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1.
Medicine (Baltimore) ; 99(2): e18499, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31914019

RESUMO

BACKGROUND: Previous studies have reported the association between Mycoplasma fermentans (M. fermentans) and the risk of human immunodeficiency virus 1 (HIV-1) infection, but the results were inconsistent. The present study aims to systematically review reported studies on M. fermentans and its association with HIV-1 infection, as well as to summarize the findings using a meta-analysis. METHODS: Studies meeting the inclusion criteria in the PubMed, Embase, China National Knowledge Infrastructure, WanFang Data, and Chongqing VIP databases up to March 2019 were identified. Cochran Q and I statistics were used to assess heterogeneity. Additionally, pooled odds ratio (OR) with 95% confidence intervals (CI) were calculated and displayed by Forest plots. Also, the funnel plot, Begg test, and Egger test were used to evaluate potential publication bias. In addition, the source of heterogeneity was investigated by subgroup and sensitivity analyses. RESULTS: A total of 11 studies comprising 1028 HIV-1-positive patients and 1298 controls were ultimately included in this meta-analysis. Our results indicated that M. fermentans could increase the risk of HIV-1 infection among humans (OR = 3.66, 95%CI 1.26-10.64). Subgroup analysis showed that the risk of HIV-1 infection associated with M. fermentans was, based on the geographical distribution, 1.19 (95%CI 0.33-4.33) in Europe, 2.83 (95%CI 0.94-8.52) in United States, 11.92 (95%CI 3.93-36.15) in Asia; based on the source of the sample, 2.97 (95%CI 0.89-9.95) in blood samples, 4.36 (95%CI 1.63-11.68) in urine samples; based on the detection method, 2.80 (95%CI 0.72-10.96) with the polymerase chain reaction method, 5.54 (95%CI 1.21-25.28) with other detection methods; based on the source of controls, 1.91 (95%CI 0.53-6.89) in sexually transmitted diseases individuals, and 8.25 (95%CI 2.16-31.60) in health individuals. CONCLUSION: Our study revealed evidence of the association between M. fermentans and HIV-1 infection. Considering the heterogeneity, further studies are warranted to understand the relationship between M. fermentans and HIV-1 infection.


Assuntos
Infecções por HIV/etiologia , Soropositividade para HIV/diagnóstico , Infecções por Mycoplasma/complicações , Mycoplasma fermentans/metabolismo , Ásia/epidemiologia , Europa (Continente)/epidemiologia , Feminino , Infecções por HIV/diagnóstico , Soropositividade para HIV/complicações , Soropositividade para HIV/virologia , HIV-1/genética , HIV-1/isolamento & purificação , Humanos , Masculino , Infecções por Mycoplasma/microbiologia , Mycoplasma fermentans/isolamento & purificação , Fatores de Risco , Estados Unidos/epidemiologia
4.
BMC Infect Dis ; 19(1): 1024, 2019 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-31795955

RESUMO

BACKGROUND: In 2018 in Ethiopia, magnitude of human immunodeficiency virus Acquired Immunodeficiency Syndrome treatment failure was 15.9% and currently the number of patient receiving second line antiretroviral therapy (ART) is more increasing than those taking first line ART. Little is known about the predictors of treatment failure in the study area. Therefore; more factors that can be risk for first line ART failure have to identified to make the patients stay on first line ART for long times. Consequently, the aim of this study was to identify determinants of first line ART treatment failure among patients on ART at St. Luke referral hospital and Tulubolo General Hospital, 2019. METHODS: A 1:2 un-matched case-control study was conducted among adult patients on active follow up. One new group variables was formed as group 1 for cases and group 0 for controls and then data was entered in to Epi data version 3 and exported to STATA SE version 14 for analysis. From binary logistic regression variables with p value ≤0.25 were a candidate for multiple logistic regression. At the end variables with a p-value ≤0.05 were considered as statistically significant. RESULT: A total of 350 (117 cases and 233 controls) patients were participated in the study. Starting ART after 2 years of being confirmed HIV positive (AOR = 3.82 95% CI 1.37,10.6), nevirapine (NVP) based initial ART (AOR = 2.77,95%CI 1.22,6.28) having history of lost to follow up (AOR 3.66,95%CI 1.44,9.27) and base line opportunistic infection (AOR = 1.97,95%CI 1.06,3.63), staying on first line ART for greater than 5 years (AOR = 3.42,95%CI 1.63,7.19) and CD4 less than100cell/ul (AOR = 2.72,95%CI 1.46,5.07) were independent determinants of first line ART treatment failure. CONCLUSION: Lost to follow up, staying on first line ART for greater than 5 years, presence of opportunistic infections, NVP based NNRT, late initiation of ART are determinant factors for first line ART treatment failure. The concerned bodies have to focus and act on those identified factors to maintain the patient on first line ART.


