1.  Title: Building laboratory infrastructure to support scale-up of HIV/AIDS treatment, care, and prevention: in-country experience. Author: Abimiku AG Author: Institute of Human Virology, University of Maryland School of Medicine PEPFAR Source: American Journal of Clinical Pathology. 2009 Jun;131(6):875-86. Abstract: An unprecedented influx of funds and support through large programs such as the Global Fund for AIDS, Malaria and Tuberculosis and the World Health Organization's and President's Emergency Plan for AIDS Relief (PEPFAR) has made it possible for more than 1 million persons in resource-limited settings to access AIDS treatment and several million more to be in care and prevention programs. Nevertheless, there remain major challenges that prevent AIDS drugs and care from reaching many more in need, especially in rural settings. The roll-out of a high-quality treatment, care, and prevention program depends on an effective and reliable laboratory infrastructure. This article presents a strategy used by the Institute of Human Virology (IHV)-University of Maryland and its affiliate IHV-Nigeria to establish a multifaceted, integrated tier laboratory program to support a PEPFAR-funded scale-up of its AIDS Care Treatment in Nigeria program, in collaboration with the Centers for Disease Control and Prevention and the Nigerian government, as a possible model for overcoming a key challenge that faces several resource-limited countries trying to roll out and scale-up their HIV/AIDS treatment, care, and prevention program. Language: English Keywords: NIGERIA | CRITIQUE | HIV INFECTIONS | CARE AND SUPPORT | TREATMENT | HIV PREVENTION | LABORATORY | EQUIPMENT AND SUPPLIES | LABORATORY EXAMINATIONS AND DIAGNOSES | TESTING | TUBERCULOSIS | INTEGRATED PROGRAMS | TRAINING ACTIVITIES | STANDARDS | QUALITY CONTROL | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Viral Diseases | Diseases | Health Services | Delivery of Health Care | Health | Medical Procedures | Medicine | Examinations and Diagnoses | Measurement | Research Methodology | Infections | Programs | Organization and Administration | Training Programs | Education Document Number: 341766 |
| 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. Title: Primary and secondary tuberculosis preventive treatment in HIV clinics: simulating alternative strategies. Author: Basu S; Maru D; Poolman E; Galvani A Source: International Journal of Tuberculosis and Lung Disease. 2009 May;13(5):652-8. Abstract: BACKGROUND: Isoniazid preventive treatment (IPT) has been recommended for human immunodeficiency virus (HIV) infected individuals. OBJECTIVE/DESIGN: We used a mathematical model to simulate the benefits and risks of preventive treatment delivered through antiretroviral (ARV) clinics using clinical data from Botswana. RESULTS: Preventive treatment was found to reduce the incidence of tuberculosis (TB) by at least 12 cases per 100000 population per year versus the scenario without such treatment over a 50-year simulation. Isoniazid (INH) resistant TB was observed to increase by <1% per year, even when using pessimistic assumptions about resistance emergence. The use of tuberculin skin testing had little impact as a screening procedure, while secondary treatment was observed to nearly double the impact of a preventive treatment program. Regardless of whether or not preventive treatment was implemented, INH-resistant TB rose in the context of increasing HIV prevalence, but was minimally amplified by preventive treatment itself. CONCLUSIONS: IPT programs implemented through ARV clinics may be effective at reducing TB incidence. The resistance contribution of IPT appears unlikely to supersede its overall incidence and mortality benefits. Language: English Keywords: BOTSWANA | RESEARCH REPORT | MATHEMATICAL MODEL | PERSONS LIVING WITH HIV/AIDS | CLIENTS | TUBERCULOSIS | DRUGS | TESTING | ANTIRETROVIRAL DRUGS | DRUG RESISTANCE | INCIDENCE | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Theoretical Models | Research Methodology | HIV Infections | Viral Diseases | Diseases | Program Activities | Programs | Organization and Administration | Infections | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement Document Number: 341945 |
| 4. Title: CD4 validation for the World Health Organization classification and clinical staging of HIV/AIDS in a developing country. Author: Edathodu J; Ali B; Alrajhi AA Source: International Journal of Infectious Diseases. 2009 Mar;13(2):243-6. Abstract: OBJECTIVES: To validate the World Health Organization (WHO) clinical staging and classification of HIV/AIDS using CD4+ T-lymphocyte counts in the setting of a developing country. METHODS: This was a retrospective chart review of HIV-infected adults at the national HIV referral clinic in the Kingdom of Saudi Arabia. Four hundred HIV-infected individuals were reviewed. All individuals under the age of 15 years and those who had received antiretroviral therapy were excluded. WHO clinical stage at presentation was determined by a single reviewer. The first CD4+ T-lymphocyte count within 6 months of diagnosis of HIV infection was then abstracted by a different reviewer. The main outcome measure was the comparison of the WHO clinical stages of HIV/AIDS at the time of diagnosis and the CD4+ T-lymphocyte counts. RESULTS: Data were available for 191 individuals, of whom 123 were men and 68 were women. The mean CD4+ T-lymphocyte count was 281/mm(3) in the men and 425/mm(3) in the women. The distribution of individuals at the WHO clinical stages was 110 at stage I, 10 at stage II, 36 at stage III, and 35 at stage IV. Mean CD4+ T-lymphocyte counts were 457, 337, 188, and 86/mm(3) at the respective stages. The difference between the mean CD4+ T-lymphocyte count in patients at stage IV and at each of the other stages was significant; p<0.0001. The correlation between the stages and the mean CD4+ T-lymphocyte counts was -0.65. CONCLUSION: The WHO clinical staging and classification of HIV/AIDS correlates well with CD4+ T-lymphocyte counts. Language: English Keywords: SAUDI ARABIA | RESEARCH REPORT | WHO | VALIDITY | HIV | AIDS | TESTING | IMMUNITY | Middle East | Developing Countries | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Measurement | Research Methodology | HIV Infections | Viral Diseases | Diseases | Immune System | Physiology | Biology Document Number: 341557 |
| 5. Title: Impact of a public antiretroviral program on TB/HIV mortality: Banteay Meanchey, Cambodia. Author: Eng B; Cain KP; Nong K; Chhum V; Sin E; Roeun S; Kim S; Keo S; Heller TA; Varma JK Source: Southeast Asian Journal of Tropical Medicine and Public Health. 2009 Jan;40(1):89-92. Abstract: The WHO recommends antiretroviral therapy (ART) for most HIV-infected tuberculosis patients. To assess the impact of ART on tuberculosis case-fatality rates in Cambodia, we compared treatment outcomes of patients newly diagnosed with tuberculosis in 2004 (before implementation of ART clinics) with outcomes of patients diagnosed in 2005 (after these clinics opened). In 2004, 37% of HIV-infected tuberculosis patients died during TB treatment compared with 5% of HIV-uninfected tuberculosis patients. In 2005, 18% of HIV-infected tuberculosis patients died compared with 5% of HIV-uninfected tuberculosis patients. The case-fatality rate for HIV-associated tuberculosis decreased from 2004 to 2005, coincident with the introduction of ART. Language: English Keywords: CAMBODIA | RESEARCH REPORT | CLIENTS | PERSONS LIVING WITH HIV/AIDS | TESTING | TUBERCULOSIS | ANTIRETROVIRAL THERAPY | Developing Countries | Asia, Southeastern | Asia | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Measurement | Research Methodology | Infections | HIV Document Number: 341780 |
