This national survey was commissioned by the African HIV Policy Network on behalf of NAHIP, the National African HIV Prevention programme for African people resident in England. NAHIP is funded by the Department of Health.
The aim was to assess the HIV prevention needs of a large sample of African people living in England to inform national interventions and aid regional and local HIV prevention planning.
Transactions of the Royal Society of Tropical Medicine and Hygiene (2008) 102, 219—224
Kelsey D.J. Jonesa, Therese Hesketh, John Yudkin
The extensively drug-resistant tuberculosis (XDR-TB) categorisation has been developed as a phenotypic description of those TB strains that are resistant to most conventional anti-TB drugs. While widely accepted to have significant incidence in those areas, such as Eastern Europe, that have high levels of multidrug resistance, recent reports have described a cluster of XDR-TB cases in the KwaZulu-Natal province of South Africa. With very high casefatality rates in this setting and a paucity of potential treatment options, concerns have grown about the possibility of an outbreak of highly lethal TB occurring in areas where TB prevalence, generally, is at its highest. In this article, we review previously documented case series of XDR-TB, and examine questions around the likelihood of rapid XDR-TB expansion in sub- Saharan Africa. We analyse how current TB control measures in the area might cope with such a challenge, and identify new areas for focus within the research and development community.
[Summary taken from document]
Published by the Center for Global Development, August 2008
Donors spend billions of dollars to fight HIV/AIDS in developing countries, but poor integration between donors and host country health systems risks undermining international efforts to prevent and treat AIDS. In this analysis, CGD’s HIV/AIDS Monitor argues that donors need to pay more attention to their overall effect on health systems.
They find that the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the World Bank’s Multi-Country AIDS Program for Africa have helped establish AIDS-specific systems and processes distinct from those of other health programs. At the same time, these AIDS-specific processes use many of the same resources as a country’s broader health system.
[Excerpt]
The AIDS Indicator Survey (AIS) was developed to provide countries with a standardized tool for monitoring nationally-representative HIV/AIDS indicators in the general population. The KAIS 2007 was the first AIS for Kenya and provides the most up-to-date information on HIV and other sexually transmitted infections. The methods and findings build upon previous population-based HIV estimates from KDHS 2003. KAIS data collection included questionnaires, including a household survey and an individual survey; biological testing based on venous blood samples; and return of test results to respondents. Incorporating blood testing for HIV and other sexually transmitted infections in the KAIS makes it possible to link socio-demographic, behavioural characteristics and household-level indicators to biological outcomes. For the first time, KAIS provides population-based information about CD4 cell counts among people with HIV. This information helps to determine HIV/AIDS care and treatment needs. KAIS also partnered with health facilities and health workers throughout the country to return results to KAIS participants approximately 6 weeks after blood specimen collection. Participants were counselled on the meaning of their test results and referred appropriately for follow-up testing and care at local facilities.
HIV drug resistance testing first started to be used extensively in HIV clinical management around 1997. The realisation that the data generated from these tests represented an important scientific resource led to the creation of the UK HIV Drug Resistance Database in 2001. The Database is a central repository for resistance tests performed as part of routine clinical care throughout the UK. It has been highly successful, capturing 80-90% of all tests performed, within a purely collaborative framework. By the end of 2007, over 48,000 resistance tests had been received and deposited.
A unique feature of the Database is extensive patient-level linkage with several clinical cohorts in the UK. This has allowed analyses which have given key insights into the epidemiology and clinical aspects of HIV drug resistance. Some of these analyses are briefly described on subsequent pages of this report.
[Summary taken from document]