Publications by authors named "Celine R Gounder"
Article Synopsis
- * A study conducted in two health facilities analyzed data from both HIV-positive and negative women, revealing that nearly all women were screened for TB and a significantly higher percentage of HIV-positive women displayed TB symptoms.
- * The results indicated a high initiation rate of IPT among HIV-positive pregnant women, though a significant number were lost to follow-up, highlighting the need for enhanced retention strategies in MCH services.
Background. Tuberculosis (TB) remains a significant global public health problem with known gender-related (male versus female) disparities. We reviewed the qualitative evidence (written/spoken narrative) for gender-related differences limiting TB service access from symptom onset to treatment initiation.
View Article and Find Full Text PDFArticle Synopsis
- Tuberculosis (TB) is a significant global health issue, highlighting gender-related disparities in accessing TB services from the onset of symptoms to treatment.
- A systematic review analyzed data from 137 quantitative studies, focusing on barriers and delays in TB care, with a significant portion coming from African and Asian regions.
- While many studies reported no gender differences, those that did found that women often faced greater barriers (financial, physical, stigma, health literacy) and longer delays in diagnosis compared to men.
In the last decade, many new rapid diagnostic tests for infectious diseases have been developed. In general, these new tests are developed with the intent to optimize feasibility and population health, not accuracy alone. However, unlike drugs or vaccines, diagnostic tests are evaluated and licensed on the basis of accuracy, not health impact (eg, reduced morbidity or mortality).
View Article and Find Full Text PDFUndiagnosed tuberculosis among HIV clinic attendees: association with antiretroviral therapy and implications for intensified case finding, isoniazid preventive therapy, and infection control.
J Acquir Immune Defic Syndr
June 2012
Objectives: Initiation of antiretroviral therapy (ART) and the 3I's are strategies to prevent HIV-associated tuberculosis (TB). We describe factors associated with undiagnosed TB among HIV-infected patients attending an HIV clinic in South Africa and discuss implications for the 3 Is.
Design: Convenience sample of HIV clinic attendees.
Objective: To assess the diagnostic accuracy of the urine lipoarabinomannan (LAM) test among ambulatory HIV-infected persons.
Design: Cross-sectional.
Methods: HIV-infected persons consecutively presenting to the HIV Clinic at Tembisa Main Clinic in Ekhuruleni, South Africa, were screened for symptoms of tuberculosis (TB) and asked to provide sputum and blood samples for smears for acid-fast bacilli and mycobacterial culture and a urine specimen for a LAM enzyme-linked immunosorbent assay.
Background: Human immunodeficiency virus (HIV) and tuberculosis (TB) are among the leading causes of death among women of reproductive age worldwide. TB is a significant cause of maternal morbidity. Detection of TB during pregnancy could provide substantial benefits to women and their children.
View Article and Find Full Text PDFObjectives: To assess adherence to a 1996 health policy change, which discontinued mandatory tuberculin skin testing (TST) of new entrants to NYC primary schools and continued mandatory testing of new entrants to secondary schools.
Methods: The proportion tested before (1991-1995) and after (1996-1998) the change in health policy was determined. Factors associated with TST positivity and the cost of continued testing were assessed.