Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 1.452
Filter
1.
HIV Nursing ; 22(1):1-4, 2022.
Article in English | Scopus | ID: covidwho-1965083

ABSTRACT

Background: Acute HIV cases have doubled during the COVID-19 pandemic. We implemented a quality improvement (Ql) project to standardize PrEP telehealth at a large metropolitan medical center in a HIV hotspot to ensure PrEP access and uptake. Methods: A 2-arm recruitment approach was implemented from August 31st, 2020-December 16th, 2020 targeting (1) patients through weekly social medial outreach and (2) providers in high-volume departments through educational in-services and dedicated chart reviews. Results: Provider referrals from the Emergency and Primary Care Departments increased 460% (p=0.03). PrEP users shifted to a majority<35 years old (n=12, 38.7%), but remained mostly Black (n=16, discontinuation during the pandemic. The low percentage of PrEP users may be related to COVID-19 on clinic follow-up. The younger demographic shift may translate to a larger decrease in HIV transmission given the relative risk of different cohorts. © 2022, ResearchTrentz Academy Publishing Education Services. All rights reserved.

2.
Clinical and Experimental Morphology ; 11(2):71-77, 2022.
Article in Russian | Scopus | ID: covidwho-1965059

ABSTRACT

The COVID-19 pandemic is now a global medical and social problem. Little is known about COVID-19 impact on some vulnerable subgroups, such as immunocompromised patients. Therefore, scientists worldwide show interest in studying the impact of SARS-CoV-2 infection on HIV-positive individuals. We report an autopsy clinical case of a deceased 60-year-old HIV-infected patient with lung damage caused by a combination of the SARS-CoV-2 virus, human herpesvirus 6, cytomegalovirus, and pneumocystis with severe fatal respiratory failure. © 2022, MDV Group. All rights reserved.

3.
Journal of Pre-Clinical and Clinical Research ; 16(2):42-44, 2022.
Article in English | ProQuest Central | ID: covidwho-1965013

ABSTRACT

Introduction: The AIDS disease epidemic is still a global problem. To date, finding the connection between HIV and SARSCoV-2 infection is very significant. Case Report: A 51-year-old woman was admitted to the Neurology Department due to neurological symptoms lasting for 1.5 months. Imaging examinations of the CNS, chest CT and cerebrospinal fluid examination revealed significant abnormalities. Tests for HIV and SARS-CoV-2 were both positive. Klebsiella pneumoniae ESBL+ was detected in rectal swab as well as findings of Candida antigens and antibodies of Cryptococcus neoformans mycosis in serum. Due to these results, appropriate treatment was implemented but with with a time delay which resulted in the death of the patient. Conclusions: HIV infection may be associated with an increased risk of severe SARS-CoV-2 infection causing an increase in mortality rate during the COVID-19 pandemic. Confirmation and early detection of HIV infection permits early and accurate diagnosis and faster treatment decisions.

