Relevant bibliographies by topics / AIDS (Disease), Patients Care. Rwanda

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  1. Journal articles
  2. Dissertations / Theses
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  4. Book chapters

Academic literature on the topic 'AIDS (Disease), Patients Care. Rwanda'

Author: Grafiati
Published: 4 June 2021
Last updated: 7 February 2022

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Journal articles on the topic "AIDS (Disease), Patients Care. Rwanda"

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Adeyemi, Olukemi, Mary Lyons, Tsi Njim, Joseph Okebe, Josephine Birungi, Kevin Nana, Jean Claude Mbanya, et al. "Integration of non-communicable disease and HIV/AIDS management: a review of healthcare policies and plans in East Africa." BMJ Global Health 6, no. 5 (May 2021): e004669. http://dx.doi.org/10.1136/bmjgh-2020-004669.

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BackgroundLow-income and middle-income countries are struggling to manage growing numbers of patients with chronic non-communicable diseases (NCDs), while services for patients with HIV infection are well established. There have been calls for integration of HIV and NCD services to increase efficiency and improve coverage of NCD care, although evidence of effectiveness remains unclear. In this review, we assess the extent to which National HIV and NCD policies in East Africa reflect the calls for HIV-NCD service integration.MethodsBetween April 2018 and December 2020, we searched for policies, strategies and guidelines associated with HIV and NCDs programmes in Burundi, Kenya, Rwanda, South Sudan, Tanzania and Uganda. Documents were searched manually for plans for integration of HIV and NCD services. Data were analysed qualitatively using document analysis.ResultsThirty-one documents were screened, and 13 contained action plans for HIV and NCDs service integration. Integrated delivery of HIV and NCD care is recommended in high level health policies and treatment guidelines in four countries in the East African region; Kenya, Rwanda, Tanzania and Uganda, mostly relating to integrating NCD care into HIV programmes. The increasing burden of NCDs, as well as a move towards person-centred differentiated delivery of services for people living with HIV, is a factor in the recent adoption of integrated HIV and NCD service delivery plans. Both South Sudan and Burundi report a focus on building their healthcare infrastructure and improving coverage and quality of healthcare provision, with no reported plans for HIV and NCD care integration.ConclusionDespite the limited evidence of effectiveness, some East African countries have already taken steps towards HIV and NCD service integration. Close monitoring and evaluation of the integrated HIV and NCD programmes is necessary to provide insight into the associated benefits and risks, and to inform future service developments.
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Santos, Edwiges, Andre Japiassu, Marcia Lazera, and Fernando Bozza. "Fungal disease in AIDS patients in intensive care." Critical Care 17, Suppl 4 (2013): P41. http://dx.doi.org/10.1186/cc12941.

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Metrikin, Aaron S., Merrick Zwarenstein, Malcolm H. Steinberg, Estelle Van Der Vyver, Gary Maartens, and Robin Wood. "Is HIV/AIDS a primary-care disease? Appropriate levels of outpatient care for patients with HIV/AIDS." AIDS 9, no. 6 (June 1995): 619–24. http://dx.doi.org/10.1097/00002030-199506000-00014.

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Rusingiza, Emmanuel K., Ziad El-Khatib, Bethany Hedt-Gauthier, Gedeon Ngoga, Symaque Dusabeyezu, Neo Tapela, Cadet Mutumbira, et al. "Outcomes for patients with rheumatic heart disease after cardiac surgery followed at rural district hospitals in Rwanda." Heart 104, no. 20 (April 20, 2018): 1707–13. http://dx.doi.org/10.1136/heartjnl-2017-312644.

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BackgroundIn sub-Saharan Africa, continued clinical follow-up, after cardiac surgery, is only available at urban referral centres. We implemented a decentralised, integrated care model to provide longitudinal care for patients with advanced rheumatic heart disease (RHD) at district hospitals in rural Rwanda before and after heart surgery.MethodsWe collected data from charts at non-communicable disease (NCD) clinics at three rural district hospitals in Rwanda to describe the outcomes of 54 patients with RHD who received cardiac valve surgery during 2007–2015.ResultsThe majority of patients were adults (46/54; 85%), and 74% were females. The median age at the time of surgery was 22 years in adults and 11 years in children. Advanced symptoms—New York Heart Association class III or IV—were present in 83% before surgery and only 4% afterwards. The mitral valve was the most common valve requiring surgery. Valvular surgery consisted mostly of a single valve (56%) and double valve (41%). Patients were followed for a median of 3 years (range 0.2–7.9) during which 7.4% of them died; all deaths were patients who had undergone bioprosthetic valve replacement. For patients with mechanical valves, anticoagulation was checked at 96% of visits. There were no known bleeding or thrombotic events requiring hospitalisation.ConclusionOutcomes of postoperative patients with RHD tracked in rural Rwanda health facilities were generally good. With appropriate training and supervision, it is feasible to safely decentralise follow-up of patients with RHD to nurse-led specialised NCD clinics after cardiac surgery.
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Vivithanaporn, P., H. B. Krentz, L. DeBlock, M. J. Gill, and C. Power. "PO09-MO-10 Neurological disease burden among HIV/AIDS patients receiving active care." Journal of the Neurological Sciences 285 (October 2009): S194. http://dx.doi.org/10.1016/s0022-510x(09)70746-4.

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Katz, Irwin, R. Glen Hass, Nina Parisi, Janetta Astone, Denise McEvaddy, and David J. Lucido. "Lay People's and Health Care Personnel's Perceptions of Cancer, Aids, Cardiac, and Diabetic Patients." Psychological Reports 60, no. 2 (April 1987): 615–29. http://dx.doi.org/10.2466/pr0.1987.60.2.615.

