Browsing by Author "Mensah E"

Filter results by typing the first few letters
Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    Association of cardiovascular disease risk with liver steatosis and fibrosis in people with HIV in low- and middle-income countries.
    (2025-Jan-01) Kuniholm MH; Murenzi G; Shumbusho F; Brazier E; Plaisy MK; Mensah E; Wandeler G; Riebensahm C; Chihota BV; Samala N; Diero L; Semeere AS; Chanyachukul T; Borse R; Nguyen DTH; Perazzo H; Lopez-Iniguez A; Castilho JL; Maruri F; Jaquet A; Department of Infectious Diseases, Inselspital, Bern University Hospital.; Graduate School of Public Health and Health Policy, City University of New York, New York, New York, USA.; Research for Development (RD Rwanda).; Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University, Indianapolis, Indiana, United States of America.; Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Mexico City, Mexico.; Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda.; AMPATH, Moi University, Eldoret, Kenya.; Institute for Implementation Science in Population Health.; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.; TREAT Asia/amfAR - The Foundation for AIDS Research, Bangkok, Thailand.; Department of Infectious Diseases, National Hospital for Tropical Diseases, Hanoi, Vietnam.; B.J. Government Medical College & Sassoon General Hospitals, Pune, Maharashtra, India.; Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, New York, USA.; Espoir Vie-Togo, Lome, Togo.; Evandro Chagas National Institute of Infectious Diseases -Oswaldo Cruz Foundation (INI/FIOCRUZ), Rio de Janeiro, Brazil.; National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, University of Bordeaux, Bordeaux Population Health Centre, Bordeaux, France.; Rwanda Military Hospital, Kigali, Rwanda.; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
    OBJECTIVE: The aim of this study was to understand the relationship between cardiovascular disease (CVD) risk and liver steatosis and fibrosis among people with HIV (PLWH) at least 40 years of age on antiretroviral therapy (ART) in low and middle-income countries (LMIC). DESIGN: We used cross-sectional behavioral and clinical data collected during study enrollment visits in 2020-2022 for the Sentinel Research Network of International epidemiology Databases to Evaluate AIDS (SRN of IeDEA). METHODS: Ten-year CVD risk was calculated using 2019 WHO nonlaboratory and laboratory models. Transient elastography was used to assess liver disease. Presence of steatosis and significant fibrosis were defined by controlled attenuation parameter (CAP) at least 248 dB/m and liver stiffness measurement (LSM) at least 7.1 kPa, respectively. Participants with viral hepatitis, hazardous alcohol consumption, and unsuppressed HIV viral load were excluded from the analysis. Logistic regression was used to estimate odds ratios, adjusting for study site, CD4 +  T cell count, stavudine and didanosine exposure, and in models stratified by sex and geographic region. RESULTS: There were 1750 participants from nine LMIC. Median CVD risk was 3% for both nonlaboratory and laboratory-based models. Adjusted odds ratios (ORs) for steatosis and significant fibrosis associated with laboratory CVD risk (≥10 vs. <5%) were OR = 1.83 [95% confidence interval (95% CI) = 1.21-2.76; P  = 0.004] and OR = 1.62 (95% CI = 0.85-3.07; P  = 0.14), respectively. Associations of CVD risk with steatosis were stronger in men and among participants at study sites outside Africa. CONCLUSION: Higher CVD risk was associated with steatosis but not with significant fibrosis in PWH in our LMIC cohort.
  • Thumbnail Image
    Item
    Comorbidities and HIV-related factors associated with mental health symptoms and unhealthy substance use among older adults living with HIV in low- and middle-income countries: a cross-sectional study.