| 6. Title: [Efficacy and safety of drospirenone-ethinylestradiol on contraception in healthy chinese women: a multicenter randomized controlled trial] Author: Fan GS; Bian ML; Cheng LN; Cao XM; Huang ZR; Han ZY; Jing XP; Li J; Wu SY; Xiong CL; Xiong ZA; Yue TF Source: Zhonghua Fu Chan Ke Za Zhi. 2009 Jan;44(1):38-44. Abstract: OBJECTIVE: To evaluate the contraception efficacy, mode of bleeding, side effects and other positive effects of drospirenone-ethinylestradiol (Yasmin) in healthy Chinese women. METHODS: This was a multicenter, randomized, control study of 768 healthy Chinese women who consulted about contraception. The subjects were randomized into Yasmin group (30 microg ethinylestradiol plus 3 mg drospirenone, 573 cases) or desogestrel group (30 microg ethinylestradiol plus 150 microg desogestrel, 195 cases) with the ratio of 3:1. Each individual was treated for 13 cycles. Further visits were required at cycle 4, cycle 7, cycle 10 and cycle 13 of treatment Weight, height, body mass index were evaluated at each visit. The menstrual distress questionnaire (MDQ) was given to the women at baseline, visit 3 (cycle 7) and visit 5 (after cycle 13). RESULTS: The values of basal features were similar between two groups (P > 0.05). The Pearl index (method failure) of Yasmin was 0. 208/hundred women year which was lower than that of desogestrel (0. 601/hundred women year). The mode of bleeding was similar between two groups after trial without showing any significant difference. According to MDQ subscale, the improvement of water retention and increasing appetite during inter-menstrual period and water retention and general well-being during menstrual period in the Yasmin group (-0.297, -0.057, 0.033, 0.150 respectively) was more obvious than that in the desogestrel group (-0.108, 0.023, 0.231, -0.023 respectively) with a significant difference (P < 0.05). Some other values which improved in both two groups, especially the improvement of breast tenderness and pain and skin abnormality in Yasmin group (18.0%, 89/494; 12.6%, 62/494) was more distinct than that in desogestrel group (11.3%, 19/168; 5.4%, 9/168). The mean weight increased in desogestrel group (0.57 kg) while it decreased in Yasmin group (-0.28 kg) with a significant difference (P < 0.01). CONCLUSIONS: Both Yasmin and desogestrel have good efficacy on contraception and similar modes of menstrual bleeding. Yasmin is better than desogestrel in terms of weight control and premenstrual syndrome of oral contraceptive. Language: Chinese Keywords: CHINA | RESEARCH REPORT | WOMEN | PEARL'S FORMULA | BODY WEIGHT | BODY HEIGHT | MENSTRUATION DISORDERS | DESOGESTREL | ETHINYL ESTRADIOL | TREATMENT | TESTING | Asia, Eastern | Asia | Developing Countries | Demographic Factors | Population | Contraceptive Use-Effectiveness | Contraceptive Effectiveness | Contraception | Family Planning | Physiology | Biology | Diseases | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Agents, Estrogen | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement | Research Methodology Document Number: 341804 |
| 7. Peer Reviewed Title: HIV prevalence and mortality among children undergoing treatment for severe acute malnutrition in sub-Saharan Africa: a systematic review and meta-analysis. Author: Fergusson P; Tomkins A Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2009 Jun;103(6):541-8. Abstract: This systematic review and meta-analysis explored HIV prevalence and mortality in children undergoing treatment for severe acute malnutrition (SAM) in sub-Saharan Africa. It included all studies reporting on HIV infection within a sample of children with SAM where HIV status was assessed using a blood test and SAM was defined using the WHO, Gomez, Wellcome or Waterlow definitions. Children from 17 studies were included in the analysis (n=4891), of whom 29.2% were HIV-infected. HIV-infected children were significantly more likely to die than HIV-uninfected children (30.4% vs. 8.4%; P<0.001; relative risk=2.81, 95% CI 2.04-3.87). HIV-negative children treated within community-based therapeutic care (CTC) programmes had lower mortality (4.3%) than those treated within an inpatient nutrition rehabilitation unit (NRU) (15.1%). There was no significant difference in mortality for HIV-infected children with SAM treated in the CTC (30.0%) or NRU (31.3%) settings. HIV prevalence is high in children with SAM in sub-Saharan Africa, and HIV-infected children are at significantly increased risk of mortality. There is an urgent need to integrate HIV testing and treatment into care for children with SAM in regions of high HIV prevalence. Language: English Keywords: AFRICA | RESEARCH REPORT | PREVALENCE | CHILD | CHILD MORTALITY | MALNUTRITION | HIV INFECTIONS | HIV TESTING | TESTING | HIV | RISK FACTORS | TREATMENT | Developing Countries | Measurement | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Mortality | Population Dynamics | Nutrition Disorders | Diseases | Viral Diseases | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342751 |
| 8. Peer Reviewed Title: Acceptability and reliability of an adolescent risk behavior questionnaire administered with audio and computer support. Author: Gutierrez JP; Torres-Pereda P Source: Revista Panamericana de Salud Publica. 2009;25(5):418-422. Abstract: Answers to sensitive behavior-related questions were obtained using ACASI systems and compared with answers to the same questions obtained through face-to-face interviews (FFIs) among adolescents in Mexico. Focus groups were conducted to explore ACASI's acceptability among adolescents and ASCASI's potential for obtaining better self-reported data on sensitive behaviors. ACASI was adolescents' preferred method for reporting risk behaviors, particularly sexual behavior. Also, more risk behaviors were reported through ACASI than FFIs. The authors conclude that using ACASI systems in disadvantaged households to obtain data on adolescent risk behavior is not only feasible but may also improve data quality in the case of complex questionnaires, compared with FFIs. Language: English Keywords: MEXICO | RESEARCH REPORT | QUESTIONNAIRES | RELIABILITY | ADOLESCENTS | TESTING | SEX BEHAVIOR | RISK BEHAVIOR | CONFIDENTIAL INFORMATION | INFORMATION PROCESSING | North America | Americas | Developing Countries | Measurement | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Behavior | Ethics | Sociocultural Factors | Information Document Number: 339854 |
