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  1. Article ; Online: The effects of MDR/RR-TB treatment on HIV disease: A systematic review of literature.

    Geiger, Keri / Stamper, Paul D / Farley, Jason E

    PloS one

    2021  Volume 16, Issue 3, Page(s) e0248174

    Abstract: Background: Multidrug-resistant or rifampicin-resistant tuberculosis (MDR/RR-TB) and human immunodeficiency virus (HIV) co-infection are a deadly combination. While evidence on the effects of HIV co-infection on MDR/RR-TB treatment outcomes is well- ... ...

    Abstract Background: Multidrug-resistant or rifampicin-resistant tuberculosis (MDR/RR-TB) and human immunodeficiency virus (HIV) co-infection are a deadly combination. While evidence on the effects of HIV co-infection on MDR/RR-TB treatment outcomes is well-documented, little published evidence describes the effects of MDR/RR-TB treatment on HIV disease.
    Methods: We conducted a review of literature published prior to June 2020. We searched Pubmed, CINAHL, and EMBASE using variations of the terms "multidrug-resistant tuberculosis," "HIV," and either "CD4" or "viral load." Two reviewers independently completed title and abstract screening, full-text screening, article evaluation, and data extraction. We also included five published articles evaluated as evidence by the World Health Organization (WHO) in preparation for the 2019 MDR/RR-TB treatment guideline update.
    Results: A total of 459 references were returned, with 362 remaining after duplicate removal. Following article screening, six manuscripts were included. Articles reported CD4 count and/or viral load results for MDR/RR-TB and HIV co-infected patients during and/or after MDR/RR-TB treatment. The additional five references identified from the WHO guideline revision did not report HIV disease indicators after MDR/RR-TB initiation.
    Conclusion: There is a paucity of evidence on HIV disease indicators following MDR/RR-TB treatment. Researchers should report longitudinal HIV disease indicators in co-infected patients in publications.
    MeSH term(s) Anti-HIV Agents/therapeutic use ; Antitubercular Agents/therapeutic use ; Coinfection/blood ; Coinfection/drug therapy ; Coinfection/epidemiology ; HIV Infections/blood ; HIV Infections/drug therapy ; HIV Infections/epidemiology ; Humans ; Tuberculosis, Multidrug-Resistant/blood ; Tuberculosis, Multidrug-Resistant/drug therapy ; Tuberculosis, Multidrug-Resistant/epidemiology
    Chemical Substances Anti-HIV Agents ; Antitubercular Agents
    Language English
    Publishing date 2021-03-05
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Systematic Review
    ISSN 1932-6203
    ISSN (online) 1932-6203
    DOI 10.1371/journal.pone.0248174
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Evaluating Integrated Care for People Living With HIV and Multidrug-Resistant Tuberculosis in South Africa: A Case-Based Approach Using the Chronic Care Model.

    Geiger, Keri / Bergman, Alanna / Farley, Jason E

    The Journal of the Association of Nurses in AIDS Care : JANAC

    2021  Volume 32, Issue 6, Page(s) e91–e102

    Abstract: Abstract: In South Africa, tuberculosis (TB) and multidrug-resistant TB (MDR-TB) frequently occur in people living with HIV. World Health Organization guidelines recommend the integration of MDR-TB and HIV care but, in practice, fully integrated care is ...

    Abstract Abstract: In South Africa, tuberculosis (TB) and multidrug-resistant TB (MDR-TB) frequently occur in people living with HIV. World Health Organization guidelines recommend the integration of MDR-TB and HIV care but, in practice, fully integrated care is difficult to achieve. In this article, we use five elements of the Chronic Care Model as a framework for evaluating a case of integrated MDR-TB/HIV care and to highlight opportunities for nurses to improve care delivery and patient outcomes. We apply the Chronic Care Model framework to a concrete example by examining the case of a 33-year-old man who developed MDR-TB treatment failure while concurrently taking a powerful new MDR-TB antiretroviral therapy regimen for his HIV.
    MeSH term(s) Adult ; Delivery of Health Care, Integrated ; HIV Infections/drug therapy ; Humans ; Male ; South Africa ; Tuberculosis, Multidrug-Resistant/drug therapy
    Language English
    Publishing date 2021-02-18
    Publishing country United States
    Document type Case Reports ; Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 1159376-3
    ISSN 1552-6917 ; 1055-3290
    ISSN (online) 1552-6917
    ISSN 1055-3290
    DOI 10.1097/JNC.0000000000000242
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 3748: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: Relationship between HIV viral suppression and multidrug resistant tuberculosis treatment outcomes.

