14 research outputs found

    S1 File -

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    IntroductionHIV viral load (VL) testing in resource-limited settings is often centralised, limiting access. In Myanmar, we assessed outcomes according to VL access and the VL cascade (case management after a first high VL result) before and after near point-of-care (POC) VL was introduced.MethodsRoutine programme data from people living with HIV (PLHIV) on antiretroviral therapy (ART) were used. We assessed the odds of getting a VL test done by year. Attrition and mortality two years after ART initiation were compared between three groups of PLHIV with different access to VL testing using Kaplan-Meier analysis. We compared VL cascades in those with a first VL result before and after near POC VL testing became available. With logistic regression, predictors of confirmed virological failure after a first high VL in the POC era were explored.ResultsAmong 4291 PLHIV who started ART between July 2009 and June 2018, 794 (18.5%) became eligible for VL testing when it was not available, 2388 (55.7%) when centralised laboratory-based VL testing was available, and 1109 (25.8%) when near POC VL testing was available. Between 2010 and 2019, the odds of getting a VL test among those eligible increased with each year (OR: 5.21 [95% CI: 4.95ÔÇô5.48]). Attrition and mortality were not different in the three groups. When comparing PLHIV with a first VL result before and after implementation of the near POC VL testing, in the latter, more had a first VL test (92% versus 15%, pConclusionNear POC VL testing enabled rapid increase of VL coverage and a well-managed VL cascade in Myanmar.</div

    Factors associated with confirmed virological failure in ART patients with enhanced adherence counselling after a first high near POC VL in Yangon, Myanmar.

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    Factors associated with confirmed virological failure in ART patients with enhanced adherence counselling after a first high near POC VL in Yangon, Myanmar.</p

    Comparing outcomes on ART among PLHIV with different access to VL testing.

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    Panel A, C present two-year attrition (dead, lost-to-follow-up) and panel B, D two-year mortality between PLHIV on ART who when becoming eligible had no access to VL testing (Group 1: No VL), access to laboratory-based VL testing (Group 2: Laboratory-based VL) or access to near POC VL testing (Group 3: Near POC VL). Panels A and B include all three groups while Panels C and D only. compare Groups 2 and 3. ART = antiretroviral therapy, PLHIV = people living with HIV/AIDS, POC = point of care, VL = viral load.</p

    Comparison of cascade after a first high VL before and after near POC VL testing was implemented.

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    Comparison of cascade after a first high VL before and after near POC VL testing was implemented.</p

    Baseline characteristics by access to VL testing of PLHIV initiated on ART between June 2009 and July 2018 in three clinics in Yangon, Myanmar.

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    Baseline characteristics by access to VL testing of PLHIV initiated on ART between June 2009 and July 2018 in three clinics in Yangon, Myanmar.</p

    MOESM1 of Genetic polymorphisms in the circumsporozoite protein of Plasmodium malariae show a geographical bias

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    Additional file 1. Frequency distribution of the NAAG tetrapeptide repeat unit in the central repeat region of pmcsp. (a) Frequency distribution of the repeat unit in isolates collected from Thailand, Myanmar, Kenya, and Cameroon. (b) Frequency distribution of the repeat unit in isolates collected from Asia and Africa. X-axis represents the number of repeat units, and Y-axis indicates the number of samples corresponding to each repeat unit
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