Dissertations / Theses: 'HIV infections – Diagnosis – Asia'

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Tang, Chui-ying, and 鄧翠瑩. "Migration and the risk of HIV infection: a review in Asia." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B4842559X.

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Asia has populated with the second largest number of people living with HIV/AIDS. Under the advancement of transportation, the open up of borders between cities and countries, and the process of globalisation, people move from their place of origin to other places for better living conditions and employment opportunities. Mobile people and migrants are identified as the high risk population of HIV infection. Poverty, discrimination, limited access to healthcare and social services, separation with supports and families, being alienated in resident communities, and gender inequalities are the unfavourable conditions which make the migrant population vulnerable to HIV infection. Existing literatures have investigated and examined the potential risk factors among the mobile population. Inconsistencies were found among research but high risk sexual behaviours and poor knowledge and attitude were observed and reviewed within the migrants. However, literatures which compared the people who migrated with other local people in the same population were not yet reviewed systemically. Therefore, this paper aimed to review the articles which compare the migrant group and the non-migrant group in Asian population to identify the association between migration and the risks of HIV infection. A literature search of five databases (PubMed, Medline, Cochrane, CNKI, Wanfang Med Online) was performed and nine articles were eventually selected for review. The migration status of literature was studied as explanatory variable and compared across studies. Outcome variables of interest were grouped into four categories as: demographic characteristics, sexual practices, awareness towards HIV/AIDS, and disease prevalence. To conclude, compared to people who did not migrate, migrants in Asia were more tend to be less educated, have multiple sex partners, engage in high risk sexual intercourse and commercial sex, but their overall condom usage were lower. Also, they had higher risk of sexually transmitted infections and poorer knowledge in HIV/AIDS.
published_or_final_version
Public Health
Master
Master of Public Health

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2

Nolte, Jeanine Lucasta. "The formulation and refinement of a polymerase chain reaction (PCR) assay for early diagnosis of paediatric HIV infection and genetic analysis of variants involved in vertical transmission of HIV-1." Master's thesis, University of Cape Town, 1996. http://hdl.handle.net/11427/26361.

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Paediatric human immunodeficiency virus (HIV) infection has become a major socio-economic health problem in recent years as the number of HIV-1 infected children steadily increases. The majority of these infants are infected through mother-to-child transmission, with the frequency of vertical transmission varying between 12,9% and 65%. In order to implement appropriate management and possible treatment of these infected neonates, it is essential to have reliable laboratory tests for the early diagnosis of an HIV infection. At the time that this study was initiated, the diagnosis of HIV-1 infection in the Groote Schuur Hospital Virology Laboratory depended almost exclusively on serological assays. Such assays are of limited value for infants under 18 months of age, as maternal lgG antibody to HIV-1 is transferred via the placenta and may persist in the baby for up to 18 months. Available lgG antibody tests do not distinguish reliably between passively acquired maternal antibody and that produced by the infant itself. A valuable method of establishing the presence of true infection is provided by the polymerase chain reaction (PCR) technique which allows the identification, and subsequent exponential amplification of low levels of specific viral nucleic acid using specific oligonucleotide primers. A major aim of this study was to develop and instigate a (PCR) assay for the early diagnosis of HIV infection in infected infants. This was successfully achieved by the adaptation and optimization of an existing standard PCR protocol to suit the specific needs of a routine diagnostic service. Preliminary requirements involved the selection of primers and probes and establishing optimal parameters for: ionic strength, Taq DNA polymerase concentration, primer concentration, deoxynucleotide triphosphate concentration, and hybridization conditions for most efficient functioning of the test. The devised method entailed the extraction of proviral DNA from peripheral blood mononuclear cells, amplification of HIV-1 specific sequences by PCR, and identification by Southern blot hybridization with digoxigenin (DIG)-labelled probes. Thereafter the efficacy of the assay was tested on 45 infants (under 15 months of age) all born to seropositive mothers and therefore at risk for HIV infection. Forty-two of these infants had antibodies to HIV-1 and the remaining 3 were seronegative. The latter 3 also tested negative for HIV proviral DNA when PCR was performed, using at least 2 different HIV-1 primer pairs and their respective DIG-labelled probes. However, 27 (64%) of the 42 seropositive infants were also HIV-PCR positive and the remaining 15 (36%) seropositive infants were negative for HIV proviral DNA. Positive PCR tests correlated well with clinical data indicative of active HIV-1 infection for the majority of infants in the neonatal period, although it could not provide proof of infection in newborn babies (less than 1 week of age). The development of an in-house PCR protocol specific for HIV-1 has not only provided a valuable diagnostic assay for neonatal infection, but has also given insight into the parameters required for high sensitivity and the stringent precautionary measures that need to be applied to avoid contamination problems. The second part of this study was devoted to DNA sequence analysis of cloned HIV isolates from an infected mother and her 3-month-old infant. Nucleotide sequence variation between isolates of HIV-1 has been well documented. Examination of the third variable region (particularly the V3- loop) in the env gene of HIV-1 of our mother-infant pair confirmed this variation and provided the first genetic epidemiological data of this nature in the local community. Proviral DNA from both mother and baby was amplified using V3-specific degenerate primers and cloned. Clones containing the insert DNA were 2 identified by colony-blot hybridization. Their nucleotide and amino acid sequences were analyzed by using various computer programs. The degree of similarity between variants from the mother and infant in this study differed to a large extent from previous studies. The virus population harboured by the mother displayed highly homogeneous V3 sequences (1,04% variation) compared to the isolates from her 3-month-old infant, which showed a higher degree (1,8%) of heterogeneity. Phylogenetic analysis of the different isolates from mother and infant demonstrated that an HIV-1 subtype C virus was the infectious agent. This classification was confirmed by the characteristic amino-acid sequence of the tetrapeptide motif of the V3 loop present in the isolates from both mother and infant as well as the absence of a potential N-linked glycosylation site proximal to the first cysteine of the V3 loop, which is characteristic of subtype C viruses. Based on the amino acids present at positions 306 and 320 of the V3 loop, it could also be concluded that isolates from both the mother and her baby were consistent with the non-syncytium inducing (NSI) phenotype of HIV-1, thus indicating that, contrary to popular belief, NSI variants can be responsible for initiating infection. Data obtained from these genetic investigations of variants involved in vertical transmission of HIV-1 can form a useful basis for future comparative studies.

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Hon, Kit-sum Annie, and 韓潔心. "Can home-based HIV testing improve test uptake in Africa?" Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B45172353.

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4

Liang, Jianguo, and 梁建国. "HIV-1 early diagnosis of men having sex with men in Hong Kong and discovery of novel agents for HIV-1 treatment from traditional Chinese herbal medicine." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/196459.

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Over the 30 years since it was first identified, the HIV/AIDS epidemic has had historically unprecedented severity and impact. There are approximately 33.4 million people living with HIV-1/AIDS which urges to seek novel approaches for HIV-1 diagnosis and HIV-1 therapy. Men who have sex with men (MSM) are severely affected by HIV-1 and constitute a large proportion of HIV-infected individuals. In Hong Kong, the transmission route of homosexual and bisexual contacts accounted for nearly 50% of incidence in 2012. To investigate HIV-1 prevalence among MSM in Hong Kong, the combination of fast antibody test (FAT) and real-time dried-blood-spot-based quantitative polymerase chain reaction (DBS-qPCR) was employed for 474 participants chosen randomly from community testing sites of MSM within a one-year period which showed a 4.01% (19/474) rate of HIV-1 prevalence among MSM in Hong Kong with three cases at the acute phase among the newly infected participants. The new survey demonstrated that the risk factors of MSM are mostly correlated with the receptive role during anal sex and syphilis infection. In this study, two traditional Chinese herbal medicines (TCHM), Sanguisorba officinalis (SO) and Spatholobus suberectus (SS), inhibited the infection of model cell lines expressing HIV-1 targets by HIV-1 pseudoviruses, while the anti-HIV-1 properties of SO were demonstrated for the first time. Both SO and SS were able to block not only infection by pseudoviral HIV-1 CCR5-tropic and CXCR4-tropic strains, but also RT and PI drug-resistant strains. Mechanistic studies revealed that SO and SS interact with the viral envelope to prevent the infection of target cells by HIV-1. Two compounds derived from SO and SS, named Gallic acid (GA) and Jiazhi (JZ), retained anti-HIV-1 properties and blocked HIV-1 infection by acting on the viral envelope. Small molecules derived from TCHM were also investigated for their capacity to activate HIV-1 from latency. A small molecule derived from SS, Daidzein (DDZ), demonstrated the potentials to trigger HIV-1 reactivation in latently infected cell lines. DDZ enhanced gene expression from HIV-1 LTR in which the Sp1 binding site plays an important role. The Akt pathway is also involved in the initiation of DDZ-induced activation. Phosflow analysis revealed that DDZ activated the Akt pathway in various subpopulations of T cells, including memory CD4+ T cells which are considered to be a major reservoir for HIV-1. The structure-activity relationships (SARs) study demonstrated the 4'-hydroxyisoflavone as bio-functional core structure. Addition of a hydroxyl group on C-5 position significantly decreases its biological function of HIV-1 latency activation. In summary, this study investigates HIV prevalence and incidence using an assay for early HIV-1 diagnosis and performs an analysis of risk factors of behavior which contributes to the effective control of HIV transmission in Hong Kong and its neighbors in Asia. It also demonstrates a drug research sourced from traditional Chinese herbal medicines that which sheds lights on drug discovery from traditional herbal medicines and facilitates mechanistic drug design for HIV-1 eradication.
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Microbiology
Doctoral
Doctor of Philosophy

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Srasuebkul, Preeyaporn Public Health &amp Community Medicine Faculty of Medicine UNSW. "Evaluating monitoring strategies, short-term disease progression and rate of treatment change in HIV-infected patients commencing antiretroviral therapy in the Asia-Pacific region." Publisher:University of New South Wales. Public Health & Community Medicine, 2008. http://handle.unsw.edu.au/1959.4/41673.

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This thesis assesses factors associated with a number of short and long-term outcomes in HIV-infected patients receiving antiretroviral treatment in Asia. Analyses in this thesis were based on two cohorts of HIV-infected patients; The Treat Asia HIV Observational Database (TAHOD), a multi-centre prospective observational cohort from countries in Asia-Pacific region, and the HIV Netherlands Australia Thailand (HIV-NAT) collaboration cohort, a cohort of patients treated with antiretroviral treatments at HIV-NAT in Bangkok, Thailand. We examined factors associated with time to immunological failure endpoints, such as CD4≤ 200 cells/??L, CD4≤ 100 cells/ ??L, and CD4 return to baseline, and with the virological failure endpoint, detectable viral load defined as a value greater than 500 copies/mL. Multivariate Cox proportional hazard models were used. Results showed that CD4 count at baseline and changes in CD4 strongly predicted immunological failure. For virological failure, detectable viral load at baseline was the strongest predictor. As a step to developing simplified monitoring strategies, in which patients with a low risk of failure could have their monitoring CD4 count and viral load tests deferred, we developed predictive models for each immunological and virological failure endpoint. Models were developed on the HIV-NAT cohort, and validated on the independent TAHOD cohort. For predictive models, the complementary log-log transformation for each endpoint was fitted appropriate to the interval censored nature of the data. To assess goodness-of-fit, cut-offs were defined for the predicted risks that separated patients from low risk to high risk. Overall, the observed versus expected failures from HIV-NAT data agreed quite well across all endpoints, probably reflecting that the HIV-NAT database was the data we built the models upon. Not only did these models fit the HIV-NAT database well, they also discriminated patients from low to high risk groups. When we validated models with TAHOD data, the observed and expected failures agreed well only in the model for CD4 count return to baseline. For most of the endpoints, the predictive models overestimated the number of failures, with predicted values larger than observed. However, the proportions of failures were lowest in the low risk group and highest in the high risk group, indicating that our models did discriminate between patients at high and low risk, and that the predictive models might still be of use for the purpose of simplified monitoring strategies. With CD4 count and viral load monitoring tests now comprising a large component of the cost of HIV treatment in resource limited settings, we developed and assessed a simplified monitoring strategy that aimed to reduce the numbers of monitoring tests performed. The predictive models developed earlier were used to calculate the probabilities of failure in TAHOD patients. We assumed that patients would have their CD4 and viral load assessments annually, at baseline and at one year, predicted risk of failure at ensuing clinical visits, week 12, 24 and 36. For patients at low predicted risk of failure at ensuing clinical visits, we assessed the effect of deferring monitoring tests, both in terms of blood tests avoided, and in terms of delaying detection of failure in some patients. A number of levels for the predicted risk of failure that lead to deferral of testing were evaluated. The results suggested that predicted probabilities of failure of 10% - 20% gave the best results across all failure endpoints. These cut-offs could save a median of 598 (51.6%) (range 37 (2.6%)_-1,218 (81.9%) ) blood tests over the first year of treatment, but would fail to detect 29 (18%) (range 10 (7.4%) - 128 (39.3%) ) failures. The median time from failure to detection in those patients who did fail and had deferred monitoring tests was 28 weeks. Rates of antiretroviral treatment change in TAHOD were examined. We identified patterns and factors associated with the rate of treatment change. Median time to the first treatment change was 3.2 years. Factors predicting rate of treatment change in TAHOD were treatment combination, being on second or third combination, number of drugs available in each site and being an injecting drug user. The overall rate of treatment change in TAHOD was 29 per 1OO-person-year. Around 30% of patients stopped their treatment due to adverse events. These rates of treatment change are lower than have been seen in patients in western countries. This may be due to patients in developing countries having access to fewer antiretroviral drugs than patients in developed countries.

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Berggren, Palme Ingela. "Tuberculosis and HIV interaction in Ethiopian children : aspects on epidemiology, diagnosis and clinical management /." Stockholm, 2002. http://diss.kib.ki.se/2002/91-7349-296-5/.

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Wong, Mei-wan Farah, and 黃美雲. "Financial burden for HIV/AIDS patients to access antiretroviral therapy in Asian developing countries." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193826.

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Background: Since the beginning of 21st century, several Asian countries started implementing their national free antiretroviral therapy (ART) programs to tackle one of the most striking public health issues in Asia – HIV/AIDS. Despite the efforts being made, the treatment coverage remains as low as 44% in 2010. Previous studies have identified financial constraint is a major barrier in accessing ART and an important reason of poor ART adherence in Asia. The purpose of this literature review is to explore the extent of financial burden experienced by people living with HIV (PLHIV) where free ART policy is implemented, and to provide valuable information for policy-making in reducing financial barriers and improve uptake of ART. Methods: Literature search was performed by entering keywords in PubMed and Medline. Articles were screened and selected for in-depth review according to the inclusion and exclusion criteria. A process on data synthesis was performed on the final eligible papers. Results: Five studies from four Asian countries describing the out-of-pocket health expenditure incurred by PLHIV during the delivery of ART were included in this review. Findings: Out of all direct medical costs, the cost of drug was most important in contributing to the total costs for patients without health insurance, while the cost of transportation was more important for patients covered by health insurance. Direct medical costs increased with advancing stage of disease. Rural patients would have spent up to 1,173% of their monthly income per capita, or more than 100% of their total household expenditure even when ART was provided free-of-charge. Patients have also highlighted free ARV drugs were sometimes not available in the health facility and they had to turn to the private market. Hence, the extent of financial burden in this review might be underestimated. Conclusion: Based on the data available, we concluded that increased accessibility of free ART should be accompanied with sustained ARV drugs supply and increased financial support for PLHIV.
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Community Medicine
Master
Master of Public Health

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Ng, Jenny, and 吳仲嫣. "Reducing HIV infections in Hong Kong: a systematic review of the cost-effectiveness of expanded screening." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48425138.