| 9. Peer Reviewed Title: Errors in 'BED'-derived estimates of HIV incidence will vary by place, time and age. Author: Hallett TB; Ghys P; Barnighausen T; Yan P; Garnett GP Source: PloS One. 2009;4(5):e5720. Abstract: BACKGROUND: The BED Capture Enzyme Immunoassay, believed to distinguish recent HIV infections, is being used to estimate HIV incidence, although an important property of the test--how specificity changes with time since infection--has not been not measured. METHODS: We construct hypothetical scenarios for the performance of BED test, consistent with current knowledge, and explore how this could influence errors in BED estimates of incidence using a mathematical model of six African countries. The model is also used to determine the conditions and the sample sizes required for the BED test to reliably detect trends in HIV incidence. RESULTS: If the chance of misclassification by BED increases with time since infection, the overall proportion of individuals misclassified could vary widely between countries, over time, and across age-groups, in a manner determined by the historic course of the epidemic and the age-pattern of incidence. Under some circumstances, changes in BED estimates over time can approximately track actual changes in incidence, but large sample sizes (50,000+) will be required for recorded changes to be statistically significant. CONCLUSIONS: The relationship between BED test specificity and time since infection has not been fully measured, but, if it decreases, errors in estimates of incidence could vary by place, time and age-group. This means that post-assay adjustment procedures using parameters from different populations or at different times may not be valid. Further research is urgently needed into the properties of the BED test, and the rate of misclassification in a wide range of populations. Language: English Keywords: AFRICA | RESEARCH REPORT | ESTIMATION TECHNIQUES | MATHEMATICAL MODEL | HIV INFECTIONS | IMMUNOLOGICAL EFFECTS | INCIDENCE | TESTING | LABORATORY PROCEDURES | ERROR SOURCES | TIME FACTORS | Developing Countries | Research Methodology | Theoretical Models | Viral Diseases | Diseases | Immunity | Immune System | Physiology | Biology | Measurement | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Population Dynamics | Demographic Factors | Population Document Number: 342159 |
| 10. Peer Reviewed Title: Good performance of rapid prostate-specific antigen test for detection of semen exposure in women: implications for qualitative research. Author: Hobbs MM; Steiner MJ; Rich KD; Gallo MF; Alam A; Rahman M; Menezes P; Chipato T; Warner L; Macaluso M Source: Sexually Transmitted Diseases. 2009 Aug;36(8):501-6. Abstract: BACKGROUND: Prostate-specific antigen (PSA) is a valid biomarker of semen exposure in women and has been used to assess reliability of self-reported sexual behavior as well as serve as a proxy measure for condom efficacy. Quantitative PSA tests are expensive and require specialized equipment. A simple, rapid, and inexpensive test for PSA would facilitate semen biomarker evaluation in a variety of research settings. This study evaluated the performance of a rapid PSA test compared with a quantitative assay to identify semen in vaginal swab specimens. METHODS: We tested 581 vaginal swabs collected from 492 women participating in 2 separate research studies in Bangladesh and Zimbabwe. PSA in vaginal secretions was detected using the quantitative IMx (Abbott Laboratories) assay and the ABAcard p30 (Abacus Diagnostics) rapid immunochromatographic strip test. RESULTS: The ABAcard test was 100% sensitive (95% confidence interval [CI], 98%-100%) and 96% specific (95% CI, 93%-97%) compared with the quantitative test in detecting >1.0 ng PSA/mL vaginal swab eluate. Rapid PSA results were semiquantitative and correlated well with PSA concentrations (kappa = 0.88; 95% CI, 0.85-0.90). CONCLUSION: Rapid PSA detection requires no instrumentation and can be performed easily and economically. Having rapid PSA results available immediately following interview provides opportunities to explore discrepancies between the objective marker of recent semen exposure and self-reported behaviors. Language: English Keywords: BANGLADESH | ZIMBABWE | RESEARCH REPORT | COMPARATIVE STUDIES | WOMEN | SEX WORKERS | SEX BEHAVIOR | SEMEN | PROSTATE | ANTIGENS | TESTING | RELIABILITY | Developing Countries | Asia, Southern | Asia | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Demographic Factors | Population | Behavior | Seminal Vesicles | Genitalia, Male | Genitalia | Urogenital System | Physiology | Biology | Immunologic Factors | Immunity | Immune System | Measurement Document Number: 342948 |
| 11. Title: Seropositivity for Listeria monocytogenes in women with spontaneous abortion: a case-control study in Iran. Author: Jamshidi M; Jahromi AS; Davoodian P; Amirian M; Zangeneh M; Jadcareh F Source: Taiwanese Journal of Obstetrics and Gynecology. 2009 Mar;48(1):46-8. Abstract: OBJECTIVE: There are many studies supporting the role of certain asymptomatic infections such as Listeria monocytogenes (L. monocytogenes) in spontaneous abortion. In some cases, latent listeriosis may complicate the pregnancy, and serologic tests can, therefore, be used to detect the disease. This study was designed to assess the relationship between seropositivity for L. monocytogenes and spontaneous abortion. MATERIALS AND METHODS: A total of 250 women with previous spontaneous abortion and a control group of 200 women with normal full-term deliveries entered the study as case and control groups, respectively. Demographic characteristics were recorded for each subject, and serum samples were obtained from all participants. All serum samples were examined using the indirect immunofluorescence antibody test for L. monocytogenes antibody. Data was analyzed using Chi-squared and t tests. RESULTS: The average age of participants was 25.6 +/- 7.6 years in cases and 25.3 +/- 6.5 years in controls. Eighty-nine (35.6%) of the cases with abortion and 35 (17.5%) of the control group were positive for L. monocytogenes antibody (p = 0.001). No relationship was observed between the number of pregnancies and infection with L. monocytogenes (p = 0.4), or between the number of previous abortions and L. monocytogenes seropositivity (p = 0.2). CONCLUSION: We suggest monitoring L. monocytogenes seroprevalence in pregnant women at high risk of threatened abortion, and further microbiological assessment of symptomatic women for detection of L. monocytogenes and insidious infection. Language: English Keywords: IRAN | RESEARCH REPORT | CASE STUDIES | WOMEN | ABORTION, SPONTANEOUS | PREGNANCY | MONITORING | INFECTIONS | TESTING | Middle East | Developing Countries | Studies | Research Methodology | Demographic Factors | Population | Pregnancy Complications | Diseases | Reproduction | Evaluation | Measurement Document Number: 342081 |
| 12. Title: A test that won't die: the serologic test for syphilis [editorial] Author: Katz LM Source: Transfusion. 2009 Apr;49(4):617-9. Abstract: We (the blood community and the regulators) are unable to articulate an answer to the question "how safe is safe enough?" for the set of blood safety measures we have already implemented.We must address this fundamental policy issue to establish priorities for our menu of potential future threats and interventions and to move solutions through development and deploy them with the urgency their importance demands. The experience of four decades with no recognized transfusion-transmitted syphilis, during which we have implemented a manylayered approach to blood safety addressing a substantial proportion of the risk of T. pallidum infection in the donor base, suggests that the time is ripe to reconsider the use of STS. (excerpt) Language: English Keywords: IOWA | CRITIQUE | RECOMMENDATIONS | CLINICAL RESEARCH | BLOOD DONORS | SYPHILIS | TESTING | SEROCONVERSION | BLOOD TRANSFUSION | SEXUALLY TRANSMITTED DISEASE PREVENTION | United States of America | North America | Americas | Developed Countries | Research Methodology | Blood Supply | Equipment and Supplies | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Measurement | Immunity | Immune System | Physiology | Biology | Treatment Document Number: 331247 |