4.
Frontiers in Neuroscience ; 2022.
Article in English | ProQuest Central | ID: covidwho-1963499

ABSTRACT

Background: Recent studies have reported that pulmo-neurotropic viruses can cause systemic invasion leading to acute respiratory failure and neuroinfection. The tetracycline class of secondary metabolites of microorganisms are effective against several migrating neurotropic viral disorders, as Japanese-Encephalitis (JE), Severe-Acute-Respiratory-Syndrome Coronavirus-2 (SARS-CoV-2), Human-Immunodeficiency-Virus (HIV), and Simian-Immunodeficiency-Virus (SIV). Another microbial secondary metabolite, cephalosporin, can be used for anti-viral combination therapy. However, a substantial public health debacle is viral resistance to such antibiotics and thus one needs to explore the antiviral efficiency of other secondary metabolites, as phytochemicals. Hence, here we investigate phytochemicals like podophyllotoxin, chlorogenic acid, naringenin, and quercetin, for therapeutic efficiency in neurotropic viral infections. Methods: To investigate the possibility of afferent neural pathways of migrating viruses in man, MRI scanning was performed on human subjects, whereby the connections between cranial nerves and brain-stem/limbic-region were assessed by fiber-tractography. Moreover, human clinical-trial assessment (n=140, p=0.028) was done for formulating a quantitative model of antiviral pharmacological intervention. Furthermore, docking-studies were performed to identify the binding affinity of phytochemicals towards antiviral targets as (i) host receptor [Angiotensin-converting Enzyme-2], (ii) main protease of SARS-CoV-2 virus (iii) NS3-Helicase/Nucleoside triphosphatase of Japanese-encephalitis-virus, and the affinities were compared to standard tetracycline and cephalosporin antibiotics. Then, network pharmacology analysis was utilized to identify the possible mechanism of action of those phytochemicals. Results: Human MRI-tractography analysis showed fiber connectivity, as (a) Path-1: From olfactory nerve to the limbic region (2) Path-2: From peripheral glossopharyngeal nerve and vagus nerves to midbrain-respiratory-center. Docking-studies revealed comparable binding affinity of phytochemicals, tetracycline, and cephalosporin antibiotics towards both (a) virus receptors, (b) host-cell receptors where virus-receptor binds. The phytochemicals effectively countered the cytokine storm-induced neuroinflammation, a critical pathogenic pathway. We also found that a systems-biology based double-hit mathematical bi-exponential model accounts for patient survival-curve under antiviral treatment, thus furnishing a quantitative-clinical-framework of secondary metabolite action on virus and host cells. Conclusion: Due to the current viral resistance to antibiotics, we identified novel phytochemicals that can have clinical therapeutic application to neurotropic virus infection. Based on human MRI-scanning and clinical-trial analysis, we demarcated the anatomical pathway and systems-biology-based quantitative formulation of the mechanism of antiviral action.

5.
Cent Eur J Public Health ; 30(2): 107-110, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1964911

ABSTRACT

The aim of this paper is to introduce the digitalization process and its effects on better reach of the target population. Progress in the digitalization and e-health tools worldwide enables new opportunities in prevention, diagnostics and treatment for people living with HIV (PLHIV) and people in the risk of HIV infection, hepatitis C (HCV) and other sexually transmitted infections (STIs), especially in the context of the COVID-19 pandemic. The system already used for voluntary counselling and testing (VCT) at the CheckPoint Centre Zagreb run by the non-governmental organization (NGO) Croatian Association for HIV and Viral Hepatitis (CAHIV) was upgraded and adapted (due to the COVID-19 prevention epidemiological measures) and developed for implementation of the pilot project of feasibility and acceptability of home HIV self-testing (HIVST) among men who have sex with men (MSM) in Zagreb. A special feature of the HIVST mobile application enables an innovative approach in collecting clients' test result feedback. This paper presents the method of use digitalization of the VCT and HIVST activities to support and increase availability of screening testing. Described procedures of new technologies application in VCT services and preliminary results of the HIVST pilot project indicate that technology-delivered interventions can contribute and improve access and utilisation of HIV/STI prevention and care services.


Subject(s)
COVID-19 , HIV Infections , Hepatitis C , Sexual and Gender Minorities , Sexually Transmitted Diseases , Counseling , Croatia/epidemiology , Digital Technology , HIV Infections/diagnosis , HIV Infections/epidemiology , HIV Infections/prevention & control , Hepacivirus , Hepatitis C/diagnosis , Hepatitis C/epidemiology , Hepatitis C/prevention & control , Homosexuality, Male , Humans , Male , Pandemics , Pilot Projects , Sexually Transmitted Diseases/diagnosis , Sexually Transmitted Diseases/epidemiology , Sexually Transmitted Diseases/prevention & control
6.
Elife ; 112022 Jul 26.
Article in English | MEDLINE | ID: covidwho-1964557