Assuntos
Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Antirretrovirais/uso terapêutico , Nevirapina/uso terapêutico , Adulto , Contagem de Linfócito CD4 , Estudos de Casos e Controles , Etiópia , Feminino , Seguimentos , Soropositividade para HIV/tratamento farmacológico , Hospitais Gerais , Humanos , Modelos Logísticos , Perda de Seguimento , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Infecções Oportunistas/tratamento farmacológico , Centros de Cuidados de Saúde Secundários , Falha de Tratamento , Adulto Jovem
5.
BMC Infect Dis ; 19(1): 1022, 2019 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-31791273

RESUMO

BACKGROUND: Few countries in sub-Saharan Africa know the magnitude of their HIV epidemic among people who inject drugs (PWID). This was the first study in Mozambique to measure prevalence of HIV, HBV, and HCV, and to assess demographic characteristics and risk behaviors in this key population. METHODS: We used respondent-driven sampling (RDS) to conduct a cross-sectional behavioral surveillance survey of PWID in two cities of Mozambique lasting six months. Participants were persons who had ever injected drugs without a prescription. Participants completed a behavioral questionnaire and provided blood specimens for HIV, hepatitis B surface antigen (HBsAg) and hepatitis C virus antibody (anti-HCV) testing. We performed RDS-adjusted analysis in R 3.2 using RDSAT 7.1 weights. RESULTS: We enrolled 353 PWID in Maputo and 139 in Nampula/Nacala; approximately 95% of participants were men. Disease prevalence in Maputo and Nampula/Nacala, respectively, was 50.1 and 19.9% for HIV, 32.1 and 36.4% for HBsAg positivity, and 44.6 and 7.0% for anti-HCV positivity. Additionally, 8% (Maputo) and 28.6% (Nampula/Nacala) of PWID reported having a genital sore or ulcer in the 12 months preceding the survey. Among PWID who injected drugs in the last month, 50.3% (Maputo) and 49.6% (Nampula/Nacala) shared a needle at least once that month. Condomless sex in the last 12 months was reported by 52.4% of PWID in Maputo and 29.1% in Nampula/Nacala. Among PWID, 31.6% (Maputo) and 41.0% (Nampula/Nacala) had never tested for HIV. In multivariable analysis, PWID who used heroin had 4.3 (Maputo; 95% confidence interval [CI]: 1.2, 18.2) and 2.3 (Nampula/Nacala; 95% CI: 1.2, 4.9) greater odds of having HIV. CONCLUSION: Unsafe sexual behaviors and injection practices are frequent among PWID in Mozambique, and likely contribute to the disproportionate burden of disease we found. Intensified efforts in prevention, care, and treatment specific for PWID have the potential to limit disease transmission.


Assuntos
Usuários de Drogas/estatística & dados numéricos , Infecções por HIV/epidemiologia , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Abuso de Substâncias por Via Intravenosa/epidemiologia , Adolescente , Adulto , Idoso , Cidades/epidemiologia , Estudos Transversais , Epidemias , Feminino , Infecções por HIV/sangue , Soropositividade para HIV/epidemiologia , Hepatite B/sangue , Antígenos de Superfície da Hepatite B/análise , Antígenos de Superfície da Hepatite B/sangue , Antígenos de Superfície da Hepatite B/imunologia , Hepatite C/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Moçambique/epidemiologia , Vigilância da População/métodos , Prevalência , Assunção de Riscos , Estudos Soroepidemiológicos , Comportamento Sexual/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adulto Jovem
6.
BMC Public Health ; 19(1): 1743, 2019 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-31881867

RESUMO

BACKGROUND: The infection of HIV continues to be an important public health problem in Ethiopia. Disclosing own HIV positive result is crucial, and considered as a good indicator of behavior change towards HIV/AIDs. A systematic review and meta-analysis was conducted to pool the prevalence of positive HIV status disclosure to sexual partners and determine the influence of selected factors. METHODS: This systematic review and meta-analysis was conducted in Ethiopia among HIV positive people receiving health care at health facilities. In this review, primary studies were searched in Medline via PubMed, Google scholar and Google up to November, 2018. Data on disclosure of HIV positive result, knowledge of partner's HIV status and prior discussion on HIV were extracted, and effect sizes like proportion and odds ratios were pooled. Heterogeneity and publication bias were assessed by chi-square and I2, and Egger test, respectively. RESULTS: A total of 12 studies with 4528 participants were included in to this review to estimate the prevalence of disclosure of HIV positive result to sexual partner, and 10 and 7 studies were included to determine the associations of the outcome variable with knowledge of sexual partner's HIV status and with prior discussion on HIV, respectively. The pooled prevalence of HIV status disclosure to sexual partner was 73% (95% CI: 64, 82%). Having the knowledge of sexual partner's HIV status [OR: 95%CI; 17.63 (7.88, 39.45)], and previous discussion on HIV [OR: 95% CI; 9.24 (5.56, 15.37)] increased the disclosure of own HIV positive result to sexual partner. The sub-group analysis indicated a prevalence of 74% in Oromia, 86% in Southern Nations Nationalities and Peoples (SNNPR), 87% in Amhara, 73% in Addis Ababa, and 54% in Tigray. CONCLUSIONS: Disclosure of HIV status to sexual partner is lower than expected. Knowledge of partner's HIV status and previous discussion on HIV were strong predictors of HIV positive status disclosure. Strategies helpful for encouraging open HIV discussion need to be strengthened to increase HIV positive result disclosure. Furthermore, since the heterogeneity of studies is high, large nationally representative study is suggested.