| 13. Peer Reviewed Title: Psychometric evaluation of the Trauma Symptoms Checklist for Children (TSCC) among children affected by HIV/AIDS in China. Author: Li X; Fang X; Stanton B; Zhao G; Lin X; Zhao J; Zhang L; Hong Y; Chen X Source: AIDS Care. 2009 Mar;21(3):261-70. Abstract: The current study, utilizing the baseline data from a longitudinal assessment of psychosocial needs of children orphaned by HIV/AIDS or living with HIV-infected parents in China, was designed to assess the psychometric properties of the Trauma Symptoms Checklist for Children (TSCC) among children affected by HIV/AIDS in China. The psychometric properties assessed in this study include internal consistency, convergent and discriminant validity, and construct validity. The sample in the current study include 296 double orphans, 459 single orphans, and 466 children living with HIV-infected parents in central China where many residents had been infected with HIV through unhygienic blood collection. The results demonstrate adequate reliability and validity of the TSCC among study population. Children who experienced more traumatic events scored significantly higher on all TSCC clinical scales and subscales than those children who experienced less such events. The Chinese version of the TSCC should provide mental health researchers and practitioners with a reliable and valid assessment instrument in studying posttraumatic distress and related psychological symptomology among children affected by HIV/AIDS in China. Language: English Keywords: CHINA | RESEARCH REPORT | SAMPLING STUDIES | ORPHANS AND VULNERABLE CHILDREN | AIDS | STRESS | SIGNS AND SYMPTOMS | ANGER | ANXIETY DISORDERS | DEPRESSION | TESTING | RELIABILITY | VALIDITY | Asia, Eastern | Asia | Developing Countries | Studies | Research Methodology | Family and Household | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Psychological Factors | Behavior | Emotions | Mental Disorders | Measurement Document Number: 341831 |
| 14. Title: Trends in the prevalence of HIV and syphilis among pregnant women under antenatal care in central Venezuela [letter] Author: Lopez-Zambrano MA; Briceno G; Rodriguez-Morales AJ Source: International Journal of Infectious Diseases. 2009 Jul;13(4):e189-91. Abstract: This letter to the editor focuses on trends in HIV and syphilis prevalence among antenatal women in Aragua state, Venezuela. It states that antenatal syphilis screening and treatment programs are cost effective and needs to be reinforced, even in low prevalence areas, to avoid STIs in pregnant women and children. Language: English Keywords: VENEZUELA | RESEARCH REPORT | PREGNANT WOMEN | HIV INFECTIONS | SYPHILIS | PREVALENCE | ANTENATAL CARE | HIV TESTING | TESTING | SCREENING | South America, Northern | South America | Latin America | Americas | Developing Countries | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Measurement | Research Methodology | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine Document Number: 342834 |
| 15. Title: Usefulness of highly active antiretroviral therapy on health-related quality of life of adult recipients in Tanzania. Author: Magafu MG; Moji K; Igumbor EU; Hashizume M; Mizota T; Komazawa O; Cai G; Yamamoto T Source: AIDS Patient Care and STDs. 2009 Jul;23(7):563-70. Abstract: This study assessed health-related quality of life (HRQOL) of highly active antiretroviral therapy (HAART) recipients aged 18 or older and associated factors, 2 years after HAART administration had started in Kagera, Tanzania. Using the 36-Item Short Form Health Survey (SF-36), 329 HAART recipients were interviewed in May 2007. Questions on sociodemographic characteristics, chronic diseases (besides HIV/AIDS), HAART side effects and adherence to antiretroviral drugs were added. Treatment data, the first and latest available CD4 counts were retrieved from patients' records. Gender and age-adjusted mean scale scores of the sample were compared to those of the general Tanzanian population of the late 1990 s using t test. Logistic regression was used to explore the effect of sex, age, education level, income, chronic diseases, CD4 count, HAART side effects and adherence to antiretroviral drugs on recipients' physical functioning and mental health scale scores. The mean scale scores of HAART recipients were generally lower than those of the general population except for general health perceptions (p = 0.191) and mental health (p = 0.161). HAART recipients with chronic disease comorbidity were more likely to score below the general population's mean score for mental health (p = 0.007). While the effect of chronic disease comorbidity on physical functioning among those who recorded a CD4 count increase was negative (odds ratio [OR] = 13.6, 95% confidence interval [CI] = 3.7, 49.9), there was no effect on those who did not have such an increase. The control of chronic diseases among recipients should be given priority to improve their HRQOL. Language: English Keywords: TANZANIA | RESEARCH REPORT | HEALTH SURVEYS | CLIENTS | SOCIOECONOMIC FACTORS | DISEASES | HIV INFECTIONS | AIDS | HIV | ANTIRETROVIRAL THERAPY | TREATMENT | QUALITY OF LIFE | PERCEPTION | MENTAL HEALTH | TESTING | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Health | Program Activities | Programs | Organization and Administration | Economic Factors | Viral Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Social Welfare | Psychological Factors | Behavior | Measurement | Research Methodology Document Number: 342980 |
| 16. Title: Characteristics of HIV-infected tuberculosis patients in Thailand. Author: Mankatittham W; Likanonsakul S; Thawornwan U; Kongsanan P; Kittikraisak W; Burapat C; Akksilp S; Sattayawuthipong W; Srinak C; Nateniyom S; Tasaneeyapan T; Varma JK Source: Southeast Asian Journal of Tropical Medicine and Public Health. 2009 Jan;40(1):93-103. Abstract: To improve understanding about the epidemiology and clinical features of HIV-associated tuberculosis (TB) infection we conducted a prospective, multi-center observational study of HIV-infected TB patients in Thailand. We enrolled HIV-infected patients diagnosed with TB at public health facilities from three provinces and the national infectious diseases referral hospital in Thailand. Patients underwent standardized interviews, evaluations, and laboratory testing at the beginning of TB treatment. We analyzed demographic and clinical characteristics of patients and stratified our findings by level of immune-suppression and whether antiretroviral therapy (ART) was used before TB diagnosis. Of 769 patients analyzed, pulmonary TB was diagnosed in 461 (60%). The median CD4+ T-lymphocyte (CD4) count was 63 cells/microl [interquartile range (IQR), 23-163.5] and the median HIV RNA viral load was 308,000 copies/ml (IQR, 51,900-759,000) at the time of TB diagnosis. Methamphetamine use was reported by 304 patients (40%), marijuana by 267 patients (35%), and injection drug use by 199 patients (26%). Three hundred three patients (40%) reported having been previously incarcerated. Among sexually active patients, 142 (42%) reported never using condoms at all. Patients with CD4 counts <200 cells/microl were significantly more likely than patients with CD4 counts > or =200 cells/microl to have extra-pulmonary TB, fever, fatigue, muscle weakness, no hemoptysis, tachycardia, low body mass index, jaundice, or no pleural effusion. Of the 94 patients that received ART before TB diagnosis, the median time from ART initiation to TB diagnosis was 105 days (IQR, 31-468). HIV-infected patients who developed TB after ART initiation were more likely than other HIV-infected TB patients to have extra-pulmonary TB, a normal chest radiograph, low HIV RNA viral load, or a history of previous TB treatment. Language: English Keywords: THAILAND | RESEARCH REPORT | PROSPECTIVE STUDIES | EPIDEMIOLOGY | PERSONS LIVING WITH HIV/AIDS | CLIENTS | TUBERCULOSIS | TESTING | Developing Countries | Asia, Southeastern | Asia | Studies | Research Methodology | Public Health | Health | HIV Infections | Viral Diseases | Diseases | Program Activities | Programs | Organization and Administration | Infections | Measurement Document Number: 341779 |
