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Capacity Needs Assessment for Pharmaceutical Services for the ART Program in Lesotho
Wang, S., N. Hoohlo, I. Tshabalala, K. Ntoi, and T. Sepetla
Arlington, VA: Management Sciences for Health
(2013)
C2
Submitted to the US Agency for International Development by the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program.
Chikungunya virus (CHIKV) is currently one of the most relevant arboviruses to public health. It is a member of the Togaviridae family and alphavirus genus and causes an arthritogenic disease known as chikungunya fever (CHIKF). It is characterized by a multifaceted disease, which is distinguished fr
...
om other arbovirus infections by the intense and debilitating arthralgia that can last for months or years in some individuals. Despite the great social and economic burden caused by CHIKV infection, there is no vaccine or specific antiviral drugs currently available. Recent outbreaks have shown a change in the severity profile of the disease in which atypical and severe manifestation lead to hundreds of deaths, reinforcing the necessity to understand the replication and pathogenesis processes. CHIKF is a complex disease resultant from the infection of a plethora of cell types. Although there are several in vivo models for studying CHIKV infection, none of them reproduces integrally the disease signature observed in humans, which is a challenge for vaccine and drug development. Therefore, understanding the potentials and limitations of the state-of-the-art experimental models is imperative to advance in the field. In this context, the present review outlines the present knowledge on CHIKV epidemiology, replication, pathogenesis, and immunity and also brings a critical perspective on the current in vitro and in vivo state-of-the-art experimental models of CHIKF.
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Pathogens . 2021 Nov 16;10(11):1493.doi: 10.3390/pathogens10111493
.Chronic manifestations of Chagas disease present as disabling and life-threatening condi-tions affecting mainly the cardiovascular and gastrointestinal systems. Although meaningful research has outlined the different molecular mech
...
anisms underlying Trypanosoma cruzi’s infection and the host-parasite interactions that follow, prompt diagnosis and treatment remain a challenge, particu-larly in developing countries and also in those where the disease is considered non-endemic. This review intends to present an up-to-date review of the parasite’s life cycle, genetic diversity, virulence factors, and infective mechanisms, as well as the epidemiology, clinical presentation, diagnosis, and treatment options of the main chronic complications of Chagas disease.
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National SOP document from Eswatini for community-based models for HIV testing and ART initiation. Contains specific procedural steps for testing and ART initiation in mobile/outreach contexts – v
...
ery practical for clinical SOP structures in similar settings.
more
Expert opinion of the European Tuberculosis Laboratory Initiative core group members for the WHO European Region.
Aлгоритм лабораторной диагностики и мониторинга лечения туберкулеза легких и туберкулеза с лекарственной устойчивостью на основе применения современных быстрых
...
молекулярных методов.
Экспертное заключение членов основной группы Европейской лабораторной инициативы, подготовленное для Европейского региона ВОЗ.
more
WHO’s sentinel surveys of acquired HIV resistance to dolutegravir among people receiving dolutegravir-containing antiretroviral therapy is intended for easy and frequent implementation. Results from sentinel surveys provide insight into the prevalence and year-over-year trends of dolutegravir resi
...
stance in adults, children and adolescents receiving dolutegravir-based ART.
This sentinel method is implemented complementary to WHO-recommended methods for estimating nationally representative levels of acquired HIV drug resistance.
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These guidelines provide new and updated recommendations on the use of point-of-care testing in children under 18 months of age and point-of-care tests to monitor treatment in people living with HIV; the treatment monitoring algorithm; and timing of antiretroviral therapy (
...
ART) among people living with HIV who are being treated for tuberculosis.
New recommendations launched today outline key new actions that countries can take to improve the delivery of HIV testing, treatment and care services by providing greater options for differentiated approaches such as, supporting HIV treatment start in the community, ensuring that children are diagnosed and treated early, and that viral load treatment monitoring is more accessible, focused and triggers clinical action
more
WHO’s antiretroviral treatment (ART) clinic-based acquired drug resistance survey method yields robust estimates of HIV viral suppression and acquired HIV drug resistance in adults, children and adolescents taking both dolutegravir and non-doluteg
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ravir based regimens.
Results are used to inform ART programme decision making regarding optimal ART regimens and support evaluation of programme quality with respect to maximizing viral load suppression and minimizing emergence of resistance in people taking ART.
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Despite progress in improving antiretroviral therapy (ART) for people with HIV in Malawi, the burden of HIV infections and HIV treatment outcomes among key populations is suboptimal. Client-centered differentiated service delivery approaches may fac
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ilitate addressing HIV prevention and treatment needs of key populations in Malawi.