Assuntos
Soropositividade para HIV/psicologia , Relações Interpessoais , Autorrevelação , Parceiros Sexuais/psicologia , Etiópia , Soropositividade para HIV/diagnóstico , Humanos
7.
Rev. enferm. UERJ ; 27: e37461, jan.-dez. 2019. tab
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1000343

RESUMO

Objetivo: descrever o perfil e avaliar a qualidade de vida de pessoas vivendo com HIV atendidas em serviços públicos de saúde. Métodos: estudo transversal, quantitativo com 281 pessoas vivendo com HIV atendidas em serviços públicos de saúde nos municípios do Rio de Janeiro e Niterói. Os dados foram coletados por meio de instrumento de dados socioeconômicos e clínicos e do WHOQOL-HIV bref, analisados por estatística descritiva, após aprovação do Comitê de Ética em Pesquisa. Resultados: a amostra foi composta majoritariamente por homens, renda de até dois salários mínimos e percepção positiva da saúde. A qualidade de vida foi positivamente avaliada na maioria das facetas, as maiores médias foram nos domínios: psicológico, relações sociais, espiritualidade, religião e crenças pessoais e a menor no domínio meio ambiente. Conclusão: o perfil das pessoas vivendo com HIV corrobora, os dados nacionais e a avaliação da qualidade de vida foi mais positiva do que em outros estudos.


Objective: to describe the profile and evaluate the quality of life of people living with HIV treated in public health services. Methods: in this cross-sectional, quantitative study of 281 people living with HIV treated in public health services in the municipalities of Rio de Janeiro and Niteroi, data were collected using a socioeconomic and clinical instrument and the WHOQOL-HIV brief questionnaire, and analyzed by descriptive statistics, with research ethics committee approval. Results: the sample comprised mainly men, with income of up to two minimum wages and a positive perception of their health. Most facets of quality of life were positively assessed, with the highest averages in the psychological, social relations, spirituality, religion and personal beliefs domains, and the lowest, in the environmental domain. Conclusion: the profile of people living with HIV corroborates national data, and the assessment of quality of life was more positive than in other studies.


Objetivo: describir el perfil y evaluar la calidad de vida de personas viviendo con VIH atendidas en servicios públicos de salud. Métodos: estudio transversal, cuantitativo, junto a 281 personas viviendo con VIH, atendidas en servicios públicos de salud en los municipios de Río de Janeiro y Niterói. Se han recolectado los datos mediante un instrumento de datos socioeconómicos y clínicos y del WHOQOL-HIV bref, analizados por estadística descriptiva, después de la aprobación del Comité de Ética en Investigación. Resultados: la muestra se compuso mayoritariamente de hombres, con ingresos de hasta dos salarios mínimos y percepción positiva de la salud. Se evaluó positivamente la calidad de vida en la mayoría de las facetas, los promedios más altos en los dominios: psicológico, relaciones sociales, espiritualidad, religión y creencias personales y el más bajo en el dominio medio ambiente. Conclusión: el perfil de las personas que viven con VIH corrobora con los datos nacionales y la evaluación de la calidad de vida fue más positiva que en otros estudios


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Qualidade de Vida , HIV , Soropositividade para HIV/psicologia , Enfermagem , Qualidade de Vida/psicologia , Estudos Transversais , Espiritualidade
8.
PLoS Med ; 16(10): e1002961, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31671150

RESUMO

BACKGROUND: Whole genome sequencing provides better delineation of transmission clusters in Mycobacterium tuberculosis than traditional methods. However, its ability to reveal individual transmission links within clusters is limited. Here, we used a 2-step approach based on Bayesian transmission reconstruction to (1) identify likely index and missing cases, (2) determine risk factors associated with transmitters, and (3) estimate when transmission happened. METHODS AND FINDINGS: We developed our transmission reconstruction method using genomic and epidemiological data from a population-based study from Valencia Region, Spain. Tuberculosis (TB) incidence during the study period was 8.4 cases per 100,000 people. While the study is ongoing, the sampling frame for this work includes notified TB cases between 1 January 2014 and 31 December 2016. We identified a total of 21 transmission clusters that fulfilled the criteria for analysis. These contained a total of 117 individuals diagnosed with active TB (109 with epidemiological data). Demographic characteristics of the study population were as follows: 80/109 (73%) individuals were Spanish-born, 76/109 (70%) individuals were men, and the mean age was 42.51 years (SD 18.46). We found that 66/109 (61%) TB patients were sputum positive at diagnosis, and 10/109 (9%) were HIV positive. We used the data to reveal individual transmission links, and to identify index cases, missing cases, likely transmitters, and associated transmission risk factors. Our Bayesian inference approach suggests that at least 60% of index cases are likely misidentified by local public health. Our data also suggest that factors associated with likely transmitters are different to those of simply being in a transmission cluster, highlighting the importance of differentiating between these 2 phenomena. Our data suggest that type 2 diabetes mellitus is a risk factor associated with being a transmitter (odds ratio 0.19 [95% CI 0.02-1.10], p < 0.003). Finally, we used the most likely timing for transmission events to study when TB transmission occurred; we identified that 5/14 (35.7%) cases likely transmitted TB well before symptom onset, and these were largely sputum negative at diagnosis. Limited within-cluster diversity does not allow us to extrapolate our findings to the whole TB population in Valencia Region. CONCLUSIONS: In this study, we found that index cases are often misidentified, with downstream consequences for epidemiological investigations because likely transmitters can be missed. Our findings regarding inferred transmission timing suggest that TB transmission can occur before patient symptom onset, suggesting also that TB transmits during sub-clinical disease. This result has direct implications for diagnosing TB and reducing transmission. Overall, we show that a transition to individual-based genomic epidemiology will likely close some of the knowledge gaps in TB transmission and may redirect efforts towards cost-effective contact investigations for improved TB control.


