Publikationer pr. år
Publikationer pr. år
Johanna Åhsberg, Peter Puplampu, Augustine Kwashie, Joseph Oliver Commey, Vincent Jessey Ganu, Michael Amo Omari, Yaw Adusi-Poku, Åse Bengård Andersen, Ernest Kenu, Margaret Lartey, Isik Somuncu Johansen, Stephanie Bjerrum
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review
Background: The lateral flow urine lipoarabinomannan assay, Determine TB LAM (Determine LAM), offers the potential for timely tuberculosis (TB) treatment among people with human immunodeficiency virus (PWH). Methods: In this cluster-randomized trial, Determine LAM was made available with staff training with performance feedback at 3 hospitals in Ghana. Newly admitted PWH with a positive World Health Organization four-symptom screening for TB, severe illness, or advanced HIV were enrolled. The primary outcome was days from enrollment to TB treatment initiation. We also reported the proportion of patients with a TB diagnosis, initiating TB treatment, all-cause mortality, and Determine LAM uptake at 8 weeks. Results: We enrolled 422 patients including 174 (41.2%) in the intervention group. The median CD4 count was 87 (interquartile range [IQR], 25-205) cells/μL, and 32.7% were on antiretroviral therapy. More patients were diagnosed with TB in the intervention compared with the control group: 59 (34.1%) versus 46 (18.7%) (P <. 001). Time to TB treatment remained constant, but patients were more likely to initiate TB treatment (adjusted hazard ratio, 2.19 [95% CI, 1.60-3.00]) during the intervention. Of patients with a Determine LAM test available, 41 (25.3%) tested positive. Of those, 19 (46.3%) initiated TB treatment. Overall, 118 patients had died (28.2%) at 8 weeks of follow-up. Conclusions: The Determine LAM intervention in real-world practice increased TB diagnosis and the probability of TB treatment but did not reduce time to treatment initiation. Despite high uptake, only half of the LAM-positive patients initiated TB treatment.
Originalsprog | Engelsk |
---|---|
Tidsskrift | Clinical Infectious Diseases |
Vol/bind | 77 |
Udgave nummer | 8 |
Sider (fra-til) | 1185-1193 |
ISSN | 1058-4838 |
DOI | |
Status | Udgivet - 15. okt. 2023 |
Publikation: Afhandling › Ph.d.-afhandling