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Background Routine voluntary HIV screening has been found to be cost-effective in regions with undiagnosed prevalence > 0.1%. However, a large proportion of infected patients are still unaware of their status and presenting to care late, leading to greater risk s for infection. As expanded ART has been shown to be highly effective in improving patient health and reducing HIV viral load, a strategy of expanded screening with earlier initiation of ART may be effective at reducing the numbers of new infections. Aim A systematic review was carried out with the aim of understanding what drives the cost-effectiveness of expanded HIV screening at low prevalence rates. A thorough investigation of sensitivity analysis was done to determine if low prevalent regions can implement screening at good value for cost and how money should be spent to maximize benefits. Methods An extensive literature review of studies published in English between 1996 and 2010 were identified from various electronic databases, included gray literature search and hand search. A qualitative assessment of the literature was undertaken. Results Results of the analysis found that expanded screening can be cost-effective at undiagnosed prevalence rates below that of current recommendations. Factors of linkage to care, and benefits of reduced secondary transmissions through reduced risk behaviors had the most impact on models. Screening while maximizing benefits due to linkage to care and secondary transmissions can may be appropriate for low prevalence regions such as Hong Kong, however further analysis would be necessary.
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Public Health
Master
Master of Public Health

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Mohaleni, Mamabolo Promise. "Pre-and post-HIV diagnosis help-seeking behaviour by patients receiving antiretroviral treatment at Witbank Hospital in Mpumalanga Province." Thesis, University of Limpopo (Turfloop Campus), 2013. http://hdl.handle.net/10386/1049.

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Thesis (M.A. (Clinical Psychology)) --University of Limpopo, 2013
Studies have indicated that help-seeking behaviour of people living with HIV is not predictable and linear and may entail the utilization of western medicine, traditional medicine and/or complementary medicine. The aim of this study was to explore pre- and post- HIV diagnosis help-seeking behaviour by patients receiving antiretroviral treatment at Witbank Hospital in Mpumalanga Province (South Africa).A qualitative, descriptive phenomenological approach was utilized in the study. Ten participants (male = 5; female = 5, and aged between 30 and 50 years)diagnosed with HIV and who came to the hospital to collect their treatment and for medical review were interviewed using semi-structured interviews. Interpretive analysis method was used to analyse the data. The results suggest the preference for western medicine pre-and post-HIV diagnosis. The results further suggest that help-seeking behaviour is a dynamic process embedded mainly in the conceptualization of the health problem, perception of its severity, the treatment given, and social support experienced.

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Orikiriza, Patrick. "Improving diagnosis of childhood tuberculosis in a high TB-HIV prevalent setting." Thesis, Montpellier, 2019. http://www.theses.fr/2019MONTT026.

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L’Organisation Mondiale de la Santé estime qu’en 2017 près d’un million d’enfants de moins de 15 ans ont développé la tuberculose mais seulement la moitié des cas ont été notifiés. Les difficultés pour recueillir des échantillons de crachat chez les enfants et la nature paucibacillifère de la tuberculose pédiatrique représentent de véritables challenges diagnostiques. Cela aboutit à la prescription fréquente de traitement empirique avec un risque de sur- ou sous-diagnostic. De plus, peu de laboratoires dans les pays à ressources limitées ont les capacités du diagnostic de la tuberculose. Les échantillons doivent être transportés vers des laboratoires de référence pouvant affecter les performances des tests, notamment en l’absence de chaine de froid.Trois études ont été menées à Mbarara (Ouganda) pour évaluer des échantillons non-respiratoires et des méthodes de conservation des échantillons pour améliorer le diagnostic de la tuberculose de l’enfant. Dans la première étude, nous avons évalué les performances de l’XpertMTB/RIF sur les expectorations et les selles d’enfants avec présomption de tuberculose et nous avons documenté le devenir des enfants selon la décision thérapeutique. Dans la deuxième étude, nous avons évalué les performances de l’XpertMTB/RIF dans les selles et du test lipoarabinomanann (LAM) dans les urines chez des enfants admis dans un état critique. Dans la troisième étude, nous avons déterminé le taux de détection avec XpertMTB/RIF et la culture MGIT d’échantillons de crachats frottis-positifs conservés à température ambiante sans traitement, ou traités avec Omnigène ou éthanol à différents périodes de temps.Sur 392 enfants (âge médian 3,9 ans, 45,5% de filles et 31% VIH positifs) inclus dans la 1e étude, 4,3% ont été confirmés microbiologiquement. L’XpertMTB/RIF dans le crachat avait une sensibilité de 90,9% et une spécificité de 99,1% contre un test de référence microbiologique. La sensibilité et la spécificité de l’Xpert dans les selles étaient de 55,6% et 98,2%. La mortalité était de 6,9% à trois mois, et était plus importante chez les enfants traités (10,7%) que chez les enfants non-traités (4,5%). Aucun des enfants traités pour une tuberculose microbiologiquement confirmée n’est décédé contre 12,3% de ceux traités de façon empirique.Parmi les 234 enfants (âge médian 16,5 mois, 48,3% de filles, 31,6% VIH positifs et 58,5% sévèrement malnutris) inclus dans la 2e étude, 5,1% avaient une tuberculose microbiologiquement confirmée. XpertMTB/RIF dans les selles avait une sensibilité de 50% et une spécificité de 99,1%. La sensibilité du test urinaire LAM était de 50% et la spécificité de 74,1%. Les faux positifs LAM étaient plus fréquents parmi les résultats positifs LAM de bas grade et dans les urines avec une contamination bactérienne.Dans la 3e étude, après 15jours, il n’y avait pas de différence de détection par XpertMTB/RIF entre les échantillons traités avec Omnigène ou éthanol et les échantillons non traités, ne montrant pas de bénéfice de l’ajout d’un conservateur. Nous avons décrit une baisse substantielle de viabilité de Mycobacterium tuberculosis dans les échantillons traités par Omnigène, ce qui n’est pas en faveur de l’utilisation de l’Omnigène pour le transport des échantillons avant culture MGIT.En conclusion, XpertMTB/RIF dans les selles a montré des résultats prometteurs chez les enfants ne pouvant pas cracher et pourrait être une alternative intéressante à des méthodes plus complexes comme l’induction du crachat et l’aspiration gastrique pour les centres de santé primaire des pays à ressources limitées. La faible spécificité du LAM dans les urines nécessite des investigations complémentaires avant son utilisation pour le diagnostic de la tuberculose de l’enfant. En dépit des résultats encourageants de l’XpertMTB/RIF sur les échantillons conservés avec Omnigène ou l’éthanol, des investigations complémentaires dans des conditions programmatiques sont nécessaires
The world health organization estimates that in 2017, close to 1 million children below 15 years developed tuberculosis but only half of them were notified. Difficulty to obtain sputum in children and the paucibacillary nature of intrathoracic childhood tuberculosis challenge the diagnosis of tuberculosis in children. This leads to the common use of empirical treatment with a high risk of over or under diagnosis. Besides that, few facilities in low resource settings have adequate laboratory capacity to diagnose tuberculosis. Samples must be transported to a reference laboratory, which can effect performance of the tests, especially in the absence of cold chain.Three studies were conducted in Mbarara (Uganda) to evaluate non-respiratory samples and specimen preservation methods to improve diagnosis of pediatric tuberculosis. In the first study, we assessed the performance of XpertMTB/RIF on sputum and stool in children with presumptive tuberculosis and documented outcomes of children according to the tuberculosis treatment decision. In the second study, we assessed the performance of stool XpertMTB/RIF and urine lipoarabinomanann (LAM) among children admitted with severe illness. In the 3rd study, we determined XpertMTB/RIF and MGIT culture recovery rates of smear positive sputum specimen kept untreated at room temperature and treated with either Omnigene or ethanol over different time periods.Of 392 children (median age 3.9 years, 45.4% female and 31% HIV infected) enrolled in the 1st study, 4.3% (17/392) were microbiologically confirmed tuberculosis. Using a microbiological reference standard, sputum XpertMTB/RIF had a 90.9% sensitivity and specificity of 99.1%. The sensitivity and specificity of stool XpertMTB/RIF was 55.6% and 98.2%. The study reported mortality of 6.9% within three months with a higher proportion (10.7%) among children treated for tuberculosis compared to the non-treated children (4.5%). None of treated children with bacteriologically confirmed tuberculosis died compared to 12.3% of those treated empirically.Of 234 patients (median age 16.5 months, 48.3% female, 31.6% HIV infected, 58.5% severely malnourished) enrolled in the 2nd study, 5.1% were microbiologically confirmed tuberculosis. Stool XpertMTB/RIF had a sensitivity of 50% and specificity of 99.1%. For the urine LAM test, it was 50% and 74.1%, respectively. False positive LAM results were more common among low grade positive LAM results and occurred more frequently when urine samples had bacterial contamination.The 3rd study documented that by 15th day, there was no difference of XpertMTB/RIF recovery rate between samples treated with Omnigene or ethanol and untreated samples, meaning that in the study conditions there was no benefit of adding any preservative for samples stored at room temperature up to 15 days. We observed a substantial loss of viability of Mycobacterium tuberculosis on samples treated with Omnigene, which does not support the use of Omnigene for sample transportation before MGIT testing.In conclusion, XpertMTB/RIF on stool gave promising results for the use in children unable to provide sputum and could be an interesting alternative to more complex methods such as sputum induction and gastric aspirate for primary health care centers of limited resource countries. The low specificity of the urine LAM requires further investigation before its use for diagnosis of tuberculosis in children. Despite the encouraging XpertMTB/RIF results from specimen preserved either with Omnigene or ethanol further evaluation under routine field conditions is necessary

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Christensen, Dustin Dean. "Changing factors contributing to increasing incidence of new HIV/AIDS diagnosis among homosexual men in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/206913.

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Human Immunodeficiency Virus (HIV) infection has continued to increase in Hong Kong and China. Since about 2006 the incidence of new HIV infections has significantly increased among homosexual men or men who have sex with men (MSM) while new infections among heterosexuals has remained steady. There are several risk factors that may be contributing to the increasing infection rates among MSM including: source for sexual partners, condom use, location of sexual partners, and how new technology may be effecting the spread of HIV. There are gaps in the literature available on MSM and HIV in Hong Kong; particularly in the methods used to identify individuals for study, and the lack of randomized controlled trials to study public health interventions to stop the spread of HIV in Hong Kong.
published_or_final_version
Public Health
Master
Master of Public Health

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Maino, Felicia Motsilisi Bopane. "The development of an early detection method for HIV infection in infants." Thesis, Bloemfontein : Central University of Technology, Free State, 2010. http://hdl.handle.net/11462/129.

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Thesis (M. Tech.) - Central University of Technology, Free State, 2010
Early detection of mother-to-child transfer of Human Immunodeficiency Virus (HIV-1) is of the utmost importance for monitoring the success of intervention strategies, as well as for optimal treatment of HIV-positive children. Serology can only be used confidently after 18 months, as remaining antibodies from the mother may give false positive results. This leaves only molecular methods for early detection of the virus; unfortunately, the technology is still too expensive for general use. The aim of this project was to develop and validate a cost-effective, fast, early detection method for HIV infection in infants. PCR was chosen as the developmental method, a technique that amplifies proviral sequences of HIV DNA, detecting HIV infection in peripheral blood mononuclear cells (PBMC) from infants of seropositive women during neonatal (age less than 28 days) and post-neonatal periods. A method based on the commercial Roche HIV-1 DNA assay was chosen for implementation on the Roche LightCycler instrument. The published primer set was used to detect both HIV-1 DNA and an internal control. The target DNA for use as internal control was constructed from the plasmid pBR322 so that an AT-rich part of the plasmid was flanked by the HIV-1 primer-binding sites. The resulting amplicon was cloned into a vector and multiplied in E. coli. Amplification of the plasmid by PCR in the Roche LightCycler in the presence of SYBR Green created an amplicon having a Tm different (81 ± 1°C ) from that of the HIV-1 amplicon (84 ± 1°C) so that post-amplification melting can be used to differentiate between HIV-1 and internal control. After construction of the internal control, the reaction conditions were optimised so that the internal control would amplify strongly only in the absence of HIV-1 target DNA. Then 50 previously tested patient samples were analysed using the assay developed here. Only half of the known positive samples came up positive in the assay, indicating that it is not sensitive enough for diagnostic use in its current form. Various ways of improving the sensitivity are suggested for further development of the assay as described here.

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13

Ho, Yuk-yi Ella, and 何玉儀. "Risk factors associated with HIV testing among Hong Kong young adults: implications for blood safety." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2001. http://hub.hku.hk/bib/B30252726.

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McIntyre, Tracy-Leigh. "An exploration of the effects of mindfulness on people with an HIV positive diagnosis living in the Eastern Cape, South Africa." Thesis, Nelson Mandela Metropolitan University, 2015. http://hdl.handle.net/10948/9903.

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Mindfulness research is growing considerably, though there is very little research in the area of HIV and mindfulness. This study explored and described the experience of a sample of HIV positive people, before and after an 8 week Mindfulness Based Stress Reduction (MBSR) programme, to ascertain whether mindfulness can positively impact the CD4 count of the participants, with the consequent improvement to their immune systems. The incidence of depression, anxiety and stress levels were also explored. The research sample consisted of 17 participants recruited from a local hospital clinic. Purposive sampling was used to source participants. The mixed method approach of data gathering was made up of a pre-test post-test battery of questionnaires and blood tests. Mindfulness levels were assessed with the Five Facet Mindfulness Questionnaire (FFMQ) and Mindfulness Attention Awareness Scale (MAAS) at 3 intervals, while depression, anxiety and stress were assessed by means of the Depression Anxiety Stress Scale (DASS-21). Key findings included the following: the drop out rate for this population group was large, mindfulness practices do not always have a positive effect on immune functioning when there are other confounding variables at play, all participants reported they benefited from the 8 week MBSR course, though their results did not always indicate this. In conclusion it is proposed that mindfulness is potentially beneficial.

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Patty, Lyndsay. "Macro Level Predictors of Community Health Center HIV Testing Approach." Thesis, University of North Texas, 2014. https://digital.library.unt.edu/ark:/67531/metadc699946/.