Assuntos
Busca de Comunicante/métodos , Genoma Bacteriano , Mycobacterium tuberculosis/genética , Tuberculose Pulmonar/microbiologia , Tuberculose Pulmonar/transmissão , Sequenciamento Completo do Genoma , Adolescente , Adulto , Idoso , Teorema de Bayes , Biomarcadores , Feminino , Genômica , Soropositividade para HIV/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Filogenia , Polimorfismo de Nucleotídeo Único , Fatores de Risco , Espanha/epidemiologia , Resultado do Tratamento , Tuberculose Pulmonar/epidemiologia , Adulto Jovem
9.
BMC Infect Dis ; 19(1): 944, 2019 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-31703562

RESUMO

BACKGROUND: Despite the numerous intervention programmes, HIV still remains a public health concern with a high impact in Sub-Saharan Africa region. Oxidative stress has been documented in HIV subjects as viral infection promotes prolonged activation of immune system, hence, production of increased reactive oxygen species. METHODS: We studied 180 subjects. Of these, 60 were HIV-infected on antiretroviral therapy (ART), 40 were ART naïve HIV-infected and 80 were apparent healthy non HIV-infected subjects. The complete blood count was performed by automated hemoanalyzer, the CD4+ T-cell count was performed by cyflow cytometer, while the antioxidant assay was performed using ELISA technique. RESULT: All evaluated parameters; glutathione (GSH), glutathione peroxidase (GPX), CD4+ T-cell count, haemoglobin (Hb), total white blood cell count (WBC) and platelet count were significantly (P < 0.05) reduced in the HIV-infected subjects. All assessed parameters were found to be significantly (P < 0.5) reduced in the HIV-infected subjects that are ART naive when compared with those on ART. HIV-infected subjects with CD4+ T-cell count < 200 cells/mm3 had significantly (P < 0.05) reduced values in all assessed parameters when compared to those with CD4+ T-cell count ≥200 cells/mm3. GSH and WBC were found to be significantly (P < 0.05) increased in the female HIV-infected subjects when compared with the male counterpart. Anemia prevalence of 74 and 33% were recorded for the HIV-infected and control subjects, respectively. Gender and ART treatment were found to be associated with anemia in HIV. Male HIV-infected subjects on ART were found to be more likely to have anemia. CONCLUSION: Antioxidants; GSH and GPX were found to be significantly reduced in HIV infection. Further probe showed that the antioxidant status was improved in the HIV-infected group on ART.


Assuntos
Anemia/epidemiologia , Glutationa Peroxidase/sangue , Glutationa/sangue , Infecções por HIV/sangue , Infecções por HIV/epidemiologia , Soropositividade para HIV , Adulto , Antirretrovirais/uso terapêutico , Contagem de Linfócito CD4 , Feminino , Infecções por HIV/tratamento farmacológico , Hospitais Universitários , Humanos , Masculino , Nigéria/epidemiologia , Estresse Oxidativo , Contagem de Plaquetas , Prevalência , Fatores Sexuais
10.
BMC Health Serv Res ; 19(1): 847, 2019 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-31744548

RESUMO

BACKGROUND: In Ethiopia, cervical cancer is a public health concern, as it is the second most cause of cancer deaths among reproductive age women and it affects the country's most vulnerable groups like; rural, poor, and HIV-positive women. Despite the strong evidence that cervical cancer screening results in decreased mortality from this disease, its utilization remains low. METHODS: An institution-based cross-sectional study was conducted from March 2 to April 1/2019 to assess the level and factors affecting utilization of cervical cancer screening among HIV positive women in Hawassa town. Quantitative data collection methods were used. Data were gathered using a structured and pretested questionnaire. Epi-Info version 7 and SPSS version 23 were used for data entry and analysis respectively. Statistically significant association of variables was determined based on Adjusted Odds ratio with its 95% confidence interval and p-value of ≤0.05. RESULTS: Of the 342 women interviewed, 40.1% (95% CI: 35.00, 45.33%) of them were screened. Having a post primary education (AOR = 5.1, 95% CI: 1.8, 14.5), less than 500 cell/mm3 CD4 count (AOR = 2.7, 95% CI: 1.2, 5.9); duration since HIV diagnosis (AOR = 4.2, 95% CI: 2.1, 8.5), partner support (AOR = 4.7, 95% CI: 2.3, 9.4), having knowledge about risk factors (AOR = 2.9 (95% CI: 1.2, 6.9) and having favorable attitude towards cervical cancer and its screening (AOR = 3.7 (95% CI: 1.8, 7.5) were associated with cervical cancer screening utilization. CONCLUSIONS: The study revealed utilization of cervical cancer screening service was low among HIV positive women. Educational status, duration of HIV diagnosis, partner support, knowledge status about risk factor, CD4 count and attitude towards cervical cancer and its screening were associated with cervical cancer screening utilization. Health care workers need to provide intensive counseling services for all ART care attendants to increase utilization.


