نتائج البحث - "Taljaard, Jantjie J"

1

دورية أكاديمية

A new approach to prevent, diagnose, and treat hepatitis B in Africa. ...

مصطلحات موضوعية: Infectious Disease, Immunology, FOS Clinical medicine, Genetics & Genomics

الوصف: There are 82 million people living with hepatitis B (PLWHB) in the World Health Organization Africa region, where it is the main cause of liver disease. Effective vaccines have been available for over 40 years, yet there are 990,000 new infections annually, due to limited implementation of hepatitis B birth dose vaccination and antenatal tenofovir prophylaxis for highly viraemic women, which could eliminate mother-to-child transmission. Despite effective and cheap antiviral treatment which can suppress hepatitis B virus replication and reduce the risk of hepatocellular carcinoma (HCC), < 2% of PLWHB are diagnosed, and only 0.1% are treated. As a result, PLWHB are frequently diagnosed only when they have already developed decompensated cirrhosis and late-stage HCC, and consequently 80,000 hepatitis B-associated deaths occur each year. Major barriers include complex treatment guidelines which were derived from high-income settings, lack of affordable diagnostics, lack or insufficient domestic funding for ...

الإتاحة: https://doi.org/10.25418/crick.25921222Test
https://crick.figshare.com/articles/journal_contribution/A_new_approach_to_prevent_diagnose_and_treat_hepatitis_B_in_Africa_/25921222Test

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2

دورية أكاديمية

A new approach to prevent, diagnose, and treat hepatitis B in Africa

الوصف: There are 82 million people living with hepatitis B (PLWHB) in the World Health Organization Africa region, where it is the main cause of liver disease. Effective vaccines have been available for over 40 years, yet there are 990,000 new infections annually, due to limited implementation of hepatitis B birth dose vaccination and antenatal tenofovir prophylaxis for highly viraemic women, which could eliminate mother-to-child transmission. Despite effective and cheap antiviral treatment which can suppress hepatitis B virus replication and reduce the risk of hepatocellular carcinoma (HCC), < 2% of PLWHB are diagnosed, and only 0.1% are treated. As a result, PLWHB are frequently diagnosed only when they have already developed decompensated cirrhosis and late-stage HCC, and consequently 80,000 hepatitis B-associated deaths occur each year. Major barriers include complex treatment guidelines which were derived from high-income settings, lack of affordable diagnostics, lack or insufficient domestic funding for hepatitis care, and limited healthcare infrastructure. Current treatment criteria may overlook patients at risk of cirrhosis and HCC. Therefore, expanded and simplified treatment criteria are needed. We advocate for decentralized community treatment programmes, adapted for low-resource and rural settings with limited laboratory infrastructure. We propose a strategy of treat-all except patients fulfilling criteria that suggest low risk of disease progression. Expanded treatment represents a financial challenge requiring concerted action from policy makers, industry, and international donor agencies. It is crucial to accelerate hepatitis B elimination plans, integrate hepatitis B care into existing healthcare programmes, and prioritize longitudinal and implementation research to improve care for PLWHB.

العلاقة: BMC Global and Public Health. 2023 Nov 02;1(1):24; http://hdl.handle.net/10852/105683Test; https://doi.org/10.1186/s44263-023-00026-1Test

الإتاحة: https://doi.org/10.1186/s44263-023-00026-1Test
http://hdl.handle.net/10852/105683Test

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3

دورية أكاديمية

Clinical features and outcomes of COVID-19 admissions in a population with a high prevalence of HIV and tuberculosis: a multicentre cohort study

المصدر: BMC Infectious Diseases ; https://bmcinfectdis.biomedcentral.comTest/ ; 22 ; 1 ; 559

مصطلحات موضوعية: HIV, COVID-19, Tuberculosis, Obesity

الوصف: 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.

