| 1. Title: Progress toward the 2012 measles elimination goal--Western Pacific Region, 1990-2008. Author: Centers for Disease Control and Prevention (CDC) Source: MMWR. Morbidity and Mortality Weekly Report. 2009 Jun 26;58(24):669-73. Abstract: In 2003, the World Health Organization (WHO) Regional Committee of the Western Pacific Region (WPR) formally declared a measles elimination goal, and in 2005, the committee established a target date of 2012 for regional measles elimination. Key strategies recommended by WHO for achievement of measles elimination include 1) very high (>or=95%) vaccination coverage with 2 doses of measles-containing vaccine (MCV1 and MCV2) through routine vaccination and/or supplemental immunization activities (SIAs); 2) high-quality case-based measles surveillance; and 3) access to an accredited measles laboratory network for testing of suspected measles cases and identification of measles virus genotypes. This report describes progress toward measles elimination in the WPR through 2008. Measles likely has been eliminated or nearly eliminated in 24 of the 37 countries and areas in the WPR (referred to in this report as countries). However, large numbers of measles cases continue to be reported from several countries. During 2008, a total of 131,441 confirmed measles cases (98.4 per million population) were reported from China and 11,015 cases (86.1 per million population) from Japan, two countries that account for 82% of the region's population and >97% of its confirmed measles cases. Intensified efforts by WPR countries, particularly China and Japan, will be required to achieve the 2012 goal. Language: English Keywords: OCEANIA | SUMMARY REPORT | INCIDENCE | MEASLES | VACCINES | IMMUNIZATION | PREVENTION AND CONTROL | MONITORING | SCREENING | Developing Countries | Measurement | Research Methodology | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Primary Health Care | Evaluation | Examinations and Diagnoses Document Number: 341752 |
2.  Title: Evidence-based, alternative cervical cancer screening approaches in low-resource settings. Author: Almeida MC; Aquino EM Source: International Perspectives on Sexual and Reproductive Health. 2009 Sep;35(3):147-154. Abstract: Cervical cancer kills approximately 270,000 women worldwide each year, with nearly 85% of those deaths occurring in resource-poor settings.1 Use of the Pap smear for routine screening of women has resulted in a dramatic decline in cervical cancer deaths over the past four decades in wealthier countries. A key reason for continuing high mortality in the developing world is the shortage of efficient, high-quality screening programs in those regions. Language: English Keywords: AFRICA | ASIA | LATIN AMERICA | SUMMARY REPORT | SCREENING | WOMEN | AGE FACTORS | CERVICAL CANCER | HPV | PREVENTION AND CONTROL | LOW INCOME POPULATION | TESTING | TREATMENT | PROGRAM EFFECTIVENESS | Developing Countries | Americas | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Demographic Factors | Population | Population Characteristics | Cancer | Neoplasms | Diseases | Viral Diseases | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Measurement | Research Methodology | Program Evaluation | Programs | Organization and Administration Document Number: 343005 |
| 3. Peer Reviewed Title: Mortality and loss-to-follow-up during the pre-treatment period in an antiretroviral therapy programme under normal health service conditions in Uganda. Author: Amuron B; Namara G; Birungi J; Nabiryo C; Levin J; Grosskurth H; Coutinho A; Jaffar S Source: BMC Public Health. 2009 Aug 11;9(1):290. Abstract: ABSTRACT: BACKGROUND: In many HIV programmes in Africa, patients are assessed clinically and prepared for antiretroviral treatment over a period of 4-12 weeks. Mortality rates following initiation of ART are very high largely because patients present late with advanced disease. The rates of mortality and retention during the pre-treatment period are not well understood. We conducted an observational study to determine these rates. METHODS: HIV-infected subjects presenting at The AIDS Support Clinic in Jinja, SE Uganda, were assessed for antiretroviral therapy (ART). Eligible subjects were given information and counselling in 3 visits done over 4-6 weeks in preparation for treatment. Those who did not complete screening were followed-up at home. Survival analysis was done using poisson regression. RESULTS: 4321 HIV-infected subjects were screened of whom 2483 were eligible for ART on clinical or immunological grounds. Of these, 637 (26%) did not complete screening and did not start ART. Male sex and low CD4 count were associated independently with not completing screening. At follow-up at a median 351 days, 181 (28%) had died, 189 (30%) reported that they were on ART with a different provider, 158 (25%) were alive but said they were not on ART and 109 (17%) were lost to follow-up. Death rates (95% CI) per 100 person-years were 34 (22, 55) (n.18) within one month and 37 (29, 48) (n.33) within 3 months. 70/158 (44%) subjects seen at follow-up said they had not started ART because they could not afford transport. CONCLUSIONS: About a quarter of subjects eligible for ART did not complete screening and pre-treatment mortality was very high even though patients in this setting were well informed. For many families, the high cost of transport is a major barrier preventing access to ART. Language: English Keywords: UGANDA | RESEARCH REPORT | PERSONS LIVING WITH HIV/AIDS | CLIENTS | ANTIRETROVIRAL THERAPY | SCREENING | AIDS PREVENTION | DEATH RATE | PROGRAM ACCESSIBILITY | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | HIV Infections | Viral Diseases | Diseases | Program Activities | Programs | Organization and Administration | HIV | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | AIDS | Mortality | Population Dynamics | Demographic Factors | Population | Program Evaluation Document Number: 342534 |
| 4. Peer Reviewed Title: Sexual risk behaviour of the first cohort undergoing screening for enrollment into Phase I/II HIV vaccine trials in South Africa. Author: Andersson KM; Van Niekerk RM; Niccolai LM; Mlungwana ON; Holdsworth IM; Bogoshi M; McIntyre JA; Gray GE; Vardas E Source: International Journal of STD and AIDS. 2009 Feb;20(2):95-101. Abstract: We assessed risk behaviour in a heterosexual cohort undergoing prescreening for the first Phase I/II HIV vaccine trials in Soweto. We developed a survey and collected self-reported data from HIV-negative potential volunteers. Of 488 participants, most were single and approximately half were from households with incomes below the poverty level. Males reported higher rates of heavy alcohol use (P < 0.001), marijuana use (P < 0.001) and other recreational drug use (P < 0.01). Males reported more sex partners than females in the previous six months (P < 0.001), as well as more casual/anonymous partners (P < 0.001) and one-night stands (P < 0.001). Multivariate analyses revealed substance use and male gender predicted higher risk behaviours, including <100% condom use with known/suspected HIV-positive partners, having casual/anonymous partners and having more than two partners. For this population, male volunteers may need increased risk-reduction counselling during Phase I/II trials and additional recruitment methods may be necessary to identify high-risk female volunteers for Phase III efficacy trials. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | KAP SURVEYS | CLINICAL TRIALS | MULTIVARIATE ANALYSIS | HETEROSEXUALS | SEXUAL PARTNERS | SEX BEHAVIOR | RISK BEHAVIOR | VACCINES | ALCOHOL USE AND ABUSE | SCREENING | POVERTY | DRUG USE AND ABUSE | SEX FACTORS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Clinical Research | Data Analysis | Behavior | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Examinations and Diagnoses | Socioeconomic Factors | Economic Factors | Population Characteristics | Demographic Factors | Population Document Number: 331093 |