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Although some writers assume that negative attitudes toward cancer and other chronic disease patients are prevalent, systematic data have been scarce. Perceptions of patients and their illnesses were assessed for college students, nurses, medical students, and chiropractic students. Subjects rated cancer, AIDS, diabetes, and heart disease patients, as well as the nonill, on 21 bipolar trait items, selected to measure competence, moral worth, dependence, depression, and morbidity. There were also measures of social distance, cancer anxiety, disease beliefs, and ascribed illness responsibility. With minor exceptions, all subsamples perceived cancer victims less favorably than diabetics, heart patients, and the nonill on competence, dependence, depression, and morbidity. Cancer patients were always seen as even more depressed than AIDS sufferers but were rated just as favorably as well people on moral worth. People with AIDS were generally the most negatively evaluated and most rejected group. Cancer was consistently described as the most painful condition and, next to AIDS, the least understood medically and most deadly. Cancer anxiety was moderately predictive of perceptions of cancer victims, and ratings of illness responsibility were moderately predictive of moral worth ratings for the cancer and AIDS groups. Theoretical and practical implications were discussed.
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Mohata, Nehal Nareshkumar, Saud Gafur Deshmukh, Sudhir Sudhakar Pendke, Akshay Rajeshwar Padgilwar, and Sunil Devrao Dokhale. "Ocular manifestation in human immunodeficiency virus patients presenting to tertiary eye care centre in rural area." Indian Journal of Clinical and Experimental Ophthalmology 7, no. 2 (June 15, 2021): 363–65. http://dx.doi.org/10.18231/j.ijceo.2021.071.

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The ocular manifestations of HIV/AIDS may lead to visual impairment or blindness. The need of hour is an understating of ocular sequelae of HIV infection leading to an early diagnosis of AIDS so that we can start early and effective treatment as per conditions.1. To study the prevalence of ocular manifestations in HIV patients; 2. To study relation of CD4 T Cell count with ocular diseases. The study concluded that HIV/AIDS is a significant cause of ocular disease. Almost around 39% patients having HIV/AIDS have eye disease. HIV Retinopathy is most common in posterior segment and lens involvement is most common in anterior segment manifestations. Usually, early presentation of ocular manifestations in HIV/AIDS patients is asymptomatic or with very less symptoms, which leads to delay in diagnosis and treatment.
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Mukakarangwa, Marie Claire, Geldine Chironda, Busisiwe Bhengu, and Godfrey Katende. "Adherence to Hemodialysis and Associated Factors among End Stage Renal Disease Patients at Selected Nephrology Units in Rwanda: A Descriptive Cross-Sectional Study." Nursing Research and Practice 2018 (June 3, 2018): 1–8. http://dx.doi.org/10.1155/2018/4372716.

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Introduction. Worldwide, End Stage Renal Disease (ESRD) has become a public health concern increasing the number of patients maintained on hemodialysis prior to renal transplantation. Nonadherence to hemodialysis continues to impact on the care of ESRD patients, causing high increase in morbidity and mortality. Purpose of the Study. The purpose of this study was to determine the level of adherence to hemodialysis and the associated factors among End Stage Renal Disease (ESRD) patients in selected nephrology units in Rwanda. Methods. This was a descriptive cross-sectional design involving 41 participants. Participants were recruited using a purposive sampling technique. Demographic and adherence to hemodialysis data were collected with the use of structured interview schedules. Descriptive statistics were used to describe the demographic variables and the level of adherence to hemodialysis. Inferential statistics of chi-square was used to establish factors associated with adherence to hemodialysis. Results. Twenty-one (51%) of ESRD participants adhered highly (scores < 80%) to HD. Seventeen (42%) adhered moderately (70–79%) to HD while three (7%) had low level of adherence to HD (below 70%). The factors associated with adherence to hemodialysis were age (mean = 27; 95% CI 26.76–29, 17; p = 038) and religion (95% CI 26.29–60.12, p = 003). Frequencies of education of health care workers about the importance of not missing dialysis (95% CI 26.71–42.56, p = .000), perceived relative importance of hemodialysis (95% CI 20.44–27.76, p = .020), and experiencing difficulties during the procedure (95% CI 20.80–28.36, p = .004) were significantly associated with adherence to hemodialysis. Conclusion. Adherence to hemodialysis is still a public health concern in Rwanda. Health care providers and particularly nurses should continue to advocate for adherence to HD for better health outcomes. Further research is needed to identify the barriers to HD in Rwanda.
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Coker, R. J., and D. M. Mitchell. "The Role of Bronchoscopy in Patients with HIV Disease." International Journal of STD & AIDS 5, no. 3 (May 1994): 172–76. http://dx.doi.org/10.1177/095646249400500303.

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Pulmonary involvement is a frequent feature of patients infected with the human immunodeficiency virus (HIV). Pneumocystis carinii pneumonia (PCP) is still the commonest AIDS defining diagnosis despite the advent of effective prophylaxis and antiretroviral treatment. Other pulmonary manifestations of AIDS, including tuberculosis, may pose a greater problem in the future. The clinical manifestations of HIV-disease are many and varied, and changing as the disease is modified by therapeutic interventions. With specific and increasingly effective treatments the need for definitive diagnosis is obvious. Fibreoptic bronchoscopy is a well established tool for the diagnosis of HIV-related pulmonary complications. This article aims to give an account on the use of bronchoscopy in a unit providing care for many HIV seropositive patients.
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Mukasahaha, D., F. Uwinkindi, L. Grant, J. Downing, J. Turyahikayo, M. Leng, and M. A. Muhimpundu. "Assessment of Palliative Care Needs in Hospital Settings in Rwanda." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 111s. http://dx.doi.org/10.1200/jgo.18.78900.

