Eastern Cape Healthcare Workers Acquisition of SARS-CoV-2 (ECHAS): Cross-Sectional (Nested Cohort) Study Protocol
- Oladele Vincent Adeniyi, David Stead, Mandisa Singata-Madliki 4, Joanne Batting, Leo Hyera, Eloise Jelliman, Shareef Abrahams, Andrew Parrish
- Authors: Oladele Vincent Adeniyi , David Stead , Mandisa Singata-Madliki 4 , Joanne Batting , Leo Hyera , Eloise Jelliman , Shareef Abrahams , Andrew Parrish
- Date: 2021
- Language: English
- Type: Journal article
- Identifier: http://hdl.handle.net/11260/3972 , vital:43978
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- Authors: Oladele Vincent Adeniyi , David Stead , Mandisa Singata-Madliki 4 , Joanne Batting , Leo Hyera , Eloise Jelliman , Shareef Abrahams , Andrew Parrish
- Date: 2021
- Language: English
- Type: Journal article
- Identifier: http://hdl.handle.net/11260/3972 , vital:43978
- Full Text:
Patient acceptance of HIV testing services in rural emergency departments in South Africa
- Aditi Rao, Caitlin Kennedy, Pamela Mda, Thomas C. Quinn, David Stead, Bhakti Hansoti
- Authors: Aditi Rao , Caitlin Kennedy , Pamela Mda , Thomas C. Quinn , David Stead , Bhakti Hansoti
- Date: 2020
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/3270 , vital:43287 , https://doi.org/10.4102/sajhivmed.v21i1.1105
- Description: Background: South Africa faces the highest burden of HIV infection globally. The National Strategic Plan on HIV recommends provider-initiated HIV counselling and testing (HCT) in all healthcare facilities. However, HIV continues to overwhelm the healthcare system. Emergency department (ED)-based HCT could address unmet testing needs. Objectives: This study examines the reasons for accepting or declining HCT in South African EDs to inform the development of HCT implementation strategies. Method: We conducted a prospective observational study in two rural EDs, from June to September 2017. Patients presenting to the ED were systematically approached and offered a point-of-care test in accordance with national guidelines. Patients demographics, presenting compaint, medical history and reasons for accepting/declining testing, were recorded. A pooled analysis is presented. Results: Across sites, 2074 adult, non-critical patients in the ED were approached; 1880 were enrolled in the study. Of those enrolled, 19.7% had a previously known positive diagnosis, and 80.3% were unaware of their HIV status. Of those unaware, 90% patients accepted and 10% declined testing. The primary reasons for declining testing were ‘does not want to know status’ (37.6%), ‘in too much pain’ (34%) and ‘does not believe they are at risk’ (19.9%). Conclusions: Despite national guidelines, a high proportion of individuals remain undiagnosed, of which a majority are young men. Our study demonstrated high patient acceptance of ED-based HCT. There is a need for investment and innovation regarding effective pain management and confidential service delivery to address patient barriers. Findings support a routine, non-targeted HCT strategy in EDs. Keywords: HIV counselling and testing; South Africa; emergency department; patient acceptance; implementation research; linkage to care.
- Full Text:
- Date Issued: 2020
- Authors: Aditi Rao , Caitlin Kennedy , Pamela Mda , Thomas C. Quinn , David Stead , Bhakti Hansoti
- Date: 2020
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/3270 , vital:43287 , https://doi.org/10.4102/sajhivmed.v21i1.1105
- Description: Background: South Africa faces the highest burden of HIV infection globally. The National Strategic Plan on HIV recommends provider-initiated HIV counselling and testing (HCT) in all healthcare facilities. However, HIV continues to overwhelm the healthcare system. Emergency department (ED)-based HCT could address unmet testing needs. Objectives: This study examines the reasons for accepting or declining HCT in South African EDs to inform the development of HCT implementation strategies. Method: We conducted a prospective observational study in two rural EDs, from June to September 2017. Patients presenting to the ED were systematically approached and offered a point-of-care test in accordance with national guidelines. Patients demographics, presenting compaint, medical history and reasons for accepting/declining testing, were recorded. A pooled analysis is presented. Results: Across sites, 2074 adult, non-critical patients in the ED were approached; 1880 were enrolled in the study. Of those enrolled, 19.7% had a previously known positive diagnosis, and 80.3% were unaware of their HIV status. Of those unaware, 90% patients accepted and 10% declined testing. The primary reasons for declining testing were ‘does not want to know status’ (37.6%), ‘in too much pain’ (34%) and ‘does not believe they are at risk’ (19.9%). Conclusions: Despite national guidelines, a high proportion of individuals remain undiagnosed, of which a majority are young men. Our study demonstrated high patient acceptance of ED-based HCT. There is a need for investment and innovation regarding effective pain management and confidential service delivery to address patient barriers. Findings support a routine, non-targeted HCT strategy in EDs. Keywords: HIV counselling and testing; South Africa; emergency department; patient acceptance; implementation research; linkage to care.