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Using a logistic regression model, this dissertation employed a macro level Gateway Provider Model to explore eight factors that may influence community health center HIV testing approach. The logistic regression model indicated that three variables related to community health center HIV testing approach. First, all else equal, the odds of offering routine HIV testing for community health centers that perceived their patients and community to be at average risk for HIV were 3.676 times the odds for those centers that perceived their patients and community to be at low or no risk for HIV. Further, the odds of offering routine HIV testing for community health centers that perceived their patients and community to be at high risk for HIV were 4.693 times the odds for those centers that perceived the community to be at low or no HIV risk. Second, all else equal, the odds of offering routine HIV testing for community health centers in which an HIV testing policy exists were 2.202 times the odds for those centers in which an HIV testing policy does not exist. Third, all else equal, the odds of offering routine HIV testing for community health centers that received funding specifically for HIV testing were 2.938 times the odds for those centers that did not receive such funding. No other individual predictor variables in the model were related to community health center HIV testing approach.

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Torres, Jonathan. "HIV false-positives : the impact doctrine and negligent infliction of emotional distress." Honors in the Major Thesis, University of Central Florida, 2001. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/252.

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This item is only available in print in the UCF Libraries. If this is your Honors Thesis, you can help us make it available online for use by researchers around the world by following the instructions on the distribution consent form at http://library.ucf.edu/Systems/DigitalInitiatives/DigitalCollections/InternetDistributionConsentAgreementForm.pdf You may also contact the project coordinator, Kerri Bottorff, at kerri.bottorff@ucf.edu for more information.
Bachelors
Health and Public Affairs
Legal Studies

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Wylde, Charlotte Anne. "The experiences of recently diagnosed HIV-positive individuals, as shared on an online forum." Thesis, Rhodes University, 2018. http://hdl.handle.net/10962/60222.

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An HIV-positive diagnosis can be an overwhelming and traumatic experience. This study explores the experiences of receiving an HIV-positive diagnosis. Employing an Interpretative Phenomenological Analysis (IPA), a sample of the initial posts from threads on an online forum, was collected and explored, in order to determine the dominant themes from the experiences expressed in the posts, as well as the support sought from the forum. The online forum was accessed as an unobtrusive observer, and posts from January to December 2015 were explored. The online forum provides a platform for disclosure following an HIV-positive diagnosis, when anxiety and fear of stigma can impact on an individual’s ability to disclose to their social support network of family and friends. The experiences expressed on the online forum reflect the emotional, mental and physical impact of an HIV-positive diagnosis on an individual. The findings in this study reflected themes of shock, guilt and hopelessness, and concerns and fears regarding disclosure and stigma associated with HIV, as well as the importance of social support for the coping mechanisms of individuals after receiving an HIV-positive diagnosis. This research demonstrates the importance of Internet accessibility for information and support for chronic illnesses, such as HIV, and the role of the online forum platform for providing a safe environment for individuals recently diagnosed HIVpositive.

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Balding, Alan Guy. "A case study on the implementation of prevalence testing for HIV in a manufacturing company in Kwazulu-Natal." Thesis, Stellenbosch : Stellenbosch University, 2005. http://hdl.handle.net/10019.1/50235.

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Thesis (MPhil)--Stellenbosch University, 2005.
On t.p.: HIV/AIDS Management.
ENGLISH ABSTRACT: This article describes the approach taken by a company to successfully implement prevalence testing for HIV at one of its manufacturing sites in KwaZulu-Natal. Ninety point four percent of the employees on site on the day of testing subjected themselves to voluntary anonymous testing. No rewards or incentives whatsoever were offered or given to the participants. The problem faced by the company was that there was increasing mortality amongst its employees, particularly those in the lower job grades, mainly machine operators and other lesser skilled positions. The cost of insured benefits provided by the company’s provident fund for death and disability were increasing and less money could be allocated to funding for retirement. In the absence of any empirical data the company had no idea how they would be affected by the HIV/AIDS pandemic, other than attempting to use provincial averages. The level of knowledge of HIV and AIDS in the company was judged as relatively poor. Many of the staff, more so the senior staff, had little or no exposure to the disease and what effect it had on those suffering from it or those supporting sufferers. Little had been achieved to manage HIV and AIDS until a workshop was organised by the company for representatives from all branches to attend. Various information topics about HIV were covered at the workshop, which concluded with the site representatives having to work out and table an action plan, and make a personal pledge of what they were going to do to help in the fight against HIV and AIDS. The workshop was attended by all board members, senior management, shop stewards and shop floor representatives. One of the key features of the presentations was by a senior official of the union, who then assisted throughout the rest of the workshop. Site plans were then later followed up when a central committee visited the sites and presentations on progress were made.At the workshop mention was made of the need to conduct prevalence testing and also the establishment of a HIV/AIDS committee. The site committee made the decision that prevalence testing should take place and consulted the workforce themselves and also through shop stewards. Once it was felt that sufficient support would be forthcoming a date for testing was set. The company had in the meantime contracted with a service provider to do testing where needed. A briefing session attended by the HIV/AIDS committee, shop stewards, the management team and two executive directors was arranged. A doctor employed by the service provider addressed the group and answered their concerns and demonstrated the saliva test on himself. On the day of testing senior management and the senior shop steward walked the factory floor encouraging employees to participate. This intervention has laid the foundation for a successful management campaign against HIV and AIDS in the workplace.
In hierdie artikel word die benadering wat n maatskappy gebruik om die voorkomsyfer van MIV by een van sy vervaardigingsterreine in KwaZulu-Natal to toets, beskryf. Op die dag waarop toetsing plaasgevind het, het 90,4% van die werknemers op die terrain hulleself vrywilliglik laat toets. Tydens hierdie anonieme toetsing is geen belonging of voordele van enige aard aan die deelnemers gebied nie. Die problem wat die maatskappy gehad het, was dat daar n toenemde sterftesyfer onder werknemers in die laer posvlakte soos masjienoperateurs en werknemers in posiese wat minder vaardighede vereis. Daar was stygende koste (in terme van dood en ongeskiktheid) van versekerde voordele waarvoor die maatskappy se voorsieningsfonds voorsiening maak, wat tot gevolg gehad het dat daar minder geld beskikbaar was vir pensionfondse. Omdat daar n tekort van empiriese data was, het die maatskappy geen idée gehad van die effek wat die MIV/VIGS-pandemie op hom sou uitoefen nie, behalwe deur die gebruik van provinsiale gemiddeldes. Die kennis van MIV/VIGS binne die maatskappy is as swak bestempel. ’n Groot hoeleevheid van die personeel, veral die in senior poste, het min of geen blootstelling gehad van die virus en die effek wat dit op VIGS-lyers en die ondersteuners van VIGS-lyers het nie. Min is gedoen on MIV/VIGS te bestuur, totdat n werkswinlek deur die maatskappy georganiseer is vir verteenwoordiges van al, die takke. ’n Verskeidenheid onderwerpe in verband met MIV/VIGS is deur die werkswinkel gedek. Een daarvan was dat die terreinverteenwoordiges n aksieplan moes opstel en n persoonlike eed moes afle dat hulle sou help in die stryd teen MIV/VIGS. Die werkswinkel is deur al die raadslede, senior bestuurslede, werkswinkelassistente en –verteenwoordiges bygewoon. Die hoofsaak van die voorleggings is deur n senior uniebeampte gelei, waarna hy vir die verloop van die program geassisteer het. Terreinplanne is opgestel en dit is later opgevolg deur n sentralle komitee wat die terreine besoek het en voorleggings gelewer het in verband met die vordering wat gemaak is. Tydens die werkswinkel is melding gemaak van die noodsaaklikheid van die toetsing van die voorkomsyfers van MIV en die instelling van n MIV/VIGS komitee. Die terreinkomitee het besluit dat die voorkomstoetsing moes plaasvind nadat die werkersmag en werkswinkelsttistente gekonsulteer is. Nadat besluit is dat die nodige ondersteuning uit hierdie toetsing sou voortspruit, is ’n datum vir die toetsing voorgestel. Vir die interementydperk het die maatskappy ’n diensverskaffer gekontrak om die toetsing, waar nodig, waar te neem. ’n Inligtingsessie is gereel wat deur die MIV/VIGS-komitee, werkswinkelassistente, die bestuurspan en twee uitvoerende direkteure bygewoon is. ’n Dokter, wat deur die diensverskaffer in diens geneem is, het die groep te word gestaan en antwoorde verskaf op hulle vraagstukke. Hy het ook die speekselftoets op himself gedemonstreer. Op die dag wat die toetsing plaasgevind het, het die seniorbestuur en werkswinkel-assistant deur die fabriek geloop en werknemers anngemoedig on aan die toetsing deel te neem. Hierdie intervensie het gelei tot die stigting van n suksesvolle bestuursveldtog teen MIV/VIGS in die werksplek.

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Kenana, Motlatsi Queen. "An evaluation of the attitudes and understanding of HIV/AIDS that underpins the decision to comply or not comply with prenatal HIV/AIDS testing." Thesis, University of the Western Cape, 2007. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_9853_1256911768.

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This study aimed to explore the attitudes to HIV testing among a group of black, low socio-economic status pregnant women from Gugulethu, South Africa. The key research interest was to evaluate the attitudes and understandings of HIV/AIDS that underpin the decision to comply or not comply with prenatal HIV testing. Theories of health behaviour concur that the extent to which an individual will engage in a given health behaviour, such as HIV test compliance, will be a function of the extent to which a person believes she is personally susceptible to the particular illness and her evaluation of the severity of the consequences of contracting the disease.

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Weston, Robyn. "An exploratory study of Rhodes students' attitudes and perceptions towards HIV/Aids." Thesis, Rhodes University, 2008. http://hdl.handle.net/10962/d1003294.

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The present study explores Rhodes students' perceptions and attitudes towards HIV/Aids issues. This study focuses on risk behaviour, stigmatisation, social perceptions and voluntary counselling and HIV testing (VCT). There is a lack of research on student attitudes, knowledge and behaviour at Rhodes University. It was therefore deemed pertinent to research this topic in that context. It was envisaged that the study would provide insights to be used in the formulation of improved strategies for HIV/Aids programs and education, ultimately impacting on the exponential increase of the pandemic in the Southern African region. A sample of six hundred and seventy five Rhodes University undergraduates completed a survey and its findings were interpreted in terms of relevant literature. A mixed methods approach using qualitative and quantitative methods was used. A focus group consisting of seven post-graduate students informed the development of the survey along with relevant literature. Four departments from the faculties of Commerce, Humanities, Science and Law were randomly sampled for the survey phase. Statistica was used to calculate descriptive statistics while the chi-square statistic was applied to examine the relationships between the variables. The findings show that the majority of students have high intention levels in planning to use preventative behaviour. However, in practise, this may not be the case. Many students feel that they belong to high or medium risk groups, as opposed to the low-risk groups. In terms of motivation levels, only sixty three percent of students are highly motivated to protect themselves from HIV/Aids and one third of respondents felt that they could not ask their partner to accompany them for an HIV/Aids test. In addition, students who had received VCT were more likely to be positive about the counselling process.

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Cupido, Ynoma. "Waiting to die: staging of HIV positive people at the first HIV test - Region A, Nelson Mandela Metropole (January 1991-April 2000)." Thesis, University of the Western Cape, 2006. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_8832_1253846190.

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This project suggested tha HIV people in Region A (Nelson Mandela Metropole, formerly Port Elizabeth) health districty of the Eastern Cape, seek HIV testing when they are already in stages three (late disease) and four (AIDS) of HIV infection. Data had been obtained from the AIDS Training Information and Counselling Centre in the Nelson Mandela Metropole in 2000. The consequences of diagnoses onlu in the advanced stages of HIV infection will have a devastating impact on case management. Therefore, this paper yielded important data for South African policy makers to write health and welfare policies that might improve the quality of life of those terminally infected with HIV.

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22

Kania, Dramane. "Développement d’outils et de stratégies pour le diagnostic et le suivi biologique des infections VIH, VHB et VHC dans les pays à ressources limitées." Thesis, Montpellier 1, 2014. http://www.theses.fr/2014MON1T017/document.