| 17. Title: Implementation of the thin layer agar method for diagnosis of smear-negative pulmonary tuberculosis in a setting with a high prevalence of human immunodeficiency virus infection in Homa Bay, Kenya. Author: Martin A; Munga Waweru P; Babu Okatch F; Amondi Ouma N; Bonte L; Varaine F; Portaels F Source: Journal of Clinical Microbiology. 2009 Aug;47(8):2632-4. Abstract: The objective of this study was to evaluate the performance of a low-cost method, the thin layer agar (TLA) method, for the diagnosis of smear-negative patients. This prospective study was performed in Homa Bay District Hospital in Kenya. Out of 1,584 smear-negative sputum samples, 212 (13.5%) were positive by culture in Lowenstein-Jensen medium (LJ) and 220 (14%) were positive by the TLA method. The sensitivities of LJ and TLA were 71% and 74%, respectively. TLA could become an affordable method for the diagnosis of smear-negative tuberculosis in resource-limited settings, with results available within 2 weeks. Language: English Keywords: KENYA | RESEARCH REPORT | PREVALENCE | PROSPECTIVE STUDIES | INCIDENCE | LABORATORY EXAMINATIONS AND DIAGNOSES | TESTING | CLIENTS | TUBERCULOSIS | HIV | IMPLEMENTATION | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Measurement | Research Methodology | Studies | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Program Activities | Programs | Organization and Administration | Infections | Diseases | HIV Infections | Viral Diseases Document Number: 342984 |
| 18. Title: The Tanzania experience: clinical laboratory testing harmonization and equipment standardization at different levels of a tiered health laboratory system. Author: Massambu C; Mwangi C Source: American Journal of Clinical Pathology. 2009 Jun;131(6):861-6. Abstract: The rapid scale-up of the care and treatment programs in Tanzania during the preceding 4 years has greatly increased the demand for quality laboratory services for diagnosis of HIV and monitoring patients during antiretroviral therapy. Laboratory services were not in a position to cope with this demand owing to poor infrastructure, lack of human resources, erratic and/or lack of reagent supply and commodities, and slow manual technologies. With the limited human resources in the laboratory and the need for scaling up the care and treatment program, it became necessary to install automated equipment and train personnel for the increased volume of testing and new tests across all laboratory levels. With the numerous partners procuring equipment, the possibility of a multitude of equipment platforms with attendant challenges for procurement of reagents, maintenance of equipment, and quality assurance arose. Tanzania, therefore, had to harmonize laboratory tests and standardize laboratory equipment at different levels of the laboratory network. The process of harmonization of tests and standardization of equipment included assessment of laboratories, review of guidelines, development of a national laboratory operational plan, and stakeholder advocacy. This document outlines this process. Language: English Keywords: TANZANIA | CRITIQUE | HIV INFECTIONS | AIDS | ANTIRETROVIRAL THERAPY | LABORATORY | PROGRAM EVALUATION | PLANNING | EQUIPMENT AND SUPPLIES | LABORATORY EXAMINATIONS AND DIAGNOSES | TESTING | STANDARDIZATION | LOGISTICS | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Viral Diseases | Diseases | HIV | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Programs | Organization and Administration | Examinations and Diagnoses | Measurement | Research Methodology | Data Adjustment | Management Document Number: 341767 |
| 19. Title: The effects of menstrual cycle phase on clinical measures of concussion in healthy college-aged females. Author: Mihalik JP; Ondrak KS; Guskiewicz KM; McMurray RG Source: Journal of Science and Medicine In Sport. 2009 May;12(3):383-7. Abstract: The management of concussion and mild traumatic brain injury is an area of clinical uncertainty for many sports medicine professionals. While recent studies suggest sex differences in neurocognitive function may exist, our understanding of the effects of menstrual cycle phase and oral contraceptive pill (OCP) use in healthy females is limited. The purpose of this study was to investigate whether there were changes in neurocognitive function, postural stability and self-reported symptoms between the early and late stages of the menstrual cycle, and also to identify whether performance across menstrual cycle would differ between females using OCP and eumenorrheic females not using OCP. Healthy college-aged females completed a standard concussion test battery including computerised assessment of neurocognitive function, postural stability and symptom status. Participants completed the counterbalanced testing design during the early and late phases of their menstrual cycle. No significant main effects or interactions for any neurocognitive function or postural stability outcome measure were observed. Eumenorrheic females endorsed a higher number of symptoms and reported an increased symptom severity score compared to females using OCP. Menstrual cycle phase had no effect on the total severity or the number of symptoms endorsed. These results suggest preseason neurocognitive and postural stability baseline tests are stable across the menstrual cycle, regardless of OCP use. Therefore, decreased performance on these measures following a suspected concussion is likely not attributable to menstrual cycle phase or use of OCP. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | PROSPECTIVE STUDIES | WOMEN | YOUTH | ACCIDENTS AND INJURIES | SPORTS | SIGNS AND SYMPTOMS | TESTING | NEUROLOGIC EFFECTS | SENSORY EFFECTS | MENSTRUAL CYCLE | ORAL CONTRACEPTIVES | Developed Countries | North America | Americas | Studies | Research Methodology | Demographic Factors | Population | Age Factors | Population Characteristics | Health | Social Behavior | Behavior | Diseases | Measurement | Physiology | Biology | Menstruation | Reproduction | Contraceptive Methods | Contraception | Family Planning Document Number: 342413 |
| 20. Peer Reviewed Title: STI prevalence and associated factors among urban men in Pakistan. Author: Mir AM; Wajid A; Reichenbach L; Khan M Source: Sexually Transmitted Infections. 2009 Jun;85(3):199-200. Abstract: OBJECTIVES: To measure the prevalence of selected sexually transmitted infections (STIs) among urban men in Pakistan and identify associated factors. METHODS: A cross-sectional survey of 2400 urban men aged 16-45 years was carried out in six cities of Pakistan. Respondents were selected through a multistage systematic sampling design. After obtaining informed consent a structured behavioural questionnaire was administered. Blood and urine samples were also collected and tested for HIV (ELISA), HSV-2 (ELISA) syphilis (RPR and TPHA), chlamydia (PCR) and gonorrhoea (PCR). RESULTS: Of the 2383 respondents whose results were received, 4.4% (n = 106) tested positive for at least one of the five STIs. The prevalence of the individual organisms was as follows: syphilis, 1.3%; HIV, 0.1%; HSV-2, 3.4%; gonorrhoea, 0.8% and chlamydia, no cases. City-wise, the highest prevalence was in Karachi (8.5%) followed by Lahore (5.3%), Faisalabad (4.0%) Quetta (4.3%), Rawalpindi (2.5%) and Peshawar (2.0%). At the univariate and multivariate level, older age, less schooling, and having more than four sexual partners were significantly associated with the presence of an STI. 92% of men who tested positive for any STI were asymptomatic. CONCLUSIONS: HIV prevalence in Pakistan remains low, however, the emergence of genital herpes is a matter of concern as it could lead to a future conduit for HIV spread. Health education messages should target less educated segments of society and specifically advocate safe sex practices and early diagnosis. Language: English Keywords: PAKISTAN | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PREVALENCE | URBAN POPULATION | MEN | RESPONDENTS | LABORATORY PROCEDURES | SEXUALLY TRANSMITTED DISEASES | HERPES GENITALIS | EXAMINATIONS AND DIAGNOSES | TESTING | Developing Countries | Asia, Southern | Asia | Research Methodology | Measurement | Population Characteristics | Demographic Factors | Population | Surveys | Sampling Studies | Studies | Laboratory Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Reproductive Tract Infections | Infections | Diseases Document Number: 342670 |