ABSTRACT

In some instances, unsuppressed HIV has been associated with severe COVID-19 disease, but the mechanisms underpinning this susceptibility are still unclear. Here, we assessed the impact of HIV infection on the quality and epitope specificity of SARS-CoV-2 T cell responses in the first wave and second wave of the COVID-19 epidemic in South Africa. Flow cytometry was used to measure T cell responses following peripheral blood mononuclear cell stimulation with SARS-CoV-2 peptide pools. Culture expansion was used to determine T cell immunodominance hierarchies and to assess potential SARS-CoV-2 escape from T cell recognition. HIV-seronegative individuals had significantly greater CD4+ T cell responses against the Spike protein compared to the viremic people living with HIV (PLWH). Absolute CD4 count correlated positively with SARS-CoV-2-specific CD4+ and CD8+ T cell responses (CD4 r=0.5, p=0.03; CD8 r=0.5, p=0.001), whereas T cell activation was negatively correlated with CD4+ T cell responses (CD4 r=-0.7, p=0.04). There was diminished T cell cross-recognition between the two waves, which was more pronounced in individuals with unsuppressed HIV infection. Importantly, we identify four mutations in the Beta variant that resulted in abrogation of T cell recognition. Taken together, we show that unsuppressed HIV infection markedly impairs T cell responses to SARS-Cov-2 infection and diminishes T cell cross-recognition. These findings may partly explain the increased susceptibility of PLWH to severe COVID-19 and also highlights their vulnerability to emerging SARS-CoV-2 variants of concern.

7.
Int J Environ Res Public Health ; 19(13)2022 Jun 21.
Article in English | MEDLINE | ID: covidwho-1963979

ABSTRACT

INTRODUCTION: The COVID-19 pandemic has been challenging time for medical care, especially in the field of infectious diseases (ID), but it has also provided an opportunity to introduce new solutions in HIV management. Here, we investigated the changes in HIV service provision across Central and Eastern European (CEE) countries before and after the COVID-19 outbreak. METHODS: The Euroguidelines in Central and Eastern Europe Network Group consists of experts in the field of ID from 24 countries within the CEE region. Between 11 September and 29 September 2021, the group produced an on-line survey, consisting of 32 questions on models of care among HIV clinics before and after the SARS-CoV-2 outbreak. RESULTS: Twenty-three HIV centers from 19 countries (79.2% of all countries invited) participated in the survey. In 69.5% of the countries, there were more than four HIV centers, in three countries there were four centers (21%), and in four countries there was only one HIV center in each country. HIV care was based in ID hospitals plus out-patient clinics (52%), was centralized in big cities (52%), and was publicly financed (96%). Integrated services were available in 21 clinics (91%) with access to specialists other than ID, including psychologists in 71.5% of the centers, psychiatrists in 43%, gynecologists in 47.5%, dermatologists in 52.5%, and social workers in 62% of all clinics. Patient-centered care was provided in 17 centers (74%), allowing consultations and tests to be planned for the same day. Telehealth tools were used in 11 centers (47%) before the COVID-19 pandemic outbreak, and in 18 (78%) after (p = 0.36), but were represented mostly by consultations over the telephone or via e-mail. After the COVID-19 outbreak, telehealth was introduced as a new medical tool in nine centers (39%). In five centers (28%), no new services or tools were introduced. CONCLUSIONS: As a consequence of the COVID-19 pandemic, tools such as telehealth have become popularized in CEE countries, challenging the traditional approach to HIV care. These implications need to be further evaluated in order to ascertain the best adaptations, especially for HIV medicine.


Subject(s)
COVID-19 , HIV Infections , COVID-19/epidemiology , COVID-19/therapy , Europe/epidemiology , Europe, Eastern/epidemiology , HIV Infections/epidemiology , HIV Infections/therapy , Humans , Pandemics , SARS-CoV-2
8.
Afr J AIDS Res ; 21(2): 201-206, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1963331