    Geiger, Keri / Patil, Amita / Budhathoki, Chakra / Dooley, Kelly E / Lowensen, Kelly / Ndjeka, Norbert / Ngozo, Jacqueline / Farley, Jason E

    PLOS global public health

    2024  Volume 4, Issue 5, Page(s) e0002714

    Abstract: The impact of HIV viral suppression on multidrug resistant tuberculosis (MDR-TB) treatment outcomes among people with HIV (PWH) has not been clearly established. Using secondary data from a cluster-randomized clinical trial among people with MDR-TB in ... ...

    Abstract The impact of HIV viral suppression on multidrug resistant tuberculosis (MDR-TB) treatment outcomes among people with HIV (PWH) has not been clearly established. Using secondary data from a cluster-randomized clinical trial among people with MDR-TB in South Africa, we examined the effects of HIV viral suppression at MDR-TB treatment initiation and throughout treatment on MDR-TB outcomes among PWH using multinomial regression. This analysis included 1479 PWH. Viral suppression (457, 30.9%), detectable viral load (524, 35.4%), or unknown viral load (498, 33.7%) at MDR-TB treatment initiation were almost evenly distributed. Having a detectable HIV viral load at MDR-TB treatment initiation significantly increased risk of death compared to those virally suppressed (relative risk ratio [RRR] 2.12, 95% CI 1.11-4.07). Among 673 (45.5%) PWH with a known viral load at MDR-TB outcome, 194 (28.8%) maintained suppression, 267 (39.7%) became suppressed, 94 (14.0%) became detectable, and 118 (17.5%) were never suppressed. Those who became detectable (RRR 11.50, 95% CI 1.98-66.65) or were never suppressed (RRR 9.28, 95% CI 1.53-56.61) were at significantly increased risk of death (RRR 6.37, 95% CI 1.58-25.70), treatment failure (RRR 4.54, 95% CI 1.35-15.24), and loss to follow-up (RRR 7.00, 95% CI 2.83-17.31; RRR 2.97, 95% CI 1.02-8.61) compared to those who maintained viral suppression. Lack of viral suppression at MDR-TB treatment initiation and failure to achieve or maintain viral suppression during MDR-TB treatment drives differences in MDR-TB outcomes. Early intervention to support access and adherence to antiretroviral therapy among PWH should be prioritized to improve MDR-TB treatment outcomes.
    Language English
    Publishing date 2024-05-06
    Publishing country United States
    Document type Journal Article
    ISSN 2767-3375
    ISSN (online) 2767-3375
    DOI 10.1371/journal.pgph.0002714
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Exploring caregivers' gender attitudes' influence on adolescent health in the eastern Democratic Republic of Congo: A mixed methods study.

    Corley, Andrew / Perrin, Nancy / Geiger, Keri / Remy, Mitima Mpanano / Glass, Nancy

    Global public health

    2022  Volume 17, Issue 12, Page(s) 3700–3720

    Abstract: Adolescence is a developmentally important phase in one's life. However, restrictive gender attitudes that gain increased importance during adolescence prevent many from reaching their health and development potential. The objective of this study is to ... ...