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Background: Rwanda is among the first African countries with a palliative care (PC) policy and implementation plan. A partnership with the Ministry of Health (MoH) through the Rwanda Biomedical Centre (RBC) and the University of Edinburgh has supported an integrated approach including expanding the evidence base. Aim: To assessing the need for (PC) to inform policy, service delivery and training. Methods: A point prevalence PC needs assessment was conducted in nine public hospitals (referral, provincial and district). A records census identified those with life-limiting illness (LLI) who were then invited to participate by interview. The assessment tool included the APCA African POS, POS S, WHO performance status and demographic information. Results: 608 case notes were reviewed, 152 eligible and 124 completed assessment. 25% of all patients admitted had LLI, of which 99.2% had evidence of unmet need determined by at least one score on the APCA POS ≥ 3. Diagnoses 29% cancer, 29% cardiovascular disease, 16.9% end-stage organ failure and 13.7% HIV. Symptoms with greatest impact; nausea and vomiting (34.7%) and pain (32.3%). 63.7% with WHO performance status 4 or 5. 8.1% seen by existing PC services. Conclusion: Although the MoH and RBC are making bold steps toward developing PC in Rwanda, there remains a significant amount of unmet PC needs. Meeting this need requires recognition of the scope of PC needs beyond cancer, feedback to the hospitals and health care workers, thinking strategically how to further strengthen the health system and further capacity building and training.
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Dissertations / Theses on the topic "AIDS (Disease), Patients Care. Rwanda"

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Uwimana, Jeannine. "Met and unmet palliative care needs for people living with HIV/AIDS in selected areas in Rwanda." Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&amp.

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The aim of this study was to investigate met and unmet palliative care needs for people living with HIV/AIDS in selected areas in Rwanda. The achieve this aim, the study, firstly, identified the palliative care needs of people living with HIV/AIDS, secondly, it identified the health care services available to meet these needs, and thirdly, it determined the extent to which palliative care needs were met.
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Leaney, Alison Ann. "An evaluation of the Buddy/home Care Program : a palliative care program operated by AIDS Vancouver." Thesis, University of British Columbia, 1990. http://hdl.handle.net/2429/28717.

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Acquired Immunodeficiency Syndrome (AIDS) is presenting a real challenge to our Canadian health care system. As the numbers of infected grow, the greater the realization that health care and social services as they currently exist, are unable to adequately address the overwhelming need. With a special emphasis on hospice/palliative care services, which are seen as essential and very appropriate in the care of persons with AIDS (PWAs), this study seeks to evaluate one such service - the Buddy/Home Care Program offered by AIDS Vancouver - as a means of improving this program and illustrating the need to establish others to achieve an integrated hospice/palliative care service. To evaluate the effectiveness of the Buddy/Home Care Program, four PWA Social Networks composed of four Persons With AIDS, five of their buddies, three Home Care Volunteers, two Buddy/Home Care Client Care Case Managers, and four Outside Agency Affiliated Persons, were interviewed using an interview guide approach. The interview guide was designed to tap the individual experiences of everyone associated with the Program, as well as their perceptions of the Program's strengths and weaknesses. Limitations in the study design and implementation arose from sampling, incomplete data, and researcher-related issues. Data analysis followed the dimensional model of the Glaser and Strauss grounded theory. The results are presented utilizing pertinent social network characteristics as a framework. First, each of the four PWA Social Networks are presented and described in relation to size and density. The networks vary in size from 12 to 25, and are characterized by low levels of density. Since the literature indicates that there is a positive association between network size and health status, it follows that the PWA with 12 individuals in his social network would have the lowest health status, while the PWA with 25 would have the highest. But this has not been found to be the case in this study. What is also unclear, is whether larger sized networks cause improved health, or whether health status determines network size. Although low density is far from the ideal prescribed by the hospice/palliative care approach, the literature is conflicting on the association between density and health status, suggesting that this low density is not necessarily undesirable. Second, an examination of the volunteer-client relationship subsystems reveals that the relationships fulfill the Client Care Case Managers expectations, in that the relationships between volunteers and clients range in intensity from being volunteer-client, to friend-friend, to parent-child oriented, and are characterized by a wide variety of emotional, informational, instrumental, and companionship support functions consistent with these relationship dynamics. And third, an examination of the volunteer-agency relationship subsystems reveals high levels of appreciation of informational support provided by the agency through its volunteer training, relatively infrequent contact between volunteers and Client Care Case Managers, variable experiences of emotional support received from Client Care Case Managers, minimal amounts of emotional support received from the Buddy Support Group, and some confusion about which staff members are responsible for volunteers pre- and post-assignment. Recommendations designed to improve volunteer-client and volunteer-agency relationships in the Buddy/Home Care Program, as well as others designed to promote the establishment of an integrated Canadian hospice/palliative care service are presented in conclusion.
Arts, Faculty of
Social Work, School of
Graduate
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Demling, Jennifer. "Family caregiving for persons with AIDS." Virtual Press, 1995. http://liblink.bsu.edu/uhtbin/catkey/962800.