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Le diagnostic et le suivi des infections par le VIH, VHB et VHC restent un défi dans les pays à faibles ressources qui sont par ailleurs les plus touchés. Il est urgent de pouvoir disposer d'outils de biologie simples, fiables et peu chers pour le contrôle de ces infections virales. Le défi est immense d'un point de vue clinique et politique de santé. L'objectif de ce travail de recherche effectué dans le cadre de la présente thèse est de développer et valider des stratégies et de nouveaux outils de biologie adaptés au diagnostic et au suivi des hépatites virales et de l'infection VIH dans les pays à ressources limitées. Dans un premier temps, nous avons investigué sur les résultats de sérologie VIH discordants, car en biologie et en pratique clinique, il est important d'établir le statut sérologique réel des personnes dépistées avec des résultats clairs pour une prise de décision adéquate à l'échelle individuelle. Dans ce travail, nous avons trouvé que les résultats discordants par l'algorithme de dépistage des femmes enceintes au Burkina Faso, étaient dans 94% des cas de faux positifs dus au test Determine™ HIV-1/2 et 4% de faux négatifs liés au test Genie II™ HIV-1/HIV-2. En matière de santé publique, les femmes présentant ce type de résultat peuvent être considérées comme séronégatives dans les centres où des investigations supplémentaires ne sont pas possibles, surtout dans les pays comme le Burkina Faso où la prévalence de l'infection est basse avec une faible diversité génétique. Dans un second temps, nous avons focalisé nos travaux sur la faisabilité d'une stratégie de dépistage qui combine la détection des trois infections (VIH, VHB et VHC) sur une seule carte DBS. Dans cette étude pilote, nous avons démontré que le DBS collecté en parallèle au test rapide VIH dans un centre de dépistage volontaire permet d'une part de faire la confirmation du VIH par immunoblot, et d'autre part de compléter par le diagnostic des hépatites B et C par ELISA suivi de western blot et PCR pour la confirmation pour le VHC. Cette stratégie peut servir de modèle pour promouvoir et vulgariser le dépistage des hépatites virales B et C dans les pays à ressources limitées. Le DBS peut servir de contrôle et de confirmation du diagnostic du VIH, VHB et VHC. Par la suite, nous avons évalué la performance de deux tests de 4ème génération immunoluminométriques (Elecsys® HIV Combi PT assay, Roche Diagnostics et Liaison® XL Murex HIV Ab/Ag test, DiaSorin) sur des échantillons séchés sur papier filtre en comparaison au test de diagnostic rapide et aux échantillons de sérum frais prélevés chez les patients en primo-infection VIH. Ces travaux ont clairement montré que les deux tests de 4ème génération réalisés sur papier filtre offrent de bonnes performances dans le diagnostic de la primo-infection par rapport aux tests de diagnostic rapide sur sérum frais. Cette méthode peut être utilisée pour détecter précocement le VIH chez les personnes difficiles à atteindre et les populations vivant dans des zones périphériques des pays à ressources limitées. Enfin, nous avons mis au point une technique de PCR en temps réel de détection et de quantification de l'ADN du VHB. A cet effet, nous sommes partis de deux PCR « maison » ciblant deux régions génomiques différentes (gène X pour la qPCR 1 et gène S pour la qPCR 2) en comparaison à un test commercial de charge virale (Cobas AmpliPrep/Cobas TaqMan HBV Test, version 2.0, Roche Diagnostics). La qPCR 2 avec un seuil de détection à 91 UI/ml (vs 104 UI/ml pour la qPCR 1) a montré une meilleure performance dans la quantification de l'ADN du VHB. Cette qPCR 2 peu chère est aujourd'hui produite sous forme de kit par une start-up appelée OMUNIS. Ce kit en développement fera l'objet d'une évaluation multicentrique en France, en Afrique et en Asie du Sud-Est à travers un réseau de laboratoires sous la promotion de l'ANRS
Diagnosis and management of hepatitis B, hepatitis C and HIV infections are a real challenge in middle and low-income countries. There is an urgent need for simple, reliable and inexpensive tools to control these infections in high prevalence sittings like Africa and Asia. The challenge is immense in clinical and public health policy hands. The main goal of this research work performed for our PhD is the development and validation of strategies and tools to diagnose and monitor HIV, HBV and HCV infections in resource-constrained countries. At a first step, we investigated the results of HIV discordant results, since it is important to establish the real HIV status of people tested with clear results for appropriate decision-making in biological and clinical practice. This work show that discordant results obtained in the algorithm of HIV screening among pregnant women in Burkina Faso, are false positive results in 94% of cases due to the Determine™ HIV-1/2 immunochromatographic test and false negative results in 4% of cases due to the Genie II ™ HIV-1 / HIV-2 test. In public health practice, women with this type of result can be considered as negative for HIV testing in centers where additional investigations are not possible, especially in countries like Burkina Faso with a low incidence and a low genetic diversity of HIV.In a second step, we focused our work on the feasibility of a screening strategy that detects HIV, HBV and HCV infections into a single card of DBS. In this pilot study, we demonstrated that DBS collected in parallel to HIV rapid testing in a voluntary counseling and testing center allows HIV confirmation using immunoblotting, and an additional testing by diagnosing HBV and HCV using ELISA followed by immunoblotting and PCR for HCV confirmation. This strategy can serve as a model to promote and scale-up the screening of HBV and HCV in resource-limited countries. DBS can be served as control and confirmation of HIV, HBV and HCV diagnosis. Furthermore, we evaluated the performance of two 4th generation chemiluminescent immunoassays (Elecsys HIV Combi PT assay, Roche Diagnostics and Liaison XL Murex HIV Ab/Ag test, DiaSorin) tested on filter paper samples in comparison to rapid diagnostic test and fresh serum samples from patients with acute HIV infection. These studies have clearly shown that the two 4th generation tests performed on filter paper offer good performance in terms of sensitivity for the diagnosis of HIV infection in its early phases compared with rapid diagnostic tests. This approach may be used in combination with HIV rapid tests in hard-to-reach individuals and populations living in remote areas of when an early HIV infection is suspected since rapid tests do not offer appropriate performance in this case.Finally, we developed a real-time PCR for HBV DNA detection and quantification. In this study, we evaluated two in-house PCR targeting two different regions of HBV genome (X gene for qPCR 1 and S gene for qPCR 2) in comparison with a commercial Roche HBV DNA test (Cobas AmpliPrep / Cobas TaqMan HBV Test, version 2.0, Roche Diagnostics) as a gold standard. The qPCR 2 with a low detection limit of 91 IU/ml (vs 104 IU/ml for 1 qPCR) showed a better performance in HBV DNA quantification. This inexpensive qPCR with best performance characteristics is producing by a start-up called OMUNIS. This kit will be evaluated in France, in Africa and in South and East Asia in a research study funded by ANRS (France REcherche Nord & sud Sida-hiv Hépatites)

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Fisher, Julian Marcus. "A study at the Brooklyn Chest Hospital to assess the change in the oral carriage of Candida species in patients co-infected with HIV and TB, before and after antifungal therapy." Thesis, Stellenbosch : Stellenbosch University, 2002. http://hdl.handle.net/10019.1/52706.

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Thesis (MSc)--Stellenbosch University, 2002.
ENGLISH ABSTRACT: The aim of this study at the Brooklyn Chest Hospital (BCH) was to assess the change in the oral carriage of Candida species in twenty-nine patients co-infected with the Human Immunodeficiency Virus (HIV) and Tuberculosis (TB), before and after anti-fungal treatment. Each patient accepted onto the study underwent a comprehensive oral and peri-oral examination where the presence, site and clinical features of all oral and peri-oral lesions were recorded. The purpose of the examination was to provide a clinical diagnosis of oral candidasis. Each patient was also asked to provide a sample of oral fluid for laboratory analysis. This was collected using an oral rinse. The results of a variety of laboratory investigations were used to identify the species of Candida obtained from the oral rinse. Both the oral and peri-oral examination and the oral rinse procedure were repeated after one month and at three months. A sample from each oral rinse was inoculated on CHROMagar Candida chromogenic medium (CHROMagar Candida, France, Paris). CHROMagar is used for the isolation and presumptive identification of Candida sp. from other yeasts on the basis of strongly contrasted colony colours, which are produced by the reactions of species-specific enzymes with a proprietary chromogenic substrate. After forty-eight hours the CHROMagar plate was examined for growth, when a record of colony morphology and colour was made. A single sample from each different colour-coded colony was taken and streaked onto a Sabouraud plate (Oxoid, Basingstake, England) and then incubated for forty eight hours at thirty-seven degrees centigrade. A variety of laboratory investigations were subsequently carried out on a single colony taken from the Sabouraud agar plate (Oxoid). The results of these tests were used to identify the individual species of Candida isolated from each oral rinse. Oral candidasis was the most prevalent oral lesion observed on admission and at three months. Six different species of Candida were identified during this study, namely Candida albicans, Candida dubliniensis, Candida krusei, Candida glabrata, Candida parapsilosis, and Candida tropicalis. C.albicans was the most commonly identified species in study population. Candida dubliniensis was isolated and identified for the first time in a South African HIV population. Each specimen of Candida sp. identified by laboratory analysis was tested for sensitivity to Nystatin, Amphotericin B and Fluconazole anti-fungal agents. An additional sensitivity test was performed using Ajoene and Allicin (extracts of garlic) to assess the comparative antifungal properties of these compounds.
AFRIKAANSE OPSOMMING: Die doelwit van hierdie studie by die Brooklyn Borshospitaal (BCH) was om die verandering in orale draerstatus van die Kandida spesies in nege-en-twintig HIVfTB koïnfekteerde pasiënte vas te stel, voor- en na antifungale behandeling. Elke pasiënt in die studie het 'n volledige intra- en ekstra-orale ondersoek ondergaan. Die teenwoordigheid, area en kliniese voorkoms van alle letsels is noteer. Die doel van die ondersoek was om 'n kliniese diagnose van orale kandidiase te verkry. 'n Monster orale vloeistof is geneem van elke pasiënt vir laboratorium analise. Die monster is in die vorm van 'n mondspoel geneem. Verskeie toetse is gedoen om die verskillende Kandida spesies in elke monster te identifiseer. Die orale- en ekstra-orale ondersoek sowel as die mondspoelmonster is na 1 en 3 maande herhaal. Elke mondspoelmonster is op CHROMagar Kandida chromogene medium (CHROMagar Candida, France) inokuleer. CHROMagar word gebruik vir die vermoedelike identifikasie en isolasie van Kandida spesies teenoor ander swamme. Dit word gedoen op die basis van kontrasterende koloniekleure, wat teweeggebring word deur spesie-spesifieke ensiemreaksies op 'n chromogene substraat. Die CHROMagar plate is na 48 uur ondersoek vir groei en die kolonie-morfologie en - kleur is noteer. 'n Enkel monster. is geneem van elke verskillende kolonie (geskei op kleur) en is uitgestreep op 'n Saboraud plaat (Oxoid, Basingstoke, England). Dit is dan vir 48 uur inkubeer teen 37°C. Verskeie laboratorium ondersoeke is daarna uitgevoer op 'n enkel kolonie geneem vanaf die Saboraud agar plaat (oxoid). Die resultate van die ondersoeke is gebruik om individuele spesies van Kandida te identifiseer. Orale Kandidiase was die mees algemene orale letsel geïdentifiseer by toelating en 3 maande ondersoeke. Ses verskillende spesies Kandida is identifiseer tydens die studie, naamlik: Kandida albicans, K.dubliniensis, K.Krusei, K.glabrata, K.parapsilosis en K.tropicalis. K.albicans was die mees algemeen identifiseerde spesie in die studiepopulasie. K.dubliniensis is vir die eerste keer in Suid-Afrika in 'n HIV<+lpopulasie isoleer en geïdentifiseer. Elke monster van identifiseerde Kandida spesies is getoets vir sensitiwiteit teenoor Nistatien, Amfotensien B en Flukonasool. Addisioneel is ook getoets vir sensitiwiteit teenoor Ajoene en Allicin (knoffelekstrakte).

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Lemos, Renata Muller Banzato Pinto de. "Proteína C reativa (PCR) em crianças com infecção pelo HIV na ausência de quadro infeccioso concomitante e na vigência de pneumonia aguda." Universidade de São Paulo, 2003. http://www.teses.usp.br/teses/disponiveis/5/5141/tde-23092014-115736/.

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Por serem as manifestações pulmonares de etiologia infecciosas muito freqüentes e potencialmente graves nas crianças com aids, o diagnóstico deve ser precoce para uma rápida e efetiva intervenção terapêutica. A proteína C reativa (PCR), um dos marcadores das provas de fase aguda, tem sido usada na prática clínica como um recurso diagnóstico na diferenciação entre patologias sistêmicas de etiologia viral e bacteriana, bem como na monitorização da eficácia da terapêutica antimicrobiana frente a uma infecção. Apesar da proteína C reativa ser um exame inespecífico e poder estar aumentada em diferentes situações clínicas (infecções sistêmicas, doenças inflamatórias e neoplásicas, isquemias, queimaduras), a infecção bacteriana é a causa mais freqüente para o seu aumento. A PCR eleva-se rapidamente após a injúria tecidual, atingindo valores 10 a 1000 vezes superiores a seu nível basal: em virtude de sua curta meia vida, retorna em pouco tempo aos valores prévios após o fim da agressão. Com o objetivo de encontrar um método laboratorial auxiliar para as infecções pulmonares nas crianças com infecção pelo HIV foi estudada a proteína C reativa, pela técnica de nefelometria, em dois momentos distintos: na ausência de quadro infeccioso concomitante (grupo 1) e na vigência de pneumonia aguda (grupo 2). O grupo 1 envolveu o estudo de 66 crianças com infecção pelo HIV, resultando em 84 amostras de PCR coletadas na ausência de quadro infeccioso concomitante.No grupo 2 foram analisadas 6 crianças com infecção pelo HIV com 9 episódios de pneumonia aguda. As crianças com infecção pelo HIV foram classificadas de acordo com as categorias clínicas e imunológicas da classificação do CDC para infecção pelo HIV em crianças. Dentre as 66 crianças incluídas no grupo 1, 6 pertenciam à categoria N, 11 à categoria A, 27 à categoria B e 22 à categoria C. Das 84 amostras de PCR coletadas no grupo 1, 76 (90,48%) encontravam-se abaixo de 5 mg/l, 7 amostras entre 5 a 20 mg /l e, apenas 1 amostra entre 20 a 40 mg/l (1,15%). No grupo 2, todas as crianças eram pertencentes às categorias B3 (1/6) ou C3 (5/6), refletindo um estágio mais avançado da doença. Das 9 amostras de PCR, 6 apresentavam valores maiores que 40 mg/l, 1 entre 20 e 40 mg/l e as 2 amostras restantes, entre 5 e 20 mg/l. Os dados sugerem portanto que a infecção pelo HIV por si só não é acompanhada de aumento da PCR, bem como não existe relação com a classificação imunológica em que o paciente se encontre. Pacientes com infecção pelo HIV na vigência de pneumonia aguda apresentam níveis aumentados de PCR. Neste estudo, o ponto de corte que diferenciou os grupos 1 e 2 foi PCR = 28,9 mg/l com sensibilidade de 77,8% e especificidade de 100% (IC 95%)
As pulmonary infection is a common and potentially serious condition in HIV-infected children, effectiveness of treatment of this kind of affection depends to a large extent on the promptness of accurate diagnosis. The C-Reactive Protein (CRP), a reasonably well-established acute phase marker, has long been used to differentiate bacterial from viral infections. Despite its lack of specifity, that is, the fact that other conditions like inflammatory diseases, neoplasms, ischemia and burns may also increase CRP levels, Bacterial infections are the most frequent cause of increased CRP found in daily clinical practice. Shortly after any tissular injury, CRP increases considerably, reaching up to 10-1000 times its previous levels. Due to its short half-life, its decrease after the end of the affection is quick as well. This study aimed at evaluating the CRP (assessed by nephelometry) as an auxiliary tool to diagnose pulmonary infection in HIV-infected children. Two groups of patients were considered in this study: group 1 was constituted by 66 HIV-infected children with no clinical signs of concomitant infection (amounting to 84 CRP samples) and group 2 was constituted by 6 HIV-infected children with pneumonia (amounting to 9 CRP samples). All the subjects were assigned to categories according to the pediatric HIV classification system (CDC, 1994). Among the 66 children from group 1, 6 were assigned to categories N, 11 to A, 27 to B and 22 to C. Regarding the levels of CRP in group 1 it was found: 76 samples (90.48%) < 5 mg/l, 7 (8.33%) in the range between 5 and 20 mg/l and 1 sample between 20 and 40 mg/l. In the group 2, all the children were assigned either to category B3 (1/6) or C3 (5/6) and the CRP level distribution was the following: 6 (6/9) > 40 mg/l, 1 (1/6) between 20 and 40 mg/l and 2 (2/6) between 5 and 20 mg/l. These results suggest that 1.HIV infection by itself does not increase the levels of CRP, regardless the immunologic classification of the patient; 2.HIV-infected children with pneumonia present increased levels of CRP 3.In this study, the cut-off point to differentiate groups 1 and 2 was 28,9 mg/l, with sensitivity of 77,8% and specificity of 100% (p < 0.05)

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Williams, Leilanie. "Barriers and enablers to acceptance of voluntary counseling and testing (VCT) services by youth males." Thesis, Stellenbosch : Stellenbosch University, 2007. http://hdl.handle.net/10019.1/19894.