    Abstract Adolescence is a developmentally important phase in one's life. However, restrictive gender attitudes that gain increased importance during adolescence prevent many from reaching their health and development potential. The objective of this study is to explore associations between caregiver gender attitudes and adolescent psychosocial health, school attendance, and food security in a sample living in the eastern Democratic Republic of Congo, a region that has experienced persistent poverty and nearly thirty years of insecurity. A mixed methods design was selected for this research. Quantitative results were combined with qualitative focus group discussion results to provide new insight into how caregiver gender attitudes might influence adolescent health and development. Findings from the research suggest that more gender equitable caregiver attitudes are associated with fewer reports of internalising behaviour and greater food security in adolescent girls. No significant associations were found between caregiver gender equality attitudes and adolescent prosocial behaviour or school attendance. Focus group discussions supported some quantitative findings while refuting others. Participants suggested that adolescent girls with caregivers who endorse more equitable gender attitudes experience less psychological control and witness less conflict and violence between caregivers in their home.
    MeSH term(s) Female ; Adolescent ; Humans ; Caregivers ; Adolescent Health ; Democratic Republic of the Congo ; Violence/prevention & control ; Attitude
    Language English
    Publishing date 2022-04-20
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2234129-8
    ISSN 1744-1706 ; 1744-1692
    ISSN (online) 1744-1706
    ISSN 1744-1692
    DOI 10.1080/17441692.2022.2049848
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Successful Multidrug-Resistant Tuberculosis Treatment Without HIV Viral Suppression: A Missed Opportunity.

    Geiger, Keri / Patil, Amita / Budhathoki, Chakra / Dooley, Kelly E / Lowensen, Kelly / Ndjeka, Norbert / Ngozo, Jacqueline / Farley, Jason E

    Journal of acquired immune deficiency syndromes (1999)

    2023  Volume 94, Issue 3, Page(s) 253–261

    Abstract: Background: Coinfection with multidrug-resistant tuberculosis (MDR-TB) and HIV is common, but few published studies examine how undergoing MDR-TB treatment affects HIV disease indicators.: Methods: Using data from a nested, retrospective cohort of ... ...

    Abstract Background: Coinfection with multidrug-resistant tuberculosis (MDR-TB) and HIV is common, but few published studies examine how undergoing MDR-TB treatment affects HIV disease indicators.
    Methods: Using data from a nested, retrospective cohort of people with HIV (PWH) and successful MDR-TB treatment outcomes, we built multivariable regression models to explore correlates of HIV viral suppression at MDR-TB treatment completion.
    Results: Among 531 PWH successfully treated for MDR-TB, mean age was 37.4 years (SD 10.2, interquartile range 30-43), 270 (50.8%) were male, 395 (74.4%) were virally suppressed at MDR-TB outcome, and 259 (48.8%) took bedaquiline. Older age (adjusted odds ratio [aOR] 1.04, 95% confidence interval [CI]: 1.01 to 1.06) increased odds of viral suppression, while having a prior TB episode (aOR 0.45, 95% CI: 0.31 to 0.64), having a detectable viral load at MDR-TB treatment initiation (aOR 0.17, 95% CI: 0.09 to 0.30), living in a township (aOR 0.49, 95% CI: 0.28 to 0.87), and being changed from efavirenz-based antiretroviral therapy (ART) to a protease inhibitor due to bedaquiline usage (aOR 0.19, 95% CI: 0.04 to 0.82) or not having an ART change while on bedaquiline (aOR 0.29, 95% CI: 0.11 to 0.75) lowered odds of viral suppression. Changing from efavirenz to nevirapine due to bedaquiline usage did not significantly affect odds of viral suppression (aOR 0.41, 95% CI: 0.16 to 1.04).
    Conclusions: Increased pill burden and adverse treatment effects did not significantly affect HIV viral suppression while switching ART to a protease inhibitor to accommodate bedaquiline or not changing ART while taking bedaquiline did, suggesting that PWH and MDR-TB may benefit from additional support if they must switch ART.
    MeSH term(s) Humans ; Male ; Adult ; Female ; HIV Infections/complications ; HIV Infections/drug therapy ; Antitubercular Agents/therapeutic use ; Retrospective Studies ; Tuberculosis, Multidrug-Resistant/drug therapy ; Treatment Outcome ; Antiviral Agents/therapeutic use ; Protease Inhibitors/therapeutic use
    Chemical Substances efavirenz (JE6H2O27P8) ; Antitubercular Agents ; Antiviral Agents ; Protease Inhibitors
    Language English
    Publishing date 2023-09-14
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 645053-2
    ISSN 1944-7884 ; 1077-9450 ; 0897-5965 ; 0894-9255 ; 1525-4135
    ISSN (online) 1944-7884 ; 1077-9450
    ISSN 0897-5965 ; 0894-9255 ; 1525-4135
    DOI 10.1097/QAI.0000000000003268
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2442: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  6. Article ; Online: Preparing the healthcare workforce in South Africa for short-course rifampicin-resistant TB treatment: inter-professional training and task-sharing considerations.