Assuntos
Soropositividade para HIV/epidemiologia , Neoplasias do Colo do Útero/prevenção & controle , Adolescente , Adulto , Instituições de Assistência Ambulatorial/estatística & dados numéricos , Contagem de Linfócito CD4 , Aconselhamento , Estudos Transversais , Detecção Precoce de Câncer/estatística & dados numéricos , Etiópia/epidemiologia , Utilização de Instalações e Serviços , Feminino , Humanos , Pessoa de Meia-Idade , Razão de Chances , Inquéritos e Questionários , Neoplasias do Colo do Útero/epidemiologia , Adulto Jovem
11.
BMC Public Health ; 19(1): 1473, 2019 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-31699061

RESUMO

BACKGROUND: Men who inject drugs (MWIDs) comprise the highest percentage of diagnosed HIV cases in Malaysia. Their female partners risk being infected through unprotected sexual contact. This paper reports the prevalence of consistent condom use and its predictors among the wives and regular sexual partners of MWIDs in Klang Valley, Malaysia. METHODS: A cross-sectional study using a self-administered questionnaire was conducted among the wives and regular sexual partners of MWIDs in the study location; 221 women were recruited through respondent-driven sampling. Data were analysed descriptively for the prevalence of consistent condom use, HIV status and HIV risk-related behaviour. Subsequently, simple and multiple logistic regressions were undertaken to identify the predictors of consistent condom use. RESULTS: The prevalence of consistent condom use among respondents was 19.5%. Slightly more than half (52.5%) of respondents had never used condoms with their partner. Fourteen women (6.3%) reported being HIV positive. While 7.7% had HIV-positive partners, 45.7% were unaware of their partner's HIV status. Consistent condom use was significantly higher among single women (AOR = 4.95; 95% CI: 2.45, 9.99), women who lived in urban areas (AOR = 2.97; 95% CI: 1.30, 6.78), HIV-positive women (AOR = 3.45; 95% CI: 1.13, 10.5) and women involved in sex work (AOR = 3.55, 95% CI: 1.45, 8.67). CONCLUSIONS: Inconsistent condom use among the majority of female sexual partners of MWIDs underscores the heightened risk faced by these women and calls for alternative prevention methods that women are able to control.


Assuntos
Preservativos/estatística & dados numéricos , Comportamento Contraceptivo/estatística & dados numéricos , Usuários de Drogas/estatística & dados numéricos , Parceiros Sexuais/psicologia , Adolescente , Adulto , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Soropositividade para HIV/epidemiologia , Humanos , Modelos Logísticos , Malásia/epidemiologia , Masculino , Prevalência , Trabalho Sexual/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
12.
BMC Infect Dis ; 19(1): 917, 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31664923

RESUMO

BACKGROUND: Hepatitis B virus is one of the major public health concerns globally. It is highly infectious and can be transmitted from person to person through vertically or horizontally via contaminated body fluids. Despite the provision of an effective vaccine, it remains a major problem worldwide, particularly among the developing countries. METHODS: Online electronic databases including PubMed, Google Scholar, Science Direct, African Index Medicus, African Journals Online, and WHO Afro Library were searched and published articles from 2010 to June 8, 2019, were considered. Both authors independently screened articles and extracted the data. Funnel-Plots and Egger's test statistics were used to determine the presence of small-study effects and publication bias. The pooled prevalence of HBV was analyzed using the random-effects model. The possible sources of heterogeneity was analyzed through subgroup analysis, sensitivity analysis, and meta-regression. RESULTS: The overall pooled prevalence of HBV was 6% and among subgroups, pregnant women, healthcare workers, and HIV positive patients accounted for 5% for each group. Relatively low prevalence (4%) was obtained among blood donors. The Egger's test statistics (p = 0.747) indicated the absence of publication bias. In addition, from the sensitivity analysis, there was no influence on the overall effect estimate while removing a single study at a time. The level of heterogeneity was reduced among pregnant women, HIV positive and studies with unknown sampling techniques. After conducting meta-regression, province, study group, screening method, and quality of papers were identified as sources of heterogeneity. CONCLUSIONS: The overall pooled prevalence of HBV in Ethiopia was high. Strengthening and scaling up of the scope of the existing vaccination program and implementing novel approaches including screen-and-treat could be implemented to reduce the burden of the disease. Generally, the study can provide current prevalence estimate of HBV that could vital for intervention to tackle the disease.


