RESUMO
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.
Assuntos
Anemia/complicações , Terapia Antirretroviral de Alta Atividade , Definição da Elegibilidade , Infecções por HIV/tratamento farmacológico , Programas de Rastreamento/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anemia/epidemiologia , Fármacos Anti-HIV/uso terapêutico , Contagem de Linfócito CD4 , Feminino , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Hemoglobinas/metabolismo , Humanos , Malaui/epidemiologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prevalência , Adulto JovemAssuntos
Terapia Antirretroviral de Alta Atividade/efeitos adversos , Necrose da Cabeça do Fêmur/etiologia , Infecções por HIV/complicações , Fármacos Anti-HIV/uso terapêutico , Artroplastia de Quadril , Necrose da Cabeça do Fêmur/diagnóstico por imagem , Necrose da Cabeça do Fêmur/cirurgia , Infecções por HIV/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Dor/etiologia , Radiografia , Coxa da Perna , Resultado do TratamentoRESUMO
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.
Assuntos
Surtos de Doenças , Transmissão de Doença Infecciosa , Meningite Meningocócica/epidemiologia , Meningite Meningocócica/transmissão , Adolescente , Adulto , Distribuição por Idade , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Recreação , Fatores de Risco , População Rural , Tanzânia/epidemiologiaRESUMO
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