| 5. Peer Reviewed Title: HIV testing rates and outcomes in a South African community, 2001-2006: implications for expanded screening policies. Author: April MD; Walensky RP; Chang Y; Pitt J; Freedberg KA; Losina E; Paltiel AD; Wood R Source: Journal of Acquired Immune Deficiency Syndromes. 2009 Jul 1;51(3):310-6. Abstract: BACKGROUND: Revised World Health Organization recommendations seek to increase HIV testing. We assessed the need for expanded testing in South Africa by examining current testing and treatment trends among a high prevalence population. METHODS: We determined the numbers of adults receiving HIV testing and antiretroviral treatment (ART) during 2001-2006 using testing registers linked to patient records from 2 health care facilities believed responsible for virtually all HIV services available to the population. We evaluated annual population testing rates using census population counts; proportions of clients testing seropositive (yield); CD4 counts and World Health Organization stage at diagnosis; and ART initiation rates. RESULTS: HIV testing rates rose from 4% in 2001 to 20% in 2006 (P < 0.001) and were highest among pregnant females receiving provider-initiated testing. Yield for first-time testers decreased from 47% in 2001 to 28% in 2006; annual incidence of seroconversion among initially HIV-negative retesters was 1.9%. Median CD4 counts and World Health Organization stage distributions for newly diagnosed clients remained stable. HIV-infected clients receiving ART within 6 months of eligibility increased from 0% in 2001 to 68% in 2006 (P < 0.001). CONCLUSIONS: Population testing and ART initiation rates rose dramatically during 2001-2006. Yet, yield remained high, and HIV-infected persons continued to receive late diagnoses. These findings highlight the continuing need for expanded testing and linkage to care. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | DATA LINKAGE | STATISTICAL STUDIES | HIV TESTING | ANTIRETROVIRAL THERAPY | VOLUNTARY COUNSELING AND TESTING | SCREENING | HEALTH POLICY | CENSUS | HIV INFECTIONS | PREVALENCE | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Data Collection | Research Methodology | Studies | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV | Viral Diseases | Diseases | Policy | Political Factors | Sociocultural Factors | Population Statistics | Measurement Document Number: 342149 |
| 6. Title: Human papillomavirus typing and soluble interleukin-2 receptor levels in female sex workers with a negative cervical smear result. Author: Arioz DT; Altindis M; Tokyol C; Kalayci R; Saylan A; Yilmazer M Source: International Journal of Gynaecology and Obstetrics. 2009 May 20; Abstract: OBJECTIVE: To investigate the association between high-risk human papillomavirus (HPV) types and soluble interleukin-2 receptor (sIL-2R) levels in female sex workers with a negative cervical smear result, and to determine the effectiveness of using sIL-2R levels to screen for high-risk strains of HPV. METHOD: A negative cervical smear result and a blood sample were obtained from 68 women: 43 female sex workers and 25 women acting as controls. HPV DNA genotyping was performed and sIL-2R levels were assessed. RESULTS: Female sex workers had significantly higher sIL-2R levels than women in the control group (318.37+/-239.7 vs 114.4+/-56.5 U/mL, respectively P<0.001). In addition, female sex workers with high-risk strains of HPV had significantly higher sIL-2R levels than those who did not have high-risk strains of HPV (736.7+/-251.5 vs 250.5+/-156.1 U/mL, respectively; P=0.001). CONCLUSION: High sIL-2R levels may be useful in screening for high-risk strains of HPV in female sex workers who have a negative cervical smear result. Language: English Keywords: TURKEY | RESEARCH REPORT | CONTROL GROUPS | SEX WORKERS | HPV | CERVICAL CANCER | RISK FACTORS | CYTOLOGIC EFFECTS | SCREENING | Europe, Southeastern | Europe | Developing Countries | Research Methodology | Sex Behavior | Behavior | Viral Diseases | Diseases | Cancer | Neoplasms | Health | Physiology | Biology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care Document Number: 341451 |
| 7. Peer Reviewed Title: Prevalence of tuberculosis, HIV and respiratory symptoms in two Zambian communities: implications for tuberculosis control in the era of HIV. Author: Ayles H; Schaap A; Nota A; Sismanidis C; Tembwe R; De Haas P; Muyoyeta M; Beyers N Author: Peter Godfrey-Faussett for the ZAMSTAR Study Team Source: PloS One. 2009;4(5):e5602. Abstract: BACKGROUND: The Stop TB Partnership target for tuberculosis is to have reduced the prevalence of tuberculosis by 50% comparing 2015 to 1990. This target is challenging as few prevalence surveys have been conducted, especially in high burden tuberculosis and HIV countries. Current tuberculosis control strategies in high HIV prevalent settings are therefore based on limited epidemiological evidence and more evidence is needed from community-based surveys to inform improved policy formulation. METHODS AND FINDINGS: 8044 adults were sampled from 2 sub-districts (wards) in Lusaka province, Zambia. Questionnaires were used to screen for symptoms, respiratory samples were obtained for culture and oral secretions collected for HIV testing. 79 individuals were found to have Mycobacterium tuberculosis in their sputum, giving an adjusted overall prevalence of tuberculosis of 870/100,000 (95% CI 570-1160/100,000). The adjusted overall prevalence of HIV was 28.61% (95% CI 26.04-31.19). HIV- infection was significantly associated with prevalent tuberculosis (Adj OR 2.3, 95% CI 1.42-3.74) and the population attributable fraction of HIV for prevalent tuberculosis was 36%. Symptoms such as prolonged cough (adj OR 12.72, 95% CI 7.05-22.94) and fever (Adj OR 2.04, 95%CI 1.23-3.39), were associated with prevalent tuberculosis, but 8 (10%) individuals with prevalent tuberculosis denied having any symptoms at all and only 34 (43%) would have been classified as a TB suspect by current guidelines. CONCLUSIONS: Undiagnosed tuberculosis is a challenge for tuberculosis control and new approaches are needed if we are to reach international targets. Epidemiological studies can inform screening algorithms for both detection and prevention of active tuberculosis. Language: English Keywords: ZAMBIA | RESEARCH REPORT | SAMPLING STUDIES | ADULTS | TUBERCULOSIS | HIV INFECTIONS | RESPIRATORY INSUFFICIENCY | PREVALENCE | SCREENING | SIGNS AND SYMPTOMS | LABORATORY EXAMINATIONS AND DIAGNOSES | PREVENTION AND CONTROL | ANTIBIOTICS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Infections | Diseases | Viral Diseases | Pulmonary Effects | Physiology | Biology | Measurement | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs | Treatment Document Number: 342445 |