| 21. Peer Reviewed Title: Comparison of T-SPOT.TB assay and tuberculin skin test for the evaluation of young children at high risk for tuberculosis in a community setting. Author: Nicol MP; Davies MA; Wood K; Hatherill M; Workman L; Hawkridge A Source: Pediatrics. 2009 Jan;123(1):38-43. Abstract: OBJECTIVE: We wished to compare the sensitivity of an enzyme-linked immunospot assay (T-SPOT.TB; Oxford Immunotec, Oxford, United Kingdom) and the tuberculin skin test for the detection of tuberculosis infection in very young children being evaluated for active tuberculosis in a rural community setting. METHODS: Children with a history of exposure to tuberculosis and children presenting to a local clinic or hospital with symptoms suggesting tuberculosis were admitted to a dedicated case verification ward. T-SPOT.TB testing was performed, and children were evaluated with a clinical examination, a tuberculin skin test, chest radiographs, and cultures of induced sputum and gastric lavage specimens. The diagnosis was determined by using a clinical algorithm. RESULTS: A total of 243 children (median age: 18 months) were recruited, of whom 214 (88%) had interpretable T-SPOT.TB results. Children > or =12 months of age were more likely than younger children to have positive T-SPOT.TB results, whereas tuberculin skin test results were unaffected by age. The sensitivity of the T-SPOT.TB was no better than that of the tuberculin skin test for culture-confirmed tuberculosis (50% and 80%, respectively) and was poorer for the combined group of culture-confirmed and clinically probable tuberculosis (40% and 52%, respectively). For the 50 children clinically categorized as not having tuberculosis, the specificity of both the T-SPOT.TB and the tuberculin skin test was 84%. CONCLUSIONS: For young children presenting in a community setting after exposure to tuberculosis or with symptoms suggesting tuberculosis, T-SPOT.TB cannot be used to exclude active disease. The sensitivity of this assay may be impaired for very young children. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | METHODOLOGICAL STUDIES | CLINICAL RESEARCH | COMPARATIVE STUDIES | CHILDREN | COMMUNITY | TUBERCULOSIS | TESTING | COMMUNITY HEALTH SERVICES | LABORATORY EXAMINATIONS AND DIAGNOSES | DERMATOLOGICAL EFFECTS | PHYSICAL EXAMINATIONS AND DIAGNOSES | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Residence Characteristics | Population Distribution | Geographic Factors | Infections | Diseases | Measurement | Primary Health Care | Health Services | Delivery of Health Care | Health | Examinations and Diagnoses | Medical Procedures | Medicine | Physiology | Biology Document Number: 328039 |
| 22. Title: Field evaluation of diagnostic accuracy of an oral fluid rapid test for HIV, tested at point-of-service sites in rural Zimbabwe. Author: Pascoe SJ; Langhaug LF; Mudzori J; Burke E; Hayes R; Cowan FM Source: AIDS Patient Care and STDs. 2009 Jul;23(7):571-6. Abstract: The objective of this study was to validate the use of OraQuick ADVANCE Rapid HIV-1/2 Antibody test (OraSure Technologies Inc., Bethlehem, PA) on oral fluid for a population-based HIV prevalence survey of rural youth in southeast Zimbabwe. The evaluation was conducted in patients presenting for voluntary counseling and testing at rural clinics. Each participant provided an oral fluid sample tested using OraQuick ADVANCE. In addition, dried blood specimens were collected and tested blind at the National Microbiology Reference Laboratory in Harare using two enzyme-linked immunosorbent assays (ELISA; Vironostika, Biomerieux BV, Boxtel, The Netherlands and Ani Labsystems, Ltd., Vantaa, Finland) with confirmatory Western blot (MP Diagnostics [formerly Genelabs Diagnostics], Medical Technology Promedt Consulting GMBH, St. Ingbert, Germany) for samples with discrepant results. Diagnostic accuracy of the oral fluid assay was determined against the ELISA/Western blot algorithm as gold standard. Five hundred and ninety-one participants took part in the study between February and July 2006. Sensitivity of the test on oral fluid was 100% (95% confidence interval [CI]: 97.9-100), and specificity was 100% (95% CI: 99.1-100). HIV prevalence based on the reference standard was 29.8% (95% CI: 26.1-33.5). This is one of the first validations of this rapid assay on oral fluid conducted in a general population to be reported in Africa. While there are some limitations with the assay (e.g., unlikely to detect those in early stages of HIV infection or with reduced viral load; altered accuracy in pregnancy) these limitations also apply to other rapid assays. The results showed the assay to be 100% accurate in determining HIV status, performed well in field settings, and can be considered suitable for use in epidemiologic surveys aiming to estimate HIV prevalence in general populations. Language: English Keywords: ZIMBABWE | RESEARCH REPORT | EVALUATION | RURAL AREAS | CLIENTS | VOLUNTARY COUNSELING AND TESTING | BLOOD | HIV TESTING | HEALTH FACILITIES | VALIDITY | TESTING | LABORATORY PROCEDURES | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Geographic Factors | Population | Program Activities | Programs | Organization and Administration | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Hemic System | Physiology | Biology | Measurement | Research Methodology Document Number: 342983 |
| 23. Title: Clinical scoring system for paediatric tuberculosis in HIV-infected and non-infected children in Rio de Janeiro. Author: Pedrozo C; Sant'Anna C; de Fatima March M; Lucena S Source: International Journal of Tuberculosis and Lung Disease. 2009 Mar;13(3):413-5. Abstract: The scoring system for diagnosing tuberculosis (TB) used in Brazil has already been validated in human immunodeficiency virus (HIV) negative tuberculous children. Here we studied HIV-positive children. The individuals were divided into four groups: 1) tuberculous infection; 2) other pulmonary diseases; 3a) pulmonary TB and 3b)pulmonary TB and HIV. Group 3a had a significantly higher score than Groups 1 and 2, and Group 1 had a higher score than Group 2. Scores for Group 3b were lower than for Group 3a, although they were still >30 points, which is enough to establish a TB diagnosis (P = 0.0005). The system was useful for the diagnosis of pulmonary TB in HIV-negative and -positive children. Language: English Keywords: BRAZIL | RESEARCH REPORT | SCORING METHODS | CHILDREN | PERSONS LIVING WITH HIV/AIDS | TUBERCULOSIS | HIV INFECTIONS | EXAMINATIONS AND DIAGNOSES | TESTING | HIV TESTING | South America, Eastern | South America | Latin America | Americas | Developing Countries | Survey Methodology | Surveys | Sampling Studies | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Infections | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement | Laboratory Examinations and Diagnoses Document Number: 341547 |