ABSTRACT

Initial and subsequent waves of COVID-19 in Uganda disrupted the delivery of HIV care. In rural areas, village health teams and organisations on the ground had to develop strategies to ensure that people living with HIV could continue their treatment. It was necessary to take evolving circumstances into account, including dealing with movement restrictions, constrained access to food and stigma due to anonymity being lost as a result of a shift from health facility-based services to community-level support. Uganda has a long history of community-driven response to HIV, although health systems and response programming have become more centralised through government and donors to address political commitments to HIV treatment and other targets. The delivery system for antiretroviral therapy was vulnerable to the impacts of COVID-19 restrictions and related circumstances. To understand the continuum of challenges, and to inform ongoing and future support of treatment for people living with HIV, interviews were conducted with HIV organisation implementers, health workers, village health team members and people living with HIV. It was found that stigma was a central challenge, which led to nuanced adaptations for delivering antiretroviral treatment. There is a need to strengthen support to households of people living with HIV through improving community capacity to manage crises through improving household food gardens and savings, as well as capacity to organise and interact with support systems such as the village health teams. In communities, there is a need to evoke dialogue on stigma and to support community leadership on pressing issues that affect communities as a whole and their vulnerable groups. There are opportunities to reawaken the grassroots civic response systems that were evident in Uganda's early response to HIV yet were lacking in the COVID-19 context.


Subject(s)
COVID-19 , HIV Infections , COVID-19/drug therapy , Community Health Workers , HIV Infections/drug therapy , HIV Infections/epidemiology , Humans , Social Stigma , Uganda/epidemiology
9.
Afr J AIDS Res ; 21(2): 183-193, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1963328

ABSTRACT

This study focuses on female sex workers as a key population group that suffers a degree of vulnerability according to the World Health Organisation (WHO). Key populations refer to people at heightened risk of contracting the human immunodeficiency virus (HIV) due to specific behaviours and social and legal environments which increase their vulnerability to the virus. Key populations are disproportionately affected by HIV, yet they have less access to HIV services compared to the general population. The coronavirus (COVID-19) lockdown and its restrictive measures have further widened the inequalities and gaps in accessing HIV services for this group. A descriptive phenomenological study was undertaken to explore female sex workers' experiences of utilisation of HIV services during COVID-19. The study setting was the Bulawayo Metropolitan Province, Zimbabwe. Data were collected through in-depth individual interviews with 10 female sex workers. Purposive sampling coupled with snowballing was utilised for recruiting participants. Data were analysed guided by the seven-step Colaizzi technique. Rigour was ensured through adhering to Lincoln and Guba's trustworthiness criteria. The study found that the COVID-19 pandemic adversely affected the livelihoods of sex workers and their utilisation of HIV services. There was limited access to HIV services due to an initial lack of travel authorisation letters and financial challenges experienced by study participants. In addition, the quality of care in health care facilities was further compromised by poor screening processes and reduced provider-client interactions. Maintaining access to HIV services for female sex workers during pandemics is critical for the country to attain HIV epidemic control.


Subject(s)
COVID-19 , HIV Infections , Sex Workers , COVID-19/epidemiology , Communicable Disease Control , Female , HIV Infections/prevention & control , Humans , Pandemics , Zimbabwe/epidemiology
10.
Afr J AIDS Res ; 21(2): 162-170, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1963327

ABSTRACT

Background: The impact of school closures due to COVID-19 raised widespread concerns about children's health and well-being. We examine the impact on the sexual health needs of learners in the context of COVID-19 related lockdowns in rural KwaZulu-Natal, South Africa.Methods: In july-November 2020 and August-November 2021 we conducted 24 in-depth interviews and 8 group discussions with teachers and learners from 4 schools, community members and key education stakeholders. All interviews were conducted by telephone. We used a thematic analysis approach and Nvivo 12 software to manage the data.Results: Four main themes related to the COVID-19 pandemic emerged from the data: the sexual and reproductive health (SRH) of learners in the lead-up to the pandemic; the impact of COVID-19 on learners' SRH and wellbeing; the opportunities schools provided to support sexual well-being of learners during the pandemic; and the role of schools in supporting SRH for learners during the pandemic. Learners and stakeholders reported that the SRH of young people was affected by alcohol misuse, poor SRH knowledge and few pathways to link learners with services. Stakeholders working with schools reported that a lack of access to biomedical interventions (e.g., contraception) increased learner pregnancies. Gender-based violence in learners' households was reported to have increased during the COVID-19 pandemic related to loss of income. School closures disrupted the provision of a safe space to provide SRH and HIV-education through Life Orientation lessons and school nurse talks. This loss of a safe space also left learners vulnerable to sexual and physical violence. However, once schools re-opened, daily COVID-19 screening in schools provided the opportunity to identify and support vulnerable children who had other social needs (food and uniforms).Conclusion: The COVID-19 pandemic may have increased SRH needs and vulnerability of school-going children in a high HIV-burden rural setting. School shutdowns reduced the opportunity for schools to provide a vital safe space and information to enhance SRH for adolescents. Schools play a vital health promotion and social protection role.


