Journal Article > ResearchFull Text
Emerg Infect Dis. 1 September 2016; Volume 22 (Issue 9); DOI:10.3201/eid2209.160354
Nanclares C, Kapetshi J, Lionetto F, de la Rosa O, Muyembe Tamfun JJ, et al.
Emerg Infect Dis. 1 September 2016; Volume 22 (Issue 9); DOI:10.3201/eid2209.160354
During July-November 2014, the Democratic Republic of the Congo underwent its seventh Ebola virus disease (EVD) outbreak. The etiologic agent was Zaire Ebola virus; 66 cases were reported (overall case-fatality rate 74.2%). Through a retrospective observational study of confirmed EVD in 25 patients admitted to either of 2 Ebola treatment centers, we described clinical features and investigated correlates associated with death. Clinical features were mainly generic. At admission, 76% of patients had >1 gastrointestinal symptom and 28% >1 hemorrhagic symptom. The case-fatality rate in this group was 48% and was higher for female patients (67%). Cox regression analysis correlated death with initial low cycle threshold, indicating high viral load. Cycle threshold was a robust predictor of death, as were fever, hiccups, diarrhea, dyspnea, dehydration, disorientation, hematemesis, bloody feces during hospitalization, and anorexia in recent medical history. Differences from other outbreaks could suggest guidance for optimizing clinical management and disease control.
Journal Article > ResearchFull Text
PLOS One. 17 June 2015; Volume 10 (Issue 6); DOI:10.1371/journal.pone.0129166
Vogt F, Tayler-Smith K, Bernasconi A, Makondo E, Taziwa F, et al.
PLOS One. 17 June 2015; Volume 10 (Issue 6); DOI:10.1371/journal.pone.0129166
CD4 cell count measurement remains an important diagnostic tool for HIV care in developing countries. Insufficient laboratory capacity in rural Sub-Saharan Africa is frequently mentioned but data on the impact at an individual patient level are lacking. Urban-rural discrepancies in CD4 testing have not been quantified to date. Such evidence is crucial for public health planning and to justify new yet more expensive diagnostic procedures that could circumvent access constraints in rural areas.
Journal Article > ResearchFull Text
PLOS One. 21 August 2015 (Issue 8); DOI:10.1371/journal.pone.013653
Vogt F, Van der Bergh R, Bernasconi A, Moyo B, Havazvidi L, et al.
PLOS One. 21 August 2015 (Issue 8); DOI:10.1371/journal.pone.013653
Blood collected in conventional EDTA tubes requires laboratory analysis within 48 hours to provide valid CD4 cell count results. This restricts access to HIV care for patients from rural areas in resource-constraint settings due to sample transportation problems. Stabilization Tubes with extended storage duration have been developed but not yet evaluated comprehensively.
Journal Article > ResearchFull Text
PLOS One. 21 November 2012; Volume 7 (Issue 11); DOI:10.1371/journal.pone.0049834
Ferreyra C, Yun O, Eisenberg N, Alonso E, Khamadi AS, et al.
PLOS One. 21 November 2012; Volume 7 (Issue 11); DOI:10.1371/journal.pone.0049834
In resource-limited settings where viral load (VL) monitoring is scarce or unavailable, clinicians must use immunological and clinical criteria to define HIV virological treatment failure. This study examined the performance of World Health Organization (WHO) clinical and immunological failure criteria in predicting virological failure in HIV patients receiving antiretroviral therapy (ART).
Journal Article > ResearchFull Text
J Int AIDS Soc. 12 October 2015; Volume 18; DOI:10.7448/IAS.18.1.20022
Vogt F, Ferreyra C, Bernasconi A, Ncube L, Taziwa F, et al.
J Int AIDS Soc. 12 October 2015; Volume 18; DOI:10.7448/IAS.18.1.20022
High retention in care is paramount to reduce vertical human immunodeficiency virus (HIV) infections in prevention of mother-to-child transmission (PMTCT) programmes but remains low in many sub-Saharan African countries. We aimed to assess the effects of community health worker-based defaulter tracing (CHW-DT) on retention in care and mother-to-child HIV transmission, an innovative approach that has not been evaluated to date.