ORCID Profile
0000-0003-0466-1976
Current Organisations
University of Cambridge
,
University of Oxford
,
World Health Organization
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Publisher: Hindawi Limited
Date: 2018
DOI: 10.1017/GHEG.2018.7
Abstract: Anti-retroviral therapy (ART) regimes for HIV are associated with raised levels of circulating triglycerides (TGs) in western populations. However, there are limited data on the impact of ART on cardiometabolic risk in sub-Saharan African (SSA) populations. Pooled analyses of 14 studies comprising 21 023 in iduals, on whom relevant cardiometabolic risk factors (including TG), HIV and ART status were assessed between 2003 and 2014, in SSA. The association between ART and raised TG ( .3 mmol/L) was analysed using regression models. Among 10 615 in iduals, ART was associated with a two-fold higher probability of raised TG (RR 2.05, 95% CI 1.51–2.77, I2 = 45.2%). The associations between ART and raised blood pressure, glucose, HbA1c, and other lipids were inconsistent across studies. Evidence from this study confirms the association of ART with raised TG in SSA populations. Given the possible causal effect of raised TG on cardiovascular disease (CVD), the evidence highlights the need for prospective studies to clarify the impact of long term ART on CVD outcomes in SSA.
Publisher: No publisher found
Date: 31-03-2021
Publisher: Informa UK Limited
Date: 02-2013
Publisher: Oxford University Press (OUP)
Date: 03-1998
DOI: 10.1016/S0035-9203(98)90727-1
Abstract: The prevalence of pulmonary tuberculosis (PTB) in patients with short duration of cough was determined. Ninety-eight adult out-patients (60 men, 38 women mean age 32 years) at Queen Elizabeth Central Hospital, Blantyre, Malawi, who had cough for 1-3 weeks which was unresponsive to a course of antibiotics, were successfully screened by microscopy and culture of 2 or 3 sputum specimens and chest radiography 34 (35%) had PTB. Ten patients were sputum smear-positive and 24 were smear-negative and culture-positive. There was no difference in age, gender or clinical features of general illness, respiratory disease and HIV-related disease between patients with PTB and those with no evidence of PTB. Nine patients (26%) with microbiologically confirmed tuberculosis (TB) had chest radiograph abnormalities consistent with TB, compared with 5 (8%) of patients with no microbiological evidence of TB. Certain classes of patients with a short history of cough would benefit from PTB screening strategies with the emphasis on sputum examination rather than chest radiography, which is unreliable in such patients. The classes include (i) patients with other features of TB whose cough has not improved with antibiotic therapy, (ii) seriously ill patients, and (iii) patients in high risk institutions such as prisons and refugee c s.
Publisher: Oxford University Press (OUP)
Date: 07-1997
DOI: 10.1016/S0035-9203(97)90262-5
Abstract: Alternative strategies for screening tuberculosis (TB) suspects are needed in sub-saharan Africa. Ambulatory adult TB suspects who were seen in the chronic cough room of Queen Elizabeth Central Hospital, Blantyre, Malawi, were assessed with respect to appropriateness of referral. Appropriate referrals (patients with cough 3 weeks or longer, weight loss and no antibiotic response) were screened by 3 sputum specimens for microscopy and culture of Mycobacterium tuberculosis and chest radiography (CXR). Hypothetical strategy A (screening by sputum smear examination followed by CXR in patients with negative sputum smears) was compared with strategy B (screening by CXR followed by sputum smear examination in patients with a CXR consistent with TB) in terms of diagnostic efficacy and cost. Of 1127 patients referred to the cough room, 402 (38%) were appropriate TB suspect referrals. Of these, 111 (28%) were sputum smear-positive, 213 (53%) were culture-positive, and 221 (55%) had smear and/or culture-positive evidence of TB. Routine CXR was consistent with pulmonary (P) TB in 230 patients (57%). With strategy A, 243 (60%) patients were diagnosed as PTB, but 40 (25%) of those not diagnosed as PTB had positive mycobacterial cultures. With strategy B, 230 patients (57%) were diagnosed as PTB, but 53 (31%) of those not diagnosed as PTB had positive mycobacterial cultures, including 13 with smear-positive sputum. The cost per diagnosed case of PTB was US$ 4.63 with strategy A and US$ 5.44 with strategy B. Screening patients with good criteria of TB has high diagnostic sensitivity, but screening by CXR is less effective and more costly than screening by sputum smear microscopy.
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Dermot Maher.