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101.
Jane S Chen Mitch Matoga Brian W Pence Kimberly A Powers Courtney N Maierhofer Edward Jere Cecilia Massa Shiraz Khan Sarah E Rutstein Sam Phiri Mina C Hosseinipour Myron S Cohen Irving F Hoffman William C Miller Kathryn E Lancaster 《Journal of the International AIDS Society》2021,24(4)
IntroductionHIV diagnosis is the necessary first step towards HIV care initiation, yet many persons living with HIV (PLWH) remain undiagnosed. Employing multiple HIV testing strategies in tandem could increase HIV detection and promote linkage to care. We aimed to assess an intervention to improve HIV detection within socio‐sexual networks of PLWH in two sexually transmitted infections (STI) clinics in Lilongwe, Malawi.MethodsWe conducted a randomized controlled trial to evaluate an intervention combining acute HIV infection (AHI) screening, contract partner notification and social contact referral versus the Malawian standard of care: serial rapid serological HIV tests and passive partner referral. Enrolment occurred between 2015 and 2019. HIV‐seropositive persons (two positive rapid tests) were randomized to the trial arms and HIV‐seronegative (one negative rapid test) and ‐serodiscordant (one positive test followed by a negative confirmatory test) persons were screened for AHI with HIV RNA testing. Those found to have AHI were offered enrolment into the intervention arm. Our primary outcome of interest was the number of new HIV diagnoses made per index participant within participants’ sexual and social networks. We also calculated total persons, sexual partners and PLWH (including those previously diagnosed) referred per index participant.ResultsA total of 1230 HIV‐seropositive persons were randomized to the control arm, and 561 to the intervention arm. Another 12,713 HIV‐seronegative or ‐serodiscordant persons underwent AHI screening, resulting in 136 AHI cases, of whom 94 enrolled into the intervention arm. The intervention increased the number of new HIV diagnoses made per index participant versus the control (ratio: 1.9; 95% confidence interval (CI): 1.2 to 3.1). The intervention also increased the numbers of persons (ratio: 2.5; 95% CI: 2.0 to 3.2), sexual partners (ratio: 1.7; 95% CI: 1.4 to 2.0) and PLWH (ratio: 2.3; 95% CI: 1.7 to 3.2) referred per index participant.ConclusionsCombining three distinct HIV testing and referral strategies increased the detection of previously undiagnosed HIV infections within the socio‐sexual networks of PLWH seeking STI care. Combination HIV detection strategies that leverage AHI screening and socio‐sexual contact networks offer a novel and efficacious approach to increasing HIV status awareness. 相似文献
102.
Ghanbari Jahromi Mohadeseh Goudarzi Reza Amini Saeed Anbari Zohreh Amiresmaili Mohammadreza 《Zeitschrift fur Gesundheitswissenschaften》2021,29(3):625-631
Journal of Public Health - Iranian New Year, with long consecutive holidays, although it is celebrated and enjoyed, might influence the quality of services provided by hospitals. The present study... 相似文献
103.
104.
Nocardia ignorata, a new agent of human nocardiosis isolated from respiratory specimens in Europe and soil samples from Kuwait 下载免费PDF全文
Rodríguez-Nava V Couble A Khan ZU Pérouse de Montclos M Brasme L Villuendas C Molinard C Boiron P Laurent F 《Journal of clinical microbiology》2005,43(12):6167-6170
Nocardia ignorata is a recently described species identified on the basis of a single isolate of unknown origin. Here we describe the epidemiological, phenotypic, and phylogenetic characteristics of this new species, based on five new clinical and soil isolates. 相似文献
105.
Mon DT Patena KR Khan S 《Journal of AHIMA / American Health Information Management Association》1997,68(9):92-8, 100-2, 104-5
The transformation taking place in health information management is causing a shift in the role of HIM professionals. This article examines the influence this shift has had on current trends in the workforce and what it means to HIM professionals. 相似文献
106.
Purpose. In a continuation of our search for novel antifungal compounds from higher plants, the standard extract of the bark of Pithecellobium racemosum was found to have good activity against important AIDS-related opportunistic yeasts.
Methods. The extract was subjected to bioguided fractionation using silica gel column chromatography which led to purification of triterpene glycosides. The structures of these compounds were determined by a combination of spectroscopic (IR, NMR, HRMS) and chemical methods.