Subject(s)
COVID-19 , HIV Infections , Sexual Health , Adolescent , COVID-19/epidemiology , Child , Communicable Disease Control , Female , HIV Infections/epidemiology , Humans , Pandemics , Pregnancy , Reproductive Health , Sexual Behavior , Sexual Health/education , South Africa/epidemiology
11.
Afr J AIDS Res ; 21(2): 207-212, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1963326

ABSTRACT

Introduction: Globally, control measures have been communicated to reverse the COVID-19 pandemic. In Uganda, as soon as the first case of COVID-19 was identified, strict lockdown measures were enforced, including a ban on all public and private transport, night curfew, closure of schools, and suspension of religious and social gatherings and closure of non-essential shops and markets. These measures affected access to health services, which could have been worse for older people living with HIV (PLHIV). In this study, we explored how COVID-19 affected the health and social life of older PLHIV.Methods: We conducted a qualitative study in HIV clinics of two hospitals in Uganda. We completed 40 in-depth interviews with adults above 50 years who had lived with HIV for more than 10 years. The interviews explored the effect of COVID-19 on their health and social life during the lockdown. We analysed data thematically.Results: The overarching themes regarding the effects of COVID-19 on older adults living with HIV were fear and anxiety during the lockdown, lack of access to health care leading to missing HIV clinic appointments and not taking their ART medicines, financial burden, loss of loved ones, and effect on children's education. Some patients overcame health-related challenges by sending motorcycles to their health facilities with their identifying documents to get the medicines refilled. Some health care providers took the ART medicines to their patients' homes.Conclusion: The COVID-19 lockdown negatively affected the health and social well-being of older PLHIV. This calls for strategies to improve HIV care and treatment access during the lockdown to sustain the HIV program gains in this vulnerable population.


Subject(s)
COVID-19 , HIV Infections , Ambulatory Care Facilities , COVID-19/epidemiology , Communicable Disease Control , Developing Countries , HIV Infections/epidemiology , HIV Infections/therapy , Humans , Middle Aged , Pandemics
12.
Afr J AIDS Res ; 21(2): 100-109, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1963324

ABSTRACT

In 2020 the Global Fund for AIDS, Tuberculosis and Malaria initiated a new funding modality, the COVID-19 Response Mechanism, to mitigate the pandemic's effects on HIV, TB and malaria programmes and health systems in implementer countries. In 2021 UNAIDS introduced an innovative technical virtual support mechanism for COVID-19 Response Mechanism proposal development to help countries quickly implement COVID-19 interventions while at the same time adapting HIV and related services to the pandemic's circumstances and mitigate its impact while maintaining hard-won gains. It also intended to ensure more attention was paid to communities, human rights and gender considerations in proposal development, resulting in successful proposals to mitigate COVID-19's impact, bring human rights-based and people-centred HIV programmes back on track and even expand their reach through using new delivery platforms. In 2021, applications from 18 sub-Saharan African and Asian countries received in-depth remote peer reviews. We discuss the reviews' key findings and recommendations to improve proposal quality and identify future opportunities for virtual technical support. The model was successful and contributed to better quality funding applications, but also highlighted challenges in pandemic mitigation, adaptations and innovations of HIV programmes. Countries still fell short on comprehensive community, human rights and gender interventions, as well as innovations in HIV service delivery, especially in prevention and gender-based violence. Several other weaknesses meant that some countries would have to refine their programme design and implementation model in the final version of their funding application. There are implications for future assistance to countries trying to mitigate the impact of COVID-19 on their health programmes and innovative ways to deliver technical support using new technologies and local expertise.


