ABSTRACT
Clinical staging determines antiretroviral therapy (ART) eligibility when CD4 count is not available. Haemoglobin (Hb) ≤8 g/dL is an indication for the treatment. We measured Hb in HIV-positive Malawian adults undergoing clinical assessment for ART eligibility and calculated the percentage of patients with CD4 ≤ 350 cells/µL deemed eligible for ART by clinical staging with and without Hb measurement, using the existing threshold and an alternative proposed after comparing Hb values to CD4 counts. Three hundred and thirty-eight patients had CD4 counts measured and 226 (67%) had CD4 ≤ 350 cells/µL. Thirty-six (16%) patients with low CD4 count were eligible for ART by clinical assessment alone, 48 (21%) when Hb was also measured with a threshold of ≤8 g/dL and 74 (34%) with a threshold of ≤10 g/dL. Measuring Hb alongside clinical assessment could increase the number of patients with CD4 ≤ 350 cells/µL starting ART by 33% using a threshold of Hb ≤ 8 g/dL or 114% with a threshold of ≤10g/dL.
Subject(s)
Anemia/complications , Antiretroviral Therapy, Highly Active , Eligibility Determination , HIV Infections/drug therapy , Mass Screening/methods , Adolescent , Adult , Aged , Aged, 80 and over , Anemia/epidemiology , Anti-HIV Agents/therapeutic use , CD4 Lymphocyte Count , Female , HIV Infections/complications , HIV Infections/epidemiology , Hemoglobins/metabolism , Humans , Malawi/epidemiology , Male , Middle Aged , Predictive Value of Tests , Prevalence , Young AdultSubject(s)
Antiretroviral Therapy, Highly Active/adverse effects , Femur Head Necrosis/etiology , HIV Infections/complications , Anti-HIV Agents/therapeutic use , Arthroplasty, Replacement, Hip , Femur Head Necrosis/diagnostic imaging , Femur Head Necrosis/surgery , HIV Infections/drug therapy , Humans , Male , Middle Aged , Pain/etiology , Radiography , Thigh , Treatment OutcomeABSTRACT
An outbreak of meningitis with 85 secondary cases and an unusually high attack rate of 16% occurred in a rural village in southern Tanzania. We investigated risk factors for clinical illness in a community-based case-control study. Attending a commercial mobile video show carried an age- and sex-adjusted odds ratio of 8.0 (95% confidence interval: 3.8-16.8). The videos had been shown in a windowless and overcrowded storeroom and had been attended by the primary case, a visitor from neighbouring Mozambique who died from meningitis on the following day. We conclude that mobile video shows, which have become popular in many developing countries, constitute a potential health hazard in areas prone to meningitis epidemics.
Subject(s)
Disease Outbreaks , Disease Transmission, Infectious , Meningitis, Meningococcal/epidemiology , Meningitis, Meningococcal/transmission , Adolescent , Adult , Age Distribution , Case-Control Studies , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Recreation , Risk Factors , Rural Population , Tanzania/epidemiologyABSTRACT
Results of the study have shown that there is actually an overconsumption of tablets of chloroquine; mebendazole; sulphadimidine and ferrous sulphate but under supply of penicillin to health centres which clearly reject assumptions and claims that essential drugs are supplied in small quantities to health centres. If there are shortages in health centres in the southern region; the shortages could be due to irrational use of drugs