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This study examines the experience of individuals who participated or did not participate in the caregiving process for a family member who died within approximately the past three years of an AIDS-related illness. The focus of this study is on the adjustment of the caregivers and non-caregivers after the death of the PWA. It was hypothesized that due to their direct involvement in the caregiving process, caregivers would differ significantly from non-caregivers on a number of measures designed to evaluate adjustment. It was hypothesized that caregivers would report better overall adjustment than non-caregivers.Participants completed the Symptom Checklist 90 (SCL-90; Derogatis, Lipman, & Covi, 1973), as well as a semi-structured interview about their experiences. A two-tailed t-test revealed no significant differences between groups. However, effect sizes computed for these variables revealed moderate to large diff ererences between caregivers and non-caregivers on the somatization and interpersonal subscales of the SCL-90. Comparisons to a standardization sample showed that caregivers differed significantly on all subscales from that standardization sample: Non-caregivers differed only on the depression and interpersonal sensitivity subscales. Analysis of the interview data revealed a significant difference in reported stress, with caregivers reporting significantly more stress during the illness of the PWA than non-caregivers. Effect sizes were computed for nine other interview categories; these suggested that caregiversreported substantially less social withdrawal, fewer feelings of guilt, fewer problems resolving issues with the PWA, substantially more physical illness, and more life affirming statements than their non-caregiver counterparts. Several other noteworthy trends that emerged in the interview portion of the study are discussed.Small sample size and pre-existing characteristics of the participants are explored as possible factors affecting the outcome of the study. More controlled studies exploring the adjustment of caregivers and non-caregivers are needed in order to better understand the possible differences that may exist between caregivers and non-caregivers in terms of adjustment after the death of their loved one from an AIDS-related illness.
Department of Psychological Science
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Wong, Wa-kit, and 王華潔. "The needs of and care for persons with HIV/AIDS in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1996. http://hub.hku.hk/bib/B31250300.

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Baylor, Rita Atkins. "Nurses' attitudes toward caring for patients with AIDS." Virtual Press, 1992. http://liblink.bsu.edu/uhtbin/catkey/845956.

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The main purpose of this study was to examine nurses' attitudes toward caring for patients with Acquired Immune Deficiency Syndrome (AIDS). The study also compared the attitudes of nurses who had cared for AIDS patients with the attitudes of nurses who had not cared for AIDS patients. Educational background was also examined to see if education influences attitudes. The Ajzen-Fishbein Model of Reasoned Action was the framework used for this study.A descriptive design was used for the purpose of gaining more information regarding nurses' attitudes toward caring for patients with AIDS. A random sample of all registered nurses in the state of Indiana was used for this study. The data obtained were analyzed using frequency distributions, independent t-tests, and analysis of variance.Nurses in general are sill uncomfortable with caring for AIDS patients. Between 40% and 50% of nurses are fearful of contracting the AIDS virus and fearful of putting their family at risk. On the other hand, approximately the same percentage are comfortable caring for AIDS patients. Furthermore, nurses believe that health care agencies should care for AIDS patients, but believe that nurses should have the right to refuse to care for AIDS patients.Results of this study indicated that educational background does not influence nurses' attitudes toward caring for patients with AIDS. However, as nurses have more experience caring for patients with AIDS, they appear to develop more positive attitudes.
School of Nursing
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Tutani, Lumka. "Nurses' experience of contesting discourses in HIV/AIDS activities in the primary health care setting." Thesis, Rhodes University, 2001. http://hdl.handle.net/10962/d1002583.

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This paper explores the experience of nurses who work both as Primary Health Care Providers and counsellors trained in the narrative model of counselling in primary health care settings. Five focus groups were conducted in both Xhosa and English. Discourse analysis was used as a method of analysing the data. Training nurses in the narrative counselling model introduced an alternative discourse, which was experienced as contradicting their usual way of working. Two dominant discourses were the “not knowing” approach, assumed by the narrative model of counselling, and the “knowing” stance, assumed by health education. The institutionalised construction of counselling by doctors and matrons, and their power versus the power of the nurse counsellors was also cited as sources of conflict. Despite the tensions, narrative model of counselling seems to be offering new positions, which may benefit people living with HIV and improve HIV/AIDS activities in the Primary Health Care (PHC) context.
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Newman, Linda C. "Maintaining self integrity in the care of AIDS patients : a grounded theory approach." Virtual Press, 1992. http://liblink.bsu.edu/uhtbin/catkey/834521.

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The purpose of the study was to explore barriers hospital nurses perceive in the care of AIDS or HIV positive patients. According to the Center for Disease Control, the total number of AIDS cases reported in the United States as of December 1991 was 206,392. The Center for Disease Control reported of the known AIDS cases in the United States 59% have resulted in death.A grounded theory approach was used in the study of sixteen nurses working with AIDS patients in a medical surgical area of the hospital. Results of the study showed nurses had a need to maintain self integrity. All barriers found as a result of the study related to the nurses need to maintain self integrity. Barriers found as a result of the study include the following: fear of contagion, family concerns, fear of the unknown, issues in confidentiality, issues in universal precautions, and emotional and spiritual aspects.
School of Nursing
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Peltier, Cécile. "Prévention de la transmission du VIH-1 par le lait maternel au Rwanda et dépistage précoce des enfants infectés." Doctoral thesis, Universite Libre de Bruxelles, 2012. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/209572.

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Ce travail est réparti en deux parties différentes issues de deux études différentes.

