportamentos de Risco à Saúde , Assunção de Riscos , Inquéritos e Questionários , Sexo sem Proteção , População Urbana , Síndrome de Imunodeficiência Adquirida/prevenção & controle , Síndrome de Imunodeficiência Adquirida/transmissão , Adolescente , Adulto , Estudos Transversais , Etiópia , Feminino , Humanos , Masculino , Prevalência
6.
An Acad Bras Cienc ; 92(4): e20200293, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33237145

RESUMO

The present study assessed clinico-epidemiological and sociodemographic characteristics and risk factors for human immunodeficiency virus (HIV) in patients who were co-infected with T. gondii in the border region of Brazil. HIV-positive patients who were attended by the Expert Assistance Service in Foz do Iguaçu city were assessed using a questionnaire and medical records. Of the 332 patients with HIV/autoimmune deficiency syndrome (AIDS) who were evaluated, 111 had serology for toxoplasmosis, which could be attributed to the location of the city (i.e., border region) and tourism that encourages the intense flow of people. Toxoplasmosis infection was prevalent among patients who were 18-60 years old, had education up to the 4th grade of elementary school, ate raw vegetables from home, handled soil without gloves, drank untreated water, and allowed street cats to enter their homes. These findings contribute to assessments of the toxoplasmosis profile of HIV/AIDS patients who have a high rate of toxoplasmosis. The results may contribute to improving public health, especially in border regions with characteristics that are similar to this study. Effective measures need to be implemented to control morbidity and mortality that are associated with HIV/AIDS and toxoplasmosis in the evaluated population.


Assuntos
Síndrome de Imunodeficiência Adquirida , Coinfecção , Infecções por HIV , Toxoplasma , Síndrome de Imunodeficiência Adquirida/complicações , Síndrome de Imunodeficiência Adquirida/epidemiologia , Adolescente , Adulto , Animais , Anticorpos Antiprotozoários , Brasil/epidemiologia , Gatos , Coinfecção/epidemiologia , HIV , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Humanos , Pessoa de Meia-Idade , Fatores de Risco , Estudos Soroepidemiológicos , Adulto Jovem
7.
Rev Saude Publica ; 54: 96, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33175030

RESUMO

OBJECTIVES: To identify spatial and space-time clusters with high incidence rates of AIDS in men living in the city of São Paulo since the first case of the disease in 1980. METHODS: HIV/AIDS notifications were obtained from the Notifiable Diseases Information System (57,440 men) between January 1980 and June 2012. The cases were geocoded by residence address; then analyses of purely spatial, space-time and spatial variation in temporal trends were performed for three sets of data: total cases of AIDS in men aged 13 years or older, men aged 50 years or older, and deaths from AIDS. RESULTS: It was possible to geocode a significant proportion of AIDS cases (93.7%). In the purely spatial scanning analysis, considering the entire period evaluated, the AIDS epidemic in men presented an important spatial concentration in the Center and in contiguous areas of the North, Southeast and West regions of the municipality, regardless of age group and evolution to death (relative risks between 1.22 and 5.90). Considering space and time simultaneously, several clusters were found, spread throughout all regions of the municipality (relative risks between 1.44 and 8.61). In the analysis of spatial variation in temporal trends, the clusters in the most peripheral regions presented a higher annual percentage increase in disease rates (up to 7.58%), denoting the tendency of "peripherization" of the epidemic in men in the city of São Paulo. CONCLUSIONS: This study allowed the detection of geographic clusters of high risk for AIDS in men, pointing to priority areas in the municipality, both for programmatic actions and to guide other studies.