| 8. Title: Evaluation of commercial HIV test kits used in Nigeria. Author: Banwat EB; Peter JY; Egah DZ Source: Nigerian Journal of Clinical Practice. 2009 Mar;12(1):11-4. Abstract: BACKGROUND:Accurate and reliable diagnosis of HIV plays a central role in any effective HIV intervention. We decided to evaluate 4 commercial HIV test kits to determine their reliability for use in developing countries. METHODS: Serum samples obtained from clients accessing tertiary health services at the STI clinic, Jos University Teaching Hospital were used to evaluate Sdbioline, Diaspot, Determine and DIALAB Elisa kits. A Western blot was used as the reference kit. RESULTS: DETERMINE kit gave 34 positive and 58 negative reactions and the positive sera were all confirmed by Western blot while DIASPOT kit gave 27 false negative results, which was at variance with the reference kit result. Other kits were SDBIOLINE with 5 false positive and DIALAB Elisa kit, which gave one false positive, and one false negative result. CONCLUSION: We conclude that Determine, SDbioline and DIALAB Elisa kits are reliable for HIV antibody testing in Nigeria and other developing countries. Language: English Keywords: NIGERIA | EVALUATION REPORT | CLIENTS | PROSPECTIVE STUDIES | COMPARATIVE STUDIES | HIV TESTING | EQUIPMENT AND SUPPLIES | RELIABILITY | EXAMINATIONS AND DIAGNOSES | LABORATORY PROCEDURES | SCREENING | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Evaluation | Program Activities | Programs | Organization and Administration | Studies | Research Methodology | Laboratory Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement Document Number: 342689 |
| 9. Peer Reviewed Title: One-stop care for HIV-positive women [letter] Author: Barber TJ; Coyne KM; Hawkins F; Desmond N Source: International Journal of STD and AIDS. 2009 Jan;20(1):67. Abstract: Language: English Keywords: UNITED KINGDOM | CRITIQUE | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN | PERSONS LIVING WITH HIV/AIDS | SCREENING | HIV INFECTIONS | PAP SMEAR | FAMILY PLANNING | SEXUALLY TRANSMITTED DISEASE PREVENTION | INTEGRATED PROGRAMS | FAMILY PLANNING EDUCATION | CONTRACEPTION | FINANCIAL ACTIVITIES | Developed Countries | Europe, Western | Europe | Research Methodology | Demographic Factors | Population | Viral Diseases | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Laboratory Examinations and Diagnoses | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Programs | Organization and Administration | Education | Economic Factors Document Number: 330713 |
| 10. Title: Fetal abnormalities leading to third trimester abortion: nine-year experience from a single medical center. Author: Barel O; Vaknin Z; Smorgick N; Reish O; Mendlovic S; Herman A; Maymon R Source: Prenatal Diagnosis. 2009 Mar;29(3):223-8. Abstract: OBJECTIVE: To assess fetal abnormalities and events leading to third-trimester abortion. METHODS: The study population included all parturient women with singleton pregnancy that underwent termination of pregnancy (TOP) in the third trimester in our institute because of fetal indications between 1998 and 2006. RESULTS: There were 777 cases of TOP due to fetal anomalies in our center during the study period, and 52 terminations were carried out in the third trimester. All cases of third-trimester abortions were due to severe malformations with high probability of perinatal death or severe handicap: 65.3% anomalies were structural, and 58.9% of them involved the central nervous system (CNS). Genetic indications included mostly genetic diseases, unlike aneupluidities in earlier terminations. Routine prenatal care raised suspicion of abnormalities in 22 (42.3%) cases, and diagnosis was established by additional tests. Abnormal findings were either missed in 4 (7.7%) cases or developed later in 11 (21.1%) cases. No routine prenatal screening was performed in the remaining 15 (28.8%) cases. CONCLUSIONS: Third-trimester abortion may be obviated by timely screening and scanning in some cases. The possibility of late TOP should be considered in malformations occurring late in pregnancy and in cases that require meticulous evaluation and follow-up from earlier stages of gestation. Language: English Keywords: ISRAEL | RESEARCH REPORT | FETUS | PREGNANCY, THIRD TRIMESTER | CHROMOSOME ABNORMALITIES | CONGENITAL ABNORMALITIES | SCREENING | ABORTION | Developed Countries | Middle East | Pregnancy | Reproduction | Neonatal Diseases and Abnormalities | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Fertility Control, Postconception | Family Planning Document Number: 331172 Notification |
| 11. Title: Novel progesterone receptor modulators with gene selective and context-dependent partial agonism. Author: Berrodin TJ; Jelinsky SA; Graciani N; Butera JA; Zhang Z; Nagpal S; Winneker RC; Yudt MR Source: Biochemical Pharmacology. 2009 Jan 15;77(2):204-15. Abstract: Progesterone receptor (PR) modulators are used in contraception and post-menopausal hormone therapy, and are under clinical development for reproductive disorders such as uterine fibroids and endometriosis. Development of tissue selective PR modulators (SPRMs) with reduced side effects and improved pharmacology represents a large unmet medical need in the area of women's health. One approach to addressing this need is to focus on the two PR isoforms PR-A and PR-B. In vitro and in vivo studies have revealed both distinct as well as overlapping gene regulation and functional responses of the two PR isoforms that suggests that PR-A selective modulators may retain a desired biological profile. We have identified a chemical series of 4-(4-chlorophenyl)-substituted piperazine carbimidothioic acid esters (PCEs) that have partial PR agonist activity and selectively activate some PR-A isoform regulated genes in T47D cells. However, full microarray analysis in these cells does not predict a global isoform selective profile for these compounds, but rather a unique gene-selective profile is observed relative to steroidal progestins. Using multiplexed peptide interaction profiling and co-activator recruitment assays we find that the mechanism of partial agonism is only partly defined by the ability to recruit known co-activators or peptides but also depends on the cell and promoter context of the gene under investigation. The data demonstrate global consequences of mechanistic and functional differences that can lead to selective biological responses of novel steroid receptor modulators. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | UTERINE EFFECTS | ENDOMETRIOSIS | NEEDS | WOMEN'S HEALTH | PROGESTERONE | SCREENING | LABORATORY PROCEDURES | Developed Countries | North America | Americas | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Diseases | Economic Factors | Health | Progestational Hormones | Hormones | Endocrine System | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Laboratory Examinations and Diagnoses Document Number: 329730 |