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Thesis (MPhil)--University of Stellenbosch, 2007.
ENGLISH ABSTRACT: Voluntary Counseling and Testing (VCT) is considered an important component of the South African government’s response to the HIV/AIDS pandemic. Despite of this, the numbers of South Africans who have accessed VCT remains low. Pregnant women in antenatal clinics remain the primary recipients of HIV testing since it is routinely offered to them at antenatal clinics. Figures from antenatal clinics constitute the most important source of HIV/AIDS statistics in South Africa. Targeting women at antenatal clinics perpetuate the stereotypes that women are solely responsible for reproductive health issues or, that they are to be blame for the mounting HIV infections. These beliefs exacerbate the culminating violence against women. According to observation, active involvement of male youth in reproductive health at the Rosedale Clinic situated in Uitenhage, a town in the Eastern Cape, appears to be very limited. This might be as a result of traditional beliefs declaring reproductive health a primarily female domain. Active involvement of males in reproductive health is considered to have positive health outcomes both for themselves, and their partners. The purpose of this study is thus to encourage males served by the Rosedale clinic to become more actively involved in one aspect of reproductive health, namely voluntary counseling and testing (VCT). The study aims to find out which factors constitute barriers and enablers to VCT acceptance by male youth. Semi-structured, face-to- face interviews were conducted in September 2006 with eighteen males, 18 to 25 years, to determine from their perspective what constitute barriers and enablers to HIV test acceptance by males. These participants were recruited from two well-known rugby clubs in Uitenhage, located in the Eastern Cape. In addition, a focus group discussion was conducted with four males recruited at a graduate development programme hosted in Uitenhage in order to explore common themes emerging from interviews and the discussion. A pervasive, psychologically rooted fear; and possible low perception of risk emerge from this study as main barriers to HIV testing. Negative perceptions regarding service delivery in the public health sector constitute another barrier to HIV testing. The possibility of teasing, a common phenomenon amongst rugby players but not exclusive to them, exacerbates peer pressure thus possibly contributing to low levels of HIV test acceptance among these males. Increased HIV test acceptance is associated with increased opportunities of exposure to HIV testing opportunities, for example at awareness campaigns. Access to medical aid and income is also associated with an increased likelihood of HIV testing since most males prefer accessing HIV testing services in the private sector. Convenience and ease of access to HIV testing services are important when these males consider going for HIV testing.
AFRIKAANSE OPSOMMING: Vrywillige Berading en MIV Toetsing, een aspek van reproduktiewe gesondheid, word beskou as ‘n belangrike komponent van die Suid-Afrikaanse regering se strategie teen MIV/VIGS. Ongeag van hierdie feit is ‘n groot aantal Suid-Afrikaners nog nie getoets vir MIV nie. Swanger vrouens word op ‘n daaglikse basis hierdie toets aangebied as deel van roetine ondersoeke. Syfers vanaf pre-natale klinieke vorm die hoofbron van Suid- Afrika se HIV/VIGS statistieke. Die feit dat swanger vrouens die hoofteikengroep is vir MIV toetsing dra by tot stereotipes wat daartoe lei dat vrouens primêr verantwoordelik is vir die behoud van reproduktiewe gesondheid; en dat hulle beskou word as die hoofverdagtes in die toenemende oordrag van MIV. Laasgenoemde beskuldiging vererger geweld teen vrouens. Volgens waarneming by Rosedale publieke kliniek geleë in Uitenhage, ‘n dorp in die Oos-kaap, is veral jeugdige mans se betrokkenheid in reproduktiewe gesondheid uiters minimaal. Dit kan moontlik wees omdat reproduktiewe gesondheid tradisioneel as ‘n vroulike domein beskou word. Aktiewe betrokkenheid van beide mans en vrouens in reproduktiewe gesondheid het positiewe gesondheidsuitkomste vir beide partye tot gevolg. Die doel van hierdie studie is dus om jongmans wie deur die Rosedale kliniek bedien word aan te moedig om meer sigbaar te word in reproduktiewe gesondheidskwessies; met die oog op een aspek daarvan naamlik, vrywillige berading en MIV toetsing. Die studie poog dus om uit te vind watter struikelblokke jeugdige mans weerhou van MIV toetsing en; watter faktore mans aanmoedig om vir die toets te gaan. Semi-gestruktureerde, aangesig-tot- aangesig onderhoude is in September 2006 met 18 mans, vanaf die ouderdomme 18 tot 25 jaar, gevoer. Hierdie mans was tydens die studie rugbyspelers vanuit twee welbekende rugbyklubs op die dorp. ‘n Addisionele fokus groep is verder gevoer met manlike studente wie ten tye van die studie aan ‘n ontwikkelingsprogram vir gradueerders deelgeneem het op die dorp. Hierdie fokusgroep is geloods om soortgelyke temas vanuit die onderhoude en die bespreking te ondersoek. Die studie toon dat ‘n diepgewortelde, sielkundige vrees; en moontlike lae bewustheid van persoonlike risiko die twee vernaamste struikelblokke is vir MIV toetsing. Negatiewe sienings rakende die publieke gesondheidssektor kan moontlik bydrae tot weerstand teen MIV toetsingsdienste. Tergery, ‘n bekende verskynsel onder rugbymans, maar nie slegs beperk tot diè groep nie, dra by tot groepsdruk en weerhou moontlik menige mans van MIV toetsing. Diegene in die studie wie alreeds vir MIV getoets is geniet toenemende blootstelling aan MIV toetsingsgeleenthede; bv tydens bewusmakingsveldtogte geloods òf by die werk òf tersiêre instellings. Toegang tot ‘n mediese fonds; en ‘n inkomste is moontlike bepalende faktore sienende dat meeste respondente gesondheidsdienste in die privaatsektor verkies. Gerieflike toegang tot MIV toetsingsdienste word deur sommige mans as belangrike beskou wanneer hulle MIV toetsing oorweeg.

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Foster, Caron. "An exploration of voluntary counselling and testing : a Port Elizabeth-based study." Thesis, Nelson Mandela Metropolitan University, 2010. http://hdl.handle.net/10948/1204.

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The purpose of this study was to explore and identify factors that either facilitate or inhibit individuals volunteering for HIV-testing. The target group was comprised of Xhosa first-language construction workers in a company with an HIV/AIDS workplace policy and programme. This programme provides basic education and awareness about HIV/AIDS. This education includes information about where to access voluntary counselling and testing (VCT) services. Interpretive qualitative research was undertaken in order to explore the beliefs, perceptions and intentions of the target group in regard to the utilisation VCT services. Data was collected using an unstructured interview guide. The data was analysed using Tesch’s approach to content analysis. Concerns about validity and reliability were engaged throughout the research process and supported further by using researcher reflexivity and an independent researcher. The independent researcher analysed data separately and only after discussion and consensus being found between the two researchers were final categories and codes agreed upon and data analysis considered complete. Findings revealed that an HIV/AIDS workplace programme has a positive impact on the health-seeking behaviour of workers in the construction company used in this research. Respondents knew how HIV/AIDS is transmitted, how to prevent transmission and where to find HIV-testing treatment and support. In this case HIV-testing services can easily be accessed further facilitating respondents volunteering for HIV-testing. It was also found that family, friends and churches support HIV-testing behaviour by providing education, guidance and support to respondents encouraging behaviour change. On the other hand, respondents held that community members who had not benefited from an HIV/AIDS workplace programme such as theirs are exposed daily to the devastating effects of HIV leading to AIDS deaths and live in fear of the disease. Debilitating illness and eventual death is equated with an HIV-positive diagnosis which causes community members to believe it is better not to volunteer for HIV-testing than to ascertain one’s HIV-status. The HIV/AIDS workplace policy and xv programme on the other hand is seen to have provided respondents with HIV/AIDS knowledge enabling them to overcome their fear of an HIV-positive diagnosis and to volunteer for regular HIV-testing.

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Mooketsi, Mapule Linah. "Factors preventing the uptake of HIV counseling and testing (HCT) programmes : the case of the Industrial Development Corporation in Johannesburg, South Africa." Thesis, Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/86375.

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Thesis (MPhil)--Stellenbosch University, 2014.
ENGLISH ABSTRACT: HIV counseling and testing (HCT) is a cornerstone of both HIV prevention and care in South Africa, but only one in five South Africans who are aware of HCT services have been tested for HIV and hence the uptake is reportedly low. This study investigated factors that prevent the uptake of HCT programme in the workplace. Specific factors that were looked at include: fear of learning about one‟s HIV status, HIV-stigma and discrimination and knowledge of and attitudes towards HCT. The study employed descriptive survey design; anonymous questionnaires were randomly distributed irrespective of age, gender, marital status, race, educational level, work position and experience. Closed and open-ended easy- to- answer questions which were written in English were asked; and they required fewer instructions. Ethical issues were considered and university guidelines followed. The results of this study showed that a great proportion of participants (93.8%) tested for HIV as compared to (6.2%) who had never tested. Of these, 59.4 % tested because they wanted to know their HIV status and, 43.8% of participants preferred using the workplace HCT programme for convenience; while 50% used private facilities for privacy and confidentiality. The study further established that fear of knowing one‟s HIV status, workplace discrimination, knowledge of and attitudes towards HCT were not associated with workplace HCT programme uptake. The results did however show that both participants who had tested and those who had not tested (68.8%) demonstrated significantly greater AIDS-related stigma. Supportive and collaborative efforts are necessary to create and promote an enabling and conducive environment in order to dispel workplace HIV-related stigma. In addition, it is imperative to develop and implement workplace stigma mitigation strategy putting in place interventions that aim to reduce all forms of stigma, as well as emphasizing on the benefits of testing.
AFRIKAANSE OPSOMMING: MIV/Vigs-voorligting en toetsing is die hoeksteen vir beide die voorkoming en versorging van MIV-pasiënte in Suid-Afrika. Ongelukkig is net ongeveer een uit elke vyf mense bewus van hulle MIV-status. Die doel van hierdie studie is 'n poging om vas te stel waarom so min mense gebruik maak van gratis toetsingsdienste in die werksplek. 'n Beskrywende studie-ontwerp is in hierdie navorsing gebruik met anonieme vraelyste wat ewekansig versprei is onder 'n steekproef waarin geen onderskeid ten opsigte van ras, geslag. opvoedkundige vlak, posisie in die werk en ervaring gemaak is nie. Geslote en oop-einde vrae is gebruik en Engels is as kommunikasiemedium gebruik omdat al die proefpersone dit verstaan het. Resultate van die studie het aangetoon dat beduidend meer mense hulle wel laat toets het teenoor die wat hulle nie laat toets het nie. Die studie het verder bevind dat faktore soos die vrees om status te weet; diskriminasie in die werksplek, kennis van en houding teenoor MIV/Vigs nie geassosieer kan word met die lae opname van vrywillige toetsing in die werksplek nie. Die studie het wel bevind dat diegene wat hulle . laat toets het, beduidend meer stigma in die werksplek ondervind. Ondersteunende dienste is uiters nodig ten einde stigma suksesvol in die werksplek te bestuur. Daar word voorgestel dat daar 'n volledige opleidingsprogram ,in die werksplek van die organisasie wat in die studie gebruik is, ontwikkel moet word ten einde die invloed van stigma tot 'n minimum te beperk.

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Chitambala, Cecilia. "Factors affecting HIV counselling and testing (HCT) in the provision of prevention of mother to child transmission (PMTCT) services among pregnant women in Kabwe, Central Province of Zambie." Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/79955.

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Thesis (MPhil)--Stellenbosch University, 2013.
ENGLISH ABSTRACT: This research study looked at the factors that affect HCT in provision of PMTCT services. It explored the socio cultural and personal factors that affect HCT. It also established the knowledge level about HIV/AIDS and PMTCT among pregnant women in Kabwe. The transmission of HIV from mother to child contributes largely to HIV prevalence among children. Efforts to reduce this mode of transmission include increasing number of women who know their HIV status and increasing the number of HIV positive women who when pregnant take instructions and act on them to protect their children from the possibility of infection (Bartlett et al. 2004). Individuals can only know their HIV status once they are tested for HIV. However, there are socio cultural and personal factors among other factors that affect the access of HCT. The aim of this study was to identify socio cultural and personal factors that affect HIV counseling and testing in provision of PMTCT services among pregnant women in Kabwe, in order to make recommendations for the development of an intervention program to help improve uptake of HIV counseling and testing for PMTCT services. Both quantitative and qualitative methodologies were used to conduct this study. Focus Group Discussions were conducted with groups of pregnant women that have never been tested for HIV before and Key Informant Interviews with health care workers (midwives or nurses) to ask them about factors affecting HCT in provision of PMTCT services among pregnant women were used. A retrospective statistical report review was also used to ascertain the accessibility rate for the HIV counseling and testing for PMTCT services. In this light, statistical report review was used to collect the number of pregnant women attending ANC and number of pregnant women receiving HIV testing. The findings of this study revealed that the pregnant women had excellent knowledge about HIV/AIDS and the update of HCT was as good as 91% among pregnant women. The research also revealed domestic violence, accusation of promiscuity by partner, abandonment by partner, and stigma & discrimination as socio factors that affect HCT in provision of PMTCT. Religion, fear disbelief of test results was revealed as personal factors affecting HCT in provision of PMTCT. The research revealed decision making, tradition medicines, and practices as cultural factors affecting HCT in provision of PMTCT. The conclusion was made that fear of abandonment by partner, fear of being accused of being promiscuous by partner, and fear of domestic violence were the main factors why some pregnant women did not accept to take an HIV test during their pregnancies. It is also concluded that most men make decisions for their families. Women in homes have no powers to make decisions, so if the husband refuses her to take a test, the wife just has to comply. It is also concluded that a person’s ability to access health related services is shaped by socio cultural and personal factors among others factors. These findings fit well with the Anderson behavioral model which describes the individual factors as having three elements that relate to the individual’s ability to access and utilize health care services.
AFRIKAANSE OPSOMMING: Hierdie navorsingstudie het gekyk na die faktore wat 'n invloed HCT in die voorsiening van VMTKO dienste. Dit ondersoek die sosio-kulturele en persoonlike faktore wat HCT. Dit het ook die kennis oor MIV / VIGS en VMNKO onder swanger vroue in Kabwe. Die oordrag van MIV van moeder na kind dra grootliks by tot die voorkoms van MIV onder kinders (Bartlett et al. 2004). Pogings om hierdie wyse van oordrag te verminder sluit in toenemende aantal vroue wat hul MIV-status ken en die verhoging van die aantal MIV-positiewe vroue wat toe swanger neem instruksies en reageer op hulle om hul kinders te beskerm teen die moontlikheid van infeksie. Individue kan slegs weet wat hul MIV-status wanneer hulle getoets word vir MIV. Egter, is daar sosiaal-kulturele en persoonlike faktore onder ander faktore wees wat die toegang van HCT. Die doel van hierdie studie was om sosiaal-kulturele en persoonlike faktore wat die MIV-berading en toetsing in die voorsiening van VMTKO dienste onder swanger vroue in Kabwe te identifiseer, ten einde aanbevelings te maak vir die ontwikkeling van 'n intervensie program te help opname van MIV-berading en toetsing vir VMNKO dienste te verbeter. Beide kwantitatiewe en kwalitatiewe metodes is gebruik om hierdie studie uit te voer. Fokusgroepbesprekings is gevoer met groepe van swanger vroue wat nog nooit vir MIV getoets is voor en onderhoude met sleutelinformante met gesondheidsorgwerkersVroedvroue of verpleegsters) is gebruik om hulle te vra oor die faktore wat HCT in voorsiening van PMTCT dienste onder swanger vroue. 'n Retrospektiewe statistiese verslag review is ook gebruik om die toeganklikheid koers vir die MIV-berading en om vas te stel toetsing vir VMNKO dienste. In hierdie lig, is statistiese verslag hersiening gebruik word om die aantal swanger vroue wat die ANC en die aantal swanger vroue MIV-toetsing in te samel. Die bevindinge van hierdie studie het aan die lig gebring dat die swanger vroue het uitstekende kennis oor MIV / VIGS en die update van HCT was so goed as 91% onder swanger vroue. Die navorsing het ook aan die lig gebring huishoudelike geweld, beskuldiging van losbandigheid deur vennoot, verlating deur vennoot, en stigma diskriminasie as sosio faktore wat 'n invloed HCT in die bepaling van die PMTCT. Godsdiens, vrees ongeloof van toetsresultate is geopenbaar as persoonlike faktore wat HCT in die voorsiening van PMTCT. Die navorsing het aan die lig gebring besluitneming, tradisie medisyne, en praktyke as kulturele faktore wat HCT in die voorsiening van PMTCT. Die gevolgtrekking is gemaak dat vrees vir verlating deur vennoot, vrees daarvan beskuldig dat hy van promisku deur vennoot, en die vrees van huishoudelike geweld was die belangrikste faktore waarom sommige swanger vroue nie aanvaar het nie 'n MIV-toets te neem tydens hul swangerskappe. Dit is ook die gevolgtrekking gekom dat die meeste mense besluite neem vir hul families. Vroue in huise het geen magte om besluite te neem, so as die man weier om vir haar 'n toets te neem, die vrou net om daaraan te voldoen. Dit is ook die gevolgtrekking gekom dat 'n persoon se vermoë om gesondheid verwante dienste om toegang te verkry tot gevorm word deur die sosiaal-kulturele en persoonlike faktore onder andere faktore. Hierdie bevindings pas goed met die Anderson gedrags-model wat die individuele faktore beskryf met drie elemente wat betrekking het op die individu se vermoë om toegang te verkry tot en gebruik van gesondheidsorgdienste.