Assuntos
Síndrome de Imunodeficiência Adquirida/epidemiologia , Infecções por HIV/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Análise Espacial , Análise Espaço-Temporal , Adulto Jovem
9.
Pan Afr Med J ; 36: 271, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33088400

RESUMO

Sub-Saharan Africa (SSA) is at a crossroad. Over the last decade, successes in the scale up of HIV care and treatment programs has led to a burgeoning number of people living with HIV (PLHIV) in care. At the same time, an epidemiologic shift has been witnessed with a concomitant rise in non-communicable diseases (NCD) related morbidity and mortality. Against low levels of domestic financing and strained healthcare delivery platforms, the NCD-HIV syndemic threatens to reverse gains made in care of people living with HIV (PLHIV). NCDs are the global health disruptor of the future. In this review, we draw three proposals for low and middle-income countries (LMICs) based on existing literature, that if contextually adopted would mitigate against impending poor NCD-HIV care outcomes. First, we call for an adoption of universal health coverage by countries in SSA. Secondly, we recommend leveraging on comparably formidable HIV healthcare delivery platforms through integration. Lastly, we advocate for institutional-response building through a multi-stakeholder governance and coordination mechanism. Based on our synthesis of existing literature, adoption of these three strategies would be pivotal to sustain gains made so far for NCD-HIV care in SSA.


Assuntos
Síndrome de Imunodeficiência Adquirida/epidemiologia , Infecções por HIV/epidemiologia , Doenças não Transmissíveis/epidemiologia , Síndrome de Imunodeficiência Adquirida/economia , Síndrome de Imunodeficiência Adquirida/terapia , África ao Sul do Saara/epidemiologia , Assistência à Saúde/economia , Assistência à Saúde/organização & administração , Países em Desenvolvimento , Infecções por HIV/economia , Infecções por HIV/terapia , Humanos , Doenças não Transmissíveis/economia , Doenças não Transmissíveis/terapia , Cobertura Universal do Seguro de Saúde
10.
Medicine (Baltimore) ; 99(43): e22889, 2020 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-33120835

RESUMO

To determine the surgical outcomes and prognostic factors of cytomegalovirus (CMV) retinitis-related retinal detachment (RD) in acquired immune deficiency syndrome (AIDS) patients following vitrectomy.A retrospective charts review was carried out on AIDS patients who were diagnosed with CMV retinitis-related RD and treated with vitrectomy between 2002 and 2016. The main outcome measures were the rates of primary anatomical success and final visual acuity (VA) success defined as postoperative VA ≥20/200. Kaplan-Meier curves on the time to retinal redetachment were performed. Multivariate logistic regression models based on a directed acyclic graph were used to identify independent factors associated with achieving VA success.Forty five AIDS patients (52 eyes) were included. Over a mean follow-up period of 41.7 months, primary anatomical success was achieved in 44 eyes (84.6%) and VA success was achieved in 34 eyes (65.4%). Receiving highly active antiretroviral therapy (HAART) prior to RD (adjusted odds ratio [aOR]=4.9, P = .043), better preoperative VA (aOR = 4.3, P = .006), undergoing vitrectomy within 3 months (aOR=6.7, P = .008), absence of optic atrophy (aOR=58.1, P < .001), and absence of retinal redetachment (aOR=38.1, P = .007) increased the odds of achieving final VA success.Vitrectomy provided favorable anatomical reattachment in AIDS patients with CMV retinitis-related RD. Majority of patients was able to retain functional vision postoperatively. The use of HAART and early vitrectomy increased the probability of achieving both anatomical and VA success.


Assuntos
Síndrome de Imunodeficiência Adquirida/complicações , Retinite por Citomegalovirus/complicações , Descolamento Retiniano/etiologia , Descolamento Retiniano/cirurgia , Vitrectomia/efeitos adversos , Infecções Oportunistas Relacionadas com a AIDS/complicações , Infecções Oportunistas Relacionadas com a AIDS/virologia , Síndrome de Imunodeficiência Adquirida/epidemiologia , Síndrome de Imunodeficiência Adquirida/virologia , Adulto , Terapia Antirretroviral de Alta Atividade/métodos , Estudos de Casos e Controles , Citomegalovirus/genética , Retinite por Citomegalovirus/diagnóstico , Retinite por Citomegalovirus/tratamento farmacológico , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Tailândia/epidemiologia , Resultado do Tratamento , Acuidade Visual/fisiologia , Vitrectomia/estatística & dados numéricos , Vitrectomia/tendências
12.
Med. clín (Ed. impr.) ; 155(7): 288-294, oct. 2020. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-195876