Subject(s)
COVID-19 , Financial Management , HIV Infections , Malaria , Tuberculosis , COVID-19/epidemiology , COVID-19/prevention & control , HIV Infections/epidemiology , HIV Infections/prevention & control , Humans , Tuberculosis/prevention & control
13.
Euro Surveill ; 27(29)2022 Jul.
Article in English | MEDLINE | ID: covidwho-1963320

ABSTRACT

Technical advances in diagnostic techniques have permitted the possibility of multi-disease-based approaches for diagnosis and treatment monitoring of several infectious diseases, including tuberculosis (TB), human immunodeficiency virus (HIV), viral hepatitis and sexually transmitted infections (STI). However, in many countries, diagnosis and monitoring, as well as disease response programs, still operate as vertical systems, potentially causing delay in diagnosis and burden to patients and preventing the optimal use of available resources. With countries facing both human and financial resource constraints, during the COVID-19 pandemic even more than before, it is important that available resources are used as efficiently as possible, potential synergies are leveraged to maximise benefit for patients, continued provision of essential health services is ensured. For the infectious diseases, TB, HIV, hepatitis C (HCV) and STI, sharing devices and integrated services starting with rapid, quality-assured, and complete diagnostic services is beneficial for the continued development of adequate, efficient and effective treatment strategies. Here we explore the current and future potential (as well as some concerns), importance, implications and necessary implementation steps for the use of platforms for multi-disease testing for TB, HIV, HCV, STI and potentially other infectious diseases, including emerging pathogens, using the example of the COVID-19 pandemic.


Subject(s)
COVID-19 , HIV Infections , Hepatitis C , Sexually Transmitted Diseases , Tuberculosis , HIV Infections/epidemiology , Hepatitis C/diagnosis , Hepatitis C/epidemiology , Humans , Pandemics , Sexually Transmitted Diseases/diagnosis , Sexually Transmitted Diseases/epidemiology , Sexually Transmitted Diseases/prevention & control , Tuberculosis/diagnosis , Tuberculosis/epidemiology , World Health Organization
14.
BMC Infect Dis ; 22(1): 559, 2022 Jun 20.
Article in English | MEDLINE | ID: covidwho-1962757

ABSTRACT

BACKGROUND: There is still a paucity of evidence on the outcomes of coronavirus disease 2019 (COVID-19) among people living with human immunodeficiency virus (PWH) and those co-infected with tuberculosis (TB), particularly in areas where these conditions are common. We describe the clinical features, laboratory findings and outcome of hospitalised PWH and human immunodeficiency virus (HIV)-uninfected COVID-19 patients as well as those co-infected with tuberculosis (TB). METHODS: We conducted a multicentre cohort study across three hospitals in Cape Town, South Africa. All adults requiring hospitalisation with confirmed COVID-19 pneumonia from March to July 2020 were analysed. RESULTS: PWH comprised 270 (19%) of 1434 admissions. There were 47 patients with active tuberculosis (3.3%), of whom 29 (62%) were PWH. Three-hundred and seventy-three patients (26%) died. The mortality in PWH (n = 71, 26%) and HIV-uninfected patients (n = 296, 25%) was comparable. In patients with TB, PWH had a higher mortality than HIV-uninfected patients (n = 11, 38% vs n = 3, 20%; p = 0.001). In multivariable survival analysis a higher risk of death was associated with older age (Adjusted Hazard Ratio (AHR) 1.03 95%CI 1.02-1.03, p < 0.001), male sex (AHR1.38 (95%CI 1.12-1.72, p = 0.003) and being "overweight or obese" (AHR 1.30 95%CI 1.03-1.61 p = 0.024). HIV (AHR 1.28 95%CI 0.95-1.72, p 0.11) and active TB (AHR 1.50 95%CI 0.84-2.67, p = 0.17) were not independently associated with increased risk of COVID-19 death. Risk factors for inpatient mortality in PWH included CD4 cell count < 200 cells/mm3, higher admission oxygen requirements, absolute white cell counts, neutrophil/lymphocyte ratios, C-reactive protein, and creatinine levels. CONCLUSION: In a population with high prevalence of HIV and TB, being overweight/obese was associated with increased risk of mortality in COVID-19 hospital admissions, emphasising the need for public health interventions in this patient population.