| 12. Peer Reviewed Title: Delivery of chlamydia screening to young women requesting emergency hormonal contraception at pharmacies in Manchester, UK : a prospective study. Author: Brabin L; Thomas G; Hopkins M; O'Brien K; Roberts SA Source: BMC Women's Health. 2009 Mar 26;9(1):7. Abstract: ABSTRACT: BACKGROUND: More women are requesting Emergency Hormonal Contraception (EHC) at pharmacies where screening for Chlamydia trachomatis is not routinely offered. The objective of this study was to assess the uptake of free postal chlamydia screening by women under 25 years who requested EHC at pharmacies in Manchester, UK. METHODS: Six Primary Care Trusts (PCTs) that had contracted with pharmacies to provide free EHC, requested the largest EHC providers ([greater than or equal to] 40 doses annually) to also offer these clients a coded chlamydia home testing kit. Pharmacies kept records of the ages and numbers of women who accepted or refused chlamydia kits. Women sent urine samples directly to the laboratory for testing and positive cases were notified. Audit data on EHC coverage was obtained from PCTs to assess the proportion of clients eligible for screening and to verify the uptake rate. RESULTS: 33 pharmacies participated. Audit data for 131 pharmacy months indicated that only 24.8% (675/2718) of women provided EHC were also offered chlamydia screening. Based on tracking forms provided by pharmacies for the whole of the study, 1348 /2904 EHC clients (46.4%) who had been offered screening accepted a screening kit. 264 (17.6%) of those who accepted a kit returned a sample, of whom 24 (9.1%) were chlamydia-positive. There was an increase in chlamydia positivity with age (OR: 1.2 per year; 1.04 to 1.44; p = 0.015). CONCLUSIONS: Chlamydia screening for EHC pharmacy clients is warranted but failure of pharmacists to target all EHC clients represented a missed opportunity for treating a well defined high-risk group. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | PROSPECTIVE STUDIES | WOMEN | YOUTH | SCREENING | EMERGENCY CONTRACEPTION | CHLAMYDIA | PHARMACY DISTRIBUTION | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Demographic Factors | Population | Age Factors | Population Characteristics | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraception | Family Planning | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration Document Number: 330849 |
| 13. Title: Targeted screening and treatment for latent tuberculosis infection using QuantiFERON-TB Gold is cost-effective in Mexico. Author: Burgos JL; Kahn JG; Strathdee SA; Valencia-Mendoza A; Bautista-Arredondo S; Laniado-Laborin R; Castaneda R; Deiss R; Garfein RS Source: International Journal of Tuberculosis and Lung Disease. 2009 Aug;13(8):962-8. Abstract: OBJECTIVE: To assess the cost-effectiveness of screening for latent tuberculosis infection (LTBI) using a commercially available detection test and treating individuals at high risk for human immunodeficiency virus (HIV) infection in a middle-income country. DESIGN: We developed a Markov model to evaluate the cost per LTBI case detected, TB case averted and quality-adjusted life year (QALY) gained for a cohort of 1000 individuals at high risk for HIV infection over 20 years. Baseline model inputs for LTBI prevalence were obtained from published literature and cross-sectional data from tuberculosis (TB) screening using QuantiFERON-TB Gold In-Tube (QFT-GIT) testing among sex workers and illicit drug users at high risk for HIV recruited through street outreach in Tijuana, Mexico. Costs are reported in 2007 US dollars. Future costs and QALYs were discounted at 3% per year. Sensitivity analyses were performed to evaluate model robustness. RESULTS: Over 20 years, we estimate the program would prevent 78 cases of active TB and 55 TB-related deaths. The incremental cost per case of LTBI detected was US$730, cost per active TB averted was US$529 and cost per QALY gained was US$108. CONCLUSIONS: In settings of endemic TB and escalating HIV incidence, targeting LTBI screening and treatment among high-risk groups may be highly cost-effective. Language: English Keywords: MEXICO | RESEARCH REPORT | SCREENING | TUBERCULOSIS | COST EFFECTIVENESS | TREATMENT | North America | Americas | Developing Countries | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Infections | Diseases | Evaluation Indexes | Quantitative Evaluation | Evaluation Document Number: 342957 |
| 14. Title: Age and height predict neuropathy risk in patients with HIV prescribed stavudine. Author: Cherry CL; Affandi JS; Imran D; Yunihastuti E; Smyth K; Vanar S; Kamarulzaman A; Price P Source: Neurology. 2009 Jul 28;73(4):315-20. Abstract: OBJECTIVE: Sensory neuropathy is a common problem in HIV-infected patients and is the dose-limiting toxicity of stavudine. Affordable methods of predicting neuropathy risk are needed to guide prescribing in countries where some use of stavudine remains an economic necessity. We therefore aimed to identify factors predictive of neuropathy risk before antiretroviral use. METHODS: A total of 294 patients attending clinics in Melbourne, Kuala Lumpur, and Jakarta were enrolled in a cross-sectional neuropathy screening program in 2006. Neuropathy was defined by the presence of symptoms and signs on the AIDS Clinical Trials Group Brief Peripheral Neuropathy Screen. Demographic, laboratory, and treatment details were considered as possible risk factors for neuropathy. The role of patient demographics in predicting stavudine neuropathy were then assessed in 181 patients who reported that they were free of neuropathy symptoms when first prescribed this drug. RESULTS: The prevalence of neuropathy was 42% in Melbourne (n = 100), 19% in Kuala Lumpur (n = 98), and 34% in Jakarta (n = 96). In addition to treatment exposures, increasing age (p = 0.002) and height (p = 0.001) were independently associated with neuropathy. Age and height cutoffs of > or=170 cm or > or =40 years predicted neuropathy. Among 181 patients who were asymptomatic before stavudine exposure, the risk of neuropathy following stavudine was 20% in younger, shorter patients, compared with 66% in older, taller individuals. CONCLUSIONS: Stavudine neuropathy risk increases with patient age and height. Prioritizing older and taller patients for alternative agents would be an inexpensive strategy to reduce neuropathy rates in countries where the burden of HIV disease limits treatment options. Language: English Keywords: INDIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PERSONS LIVING WITH HIV/AIDS | SCREENING | NEUROLOGIC EFFECTS | TREATMENT | PRESCRIPTIONS | ANTIRETROVIRAL DRUGS | AGE FACTORS | BODY HEIGHT | Asia, Southern | Asia | Developing Countries | Research Methodology | HIV Infections | Viral Diseases | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Physiology | Biology | Distributional Activities | Program Activities | Programs | Organization and Administration | Population Characteristics | Demographic Factors | Population Document Number: 342727 |
| 15. Title: HIV: time for the medical community to move forward [editorial] Author: Chua AC Source: Annals of the Academy of Medicine, Singapore. 2009 Feb;38(2):97-8. Abstract: As we encourage more people to undergo HIV testing, it is important to understand the implications of an HIV diagnosis and to respect confidentiality and the voluntary consent process. Regarding HIV testing, 50% believe that it should be voluntary and 62.5% believe that mandatory HIV tests should be conducted on men who have sex with men (unpublished data -data available upon request from author). How do we begin to address these issues in our medical profession? We need sound policies and to challenge traditional medical education. (excerpt) Language: English Keywords: SINGAPORE | SUMMARY REPORT | SCREENING | PERSONS LIVING WITH HIV/AIDS | CLIENTS | HIV TESTING | HIV PREVENTION | TREATMENT | HEALTH SERVICES | DELIVERY OF HEALTH CARE | HEALTH POLICY | INFORMED CONSENT | Asia, Southeastern | Asia | Developed Countries | Examinations and Diagnoses | Medical Procedures | Medicine | Health | HIV Infections | Viral Diseases | Diseases | Program Activities | Programs | Organization and Administration | Laboratory Examinations and Diagnoses | Policy | Political Factors | Sociocultural Factors Document Number: 341548 |
