Browsing by Author "Kancheya NG"

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    A model of tuberculosis screening for pregnant women in resource-limited settings using Xpert MTB/RIF.
    (2012) Turnbull ER; Kancheya NG; Harris JB; Topp SM; Henostroza G; Reid SE; Tuberculosis Department, Centre for Infectious Disease Research in Zambia, 5977 Benakale Road, P.O. Box 34681, Northmead, Lusaka, Zambia; Schools of Medicine and Public Health, University of Alabama at Birmingham, AL 35233, USA. eleanor.turnbull@cidrz.org; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
    Timely diagnosis and treatment of maternal tuberculosis (TB) is important to reduce morbidity and mortality for both the mother and child, particularly in women who are coinfected with HIV. The World Health Organization (WHO) recommends the integration of TB/HIV screening into antenatal services but available diagnostic tools are slow and insensitive, resulting in delays in treatment initiation. Recently the WHO endorsed Xpert MTB/RIF, a highly sensitive, real-time PCR assay for Mycobacterium tuberculosis that simultaneously detects rifampicin resistance directly from sputum and provides results within 100 minutes. We propose a model for same-day TB screening and diagnosis of all pregnant women at antenatal care using Xpert MTB/RIF. Pilot studies are urgently required to evaluate strategies for the integration of TB screening into antenatal clinics using new diagnostic technologies.
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    Early lessons from the integration of tuberculosis and HIV services in primary care centers in Lusaka, Zambia.
    (2008-Jul) Harris JB; Hatwiinda SM; Randels KM; Chi BH; Kancheya NG; Jham MA; Samungole KV; Tambatamba BC; Cantrell RA; Levy JW; Kimerling ME; Reid SE; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia. Jennie.Harris@cidrz.org; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
    BACKGROUND: Zambia faces overlapping tuberculosis (TB) and human immunodeficiency virus (HIV) epidemics; however, care for co-infected patients often occurs through separate, vertical programs. OBJECTIVE: To establish a program to integrate TB and HIV services in Lusaka primary care centers. METHODS: In collaboration with the Zambian Ministry of Health, TB-HIV integration activities began in December 2005 and were expanded to seven health centers by March 2007. Principal activities included developing staff capacity to manage co-infected patients, implementing HIV testing within TB departments and establishing referral systems between departments. RESULTS: Using a provider-initiated approach, 2053 TB patients were offered HIV testing. Seventy-seven per cent agreed to be tested; 69% of those tested were HIV-infected. Of these, 59% were enrolled in HIV care. The proportion of antiretroviral treatment (ART) program enrollees who were TB-HIV co-infected increased by 38% after program implementation. The median CD4 count among co-infected patients was 161 cells/microl, with 88% eligible for ART. CONCLUSION: Integration of HIV testing and referral services into urban primary care centers identified many co-infected patients and significantly increased the proportion of TB patients among people accessing HIV care. Ongoing challenges include maximizing the number of patients accepting HIV testing and overcoming barriers to enrollment into HIV care.