RESUMO

INTRODUCCIÓN: Se ha descrito una mayor incidencia de neoplasias en los pacientes con infección por VIH en comparación con la población general. PACIENTES Y MÉTODOS: Estudio observacional retrospectivo de la población infectada por VIH en seguimiento en el Hospital Vall d'Hebron (Barcelona) entre 2009 y 2017. El objetivo de este estudio fue estimar la incidencia de neoplasias en estos pacientes con infección por VIH y su supervivencia. Se comparó la incidencia ajustada por edad y sexo en dicha población con la calculada por la Red Española de Registros de Cáncer (REDECAN) en 2015. RESULTADOS: Se incluyeron 2.773 pacientes (41.238 pacientes-año). Se diagnosticaron 211 cánceres en 182 pacientes. El 78,2% de las neoplasias fueron no definitorias de sida (NNDS). La tasa global de incidencia de cáncer fue 485 neoplasias por 100.000 pacientes-año. La mortalidad a 20años en pacientes con cáncer fue del 31,2%, y del 7,8% en pacientes sin cáncer. En varones, ajustada por edad, la incidencia de neoplasias fue mayor que en la población general (978,4 vs. 641 por 100.000 pacientes-año, p < 0,001); las más frecuentes fueron carcinomas de pulmón, sarcoma de Kaposi y linfoma no Hodgkin. En mujeres, la incidencia no fue mayor a la de la población general (340,6 vs. 404,7 por 100.000 pacientes-año, p = 0,27). Las neoplasias más frecuentes fueron carcinomas pulmonares, carcinomas de cabeza y cuello, cérvix y linfoma Hodgkin. CONCLUSIONES: Los varones con infección por VIH presentaron una incidencia significativamente mayor de cáncer que la población española del mismo sexo. Los carcinomas pulmonares fueron las NNDS más frecuentes


INTRODUCTION: A higher incidence of malignancies has been described in patients with HIV infection compared to the general population. PATIENTS AND METHODS: Observational retrospective study in patients with HIV infection followed up at the Vall d'Hebron University Hospital (Barcelona, Spain) between 2009 and 2017. The objective of this research was to estimate the incidence of malignancies in HIV patients and their surveillance. Age and sex-adjusted incidence was compared to the incidence calculated by the Spanish Cancer Registry network (REDECAN) in 2015. RESULTS: We included 2,773 patients (41,238 patients-year). Two hundred and eleven malignancies were diagnosed in 182 patients. Non-AIDS defining cancers accounted for 78.2% of the malignancies. The global incidence of cancer was 485 cases per 100,000 person-years. Twenty-year mortality rate was 31.2% in patients with cancer and 7.8% in patients without cancer. In men, adjusted for age, the incidence of malignancies was higher than the incidence in the general population (978.4 vs. 641 cases per 100,000 person-years, P<.001). The most common malignancies in men were lung cancer, Kaposi sarcoma and Hodgkin lymphoma. In women, the incidence of malignancies was not higher than in the general population (340.6 vs. 404.7 cases per 100,000 person-years, P=.27). The most common malignancies among women were lung cancer, head and neck cancer, cervical cancer and Hodgkin's lymphoma. CONCLUSIONS: Men with HIV infection showed a statistically significant higher incidence of malignancies compared to the general Spanish population. Lung cancer was the most common non-AIDS defining cancer


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Síndrome de Imunodeficiência Adquirida/epidemiologia , Soropositividade para HIV/epidemiologia , Neoplasias/epidemiologia , Espanha/epidemiologia , Estudos Retrospectivos , Sistema de Registros/normas , Neoplasias Pulmonares/epidemiologia , Neoplasias de Cabeça e Pescoço/epidemiologia , Linfoma não Hodgkin/epidemiologia , Taxa de Sobrevida , Intervalo Livre de Doença
13.
BMC Infect Dis ; 20(1): 751, 2020 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-33054788