    Farley, Jason E / Ndjeka, Norbert / Mlandu, Khaya / Lowensen, Kelly / Geiger, Keri / Nguyen, Yen / Budhathoki, Chakra / Stamper, Paul D

    Human resources for health

    2021  Volume 19, Issue 1, Page(s) 6

    Abstract: Background: Treatment for rifampicin-resistant Mycobacterium tuberculosis (RR-TB) is complex, however, shorter treatment, with newer antimicrobials are improving treatment outcomes. The South African National Department of Health (NDoH) recently ... ...

    Abstract Background: Treatment for rifampicin-resistant Mycobacterium tuberculosis (RR-TB) is complex, however, shorter treatment, with newer antimicrobials are improving treatment outcomes. The South African National Department of Health (NDoH) recently accelerated the rollout of 9-month, all-oral, RR-TB short-course regimens. We sought to evaluate an inter-professional training program using pre-test and post-test performance of Professional Nurses (PNs), Advanced Practice Professional Nurses (APPNs) and Medical Officers (MOs) to inform: (a) training needs across cadres; (b) knowledge performance, by cadres; and (c) training differences in knowledge by nurse type.
    Methods: A 4-day didactic and case-based clinical decision support course for RR-TB regimens in South Africa (SA) was developed, reviewed and nationally accredited. Between February 2017 and July 2018, 12 training events were held. Clinicians who may initiate RR-TB treatment, specifically MOs and PN/APPNs with matched pre-post tests and demographic surveys were analyzed. Descriptive statistics are provided. Pre-post test evaluations included 25 evidence-based clinically related questions about RR-TB diagnosis, treatment, and care.
    Results: Participants (N = 842) participated in testing, and matched evaluations were received for 800 (95.0%) training participants. Demographic data were available for 793 (99.13%) participants, of whom 762 (96.1%) were MOs, or nurses, either PN or APPNs. Average correct response pre-test and post-test scores were 61.7% (range 7-24 correct responses) and 85.9% (range 12-25), respectively. Overall, 95.8% (730/762) of participants demonstrated improved knowledge. PNs improved on average 25% (6.22 points), whereas MOs improved 10% (2.89 points) with better mean test scores on both pre- and post-test (p < 0.000). APPNs performed the same as the MOs on post-test scores (p = NS).
    Conclusions: The inter-professional training program in short-course RR-TB treatment improved knowledge for participants. MOs had significantly greater pre-test scores. Of the nurses, APPNs outperformed other PNs, and performed equally to MOs on post-test scores, suggesting this advanced cadre of nurses might be the most appropriate to initiate and monitor treatment in close collaboration with MOs. All cadres of nurse reported the need for additional clinical training and mentoring prior to managing such patients.
    MeSH term(s) Delivery of Health Care ; Humans ; Rifampin/therapeutic use ; South Africa ; Tuberculosis, Multidrug-Resistant ; Workforce
    Chemical Substances Rifampin (VJT6J7R4TR)
    Language English
    Publishing date 2021-01-06
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ISSN 1478-4491
    ISSN (online) 1478-4491
    DOI 10.1186/s12960-020-00552-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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