Assuntos
Vírus da Hepatite B/isolamento & purificação , Hepatite B/epidemiologia , Doadores de Sangue , Estudos Transversais , Países em Desenvolvimento , Ensaio de Imunoadsorção Enzimática , Etiópia/epidemiologia , Feminino , Soropositividade para HIV/epidemiologia , Pessoal de Saúde , Hepatite B/prevenção & controle , Hepatite B/transmissão , Antígenos de Superfície da Hepatite B/análise , Vacinas contra Hepatite B , Humanos , Masculino , Gravidez , Gestantes , Prevalência , Vacinação
13.
BMC Infect Dis ; 19(1): 915, 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31664936

RESUMO

BACKGROUND: A bi-directional interaction between diabetes mellitus and tuberculosis is well established and has been likened to that between HIV and TB. Whereas HIV screening is standard of care test in sub Saharan Africa TB programs, the same is not true for diabetes mellitus (DM). Sub Saharan Africa, a region with high TB infection rates, is going through an epidemiological transition with rapidly rising prevalence of diabetes. We aimed at characterizing TB patients with DM in order to identify factors associated with TB-DM dual disease among patients attending TB clinics in Dar es Salaam. METHODS: A cross-sectional study was conducted between September 2016 and January 2017 among patients attending TB clinics in Dar es Salaam. We collected socio-demographic characteristics, anthropometric measurements and screened for diabetes by measuring fasting blood glucose that was followed by a 2 h postprandial glucose for participants with impaired fasting blood glucose. We examined for socio-demographic and clinical factors associated with diabetes using logistic regression analysis. RESULTS: Of the 660 enrolled participants with TB, 25 (3.8%) were on treatment for diabetes while 39 (6.1%) and 147 (23%) of the remaining 635 participants were ultimately diagnosed with DM and impaired fasting blood glucose respectively. The overall prevalence of DM was 9.7% (64/660). Independent risk factors for diabetes included: age > 44 years {OR 4.52, 95% CI: [1.28-15.89]}; family history of diabetes {OR 3.42, 95% [CI 1.88-6.21]}. HIV sero-positive TB patients were less likely to have DM compared to those who were HIV sero-negative {OR 0.35, 95% CI [0.17-0.73]}. CONCLUSIONS: Screening for diabetes should be advocated for TB patients aged above 44 years and/or with a family history of diabetes. HIV sero-negative TB patients were more likely to have DM compared to those who were HIV sero-positive. Further studies are needed to confirm this observation and the underlying factors.


Assuntos
Diabetes Mellitus/epidemiologia , Programas de Rastreamento , Tuberculose/epidemiologia , Adulto , Glicemia/análise , Estudos Transversais , Diabetes Mellitus/sangue , Feminino , HIV/imunologia , Soropositividade para HIV , Humanos , Modelos Logísticos , Masculino , Anamnese , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Escarro/microbiologia , Inquéritos e Questionários , Tanzânia/epidemiologia , Tuberculose/virologia , Adulto Jovem
15.
BMC Womens Health ; 19(1): 123, 2019 10 23.
Artigo em Inglês | MEDLINE | ID: mdl-31647013

RESUMO

BACKGROUND: Cervical cancer is the most common cancer in women in Ghana, but knowledge and experience of women who have had cervical screening is under-evaluated. This study examined knowledge and understanding of HPV and cervical cancer and evaluated experiences of screening in a cohort of women of mixed HIV status. METHODS: This was a mixed methods study using questionnaires and focus group discussions, with a knowledge score constructed from the questionnaire. HIV-positive and HIV-negative women were recruited from a larger cervical screening study in Ghana and were interviewed 6 months after receiving screening. Quantitative data was analyzed and triangulated with qualitative data following thematic analysis using the framework approach. RESULTS: A total of 131 women were included (HIV-positive, n = 60). Over 80% of participants had a knowledge score deemed adequate. There was no difference between HIV-status groups in overall knowledge scores (p = 0.1), but variation was seen in individual knowledge items. HIV-positive women were more likely to correctly identify HPV as being sexually-transmitted (p = 0.05), and HIV negative women to correctly identify the stages in developing cervical cancer (p = < 0.0001). HIV-positive women mostly described acquisition of HPV in stigmatising terms. The early asymptomatic phase of cervical cancer made it difficult for women to define "what" cancer was versus "what" HPV infection was. All women expressed that they found it difficult waiting for their screening results but that receiving information and counselling from health workers alleviated anxiety. CONCLUSIONS: Knowledge of women who had participated in a cervical screening study was good, but specific misconceptions existed. HIV-positive women had similar levels of knowledge to HIV-negative, but different misconceptions. Women expressed generally positive views about screening, but did experience distress. A standardized education tool explaining cervical screening and relevance specifically of HPV-DNA results in Ghana should be developed, taking into consideration the different needs of HIV-positive women.


Assuntos
Detecção Precoce de Câncer/psicologia , Soropositividade para HIV/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Infecções por Papillomavirus/psicologia , Neoplasias do Colo do Útero/psicologia , Adulto , Estudos de Coortes , Aconselhamento , Detecção Precoce de Câncer/métodos , Feminino , Grupos Focais , Gana , Soropositividade para HIV/complicações , Humanos , Pessoa de Meia-Idade , Papillomaviridae , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/virologia , Inquéritos e Questionários , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/virologia
16.
BMC Infect Dis ; 19(1): 876, 2019 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-31640585