La première partie décrit l’étude AMATA conçue en 2005 au Rwanda, étude prospective basée sur le suivi d’une cohorte répartie en deux groupes d’intervention postnatale. Cette étude avait pour objectif de tester l’hypothèse que l’allaitement maternel (AM) sous trithérapie antirétrovirale maternelle (HAART) pouvait être une prévention aussi efficace que le lait artificiel (LA) afin de réduire drastiquement la transmission du virus VIH de la mère à l’enfant avec une moindre mortalité infantile. Cette intervention permettait de préserver les avantages de l’AM, connue pour offrir une prévention naturelle minimisant les infections graves, en particulier les gastro-entérites et diminuant le taux de malnutrition protéino-énergétique (MPE). Dans la cohorte « AMATA », un groupe d’enfants était allaité exclusivement durant six mois, les mères étant sous trithérapie antirétrovirale systématique et un autre groupe d’enfants était nourri au LA durant les six premiers mois de vie. L’intervention débutait durant la grossesse à partir de la 28ème semaine d’âge gestationnel, une trithérapie antirétrovirale étaient donnée à toutes ces femmes enceintes infectées par le VIH participant à l’étude, quel que soit leur stade immunitaire ou clinique. Cette trithérapie était poursuivie à vie pour les femmes nécessitant cette combinaison de traitements antirétroviraux pour des raisons cliniques et/ou immunitaires et non poursuivie pour les autres femmes, avec un schéma d’interruption minimisant les résistances aux ARVs.

Les critères d’évaluation de comparaison des deux interventions postnatales étaient la survie à 9 mois des enfants non infectés, le taux d’infection par le VIH et la mortalité des enfants dans chaque groupe. La présence de facteurs confondants a été recherchée en effectuant une analyse de variance car la randomisation était impossible pour des raisons éthiques.

Dans l’étude AMATA, parmi les 532 enfants inclus, 227 (43%) étaient allaités et 305 (57%) recevaient du LA, 7 enfants furent infectés par le VIH (1,3%) dont 6 in utero (3 enfants par groupe). Un enfant fut infecté par l’AM correspondant à un risque cumulatif postnatal de 0,5% [IC95% 0,1–3,4%; P 0,24]. Ce taux de transmission reste parmi les plus bas dans un pays à ressources limitées même en comparant avec d’autres études où la trithérapie fut aussi utilisée durant l’AM. Ces études furent publiées après le début de l’enrôlement des patientes dans l’étude rwandaise AMATA en 2005.

La différence de mortalité à 9 mois n’était pas statistiquement différente dans les 2 groupes avec 3,3% (95% IC 1,6–6,9%) pour les enfants allaités et 5,7% (95% IC 3,6–9,2%) pour les enfants recevant du LA (P= 0,20).

Cette étude renforce la notion que l’AM sous trithérapie antirétrovirale (HAART) reste une approche à recommander dans les contextes où la mortalité infantile est élevée. Cette prévention postnatale permet non seulement de réduire très efficacement la transmission du VIH de la mère à l’enfant en préservant les avantages de l’AM et en évitant les risques du LA distribué dans des contextes d’hygiène précaire où un accès à l’eau potable est difficile.

Dans cette étude, l’efficacité de ces 2 interventions postnatales était comparable avec des taux de transmission et de mortalité semblables statistiquement.

La deuxième partie de ce travail, basée sur les résultats d’une cohorte d’enfants âgés de moins de 18 mois nés de mères infectées par le VIH permettait d’évaluer les signes cliniques présomptifs proposés par l’OMS en 2005. Ces signes

étaient créés afin de pouvoir effectuer le diagnostic clinique d’infection par le VIH chez les enfants exposés au virus VIH

dans les pays où les techniques moléculaires de PCR n’étaient pas accessibles. Les enfants nés de mères infectées par le

VIH gardent parfois des anticorps anti-VIH maternels jusqu’à l’âge de 18 mois sans être pourtant contaminés par le VIH/SIDA. Avant cet âge, la confirmation de l’infection par le VIH repose sur la démonstration de la présence d’ADN proviral ou ARN par la technique PCR. La mortalité précoce des nourrissons infectés par le VIH est élevée, il est important de pouvoir bénéficier d’ARVs dès le diagnostic précoce de l’infection.

Les signes cliniques de présomption d’infection par le VIH chez l’enfant exposé (sérologie VIH +) de moins de 18 mois ont été proposés en 2005 par l’OMS et modifiés en 2006 mais ne furent jamais évalués.

Cette étude transversale comprenant 236 enfants de moins de 18 mois ayant une sérologie VIH positive consistait à évaluer la sensibilité (76,6%) et la spécificité (52,7%) de ces signes cliniques en confirmant leur statut infectieux réel par le test PCR pour le VIH, test de référence.

Cette spécificité basse inquiétante était liée aux enfants présentant des signes cliniques similaires bien que non infectés par le VIH mais souvent carencés par manque d’apport calorique et/ou souffrant d’une forme avancée de tuberculose extra pulmonaire ou d’autres affections chroniques. Ces enfants cachectiques pouvaient présenter les mêmes signes cliniques que les enfants infectés par le VIH car ils avaient une baisse de leur immunité cellulaire due à la MPE.

Dans la première partie de ce travail, l’étude AMATA a montré 2 façons efficaces de diminuer la transmission du VIH de la mère à l’enfant.

Dans la deuxième partie, on a évalué une méthode de diagnostic clinique précoce proposé par l’OMS afin de détecter les enfants infectés par le VIH en l’absence de test virologique PCR mais la basse spécificité indique la nécessité d’améliorer cette méthode diagnostique.


Doctorat en Sciences médicales
info:eu-repo/semantics/nonPublished

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Naidoo, Sherina. "The sense of coherence and coping resources of adult family caregivers of HIV/AIDS patients in the Kwazakhele area of Port Elizabeth." Thesis, Nelson Mandela Metropolitan University, 2009. http://hdl.handle.net/10948/1021.