| 24. Peer Reviewed Title: The Whole is Greater than the Sum of the Parts: Recognising missed opportunities for an optimal response to the rapidly maturing TB-HIV co-epidemic in South Africa. Author: Perumal R; Padayatchi N; Stiefvater E Source: BMC Public Health. 2009 Jul 16;9(1):243. Abstract: ABSTRACT: BACKGROUND: Despite widely acknowledged WHO guidelines for the integration of TB and HIV services, heavily burdened countries have been slow to implement these and thus significant missed opportunities have arisen. DISCUSSION: The individual-centred, rights-based paradigm of the SA National AIDS Policy, remains dissonant with the compelling public-health approach of TB control. The existence of independent and disconnected TB and HIV services results in a wastage of scarce health resources, an increased burden on patients' time and finances, and ignores evidence of patients' preference for an integrated service. The current situation translates into a web of unacceptable, ongoing missed opportunities such as failure to maximize collaborative disease surveillance, VCT, adherence support, infection control, and positive prevention. TB services present a readily identifiable cohort for HIV provider-initiated testing. Integrating HAART and DOTS will promote efficient usage of health workers' time and a more navigable experience for patients, ultimately ensuring increased TB treatment completion rates and MDR-TB prevention. As direct observation evolves into a more supportive, empowering experience for patients, adherence to both TB drugs and ARVs will be bolstered. Little attention has been paid to the transmission of TB within HIV services. Low cost infection control interventions include: triaging patients, scheduling new and follow-up patients separately; well-ventilated, sheltered waiting rooms; and the use of personal respirators by patients and staff. A more patient-centred approach to TB care may be able to recruit the active participation of TB patients in positive prevention efforts, including maximizing personal infection control, limiting exposure of social contacts to TB during the intensive phase of treatment, advocating isoniazid prophylaxis within the home and patient-centred education efforts to reduce overall transmission. Several model programmes demonstrated synergy, in which the impact of the "whole" or integrated response was greater than the sum of the non-integrated parts. SUMMARY: The full potential of an integrated TB-HIV service has not been fully harvested. Perpetuated missed opportunities discount existing efforts in both programmes, will perpetuate the burden of disease, and prevent major gains in future interventions. This paper outlines simple, readily-implementable strategies to narrow the gap and reclaim existing missed opportunities. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | CLIENTS | PERSONS LIVING WITH HIV/AIDS | TESTING | TUBERCULOSIS | HIV TESTING | VOLUNTARY COUNSELING AND TESTING | HEALTH SERVICES | SCREENING | PERFORMANCE IMPROVEMENT | ANTIRETROVIRAL THERAPY | DIRECTLY OBSERVED THERAPY SHORT-COURSE (DOTS) | PROGRAM DESIGN | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Measurement | Research Methodology | Infections | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Delivery of Health Care | Health | Management | HIV | Treatment Document Number: 342042 |
| 25. Title: Genetic counselling and genetic testing in hereditary gastrointestinal cancer syndromes. Author: Raymond VM; Everett JN Source: Best Practice and Research. Clinical Gastroenterology. 2009;23(2):275-83. Abstract: Up to 10% of cancers are caused by inherited mutations in single genes. The process of genetic counselling and genetic testing allows for identification of these high-risk individuals and their at risk family members and enrolment into appropriate screening protocols. The medical impact of genetic testing is evidenced by reduced morbidity and mortality, however, the impact on a personal or psychosocial level has been more difficult to evaluate. We present a review of the current literature regarding the role of genetic counselling and testing in the setting of gastrointestinal cancers and explore several related issues including risk perception and risk communication, family communication, psychosocial factors and decision making, and family planning. We also provide guidelines for referral to cancer genetics clinics and for promoting discussions about genetic counselling and genetic testing. Language: English Keywords: UNITED STATES OF AMERICA | MICHIGAN | RESEARCH REPORT | CANCER | HEREDITARY DISEASES | POPULATION GENETICS | COUNSELING | FAMILY PLANNING | COMMUNICATION | RISK FACTORS | GASTROINTESTINAL EFFECTS | TESTING | Developed Countries | North America | Americas | Neoplasms | Diseases | Genetics | Biology | Clinic Activities | Program Activities | Programs | Organization and Administration | Health | Physiology | Measurement | Research Methodology Document Number: 342072 |
| 26. Title: Dengue virus antibodies in blood donors from an endemic area. Author: Rodriguez Rodriguez D; Garza Rodriguez M; Chavarria AM; Ramos-Jimenez J; Rivera MA; Tamez RC; Farfan-Ale J; Rivas-Estilla AM Source: Transfusion Medicine. 2009 Jun;19(3):125-31. Abstract: We evaluated the incidence of anti-Dengue virus (DENV) antibodies and dengue viremia in a region of Mexico with a high prevalence of dengue. DENV is the most important arthropod-borne virus in terms of human morbidity and mortality in America We tested 800 blood donors from a tertiary care teaching hospital that provides care in Northeast Mexico, to identify anti-DENV IgM and IgG antibodies by enzyme-linked immunosorbent assay (ELISA) and DENV genome by reverse transcription polymerase chain reaction (RT-PCR). In addition, routine tests for donors including Brucella, Hepatitis C virus (HCV), Venereal Disease Research Laboratory (VDRL), HIV-1 and HBsAg identification were performed. We found that 59% of donors were reactive for anti-DENV IgG and none of them had reported recent DENV infection; however, 16 (2%) were reactive for anti-DENV IgM antibodies. None of them were viremic at the time of donation. Routine tests showed that the prevalence of anti-Brucella was 0.71%, anti-HCV 0.71%, anti-HIV-1-2 0.14%, HBsAg 0.14% and VDRL test 0.57%. Although DENV transmission by blood transfusion had not been confirmed in Mexico, the finding of a high prevalence of anti-DENV IgM-positive donors with asymptomatic manifestations and the recent viremia reported in blood donors suggests that this route of transmission might be possible. Language: English Keywords: MEXICO | RESEARCH REPORT | TESTING | PREVALENCE | DENGUE | BLOOD DONORS | BLOOD TRANSFUSION | ANTIBODIES | TRANSMISSION | North America | Americas | Developing Countries | Measurement | Research Methodology | Viral Diseases | Diseases | Blood Supply | Equipment and Supplies | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Treatment | Immunologic Factors | Immunity | Immune System | Physiology | Biology | Infections Document Number: 342973 |