    (2025-Mar) Ross JL; Rupasinghe D; Chanyachukul T; Crabtree Ramírez B; Murenzi G; Kwobah E; Mureithi F; Minga A; Marbaniang I; Perazzo H; Parcesepe A; Goodrich S; Chimbetete C; Mensah E; Maruri F; Thi Hoai Nguyen D; López-Iñiguez A; Lancaster K; Byakwaga H; Tlali M; Plaisy MK; Nimkar S; Moreira R; Anastos K; Semeere A; Wandeler G; Jaquet A; Sohn A; Newlands Clinic, Harare, Zimbabwe.; Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.; Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Division of Infectious Diseases, Indiana University School of Medicine, Indianapolis, Indiana, USA.; Centre for Infectious Disease Epidemiology & Research, School of Public Health, University of Cape Town, Cape Town, South Africa.; Research for Development (RD Rwanda), Kigali, Rwanda.; Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición, México City, México.; TREAT Asia/amfAR - The Foundation for AIDS Research, Bangkok, Thailand.; Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.; The HIV care clinic of the National Blood Transfusion Centre, Blood Bank Medical Centre, Abidjan, Côte d'Ivoire.; NGO Espoir-Vie Togo, Lomé, Togo.; National Hospital for Tropical Diseases, Hanoi, Vietnam.; BJ Government Medical College-JHU Clinical Research Site, Pune, India.; The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia.; Montefiore Medical Center, Albert Einstein College of Medicine, New York, New York, USA.; Infectious Diseases Institute, Kampala, Uganda.; Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland.; Mbarara ISS Clinic, Mbarara, Uganda.; National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, University of Bordeaux, Bordeaux Population Health Centre, Bordeaux, France.; AMPATH MOI University, Eldoret, Kenya.; Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia.; Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil.
    INTRODUCTION: People with HIV (PWH) are vulnerable to mental health and substance use disorders (MSDs), but the extent to which these are associated with other non-communicable diseases in ageing PWH populations remains poorly documented. We assessed comorbidities associated with symptoms of MSD among PWH ≥40 years in the Sentinel Research Network (SRN) of the International epidemiology Database to Evaluate AIDS (IeDEA). METHODS: Baseline data collected between June 2020 and September 2022, from 10 HIV clinics in Asia, Latin America and Africa contributing to the SRN, were analysed. Symptoms of MSDs and comorbidities were assessed using standardized questionnaires, anthropometric and laboratory tests, including weight, height, blood pressure, glucose, lipids, chronic viral hepatitis and liver transient elastography. HIV viral load, CD4 count and additional routine clinical data were accessed from participant interview or medical records. HIV and non-HIV clinical associations of mental illness symptoms and unhealthy substance use were analysed using logistic regression. Mental illness symptoms were defined as moderate-to-severe depressive symptoms (PHQ-9 score >9), moderate-to-severe anxiety symptoms (GAD-7 >9) or probable post-traumatic stress disorder (PCL-5 >32). Unhealthy substance use was defined as ASSIST score >3, or AUDIT ≥7 for women (≥8 for men). RESULTS: Of 2614 participants assessed at baseline study visits, 57% were female, median age was 50 years, median CD4 was 548 cells/mm CONCLUSIONS: Improved integration of MSD and comorbidity services in HIV clinical settings, and further research on the association between MSD and comorbidities, and care integration among older PWH in low-middle-income countries, are required.
  • Thumbnail Image
    Item
    Protocol for an evaluation of the initiation of an integrated longitudinal outpatient care model for severe chronic non-communicable diseases (PEN-Plus) at secondary care facilities (district hospitals) in 10 lower-income countries.