Methods
De-identified program data routinely collected as part of the LINKAGES project–Malawi were assembled from October 2017 to September 2019. HIV case finding was compared across different testing modalities for each population. Poisson regression was used to estimate the association between testing modalities and ART initiation.
Results
Of the 18 397 people included in analyses, 10 627 (58%) were female sex workers (FSWs), 2219 (12%) were men who have sex with men (MSM), and 4970 (27%) were clients of FSWs. HIV case finding varied by modality and population, with index testing and enhanced peer outreach demonstrating high yield despite reaching relatively few individuals. FSWs who tested positive through risk network referral testing were more likely to initiate ART within 30 days compared with those who tested positive through clinic-based testing (adjusted risk ratio [aRR], 1.50; 95% CI, 1.23–1.82). For MSM, index testing (aRR, 1.45; 95% CI, 1.06–2.00) and testing through a drop-in center (aRR, 1.82; 95% CI, 1.19–2.78) were associated with 30-day ART initiation.
Conclusions
These data suggest that differentiated HIV testing and outreach approaches tailored to the needs of different key populations may facilitate improved ART initiation in Malawi. Achieving 0 new infections by 2030 suggests the need to adapt treatment strategies given individual and structural barriers to treatment for key populations with HIV in high-prevalence settings.
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AIDS 2024, 38:1579–1588. Treatment interruptions are a barrier to successful antiretroviral therapy (ART). 'Fresh start messages', which leverage significant days on the calendar (e.g., new year, public holiday) in order to prompt action, have the
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potential to encourage people with HIV (PWH) to return to care. We evaluated a 'fresh start' intervention (text messages) to increase return to care in PWH who had missed their last appointment.
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The goal of producing these Standard Operating Procedures (SOPs) was therefore targeted at fostering standardization across all levels of care to ensure HIV viral load monitoring remains a basic right offered to all people living with HIV (PLHIV) on lifelong antiretroviral therapy (
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ART) regardless of their location and place where they are accessing care.
These SOPs are designed to provide practical information to healthcare providers. They must be considered as supplementary and secondary to all guidelines issued by the MOH, including the Malawi Clinical Management of HIV in Children and Adults Guidelines and the Malawi HIV Testing Services (HTS) Guidelines.
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Lancet HIV 2019 Published Online March 15, 2019 http://dx.doi.org/10.1016/S2352-3018(19)30052-9
Analytical antiretroviral treatment interruption (ATI) is an important feature of HIV research, seeking to achieve
sustained viral suppression in the absence of antiretroviral therapy (
...
ART) when the goal is to measure effects of
novel therapeutic interventions on time to viral load rebound or altered viral setpoint. Trials with ATIs also intend
to determine host, virological, and immunological markers that are predictive of sustained viral control off ART.
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Journal of the International AIDS Society 2024, 27:e26233.
Most adult ART clients in South Africa were satisfied with their care, but those enrolled in DSD models expressed slightly greater satisfaction than those remaining in conventional care. Ef
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forts should focus on enrolling more eligible patients into DSD models, expanding eligibility criteria to cover a wider client base, and further improving the models’ desirable characteristics.
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WHO guideline on health policy and system support to optimize community health worker programmes
recommended
The guideline uses state-of-the-art evidence to identify effective policy options to strengthen community health worker (CHW) programme performance through their proper integration in health systems and communities.
Successful delivery of services
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through CHWs requires evidence-based models for education, deployment and management of these health workers. The guideline is intended as a tool for national policy makers and planners and their international partners to use in the design, implementation, performance and evaluation of effective community health worker programmes. It contains pragmatic recommendations on selection, training and certification; management and supervision: and integration into health systems and community engagement.
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Es fasst in kompakter und praxistauglicher Art und Weise die Erfahrungen und Impulse aus dem ersten Projektjahr zusammen. Sie gibt wertvolle Handlungsempfehlungen für die Praxis der Sprachmittlung im Bereich der sexuellen und reproduktiven Gesundhe
...
it und Rechte. Sie richtet sich als Leitfaden direkt an Sprachmittler*innen, die indiesem Themenbereich mit geflüchteten Menschen
arbeiten (möchten)
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Global update on HIV treatment 2013: Results, impact and opportunities
World Health Organization; UNICEF; UNAIDS
(2013)
Chapter 1 provides new data on the latest developments in the global treatment effort, highlighting positive trends as well as aspects that require improvement. Chapter 2 summarizes the impact of the scale-up in reducing AIDS-related mortality and new HIV infections. Chapter 3 examines the sequence
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of steps in the continuum of care from HIV diagnosis to successful provision of ART services and outlines key supportive innovations. Chapter 4 discusses the implications and anticipated impact of the new "Consolidated guidelines on the use of ARV drugs for treating and preventing HIV infection
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