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- Volume 2005, Issue 19, 2005
Southern African Journal of HIV Medicine - Volume 2005, Issue 19, 2005
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Volume 2005, Issue 19, 2005
Author John DamontiSource: Southern African Journal of HIV Medicine 2005 (2005)More Less
Extracted from text ... THE SOUTHERN AFRICAN JOURNAL OF HIV MEDICINE JUNE 2005 5 The Bristol-Myers Squibb Foundation creates meaningful and sustainable improvements in health and education for people around the world by developing partnerships and supporting innovative programmes that actively fulfil the Bristol-Myers Squibb Company mission - to extend and enhance human life. The Foundation focuses specifically on programmes in seven areas of critical need where it has the knowledge, resources and experience to make a meaningful impact. These are global HIV/AIDS, women's health, health education, science education, product donations, employee-driven contributions and community support, and unrestricted biomedical research support. Its efforts seek ..
Author R. Sebastian WanlessSource: Southern African Journal of HIV Medicine 2005 (2005)More Less
Extracted from text ... 7 More than five years have passed since Bristol-Myers Squibb Company and Foundation pledged Secure the Future $100 million for Community Outreach and Education and Medical Care and Research HIV / AIDS projects in the five southern African countries - Botswana, Swaziland, Lesotho, Namibia and South Africa. These programmes were aimed primarily at alleviating the impact of the disease on women and children. Through extensive consultation with governments, community workers, physicians and academics, the best ways of allocating the funding were determined. By late 2002, with the able assistance of Secure the Future's Technical Advisory Committee, more than 130 projects ..
Feasibility and acceptability of postpartum voluntary counseling and testing (PPVCT) in a large tertiary hospital in the South African settingSource: Southern African Journal of HIV Medicine 2005, pp 8 –10 (2005)More Less
<I>Objective.</I> To demonstrate the feasibility and acceptability of introducing postpartum voluntary counselling and testing (PPVCT) and the provision of post-exposure nevirapine prophylaxis (PEP) to HIV-exposed infants whose mothers did not receive any antiretroviral prophylaxis to prevent mother-to-child transmission (PMTCT) in a large, tertiary hospital in the South African setting. <br><I>Design.</I> Observational, interventional study. <br><I>Setting.</I> The programme was implemented at Chris Hani Baragwanath Hospital (tertiary referral centre) in Soweto, South Africa, following a study that established the efficacy of a postpartum regimen of PEP in PMTCT. <br><I>Participants.</I> From January 2003 to December 2004, 7 500 women who delivered at Chris Hani Baragwanath Hospital without a documented HIV-1 result were identified in the postnatal wards. PPVCT was offered to all eligible participants. <br><I>Intervention.</I> On-site HIV rapid tests were performed on all women who agreed to testing. For those women testing HIV-1 positive, a single dose of nevirapine syrup was offered to their infants as PEP within 72 hours after delivery. Infant feeding <br><I>counseling</I>, assistance with follow-up care and support programmes were also offered. <br><I>Main outcome.</I> From January 2003 to December 2004, 34 776 deliveries occurred at Chris Hani Baragwanath Hospital. Of these, 7 500 (21.5%) had no documented HIV status. After delivery 5 751 (76.7%) women were offered VCT, and of these 3 794 (66%) accepted testing. Of these women, 1 294 (34%) tested HIV positive and 1 243 (96%) women accepted the administration of single-dose nevirapine to their infants. <br><I>Conclusions.</I> The uptake of PPVCT is comparable to that seen in established antenatal VCT despite the numerous challenges PPVCT presents. This suggests that PPVCT is both an acceptable and a feasible option in a busy, resource-limited setting and remains an important strategy in PMTCT in untreated individuals.
Source: Southern African Journal of HIV Medicine 2005, pp 11 –16 (2005)More Less
<I>Objectives.</I> To describe the incidence, spectrum and prognosis of AIDS-defining illnesses (ADI) in patients without access to antiretroviral therapy (ART). <BR><I>Design.</I> Prospective cohort study. <BR><I>Subjects.</I> 1 215 HIV-infected patients attending adult HIV clinics affiliated to the University of Cape Town in the New Somerset and Groote Schuur Hospitals from 1992 to 2000. <BR><I>Main outcome measures.</I> Incidence rate (IR) of ADIs and survival after the development of ADI. <BR><I>Results.</I> During follow-up, 430 ADIs occurred (IR = 21.3 cases per 100 patient-years (PYs)). IR varied according to CD4 count, with 38.8, 17.0 and 8.52 cases/100 PYs in patients with CD4 counts < 200 cells/µl, 200 - 350 cells/µl and > 350 cells/µl, respectively. Tuberculosis (TB) was the commonest ADI, followed by candidiasis of the oesophagus/trachea/bronchi. IRs for chronic herpes simplex ulcers, HIV wasting, <I>Pneumocystis carinii</I> pneumonia and Kaposi's sarcoma were > 1.00 cases/100 PYs. TB was diagnosed in all CD4 strata, and was the only illness to occur commonly above 200 cells/µl. The median CD4 counts within 6 months of diagnosis of ADI ranged from 138 cells/µl for TB to 17 cells/µl for cryptococcosis. Overall, median time to death from date of diagnosis was 18 months, and ranged from 24.1 months for patients diagnosed with TB to 6 months for those diagnosed with cytomegalovirus. <BR><I>Conclusions.</I> HIV-infected patients with no access to ART in Cape Town are at high risk of AIDS-defining illnesses. This study provides useful data for designing therapeutic interventions for preventing these infections.