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Human Immune Deficiency Virus (HIV), which results in Acquired Immune Deficiency Syndrome (AIDS), has many manifestations. Literature reveals that some of these manifestations may compromise the infected individual’s sense of well-being and negatively impact on health related quality of life. As the number of people living with HIV/AIDS disease grows, so does the need for their care. In the early days of the AIDS epidemic, care was primarily handled by special agencies, hospitals and clinics. These agencies have been inundated with the demands of people living with HIV/AIDS, while their resources are shrinking. As it stands now, the total assistance given to people living with HIV/AIDS is provided by relatives and this responsibility of caregiving will more increasingly rest with families. This situation is particularly salient for the rural community in South Africa, which has been disproportionately affected by the AIDS epidemic. AIDS has a tremendous impact on the entire family system, particularly on the individual who has primary responsibility for caregiving. The caregiver must cope with many circumstances that are frustrating and often beyond their control. Caring for a Person Living with HIV/AIDS (PLWHA) appears to be a major stressor in the lives of caregivers, and can be very demanding, impacting on carers financially, physically, emotionally and socially. Given the lack of research on HIV/AIDS family caregiving from a salutogenic approach, this study aimed to explore and describe the sense of coherence and coping of family caregivers of HIV/AIDS patients in the Kwazakhele area in Port Elizabeth. The sample consisted of 50 participants aged between 21 and 65 years, recruited via the Kwazakhele Masizakhe Project. An exploratory-descriptive design was employed. Data was obtained by a biographical questionnaire, the Coping Resources Inventory (CRI) and the Sense of Coherence (SOC-29) Questionnaire. A non-probability convenience sample of adult male and female family caregivers were sampled. Descriptive statistics and correlation coefficients were utilized to describe and explore the coping and sense of coherence of the family caregivers and the correlation between these constructs, respectively. The data obtained from the biographical questionnaire was analysed by using descriptive statistics and frequency counts. Key findings include the following: Results from the coping resources measure indicated that this sample perceived themselves as having an average level of coping resources. The sample tended to rely more readily on spiritual resources and less on cognitive resources. Results from the SOC-29 revealed fairly high mean scores. There is no positive relationship between the SOC-29 and the CRI for the current sample. No significant relationship existed between the SOC and the subscales of the CRI. Suggestions are made for future research, the limitations and value of research were outlined.
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10

Wichman, Heidi Sandra. "Stigma within health care settings: an exploration of the experiences of people living with HIV and AIDS." Thesis, University of the Western Cape, 2006. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_3785_1255514529.

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South Africa has one of the highest HIV and AIDS prevalence rates and the pandemic shows no signs of abating. Challenges facing South Africa in combating this pandemic include the social responses of fear, denial, stigma and discrimination. Stigma related to HIV and AIDS poses a major barrier to treating and managing HIV and AIDS. Stigma is defined as involving an attribute which significantly discredits an individual in the eyes of others or society. This attribute is therefore seen by others as being negative, something which devalues, spoils or flaws an individual. Perceived or felt stigma is described as being the anticipation of rejection and the shame of having the stigma, whereas enacted stigma refers to actual incidents of discrimination. The aim of this study was to determine, from the experiences of people living with HIV and AIDS, whether stigma manifests within the South African primary health care system.

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Books on the topic "AIDS (Disease), Patients Care. Rwanda"

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A, Moss Veronica, ed. Terminal care for people with AIDS. Sevenoaks: Edward Arnold, 1991.

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Virgilio, Margherita Di, and Ivana Cucco. AIDS: Malattia, prevenzione, assistenza. Milano: FrancoAngeli, 2000.

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Health, Great Britain Department of. AIDS-HIV infected health care workers: Practical guidance on notifying patients. London: DH, 1993.

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AIDS pastoral care: An introductory guide. Grantsburg, Wis: Arc Research Co., 1994.

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Jackson, Helen. AIDS home care: A baseline survey in Zimbabwe. Edited by Mhambi Kate and Zimunya Viola. Kopje, Harare, Zimbabwe: Journal of social development in Africa, School of Social Work, 1992.

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Home care for the client living with HIV/AIDS. Albany, NY: Delmar Publishers, 2000.

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Karmochkine, Marina. Saurai-je parler du sida?: Un médecin face à la banalisation. Paris: First éditions, 2007.

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World Health Organization. Country Office in Myanmar. Comprehensive continuum of care framework for people living with HIV/AIDS in Myanmar. Yangon: WHO, 2010.

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Liomba, George. Family and community care: Situation analysis report. [Lilongwe]: UNICEF-Malawi, 1994.

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American Psychiatric Association. Practice guideline for the treatment of patients with HIV/AIDS. Washington, D.C: The Association, 2000.

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Book chapters on the topic "AIDS (Disease), Patients Care. Rwanda"

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"The individualized care of patients with HIV disease." In HIV & AIDS, 5Ed, 264–318. CRC Press, 2003. http://dx.doi.org/10.1201/b13504-17.

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Brennan, Troyen A. "Removing Barriers to Health Care for People with HIV-Related Disease: A Matter of Law or Ethics?" In Public and Professional Attitudes Toward AIDS Patients, 55–73. Routledge, 2019. http://dx.doi.org/10.4324/9780429303388-6.

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Pahuja, Meera, and Peter Selwyn. "HIV/AIDS." In Oxford Textbook of Palliative Medicine, edited by Nathan I. Cherny, Marie T. Fallon, Stein Kaasa, Russell K. Portenoy, and David C. Currow, 949–63. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198821328.003.0089.