| 16. Title: Chronic viral hepatitis may diminish the gains of HIV antiretroviral therapy in sub-Saharan Africa. Author: Cooper CL; Mills E; Wabwire BO; Ford N; Olupot-Olupot P Source: International Journal of Infectious Diseases. 2009 May;13(3):302-6. Abstract: There is a heavy burden of HIV-hepatitis B virus (HBV) and HIV-hepatitis C virus (HCV) co-infection in many regions of the developing world. An often unmentioned illness, issues of poverty, socio-economic status, nutrition, access to medical care, and mistrust of Western-style medicine conspire to reduce the opportunity to receive clinical work-up and treatment for chronic viral hepatitis. We discuss key issues specific to the treatment of viral hepatitis and obstacles to success with this endeavor in the context of HIV co-infection in Africa. We predict that provision of viral hepatitis antiviral therapy will become a more pressing issue as more HIV-infected patients receive lifesaving combination antiretroviral therapy only to succumb thereafter from viral hepatitis-induced liver disease. Given the lessons learned from combination antiretroviral rollout in sub-Saharan Africa, establishing expertise and infrastructure for viral hepatitis care and antiviral therapy is relevant. Failure to act now may diminish the milestones and the gains made with antiretroviral therapy in the developing world. Language: English Keywords: AFRICA, SUB SAHARAN | CRITIQUE | ANTIRETROVIRAL THERAPY | ANTIRETROVIRAL DRUGS | SIDE EFFECTS | HEPATIC EFFECTS | TOXICITY | HEPATITIS | ANTIVIRAL DRUGS | OBSTACLES | SCREENING | Africa | Developing Countries | HIV | HIV Infections | Viral Diseases | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Physiology | Biology | Drugs | Organization and Administration | Examinations and Diagnoses Document Number: 342111 |
| 17. Peer Reviewed Title: Prevalence and risk factors for Hepatitis C and HIV-1 infections among pregnant women in Central Brazil. Author: Costa ZB; Machado GC; Avelino MM; Gomes Filho C; Macedo Filho JV; Minuzzi AL; Turchi MD; Stefani MM; de Souza WV; Martelli CM Source: BMC Infectious Diseases. 2009;9:116. Abstract: BACKGROUND: Hepatitis C (HCV) and human immunodeficiency virus (HIV) infections are a major burden to public health worldwide. Routine antenatal HIV-1 screening to prevent maternal-infant transmission is universally recommended. Our objectives were to evaluate the prevalence of and potential risk factors for HCV and HIV infection among pregnant women who attended prenatal care under the coverage of public health in Central Brazil. METHODS: Screening and counselling for HIV and HCV infections was offered free of charge to all pregnant women attending antenatal clinic (ANC) in the public health system, in Goiania city (~1.1 million inhabitants) during 2004-2005. Initial screening was performed on a dried blood spot collected onto standard filter paper; positive or indeterminate results were confirmed by a second blood sample. HCV infection was defined as a positive or indeterminate sample (EIA test) and confirmed HCV-RNA technique. HIV infection was defined according to standard criteria. Factors associated with HIV and HCV infections were identified with logistic regression. The number needed to screen (NNS) to prevent one case of infant HIV infection was calculated using the Monte Carlo simulation method. RESULTS: A total of 28,561 pregnant women were screened for HCV and HIV-1 in ANC. Mean maternal age was 23.9 years (SD = 5.6), with 45% of the women experiencing their first pregnancy. Prevalence of HCV infection was 0.15% (95% CI 0.11%-0.20%), and the risk increased with age (p < 0.01). The prevalence of anti-HIV infection was 0.09% (95% CI 0.06%-0.14%). Black women had a 4.9-fold (95% CI 1.42-16.95) greater risk of HIV-1 infection compared to non-black women. NNS to prevent one case of infant HIV infection ranged from 4,141 to 13,928. CONCLUSION: The prevalence of HIV and HCV infections were low among pregnant women, with high acceptability rates in the opt-in strategy in primary care. Older maternal age was a risk factor for HCV and antenatal HCV testing does not fulfill the requirements for screening recommendation. The finding of higher risk of HIV-1 infection among black women despite being in consonance with the HIV-1 ethnic pattern in some American regions cannot be ruled out to be a surrogate marker of socio-economic condition. Language: English Keywords: BRAZIL | RESEARCH REPORT | PREVALENCE | RISK FACTORS | PREGNANT WOMEN | BLACKS | ANTENATAL CARE | HIV TESTING | HIV INFECTIONS | SCREENING | COUNSELING | PRIMARY HEALTH CARE | AGE FACTORS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Measurement | Research Methodology | Health | Population Characteristics | Demographic Factors | Population | Ethnic Groups | Cultural Background | Maternal Health Services | Maternal-Child Health Services | Health Services | Delivery of Health Care | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Viral Diseases | Diseases | Clinic Activities | Program Activities | Programs | Organization and Administration Document Number: 342683 |
| 18. Title: Thrombophilic conditions in the adolescent: the gynecologic impact. Author: Dietrich JE; Yee DL Source: Obstetrics and Gynecology Clinics of North America. 2009 Mar;36(1):163-75. Abstract: As Virchow's triad suggests, a fine balance exists between the vascular wall, intravascular contents, and dynamic blood flow, such that a shift in this balance predisposes to thrombosis. Although thromboembolic events (TEs) are relatively infrequent in adolescents, the morbidity and mortality associated with TEs can be significant. Over the past 15 years, TEs and inherited and acquired thrombophilic conditions underlying them have become increasingly recognized in teens at risk, with combined hormonal contraception constituting one of the most significant of these risk factors. Therefore, managing gynecologic problems in teens who have thrombophilic conditions can be challenging. It is important to have a clear understanding about safe options available to help address adolescent gynecologic concerns in this setting and to manage situations collaboratively with a hematologist. Language: English Keywords: UNITED STATES OF AMERICA | RECOMMENDATIONS | ADOLESCENTS, FEMALE | GYNECOLOGY | THROMBOSIS | RISK FACTORS | HEREDITARY DISEASES | CONTRACEPTIVE AGENTS, FEMALE | ORAL CONTRACEPTIVES, COMBINED | BLOOD COAGULATION EFFECTS | SCREENING | PROGESTERONE | CONTRACEPTIVE METHODS | Developed Countries | North America | Americas | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Medicine | Health Services | Delivery of Health Care | Health | Thromboembolism | Embolism | Vascular Diseases | Diseases | Contraceptive Agents | Contraception | Family Planning | Oral Contraceptives | Hematological Effects | Hemic System | Physiology | Biology | Examinations and Diagnoses | Medical Procedures | Progestational Hormones | Hormones | Endocrine System Document Number: 342856 |
19.  Title: The growing chronic disease burden: implications for reproductive health. Author: Drake JK Source: Outlook. 2009 Jul;26(1):8 p. Abstract: Approximately 80 percent of deaths from chronic disease occur in low- and middle-income countries, where people tend to develop these diseases at younger ages, suffer longer, and die sooner. A recent analysis found that chronic disease is an "important cause of female death, even during childbearing years, and for women with young families." The newsletter provides background on the growing chronic disease burden in developing countries, and explores current and anticipated impacts of cardiovascular conditions, diabetes, and obesity on reproductive health. Examples include hypertension and diabetes in pregnancy and contraceptive choice and access for women with cardiovascular conditions and risk factors. Language: English Keywords: DEVELOPING COUNTRIES | SUMMARY REPORT | EPIDEMIOLOGY | DISEASES | REPRODUCTIVE HEALTH | MATERNAL MORTALITY | DEATH RATE | HYPERTENSION | DIABETES | SCREENING | FAMILY PLANNING | TREATMENT | PREVENTION AND CONTROL | Public Health | Health | Mortality | Population Dynamics | Demographic Factors | Population | Vascular Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care Document Number: 341982 |