    (2024-Jan-30) Adler AJ; Wroe EB; Atzori A; Bay N; Bekele W; Bhambhani VM; Nkwiro RB; Boudreaux C; Calixte D; Chiwanda Banda J; Coates MM; Dagnaw WW; Domingues K; Drown L; Dusabeyezu S; Fenelon D; Gupta N; Ssinabulya I; Jain Y; Kalkonde Y; Kamali I; Karekezi C; Karmacharya BM; Koirala B; Makani J; Manenti F; Mangwiro A; Manuel B; Masiye JK; Goma FM; Mayige MT; McLaughlin A; Mensah E; Salipa NM; Mutagaywa R; Mutengerere A; Ngoga G; Patiño M; Putoto G; Ruderman T; Salvi D; Sesay S; Taero F; Tostão E; Toussaint S; Bukhman G; Mocumbi AO; NCDI Poverty Network, Addis Ababa, Ethiopia.; Mathiwos Wondu-Ye Ethiopia Cancer Society, Addis Ababa, Ethiopia.; Partners In Health, Boston, Massachusetts, USA.; Chhattisgarh NCD Plus Initiative, Ambikapur, Chhattisgarh, India.; Partners In Health/Inshuti Mu Buzima, Rwinkwavu, Rwanda.; Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania.; School of Medical Sciences, Kathmandu University, Kathmandu, Nepal.; Zamni Lasante, Croix-des-Bouquets, Haiti.; Clinton Health Access Initiative, Harare, Zimbabwe.; SolidarMed, Harare, Zimbabwe.; Noncommunicable Diseases and Mental Health, Sierra Leone Ministry of Health and Sanitation, Freetown, Sierra Leone.; Doctors with Africa CUAMM, Padova, Italy.; Uganda Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda.; Partners In Health, Maryland County, Liberia.; Department of Agricultural Economics and Development, Universidade Eduardo Mondlane, Maputo, Mozambique.; NCDI Poverty Network, Surguja, Chhattisgarh, India.; Center for Integration Science, Brigham and Women's Hospital, Boston, Massachusetts, USA.; Partners In Health, Neno, Malawi.; NCD Division, Ministry of Health, Lilongwe, Malawi.; Universidade Eduardo Mondlane, Maputo, Mozambique.; Instituto Nacional de Saúde, Maputo, Mozambique.; Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.; Centre for Infectious Diseases Research in Zambia, Lusaka, Zambia.; Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, USA.; Noncommunicable Diseases and Mental Health Clinical Services, Malawi Ministry of Health, Lilongwe, Malawi.; National Institute for Medical Research, Dar es Salaam, Tanzania.; Non-Communicable Diseases Alliance Kenya, Nairobi, Kenya.; Partners In Health Sierra Leone, Kono, Sierra Leone.; Center for Integration Science, Brigham and Women's Hospital, Boston, Massachusetts, USA aadler2@bwh.harvard.edu.; Mozambique Institute for Health Education and Research, Maputo, Mozambique.; Kathmandu Institute of Child Health, Kathmandu, Nepal.; Department of Community Health, Universidade Eduardo Mondlane, Maputo, Mozambique.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
    INTRODUCTION: The Package of Essential Noncommunicable Disease Interventions-Plus (PEN-Plus) is a strategy decentralising care for severe non-communicable diseases (NCDs) including type 1 diabetes, rheumatic heart disease and sickle cell disease, to increase access to care. In the PEN-Plus model, mid-level clinicians in intermediary facilities in low and lower middle income countries are trained to provide integrated care for conditions where services traditionally were only available at tertiary referral facilities. For the upcoming phase of activities, 18 first-level hospitals in 9 countries and 1 state in India were selected for PEN-Plus expansion and will treat a variety of severe NCDs. Over 3 years, the countries and state are expected to: (1) establish PEN-Plus clinics in one or two district hospitals, (2) support these clinics to mature into training sites in preparation for national or state-level scale-up, and (3) work with the national or state-level stakeholders to describe, measure and advocate for PEN-Plus to support development of a national operational plan for scale-up. METHODS AND ANALYSIS: Guided by Proctor outcomes for implementation research, we are conducting a mixed-method evaluation consisting of 10 components to understand outcomes in clinical implementation, training and policy development. Data will be collected through a mix of quantitative surveys, routine reporting, routine clinical data and qualitative interviews. ETHICS AND DISSEMINATION: This protocol has been considered exempt or covered by central and local institutional review boards. Findings will be disseminated throughout the project's course, including through quarterly M&E discussions, semiannual formative assessments, dashboard mapping of progress, quarterly newsletters, regular feedback loops with national stakeholders and publication in peer-reviewed journals.