RESUMO

BACKGROUND: HIV is a major public health issue, especially in developing countries. It is important to track and design successful intervention programs to explore the spatial pattern, distribution, and associated factors of HIV Seropositivity. This study therefore showed the spatial variation of HIV Seropositivity and related factors in Ethiopia. METHODS: A total sample of 25,774 individual data collected from the 2016 EDHS data were primarily HIV biomarkers, IR, MR, and GPS. Spatial heterogeneity analysis was used with methods such as Morans I, Interpolation, and Kulldorff 's scan statistic. Spatial analysis was conducted using open source tools (QGIS, GeoDa, SaTScan). Multilevel logistic regression analysis was performed using Stata14 to identify HIV-associated factors. Finally, the AOR with a 95% confidence interval was used to report the mixed-effect logistic regression result in the full model. RESULT: The prevalence of HIV / AIDS at national level was 0.93%. The highest prevalence regions were Gambela, Addis Abeba, Harari and Diredawa, accounting for 4.79, 3.36, 2.65 and 2.6%, respectively. Higher HIV seropositive spatial clusters have been established in the Gambela and Addis Ababa regions. Multilevel analysis at the individual level being married [AOR = 2.19 95% CI: (1.11-4.31)] and previously married [AOR = 6.45, 95% CI: (3.06-13.59)], female [AOR = 1.8, 95% CI: (1.19-2.72)], first-sex at age ≤15 [AOR = 4.39, 95% CI: (1.70-11.34)], 18-19 [AOR = 2.67 95% CI: (1.05-6.8)], middle age group (25-34) [AOR = 6.53, 95% CI: (3.67-11.75)], older age group (>34) [AOR = 2.67 95% CI: (1.05-6.8)], primary school [AOR = 3.03, 95% CI: (1.92-4.79)], secondary school [AOR = 3.37, 95% CI: (1.92-5.92) were significantly associated with serropositivity. Regarding household level, place of residence [urban: AOR = 6.13 CI: (3.12, 12.06)], female-headed households (AOR = 2.24 95% CI: (1.57-3.73), media exposure [low exposure (AOR = 0.53 95% CI: (0.33-0.86), no exposure AOR = 0.39 95% CI: (0.23-0.65)] and increased household size [AOR = 0.72 95% CI: (0.65-0.8)] were associated with HIV Seropositivity. CONCLUSION: High cluster HIV cases were found in Gambela, Addis Abeba, Harari, and Diredawa. Having a history of married, start sex at a younger age, female-headed household, urban residence, and lower household size is more affected by HIV/AIDS. So any concerned body work around this risk group and area can be effective in the reduction of transmission.


Assuntos
Soropositividade para HIV/epidemiologia , Síndrome de Imunodeficiência Adquirida/epidemiologia , Adolescente , Adulto , Estudos Transversais , Etiópia/epidemiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multinível , Prevalência , Fatores de Risco , Análise Espacial , Adulto Jovem
14.
J Mycol Med ; 30(4): 101044, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33046394

