Nyt fra tidsskrifterne
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=aids&setpoint=101393#102845
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=aids&setpoint=101393#102827
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=aids&setpoint=101393#102796
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=aids&setpoint=101393#102788
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=aids&setpoint=101393#102789
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=aids&setpoint=101393#102776
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=aids&setpoint=101393#102740
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=aids&setpoint=101393#102722
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=aids&setpoint=101393#102683
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=aids&setpoint=101393#102597
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=aids&setpoint=101393#102549
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=aids&setpoint=101393#102522
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=aids&setpoint=101393#102503
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=aids&setpoint=101393#102510
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=aids&setpoint=101393#102419
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=aids&setpoint=101393#102341
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=aids&setpoint=101393#102261
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=aids&setpoint=101393#102232
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=aids&setpoint=101393#102235
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=aids&setpoint=101393#102185
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=aids&setpoint=101393#102186
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=aids&setpoint=101393#102170
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=aids&setpoint=101393#102103
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=aids&setpoint=101393#101991
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=aids&setpoint=101393#101967
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=aids&setpoint=101393#101923
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=aids&setpoint=101393#101883
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=aids&setpoint=101393#101736
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=aids&setpoint=101393#101688
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=aids&setpoint=101393#101644
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=aids&setpoint=101393#101649
Klik på knappen for at kopiere eller tryk på linket nedenfor.
Kopieret til udklipsholder!
https://www.infmed.dk/nyheder-udefra?rss_filter=aids&setpoint=101393#101393
Søgeord (aids) valgt.
32 emner vises.
Tang, J., Ren, J., Wang, H., Shi, M., Jia, X., Zhang, L.
BMJ Open, 8.05.2024
Tilføjet 8.05.2024
ObjectiveThis study aimed to investigate the caregiving behaviours and supportive needs of caregivers of patients with HIV/AIDS and provide a basis for healthcare institutions to carry out caregiver interventions. DesignA purposive sampling method was used to select 11 caregivers of patients with HIV/AIDS in the Infectious Disease Department of a tertiary hospital in Nanjing, China, to conduct semistructured interviews. Colaizzi analysis was used to collate and analyse the interview data. SettingAll interviews were conducted at a tertiary hospital specialising in infectious diseases in Nanjing, Jiangsu Province. ParticipantsWe purposively sampled 11 caregivers of people with HIV/AIDS, including nine women and two men. ResultsAnalysing the results from the perspective of iceberg theory, three thematic layers were identified: behavioural, value and belief. The behavioural layer includes a lack of awareness of the disease, physical and mental coping disorders, and an increased sense of stigma; the values layer includes a heightened sense of responsibility, the constraints of traditional gender norms, the influence of strong family values and the oppression of public opinion and morality and the belief layer includes the faith of standing together through storms and stress. ConclusionHealthcare professionals should value the experiences of caregivers of patients with HIV/AIDS and provide professional support to improve their quality of life.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 7.05.2024
Tilføjet 7.05.2024
Abstract Tools to evaluate and accelerate tuberculosis (TB) vaccine development are needed to advance global TB control strategies. Validated human infection studies for TB have the potential to facilitate breakthroughs in understanding disease pathogenesis, identify correlates of protection, develop diagnostic tools, and accelerate and de-risk vaccine and drug development. However, key challenges remain for realizing the clinical utility of these models, which require further discussion and alignment amongst key stakeholders. In March 2023, the Wellcome Trust and the International AIDS Vaccine Initiative (IAVI) convened international experts involved in developing both TB and Bacillus Calmette-Guerin (BCG) human infection studies (including mucosal and intradermal challenge routes) to discuss the status of each of the models and the key enablers to move the field forward. This report provides a summary of the presentations and discussion from the meeting. Discussions identified key issues, including demonstrating model validity, to provide confidence for vaccine developers, which may be addressed through demonstration of known vaccine effects, e.g. BCG vaccination in specific populations, and by comparing results from field efficacy and human infection studies. The workshop underscored the importance of establishing safe and acceptable studies in high-burden settings, and the need to validate more than one model to allow for different scientific questions to be addressed as well as to provide confidence to vaccine developers and regulators around use of human infection study data in vaccine development and licensure pathways.
Læs mere Tjek på PubMedKelong HanParul PatelScott McCallisterAlex R. RinehartYash GandhiWilliam SpreenRaphael J. LandovitzSinead Delany-MoretlweMark A. MarzinkeTodd McKeonPiotr BudnikJean van WykSusan L. Ford1GSK, Collegeville, Pennsylvania, USA2ViiV Healthcare, Durham, North Carolina, USA3ViiV Healthcare, Branford, Connecticut, USA4Center for Clinical AIDS Research and Education, David Geffen School of Medicine, University of California, Los Angeles, California, USA5Wits RHI, University of the Witwatersrand, Johannesburg, South Africa6Johns Hopkins University, Baltimore, Maryland, USA7ViiV Healthcare, Brentford, United Kingdom8GSK, Durham, North Carolina, USA, Ryan K. Shields
Antimicrobial Agents And Chemotherapy, 6.05.2024
Tilføjet 6.05.2024
Norma Rallón, Daniel Jiménez‐Carretero, Clara Restrepo, José M. Ligos, Jaime Valentín‐Quiroga, Ignacio Mahillo, Alfonso Cabello, Eduardo López‐Collazo, Fátima Sánchez‐Cabo, Miguel Górgolas, Vicente Estrada, José M. Benito, ECRIS integrated in the Spanish AIDS Research Network
Journal of Medical Virology, 4.05.2024
Tilføjet 4.05.2024
Norma Rallón, Daniel Jiménez‐Carretero, Clara Restrepo, José M. Ligos, Jaime Valentín‐Quiroga, Ignacio Mahillo, Alfonso Cabello, Eduardo López‐Collazo, Fátima Sánchez‐Cabo, Miguel Górgolas, Vicente Estrada, José M. Benito, ECRIS integrated in the Spanish AIDS Research Network
Journal of Medical Virology, 4.05.2024
Tilføjet 4.05.2024
Raphael Adu-Gyamfi, Juliana Enos, Kwame Yeboah, Veronika Shabanova, Nicola Hawley, Deda Alangea Ogum, Adwoa Agyei Nkansah, Elijah Paintsil, Kwasi Torpey
PLoS One Infectious Diseases, 4.05.2024
Tilføjet 4.05.2024
by Raphael Adu-Gyamfi, Juliana Enos, Kwame Yeboah, Veronika Shabanova, Nicola Hawley, Deda Alangea Ogum, Adwoa Agyei Nkansah, Elijah Paintsil, Kwasi Torpey Background Although AIDS-related deaths have reduced with increased access to antiretroviral care, cardiovascular disease-related morbidities among persons living with HIV are rising. Contributing to this is the higher incidence of Hypertension among Persons Living with HIV. The duration of exposure to the virus and antiretroviral drugs plays a vital role in the pathogenesis, putting perinatally infected children and adolescents at higher risk than behaviorally-infected ones, supporting the calls for increased surveillance of Hypertension among them. Despite the availability of guidelines to support this surveillance, the blood pressure (BP) of adolescents living with HIV (ADLHIV) is not checked during clinical visits. This study aims to assess the effect of a theory-based intervention on healthcare workers’ adherence to the guidelines for hypertension screening among adolescents. Methods A multi-facility cluster-randomized study will be conducted. The clusters will be 20 antiretroviral therapy sites in the Greater Accra Region of Ghana with the highest adolescent caseload. Data will be extracted from the folders of adolescents (10–17 years) who received care in these facilities six months before the study. The ART staff of intervention facilities will receive a multicomponent theory of planned behaviour-based intervention. This will include orientation on hypertension risk among ADLHIV, provision of job aids and pediatric sphygmomanometers. Six months after the intervention, the outcome measure will be the change from baseline in the proportion of ADLHIV whose BP was checked during clinical visits. The calculated sample size is 400 folders. Implications of findings This study will generate evidence on the effectiveness of a multicomponent theory-based intervention for improving the implementation of clinical practice guidelines. Trial registration PACTR202205641023383.
