Browsing by Author "Nyasulu, Peter S"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Open Access
    Acceptability of community-based adherence clubs among health facility staff in South Africa: a qualitative study
    (2017) Tshuma, Ndumiso; Mosikare, Ofentse; Yun, Jessica A; Alaba, Olufunke A; Maheedhariah, Meera S; Muloongo, Keith; Nyasulu, Peter S
    Patient retention in care for HIV/AIDS is a critical challenge for antiretroviral treatment programs. Community-based adherence programs (CBAPs) as compared to health care facility-based adherence programs have been considered as one of the options to provide treatment maintenance support for groups of patients on antiretroviral therapy. Such an approach provides a way of enhancing self-management of the patient’s condition. In addition, CBAPs have been implemented to support antiretroviral treatment expansion in resource-limited settings. CBAPs involve 30 patients that are allocated to a group and meet at either a facility or a community venue for less than an hour every 2 or 3 months depending on the supply of medication. Our study aimed to establish perceived challenges in moving adherence clubs from health facilities to communities.
  • Thumbnail Image
    Item
    Open Access
    Clinical features and outcomes of COVID-19 admissions in a population with a high prevalence of HIV and tuberculosis: a multicentre cohort study
    (2022-06-20) Parker, Arifa; Boloko, Linda; Moolla, Muhammad S; Ebrahim, Nabilah; Ayele, Birhanu T; Broadhurst, Alistair G B; Mashigo, Boitumelo; Titus, Gideon; de Wet, Timothy; Boliter, Nicholas; Rosslee, Michael-Jon; Papavarnavas, Nectarios; Abrahams, Riezaah; Mendelson, Marc; Dlamini, Sipho; Taljaard, Jantjie J; Prozesky, Hans W; Mowlana, Abdurasiet; Viljoen, Abraham J; Schrueder, Neshaad; Allwood, Brian W; Lalla, Usha; Dave, Joel A; Calligaro, Greg; Levin, Dion; Maughan, Deborah; Ntusi, Ntobeko A B; Nyasulu, Peter S; Meintjes, Graeme; Koegelenberg, Coenraad F N; Mnguni, Ayanda T; Wasserman, Sean
    Background There is still a paucity of evidence on the outcomes of coronavirus disease 2019 (COVID-19) among people living with human immunodeficiency virus (PWH) and those co-infected with tuberculosis (TB), particularly in areas where these conditions are common. We describe the clinical features, laboratory findings and outcome of hospitalised PWH and human immunodeficiency virus (HIV)-uninfected COVID-19 patients as well as those co-infected with tuberculosis (TB). Methods We conducted a multicentre cohort study across three hospitals in Cape Town, South Africa. All adults requiring hospitalisation with confirmed COVID-19 pneumonia from March to July 2020 were analysed. Results PWH comprised 270 (19%) of 1434 admissions. There were 47 patients with active tuberculosis (3.3%), of whom 29 (62%) were PWH. Three-hundred and seventy-three patients (26%) died. The mortality in PWH (n = 71, 26%) and HIV-uninfected patients (n = 296, 25%) was comparable. In patients with TB, PWH had a higher mortality than HIV-uninfected patients (n = 11, 38% vs n = 3, 20%; p = 0.001). In multivariable survival analysis a higher risk of death was associated with older age (Adjusted Hazard Ratio (AHR) 1.03 95%CI 1.02–1.03, p < 0.001), male sex (AHR1.38 (95%CI 1.12–1.72, p = 0.003) and being “overweight or obese” (AHR 1.30 95%CI 1.03–1.61 p = 0.024). HIV (AHR 1.28 95%CI 0.95–1.72, p 0.11) and active TB (AHR 1.50 95%CI 0.84–2.67, p = 0.17) were not independently associated with increased risk of COVID-19 death. Risk factors for inpatient mortality in PWH included CD4 cell count < 200 cells/mm3, higher admission oxygen requirements, absolute white cell counts, neutrophil/lymphocyte ratios, C-reactive protein, and creatinine levels. Conclusion In a population with high prevalence of HIV and TB, being overweight/obese was associated with increased risk of mortality in COVID-19 hospital admissions, emphasising the need for public health interventions in this patient population.