Subject(s)
COVID-19 , HIV Infections , Tuberculosis , Adult , COVID-19/epidemiology , Cohort Studies , HIV Infections/complications , HIV Infections/epidemiology , Hospitalization , Humans , Male , Obesity/complications , Overweight , Prevalence , South Africa/epidemiology , Tuberculosis/complications , Tuberculosis/epidemiology
15.
BMJ Open ; 12(7): e060079, 2022 07 20.
Article in English | MEDLINE | ID: covidwho-1962291

ABSTRACT

OBJECTIVE: To assess the impact of an interprofessional case-based training programme to enhance clinical knowledge and confidence among clinicians working in high HIV-burden settings in sub-Saharan Africa (SSA). SETTING: Health professions training institutions and their affiliated clinical training sites in 12 high HIV-burden countries in SSA. PARTICIPANTS: Cohort comprising preservice and in-service learners, from diverse health professions, engaged in HIV service delivery. INTERVENTION: A standardised, interprofessional, case-based curriculum designed to enhance HIV clinical competency, implemented between October 2019 and April 2020. MAIN OUTCOME MEASURES: The primary outcomes measured were knowledge and clinical confidence related to topics addressed in the curriculum. These outcomes were assessed using a standardised online assessment, completed before and after course completion. A secondary outcome was knowledge retention at least 6 months postintervention, measured using the same standardised assessment, 6 months after training completion. We also sought to determine what lessons could be learnt from this training programme to inform interprofessional training in other contexts. RESULTS: Data from 3027 learners were collected: together nurses (n=1145, 37.9%) and physicians (n=902, 29.8%) constituted the majority of participants; 58.1% were preservice learners (n=1755) and 24.1% (n=727) had graduated from training within the prior year. Knowledge scores were significantly higher, postparticipation compared with preparticipation, across all content domains, regardless of training level and cadre (all p<0.05). Among 188 learners (6.2%) who retook the test at >6 months, knowledge and self-reported confidence scores were greater compared with precourse scores (all p<0.05). CONCLUSION: To our knowledge, this is the largest interprofessional, multicountry training programme established to improve HIV knowledge and clinical confidence among healthcare professional workers in SSA. The findings are notable given the size and geographical reach and demonstration of sustained confidence and knowledge retention post course completion. The findings highlight the utility of interprofessional approaches to enhance clinical training in SSA.


Subject(s)
Curriculum , HIV Infections , Clinical Competence , Cohort Studies , HIV Infections/therapy , Health Personnel/education , Humans
16.
J Law Med Ethics ; 50(S1): 29-31, 2022.
Article in English | MEDLINE | ID: covidwho-1960155

ABSTRACT

The complexity and inefficiency of the U.S. health care system complicates the distribution of life-saving medical technologies. When the public health is at stake, however, there are alternatives. The proposal for a national PrEP program published in this issue of the Journal applies some of the lessons of the national COVID vaccine campaign to HIV prevention. In doing so, it draws on other examples of public health approaches to the financing of medical technology, from vaccines for children to hepatitis C treatment.