| 20. Title: Consequences of thrombophilia screening for life quality in women before prescription of oral contraceptives and family members of VTE patients. Author: Eichinger S Source: Hamostaseologie. 2009 Feb;29(1):110-1. Abstract: A large number of hereditary and acquired alterations in the coagulation system that are associated with an increased risk of venous thrombosis have been described. Screening for these thrombophilic defects has become particularly popular in women before the prescription of oral contraceptives. The relevance of the results with regard to the management of the patients remains, however, to be questioned. In a recent review of six articles that were aimed to determine the nature and extent of psychological impact of thrombophilia screening, no valid conclusions could be drawn about the psychological impact due to heterogeneity of the data and lack of methodological accuracy. We performed a questionnaire-based study in 247 women with and in 132 women without factor V Leiden who were referred for factor V Leiden testing before oral contraceptive intake. A large proportion (76%) of the women reported being emotionally disturbed by genetic testing. 16% of women with wildtype factor V were discouraged from OC use, while 3% of women with factor V Leiden were encouraged to take OC. This indicates that recommendations after testing are not consistently driven by the test result, which compromises the quality of patient care. Given the large number of women who are taking oral contraceptives unequivocal guidelines for counseling prior to their prescription are urgently needed. These guidelines should integrate the risks and benefits of oral contraceptives but also the impact of screening on quality of life and aspects of counselling. Language: English Keywords: AUSTRIA | RESEARCH REPORT | WOMEN | ORAL CONTRACEPTIVES | COUNSELING | THROMBOSIS | RISK FACTORS | SCREENING | GENETIC TECHNIQUES | EMOTIONS | QUALITY OF LIFE | Developed Countries | Europe, Central | Europe | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Clinic Activities | Program Activities | Programs | Organization and Administration | Thromboembolism | Embolism | Vascular Diseases | Diseases | Health | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Laboratory Examinations and Diagnoses | Psychological Factors | Behavior | Social Welfare | Economic Factors Document Number: 329794 |
| 21. Title: Is the process of diagnosing and treating incidental medical findings a barrier to contraceptive acceptance and use? Author: Ekabua JE; Ekabua KJ; Ekanem EI; Iklaki CU Source: Journal of Obstetrics and Gynaecology. 2009 Apr;29(3):237-9. Abstract: The objective of this study is to determine the impact of diagnosing and treating incidental medical disorders on contraceptive acceptance/use. The setting was the University of Calabar Teaching Hospital, a tertiary referral centre for the South-South zone of Nigeria and South-west Cameroon. Subjects were apparently healthy women seeking contraceptive counselling at the Teaching Hospital, Calabar (2001-2005). A total of 4,990 women's records were studied for the diagnosis of incidental medical findings. Two levels of missed opportunity for contraceptive uptake were identified. Incidental medical findings were seen in 26.9% of women. Contraceptive acceptance in women with incidental medical findings was 24.8%. Defaults from the screening process and treatment of incidental medical findings were significantly associated with high parity and low social status (p < 0.5). Incidental medical disorders, although uncommon in women desiring contraception were associated with low contraceptive uptake in women with high parity and low social status. Language: English Keywords: NIGERIA | CAMEROON | RESEARCH REPORT | KAP SURVEYS | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | EXAMINATIONS AND DIAGNOSES | SCREENING | PSYCHOSOCIAL FACTORS | CONTRACEPTIVE USAGE | MULTIPARITY | SOCIAL CLASS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Behavior | Contraception | Family Planning | Parity | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Socioeconomic Status | Socioeconomic Factors Document Number: 330945 |
| 22. Title: Seroprevalence of human immunodeficiency virus and syphilis in blood donors of Delhi [letter] Author: Ekadashi R; Langer S Source: Indian Journal of Medical Microbiology. 2009 Apr-Jun;27(2):167-8. Abstract: Transfusion of blood and blood products is a life saving measure that benefits numerous patients worldwide. At the same time it is an important mode of infection to the recipients. In up to 15% of the total patients infected with human immunodeficiency virus (HIV), blood transfusion has been the route of transmission. Syphilis positivity varies from 0.8% in voluntary donors to more than 15% in paid commercial donors. Although HIV infection has been reported in all groups of blood donors in Delhi, it is particularly high among replacement donors. Concealing the medical history by professional or replacement donors pose a great threat to safe blood supply. Problems are also due to the prevalence of asymptomatic carriers in the society, blood donations during the window period, genetic variability in the viral strains and laboratory errors. Only few reports are available regarding the trend of HIV seropositivity and syphilis serology, particularly in blood donors from northern India. In this study, we aimed to assess the prevalence and trend of HIV and syphilis over 4 years, 2004-2007, among blood donors of Central Delhi. A total of 13,672 blood units were collected from blood donors during the period from January 1 2004 to December 31 2007 at the blood bank of Delhi Heart and Lung Institute in New Delhi, India. This is a tertiary care level hospital super specializing in heart and lung ailments. Blood donors were either replacement or voluntary. Care was taken to exclude professional donors by taking appropriate history and examination. (excerpt) Language: English Keywords: INDIA | CRITIQUE | BLOOD DONORS | HIV TRANSMISSION | SYPHILIS | HIV | LABORATORY PROCEDURES | SCREENING | SAFETY | PREVENTION AND CONTROL | Asia, Southern | Asia | Developing Countries | Blood Supply | Equipment and Supplies | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Public Health Document Number: 341204 |