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Komanyane, Lorato. "Factors influencing the utilization of voluntary counselling and testing services amongst employees of the Lobatse Town Council in Botswana." Thesis, Nelson Mandela Metropolitan University, 2007. http://hdl.handle.net/10948/535.

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In this study both qualitative and quantitative methods were used to find out to what extent the Lobatse Town Council employees used Voluntary Counseling and Testing (VCT) HIV and AIDS services, the reasons for using or not using the services, the preferred service providers reasons for choosing a service provider. Lastly recommendations were made on how the uptake HIV and AIDS VCT services could increased amongst the employees. A sample of 200 respondents was selected from the employees of the Lobatse Town Council, and it was established that 65.5 percent of the respondents had used VCT. Females had a higher testing participation rates than males, white collar respondents had a higher testing participation than the blue collar respondents. There was a higher rate amongst the married than the single respondents and the older ages of 30 and above than the young ages of 29 years and under. In the study it was also established that the majority of the respondents considered voluntary counselling and testing for HIV and AIDS as being important. However there were some groups that were more positive than others regarding the importance of testing. More females than males were positive regarding the importance of testing, and also amongst the employment categories the white collar respondents were more positive than the blue collar respondents regarding the importance of HIV and AIDS testing. Furthermore it was established that the most important reason for testing amongst the employees that did test for HIV and AIDS was that they felt that they needed to undergo testing before they tested. The respondents that did not test for HIV and AIDS indicated that the most important reason for not testing was that they were scared the results could not be kept confidential. The research also showed that the most preferred service provider was Tebelopele. Tebelopele was the most used and preferred service provider amongst both gender and age groups, all marital groups and the blue collar group in the employment categories. However, for the white collar group the most preferred service provider was the private practitioners. The most common reason for choosing a service provider was confidentiality and privacy. Lastly, the research makes recommendations on what needs to be done to increase the uptake of VCT HIV and AIDS testing amongst the Lobatse Town Council employees. One of the recommendations is that there was a need to educate the employees of the Lobatse Town Council and that the education should be specific for each group. For example from the group discussion the participants felt that the reason to why males did not want to utilise HIV and AIDS VCT was because they lacked knowledge on the importance of testing. Also the respondents indicated that there was a need to remove stigma and discrimination through removing confidentiality attached to HIV and AIDS. It was also, recommended that the Lobatse Town Council formulate and implements a workplace policy on HIV and AIDS

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Kla, Minga Albert. "Intérêt d'une cohorte de sujets adultes à date d'infection par le VIH estimée en Afrique Sub-saharienne." Thesis, Bordeaux 2, 2011. http://www.theses.fr/2011BOR21837/document.

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L’infection par le VIH est caractérisée en l’absence d’intervention par une évolution progressive vers un état d’immunodépression favorisant la survenue d’affections opportunistes et entrainant le décès. La connaissance de l’évolution spontanée de l’infection par le VIH repose sur les données observationnelles issues des cohortes. La meilleure façon d’aborder l’histoire naturelle de cette infection est de l’étudier à partir de la date de séroconversion, ce qui ne peut se faire que dans les cohortes dites incidentes. Ces cohortes incidentes font appel à des structures parfois lourdes et des procédures rigoureuses que l’on peut plus aisément mettre en place dans les pays à ressources élevées. Les cohortes de personnes à date estimée de séroconversion permettent d’identifier les facteurs de risque de la transmission, d’étudier l’évolution de l’infection, d’étudier l’évolution de ses marqueurs et ses déterminants en minimisant le biais de sélection inhérent aux études prévalentes. L’évolution naturelle concerne la période qui s’écoule entre la date d’infection et le décès pour les patients qui n’ont pas bénéficié de prescription du traitement antirétroviral. Cette période s’arrête à la date de prescription des antirétroviraux pour ceux qui en bénéficient.La cohorte ANRS 1220 Primo-CI de personnes à date estimée de séroconversion pour le VIH-1 a été mise en place en juin 1997 sur le site de l'ANRS d'Abidjan en Côte d'Ivoire, au Centre national de transfusion sanguine (CNTS), avec la coordination de l'INSERM U330/593/897-ISPED de Bordeaux. C’est l’une des rares cohortes de séroconverteurs pour le VIH-1 dans le contexte des pays à faibles ressources et l’unique en Afrique de l’ouest. Dans cette cohorte de patients dépistés parmi les donneurs de sang effectuant plus de deux dons de sang par an, les données cliniques et biologiques ont été recueillies régulièrement pour tous les patients, tous les six mois depuis leur inclusion dans la cohorte.Les principaux apports de la cohorte Primo-CI dans la lutte contre le VIH en Côte d’Ivoire, ont consisté à recueillir des informations sur les facteurs de risque d’infection par le VIH pour aider à améliorer la sélection des donneurs de sang. La cohorte Primo-CI a permis d’améliorer également les capacités de la structure de prise en charge qui a servi de centre de recrutement et de prise en charge des patients de la cohorte. Cette cohorte a contribué à la mise en place d’un cadre d’échanges réguliers entre les médecins chargés de la sélection des dons de sang et l’équipe de la cohorte Primo-CI.Nos données ont fourni des estimations de la probabilité d'atteindre les critères d'initiation des antirétroviraux depuis le premier contact dans une population de séroconverteurs récents pour le VIH en Afrique de l’ouest et de la probabilité de survenue des événements morbides au cours du temps.L'ADN intracellulaire du VIH-1 était la variable la plus fortement associée à la progression de la maladie, indépendamment des autres variables explicatives. Il était suivi des lymphocytes CD4 avec une association plus faible. La charge virale plasmatique VIH-1 était faiblement associée à la progression de la maladie et ce après la prise en compte de l'ADN.La cohorte ANRS 1220 Primo-CI a participé à plusieurs travaux de collaborations portant sur les seuils d’éligibilité aux antirétroviraux, la comparaison de la baisse des lymphocytes CD4 avec des patients européens, la morbidité et la mortalité liées au SIDA et le rôle prédictif de l'ADN intracellulaire du VIH-1. Elle a également contribué à la réalisation de travaux scientifiques en virologie et immunologie qui ne portent pas sur l’objectif principal de ce travail
In the absence of any intervention, HIV infection is characterized by a gradual evolution towards a state of immunosuppression favoring the occurrence of opportunistic infections and causing death. The natural history of HIV infection is usually documented based on data from observational cohorts. But the best way to address the natural history of this infection is to observe subjects from the date of their seroconversion (within an “incident” cohort). However these incident cohorts often involve heavy structures and complex procedures that are more easily set-up in high-resources countries.Cohorts of individuals with estimated date of seroconversion can identify risk factors for HIV transmission, study the evolution of the infection, and study the evolution of its markers and determinants by minimizing the selection bias inherent in prevalent studies. The natural history of HIV is defined by the period between the date of infection and either the date of death for patients who were not prescribed antiretroviral therapy or the date of antiretroviral therapy prescription for others.The ANRS 1220 Primo-CI Cohort of people with a known date of HIV-1 seroconversion was launched in June 1997 in the site of the ANRS Abidjan in Côte d'Ivoire, National Blood Transfusion Centre (CNTS), with the coordination of U330/593/897-ISPED INSERM Bordeaux. This is one of the few adult cohorts of HIV-1 seroconverters in the context of low-resource countries and the only one in West Africa. Within this cohort of patients recruited among blood donors performing more than two blood donations per year, the clinical and laboratory data were collected routinely every six months from their inclusion.One of the main contributions of the Primo-CI cohort in the fight against HIV in Côte d’Ivoire was the collection of information on the risk factors for HIV infection. It helped to improve the selection of blood donors. It also helped to improve the capacity of the health structure where the cohort patients were recruited and followed-up.This cohort has contributed to establish a system for regular exchanges between physicians responsible for the selection of blood donations and the team of the Primo-CI cohort. Our data have provided estimates of the probability of reaching the criteria for initiating antiretroviral drugs from the first contact and the probability of occurrence of morbid events over time, in a population of recent HIV seroconverters in West Africa.The HIV-1 intracellular DNA was the variable most strongly associated with disease progression, independently of other variables. It was followed by lower CD4. Plasma viral load HIV-1 was poorly associated with disease progression after taking into account the HIV-1 intracellular DNA.Finally, the ANRS 1220 Primo-CI cohort participated in several collaborative studies regarding the threshold of eligibility for antiretroviral drugs, the comparison of the decrease in CD4 lymphocytes with European patients, morbidity and mortality related to AIDS and the predictive role of HIV-1 intracellular DNA. It also contributed to scientific studies in virology and immunology that do not concern the main objective of this work

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Nahas, Caio Sergio Rizkallah. "Rastreamento da displasia anal em pacientes infectados pelo HIV: há concordância entre o estregaço anal e a biópsia guiada por anuscopia de alta resolução?" Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/5/5154/tde-10072012-145651/.

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OBJETIVO: O objetivo deste estudo foi analisar a concordância entre o esfregaço anal e a biópsia guiada por anuscopia de alta resolução no diagnóstico da displasia anal em pacientes infectados pelo HIV. MÉTODO: Conduzimos uma análise transversal de pacientes infectados pelo HIV submetidos a rastreamento de displasia anal rotineiro. A concordância entre mensurações foi estimada por índice de kappa ponderado através de sistema de avaliação citológica e histológica de três categorias (normal, displasia de baixo grau, e displasia de alto grau). Estimativas de sensibilidade, especificidade e valores preditivos foram calculados através de sistema de avaliação citológica e histológica de duas categorias (ausência de displasia e displasia de qualquer grau). Estimativas foram calculadas também para a detecção de displasia de alto grau. RESULTADOS: No decorrer de um ano, 222 pacientes foram submetidos a 330 esfregaços anais seguidos de biópsias guiadas por anuscopia de alta resolução. Trezentos e onze (311) esfregaços com biópsias concomitantes foram satisfatórios. Considerando-se a histologia como padrão, a freqüência de displasia anal foi de 46%. O índice kappa ponderado para concordância entre o esfregaço anal e a biópsia foi de 0,20. Para detecção de displasia anal de qualquer grau, o esfregaço anal demonstrou sensibilidade de 61%, especificidade de 60%, valor preditivo positivo de 56% e valor preditivo negativo de 64%. Para displasia de alto grau, o esfregaço anal demonstrou sensibilidade de 16% e especificidade de 97%. CONCLUSÃO: Os resultados obtidos no presente estudo, em que comparamos os achados da citologia dos esfregaços com os achados histológicos das biópsias dirigidas pela anuscopia de alta resolução em pacientes infectados pelo HIV permitiram concluir que houve baixa concordância entre eles
Purpose: To analyze the agreement between anal Pap smear and high resolution anoscopy guided biopsy to diagnose anal dysplasia in HIV-infected patients. Methods: Cross sectional analysis of HIV-infected patients receiving anal dysplasia screening as part of routine care. Agreement between measures was estimated by weighted kappa-statistics, using 3-tiered cytologic and histologic grading system (normal, low grade dysplasia, and high grade dysplasia). Estimates of sensitivity, specificity, and predictive values were calculated using a 2-tiered cytologic and histologic grading system (without dysplasia, and with dysplasia of any grade). Estimates were also calculated for the detection of high grade dysplasia. Results: Two hundred and twenty-two patients underwent 330 anal Pap smears followed by high resolution anoscopy guided biopsies in one year period. There were 311 satisfactory Pap smears with concurrent biopsy. Considering histology the standard, the frequency of anal dysplasia was 46 percent (95 percent confidence interval: 40-51 percent). Kappa-agreement between anal Pap smear and biopsy was 0.20 (95 percent confidence interval: 0.10 0.29). Anal Pap smear showed sensitivity of 61 percent, specificity of 60 percent, positive predictive value of 56 percent, and negative predictive value of 64 percent for detection of anal dysplasia of any grade. For high grade dysplasia, anal Pap smear showed sensitivity of 16 percent, and specificity of 97 percent. Conclusion: The present study showed a low concordance between anal Pap smears and high resolution anoscopy-guided biopsy

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Noluvuyo, Leonelle Gosangaye. "Evalution of the knowledge and skills of the professional nurses regarding IMCI service delivery, including HIV/AIDS case management in primary health care facilities in Buffalo City Sub-District, Eastern Cape Province, South Africa." Thesis, University of Fort Hare, 2013. http://hdl.handle.net/10353/d1006782.

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An increase in diarrhoea and upper respiratory tract infection has been noted for the past five years and this is associated with the prevalence of Human Immune-deficiency Virus and Acquired Immune Deficiency Syndrome. HIV infection is an increasingly common cause of childhood morbidity and mortality in South Africa. In some areas of the country, like the Eastern Cape, more than 30 percent of the women attending antenatal clinics are HIV infected. Without intervention, approximately one third of the babies born to these HIV infected mothers will get infection from their mothers (WHO, 2003). Aim and Objectives of the study: The study was meant to assess the specific knowledge and skills of professional nurses at the primary health facilities regarding management and integration of childhood illnesses, evaluate the quality of training of professional nurses on aspects of IMCI including integration of HIV within IMCI programme for children under five years in Primary Health Care facilities in Mdantsane Township. Methods: A quantitative descriptive method was used for this study. The questionnaire developed by the researcher was used for data collection. The items on the questionnaire were divided into four (4) subsections. The questionnaire was administered to all professional nurses on duty and those available at the time of data collection. A checklist for IMCI was used to collect data from Road to Health files of children who were HIV positive admitted in the pediatric ward at Cecilia Makhiwane Hospital. Results: The results of this study for all the variables examined showed that the highest score was 56 percent and the lowest was18 percent.These results indicated that the knowledge and skills of professional nurses were inadequate.