Læs mere Tjek på PubMedMaxwell Philip Omondi
PLoS One Infectious Diseases, 3.05.2024
Tilføjet 3.05.2024
by Maxwell Philip Omondi Introduction The HIV/AIDS continues being a significant global public health priority in the 21st century with social and economic consequences Mother-to-child transmission (MTCT) occurs when an HIV-infected woman passes the virus to her infant and about 90% of these MTCT infections occurs in Africa where children and infants are still dying of HIV. Early definitive diagnosis using Deoxyribonucleic acid reaction of HIV infection in infants is critical to ensuring that HIV-infected infants receive appropriate and timely care and treatment to reduce HIV related morbidity and mortality. Objective To assess the Infant Deoxyribonucleic acid–Polymerase Chain Reaction (DNA-PCR) Turnaround Time (TAT) of dry blood spots and associated factors in Vihiga, Bungoma, Kakamega and Busia counties, in Kenya. Method A mixed methods study using a) retrospectively collected data from Ministry of Health Laboratory registers, Early Infant Diagnosis (EID) database from 28 health facilities and b) 9 key informant interviews with laboratory in-charges were conducted. A total of 2,879 HIV exposed babies’ data were abstracted from January 2012 to June 2013. Results The mean TAT from specimen collection and results received back at the facilities was 46.90 days, Vihiga county having the shortest mean duration at 33.7days and Kakamega county having the longest duration at 51.7days (p = 0.001). In addition, the mean transport time from specimen collection and receipt at Alupe Kenya Medical Research Institute (KEMRI) reference Laboratory was 16.50 days. Vihiga County had the shortest transport time at 13.01 days while Busia had the longest at 18.99 days (p = 0.001). Longer TAT was due to the batching of specimens at the peripheral health facilities and hubbing to the nearest referral hospitals. Conclusion The TAT for DNA-PCR specimen was 46.90 days with Vihiga County having the shortest TAT due to lack of specimen batching and hubbing. Recommendation Discourage specimen batching/hubbing and support point-of-care early infant diagnosis (EID) tests.
Læs mere Tjek på PubMedKelebie, M. A., Tinsae, T., Alemayehu, B. F., Walelign, G. K., Takelle, G. M.
BMJ Open, 2.05.2024
Tilføjet 2.05.2024
ObjectiveTo assess the prevalence and associated factors of neurocognitive disorder among people living with HIV/AIDS in South Gondar primary hospitals, North-West Ethiopia, 2023. DesignInstitution-based cross-sectional study design. SettingSouth Gondar primary hospitals, North-West Ethiopia. Participants608 participants were recruited using the systematic random sampling technique. MeasurementData were collected using an interviewer-administered questionnaire and medical chart reviews. The International HIV Dementia Scale was used to screen for neurocognitive disorder. The data were entered through EPI-DATA V.4.6 and exported to SPSS V.21 statistical software for analysis. In the bivariable logistic regression analyses, variables with a value of p
Læs mere Tjek på PubMedTrager, R. J., Cupler, Z. A., Srinivasan, R., Casselberry, R. M., Perez, J. A., Dusek, J. A.
BMJ Open, 2.05.2024
Tilføjet 2.05.2024
ObjectivesPatients receiving chiropractic spinal manipulation (CSM) for low back pain (LBP) are less likely to receive any opioid prescription for subsequent pain management. However, the likelihood of specifically being prescribed tramadol, a less potent opioid, has not been explored. We hypothesised that adults receiving CSM for newly diagnosed radicular LBP would be less likely to receive a tramadol prescription over 1-year follow-up, compared with those receiving usual medical care. DesignRetrospective cohort study. SettingUS medical records-based dataset including >115 million patients attending academic health centres (TriNetX, Inc), queried 9 November 2023. ParticipantsOpioid-naive adults aged 18–50 with a new diagnosis of radicular LBP were included. Patients with serious pathology and tramadol use contraindications were excluded. Variables associated with tramadol prescription were controlled via propensity matching. InterventionsPatients were divided into two cohorts dependent on treatment received on the index date of radicular LBP diagnosis (CSM or usual medical care). Primary and secondary outcome measuresRisk ratio (RR) for tramadol prescription (primary); markers of usual medical care utilisation (secondary). ResultsAfter propensity matching, there were 1171 patients per cohort (mean age 35 years). Tramadol prescription was significantly lower in the CSM cohort compared with the usual medical care cohort, with an RR (95% CI) of 0.32 (0.18 to 0.57; p
Læs mere Tjek på PubMedSharana Mahomed1Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa, Graeme N. Forrest
Clinical Microbiology Reviews, 1.05.2024
Tilføjet 1.05.2024
Gamble, A. R., McKay, M. J., Anderson, D. B., Pappas, E., Alvarez Cooper, I., Macpherson, S., Harris, I. A., Filbay, S. R., McCaffery, K., Thompson, R., Hoffmann, T. C., Maher, C. G., Zadro, J. R.