RESUMO

BACKGROUND: Blastocystis is one of the most common intestinal protozoa in human faecal samples with uncertain impact on public health. Studies on the prevalence of Blastocystis in HIV-positive patients are limited and dated. METHODS: A cross-sectional study was carried out involving 156 HIV-positive patients to evaluate the prevalence of Blastocystis-subtypes by molecular amplification and sequencing the small subunit rRNA gene (SSU rDNA), to identify the risk factors for its transmission, to examine the relationship between the presence of the protist and gastrointestinal disorders. Furthermore, the evaluation of the faecal calprotectin by immunoassay from a sample of subjects was performed to evaluate the gut inflammation in Blastocystis-carriers. RESULTS: Blastocystis-subtypes ST1, ST2, ST3, ST4 were identified in 39 HIV-positive patients (25%). No correlation was found between the presence of the protist and virological or epidemiological risk factors. Blastocystis was more frequently detected in homosexual subjects (p = 0.037) infected by other enteric protozoa (p = 0.0001) and with flatulence (p = 0.024). No significant differences in calprotectin level was found between Blastocystis-carriers and free ones. CONCLUSIONS: Blastocystis is quite common in HIV-positive patients on ART showing in examined patients 25% prevalence. Homosexual behaviour may represent a risk factor for its transmission, while CD4 count and viremia didn't correlate with the presence of the protist. The pathogenetic role of Blastocystis remains unclear and no gut inflammation status was detected in Blastocystis-carriers. The only symptom associated with Blastocystis was the flatulence, evidencing a link between the presence of the protist and the composition and stability of gut microbiota.


Assuntos
Infecções por Blastocystis/epidemiologia , Blastocystis/patogenicidade , Soropositividade para HIV/parasitologia , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Infecções Oportunistas Relacionadas com a AIDS/parasitologia , Adulto , Idoso , Animais , Animais Domésticos , Blastocystis/genética , Infecções por Blastocystis/etiologia , Infecções por Blastocystis/transmissão , Estudos Transversais , Fezes/química , Fezes/parasitologia , Feminino , Soropositividade para HIV/tratamento farmacológico , Homossexualidade Masculina , Humanos , Complexo Antígeno L1 Leucocitário/análise , Masculino , Pessoa de Meia-Idade , Filogenia , Prevalência , Fatores de Risco , Adulto Jovem
17.
BMC Public Health ; 19(1): 1336, 2019 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-31640612

RESUMO

BACKGROUND: Perceived risk of HIV plays an important role in the adoption of protective behaviours and HIV testing. However, few studies have used multiple-item measures to assess this construct. The Perceived Risk of HIV Scale (PRHS) is an 8-item measure that assesses how people think and feel about their risk of HIV infection. This cross-sectional study aimed to assess the psychometric properties (reliability and validity) of the European Portuguese version of the PRHS, including the ability of this scale to discriminate between individuals from the general population and HIV-uninfected partners from sero-different couples on their perceived risk of HIV infection (known-groups validity). METHODS: This study included 917 individuals from the general population (sample 1) to assess the psychometric properties of the PRHS. To assess the known-groups validity, the sample comprised 445 participants from the general population who were in an intimate relationship (sub-set of sample 1) and 42 HIV-uninfected partners from sero-different couples (sample 2). All participants filled out a set of questionnaires, which included a self-reported questionnaire on sociodemographic information, sexual behaviours, HIV testing and the PRHS. Sample 1 also completed the HIV Knowledge Questionnaire - 18-item version. RESULTS: The original unidimensional structure was reproduced both in exploratory and confirmatory factor analyses, and the PRHS demonstrated good reliability (α = .78; composite reliability = .82). The differential item functioning analyses indicated that the items of the PRHS, in general, did not function differently for men and women or according to HIV testing. Significant associations with sexual risk behaviours and HIV testing provided evidence for criterion validity. The known-groups validity was supported. CONCLUSIONS: The PRHS is a suitable scale in the evaluation of the perceived risk of HIV, and its psychometric characteristics validate its use in the Portuguese population. Furthermore, the present study suggests that interventions improving individuals' HIV risk perceptions may be important since they were associated with different sexual behaviours and the likelihood of HIV testing.


Assuntos
Infecções por HIV/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Parceiros Sexuais/psicologia , Inquéritos e Questionários , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Soronegatividade para HIV , Soropositividade para HIV , Humanos , Masculino , Pessoa de Meia-Idade , Portugal , Psicometria , Reprodutibilidade dos Testes , Medição de Risco , Traduções , Adulto Jovem
18.
Niger J Clin Pract ; 22(10): 1341-1348, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31607722

RESUMO

Background: To reduce the number of new HIV infections among children, retesting of HIV negative pregnant women in labor to identify new infections and instituting appropriate modified obstetrics practices (MOP) has a huge role to play. Aims and Objectives: This study evaluated the HIV sero-positivity in labor among pregnant women who earlier tested negative in antenatal clinic, associated risk factors and the corresponding rate of mother-to-child transmission of HIV infection. Methods: This was a prospective observational study where pregnant women in labor who had earlier tested HIV negative in the antenatal clinic at Imo State University Teaching Hospital Orlu, Imo state, Nigeria, were retested. The infants of the women who seroconverted were tested for HIV infection at 6 weeks using Deoxyribonucleic acid polymerase chain reaction (DNA PCR) by collecting Dried Blood Sample. This study was conducted from October 2015 to March 2016. Result: Out of the 163 patients studied, 6 demonstrated HIV seroconversion giving a seroconversion rate of 3.7%. Deliveries from the seroconverted patients were 5 live births and 1 intrauterine fetal death. All the 5 live babies tested HIV negative at 6 weeks of age. Predictors of seroconversion in late pregnancy include spouse's HIV status and number of other sexual partners. Conclusion: Retesting of HIV negative pregnant women in labor to identify new infections and instituting appropriate modified obstetrics practices has a huge role to play in the prevention of mother to child transmission of HIV infection.