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- Date Issued: 2020
Southern African HIV Clinicians Society guidelines for antiretroviral therapy in adults: 2020 update
- Authors: David Stead
- Date: 2020
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/3281 , vital:43293 , https://doi.org/10.4102/sajhivmed.v21i1.1115
- Description: What is new in the 2020 guidelines update? Key updates ÿ A recommendation for dolutegravir (DTG)-based therapies as the preferred first-line antiretroviral therapy (ART) option (section 11). ÿ Updated guidelines for second- and third-line ART regimens (section 13). ÿ New recommendations on the management of patients on DTG-based therapies who have an elevated viral load (section 12). ÿ A lowering of the threshold for virological failure from 1000 copies/mL to 50 copies/mL (section 8). ÿ A recommendation against routine cluster of differentiation 4 (CD4+) monitoring in patients who are clinically well once the CD4+ count is > 200 cells/μL (section 9). ÿ Updated recommendations for isoniazid preventive therapy (IPT) in human immunodeficiency virus (HIV)-positive patients (section 27). ÿ A recommendation for the use of low-dose prednisone as prophylaxis for paradoxical tuberculosis (TB) immune reconstitution inflammatory syndrome (IRIS) in TB/HIV co-infected patients commencing ART within 1 month of TB therapy (section 26).
- Full Text:
- Date Issued: 2020
Southern African HIV Clinicians Society guidelines for antiretroviral therapy in adults: 2020 update
- Authors: David Stead
- Date: 2020
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/3281 , vital:43293 , https://doi.org/10.4102/sajhivmed.v21i1.1115
- Description: What is new in the 2020 guidelines update? Key updates ÿ A recommendation for dolutegravir (DTG)-based therapies as the preferred first-line antiretroviral therapy (ART) option (section 11). ÿ Updated guidelines for second- and third-line ART regimens (section 13). ÿ New recommendations on the management of patients on DTG-based therapies who have an elevated viral load (section 12). ÿ A lowering of the threshold for virological failure from 1000 copies/mL to 50 copies/mL (section 8). ÿ A recommendation against routine cluster of differentiation 4 (CD4+) monitoring in patients who are clinically well once the CD4+ count is > 200 cells/μL (section 9). ÿ Updated recommendations for isoniazid preventive therapy (IPT) in human immunodeficiency virus (HIV)-positive patients (section 27). ÿ A recommendation for the use of low-dose prednisone as prophylaxis for paradoxical tuberculosis (TB) immune reconstitution inflammatory syndrome (IRIS) in TB/HIV co-infected patients commencing ART within 1 month of TB therapy (section 26).
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- Date Issued: 2020
Southern African HIV Clinicians Society guidelines for antiretroviral therapy in adults: 2020 update
- Venter, Willem D F, Woods, Joana F, Rosie Burton, John M. Black, Graeme Meintjes, Natasha E.C.G. Davies, Gary Maartens, Sipho Dlamini, Jeremy Nel, Eric Hefer, Moeketsi T. Mathe, Mahomed-Yunus Moosa, Muhangwi B. Mulaudzi, Michelle Moorhouse, Jennifer Nash, Thandeka C. Nkonyane, Wolfgang Preiser, Mohammed S. Rassool, David Stead, Helen van der Plas, Cloete van Vuuren
- Authors: Venter, Willem D F , Woods, Joana F , Rosie Burton , John M. Black , Graeme Meintjes , Natasha E.C.G. Davies , Gary Maartens , Sipho Dlamini , Jeremy Nel , Eric Hefer , Moeketsi T. Mathe , Mahomed-Yunus Moosa , Muhangwi B. Mulaudzi , Michelle Moorhouse , Jennifer Nash , Thandeka C. Nkonyane , Wolfgang Preiser , Mohammed S. Rassool , David Stead , Helen van der Plas , Cloete van Vuuren
- Date: 2020
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/4280 , vital:44078
- Full Text:
Southern African HIV Clinicians Society guidelines for antiretroviral therapy in adults: 2020 update
- Authors: Venter, Willem D F , Woods, Joana F , Rosie Burton , John M. Black , Graeme Meintjes , Natasha E.C.G. Davies , Gary Maartens , Sipho Dlamini , Jeremy Nel , Eric Hefer , Moeketsi T. Mathe , Mahomed-Yunus Moosa , Muhangwi B. Mulaudzi , Michelle Moorhouse , Jennifer Nash , Thandeka C. Nkonyane , Wolfgang Preiser , Mohammed S. Rassool , David Stead , Helen van der Plas , Cloete van Vuuren
- Date: 2020
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/4280 , vital:44078
- Full Text:
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