Publications by authors named "Zegabriel Tedla"
Background: Xpert® MTB/RIF (Xpert) has high sensitivity for diagnosing tuberculosis (TB) compared to sputum-smear microscopy (smear) and can reduce time-to-diagnosis, time-to-treatment and potentially unfavorable patient-level treatment outcome.
Methods: People living with HIV (PLHIV) initiating antiretroviral therapy at 22 HIV clinics were enrolled and underwent systematic screening for TB (August 2012-November 2014). GeneXpert instruments were deployed following a stepped-wedge design at 13 centers from October 2012-June 2013.
Background: Non-tuberculous mycobacteria (NTM) can cause pulmonary infection and disease especially among people living with HIV (PLHIV). PLHIV with NTM disease may clinically present with one of the four symptoms consistent with tuberculosis (TB). We describe the prevalence of NTM and Mycobacterium tuberculosis complex (MTBC) isolated among PLHIV who presented for HIV care and treatment.
View Article and Find Full Text PDFBackground: In 2011, the Botswana National Tuberculosis Program adopted World Health Organization guidelines and introduced Xpert MTB/RIF (Xpert) assay to support intensified case finding among people living with HIV enrolling in care. An evaluation was designed to assess performance under operational conditions to inform the national Xpert scale-up.
Methods: Xpert was implemented from August 2012 through November 2014 with 13 GeneXpert instruments (GeneXpert) deployed in a phased approach over nine months: nine centralized laboratory and four point-of-care (POC) peripheral clinics.
Article Synopsis
- A 36-month isoniazid preventive therapy (36IPT) was found to be more effective than a shorter 6-month version (6IPT) in preventing tuberculosis (TB) in HIV-infected adults in Botswana, but the lasting benefits were evaluated post-trial.
- During the follow-up period, TB incidence rates were similar between both treatment groups, suggesting the effectiveness of 36IPT diminished over time.
- Antiretroviral therapy (ART) was linked to lower mortality rates but did not significantly reduce TB cases in the posttrial phase, indicating a need for additional strategies to prevent TB in HIV patients on long-term ART in high-risk areas.
Article Synopsis
- The study investigates the rates and risk factors of isoniazid-associated hepatitis in adults with HIV undergoing 36 months of isoniazid preventive therapy (36IPT) in Botswana.
- Out of 1,006 participants, 1.9% developed severe hepatitis, while 3.1% experienced moderate hepatitis, with most cases arising within the first two months of treatment.
- Results suggest that the incidence of hepatitis among those receiving 36IPT is comparable to existing data, and receiving antiretroviral therapy (ART) does not increase the risk of hepatitis compared to those not on ART.
Background: In accordance with WHO guidelines, people with HIV infection in Botswana receive daily isoniazid preventive therapy against tuberculosis without obtaining a tuberculin skin test, but duration of prophylaxis is restricted to 6 months. We aimed to assess effectiveness of extended isoniazid therapy.
Methods: In our randomised, double-blind, placebo-controlled trial we enrolled adults infected with HIV aged 18 years or older at government HIV-care clinics in Botswana.
Rationale: Little is known about the incidence of isoniazid-associated hepatitis in HIV-infected Africans who receive both isoniazid preventive therapy (IPT) and antiretroviral therapy (ART).
Objectives: To assess the rate of and risk factors for isoniazid (INH)-associated hepatitis in persons living with HIV (PLWH) during IPT.
Methods: PLWH recruited for a clinical trial received 6 months of open-label, daily, self-administered INH at public health clinics.
Objectives: To describe reasons for exclusion from isoniazid tuberculosis preventive therapy (IPT) and outcomes of persons living with HIV (PLWH) during 6 months of IPT.
Methods: In a clinical trial conducted in government clinics, first screening (screen 1) used National IPT Program guidelines and a second screening (screen 2) was trial specific. Adherence was defined as attending 6 monthly visits.