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AIDS has been transformed from a rapidly fatal, untreatable illness to a manageable chronic disease. Early in the AIDS epidemic, HIV care and palliative care were inseparable; over time, these two treatment paradigms diverged. Whereas palliative care for AIDS once focused primarily on end of life care and pain and symptom management related to the manifestations of AIDS-specific opportunistic infections and malignancies, it now addresses the needs of a growing number of HIV-infected patients living for years with the disease and an expanding range of comorbidities, as well as a process that has been described as ‘accelerated ageing’. Comorbid chronic diseases which commonly occur in HIV-infected patients may affect cardiovascular, pulmonary, renal, hepatic, metabolic, and neurocognitive function. Attention to the symptoms that result, and to quality of life issues and psychosocial problems in long-surviving patients, will be increasingly important to support engagement with care and effective adherence with antiretroviral therapy over time. End of life care also remains important, as patients may still die from AIDS, or even more commonly, from end-organ failure, non-AIDS defining malignancies, and/or other complications of ageing and chronic comorbid disease. All these converging factors have now resulted in a new need for the reintegration of HIV care and palliative care, both to help HIV-infected patients live better and longer, as well as to manage late-stage and end of life issues when they emerge.
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McDowell, F. H. "Rehabilitation in Parkinson's disease, day care programs for demented patients, and aids for living and home modifications for patients with neurologic physical disability." In Principles and Practice of Restorative Neurology, 152–60. Elsevier, 1992. http://dx.doi.org/10.1016/b978-0-7506-1172-5.50020-x.

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Batista, Sharon M., and Joseph Z. Lux. "A Biopsychosocial Approach to Psychiatric Consultation in Persons with HIV and AIDS." In Handbook of AIDS Psychiatry. Oxford University Press, 2010. http://dx.doi.org/10.1093/oso/9780195372571.003.0006.

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For persons with HIV and AIDS, a thorough and comprehensive assessment has far-reaching implications not only for compassionate, competent, and coordinated care but also for adherence to medical treatment and risk reduction, as well as public health. Primary physicians, HIV specialists, as well as psychiatrists and other mental health professionals can play an important role in preventing the spread of HIV infection. Psychiatric disorders are associated with inadequate adherence to risk reduction, medical care, and antiretroviral therapy. While adherence to medical care for most medical illnesses has major meaning to patients, loved ones, and families, adherence to medical care for HIV and AIDS has major implications for reduction of HIV transmission and prevention of emergence of drug-resistant HIV viral strains (Cohen and Chao, 2008). Many persons with HIV and AIDS have psychiatric disorders (Stoff et al., 2004) and can benefit from psychiatric consultation and care. The rates of HIV infection are also higher among persons with serious mental illness (Blank et al., 2002), indicating a bidirectional relationship. Some persons with HIV and AIDS have no psychiatric disorder, while others have a multiplicity of complex psychiatric disorders that are responses to illness or treatments or are associated with HIV/AIDS (such as HIV-associated dementia) or multimorbid medical illnesses and treatments (such as hepatitis C, cirrhosis, end-stage liver disease, HIV nephropathy, end-stage renal disease, anemia, coronary artery disease, and cancer). Persons with HIV and AIDS may also have multimorbid psychiatric disorders that are co-occurring and may be unrelated to HIV (such as posttraumatic stress disorder, or PTSD, schizophrenia, and bipolar disorder). The complexity of AIDS psychiatric consultation is illustrated in an article (Freedman et al., 1994) with the title “Depression, HIV Dementia, Delirium, Posttraumatic Stress Disorder (or All of the Above).” Comprehensive psychiatric evaluations can provide diagnoses, inform treatment, and mitigate anguish, distress, depression, anxiety, and substance use in persons with HIV and AIDS. Furthermore, thorough and comprehensive assessment is crucial because HIV has an affinity for brain and neural tissue and can cause central nervous system (CNS) complications even in healthy seropositive individuals. Because of potential CNS complications as well as the multiplicity of other severe and complex medical illnesses in persons with HIV and AIDS (Huang et al., 2006), every person who is referred for a psychiatric consultation needs a full biopsychosocial evaluation.
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Dognin, Joanna S., and Peter A. Selwyn. "HIV Infection and AIDS-Associated Neoplasms." In Psycho-Oncology, edited by Mark Lazenby, 226–32. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780190097653.003.0032.

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Since the advent of highly active antiretroviral therapy (HAART), people living with HIV have aged and shown a growing vulnerability to a variety of comorbidities, including cancer. While the availability of HAART has led to a sharp decrease in the rates of non-AIDS-defining malignancies (non-ADMs), HIV-infected people exhibit increased risks for a range of non-AIDS-defining cancers, both at younger ages and in more aggressive forms than non-HIV-infected persons. The uncertainty of living with both HIV and cancer places significant stressors on the patient and their family and social unit. This chapter describes the prevalence of cancer in the HIV-infected population and presents behavioral risk factors for developing cancer. It discusses three patient vignettes to illustrate how the additional burden of cancer interfaces with psychological and systemic resources required for living with HIV. As HIV extends into its fifth decade, medical practices treating HIV require additional cancer education, prevention, and intervention initiatives to better serve this vulnerable population. Finally, given the tremendous mortality still exacted by HIV disease and malignancies, HIV team models must also incorporate and integrate palliative care and end-of-life care expertise into the comprehensive care of patients living with and dying from HIV.
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Wyld, Lucy N., Clare Rayment, and Mike I. Bennett. "Definition and assessment of chronic pain in advanced disease." In Oxford Textbook of Palliative Medicine, edited by Nathan I. Cherny, Marie T. Fallon, Stein Kaasa, Russell K. Portenoy, and David C. Currow, 313–20. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198821328.003.0034.