BMJ Open, 30.04.2024
Tilføjet 30.04.2024
AimTo develop and user test an evidence-based patient decision aid for children and adolescents who are considering anterior cruciate ligament (ACL) reconstruction. DesignMixed-methods study describing the development of a patient decision aid. SettingA draft decision aid was developed by a multidisciplinary steering group (including various types of health professionals and researchers, and consumers) informed by the best available evidence and existing patient decision aids. ParticipantsPeople who ruptured their ACL when they were under 18 years old (ie, adolescents), their parents, and health professionals who manage these patients. Participants were recruited through social media and the network outreach of the steering group. Primary and secondary outcomesSemistructured interviews and questionnaires were used to gather feedback on the decision aid. The feedback was used to refine the decision aid and assess acceptability. An iterative cycle of interviews, refining the aid according to feedback and further interviews, was used. Interviews were analysed using reflexive thematic analysis. ResultsWe conducted 32 interviews; 16 health professionals (12 physiotherapists, 4 orthopaedic surgeons) and 16 people who ruptured their ACL when they were under 18 years old (7 were adolescents and 9 were adults at the time of the interview). Parents participated in 8 interviews. Most health professionals, patients and parents rated the aid’s acceptability as good-to-excellent. Health professionals and patients agreed on most aspects of the decision aid, but some health professionals had differing views on non-surgical management, risk of harms, treatment protocols and evidence on benefits and harms. ConclusionOur patient decision aid is an acceptable tool to help children and adolescents choose an appropriate management option following ACL rupture with their parents and health professionals. A clinical trial evaluating the potential benefit of this tool for children and adolescents considering ACL reconstruction is warranted.
Læs mere Tjek på PubMedHardman, K., Davies, A., Demetri, A., Clayton, G., Bakhbakhi, D., Birchenall, K., Barnfield, S., Fraser, A., Burden, C., McGuinness, S., Miller, R., Merriel, A.
BMJ Open, 29.04.2024
Tilføjet 29.04.2024
ObjectivesTo explore and characterise maternity healthcare professionals’ (MHCPs) experience and practice of shared decision-making (SDM), to inform policy, research and practice development. DesignQualitative focus group study. SettingLarge Maternity Unit in the Southwest of England. ParticipantsMHCPs who give information relating to clinical procedures and pregnancy care relating to labour and birth and are directly involved in decision-making conversations were purposively sampled to ensure representation across MHCP groups. Data collectionA semistructured topic guide was used. Data analysisReflexive thematic analysis was undertaken. ResultsSeven focus groups were conducted, comprising a total of 24 participants (3–5 per group). Two themes were developed: contextualising decision-making and controversies in current decision-making. Contextual factors that influenced decision-making practices included lack of time and challenges faced in intrapartum care. MHCPs reported variation in how they approach decision-making conversations and asked for more training on how to consistently achieve SDM. There were communication challenges with women who did not speak English. Three controversies were explored: the role of prior clinical experience, the validity of informed consent when women were in pain and during life-threatening emergencies and instances where women declined medical advice. ConclusionsWe found that MHCPs are committed to SDM but need better support to deliver it. Structured processes including Core Information Sets, communication skills training and decision support aids may help to consistently deliver SDM in maternity care.
Læs mere Tjek på PubMedCoburn, Sally B.; Pimentel, Noel; Leyden, Wendy; Kitahata, Mari; Moore, Richard D.; Althoff, Keri N.; Gill, M. John; Lang, Raynell; Horberg, Michael A.; D’Souza, GypsyAmber; Hussain, Shehnaz K.; Dubrow, Robert; Novak, Richard M.; Rabkin, Charles S.; Park, Lesley S.; Sterling, Timothy R.; Neugebauer, Romain S.; Silverberg, Michael J.; for the North American AIDS Cohort Collaboration on Research and Design of the International Epidemiologic Databases to Evaluate AIDS
Journal of Acquired Immune Deficiency Syndromes, 29.04.2024
Tilføjet 29.04.2024
Background: The effect of initial antiretroviral therapy (ART) class on cancer risk in people with HIV (PWH) remains unclear. Setting: Cohort study of 36,322 PWH enrolled (1996-2014) in the North American AIDS Cohort Collaboration on Research and Design. Methods: We followed individuals from ART initiation (protease inhibitor [PI]-, non-nucleoside reverse transcriptase inhibitor [NNRTI]-, or integrase strand transfer inhibitor [INSTI]-based) until incident cancer, death, loss-to-follow-up, 12/31/2014, 85 months (intention-to-treat analyses [ITT]), or 30 months (per-protocol [PP] analyses). Cancers were grouped (non-mutually exclusive) as: any cancer, AIDS-defining cancers (ADC), non-AIDS-defining cancers (NADC), any infection-related cancer, and common individual cancer types. We estimated adjusted hazard ratios (aHR) comparing cancer risk by ART class using marginal structural models emulating ITT and PP trials. Results: We observed 17,004 PWH (954 cancers) with PI-based (median 6 years follow-up), 17,536 (770 cancers) with NNRTI-based (median 5 years follow-up) and 1,782 (29 cancers) with INSTI-based ART (median 2 years follow-up). Analyses with 85 months follow-up indicated no cancer risk differences. In truncated analyses, risk of ADCs (aHR 1.33; 95% CI 1.00, 1.77 [PP-analysis]) and NADCs (aHR 1.23; 95% CI 1.00, 1.51[ITT-analysis]) were higher comparing PIs vs. NNRTIs. Conclusions: Results with longer-term follow-up suggest being on a PI- versus NNRTI-based ART regimen does not affect cancer risk. We observed shorter-term associations that should be interpreted cautiously and warrant further study. Further research with longer duration of follow-up that can evaluate INSTIs, the current first-line recommended therapy, is needed to comprehensively characterize the association between ART class and cancer risk. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedRosenthal, Mark; Patterson, Wendy; Rajulu, Deepa T.