Subject(s)
COVID-19 , HIV Infections , Vaccines , COVID-19/prevention & control , COVID-19 Vaccines , Child , HIV Infections/prevention & control , Humans , Pharmaceutical Preparations
18.
Issues in Science and Technology ; 38(4):39-44, 2022.
Article in English | ProQuest Central | ID: covidwho-1958458

ABSTRACT

Decades before the COVID-19 pandemic demonstrated how rapidly infectious diseases could emerge and spread, the world faced the AIDS epidemic. Initial efforts to halt the contagion were slow as researchers focused on understanding the epidemiology of the virus. It was only by integrating epidemiological theory with behavioral theory that successful interventions began to control the spread of HIV. As the current pandemic persists, it is clear that similar applications of interdisciplinary theory are needed to inform decisions, interventions, and policy. Continued infections and the emergence of new variants are the result of complex interactions among evolution, human behavior, and shifting policies across space and over time. Due to this complexity, predictions about the pandemic based on data and statistical models alone--in the absence of any broader conceptual framework--have proven inadequate. Classical epidemiological theory has helped, but alone it has also led to limited success in anticipating surges in COVID-19 infections. Integrating evolutionary theory with data and other theories has revealed more about how and under what conditions new variants arise, improving such predictions.

19.
Infection ; 2022 Jul 27.
Article in English | MEDLINE | ID: covidwho-1959190

ABSTRACT

PURPOSE: Immunocompromised patients are postulated to be at elevated risk of unfavorable outcomes of COVID-19. The exact effect of HIV infection on the course of COVID-19 remains to be elucidated. The aim of the study was to describe the epidemiological and clinical aspects of SARS-CoV-2 infection in HIV-infected individuals. METHODS: The HIV-positive patients who were diagnosed with SARS-CoV-2 infection were identified through thirteen specialist HIV clinics routinely following them due to HIV treatment. The data were collected between November 2020 and May 2021 through an on-line electronical case report form (SurveyMonkey®). The collected information included demographics, lifestyle, comorbidities, HIV care history, COVID-19 clinical course and treatment. Logistic regression models were used to identify factors associated with the odds of death or hospitalization due to COVID-19. RESULTS: One hundred and seventy-three patients with HIV-SARS-CoV-2 coinfection were included in the analysis. One hundred and sixty-one (93.1%) subjects had a symptomatic course of the disease. Thirty-nine (23.1%) of them were hospitalized, 23 (13.3%) necessitated oxygen therapy. Three (1.8%) patients required admission to the intensive care unit and 6 (3.5%) patients died. The presence of comorbidities and an HIV viral load of more than 50 copies/mL were linked to the increased odds of hospitalization (OR 3.24 [95% CI 1.27-8.28]) and OR 5.12 [95% CI 1.35-19.6], respectively). CONCLUSIONS: As depicted by our analyses, HIV-positive patients with comorbidities and/or uncontrolled HIV replication who are diagnosed with SARS-CoV-2 infection should be considered of high risk of poor COVID-19 outcome and followed up carefully.

20.
Biometals ; 35(4): 639-652, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1959020

ABSTRACT

The first appearance of SARS-CoV-2 is dated back to 2019. This new member of the coronavirus family has caused more than 5 million deaths worldwide up until the end of January 2022. At the moment, and after intensive vaccination programmes throughout the world, the pandemic is still active, whilst new mutations constantly appear. Researchers are working intensively to discover antiviral drugs to combat the severe cases in intensive care units, giving the overloaded hospital units a breather. Alongside various research projects focusing on developing small pharmaceutical molecules, a significant proportion of the research community has shifted towards paying attention to metal drugs. In this small review, we make brief reference to the use of metal drugs in therapeutics and provide some examples of metal drugs that are of extreme interest in the current pandemic. At the same time, we will also examine some of their promising mechanisms of action and possible effectiveness against COVID-19.


Subject(s)
COVID-19 , Coordination Complexes , Antiviral Agents/pharmacology , Antiviral Agents/therapeutic use , COVID-19/drug therapy , Humans , Pandemics , SARS-CoV-2
SELECTION OF CITATIONS
SEARCH DETAIL