Source: Southern African Journal of HIV Medicine 2005, pp 18 –22 (2005)More Less
More than 60% of the estimated 40 million persons with HIV / AIDS worldwide live in sub-Saharan Africa, where poverty, social insecurity, food shortages and malnutrition are major problems. In children under the age of 5 years, who live in developing countries, malnutrition has been associated with 50% of the 10.8 million deaths mainly caused by neonatal disorders, diarrhoea, pneumonia, malaria and HIV / AIDS. Likewise micronutrient deficiencies are widespread and are associated with increased morbidity and mortality particularly in relation to infectious diseases. This review focuses on the interaction between micronutrients and HIV / AIDS and discusses recent research findings that may have important public health implications in terms of the case management of persons with HIV / AIDS.
Author Douglas WilsonSource: Southern African Journal of HIV Medicine 2005, pp 23 –26 (2005)More Less
<I>'The world has made defeating AIDS a top priority. This is a blessing. But TB remains ignored. Today we are calling on the world to recognise that we can't fight AIDS unless we do much more to fight TB as well.'</I> Nelson Mandela : Media briefing on 'Confronting the Joint HIV-TB Epidemics', co-convened by the Bill & Melinda Gates Foundation, Thursday 15 July 2004.
Source: Southern African Journal of HIV Medicine 2005, pp 30 –36 (2005)More Less
We describe lessons learned from independent evaluations of nine home-based care (HBC) projects in Lesotho, South Africa and Swaziland. Projects were funded through Bristol-Myers Squibb's Secure the Future (STF) initiative and evaluated through the STF Monitoring and Evaluation Unit (MEU) at Yale University. The objectives of this study were to: <ul><li>assess the management capacity of the HBC organisations reviewed, concentrating on monitoring and supervision mechanisms</li> <li>identify innovations in responding to the challenges of delivering care in resource-poor settings, and</li> <li>explore the nature of linkages between HBC projects and governments.</li></ul> Specific strategies to assure quality are discussed, as are policy changes necessary to provide system-wide improvements in quality and the integration of HBC. These are particularly important as governments seek ways to use existing resources to make antiretroviral (ARV) roll-outs successful.
Source: Southern African Journal of HIV Medicine 2005, pp 37 –41 (2005)More Less
Arising out of and based on a pilot intervention project of the Albertina and Walter Sisulu Institute of Ageing in Africa, a nonprofit organisation called Grandmothers Against Poverty and AIDS (GAPA) was formed. <br>GAPA has been operating in Khayelitsha since October 2001. In that time the number of grandmothers participating in GAPA activities, namely workshops and psychosocial support groups, has been growing steadily. Anecdotal evidence suggests that the grandmothers are developing the capacity to cope with the effects of the AIDS crisis and are becoming empowered members of their communities.
Botswana-Baylor Children's Clinical Centre of Excellence : the role of a paediatric centre of excellence in assuring the prioritisation and quality of paediatric care within a developing national HIV care programmeSource: Southern African Journal of HIV Medicine 2005, pp 42 –46 (2005)More Less
Extracted from text ... JUNE 2005 THE SOUTHERN AFRICAN JOURNAL OF HIV MEDICINE 42 PAEDIATRIC CARE Botswana-Baylor Children's Clinical Centre of Excellence The role of a paediatric centre of excellence in assuring the prioritisation and quality of paediatric care within a developing national HIV care programme Elizabeth D Lowenthal, MD1 Gabriel M Anabwani, MB ChB, MMed, MSc1 Haruna B Jibril, MB BS, PMCPaed, MSc2 Beth Barr, MPH1 Opelo M Rankopo, RN, BN, MN1 Mark W Kline, MD1 1Baylor College of Medicine, Baylor International Pediatric AIDS Initiative, Botswana-Baylor Children's Clinical Centre of Excellence 2Princess Marina Hospital, Botswana The HIV / AIDS epidemic is having ..