Journal of Acquired Immune Deficiency Syndromes, 29.04.2024
Tilføjet 29.04.2024
Background: Late HIV diagnosis is associated with a wide range of negative outcomes. This study aims to identify characteristics of individuals who received a concurrent diagnosis (CDX) in New York State (NYS) so that more effective interventions can be developed to encourage earlier testing among these populations. Methods: The NYS HIV registry was used to identify people who received a CDX from 2016 – 2021. A CDX was a diagnosis that met the criteria for a stage 3 HIV infection within 30 days of the initial HIV diagnosis. Sex at birth, race/ethnicity, transmission risk group, age at diagnosis, region of residence at diagnosis, urbanicity of zip code of diagnosis, and type of diagnosing facility were used as covariates. Bivariate and multivariate risk ratios were calculated to quantify associations between CDX and covariates. Results: There were 14,866 people newly diagnosed with HIV in NYS from 2016 – 2021, of which 19.0% had a CDX. Those with female sex at birth, IDU, or MSM/IDU risk were less likely to have a CDX. Increased age, Asian race/ethnicity, residence outside of New York City, and diagnosis at inpatient facilities or emergency rooms were associated with an increased likelihood of a CDX. Conclusion: Populations with the highest proportions of CDX were ones that made up a small percentage of all new HIV diagnoses and may not be benefiting as much from current HIV prevention efforts. There are complex interactions between many factors including geographic and social characteristics which may lead to delayed diagnostic testing. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedClinical Infectious Diseases, 26.04.2024
Tilføjet 26.04.2024
Abstract Background Mortality among people with HIV declined with the introduction of combination antiretroviral therapy. We investigated trends over time in all-cause and cause-specific mortality in people with HIV from 1999—2020.Methods Data were collected from the D:A:D cohort from 1999 through January 2015 and RESPOND from October 2017 through 2020. Age-standardized all-cause and cause-specific mortality rates, classified using Coding Causes of Death in HIV (CoDe), were calculated. Poisson regression models were used to assess mortality trends over time.Results Among 55716 participants followed for a median of 6 years (IQR 3-11), 5263 participants died (crude mortality rate [MR] 13.7/1000 PYFU; 95%CI 13.4-14.1). Changing patterns of mortality were observed with AIDS as the most common cause of death between 1999- 2009 (n = 952, MR 4.2/1000 PYFU; 95%CI 4.0-4.5) and non-AIDS defining malignancy (NADM) from 2010 -2020 (n = 444, MR 2.8/1000 PYFU; 95%CI 2.5-3.1). In multivariable analysis, all-cause mortality declined over time (adjusted mortality rate ratio [aMRR] 0.97 per year; 95%CI 0.96, 0.98), mostly from 1999 through 2010 (aMRR 0.96 per year; 95%CI 0.95-0.97), and with no decline shown from 2011 through 2020 (aMRR 1·00 per year; 95%CI 0·96-1·05). Mortality due all known causes except NADM also declined over the entire follow-up period.Conclusion Mortality among people with HIV in the D:A:D and/or RESPOND cohorts decreased between 1999 and 2009 and was stable over the period from 2010 through 2020. The decline in mortality rates was not fully explained by improvements in immunologic-virologic status or other risk factors.
Læs mere Tjek på PubMedClinical Infectious Diseases, 24.04.2024
Tilføjet 24.04.2024
Abstract During pandemics, healthcare providers struggle with balancing obligations to self, family, and patients. While HIV/AIDS seemed to settle this issue, coronavirus disease 2019 (COVID-19) rekindled debates regarding treatment refusal. We searched MEDLINE, Embase, CINAHL Complete, and Web of Science using terms including obligation, refusal, HIV/AIDS, COVID-19, and pandemics. After duplicate removal and dual, independent screening, we analyzed 156 articles for quality, ethical position, reasons, and concepts. Diseases in our sample included HIV/AIDS (72.2%), severe acute respiratory syndrome (SARS) (10.2%), COVID-19 (10.2%), Ebola (7.0%), and influenza (7.0%). Most articles (81.9%, n = 128) indicated an obligation to treat. COVID-19 had the highest number of papers indicating ethical acceptability of refusal (60%, P < .001), while HIV had the least (13.3%, P = .026). Several reason domains were significantly different during COVID-19, including unreasonable risks to self/family (26.7%, P < .001) and labor rights/workers\' protection (40%, P < .001). A surge in ethics literature during COVID-19 has advocated for permissibility of treatment refusal. Balancing healthcare provision with workforce protection is crucial in effectively responding to a global pandemic.
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.04.2024
Tilføjet 23.04.2024
Abstract Background Mental health (MH) is extremely relevant when referring to people living with a chronic disease, such as people living with HIV (PLWH). In fact – although life expectancy and quality have increased since the advent of antiretroviral therapy (ART) – PLWH carry a high incidence of mental disorders, and this burden has been exacerbated during the COVID-19 pandemic. In this scenario, UNAIDS has set new objectives for 2025, such as the linkage of at least 90% of PLWH to people-centered, context-specific MH services. Aim of this study was to determine the prevalence of MD in PLWH followed at the Clinic of Infectious Diseases of the University of Bari, Italy. Methods From January 10th to September 10th, 2022, all PLWH patients accessing our outpatient clinic were offered the following standardized tools: HAM-A for anxiety, BDI-II for depression, PC-PTSD-5 for post-traumatic stress disorder, CAGE-AID for alcohol-drug abuse. Factors associated with testing positive to the four MD were explored with a multivariable logistic regression model. Results 578 out of 1110 HIV-patients agreed to receive MH screening, with 141 (24.4%) people resulting positive to at least one MH disorder. HAM-A was positive in 15.8% (n = 91), BDI-II in 18% (n = 104), PC-PTSD-5 in 5% (n = 29) and CAGE in 6.1% (n = 35). The multivariable logistic regression showed a higher probability of being diagnosed with anxiety, depression and post-traumatic stress disorder for PLWH who reported severe stigma, social isolation, psychological deterioration during the COVID-19 pandemic and for those receiving a dolutegravir (DTG)-based regimen. Moreover, history of drug use (OR 1.13; [95% CE 1.06–4.35]), family stigma (2.42 [1.65–3.94]) and social isolation (2.72 [1.55;4.84]) were found to be associated to higher risk for substance use disorder. Conclusions In this study, stigma was a strong predictor for being diagnosed of a MH disorder among PLWH. Also, the possible role of dolutegravir as a risk factor for the onset of MH disorders should be considered in clinical practice, and MH of patients receiving DTG-containing regimens should be constantly monitored.