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Ndawinz, Jacques Deval Armstrong. "Estimation de l'Incidence de l'Infection par le VIH et autres Indicateurs de Surveillance de l'Épidémie du VIH : le cas de la France et du Cameroun." Thesis, Paris 6, 2015. http://www.theses.fr/2015PA066179/document.

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Une solution envisageable pour éliminer la propagation de l'épidémie du VIH est que les personnes vivant avec le VIH (PVVIH) ignorant leur statut sérologique (épidémie cachée) soient diagnostiquées et que les PVVIH aient accès rapidement au traitement antirétroviral (TARV). C'est pour cette raison qu'il est recommandé de mettre en place les interventions combinant notamment le dépistage précoce du VIH et l'initiation précoce du TARV. L'objectif de cette thèse est de développer des méthodes statistiques pour estimer les indicateurs permettant de désigner, de suivre et d'évaluer ces interventions dans différents contextes épidémiques. Ainsi, un premier modèle de rétrocalcul combinant les données de diagnostic du VIH et les changements dans l'accès au dépistage est développé, avec une application en France, pour estimer l'incidence de l'infection à VIH, la durée entre l'infection et le diagnostic du VIH et la taille de l'épidémie cachée. Une analyse multiniveaux est mise en œuvre pour identifier les facteurs de risque d'accès tardif au TARV au Cameroun. Une méthode basée sur les modèles multiniveaux est proposée, avec une application au Cameroun, pour estimer deux nouveaux indicateurs, la durée entre la seroconversion et l'initiation du TARV et la durée entre l'éligibilité théorique au TARV et son initiation effective. Un second modèle de rétrocalcul plus adapté aux pays d'Afrique est développé à partir des données des PVVIH mises au TARV, avec une application au Cameroun, pour estimer l'incidence de l'infection à VIH. Cette thèse propose des méthodes originales pour estimer l'incidence du VIH et le délai entre l'infection et le diagnostic du VIH ou l'initiation du TARV
A possible solution to eliminate the spread of the HIV epidemic is that people living with HIV (PLHIV) unaware of their HIV status (the hidden epidemic) are diagnosed and that all PLHIV have timely access to antiretroviral treatment (ART). That is why it is now recommended to put in place interventions combining early diagnosis of HIV and early initiation of ART. The objective of this thesis is to develop statistical methods to estimate indicators to identify, monitor and evaluate these interventions in different epidemic settings. Thus, a first back-calculation model combining HIV diagnosis data and changes in access to HIV screening is developed - with an application in France -to estimate the incidence of HIV infection, the duration between infection and HIV diagnosis and the size of the hidden epidemic. A multilevel analysis is implemented to identify risk factors associated with late ART initiation in Cameroon. A method based on multilevel models is proposed - with an application to Cameroon - to estimate two new indicators, the time between seroconversion and ART initiation and the delay between the theoretical time of ART eligibility and the effective time of ART initiation. A second back-calculation model more adapted to Africa countries is developed from data on PLHIV initiating ART - with an application in Cameroon - to estimate the incidence of HIV infection. This thesis proposes original methods to estimate the incidence of HIV infection and the time to HIV diagnosis or ART initiation

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Zhou, Jialun Public Health &amp Community Medicine Faculty of Medicine UNSW. "HIV/AIDS natural history and treatment in the Asia-Pacific region: the treat Asia HIV observational database." 2007. http://handle.unsw.edu.au/1959.4/40606.

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This thesis examines HIV disease natural history and response to antiretroviral treatment (ART) in patients from The TREAT Asia HIV Observational Database (TAHOD), a mulitcentre, prospective observational cohort of HIV-infected patients from countries in the Asia-Pacific region. By September 2005, 2979 patients have been recruited to TAHOD from 15 participating sites. The majority were male (73%), median age 37 years. Chinese (37%), Thai (25%) and Indian (17%) were the main ethnicities. Most patients reported HIV infection through heterosexual (59%) and homosexual contact (23%); 5% injecting drug use. At baseline, 41% of patients were diagnosed with AIDS defining illness, and 77% were being treated with highly active antiretroviral therapy (HAART). Baseline and retrospective data suggest that the overall response to HAART in TAHOD is similar to that seen in western cohorts, with mean CD4 count increase of 115 cells/μL and 69% achieving a viral load less than 400 copies/mL six-month after HAART initiation. Baseline CD4 count was the strongest predictor of short-term disease progression. Prognostic models based on routine clinical data and haemoglobin gave a good estimation of disease progression. The rate of new AIDS defining illness was 26% in the first 90 days after HAART initiation, which may partly be due to immune reconstitution syndrome occurring shortly after treatment. The most frequently used first-line ART combination was stavudine/lamivudine/nevirapine. Approximately 22% of patients receiving this treatment changed or stopped at least one drug in the first year, with adverse effect (including lipodystrophy, hepatitis, rash and peripheral neuropathy) the major reasons. The rates of discontinuation of efavirenz or nevirapine as part of HAART were similar (16 vs. 20/100 person years). Older age and positive HCV antibody were associated with an elevated liver function (ALT) test. Both prevalence of HBV and HCV coinfection with HIV were approximately 10%. The impact of hepatitis coinfection on immunological and virological responses to ART and HIV disease progression was not statistically significant. Both HBV and HCV remained independently associated with elevated ALT in the multivariate models. The overall HIV disease progression and response to ART in TAHOD patients were similar to those seen in the western countries.

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Yang, Biru Wolverton Marcia Lynn Chan Shirley Kim-Ying Pang Chan Wenyaw Risser Jan Mary Hale. "HIV incidence estimates and HIV/AIDS concurrent diagnosis in Houston/Harris County." 2009. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3350201.

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Chosmata, Benford Ivan. "Comparison of multiple methods of diagnosis of mycobacterial infection from bone marrow samples of HIV positive patients." Thesis, 2011. http://hdl.handle.net/10539/9053.

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MMed, Haematology, Faculty of Health Sciences, University of the Witwatersrand
Background: Mycobacterium tuberculosis (MTB) infection remains a serious public health challenge in sub-Saharan Africa. Rapid and early diagnosis is critical in the successful control of this eminently treatable infection. This study compared the diagnostic usefulness of culture, bone marrow trephine biopsy granulomata, bone marrow trephine biopsy Ziehl-Neelsen (ZN) stain and bone marrow mycobacterial polymerase chain reaction (PCR) in establishing the diagnosis of mycobacterial infection in HIV infected patients. Materials and methods: The trephine biopsies of HIV positive patients done for the investigation of suspected tuberculosis were reviewed for granulomata and stained with ZN stain. The corresponding bone marrow aspirates were subjected to DNA real-time PCR analyses using LightCyler TB Kit® (Roche Diagnostic). Culture results were used as diagnostic gold standard. Results: Of the 60 patients studied, 24 were culture negative. Of the 34 culture positive, 62% were Mycobacterium tuberculosis and 38% were Mycobacterium avium intracellulare. Using the culture method as a gold standard, the sensitivities and specificities were 97% and 23% for bone marrow trephine biopsy granulomata, 65% and 58% for bone marrow trephine biopsy ZN staining and 50% and 73% for bone marrow aspirate PCR analysis respectively. Ninety-seven percent of all trephine biopsies with positive ZN stain had granulomata. Conclusion: The presence of granulomata in bone marrow trephine biopsies of HIV infected patients appear to have a high diagnostic yield whilst mycobacterial PCR has the lowest yield but highest specificity. These results should be confirmed in a prospective case controlled study because the sample size in this study was small, and the study was a retrospective one.

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Ross, Margaret Helen. "Voluntary counselling and testing (VCT) for HIV as a beneficial tool in the health care delivery system from a developing world perspective ; a psychosocial analysis of limitations and possibilities using qualitative grounded theory and quantitative methods." Thesis, 2001. http://hdl.handle.net/10413/5893.

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The intervention of Voluntary Counselling and Testing (VCT) for the Human Immunodeficiency Virus (HIV) is rapidly gaining ground as an essential component in the health care system in an effort to combat and confront the spread of this disease. In South Africa where this intervention is gradually being introduced the application of VCT and the benefits and consequences likely to ensue from the application of the procedure were evaluated in-depth using a grounded theory and quantitative approach to describe the psychosocial dynamics. The interactive transfer of information embodied in VCT forms an integral part of the intervention and will continue to do so even when antiretroviral dnugs are uniformly available throughout the South African healthcare service. The way in which the women who will undergo this procedure internalise and respond to the information imparted to them during the counselling is highly significant from an educational and empowering perspective, regardless of the outcome of the test result. The aim of the counselling is primarily to promote a rising consciousness amongst patients and subsequently within their communities in an endeavour to move away from what is termed 'exceptionalism' and towards 'normalisation' of the treatment of HIV/AIDS. Communicating the facts about HIV will help to dispel the myths and stigma which still surround the disease. A convenience sample of one hundred and twelve women were interviewed whilst attending antenatal clinics at four different sites in KwaZulu-Natal. In addition a small cross-sectional sample of service providers and key informants in communities situated near to the chosen sites were interviewed to explore the perceptions of VCT and HIV in the current health service and community environment. The findings revealed that there is to date no mandatory policy which offers VCT routinely at any of the health centres primarily due to the cost of testing, lack of posts for trained counsellors and timeous laboratory facilities. Confusion amongst health personnel regarding current policies of treatment regimens for HIV/AIDS patients, as well as differing opinions about feeding options for infants, can undermine counsellors' confidence to handle complex issues competently from an informed position. Recommendations are that trained counsellor posts with opportunities for updating of current policies, easily accessible laboratory facilities and suitable space for confidential counselling (both oral and visual) be implemented as a priority in the health service. A more comprehensive service should be universally implemented, not just in antenatal and communicable disease clinics for ethical reasons of equity between all members of society. In the same vein the networking and cumulative energy of NGOs, religious groups and health professionals must be harnessed to work synergistically to provide sustainable solutions for those living with HIV and those at risk of becoming infected.
Thesis (M.A.)-University of Natal, Durban, 2001.

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Chonco, Siziwe Teressa. "Factors influencing delayed HIV testing : a client perspective." Thesis, 2016. http://hdl.handle.net/10321/2491.

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Submitted in fulfillment of the requirements for the Degree in Master of Health Sciences (Nursing), Durban University of Technology, Durban, South Africa, 2016.
Background South Africa, especially KwaZulu-Natal remains heavily burdened with HIV and AIDS. Timely HIV testing is the cornerstone to HIV prevention in terms of early diagnosis and access to treatment, care and support services. Factors that influence delayed HIV testing must be investigated and reported to inform plans that are directed at improving implementation of HIV testing services and access to care, treatment and support services for people living with HIV. Purpose of the study This study was aimed at identifying factors that lead to delayed HIV testing in a sample of people attending a Primary Health Care clinic in KwaZulu-Natal, South Africa. Methodology A descriptive qualitative design was used in this study. The population in this study was HIV positive patients who had recently tested for HIV and received their first CD4 count result of 350 mm3 or less. Purposive sampling, which is a type of non-probability sampling, was used to select the study participants from the population. Semi structured interviews using an interview schedule were used to collect data. Data was collected until data saturation was reached. Results The data was analysed by means of content analysis and raw data was coded and sorted into sub categories and categories. The underlying meaning of categories was formulated into one overarching theme: Testing for HIV is daunting and embedded with issues of stigma, denial and a fear of knowing one’s positive status. Conclusion To encourage early HIV testing before HIV positive people become noticeably ill requires efforts directed at change of attitude and improvement of support for HIV positive people in families, communities and health service institutions. Community forums to be actively involved in eliminating the stigma and discrimination associated with HIV positive people by creating awareness of these matters and encouraging community and family support for people with HIV.
M

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Nefale, Matshepo Catherine. "The health belief model and motivations for/against HIV-testing." Thesis, 1999. http://hdl.handle.net/10413/4665.

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This dissertation has made an attempt at exploring the psychological factors that motivates individuals into opting for or against undertaking an HIV-test. The Health Belief Model is used to ascertain its predictive powers towards the motivation for undertaking such a test. Literature on HIV-testing indicates non-exploration of voluntary HIV-testing, as opposed to massive reporting on mandatory HIV-testing. Therefore, the focus of this dissertation is on voluntary HIV-testing. The sample used for the study. comprised of antenatal mothers who were offered HIV/Aids education and then presented with an option of either undertaking the HIV-test, or not. The results of the study indicate that the Health Belief Model has failed in its predictive powers towards motivations for or against HIV-testing. However, the study provided valuable psychological factors that are associated with the decision to undertake the HIV-test, which will be important for future research on HIV/Aids and on the control in the spread of the disease.
Thesis (M.A.)-University of Natal, Pietermaritzburg, 1999.

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Minja, Emmanuel Japhet Risser Jan Mary Hale Schroder Gene D. Dunn Judith Kay. "Racial disparities in CD4 counts at initial HIV-1 diagnosis : analysis of the Adult Spectrum of HIV disease dataset and public health implications." 2008. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:1450342.

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Collett, James Raymond. "RNA aptamer microarrays for the specific detection of proteins and their potential use as molecular diagnostics for the treatment of HIV." Thesis, 2006. http://hdl.handle.net/2152/2854.

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Naidoo, Sharlene. "Laboratory diagnosis of Epstein Barr Virus in diffuse large B cell lymphoma." Thesis, 2017. https://hdl.handle.net/10539/24731.

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A dissertation submitted to the Faculty of Health Sciences, University of Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Master of Science in the branch of Anatomical Pathology. 21 July 2017.
Aims and objectives The study design aimed to assess and validate various laboratory techniques in the detection of EBV in HIV positive patients with diffuse large B cell lymphoma. The sensitivity and specificity of each technique was determined, as was the presence of an asymptomatic (latent) or lytic phase infection and the viral strain. DLBL samples occurring in HIV seropositive patients were used as a vehicle for these laboratory procedures which included chromogenic in situ hybridisation (EBER), immunohistochemistry (EBNA 2, LMP 1), real time PCR, (EBNA 1, LMP 2 and BZLF 1) and nested PCR (EBNA 2). Materials and Methods 46 cases of previously diagnosed DLBL from HIV positive individuals were identified and retrieved from the archives of the Department of Anatomical Pathology of the University of Witwatersrand and NHLS. All in-situ hybridisation, immunohistochemical and PCR laboratory procedures were carried out in accordance with the Standard Operating Procedures of the Anatomical Pathology Molecular Laboratory, using appropriate negative and positive controls throughout. Ethical clearance was obtained (M140273). Results/Conclusion A 20% frequency of EBV in HIV positive DLBL cases was established. All EBV infections were found to be in the lytic phase, with an almost equal distribution of latency patterns II and III and an equal distribution of EBV strains 1 and 2. EBER in situ hybridisation was confirmed to be the most sensitive and reliable method of viral detection, and the presence of the BZLF 1 gene determined by real time PCR was found to be a reliable indicator of a lytic infection.
LG2018

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Lugongolo, Masixole Yvonne. "Optical micro-manipulation in HIV-1 infected cells for improved HIV-1 treatment and diagnosis." Thesis, 2020. http://hdl.handle.net/10500/26551.