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This chapter discusses the various definitions applied to pain including chronic, nociceptive, neuropathic, and breakthrough. It gives a broad overview of the epidemiology of pain including its prevalence of greater than 50% in those patients with advanced disease and its under-treatment. The second part of the chapter explains how best to characterize the pain complaint. It acknowledges the importance of a thorough history, including pain characteristics such as severity and associated features. Several pain measurement scales, which can be used both in clinical practice and research, are presented. Clinical examination and imaging are also discussed as aids to diagnosis and management of pain. It concludes with how to assess pain in the context of a palliative plan of care, stressing the need to consider the many challenges that patients face with advancing disease and how the management of pain is affected by other symptoms patients may have.
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Soffer, Jocelyn, and Mary Ann Cohen. "Psychotherapeutic Treatment of Psychiatric Disorders." In Handbook of AIDS Psychiatry. Oxford University Press, 2010. http://dx.doi.org/10.1093/oso/9780195372571.003.0012.

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Persons living with HIV and AIDS face a complex array of stresses and challenges, as discussed throughout this book, which may overwhelm psychological functioning. This leads to considerable distress and suffering (Cohen et al., 2002), manifests in a multitude of psychiatric symptoms, and increases nonadherence to risk reduction and medical care. The aim of psychotherapeutic care for persons with HIV is to mitigate such distress through a combination of psychosocial interventions. Goals of such therapies may include enhancing adaptive coping strategies, facilitating adjustment to living with HIV, increasing social supports, and improving a patient’s sense of purpose, self-esteem, and overall well-being. Goals may also include improving adherence to risk reduction and medical care, as well as preventing HIV transmission. Psychological distress in persons with HIV infection is associated with decreased quality of life, disease progression, and mortality (Leserman, 2008). Considering the biopsychosocial model, emotional distress in HIV can be viewed as resulting from a combination of medical, psychological, and social factors related to the illness (see Table 8.1). In some studies, improved social support and active coping styles in response to illness and stress have correlated with improved immunological parameters. Studies have also linked depressed mood and stressful life events to worsened immunological status, including decreased CD4 cell counts. Nonetheless, randomized controlled data demonstrating the ability of behavioral and social interventions to improve immune status remain conflicted; further evidence-based research is needed. While improving immunological status is a potential benefit of psychosocial treatment for people with HIV infection, it is relieving the suffering inherent to psychiatric illness and improving patients’ quality of life that remain the primary goals. A variety of psychosocial interventions are available to persons with HIV, from individual to group-based formats. Such treatments span a spectrum of psychotherapeutic approaches, including supportive, psychodynamic, interpersonal, and cognitive-behavioral. This chapter will consider the benefits of such psychosocial interventions by summarizing the current state of research and findings for each of these treatment approaches, addressing both individual and group settings.
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Goforth, Harold W., and Mary Ann Cohen. "Symptoms Associated with HIV and AIDS." In Handbook of AIDS Psychiatry. Oxford University Press, 2010. http://dx.doi.org/10.1093/oso/9780195372571.003.0013.

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Many persons with HIV and AIDS have symptoms that are unrelated to underlying psychiatric disorders but may masquerade as such. These symptoms may include insomnia, fatigue, nausea, or other troubling symptoms, and often result in suffering for patients, their families, and loved ones. The symptoms are common throughout the course of HIV and AIDS, from onset of infection to late-stage and end-stage AIDS. They need to be addressed whenever they occur and not only as part of end-of-life care. We present protocols to ameliorate or eliminate these symptoms and alleviate suffering. Fatigue is one of the most prevalent but underreported and undertreated aspects of HIV disease. The prevalence of fatigue in an HIV population has been estimated to affect at least 50% of seropositive individuals (Breitbart et al., 1998) and may affect up to 80% of the population. Darko and colleagues (1992) found that HIV-seropositive individuals were more fatigued, required more sleep and daytime naps, and showed less alert morning functioning than did persons who are HIV-seronegative. While the symptom of fatigue may fluctuate with increasing viral loads, there is no evidence base for a consistent correlation between fatigue and viral load. Fatigue is a pseudo-specific symptom common to a variety of disabilities found in an HIV population, and it has been linked to a variety of other AIDS-related disabilities including pain, anemia, impaired physical function, psychological distress, and depression. Hormonal alterations, such as those in testosterone and thyroxin, that occur in the context of HIV infection are also common in this group. While these findings are further discussed in Chapter 10, it is worth noting here that they can contribute substantially to tiredness and fatigue in this population. Other sources of fatigue include multimorbid chronic illnesses (opportunistic infections and cancers, chronic renal insufficiency, hepatitis C and other hepatic illnesses, and chronic obstructive pulmonary disease [COPD]) and some of their treatments (notably interferon/ribavirin for hepatitis C and cancer chemotherapy). Substances such as recreational drugs, nicotine, and caffeine are also factors in HIV-related fatigue.
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Grosse-Wortmann, Lars. "Assessing shunts." In The EACVI Textbook of Cardiovascular Magnetic Resonance, edited by Massimo Lombardi, Sven Plein, Steffen Petersen, Chiara Bucciarelli-Ducci, Emanuela R. Valsangiacomo Buechel, Cristina Basso, and Victor Ferrari, 509–15. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198779735.003.0050.

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Appropriate care for patients with shunt lesions mandates an exact understanding of their anatomy and haemodynamics. While echocardiography remains the first-line imaging tool and is frequently sufficient in the evaluation of shunts, there are situations in which the anatomical delineation remains incomplete and the shunt magnitude is uncertain. Cardiovascular magnetic resonance (CMR) demonstrates the anatomy of intra- and extra-cardiac shunts and is the gold standard for the quantification of shunt magnitude and ventricular volume loading. Particularly in complex shunt lesions and patients with insufficient acoustic windows, CMR is a valuable diagnostic tool. Short-cut communications between the pulmonary and systemic circulation shunts occur in isolation or as part of complex congenital heart disease. This chapter explores how CMR aids in the diagnosis, workup, and interventional planning of shunt lesions.
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