Improving Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) Treatment Monitoring in South Africa: Evaluation of an Advanced TB/HIV Course for Healthcare Workers.

BACKGROUND: South Africa has dual epidemics of human immunodeficiency virus (HIV) and tuberculosis (TB). Nurse-focused training was combined with onsite mentoring for nurses to improve HIV and TB care. A pre-/postevaluation was conducted in 3 districts in South Africa to assess the effects of the course on clinical patient monitoring and integration of TB and HIV care. METHODS: Two cross-sectional, unmatched samples of patient charts at 76 primary healthcare facilities were collected retrospectively in 2014 to evaluate the impact of training on treatment monitoring. Proportions of HIV patients receiving a viral load test 6 months after initiating antiretroviral therapy (ART) and TB patients receiving end of intensive phase sputum testing were compared pre- and posttraining. Analysis of creatinine clearance testing and integration of TB and HIV care were also performed. RESULTS: Data were analyzed from 1074 pretraining and 1048 posttraining records among patients initiating ART and from 1063 pretraining and 1008 posttraining among patients initiating TB treatment. Documentation of a 6-month viral load test was 36.3%, and a TB test at end of intensive phase was 70.7%, and neither increased after training. Among patients with a viral load test, the percentage with viral load less than 50 copies/mL increased from 48.6% pretraining compared with 64.2% posttraining (P = .001). Integration of TB and HIV care such as isoniazid preventive therapy increased significantly. CONCLUSIONS: The primary outcome measures did not change after training. However, the evaluation documented many other improvements in TB and HIV care that may have been supported by the course.

Development of a triplex PCR assay for the specific detection of Campylobacter jejuni, Salmonella spp., and Escherichia coli O157:H7.

A triplex PCR assay was developed and evaluated for efficacy in detecting Campylobacter jejuni, Salmonella spp., and Escherichia coli O157:H7 in a variety of raw and ready-to-eat food products. Following a short enrichment period, artificially contaminated food samples were subjected to a triplex PCR assay, which incorporated published primers for each food pathogen, a protocol for sample collection, and a PCR procedure designed specifically for the assay. The selected primers amplified fragment sizes of 159 bp, 252 bp, and 360 bp for C. jejuni, E. coli O157:H7, and Salmonella spp., respectively. This assay provides specific and reliable results and allows for the cost-effective detection of all three bacterial pathogens in one reaction tube.