وصف الملف: application/pdf

العلاقة: https://doi.org/10.1186/s12879-022-07519-8Test; http://hdl.handle.net/11427/36814Test; https://open.uct.ac.za/bitstream/11427/36814/1/12879_2022_Article_7519.pdfTest

الإتاحة: https://doi.org/10.1186/s12879-022-07519-8Test
http://hdl.handle.net/11427/36814Test
https://open.uct.ac.za/bitstream/11427/36814/1/12879_2022_Article_7519.pdfTest

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4

دورية أكاديمية

A new approach to prevent, diagnose, and treat hepatitis B in Africa.

المصدر: BMC Global & Public Health; 11/2/2023, Vol. 1 Issue 1, p1-11, 11p

مصطلحات موضوعية: HEPATITIS B treatment, HEPATITIS B prevention, HEPATITIS B vaccines, TENOFOVIR, LIVER cancer, CIRRHOSIS of the liver

مصطلحات جغرافية: AFRICA

الشركة/الكيان: WORLD Health Organization

مستخلص: There are 82 million people living with hepatitis B (PLWHB) in the World Health Organization Africa region, where it is the main cause of liver disease. Effective vaccines have been available for over 40 years, yet there are 990,000 new infections annually, due to limited implementation of hepatitis B birth dose vaccination and antenatal tenofovir prophylaxis for highly viraemic women, which could eliminate mother-to-child transmission. Despite effective and cheap antiviral treatment which can suppress hepatitis B virus replication and reduce the risk of hepatocellular carcinoma (HCC), < 2% of PLWHB are diagnosed, and only 0.1% are treated. As a result, PLWHB are frequently diagnosed only when they have already developed decompensated cirrhosis and late-stage HCC, and consequently 80,000 hepatitis B-associated deaths occur each year. Major barriers include complex treatment guidelines which were derived from high-income settings, lack of affordable diagnostics, lack or insufficient domestic funding for hepatitis care, and limited healthcare infrastructure. Current treatment criteria may overlook patients at risk of cirrhosis and HCC. Therefore, expanded and simplified treatment criteria are needed. We advocate for decentralized community treatment programmes, adapted for low-resource and rural settings with limited laboratory infrastructure. We propose a strategy of treat-all except patients fulfilling criteria that suggest low risk of disease progression. Expanded treatment represents a financial challenge requiring concerted action from policy makers, industry, and international donor agencies. It is crucial to accelerate hepatitis B elimination plans, integrate hepatitis B care into existing healthcare programmes, and prioritize longitudinal and implementation research to improve care for PLWHB. [ABSTRACT FROM AUTHOR]

: Copyright of BMC Global & Public Health is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

5

دورية أكاديمية

The diagnostic challenge of pneumocystis pneumonia and COVID‐19 co‐infection in HIV

المؤلفون: Broadhurst, Alistair G.B., Lalla, Usha, Taljaard, Jantjie J., Louw, Elizabeth H., Koegelenberg, Coenraad F.N., Allwood, Brian W.

المصدر: Respirology Case Reports ; volume 9, issue 4 ; ISSN 2051-3380 2051-3380

الوصف: Coronavirus disease 2019 (COVID‐19) and pneumocystis pneumonia (PCP) share many overlapping features and may be clinically indistinguishable on initial presentation in people living with HIV. We present the case of co‐infection with COVID‐19 and PCP in a patient with progressive respiratory failure admitted to our intensive care unit where the dominant disease was uncertain. This case highlights the difficulty in differentiating between the two diseases, especially in a high HIV prevalence setting where PCP is frequently diagnosed using case definitions and clinical experience due to limited access to bronchoscopy, appropriate laboratory testing, and computed tomography scans. In addition, diagnostic testing may yield false‐negative results in both diseases, and clinician awareness to the overlap and pitfalls is essential if COVID‐19 becomes endemic in such settings.