Results. Compound 1 is a new glycoside, 3-O[-L-arabinopyranosyl (1 -2)][-L arabinopyranosyl (1 -6)]2-acetoamido-2-deoxy--D-gluco-pyranosyl oleanolic acid and Compound 2 was identified as the known compound 3-O-[-L-arabinopyranosyl (l-2)]-L-arabinopyranosyl (1-6)] 2-acetamido-2-deoxy--D-glucopyranosyl echinocystic acid.
Conclusions. Compound 1 is a new glycoside, 3-O-[-L-arabinopyranosyl (1-2)]-L-arabinopyranosyl (l-6)]-2-acetoamido-2-deoxy--D-glucopyranosyl oleanolic acid and exhibits moderate antifungal activity against T. mentogrophytes, C. albicans and S. cerevisiae with MIC values of 6.25, 12.5 and 12.5 g/ml respectively. 相似文献
107.
108.
Despite some serious past efforts to clarify its multiple dimensions and meanings, access to health care has remained a rather elusive concept, hampering the work of health care policymakers and professionals as they endeavor to effect meaningful health care reform. This article provides perhaps the most detailed clarification of the access concept, especially the crucial linkages among the various access dimensions, and presents a comprehensive conceptual framework for evaluation and planning activities as they relate to people's access to health care services. The proposed conceptual model recognizes access as the outcome of a process involving the interplay between the characteristics of the health care service system and of potential users in a specified area, and moderated by health care related public policy and planning efforts. An elaborate typology of access, incorporating four pairs of access dimensions, is also derived. This atomization of the concept allows us to focus on specific aspects of the access to health care problem, and to develop precise outcome indicators of health system performance for evaluative purposes. Further, it enables the access concept and its pertinent dimensions to be put into proper perspective when assessing the health care access situation in a specific national or regional context. The relevance of the proposed access model and the typology to health care planning in general, and to spatial planning of health care service systems in particular, is also discussed. 相似文献
109.
Ethanolic extract ofDaucus carota (DC) at the dose of 10–100 mg/kg caused a dose-dependent fall in systolic and diastolic arterial, blood pressure in normotensive anesthetized rats. These effects were not blocked by atropine (1 mg/kg) and pretreatment withDC did not alter the pressor response to norepinephrine indicating that, cardiovascular effects ofDC are independent of cholinergic or adrenergic receptors involvement. In spontaneously beating guinea-pig paired atria,DC induced a, concentration-dependent (0.3–5 mg/ml) decrease in force and rate of atrial contractions. In rabbit thoracic aorta,DC caused inhibition of K+-induced contractions at similar concentrations. These results suggest that the extract may exhibit Ca2+ channel blocking-like direct relaxant action on cardiac and smooth muscle preparations and this action may be responsible for its hypotensive effect observed in thein vivo studies. 相似文献
110.
Khan TM 《AIDS/STD health promotion exchange》1995,(4):7-8
75-80% of the general public in Pakistan visits a private practitioner first in the case of illness. Private practitioners are therefore an important primary target for HIV/AIDS training and clinics are an ideal site in which to convey HIV prevention messages. The Physicians Forum for Family Planning in 1991 conducted a random survey of private practitioners' knowledge, attitudes, and beliefs about AIDS. 48% did not know what AIDS stands for, 68% were unaware of the meaning of HIV, none could identify all three modes of HIV transmission, 33% knew that contaminated needles can transmit HIV, and none knew about perinatal transmission. Training workshops were therefore organized to improve HIV/AIDS awareness among private practitioners, concentrating upon transmission, risk factors, clinical signs and symptoms, HIV prevention, HIV and contraception, the role of private practitioners in prevention and care, and counseling. 398 private practitioners had participated in the workshops by the end of September 1993. When pre- and post-workshop awareness were compared, correct answers had increased from 45% to 95%. It was difficult, however, to convince participants that kissing is not risky. It was also a challenge to make them understand the difference between HIV infection and AIDS. Interactive discussions and slide talks were particularly popular. Counseling on sexuality and clinical care for and counseling people with HIV/AIDS are areas for follow-up for those interested. A post-intervention evaluation in 1994 found that the workshops had a significant impact upon the clinical practice of private practitioners. 相似文献