Subject(s)
Alphavirus Infections/diagnosis , Alphavirus Infections/virology , Chikungunya virus/isolation & purification , Communicable Diseases, Emerging/virology , Sentinel Surveillance , Adolescent , Adult , Aedes/virology , Aged , Alphavirus Infections/epidemiology , Alphavirus Infections/transmission , Animals , Chikungunya Fever , Chikungunya virus/genetics , Child , Communicable Diseases, Emerging/epidemiology , Disease Outbreaks , Humans , Incidence , Middle Aged , RNA, Viral/genetics , Real-Time Polymerase Chain Reaction , West Indies/epidemiology , Young AdultABSTRACT
To strengthen HIV screening in the French West Indies (FWI), we evaluated the feasibility of rapid tests in sexually transmitted infection (STI) testing centres. Rapid testing was offered to each user ahead of the standard screening tests. Between October 2007 and December 2008, 847 users had HIV rapid testing, and 1724 users did not have rapid testing. The results of rapid testing were returned to 99.1% of testers. However, clients who underwent rapid testing were significantly more likely than others to have not returned to get the results of their standard screening tests (for HIV and other STIs): 27.4% versus 14.0% with a relative risk of 1.96 (95% confidence interval [CI] 1.67-2.30, P < 0.0001). Rapid HIV testing has the capacity to reduce the return rates for confirmatory results of HIV testing and other STIs.
Subject(s)
HIV Infections/diagnosis , Adult , Aged , Ambulatory Care Facilities/statistics & numerical data , Feasibility Studies , Female , HIV Infections/epidemiology , Humans , Male , Mass Screening/methods , Mass Screening/statistics & numerical data , Middle Aged , Time Factors , West Indies/epidemiologyABSTRACT
OBJECTIVE: Late screening for HIV is frequent in people living in the French West Indies. Rapid tests (RT) create new opportunities to improve screening for HIV. We evaluated the feasibility and acceptability of RT among users of free and anonymous screening consultations in Fort-de-France and Saint-Martin. METHODS: After confirming its reliability on more than 20,000 samples, a RT (Determine HIV-1+2 was offered on site to all testers in addition to the classic tests. RESULTS: From October 2007 to May 2008, 373 RT were performed, four were confirmed positive. Results of RT were returned to 99.4% of testers versus 89.4% of persons who underwent additional classic tests. The rate for unclaimed classic tests results was higher for the latter than for persons who had only RT: 22.2% versus 10.6%. CONCLUSIONS: Results show that RT improves the proportion of people who are informed of their results. Nevertheless, efforts must be made to persuade patients to come back for results of the standard tests to be informed of a potential sexually transmitted infection or an acute HIV infection.
Subject(s)
Anonymous Testing/methods , HIV Infections/diagnosis , False Negative Reactions , False Positive Reactions , HIV Infections/prevention & control , HIV-1/isolation & purification , HIV-2/isolation & purification , Hospitals, University , Humans , Infectious Disease Transmission, Vertical/prevention & control , Martinique , Mass Screening/methods , Mass Screening/statistics & numerical data , Predictive Value of Tests , Prospective Studies , Risk Factors , Substance Abuse, Intravenous , Time FactorsABSTRACT
It is a randomised cross-over multicenter study comparing the efficacy and the tolerance of granisetron (Gra) 1 mg and ondansetron (Ond) 8 mg, oral, given during two consecutive cycles to 188 naive patients scheduled to receive a moderately emetogenic chemotherapy. The antiemetic treatment is given one day per course, 1 hour before chemotherapy and the second administration from 8 to 12 hours after the beginning, during each of the two cycles; alternatively according to the randomisation. Five criteria are assessed; nausea (ordinal and visual analogic scales), emeric episodes (vomiting orland retching), complete response (minor or no nausea, no emetic episode and no rescue treatment), patient preference and tolerance. The intent to treat analysis showed no significant difference at cycle 1 between Gra and Ond; at cycle 2, there is no significant difference in the number of emetic episodes; for the prevention of nausea, the ordinal scale shows a significant difference (p = 0.028 in favour of Gra at day 1 (D1) but not from D2 to D5. Gra induced more complete response than Ond at D1 (p = 0.028), but not from D2 to D5. The cross-over study did not show any period or order effect, whereas a treatment effect on Ond was significant in favour of Gra (p = 0.01). There is no significant patients preference in favour of Gra or Ond. In conclusion, Gra was more efficient in preventing nausea and obtaining complete response on the first day of treatment, significantly at the second cycle. Both Gra and Ond had a good antiemetic activity for moderately emetogenic chemotherapy with complete response rates always over 50% on day 1; delayed emesis remain less weli controlled.