Læs mere Tjek på PubMedJang, Yoonyoung; Kim, Taehwa; Choi, Yunsu; Ahn, Kyoung Hwan; Kim, Jung Ho; Seong, Hye; Kim, Youn Jeong; Kim, Shin-Woo; Choi, Jun Yong; Kim, Hyo Youl; Song, Joon Young; Choi, Hee Jung; Kim, Sang Il.; Sohn, Jang Wook; Chin, BumSik; Choi, Bo-Youl; Park, Boyoung
AIDS, 22.04.2024
Tilføjet 22.04.2024
Introduction: This study aimed to investigate the association between obesity and cancer risk as well as site-specific cancer risks in adults with HIV using a nationwide health screening database in Korea. Methods: Of the 16,671 adults with a new diagnosis of HIV from 2004 to 2020, 456 incident cancer cases and 1,814 individually matched controls by sex, year of birth, year of HIV diagnosis, and follow-up duration (1:4 ratio) were included in this nested case-control study. The association between obesity (body mass index ≥25 kg/m2) and cancer risks was estimated and presented as odds ratios (ORs) and 95% confidence intervals (CIs). Results: Of the 456 cancer incident cases, there were 146 AIDS-defining cancer cases and 310 non-AIDS-defining cancer cases. Compared with non-obese adults with HIV, obese adults with HIV were at higher risk of non-AIDS-defining cancer (OR = 1.478, 95% CI = 1.118–1.955). Otherwise, the overall risk of AIDS-defining cancer (OR = 0.816, 95% CI = 0.520–1.279) and each type of AIDS-defining cancer (Kaposi sarcoma and non-Hodgkin\'s lymphoma) were not high in obese adults with HIV. Of the specific types of non-AIDS-defining cancers, obesity was associated with an increased risk of colorectal cancer (OR = 3.090, 95% CI = 1.110–8.604) and liver, bile duct, and pancreatic cancers (OR = 2.532, 95% CI = 1.141–5.617). Conclusions: Obesity, which is one of the important health concerns in HIV management, was associated with an increased risk of non-AIDS-defining cancer but not AIDS-defining cancer. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedFlores, John M.; Moline, Tyrone; Regan, Seann D.; Chen, Yen-Tyng; Shrader, Cho-Hee; Schneider, John A.; Duncan, Dustin T.; Kim, Byoungjun
AIDS, 22.04.2024
Tilføjet 22.04.2024
Objective: The objective of this study is to use GPS technology to determine if violent and property crime exposure to participants activity spaces affect outcomes of the HIV prevention and care continuum (PCC) among Young Black sexually minoritized men (YBSMM) and Transgender women (TW), a subgroup at high vulnerability for new HIV diagnoses. Exposure to violent and property crime adversely affects a variety of acute and chronic medical conditions; however the relationship between exposure to violent and property crime and HIV risk (e.g., PrEP non use) is unknown. Spatial analytic analysis using dynamic Global Position Systems (GPS) technology can accurately detect geospatial associations between the crime exposure and objective HIV related outcomes. Methods: With the Neighborhoods and Networks (N2) Cohort Study, GPS technology to identify the activity space of 286 (123 PLWH and 163 PWoH) YBSMM & TW living in Chicago, IL, to identified spatial associations between violent and property crime exposures with HIV PCC outcomes. Results: We found that YBSMM & TGW with higher exposure areas with higher levels of violent crime were less likely to use HIV preexposure prophylaxis (PrEP) therapy (aOR 0.76, 95% CI 0.63-0.91, p = 0.03). Conclusion: This study demonstrates the importance of clinical providers to consider violent crime as a potential sociostructural barrier that may impact medication adherence and health care outcomes among vulnerable populations. Additionally, GPS technology offers an alternative data analytic process that may be used to future studies to assist in identifying barriers to ending the HIV epidemic. JOURNAL/aids/04.03/00002030-990000000-00476/figure1/v/2024-04-10T095129Z/r/image-jpeg Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedBMC Infectious Diseases, 20.04.2024
Tilføjet 20.04.2024
Abstract Background HIV/AIDS is a global health challenge and continues to threaten lives in sub-Saharan African countries such as Ghana. One of the important interventions for controlling its transmission is through testing and receiving medication. In this study, we present findings on the prevalence and factors associated with HIV testing among young women in Ghana. Methods We used data from the 2014 Ghana Demographic and Health Survey comprising young women aged 15–24 years. We calculated the proportion of these young women who have ever been tested for HIV. The multivariable logistic regression analysis was used to assess the determinants of HIV testing at a 95% confidence interval (CI), and adjusted odds ratio (aORs) and p-values were reported. All analyses were adjusted using survey weights to account for unequal sampling probabilities. Results The results showed that 31.4% (95% CI [29.63, 32.81]) of young women in Ghana had tested for HIV. The odds of HIV testing were likely to be higher among young women aged 20–24 (aOR = 2.24, 95% CI [1.75, 2.87]), those who were pregnant (aOR = 3.17, 95% CI [2.03, 4.95]) and those with one (aOR = 7.99, 95% CI [5.72, 11.17]), two (aOR = 10.43, 95% CI [6.47, 16.81]) or three or more children (aOR = 14.60, 95% CI [8.37, 25.48]) compared to their counterparts in the reference category. Women who had attained secondary education or higher (aOR = 2.66, 95% CI [1.67, 4.23]), were sexually active (aOR = 2.82, 95% CI [2.00, 3.97]), and in richer (aOR = 1.98, 95% CI [1.17, 3.34]) and richest wealth index (aOR = 1.99, 95% CI [1.10, 3.61]) were more likely to test for HIV than those with no formal education, who had not had sex before or in the poorest wealth index. Women from the Eastern (aOR = 1.69, 95% CI [1.04,2.72]) and Upper East regions (aOR = 2.62, 95% CI [1.44, 4.75]) were more likely than those in the Western region to get tested for HIV. However, the odds of testing for HIV were lower among women belonging to other religions (aOR = 0.43, 95% CI [0.23,0.82]) than Christians. Conclusion The findings show that HIV testing is low among young women in Ghana. To address this issue, it is recommended that both government and non-governmental organizations collaborate to create effective programmes and strategies. These may include continuous health education, regular sensitization programs and making HIV testing services much more accessible and affordable, taking into consideration the sociodemographic characteristics of young women.