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Laser application in the field of biological and medical sciences has significantly grown, thereby strengthening the field of Biophotonics. Research conducted in Biophotonics focuses on the concept of using light especially in the visible and near infrared regions of the electromagnetic radiation for the evaluation of living systems. In this thesis new discoveries are presented about low level laser therapy, optical trapping, transmission spectroscopy, luminescence spectroscopy and structured illumination microscopy (SIM), displaying the impact each technique has on HIV infected cells. The results showed that the irradiation of HIV-1 infected TZM-bl cells with low power red laser reduces HIV-1 infection. The outcomes of this study further proved that when irradiation is used in conjunction with efavirenz, an antiretroviral drug, HIV-1 infection could be reduced to undetectable levels in TZM-bl cells. Through the coupling of transmission spectroscopy with optical trapping, and separately, use of luminescence spectroscopy, label free diagnosis of HIV in infected cell samples was achieved. This finding affirms that HIV-1 infection can be detected in a label free manner when using laser based techniques. Furthermore, the photoluminescence spectrometer system was employed to generate a decay curve, which was necessary so as to have some understanding on lifetime of the luminescent signal in infected TZM-bl cells. Finally, in order to confirm that indeed TZM-bl cells were infected, an established super-resolution microscopy system SIM was used to detect HIV-1 infection in TZM-bl cells. Indeed in the infected cells viral molecules p24 and gp41 were detected through SIM, while they were not detected in uninfected cells. In future studies, super resolution microscopy would be coupled to an optical trapping system in order to confirm that each trapped cells is whether infected or uninfected so as to improve HIV diagnosis.
College of Science, Engineering and Technology
Ph. D. (Science, Engineering and Technology)

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Fleming, Thomas Rolland. "Are HIV prevention programs effective in addressing rising HIV/AIDS rates among Central Asian labor migrants?" Thesis, 2011. http://hdl.handle.net/2152/ETD-UT-2011-05-3077.

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Within the last ten years HIV rates in Central Asia have more than quadrupled amongst the general population. Labor migrants from the region who are working in Russia are considered at high risk of HIV infection due to risky sexual practices. Similar behavior has been documented among labor migrants in sub Saharan Africa. By reviewing medical data and literature written by international health professionals in both regions, I analyze the chain of sexual contact of labor migrants within female partners that contribute to the spread of HIV from Russia to the general population within Central Asia. I use Tajikistan as a case study. The findings of this study recommend that existing behavior modification strategies need to recognize existing gender structures when addressing at risk populations. They must also emphasize collaboration with community religious leaders and civil society organizations to promote effective and appropriate HIV/AIDS education efforts in order to curb the growing prevalence rates among male labor migrants in Central Asia.
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Schutte, Clara-Maria. "Meningitis in South African adults : an evaluation of prognostic indicators, impact of HIV-infection, and diagnostic dilemmas." Thesis, 2002. http://hdl.handle.net/2263/29079.

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Meningitis remains a frightening disease with a high morbidity and mortality in spite of optimal treatment. In South Africa in particular, the incidence of HIV-infected patents with meningitis has risen considerably during the past decade. The first part of this meningitis study evaluated prognostic indicators in meningitis. In 100 adult patients with meningitis it was found that the Glasgow Coma Scale (GCS) at admission was a good indicator of the ultimate prognosis of the patient, with a GCS value of > 12 associated with a good outcome in 88% of patients. A GCS value of < 8 predicted an unfortunate outcome in 88% of patients. A high CSF protein level was also associated with an unfortunate outcome but the statistical significance was not as marked as with the GCS value. Age, CSF-neutrophil count, and glucose levels were also evaluated as possible prognostic indicators but were not found to be statistically significant. The electroencephalograms of 12 patients with pneumococcal meningitis showed that a grade 4 dysfunction within 48 hours of admission indicated a poor outcome; CT brain scans of 26 patients with TB meningitis showed that an adverse outcome was seen particularly in patients with TB meningitis and infarcts while in 33 patients with bacterial meningitis no specific sign was found to indicate a bad prognosis - probably due to the small number of patients evaluated. Prognostic factors in cryptococcal meningitis were lastly evaluated retrospectively in 44 patients; age, CSF white cell count and CD 4 counts were not found to be associated with outcome, while a GCS value of ≤ 14 at admission was found in almost three quarters of patients with an eventual adverse outcome. The second part of the study evaluated the impact of HIV-infection on meningitis. Between 1994 and 1998, the HIV-epidemic caused a marked shift in the spectrum of meningitis towards chronic infections such as TB and cryptococcal meningitis, while the incidence of HIV-related cases with meningitis rose from 14% in 1994 to 5% in 1998. A comparison of clinical, CSF and pathological findings and outcomes in 20 HIV-positive and 17 HIV-negative patients with tuberculous meningitis showed that HIV-infection does not significantly alter clinical and CSF findings in TB meningitis in South Africa, but ventricular dilatation and infarcts occur more frequently in HIV-positive patients. Diagnostic aids in meningitis were assessed in the final part of this study. The polymerase chain reaction for TB was measured in the CSF of 10 patients with suspected tuberculous meningitis and disappointingly only positive in two patients in spite of positive CSF cultures for TB in an additional four patients. Lymphnode biopsies were performed on seven patients with intracranial tuberculosis. Excision biopsy of an enlarged Iymphnode showing caseating granulomas and/or acid-fast bacilli confirmed the diagnosis of TB within 48 hours of admission. Thus, Iymphnode biopsies may be an effective and practical aid in diagnosing intracranial TB. Adenosine deaminase (ADA) levels are often elevated in both tuberculous and bacterial meningitis. ADA iso-enzymes analysis in 26 patients however, showed that the ADA2 iso-enzyme was the major contributor to increased ADA activity in the CSF of patients with tuberculous meningitis and not with bacterial meningitis. The EEG was evaluated as diagnostic aid in 55 patients with meningitis to discriminate between viral and non-viral meningitis. Sensitivities of 70% and 80% of VEEG and QEEG's respectively were attained for the prediction of patients with non-viral meningitis, while the VEEG had a specificity of 100% for the prediction of viral meningitis.
Thesis (MD (Neurology))--University of Pretoria, 2005.
Neurology
unrestricted

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46

Vivian, John Suru. "Towards HIV sensing : the development of electrochemical DNA/RNA aptamer biosensors on dendrimer-gold platforms." Thesis, 2013. http://hdl.handle.net/10210/8580.

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M.Sc. (Chemistry)
With the increase in the number of new Human Immunodeficiency Virus (HIV) infection and mortality rate worldwide partly due to diagnostic drawbacks which gives false negatives during the window period, it is imperative to find an alternative method of detection. The need for prompt, bed-side and field applicable analytical devices for biomedical purposes cannot be over emphasized in our fast paced world today. As a contribution to meeting these challenges, this dissertation reports (i) the development of novel electrochemical DNA/RNA aptamer biosensor for HIV sensing and (ii) the development of other DNA sequence specific electrochemical biosensors. These biosensors were based on composite platforms of dendrimer and gold nanoparticles...

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47

Govind, Mayuri. "The impact of HIV infection when superimposed on pulmonary tuberculosis (either active or sequelae tuberculosis) on the success of bronchial artery embolisation." Thesis, 2011. http://hdl.handle.net/10413/5637.

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ABSTRACT Pulmonary Tuberculosis (PTB) rates in Kwa Zulu Natal (KZN) is amongst the highest in the South Africa and is often associated with Human Immunodeficiency Virus (HIV) co-infection. Bronchial Artery Embolisation (BAE) is an expensive, time consuming procedure requiring operator skill and is accompanied by risk to both patient and operator. Aim: To investigate the impact of HIV infection when superimposed on PTB (active or sequelae) on the success of BAE. Method: A retrospective cross sectional study with descriptive and analytical components of the BAE procedure between January 2006 and December 2007 was performed on sequential BAE studies. These were analyzed for procedural and clinical outcome and reasons for procedural failure were investigated. The impact of CD4 level on procedural and clinical failure was investigated for a subset of cases. Cases were included if they presented with massive or life threatening haemoptysis with a diagnosis of previous or active PTB (made clinically, radiologically or microbiologically) in whom HIV status is known and where the clinician assessed a need for BAE, but excluded any third or more attempt at the procedure for that patient. Results: The final sample size after exclusion of 91 cases is 107. Each attempt at BAE was viewed as an individual case. The study population is made up of 74 HIV positive and 33 HIV negative cases. The median CD4 level is 176 cells / microlitre. Statistically, procedural success does not imply clinically successful outcome.HIV status does not correlate significantly with clinical or procedural results of BAE.CD4 level does not correlate significantly with clinical or procedural results of BAE. There is no technical reason of statistical significance that impacts on the success of the procedure when correlated with HIV status. These include being unable to select, unable to subselect, unable to engage securely, reflux, presence of fistulae and the presence of spinal feeder arteries. The complication rate is not statistically significant when correlated with HIV status. The differences in follow up of clinically unsuccessful cases were not significant when correlated with HIV status. On imaging, all cases demonstrated pathology. No particular zone is significant when correlated with HIV status. The most common finding is parenchymal architectural distortion followed closely by features of active tuberculous infection and no statistical significance is attributed to either when correlated with HIV status. The detection of lymphadenopathy is noted in 19.1% of HIV positive cases and 42.4% of HIV negative cases, and is the only feature of significance when correlated with HIV status. Interpretation: Coinfection with HIV does not have an impact on the success of BAE in patients with active or sequelae PTB who present with massive or life threatening haemoptysis. The rate of technical failure of the procedure suggests that this needs to be performed by persons that are adequately trained. Technical success does not imply clinical success but this finding was not statistically significant when correlated with HIV status. Re-evaluation of the procedure technique and improvements in local practice may produce results that correlate better with international standards.
Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2011.

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Gumede, Sibongiseni Daphney. "Knowledge, attitudes and perceptions of health care users towards HIV self-testing at selected Gateway clinics at eThekwini District, KwaZulu-Natal." Thesis, 2017. http://hdl.handle.net/10321/2901.

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Submitted in fulfillment of the requirements for the Master of Health Sciences in Nursing, Durban University of Technology, Durban, South Africa, 2017.
Background Human immunodeficiency virus (HIV) testing, treatment and prevention programmes have been initiated and implemented, but nearly 19 million of the 35 million people globally who are living with HIV do not know they have it. A new and powerful movement called 90-90-90 has been set in motion where the target is that by the year 2020, 90% of all people should know their HIV status, 90% of those testing HIV positive should be commenced on lifelong antiretroviral treatment and 90% of the people receiving treatment should be virally suppressed. It is argued the new innovative HIV self-testing strategy can increase the uptake of HIV testing among key populations and the general public. Aim of the study The aim of the study was to assess health care users’ knowledge, attitudes and perceptions towards HIV self-testing at selected Gateway clinics in eThekwini District, KwaZulu-Natal. Methodology A quantitative, non-experimental descriptive design was used to determine knowledge, attitudes and perceptions of health care users at three selected Gateway clinics in eThekwini Health District. The researcher requested permission and was granted to conduct the study from all the relevant stakeholders. Human rights were protected and ethical considerations were adhered to throughout the research process. The convenience sample was 442 participants with a minimum of 98 and a maximum of 246 participants sampled from each of the three study sites. A survey questionnaire was used to collect data. Version 23 of SPSS was used to analyse data. Graphs and tables were used to represent frequencies. Inferential statistical were used to test whether any of the response options were selected significantly more or less than others Results Results of the study revealed that health care users had a reasonable knowledge of HIV self-testing and there were indications that they would use it if it was made freely available to the public and was properly regulated. Generally, there were indications that health care users had positive attitudes towards HIV self-testing. It was seen as a good idea as it can be performed in the privacy of one’s home and the person would be first to know about the results. Results also revealed that there could be more people who would know their HIV status and people could test more frequently. There were perceptions that there would be no difficulty in performing an HIV self-test. The lack of pre-test counselling, false negative results, possible coercion and sale of unregulated testing kits seemed to be issues of concern that require addressing if HIV self-testing is to be promulgated.
M

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Mphaya, Joyce Caroline. "Factors that motivate young people aged 14 - 25 years to go for voluntary counseling and testing for HIV in Malawi." Diss., 2006. http://hdl.handle.net/10500/2302.

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The study sought to identify factors motivating young people aged 14-25 years to use voluntary counseling and testing (VCT) for HIV in Malawi by interviewing 145 young people. The study identified barriers affecting and strategies promoting young people's access to VCT. The research results indicate that young people go for VCT mainly to know their HIV status. The availability of VCT services, and the provision of VCT services by peers motivate young people to access VCT. Some young people do not access VCT services due to fears of being found HIV+ve and because of the poor attitudes of the health service providers. Providing more information about VCT, involving young people as VCT providers, using youth friendly health service providers, providing VCT in a separate room for young people and through mobile services will increase young people's access to VCT services in Malawi.
Health Studies
M.A. (Public Health)

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50

Shapiro, Michelle. "HIV testing for insurance purposes : a multi-faceted exploration of the clients' experience and aspects of current practice." Thesis, 2001. http://hdl.handle.net/10413/3037.

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HIV testing is required for life assurance applications. A written information document distributed at blood collection (venisection) serves as pre-test preparation. This study reviewed the adequacy of the document and explored possible alternative arrangements, by means of three research phases conducted at the point of venisection. Phase 1 used a specifically designed questionnaire which included a demographic section and questions assessing the applicant's appraisal of being adequately prepared, and their understanding and experience of testing. Constructed measures established their state of anxiety at testing and their range of information about HIV/AIDS. Phase 2 consisted of a counselling intervention, followed by the questionnaire used in Phase 1. Phase 3 consisted of semi-structured interviews with nursing personnel and insurance brokers. The phase 1 results indicated that the majority of applicants knew they were having an HIV test, did not feel coerced, had a moderate level of information about HIV and were not overly anxious at testing. The level of information about HIV/AIDS showed a significant correlation with their level of education, and the information document emerged as inadequate preparation. Answers given in Phase 2 differed qualitatively from those in Phase 1. Greater consideration of the impact of a positive result was shown, with increased concern about the implications for other people and anticipated acceptance of a positive result emerged in Phase 2. The personnel interviewed for Phase 3 indicated that they felt ill equipped to offer pre-test preparation.
Thesis (M.A.)-University of Natal, Pietermaritzburg, 2001.

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Dissertations / Theses on the topic 'HIV infections – Diagnosis – Asia'

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