Journal Article > ResearchFull Text
Trop Doct. 2006 April 1; Volume 36 (Issue 2); DOI:10.1258/004947506776593314
Zachariah R, Massaquoi M
Trop Doct. 2006 April 1; Volume 36 (Issue 2); DOI:10.1258/004947506776593314
Despite provisional recommendations from the World Health Organization and UNAIDS that cotrimoxazole (CTX) prophylaxis be offered to all individuals living with AIDS, including HIV-positive patients with TB, its routine use in developing countries particularly Africa has been minimal. Concerns were expressed regarding its effectiveness in areas of high bacterial resistance, that its widespread use might substantially increase bacterial cross-resistance in the community and that this intervention might promote resistance of malaria parasites to sulphadoxine-pyrimethamine. We review the current evidence on the above concerns and highlight the main operational considerations related to implementing CTX prophylaxis as a basic component of care for HIV-positive TB patients in developing countries.
Journal Article > ResearchFull Text
Trop Doct. 2008 January 1; Volume 38 (Issue 1); DOI:10.1258/td.2007.060091
Buhendwa L, Zachariah R, Teck R, Massaquoi M, Kazima J, et al.
Trop Doct. 2008 January 1; Volume 38 (Issue 1); DOI:10.1258/td.2007.060091
This study shows that cabergoline (single oral-dose) is an acceptable, safe and effective drug for suppressing puerperal lactation. It could be of operational benefit not only for artificial feeding, but also for weaning in those that breast-feed within preventive mother-to-child HIV transmission programmes in resource-limited settings.
Journal Article > LetterAbstract
Trop Doct. 2013 April 1; Volume 43 (Issue 2); DOI:10.1177/0049475513483726
Ho L, Cohn J, Comte E
Trop Doct. 2013 April 1; Volume 43 (Issue 2); DOI:10.1177/0049475513483726
Journal Article > ResearchFull Text
Trop Doct. 2003 April 1; Volume 33 (Issue 2); 88-91.; DOI:10.1177/004947550303300211
Zachariah R, Spielmann M P, Harries AD, Buhendwa L, Chingi C
Trop Doct. 2003 April 1; Volume 33 (Issue 2); 88-91.; DOI:10.1177/004947550303300211
A study was conducted among individuals seeking voluntary HIV counselling and testing (VCT) in order to (a) describe their motives and source(s) of information, (b) describe their sexual behaviour; and (c) identify risk factors associated with HIV infection. Of 723 individuals who sought VCT, the most common reason (50%) was recent knowledge of HIV/AIDS and a desire to know their HIV status. The majority (77%) underwent VCT after being encouraged by others who knew their status. Ninety five per cent reported sexual encounters, with 337 (49%) engaging in unprotected sex. HIV prevalence was 31% and an HIV-positive status was associated with being female, being over 25 years of age and/or being a farmer. There is a demand for VCT, and the service provides an opportunity for intensive education about HIV/AIDS prevention on a one-to-one basis. It could also be an entry point to prevention and care for those who are infected.
Journal Article > CommentaryFull Text
Trop Doct. 2002 April 1; Volume 32 (Issue 2); 94-97.; DOI:10.1177/004947550203200214
Blair A, Shiels C
Trop Doct. 2002 April 1; Volume 32 (Issue 2); 94-97.; DOI:10.1177/004947550203200214
Journal Article > ResearchFull Text
Trop Doct. 2008 January 1; Volume 38 (Issue 1); DOI:10.1258/td.2007.060023
Makombe SD, Harries AD, Yu JKL, Hochgesang M, Mhango E, et al.
Trop Doct. 2008 January 1; Volume 38 (Issue 1); DOI:10.1258/td.2007.060023
AIDS-associated Kaposi's sarcoma (KS) is the most common AIDS-related malignancy in sub-Saharan Africa, with a generally unfavourable prognosis. We report on six-month and 12-month cohort treatment outcomes of human immunodeficiency virus (HIV)-positive KS patients and HIV-positive non-KS patients treated with antiretroviral therapy (ART) in public sector facilities in Malawi. Data were collected from standardized antiretroviral (ARV) patient master cards and ARV patient registers. Between July and September 2005, 7905 patients started ART-488 (6%) with a diagnosis of KS and 7417 with a non-KS diagnosis. Between January and March 2005, 4580 patients started ART-326 (7%) with a diagnosis of KS and 4254 with a non-KS diagnosis. At six-months and 12-months, significantly fewer KS patients were alive and significantly more had died or defaulted compared to non-KS patients. HIV-positive KS patients on ART in Malawi have worse outcomes than other patients on ART. Methods designed to improve these outcomes must be found.
Journal Article > ResearchFull Text
Trop Doct. 2003 October 1; Volume 33 (Issue 4); 220-224.; DOI:10.1177/004947550303300411
Zachariah R, Harries AD, Buhendwa L, Spielmann M P, Chantulo A, et al.
Trop Doct. 2003 October 1; Volume 33 (Issue 4); 220-224.; DOI:10.1177/004947550303300411
A study was conducted among commercial sex workers (CSWs) in rural southern Malawi, in order to (a) assess the acceptability of the female condom and (b) identify common technical problems and discomforts associated with its use. There were 88 CSWs who were entered into the study with a total of 272 female condom utilizations. Eighty-six (98%) were satisfied with the female condom, 80% preferred it to the male condom and 92% were ready to use the device routinely. Of all the utilizations, the most common technical problem was reuse of the device with consecutive clients, 6% after having washed it, and 2% without any washing or rinsing. The most common discomfort that were reported included too much lubrication (32%), device being too large (16%), and noise during sex (11%). This study would be useful in preparing the introduction of the female condom within known commercial sex establishments in Malawi.
Journal Article > ResearchFull Text
Trop Doct. 2007 January 1; Volume 37 (Issue 1); DOI:10.1258/004947507779951899
Arendt V, Mossong J, Zachariah R, Inwani C, Farah B, et al.
Trop Doct. 2007 January 1; Volume 37 (Issue 1); DOI:10.1258/004947507779951899
A study was conducted among patients attending a public health centre in Nairobi, Kenya in order to (a) verify the prevalence of HIV, (b) identify clinical risk factors associated with HIV and (c) determine clinical markers for clinical screening of HIV infection at the health centre level. Of 304 individuals involved in the study,107(35%) were HIV positive. A clinical screening algorithm based on four clinical markers, namely oral thrush, past or present TB, past or present herpes zoster and prurigo would pick out 61 (57%) of the 107 HIV-positive individuals. In a resource-poor setting, introducing a clinical screening algorithm for HIV at the health centre level could provide an opportunity for targeting voluntary counselling and HIV testing, and early access to a range of prevention and care interventions.