| 23. Title: Urinary screening abnormalities in antiretroviral-naive HIV-infected outpatients and implications for management--a single-center study in South Africa. Author: Fabian J; Naicker S; Venter WD; Baker L; Naidoo S; Paget G; Wadee S Source: Ethnicity and Disease. 2009 Spring;19(1 Suppl 1):S1-80-5. Abstract: Few urinary screening studies have been performed to determine the incidence of urinary abnormalities in antiretroviral therapy-naive, HIV-infected outpatients. From published data, the incidence appears to be high, particularly when compared with populations outside sub-Saharan Africa. In South Africa, urinary screening in antiretroviral therapy clinics is not routinely practiced. The aim of this descriptive study was to screen antiretroviral therapy-naive, HIV-infected outpatients attending the HIV clinic for urinary abnormalities, namely leukocyturia, microscopic hematuria, and microalbuminuria/proteinuria. This study showed that 84% of the screened population had AIDS (CD4 count < 200 cells/ mm3), and the incidence of abnormalities on urinary dipstick testing was high: 30% had leukocyturia, 33% had microscopic hematuria, and 44% had microalbuminuria/proteinuria. In patients with leukocyturia, an infective organism was cultured in only 29.1% of cases, predominantly Escherichia coli (70%) with sterile leukocyturia comprising the remainder. There may be an association with tuberculosis (TB) or sexually transmitted infections (STI) in the sterile leucocyturia group, but this remains to be confirmed. In those with a culture positive result the most common organism was E. coli (70%), which exhibited 90% resistance to cotrimoxazole, demonstrating that cotrimoxazole prophylaxis is not effective to prevent urinary tract infection in this group. On the basis of these findings, it has been proposed that urinary screening be considered standard of care in HIV clinics in South Africa. An algorithm has been proposed for use in antiretroviral therapy clinics in South Africa to guide clinicians regarding the cost-effective management of urinary dipstick abnormalities. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | SAMPLING STUDIES | CLIENTS | PERSONS LIVING WITH HIV/AIDS | RENAL EFFECTS | UROGENITAL EFFECTS | SCREENING | AIDS | PREVALENCE | CLINIC ACTIVITIES | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Urogenital System | Physiology | Biology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement Document Number: 341942 |
| 24. Peer Reviewed Title: Family planning provider referral, facilitation behavior, and patient follow-up for abnormal Pap smears. Author: Felix HC; Bronstein J; Bursac Z; Stewart MK; Foushee HR; Klapow J Source: Public Health Reports. 2009 Sep-Oct;124(5):733-44. Abstract: OBJECTIVES: Family planning (FP) clinics are important access points for cervical cancer screening and referrals for follow-up care for abnormal Papanicolaou (Pap) smears for a substantial number of U.S. women. Because little is known about referral and facilitation practices in these clinics or client action based on referrals, we sought to determine FP provider referral and facilitation practices when seeing FP clients with abnormal Pap smear results, and FP client follow-up for abnormal Pap smears due to FP provider referrals. METHODS: We conducted a mail survey of Medicaid-enrolled FP providers in Arkansas and Alabama, and conducted a telephone survey with a sample of FP clients of those providers responding to the provider survey. RESULTS: Major provider factors associated with referral included rural location, health department and clinic institutional setting, large Title X practice/clinic size, and high FP clinic focus. Major factors associated with facilitation included rural location, non-physician specialty, health department and clinic institutional setting, and small Title X clinic size. Of women reporting abnormal results, 62.4% reported follow-up care. Of those who received follow-up care, 40.0% received some care and a referral from their FP provider. A major factor associated with clients seeking follow-up care was being told by their FP provider where to go for follow-up care. Age was a major factor associated with clients actually obtaining follow-up care. CONCLUSIONS: Where follow-up care is not available at the FP site, referrals are critical and are a major factor associated with whether women seek care for the condition. Interventions to increase follow-up rates should focus on provider and system features, rather than clients. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | REFERRAL AND CONSULTATION | FAMILY PLANNING | CERVICAL CANCER | SCREENING | PAP SMEAR | HEALTH SERVICES | QUALITY OF HEALTH CARE | Developed Countries | North America | Americas | Program Activities | Programs | Organization and Administration | Cancer | Neoplasms | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Delivery of Health Care | Health | Laboratory Examinations and Diagnoses | Health Services Evaluation | Program Evaluation Document Number: 342766 |
| 25. Title: Development connections: a manual for integrating the programmes and services of HIV and violence against women. Author: Ferdinand DL Source: Washington, D.C., Development Connections, 2009. [80] p. Abstract: The aim of this manual is to support government agencies, NGOs and inter-institutional networks in the development of processes for integrating HIV and VAW interventions in the specific areas of prevention, VCT, PMTCT, care, support and treatment. Also, it can be applied to the analysis of emerging public policy issues regarding HIV and VAW. Language: English Keywords: GLOBAL | MANUAL | STANDARDS | DATA COLLECTION | PERSONS LIVING WITH HIV/AIDS | HIV TESTING | VIOLENCE AGAINST WOMEN | SCREENING | TREATMENT | HIV INFECTIONS | SOCIOECONOMIC FACTORS | SOCIAL PROBLEMS | HEALTH SERVICES | INTEGRATED PROGRAMS | Research Methodology | Viral Diseases | Diseases | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Delivery of Health Care | Health | Domestic Violence | Crime | Sociocultural Factors | Economic Factors | Programs | Organization and Administration Document Number: 328698 |
| 26. Peer Reviewed Title: Tubal sterilization by laparoscopy or hysteroscopy: which is the most cost-effective procedure? Author: Franchini M; Cianferoni L; Lippi G; Calonaci F; Calzolari S; Mazzini M; Florio P Source: Fertility and Sterility. 2009 Apr;91(4 Suppl):1499-502. Abstract: By using the activity-based cost/management (ABC/M) system we computed and compared costs needed for laparoscopic tubal sterilization (LTS) and Essure hysteroscopic tubal occlusion (EHTO). We found that total health costs related to consultation and presurgery did not differ between LTS and EHTO; EHTO has low recovery unit costs but is more costly for the operating theater, mainly due to Essure microinserts. Language: English Keywords: UNITED STATES OF AMERICA | ITALY | RESEARCH REPORT | WOMEN | TUBAL LIGATION | FEMALE STERILIZATION | SURGERY | COST BENEFIT ANALYSIS | TREATMENT | DELIVERY OF HEALTH CARE | MANAGEMENT | LOGISTICS | SCREENING | PROGRAM EFFICIENCY | Developed Countries | North America | Americas | Europe, Southern | Europe | Demographic Factors | Population | Sterilization, Sexual | Family Planning | Medical Procedures | Medicine | Health Services | Health | Quantitative Evaluation | Evaluation | Organization and Administration | Examinations and Diagnoses | Program Evaluation | Programs Document Number: 341007 |
| 27. Title: Contraception and screening for cervical and breast cancer in neuromuscular disease: A retrospective study of 50 patients monitored at a clinical reference centre. Author: Goutard S; Baron C; Bouton C; Penisson-Besnier I; Fosse G; Aube-Nathier AC; Havet-Thomassin V; Dubas F; Richard I Source: Annals of Physical and Rehabilitation Medicine. 2009 Aug 14; Abstract: OBJECTIVE: To analyse contraceptive methods and the extent of screening for breast and cervical cancer in women with neuromuscular disease, compare these results with data and guidelines for the general population and determine the environmental and attitudinal barriers encountered. PATIENTS AND METHODS: A retrospective, descriptive study in a population of female neuromuscular disease patients (aged 20 to 74) monitored at a clinical reference centre. RESULTS: Complete datasets were available for 49 patients. Seventy percent used contraception (hormonal contraception in most cases). Sixty-eight percent had undergone screening for cervical cancer at some time in the previous 3 years and 100% of the patients over 50 had undergone a mammography. Architectural accessibility and practical problems were the most common barriers to care and were more frequently encountered by wheelchair-bound, ventilated patients. CONCLUSIONS: In general, the patients had good access to contraceptive care and cervical and breast cancer screening. However, specific measures may be useful for the most severely disabled patients. Language: English Keywords: FRANCE | RESEARCH REPORT | RETROSPECTIVE STUDIES | CLIENTS | WOMEN | ORAL CONTRACEPTIVES | CONTRACEPTION | BREAST CANCER | CERVICAL CANCER | SCREENING | MUSCULAR EFFECTS | PROGRAM EVALUATION | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Demographic Factors | Population | Contraceptive Methods | Family Planning | Cancer | Neoplasms | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Physiology | Biology Document Number: 342589 |