Læs mere Tjek på PubMedBMC Infectious Diseases, 20.04.2024
Tilføjet 20.04.2024
Abstract Background HIV/AIDS is a global health challenge and continues to threaten lives in sub-Saharan African countries such as Ghana. One of the important interventions for controlling its transmission is through testing and receiving medication. In this study, we present findings on the prevalence and factors associated with HIV testing among young women in Ghana. Methods We used data from the 2014 Ghana Demographic and Health Survey comprising young women aged 15–24 years. We calculated the proportion of these young women who have ever been tested for HIV. The multivariable logistic regression analysis was used to assess the determinants of HIV testing at a 95% confidence interval (CI), and adjusted odds ratio (aORs) and p-values were reported. All analyses were adjusted using survey weights to account for unequal sampling probabilities. Results The results showed that 31.4% (95% CI [29.63, 32.81]) of young women in Ghana had tested for HIV. The odds of HIV testing were likely to be higher among young women aged 20–24 (aOR = 2.24, 95% CI [1.75, 2.87]), those who were pregnant (aOR = 3.17, 95% CI [2.03, 4.95]) and those with one (aOR = 7.99, 95% CI [5.72, 11.17]), two (aOR = 10.43, 95% CI [6.47, 16.81]) or three or more children (aOR = 14.60, 95% CI [8.37, 25.48]) compared to their counterparts in the reference category. Women who had attained secondary education or higher (aOR = 2.66, 95% CI [1.67, 4.23]), were sexually active (aOR = 2.82, 95% CI [2.00, 3.97]), and in richer (aOR = 1.98, 95% CI [1.17, 3.34]) and richest wealth index (aOR = 1.99, 95% CI [1.10, 3.61]) were more likely to test for HIV than those with no formal education, who had not had sex before or in the poorest wealth index. Women from the Eastern (aOR = 1.69, 95% CI [1.04,2.72]) and Upper East regions (aOR = 2.62, 95% CI [1.44, 4.75]) were more likely than those in the Western region to get tested for HIV. However, the odds of testing for HIV were lower among women belonging to other religions (aOR = 0.43, 95% CI [0.23,0.82]) than Christians. Conclusion The findings show that HIV testing is low among young women in Ghana. To address this issue, it is recommended that both government and non-governmental organizations collaborate to create effective programmes and strategies. These may include continuous health education, regular sensitization programs and making HIV testing services much more accessible and affordable, taking into consideration the sociodemographic characteristics of young women.
Læs mere Tjek på PubMedFrancesco Di Gennaro, Francesco Vladimiro Segala, Giacomo Guido, Mariacristina Poliseno, Laura De Santis, Alessandra Belati, Carmen Rita Santoro, Irene Francesca Bottalico, Carmen Pellegrino, Roberta Novara, Luisa Frallonardo, Mariangela Cormio, Michele Camporeale, Sergio Cotugno, Vincenzo Giliberti, Stefano Di Gregorio, Valentina Totaro, Nicola Catucci, Anna De Giosa, Roberta Giusto, Ilaria Viviana Lanera, Gioacchino Angarano, Sergio Lo Caputo, Annalisa Saracino
PLoS One Infectious Diseases, 20.04.2024
Tilføjet 20.04.2024
by Francesco Di Gennaro, Francesco Vladimiro Segala, Giacomo Guido, Mariacristina Poliseno, Laura De Santis, Alessandra Belati, Carmen Rita Santoro, Irene Francesca Bottalico, Carmen Pellegrino, Roberta Novara, Luisa Frallonardo, Mariangela Cormio, Michele Camporeale, Sergio Cotugno, Vincenzo Giliberti, Stefano Di Gregorio, Valentina Totaro, Nicola Catucci, Anna De Giosa, Roberta Giusto, Ilaria Viviana Lanera, Gioacchino Angarano, Sergio Lo Caputo, Annalisa Saracino High School students, recognized as a high-risk group for sexually transmitted infections (STIs), were the focal point of an educational campaign in Southern Italy to share information and good practices about STIs and HIV/AIDS. A baseline survey comprising 76 items was conducted via the REDCap platform to assess students’ initial knowledge, attitudes, and practices (KAP) related to STIs and HIV/AIDS. Sociodemographic variables were also investigated. The association between variables and KAP score was assessed by Kruskal-Wallis’ or Spearman’s test, as appropriate. An ordinal regression model was built to estimate the effect size, reported as odds ratio (OR) with a 95% confidence interval (CI), for achieving higher KAP scores among students features. On a scale of 0 to 29, 1702 participants achieved a median KAP score of 14 points. Higher scores were predominantly reported by students from classical High Schools (OR 3.19, 95% C.I. 1.60–6.33, p
Læs mere Tjek på PubMedRockwell, M. S., Oyese, E. G., Singh, E., Vinson, M., Yim, I., Turner, J. K., Epling, J. W.
BMJ Open, 18.04.2024
Tilføjet 18.04.2024
ObjectivesPotentially harmful non-steroidal anti-inflammatory drugs (NSAIDs) utilisation persists at undesirable rates worldwide. The purpose of this paper is to review the literature on interventions to de-implement potentially harmful NSAIDs in healthcare settings and to suggest directions for future research. DesignScoping review. Data sourcesPubMed, CINAHL, Embase, Cochrane Central and Google Scholar (1 January 2000 to 31 May 2022). Study selectionStudies reporting on the effectiveness of interventions to systematically reduce potentially harmful NSAID utilisation in healthcare settings. Data extractionUsing Covidence systematic review software, we extracted study and intervention characteristics, including the effectiveness of interventions in reducing NSAID utilisation. ResultsFrom 7818 articles initially identified, 68 were included in the review. Most studies took place in European countries (45.6%) or the USA (35.3%), with randomised controlled trial as the most common design (55.9%). Interventions were largely clinician-facing (76.2%) and delivered in primary care (60.2%) but were rarely (14.9%) guided by an implementation model, framework or theory. Academic detailing, clinical decision support or electronic medical record interventions, performance reports and pharmacist review were frequent approaches employed. NSAID use was most commonly classified as potentially harmful based on patients’ age (55.8%), history of gastrointestinal disorders (47.1%), or history of kidney disease (38.2%). Only 7.4% of interventions focused on over-the-counter (OTC) NSAIDs in addition to prescription. The majority of studies (76.2%) reported a reduction in the utilisation of potentially harmful NSAIDs. Few studies (5.9%) evaluated pain or quality of life following NSAIDs discontinuation. ConclusionMany varied interventions to de-implement potentially harmful NSAIDs have been applied in healthcare settings worldwide. Based on these findings and identified knowledge gaps, further efforts to comprehensively evaluate the effectiveness of interventions and the combination of intervention characteristics associated with effective de-implementation are needed. In addition, future work should be guided by de-implementation theory, focus on OTC NSAIDs and incorporate patient-focused strategies and outcomes, including the evaluation of unintended consequences of the intervention.