RESUMO

INTRODUCTION: Cryptococcus neoformans is an opportunistic pathogen that causes ∼15% mortality in AIDS patients. Rio Grande City, Rio Grande do Sul (RS), Brazil, has the highest national rate of HIV/AIDS, considering cities with population more than 100,000 habitants. OBJECTIVE: We aimed to evaluate the clinical and epidemiological profile of cryptococcosis in a reference service for HIV-AIDS patients in the South region of Brazil, over seven years. Material and methods A retrospective study was performed including all cryptococcosis cases diagnosed at the University Hospital, Federal University of Rio Grande (UH-FURG) between January 2010 and December 2016. RESULTS: Seventy cases of cryptococcosis were diagnosis from 2010 to 2016 in the UH-FURG in the seven years of the study. These numbers were responsible for 2.1% to 8.1% of the hospitalizations/year for HIV patients. All were caused by C. neoformans infection (95% C. neoformans var. grubii VNI and 5% C. neoformans var. grubii VNII). Neurocryptococcosis was the major clinical manifestation and cryptococcosis was the HIV- defining condition in 40% of patients. The period of hospitalization was an average of 39.3 days (SD=31.3), and more than half of patients (53%; 37/70) died after a mean of 82 days. DISCUSSION: The present study showed the importance of cryptococcosis as an AIDS-defining disease in HIV-AIDS patients in a tertiary hospital from Southern Brazil. More investment is necessary to reduce the impact of this opportunistic mycosis in HIV-AIDS patients from southern Brazil.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Síndrome de Imunodeficiência Adquirida/epidemiologia , Criptococose/epidemiologia , Infecções por HIV/epidemiologia , Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Síndrome de Imunodeficiência Adquirida/complicações , Síndrome de Imunodeficiência Adquirida/microbiologia , Adulto , Idoso , Brasil/epidemiologia , Criptococose/complicações , Criptococose/microbiologia , Cryptococcus neoformans/isolamento & purificação , Feminino , HIV , Infecções por HIV/complicações , Infecções por HIV/microbiologia , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Meningite Fúngica/epidemiologia , Meningite Fúngica/etiologia , Meningite Fúngica/microbiologia , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Análise de Sobrevida , Adulto Jovem
15.
Medicine (Baltimore) ; 99(40): e22416, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019418

RESUMO

Human immunodeficiency virus (HIV) supresses immune system, primarily cell-mediated immunity. Cluster of differentiation 4 (CD4) cell count, viral load, and oral lesions are the most important laboratory parameters to evaluate the evolution of acquired immunodeficiency syndrome. The present study aims to determine the incidence of HIV-related oral lesions with CD4 cell count and viral load in Yunnan, China.A cross-sectional study was conducted from December 2007 to December 2009, in 1812 HIV positive patients from Department of Infectious Diseases in Kunming Third People's Hospital. CD4, CD8, and viral load data were collected and analyzed statistically using SPSS 11.3.Out of 1812 HIV positive patients, 929 (51.27%) were associated with 1 or more oral lesions. The most common oral lesions observed were Candida Pseudomembranous (13.75%), Candida erythematous (10.93%), Oral hairy leukoplakia (7.95%), Aphthous ulcer (6.18%), Herpes simplex infection (5.58%). In most patients with oral lesions, the CD4 cell count was < 200/µL. The incidence of oral lesions was lower when CD4 count was > 200/µL and with undetectable (P < .01) HIV viral load. Almost no oral lesions was observed when CD4 count > 500/µL (P < .01). With highly active antiretroviral therapy, reduction in HIV-related oral lesions was observed especially in Candida erythematous, Candida Pseudomembranous, Oral hairy leukoplakia, and Aphthous ulcer.The higher incidence of oral lesions with lower CD4 count (<200/µL) in HIV-infected patients indicated importance of CD4 cell count in identifying disease progression.


Assuntos
Contagem de Linfócito CD4/estatística & dados numéricos , Infecções por HIV/epidemiologia , Doenças da Boca/epidemiologia , Carga Viral/fisiologia , Síndrome de Imunodeficiência Adquirida/epidemiologia , Síndrome de Imunodeficiência Adquirida/patologia , Adulto , Terapia Antirretroviral de Alta Atividade/métodos , China/epidemiologia , Estudos Transversais , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Doenças da Boca/microbiologia , Adulto Jovem
16.
Int J Infect Dis ; 100: 286-291, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32920231

RESUMO

This article outlines the role of African civil society in safeguarding gains registered to date in sexual and reproductive health and the response to HIV. The case is made for why civil society organizations (CSOs) must be engaged vigilantly in the COVID-19 response in Africa. Lockdown disruptions and the rerouting of health funds to the pandemic have impeded access to essential sexual and reproductive health (SRH) and social protection services. Compounded by pre-existing inequalities faced by vulnerable populations, the poor SRH outcomes amid COVID-19 call for CSOs to intensify demand for the accountability of governments. CSOs should also continue to persevere in their aim to rapidly close community-health facility gaps and provide safety nets to mitigate the gendered impact of COVID-19.