| 28. Peer Reviewed Title: Sexual behaviour, condom use and rates of sexually transmitted infections in HIV clinic attendees in South East London. Author: Hamlyn E; Welz T; Rebaudengo S; Simms H; Poulton M Source: International Journal of STD and AIDS. 2009 Sep 16; Abstract: The aim of this study was to examine sexual behaviour, condom use and rates of sexually transmitted infections (STIs) among attendees at a dedicated on-site STI clinic at a South London HIV centre. Data were prospectively collected by using a nurse-completed questionnaire. Ninety-eight percent of women reported one or no sexual partners in the preceding three months, whereas 57% of men who have sex with men (MSM) reported two or more partners. Only 28% of women, 53% of heterosexual men and 29% of MSM always used a condom for vaginal or anal intercourse. Positive STI diagnoses were found in 17.5% of women, 20% of heterosexual men and 49% of MSM. Twenty percent of patients who reported always using a condom and 38% of MSM reporting no sexual activity in the preceding three months had an STI. These results highlight the need for safe sex promotion and STI screening in HIV-infected patients regardless of self-reported sexual activity. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | PROSPECTIVE STUDIES | CLIENTS | PERSONS LIVING WITH HIV/AIDS | HETEROSEXUALS | MEN HAVING SEX WITH MEN | CONDOM USE | SEX BEHAVIOR | SEXUALLY TRANSMITTED DISEASES | PREVALENCE | QUESTIONNAIRES | CLINIC ACTIVITIES | SCREENING | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Behavior | Risk Reduction Behavior | Reproductive Tract Infections | Infections | Measurement | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342841 |
| 29. Peer Reviewed Title: High incidence of tuberculosis among HIV-infected infants: evidence from a South African population-based study highlights the need for improved tuberculosis control strategies. Author: Hesseling AC; Cotton MF; Jennings T; Whitelaw A; Johnson LF; Eley B; Roux P; Godfrey-Faussett P; Schaaf HS Source: Clinical Infectious Diseases. 2009 Jan 1;48(1):108-14. Abstract: BACKGROUND: There are limited population-based estimates of tuberculosis incidence among human immunodeficiency virus (HIV)-infected and HIV-uninfected infants aged < or =12 months. We aimed to estimate the population-based incidence of culture-confirmed tuberculosis among HIV-infected and HIV-uninfected infants in the Western Cape Province, South Africa. METHODS: The incidences of pulmonary, extrapulmonary, and disseminated tuberculosis were estimated over a 3-year period (2004-2006) with use of prospective representative hospital surveillance data of the annual number of culture-confirmed tuberculosis cases among infants. The total number of HIV-infected and HIV-uninfected infants was calculated using population-based estimates of the total number of live infants and the annual maternal HIV prevalence and vertical HIV transmission rates. RESULTS: There were 245 infants with culture-confirmed tuberculosis. The overall incidences of tuberculosis were 1596 cases per 100,000 population among HIV-infected infants (95% confidence interval [CI], 1151-2132 cases per 100,000 population) and 65.9 cases per 100,000 population among HIV-uninfected infants (95% CI, 56-75 cases per 100,000 population). The relative risk of culture-confirmed tuberculosis among HIV-infected infants was 24.2 (95% CI, 17-34). The incidences of disseminated tuberculosis were 240.9 cases per 100,000 population (95% CI, 89-433 cases per 100,000 population) among HIV-infected infants and 14.1 cases per 100,000 population (95% CI, 10-18 cases per 100,000 population) among HIV-uninfected infants (relative risk, 17.1; 95% CI, 6-34). CONCLUSIONS: This study indicates the magnitude of the tuberculosis disease burden among HIV-infected infants and provides population-based comparative incidence rates of tuberculosis among HIV-infected infants. This high risk of tuberculosis among HIV-infected infants is of great concern and may be attributable to an increased risk of tuberculosis exposure, increased immune-mediated tuberculosis susceptibility, and/or possible limited protective effect of bacille Calmette-Guerin vaccination. Improved tuberculosis control strategies, including maternal tuberculosis screening, contact tracing of tuberculosis-exposed infants coupled with preventive chemotherapy, and effective vaccine strategies, are needed for infants in settings where HIV infection and tuberculosis are highly endemic. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | INCIDENCE | INFANT | PERSONS LIVING WITH HIV/AIDS | TUBERCULOSIS | HIV TRANSMISSION | SCREENING | EXPOSURE | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Measurement | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Infections | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Risk Factors | Biology Document Number: 329778 |
| 30. Peer Reviewed Title: Women's motivation to participate in contraceptive efficacy trials. Author: Hohmann H; Reid L; Creinin MD Source: Contraception. 2009 Sep;80(3):270-5. Abstract: BACKGROUND: We sought to determine whether there are differences in subject's motivation to participate in hormonal and barrier method contraceptive efficacy studies. STUDY DESIGN: All women presenting for screening appointments for either barrier or hormonal contraceptive efficacy trials were asked to complete a survey including demographic questions and questions which utilized Likert scales to grade the importance of potential motivating factors for research participation. RESULTS: A total of 72 hormonal and 36 barrier method subjects completed the survey. More women in the barrier group cited an altruistic reason as their primary motivator for participation in comparison to the hormonal group (61.2% vs. 31.9%, respectively, p=.004). This difference continued to be statistically significant in multiple logistic regression controlling for demographic variables. The most common primary motivating factor cited by the barrier group was the belief that research is important (30.6%), whereas the most common reason cited by the hormonal group was the desire for free contraception (22.2%). CONCLUSION: Women enrolling in barrier method studies are more likely than women enrolling in hormonal studies to cite an altruistic reason for their participation in these trials. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | CLINICAL TRIALS | WOMEN | SCREENING | CONTRACEPTION | MOTIVATION | PARTICIPATION | Developed Countries | North America | Americas | Clinical Research | Research Methodology | Demographic Factors | Population | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Family Planning | Psychological Factors | Behavior | Social Behavior Document Number: 342574 |
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