Læs mere Tjek på PubMedDirajlal-Fargo, Sahera; Yu, Wendy; Jacobson, Denise L.; Mirza, Ayesha; Geffner, Mitchell E.; Jao, Jennifer; Mccomsey, Grace A.; for the Pediatric HIV/AIDS Cohort Study (PHACS)
AIDS, 14.04.2024
Tilføjet 14.04.2024
The relationships between alterations in the intestinal barrier, and bacterial translocation with the development of metabolic complications in youth with perinatally-acquired HIV (YPHIV) have not been investigated. The PHACS Adolescent Master Protocol enrolled YPHIV across 15 U.S. sites, including Puerto Rico, from 2007-2009. For this analysis, we included YPHIV with HIV viral load ≤1000 c/mL, with at least one measurement of homeostatic assessment of insulin resistance (HOMA-IR) or non-high density lipoprotein (non-HDLc) between baseline and year 3 and plasma levels of intestinal fatty-acid binding protein (I-FABP), lipopolysaccharide binding protein (LBP), and zonulin levels at baseline. We fit linear regression models using generalized estimating equations to assess the association of baseline log10 gut markers with log10 HOMA-IR and non-HDLc at all timepoints. HOMA-IR or non-HDLc was measured in 237, 189, and 170 PHIV at baseline, Yr2, and Yr3, respectively. At baseline, median age (Q1, Q3) was 12 yrs (10, 14), CD4 count was 762 cells/mm3 (574, 984); 90% had HIV RNA
Læs mere Tjek på PubMedBMC Infectious Diseases, 13.04.2024
Tilføjet 13.04.2024
Abstract Background Tuberculosis (TB) and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) co-morbidity continues to be a serious worldwide health issue, particularly in Sub-Saharan Africa. Studies on the quality of life (QOL) of TB/HIV co-infected patients guide stakeholders on the delivery of patient-centred healthcare. This study evaluated QOL of TB/HIV co-infected individuals and its contributing factors. Methods We conducted a cross-sectional study among TB/HIV co-infected patients, receiving treatment at clinics in the Northern Region of Ghana. Simple random sampling technique was used to select 213 patients from 32 clinics. We gathered information on patients’ QOL using the World Health Organization QOL-HIV BREF assessment tool. At a 5% level of significance, multiple logistic regression analyses were carried out to find correlates of QOL among the patients. Results The mean age of the patients was (38.99 ± 14.00) years with most, 33.3% (71/213) aged 30–39 years. Males constituted 54.9% (117/213). About 30.0% (64/213) of the patients reported a good QOL. Being employed (aOR = 5.23, 95% CI: 1.87 – 14.60), and adhering to treatment (aOR = 6.36, 95% CI: 1.51 – 26.65) were significantly associated with a good QOL. Being depressed (aOR = 0.02, 95% CI: 0.03 – 0.29), stigmatized (aOR = 0.31, 95% CI : 0.11 – 0.84), and not exercising (aOR = 0.28, 95% CI: 0.12 – 0.67) were negatively associated with a good QOL. Conclusion Less than one-third of TB/HIV co-infected patients in the region have good QOL. To guarantee good QOL, modifiable predictors such as patients’ physical activity and medication adherence should be targeted by the National AIDS and TB Control Programs.
Læs mere Tjek på PubMedBMC Infectious Diseases, 12.04.2024
Tilføjet 12.04.2024
Abstract Background The world is moving towards the third target of the Joint United Nations Programme on HIV/AIDS to ensure most people receiving antiretroviral therapy (ART) are virologically suppressed. Little is known about viral suppression at an undetectable level and the risk of viral rebound phenomenon in sub-Saharan Africa which covers 67% of the global HIV burden.This study aimed to investigate the proportion of viral suppression at an undetectable level and the risk of viral rebound among people living with HIV receiving ART in northern Tanzania. Methodology A hospital based-retrospective study recruited people living with HIV who were on ART for at least two years at Kibong’oto Infectious Disease Hospital and Mawenzi Regional Referral Hospital in Kilimanjaro Region, Tanzania. Participants’ two-year plasma HIV were captured at months 6, 12, and 24 of ART. Undetectable viral load was defined by plasma HIV of viral load (VL) less than 20copies/ml and viral rebound (VR) was considered to anyone having VL of more than 50 copies/ml after having history of undetectable level of the VL less than 20copies/ml. A multivariable log-binomial generalized linear model was used to determine factors for undetectable VL and viral VR. Results Among 416 PLHIV recruited, 226 (54.3%) were female. The mean (standard deviation) age was 43.7 (13.3) years. The overall proportion of undetectable VL was 68% (95% CI: 63.3–72.3) and 40.0% had viral rebound (95% CI: 34.7–45.6). Participants who had at least 3 clinic visits were 1.3 times more likely to have undetectable VL compared to those who had 1 to 2 clinic visits in a year (p = 0.029). Similarly, participants with many clinical visits ( > = 3 visits) per year were less likely to have VR compared to those with fewer visits ( = 2 visits) [adjusted relative risk (aRR) = 0.64; 95% CI: 0.44–0.93]. Conclusion Participants who had fewer clinic visits per year(ART refills) were less likely to achieve viral suppression and more likely to experience viral rebound. Enhanced health education and close follow-up of PLHIV on antiretroviral therapy are crucial to reinforce adherence and maintain an undetectable viral load.
Læs mere Tjek på PubMedBing Li, Chao Wen, Shenglan Yang, Mingzhao Ma, Jie Cheng, Wenxin Li
PLoS One Infectious Diseases, 10.04.2024
Tilføjet 10.04.2024
by Bing Li, Chao Wen, Shenglan Yang, Mingzhao Ma, Jie Cheng, Wenxin Li This paper focuses on optimizing the management of delayed trains in operational scenarios by scientifically categorizing train delay levels. It employs static and dynamic models grounded in real-world train delay data from high-speed railways. This classification aids dispatchers in swiftly identifying and predicting delay extents, thus enhancing mitigation strategies’ efficiency. Key indicators, encompassing initial delay duration, station impacts, average station delay, delayed trains’ cascading effects, and average delay per affected train, inform the classification. Applying the K-means clustering algorithm to standardized delay indicators yields an optimized categorization of delayed trains into four levels, reflecting varying risk levels. This static classification offers a comprehensive overview of delay dynamics. Furthermore, utilizing Markov chains, the study delves into sequential dynamic analyses, accounting for China’s railway context and specifically addressing fluctuations during the Spring Festival travel rush. This research, combining static and dynamic approaches, provides valuable insights for bolstering railway operational efficiency and resilience amidst diverse delay scenarios.