Assuntos
Síndrome de Imunodeficiência Adquirida/prevenção & controle , Saúde Pública , Saúde Reprodutiva , Síndrome de Imunodeficiência Adquirida/epidemiologia , África , Humanos , Organizações , Pandemias/prevenção & controle , Fatores Sociológicos
18.
An. psicol ; 36(2): 232-241, mayo 2020. tab
Artigo em Inglês | IBECS | ID: ibc-192059

RESUMO

BACKGROUND: The cardinal aim of the present study was to assess the level of social support, self esteem and quality of life among people living with HIV/AIDS in Jammu and Kashmir State of India. Further, the study strived to explore the relationship between independent and dependent variables. METHOD: The study consists a sample of 460 AIDS patients selected through purposive sampling technique, out of them 177 (38.3%) were male, 283 (61.5%) were female patients; 295 (64.1%) were married and 165 (35.9%) were unmarried. Measures included Enriched Social Support Inventory by Mitchell et al., (2003), Rosenberg's Self-Esteem Scale (1965) and Quality of Life Scale by Sharma & Nasreen (2014). For the statistical analysis of data Mean, Standard deviation, Frequency distribution, t-test, one way analysis of variance, correlation analysis and Scheffe's post hoc test was applied by SPSS 20.0 version. Findings: The findings illustrated that majority of patients have poor social support, lower self-esteem and poor quality of life; also it reveals that patient's social support, and self-esteem differs by age, occupation, duration of illness, gender, and marital status. However their quality of life differs only by their age, occupation, duration of illness, and marital status. Further the result shows social support and self-esteem are positively correlated with quality of life


ANTECEDENTES: El objetivo principal del presente estudio fue evaluar el nivel de apoyo social, autoestima y calidad de vida entre las personas que viven con el VIH / SIDA en Jammu y el Esta do de Cachemira de la India. Además, el estudio se esforzó por explorar la relación entre variables independientes y dependientes. Método: El estudio consiste en una muestra de 460 pacientes con SIDA seleccionados mediante una técnica de muestreo intencional, de ellos 177 (38.3%) eran hombres, 283 (61.5%) eran pacientes femeninas; 295 (64.1%) estaban casados y 165 (35.9%) no estaban casados. Las medidas incluyeron el Inventario de apoyo social enriquecido de Mitchell et al. (2003), la Escala de autoestima de Rosenberg (1965) y la Escala de calidad de vida de Sharma y Nasreen (2014). Para el análisis estadístico de los datos, la versión SPSS 20.0 aplicó la media, la desviación estándar, la distribución de frecuencia, la prueba t, el análisis de varianza unidireccional, el cuadrado de eta, el análisis de correlación y la prueba post hoc de Scheffe. Hallazgos: Los hallazgos ilustran que la mayoría de los pacientes tienen poco apoyo social, baja autoestima y mala calidad de vida; también revela que el apoyo social y la autoestima del paciente difieren según la edad, la ocupación, la duración de la enfermedad, el género y el estado civil. Sin embargo, su calidad de vida difiere solo por su edad, ocupación, duración de la enfermedad y estado civil. Además, el resultado muestra que el apoyo social y la autoestima se correlacionan positivamente con la calidad de vida


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Infecções por HIV/epidemiologia , Síndrome de Imunodeficiência Adquirida/epidemiologia , Síndrome de Imunodeficiência Adquirida/psicologia , Apoio Social , Qualidade de Vida/psicologia , Autoimagem , Infecções por HIV/psicologia , Índia/epidemiologia , Análise de Variância
19.
PLoS One ; 15(9): e0239087, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32960927

