Closing gaps in antiretroviral therapy access: human immunodeficiency virus-associated dementia screening instruments for non-physician healthcare workers.

Full Abstract

Human immunodeficiency virus-associated dementia (HIV-D) is an indication for antiretroviral therapy (ART), but HIV-D is not routinely screened for in ART clinics in sub-Saharan Africa. Given the dearth of physicians in sub-Saharan Africa, enabling non-physician healthcare workers to identify HIV-D is crucial for early treatment initiation and preventing chronic neurologic disability. Non-physician healthcare workers administered locally adapted screening instruments to 48 persons living with acquired immunodeficiency syndrome (PLWAs), and 15 healthy comparison persons provided normative data. Stage IV PLWAs performed worse than the comparison group on all tests. Overall, 24 (50%) of 48 PLWAs had significant cognitive impairment. Among HIV staging categories, 1 stage II (33%), 6 stage III (42%), and 17 stage IV (55%) patients were identified as cognitively impaired. Our pilot study indicates that screening instruments used by non-physician healthcare workers can identify cognitive impairment in PLWAs and may facilitate appropriate initiation of ART in resource-poor settings.

Author information

Author/s: Kvalsund, Michelle P (MP); Haworth, Alan (A); Murman, Daniel L (DL); Velie, Ellen (E); Birbeck, Gretchen L (GL);

Affiliation: International Neurologic and Psychiatric Epidemiology Program, and College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan 48824, USA.

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: The American journal of tropical medicine and hygiene (Am J Trop Med Hyg), published in United States. (Language: eng)

Reference: 2009-Jun; vol 80 (issue 6) : pp 1054-9

Dates: Created 2009/05/29; Completed 2009/06/25;

PMID: 19478275, status: MEDLINE (last retrieval date: 6/25/2009, IMS Date: 25 Jun 2009 00:00:00)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

External Links for this article
(including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.

MeSH headings (categories)

This article was linked to the MESH Headings shown below.

AIDS Dementia Complex - diagnosis; epidemiology
Adult
Anti-HIV Agents - administration & dosage; therapeutic use
Cross-Sectional Studies
Female
Health Personnel

Associated Chemicals: Anti-HIV Agents (0)

This article has not been indexed for related articles as yet, however you can still use the live related article search links below.

See 100+ related articles.

See a large map of 100+ related articles.