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Fulltext Challenges in expanding access to antiretroviral therapy for key affected populations

Kamarulzaman A

Public Health Action, 2014 Jun 21;4(2):73.
PMID: 26393075 DOI: 10.5588/pha.14.0050
Fulltext Enrolment and retention of people who inject drugs in the Needle & Syringe Exchange Programme in Malaysia

Chandrasekaran S, Kyaw NTT, Harries AD, Yee IA, Ellan P, Kurusamy T, et al.

Public Health Action, 2017 Jun 21;7(2):155-160.
PMID: 28695090 DOI: 10.5588/pha.17.0003

Setting: Needle and Syringe Exchange Programme (NSEP) implemented by non-governmental organisations in Malaysia. Objectives: To determine enrolment, characteristics and retention in the NSEP of people who inject drugs (PWID) between 2013 and 2015. Design: Retrospective cohort study. Results: There were 20 946 PWID, with a mean age of 38 years. The majority were male (98%) and of Malay ethnicity (92%). Follow-up data were available for 20 761 PWID. Annual retention of newly enrolled PWID for each year was respectively 85%, 87% and 78% for 2013, 2014 and 2015, although annual enrolment over these years declined from 10 724 to 6288 to 3749. Total person-years (py) of follow-up were 27 806, with loss to follow-up of 40 per 100 py. Cumulative probability of retention in NSEP was 66% at 12 months, 45% at 24 months and 26% at 36 months. Significantly higher loss to follow-up rates were observed in those aged 15-24 years or ⩾50 years, females, transgender people and non-Malay ethnic groups. Conclusion: Annual retention of new PWID on NSEP was impressive, although enrolment declined over the 3 years of the study and cumulative loss to follow-up was high. A better understanding of these programmatic outcomes is required.
Fulltext A nested case-control study on relapse predictors among tuberculosis patients treated in Yemen's NTCP

Anaam MS, Ibrahim MI, Al Serouri AW, Bassili A, Aldobhani A

Public Health Action, 2012 Dec 21;2(4):168-73.
PMID: 26392978 DOI: 10.5588/pha.12.0044

SETTING: The National Tuberculosis (TB) Control Programme in Yemen.
OBJECTIVE: To identify risk factors associated with TB relapse.
METHODS: In a prospective nested case-control study, relapse cases were recruited from a cohort of pulmonary TB patients registered between July 2007 and June 2008. Four controls per case were randomly selected from the list of non-relapse patients. Three forms were used for data collection, which included interviews with the participants and review of their medical cards and TB registers. Multivariate logistic regression analysis was performed to identify independent risk factors for relapse.
RESULTS: A relapse rate of 5.7% was found. Multivariate logistic regression analysis showed that unemployment, smoking, presence of cavitations, weight gain, weight loss, non-adherence during the continuation phase and diabetes were significantly associated with relapse (P < 0.05).
CONCLUSION: Relapse rates can be reduced by ensuring that patients take their treatment regularly and are counselled effectively to stop smoking. Reinforcing the implementation of the DOTS strategy and strengthening the anti-smoking campaigns are important actions. Action to help unemployed patients, including free services and the creation of new job opportunities, should be adopted. Using rifampicin-based regimens in the treatment of cavitary TB and bi-directional screening in TB and diabetes patients are recommended.

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