RESUMO

BACKGROUND: Uganda has been making progress towards universal HIV test and treat since 2013 and the 2016 test and treat policy was expanded from the 2013 guidelines. The expanded policy was rolled out in 2017 across the country. The treatment outcomes of this new policy have not yet been assessed at program level. The objective of this study was to determine the treatment outcome of the HIV test and treat policy in TASO Tororo Clinic, Eastern Uganda. METHODOLOGY: This was a retrospective cohort study using secondary data. The study involved 580 clients who were newly diagnosed HIV positive in TASO Tororo clinic between June 2017 and May 2018, who were then followed up for ART initiation, retention in care, viral load monitoring and viral load suppression. The data was analyzed using Stat 14.0 version statistical software application. RESULTS: Of the 580 clients, 93.1%(540) were adults aged ≥20 years. The uptake of test and treat was at 92.4%(536) and 12 months retention was at 78.7% (422). The factors associated with retention in care were a) being counselled before ART initiation, AOR 2.41 (95%CI, 1.56-3.71), b) having a treatment supporter, AOR 1.57 (95%CI, 1.02-2.43) and having an opportunistic infection, AOR 2.99 (95%CI:1.21-7.41). The viral load coverage was 52.4% (221) and viral load suppression rate was 89.1% (197) of clients monitored. Age <20 years was the only identified factor associated with vial load non suppression, AOR 7.35 (95% CI = 2.23-24.24). CONCLUSION: This study found high uptake of ART under test and treat policy, with very low viral load coverage, and a high viral load suppression rate among those monitored. The study therefore highlights a need to differentiate viral load testing based on the population needs and ensure each client testing positive receives pre-ART initiation counselling so as to improve retention in care.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/diagnóstico , Infecções por HIV/tratamento farmacológico , Síndrome de Imunodeficiência Adquirida/diagnóstico , Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Síndrome de Imunodeficiência Adquirida/epidemiologia , Adolescente , Adulto , Criança , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Programas de Rastreamento , Estudos Retrospectivos , Resultado do Tratamento , Uganda/epidemiologia , Carga Viral , Adulto Jovem
20.
BMC Infect Dis ; 20(1): 714, 2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-32993536

RESUMO

BACKGROUND: Human Immunodeficiency virus continues to be a major global health problem infecting 75 million and killing 32 million people since the beginning of the epidemic. It badly hit Sub Saharan Africa than any country in the world and youths are sharing the greatest burden. The study aims to assess the level of HIV-knowledge and its determinants among Ethiopian youths using the 2016 Ethiopia Demographic and Health Survey data. METHODS: A nationally representative 2016 Ethiopian Demographic and Health Survey data were used. A total of 10,903 youths comprising 6401 females and 4502 males were included in the study. Descriptive statistics and multilevel order logistic regression were used and confidence interval was used to declare statistical significance in the final model. RESULTS: The mean age and SD of youths included in this study was 19.10 (±2.82). Among Ethiopian youths, 20.92% (95% CI: 18.91, 23.09%) had low knowledge of HIV whereas, 48.76% (95% CI: 47.12, 50.41%) and 30.31% (95% CI: 28.51, 32.18%) of them had moderate and comprehensive HIV knowledge respectively. Being male, access to TV and radio, ever tested for HIV/AIDS, owning a mobile telephone, and attending primary school and above compared to non-attendants were associated with having higher HIV knowledge. But, dwelling in rural Ethiopia, being in the Protestant and Muslim religious groups as compared to those of Orthodox followers and being in married groups were associated with having lower HIV knowledge. Approximately, 12% of the variation in knowledge of HIV was due to regions. CONCLUSION: Only one-third of Ethiopian youths have deep insight into the disease, whereas, nearly one-fifth of them have lower HIV-knowledge. There is a significant disparity in HIV-related knowledge among Ethiopian youths living in different regions. Rural residents, less educated, female, and married youths have less knowledge of HIV as compared to their counterparts. Youths who do not have a mobile phone, who lack health insurance coverage, and who have limited access to media have less knowledge about HIV. Therefore, the due focus should be given to the aforementioned factors to minimize the disparities between regions and to enhance Ethiopian youths' HIV-knowledge.


Assuntos
Síndrome de Imunodeficiência Adquirida/epidemiologia , Síndrome de Imunodeficiência Adquirida/psicologia , Conscientização , Conhecimento , Acesso à Informação , Adolescente , Estudos Transversais , Etiópia/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Modelos Logísticos , Masculino , População Rural , Instituições Acadêmicas , Fatores Sexuais , Adulto Jovem
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