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F Dabis

Publications and source records attributed to F Dabis.

203 records · Page 12Linked to original sources
PubMedDate not supplied

[Attitudes to counseling related to HIV infection screening in Bobo-Dioulasso, Burkina Faso].

Two approaches, a questionnaire administered to pregnant women and interviews independently with selected individuals in posts of responsibility, were used to assess (i) the perception of HIV screening among patients attending a Maternal and Child Health Clinic and (ii) the attitudes of health staff and local authorities. One hundred and thirty five pregnant women were individually interviewed in their native language at the Farakan Maternal and Child Health Clinic, Bobo Dioulasso. Ninety six percent accepted the principle of being screened for HIV, and 91% wanted to be given the result, 46% in the presence of a family member. The person most often chosen to share the announcement of the result was the regular partner. Three physicians, two midwives, a hospital director, a parish priest and a politician were interviewed. One midwife did not approve of offering screening tests in the absence of available treatment. Four of these individuals suggested that the presence of a member of the family during counselling would be valuable to promote a sense of partnership. Many reasons were given to explain the difficulties associated with announcing the results of tests. They included: the absence of treatment; the cost of the test; the lack of confidentiality; psychosocial consequences; the reaction, particularly fear, of the patient; difficulties associated with communication and with changing behavior. These observations contribute to a basis for analysis to develop a local and national consensus about HIV testing and counselling for pregnant woman.

Adolescent↗
PubMedDate not supplied

[Human immunodeficiency virus infection and AIDS in Aquitaine. 10 years' experience of a hospital information system, 1985-1995. Le Groupe d'Epidemiologie Clinique du SIDA en Aquitaine (GECSA)].

OBJECTIVES: To describe the hospital-based information system developed by the GESCA (Clinical epidemiology group on AIDS in Aquitaine) and evaluate the main results obtained over the last 10 years, specifically data related to epidemiological monitoring, medico-economic analysis and clinical research in HIV infection. METHODS: Inclusion criteria were HIV-1 seropositivity confirmed by Western blot, age over 13 years, consultation or hospitalization is one of the 18 participating units. Follow-up data were collected at each hospital visit. RESULTS: On December 31, 1995, 4268 subjects had been registered in the GECSA system, including 25.7% women. Contamination categories were homosexuals 33.4%, intravenous drug abusers 32.8%, heterosexuals 13.9%. A clear drop in the number of new cases in intravenous drug abusers and an increase in the number with heterosexual transmission was observed after 1988. The medico-economic analysis showed that patients followed in the system were in a more advanced stage at registry since 1992. More than half of the subjects are now taking antiretroviral therapy and prophylaxis for opportunistic infections. Clinically, after adjusting data for the major known prognosis factors, the risk of progression to AIDS is higher in homosexuals and intravenous drug abusers than in heterosexuals. Transmission route does not however have any significant effect on survival after development of AIDS. There is no significant difference in outcome of HIV infection between men and women and pregnancy is not associated with poorer outcome. CONCLUSION: This regional registry provides valuable data for epidemiological monitoring, medico-economic analysis, hospital management and clinical research.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[Primary chemoprevention of tuberculosis in HIV-infected patients in non-industrialized countries].

In randomized placebo-controlled trials in Haïti, Zambia and Uganda, prophylactic use of isoniazid (INH) for 6 to 12 months reduced the annual incidence of tuberculosis in HIV-infected patients by more than 50 per cent. For several years, WHO, IUTATLD and CDC have recommended that HIV-positive patients testing positive in a PPD test should be treated with INH as a form of anti-tuberculosis chemoprophylaxis (ATC). Whilst these recommendations are easy to follow in industrialized countries, widespread use of ATC in developing countries remains problematic because: (i) It is unknown what proportion of patients are likely to be re-infected at the end of ATC in countries where TB is endemic; (ii) It is possible that resistant bacilli may be selected due to the incomplete exclusion from the ATC program of patients with active TB at enrollment; (iii) It is difficult to identify asymptomatic carriers of M. tuberculosis at enrollment; (iv) It is doubtful that all patients will comply with a treatment regime which lasts several months; (v) The cost of a widespread ATC program, whose full benefit remains to be evaluated, may be difficult to justify. This paper attempts to review these issues and demonstrates the need for more population-based clinical trials in the field.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

[Attitudes and behavior of pregnant women towards HIV screening in Abidjan (Ivory Coast) in 1995 and 1996].

A research program into ways of reducing the maternal transmission of HIV (Project DITRAME, trial ANRS 049) was started in December 1994 in the maternity and child health clinics of the University Hospital and a community health center (Formation Sanitaire de Yopougon, FSU) in Abidjan. The first stage of this program was the introduction of voluntary HIV testing for pregnant women. During their first visit to the maternity clinic, all women were asked their age, how long they had been pregnant and where they were planning to give birth. Women over the age of 18, less than 32 weeks into gestation, who were planning to give birth in Abidjan were routinely offered an HIV test. Women who gave written consent to the test then gave a blood sample for HIV testing. Those testing positive for HIV were given posttest counseling and were invited to participate in a clinical trial of AZT. There were high rates of refusal to be tested and failure to return for posttest counseling during the first year of voluntary HIV testing. We therefore carried out a qualitative study of the reasons for refusal and failing to return. The study involved in-depth interviews with 50 pregnant women who refused to be tested and 50 others who missed the posttest appointment. Most of the women who refused to be tested thought they were probably HIV-positive. The main reason for refusing the test was the fear that the disease process would accelerate once they were informed of their HIV infection. Many women were also afraid of the reactions of their relatives, and particularly of their husband or partner, to a positive test result. There was also concern about possible breaches of confidentiality. Some women felt that pregnancy was not the best time to find out that they were HIV-positive. The reasons for not returning after testing were essentially the same, although some women were confused about the date of the appointment or did not understand the difference between standard prenatal blood test and HIV testing. Our study shows that even when most pregnant women accept the test, there are persistent problems. Some relate to the perception of HIV infection in Africa as "the disease" that cannot be cured, resulting in the view that there is no point in knowing that you are infected. Refusal to be tested is also associated with the socioeconomic vulnerability of women and their fear of exclusion. Means of reducing the maternal transmission of HIV will shortly become available in developing countries. Therefore, we need to address this problem and make voluntary HIV testing for pregnant women as widely available as possible.

Adult↗