Læs mere Tjek på PubMedAlhassan, J. A. K., Wills, O.
BMJ Open, 6.04.2024
Tilføjet 6.04.2024
BackgroundThe last 3 years have witnessed global health challenges, ranging from the pandemics of COVID-19 and mpox (monkeypox) to the Ebola epidemic in Uganda. Public health surveillance is critical for preventing these outbreaks, yet surveillance systems in resource-constrained contexts struggle to provide timely disease reporting. Although community health workers (CHWs) support health systems in low-income and middle-income countries (LMICs), very little has been written about their role in supporting public health surveillance. This review identified the roles, impacts and challenges CHWs face in public health surveillance in 25 LMICs. MethodsWe conducted a scoping review guided by Arksey and O’Malley’s framework. We exported 1,156 peer-reviewed records from Embase, Global Health and PubMed databases. After multiple screenings, 29 articles were included in the final review. ResultsCHWs significantly contribute to public health surveillance in LMICs including through contact tracing and patient visitation to control major infectious diseases such as HIV/AIDS, malaria, tuberculosis, Ebola, neglected tropical diseases and COVID-19. Their public health surveillance roles typically fall into four main categories including community engagement; data gathering; screening, testing and treating; and health education and promotion. The use of CHWs in public health surveillance in LMICs has been impactful and often involves incorporation of various technologies leading to improved epidemic control and disease reporting. Nonetheless, use of CHWs can come with four main challenges including lack of education and training, lack of financial and other resources, logistical and infrastructural challenges as well as community engagement challenges. ConclusionCHWs are important stakeholders in surveillance because they are closer to communities than other healthcare workers. Further integration and training of CHWs in public health surveillance would improve public health surveillance because CHWs can provide health data on ‘hard-to-reach’ populations. CHWs’ work in public health surveillance would also be greatly enhanced by infrastructural investments.
Læs mere Tjek på PubMedMonower, M. M., Abid, S. U. A., Abrar, A. K., Choudhury, S. R.
BMJ Open, 5.04.2024
Tilføjet 5.04.2024
ObjectivesThis study aimed to examine the distribution of daily salt intake across the hypertension care cascade and assess the proportional distribution of these care cascade categories across various salt consumption level. DesignA population-based national cross-sectional study. SettingsData from the Bangladesh STEPS 2018 survey were used, encompassing both urban and rural strata within all eight divisions. National estimates were generated from weighted data. ParticipantsA diverse population of 6754 men and women aged 18–69 years was included in the study. Outcome measuresDaily salt consumption was estimated using the spot urine sodium concentration following Tanaka equation. Distribution of salt intake among different categories of hypertension care cascade, including hypertensives, aware of hypertension status, on treatment and under control, was assessed. ResultsIndividuals with hypertension consume more salt on average (9.18 g/day, 95% CI 9.02 to 9.33) than those without hypertension (8.95 g/day, 95% CI 8.84 to 9.05) (p
Læs mere Tjek på PubMedThe Lancet
Lancet, 5.04.2024
Tilføjet 5.04.2024
The theme of World Health Day on April 7 is ‘my health, my right’, underscoring the UN\'s assertion that “every human being is entitled to the enjoyment of the highest attainable standard of health conducive to living a life in dignity”. In this week\'s issue, the report from Under threat: the International AIDS Society–Lancet Commission on Health and Human Rights examines the steady deterioration of the global commitment to human rights in the 21st century, with serious and increasingly damaging effects on health.
Læs mere Tjek på PubMedChris Beyrer, Adeeba Kamarulzaman, Michael Isbell, Joseph Amon, Stefan Baral, Mary T Bassett, Javier Cepeda, Harriet Deacon, Lorraine Dean, Lilianne Fan, Rita Giacaman, Carolyn Gomes, Sofia Gruskin, Ravi Goyal, Sandra Hsu Hnin Mon, Samer Jabbour, Michel Kazatchkine, Kasoka Kasoka, Carrie Lyons, Allan Maleche, Natasha Martin, Martin McKee, Vera Paiva, Lucy Platt, Dainius Puras, Robert Schooley, Gerson Smoger, Lucy Stackpool-Moore, Peter Vickerman, Josephine G Walker, Leonard Rubenstein
Lancet, 5.04.2024
Tilføjet 5.04.2024
2023 marked the 75th anniversary of the UN\'s Universal Declaration of Human Rights. The Universal Declaration articulates an inspiring vision of a world that is just, equitable, tolerant, and strategically focused on actions to address the most vulnerable and marginalised populations—a counterpoint to the atrocities, repression, and colonialism that characterised much of the 20th century. Endorsement of the Universal Declaration was not commensurate with reality in many cases—especially because numerous signatories still had colonies and because Cold War politics resulted in divisions of social, economic, and political rights into separate international covenants—but it nevertheless inspired decades of progress.
Læs mere Tjek på PubMedHaw, Nel Jason L.; Lesko, Catherine R.; Ng, Derek K.; Lam, Jennifer; Lang, Raynell; Kitahata, Mari M.; Crane, Heidi; Eron, Joseph Jr.; Gill, M. John; Horberg, Michael A.; Karris, Maile; Loutfy, Mona; Mcginnis, Kathleen A.; Moore, Richard D.; Althoff, Keri; Agwu, Allison; North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD)∗
AIDS, 30.03.2024
Tilføjet 30.03.2024
Objective: To describe the incidence of diabetes mellitus type 2 (T2DM), hypercholesterolemia, hypertriglyceridemia, hypertension, and chronic kidney disease (CKD) from 2000 to 2019 among North American adults with perinatally-acquired HIV (PHIV) aged 18 to 30 Design: Description of outcomes based on electronic health records for a cohort of 375 young adults with PHIV enrolled in routine HIV care at clinics contributing data to the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) Methods: We estimated overall, sex-, and race-stratified cumulative incidences using Turnbull estimation, and incidence rates using quasi-Poisson regression. T2DM was defined as glycosylated hemoglobin >6.5% or based on clinical diagnosis and medication use. Hypercholesterolemia was based on medication use or total cholesterol ≥200 mg/dL. Hypertriglyceridemia was based on medication use or fasting triglyceride ≥150 mg/dL or non-fasting ≥200 mg/dL. Hypertension was based on clinical diagnosis. CKD was defined as estimated glomerular filtration rates
Læs mere Tjek på PubMed