| 27. Title: Anti-tuberculosis drug resistance and HIV co-infection in Phnom Penh, Cambodia. Author: Sar B; Keo C; Leng C; Saman M; Min DC; Chan S; Monchy D; Sarthou JL Source: Southeast Asian Journal of Tropical Medicine and Public Health. 2009 Jan;40(1):104-7. Abstract: The objective of this study was to observe the prevalence of drug resistance in Mycobacterium tuberculosis isolates in HIV associated tuberculosis co-infected patients in Phnom Penh City. The isolates of M. tuberculosis were collected during active laboratory-based surveillance. Of the 98 isolates studied, M. tuberculosis resistance to isoniazid was seen in 23.5%, resistance to rifampicin was seen in 16.3% and multidrug-resistance (MDR-TB) was seen in 5.1%. Our findings reveal an alarmingly high level of resistance to isoniazid and rifampicin, and confirms the need for drug susceptibility testing to guide treatment in patients with culture positive tuberculosis. Language: English Keywords: CAMBODIA | RESEARCH REPORT | PREVALENCE | CLIENTS | PERSONS LIVING WITH HIV/AIDS | TUBERCULOSIS | HIV INFECTIONS | DRUG RESISTANCE | TESTING | Developing Countries | Asia, Southeastern | Asia | Measurement | Research Methodology | Program Activities | Programs | Organization and Administration | Viral Diseases | Diseases | Infections | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 341778 |
| 28. Title: Development and evaluation of an enzyme-linked immunosorbent assay to detect Histoplasma capsulatum antigenuria in immunocompromised patients. Author: Scheel CM; Samayoa B; Herrera A; Lindsley MD; Benjamin L; Reed Y; Hart J; Lima S; Rivera BE; Raxcaco G; Chiller T; Arathoon E; Gomez BL Source: Clinical and Vaccine Immunology. 2009 Jun;16(6):852-8. Abstract: Histoplasma capsulatum infection causes significant morbidity and mortality in human immunodeficiency virus-infected individuals, particularly those in countries with limited access to rapid diagnostics or antiretroviral therapies. The fungus easily disseminates in persons with AIDS, resulting in progressive disseminated histoplasmosis (PDH), which can progress rapidly to death if undiagnosed. The availability of a simple, rapid method to detect H. capsulatum infection in less developed countries where the infection is endemic would dramatically decrease the time to diagnosis and treatment of PDH. We have developed an antigen-capture enzyme-linked immunosorbent assay (ELISA) to detect PDH antigenuria in infected patients. The assay uses polyclonal antibodies against H. capsulatum as both capture and detection reagents, and a standard reference curve is included to quantify antigenuria and ensure reproducibility. We evaluated this assay using specimens collected from patients with AIDS and culture-proven histoplasmosis in a Guatemalan clinic (n = 48), from healthy persons (n = 83), and from patients with other, nonhistoplasmosis diseases (n = 114). The ELISA demonstrated a sensitivity of 81% and a specificity of 95% in detecting H. capsulatum antigen in urine. This assay relies on simple technology that can be performed in institutions with limited resources. Use of this test will facilitate rapid diagnosis of PDH in countries where mortality is high, expediting treatment and likely reducing PDH-related mortality. Language: English Keywords: DEVELOPING COUNTRIES | RESEARCH REPORT | LABORATORY PROCEDURES | PERSONS LIVING WITH HIV/AIDS | BACTERIAL AND FUNGAL DISEASES | ANTIGENS | IMMUNOLOGIC FACTORS | TESTING | PROGRAM EVALUATION | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases | Infections | Immunity | Immune System | Physiology | Biology | Measurement | Research Methodology | Programs | Organization and Administration Document Number: 342080 |
| 29. Title: The WHO/PEPFAR collaboration to prepare an operations manual for HIV prevention, care, and treatment at primary health centers in high-prevalence, resource-constrained settings: defining laboratory services. Author: Spira T; Lindegren ML; Ferris R; Habiyambere V; Ellerbrock T Source: American Journal of Clinical Pathology. 2009 Jun;131(6):887-94. Abstract: The expansion of HIV/AIDS care and treatment in resource-constrained countries, especially in sub-Saharan Africa, has generally developed in a top-down manner. Further expansion will involve primary health centers where human and other resources are limited. This article describes the World Health Organization/President's Emergency Plan for AIDS Relief collaboration formed to help scale up HIV services in primary health centers in high-prevalence, resource-constrained settings. It reviews the contents of the Operations Manual developed, with emphasis on the Laboratory Services chapter, which discusses essential laboratory services, both at the center and the district hospital level, laboratory safety, laboratory testing, specimen transport, how to set up a laboratory, human resources, equipment maintenance, training materials, and references. The chapter provides specific information on essential tests and generic job aids for them. It also includes annexes containing a list of laboratory supplies for the health center and sample forms. Language: English Keywords: DEVELOPING COUNTRIES | CRITIQUE | WHO | HIV PREVENTION | CARE AND SUPPORT | TREATMENT | PRIMARY HEALTH CARE | HEALTH FACILITIES | PROCEDURES | LABORATORY | LABORATORY EXAMINATIONS AND DIAGNOSES | TESTING | QUALITY CONTROL | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Health Services | Delivery of Health Care | Health | Medical Procedures | Medicine | Organization and Administration | Equipment and Supplies | Examinations and Diagnoses | Measurement | Research Methodology Document Number: 341765 |
| 30. Peer Reviewed Title: Application of cumulative odds logistic model on risk factors analysis for sexually transmitted infections among female sex workers in Kaiyuan city, Yunnan province, China. Author: Wang H; Wang N; Bi A; Wang G; Ding G; Jia M; Lu L; Smith K Source: Sexually Transmitted Infections. 2009 Aug;85(4):290-5. Abstract: OBJECTIVES: To investigate the epidemiology of sexually transmitted infections (STI) among female sex workers (FSW) in Kaiyuan city, Yunnan province, China, and to identify risk factors associated with STI. METHODS: A cross-sectional study of 737 FSW was carried out from March to May 2006, with confidential interviews and laboratory tests for STI. A cumulative logit model was used to evaluate the risk factors for STI. RESULTS: The overall prevalence of HIV is 10.3%. The prevalence of syphilis, herpes simplex virus type 2, gonorrhoea, chlamydia and trichomonas was 7.5%, 68.1%, 8.3%, 25.9% and 10.6%, respectively. In multivariate cumulative odds logistic analysis, the factors associated with STI were education level, living in the entertainment location, injection drug use, non-injection drug use, over five clients in the previous week and inconsistent use of condoms with clients. CONCLUSION: The findings highlight the gravity of the STI epidemic among FSW in China, where sexual transmission has now overtaken unsafe injection practices as the dominant mode of HIV transmission. Targeted intervention programmes for FSW should focus on increasing condom use, strengthening knowledge and awareness of STI/HIV and encouraging routine screening and treatment-seeking behaviours. Reducing the spread of STI also has profound implications for the prevention of HIV. Language: English Keywords: CHINA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PREVALENCE | SEX WORKERS | WOMEN | RISK FACTORS | SEXUALLY TRANSMITTED DISEASES | HIV INFECTIONS | TESTING | LABORATORY PROCEDURES | Asia, Eastern | Asia | Developing Countries | Research Methodology | Measurement | Sex Behavior | Behavior | Demographic Factors | Population | Health | Reproductive Tract Infections | Infections | Diseases | Viral Diseases | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care Document Number: 342722 |
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