Assuntos
Infecções por HIV/diagnóstico , Infecções por HIV/transmissão , Soropositividade para HIV/sangue , Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Trabalho de Parto/sangue , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/virologia , Adulto , Anticorpos Antivirais/sangue , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Soropositividade para HIV/epidemiologia , Humanos , Lactente , Recém-Nascido , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Masculino , Programas de Rastreamento/métodos , Nigéria/epidemiologia , Parto , Reação em Cadeia da Polimerase , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Estudos Prospectivos , Fatores de Risco , Soroconversão
19.
West Afr J Med ; 36(3): 199-204, 2019.
Artigo em Inglês, Francês | MEDLINE | ID: mdl-31622480

RESUMO

BACKGROUND: HIV infection in pregnant women is a known cause of low birth weight (LBW) and small for gestational age (SGA). This study compared the birth weight for gestational age (GA) of HIV exposed and non-exposed babies in Nnamdi Azikiwe University Teaching Hospital, (NAUTH) Nnewi, Nigeria. SUBJECTS AND METHODS: A retrospective comparative appraisal of birth weights for GA of babies born to HIV- positive and negative women, over a 7-year period (January 2009-December 2015), was conducted. Data were abstracted from PMTCT database, ANC and Labor ward registers of NAUTH. RESULTS: A total of 3459 babies (1782 males, 1677 females) were enrolled, out of which 1829 were HIV- exposed and 1630 were not. GA spanned from 26-42 weeks (mean 38.7 ± 2.2 weeks) and birth weights (BW) from 400-5300g (mean 3072.5 ± 630g). The mean BW of exposed babies was significantly lower than the unexposed babies (p=0.048). LBW occurred in 12.0% of exposed and 13.5% of non-exposed babies (p<0.001). Using either percentile or Z-score cut-offs, HIV-exposed babies had twice the proportion of SGA compared to their non-exposed counterparts. Using Z-score, maternal antiretroviral use for >5 years was significantly associated with the lowest proportion of SGA compared to shorter duration of use. CONCLUSION: Maternal HIV infection is associated with SGA. However, maternal ARV use in excess of 5 years is associated with better BW outcome. Targeted enhancement of maternal nutrition and strict adherence to ARV therapy prior to and during pregnancy will improve birth outcome.


Assuntos
Peso ao Nascer , Retardo do Crescimento Fetal/etiologia , Infecções por HIV/complicações , Soronegatividade para HIV , Transmissão Vertical de Doença Infecciosa , Complicações Infecciosas na Gravidez/epidemiologia , Adulto , Feminino , Retardo do Crescimento Fetal/epidemiologia , Idade Gestacional , Infecções por HIV/epidemiologia , Soropositividade para HIV , Humanos , Recém-Nascido , Masculino , Mães , Nigéria/epidemiologia , Gravidez , Estudos Retrospectivos , Centros de Atenção Terciária
20.
West Afr J Med ; 36(3): 246-252, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31622487

RESUMO

BACKGROUND AND OBJECTIVE: Disclosure of human immuno-deficiency virus (HIV) sero-status is a difficult process that involves communication of information about a potentially stigmatizing and transmissible illness. Despite this, it is important for preventing HIV infection and mitigating its impacts. This study aimed to assess the rate and determinants of self-disclosure of HIV sero-status among people living with HIV/AIDS (PLHIV) attending an Antiretroviral Therapy (ART) Clinic in North Central Nigeria with a view to promoting self- disclosure as an intervention for secondary prevention of HIV/AIDS. METHODS: It was a cross-sectional study involving 325 consenting adults aged 18 to 65 years PLHIV attending ART clinic who were recruited using systematic random sampling method. Data collected from the participants include socio-demographic data and medical history. The rate and factors affecting self-disclosure of HIV sero-status were obtained by using a structured interviewer-administered questionnaire. Data was analysed using Statistical Package for Social Sciences (SPSS) version 20.0 Results: Most of the participants (66.2%) were females. 96% of the participants had disclosed their HIV sero-status. Self-disclosure of HIV sero-status had statistically significant association with age (c2 = 12.614; p = 0.027) and gender (c2 = 4.638; p = 0.031). CONCLUSION: Self-disclosure of HIV sero-status was high among the participants. Being female and within 15-44 year age group were statistically significant factors associated with disclosure of HIV sero-status. Multiple counselling sessions are needed to improve disclosure particularly in males and older PLHIV as self-disclosure of HIV sero-status is a process that requires ongoing support and encouragement.


Assuntos
Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Fármacos Anti-HIV/uso terapêutico , Terapia Antirretroviral de Alta Atividade , Infecções por HIV/tratamento farmacológico , Infecções por HIV/psicologia , Soropositividade para HIV/psicologia , Revelação da Verdade , Adolescente , Adulto , Grupo com Ancestrais do Continente Africano/psicologia , Idoso , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Soropositividade para HIV/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Ambulatório Hospitalar/estatística & dados numéricos , Parceiros Sexuais , Centros de Atenção Terciária , Adulto Jovem
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