الإتاحة: https://doi.org/10.1002/rcr2.725Test

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6

دورية أكاديمية

Thyrotoxicosis secondary to thyroiditis following SARS-CoV-2 infection

المؤلفون: Coetzee, Ankia, Bhikoo, Raisa, Berndorfler, Bianca, Conradie, Wilhelmina, Taljaard, Jantjie J, Conradie-Smit, Marli

المصدر: Journal of Endocrinology, Metabolism and Diabetes of South Africa ; volume 26, issue 2, page 72-75 ; ISSN 1608-9677 2220-1009

الإتاحة: https://doi.org/10.1080/16089677.2021.1897228Test

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7

دورية أكاديمية

The utility of high-flow nasal oxygen for severe COVID-19 pneumonia in a resource-constrained setting: A multi-centre prospective observational study.

الوصف: Background: The utility of heated and humidified high-flow nasal oxygen (HFNO) for severe COVID-19-related hypoxaemic respiratory failure (HRF), particularly in settings with limited access to intensive care unit (ICU) resources, remains unclear, and predictors of outcome have been poorly studied. Methods: We included consecutive patients with COVID-19-related HRF treated with HFNO at two tertiary hospitals in Cape Town, South Africa. The primary outcome was the proportion of patients who were successfully weaned from HFNO, whilst failure comprised intubation or death on HFNO. Findings: The median (IQR) arterial oxygen partial pressure to fraction inspired oxygen ratio (PaO2/FiO2) was 68 (54-92) in 293 enroled patients. Of these, 137/293 (47%) of patients [PaO2/FiO2 76 (63-93)] were successfully weaned from HFNO. The median duration of HFNO was 6 (3-9) in those successfully treated versus 2 (1-5) days in those who failed (p<0.001). A higher ratio of oxygen saturation/FiO2 to respiratory rate within 6 h (ROX-6 score) after HFNO commencement was associated with HFNO success (ROX-6; AHR 0.43, 0.31-0.60), as was use of steroids (AHR 0.35, 95%CI 0.19-0.64). A ROX-6 score of ≥3.7 was 80% predictive of successful weaning whilst ROX-6 ≤ 2.2 was 74% predictive of failure. In total, 139 patents (52%) survived to hospital discharge, whilst mortality amongst HFNO failures with outcomes was 129/140 (92%). Interpretation: In a resource-constrained setting, HFNO for severe COVID-19 HRF is feasible and more almost half of those who receive it can be successfully weaned without the need for mechanical ventilation.

وصف الملف: text

العلاقة: https://researchonline.lshtm.ac.uk/id/eprint/4660445/1/The%20utility%20of%20high-flow%20nasal%20oxygen%20for%20severe%20COVID-19%20pneumonia%20in%20a%20resource-constrained%20setting%20A%20multi-centre%20prospec.pdfTest; Calligaro, Gregory L; Lalla, Usha; Audley, Gordon; Gina, Phindile; Miller, Malcolm G; Mendelson, Marc; Dlamini, Sipho; Wasserman, Sean; Meintjes, Graeme; Peter, Jonathan; +13 more. Levin, Dion; Dave, Joel A; Ntusi, Ntobeko; Meier, Stuart; Little, Francesca; Moodley, Desiree L; Louw, Elizabeth H; Nortje, Andre; Parker, Arifa; Taljaard, Jantjie J; Allwood, Brian W; Dheda, Keertan ; Koegelenberg, Coenraad FN; (2020) The utility of high-flow nasal oxygen for severe COVID-19 pneumonia in a resource-constrained setting: A multi-centre prospective observational study. EClinicalMedicine, 28. 100570-. ISSN 2589-5370 DOI: https://doi.org/10.1016Test/j.eclinm.2020.100570

الإتاحة: https://doi.org/10.1016Test/j.eclinm.2020.100570
https://researchonline.lshtm.ac.uk/id/eprint/4660445Test/
https://researchonline.lshtm.ac.uk/id/eprint/4660445/1/The%20utility%20of%20high-flow%20nasal%20oxygen%20for%20severe%20COVID-19%20pneumonia%20in%20a%20resource-constrained%20setting%20A%20multi-centre%20prospec.pdfTest

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