Chenai Mathabire, Zimbabwean Doctors Without Borders (MSF) nurse and researcher has won an HIV/TB Research Prize at this year’s International Aids Society Conference on HIV Science (IAS2017). Through a study conducted in Malawi and Mozambique, Chenai has provided strong evidence that an easy-to-use point-of-care TB LAM test, which quickly diagnoses tuberculosis (TB) in severely ill HIV patients, is feasible to use in real-life clinics with high numbers of HIV-TB patients.
TB is the biggest killer of people living with advanced HIV, with over 400,000 patients dying each year from the disease. People with advanced HIV, also known as Acquired Immune Deficiency Syndrome (AIDS) have very weakened immune systems, leaving them susceptible to common infections, which can quickly become deadly.
Successfully treating ill AIDS patients involves rapidly assessing the strength of their immune systems and putting them on the right treatment straight away, whether they have TB or another disease deadly to HIV patients, cryptococcal meningitis.
However, in poorer countries, limited laboratory and X-ray facilities, and the time spent waiting on results can mean long and often deadly delays for sick patients arriving at clinics or hospitals. At the same time, people with late-stage HIV often can’t produce enough sputum for more common TB sputum tests so common tests such as sputum microscopy cannot be done. X-rays are also less useful to detect TB in people with advanced HIV.
At $3 per test, the TB LAM test offers a quick, simple and cost-effective alternative that gives on-the-spot results in 30 minutes. Yet despite being available since 2010, only 140,000 TB LAM tests are used each year.
“In Malawi, some HIV patients with suspected TB were waiting months for laboratory or X-ray results to come back. Clinicians don’t like to start patients on treatment based only on clinical signs and symptoms, they prefer to have a diagnostic test result,” says Chenai, who was responsible for implementing and supervising the study. “The TB LAM test helped them make that decision, and they felt better about starting HIV patients on TB treatment. It doesn’t replace existing tests, but adding this test helps us identify more TB cases and can improve the patients’ chances of survival.”
The test uses the HIV patient’s urine to detect LAM (Lipoarabinomanan), a protein created when TB bacteria cells break down. The lower the patients’ immunity, which is measured by numbers of CD4 T-cells, the more LAM appears in the urine and the more sensitive the test becomes. This is why the test is recommended for use in patients with CD4 cells below 100. The MSF study found the test was well accepted by staff, easy to use, and led to better, faster results than sputum or X-ray tests. Nearly 99% of TB LAM test patients received a timely result, versus 70% with sputum and 35% with X-rays.
Currently the main barrier to wider use of the TB LAM test by national governments is that it isn’t included in country guidelines and national TB programmes are not actively pushing it. Use of the TB LAM test has been recommended by the new WHO guidelines for advanced HIV for use in severely ill patients in hospitals but not yet in primary care, given the test’s decreased accuracy in patients with stronger immune responses.
MSF will use the study to advocate for health ministries in countries with high HIV TB burdens to use the TB LAM test in primary care and hospital centres, as well as include TB LAM within a diagnostic package for patients with advanced HIV. This would include point-of-care tests for CD4 (to allow rapid bed-side assessment of immune strength), cryptococcal meningitis and TB to help quick diagnosis and, most importantly, improve patients’ chances of survival.
MSF currently uses TB LAM as part of a diagnostic package in HIV projects in Democratic Republic of Congo (DRC), Guinea, Kenya, Malawi, Mozambique, Niger, Uganda and Zimbabwe. MSF currently supports over 230,000 people living with HIV on antiretrovirals in 19 countries, with a focus on free quality care, and provides free hospital-based care for people living with advanced HIV in DRC, Kenya Guinea, and Malawi.
Governor Wike proscribes IPOB’s activities in Rivers
Governor Nyesom Wike of Rivers state has signed an Executive Order proscribing the Indigenous People of Biafra (IPOB) in the state.
Governor Wike, who made this known on Wednesday during a state-wide broadcast in Port Harcourt, also emphasized that the state is home to all tribes.
According to him, “We have everything against the presence and activities of the legally proscribed and anarchic Indigenous People of Biafra (IPOB) and whatever that group stands for in Rivers State.
“This is clearly a terrorist group whose existence, creed, mission, and activities are strongly denounced even by the Government and peoples of the South-Eastern States of the country.
“I have therefore signed the executive order to reinforce the total ban on IPOB and its activities in Rivers State or any part thereof and nothing will stop us from enforcing this ban in its entirety”, Governor Wike assured
Oyo: Makinde Mother’s Burial Holds December
Body of Chief (Mrs.) Abigail Makinde, the mother of Oyo state governor, Engr. Seyi Makinde will be interred in the first week of December.
Governor Makinde disclosed this yesterday while playing host to a delegation from the Deji of Akure, Oba Aladetoyinbo Aladelusi Ogunlade Odundun II, which was in Ibadan, the state capital to commiserate with him on the death of his mother.
The governor said he was very delighted with the visit, urging Akure people, the kingdom where his mother was born, to actively participate in her funeral.
Makinde, who described them as one of the most upright, bold and honest people in Yoruba land and the nation at large, also added that his late mother was a role model whose dedication to work, uprightness, boldness and honesty were the traits of Akure people.
A statement by Mr. Taiwo Adisa, the Chief Press Secretary to Governor Makinde, quoted the governor as saying “when you see an average Akure man or woman, you see courage and see people who are true to their words.”
While delivering the condolence message from the Deji of Akure, the leader of the delegation, who is the Asae of Akure Kingdom, Senior High Chief Sola Adegbonmire, described the governor’s mother as a worthy daughter of Akure Kingdom.
He stressed that the Omoregie family, where Madam Abigail Omojolagbe Makinde hailed from, is a family of exceptional and wonderful people in Akureland.
Oba Aladetoyinbo further described the death of Madam Makinde as a painful loss not only to the Makinde family but also to the entire Akure Kingdom.
He then prayed that God would grant the family the fortitude to bear the irreparable loss.
‘My mother was an epitome of love, humility’ – Gov. Makinde mourns
The Oyo state governor, Engr Seyi Makinde, has described his late mother, Chief (Mrs.) Abigail Omojolagbe Makinde, as an epitome of love and humility, despite being a disciplinarian.
The governor stated this on Friday while receiving the National Working Committee (NWC) of the Peoples Democratic Party (PDP) led by the National Chairman, Prince Uche Sencondus, on a condolence visit to his house at Ikolaba GRA, Ibadan.
According to a statement signed by the Chief Press Secretary to Governor Makinde, Mr. Taiwo Adisa, the governor expressed gratitude to the PDP NWC, noting that the fact that the leadership of the party made it to Ibadan barely 24 hours after Mama’s demise showed the love they have for him.
The statement also noted that apart from the PDP NWC entourage, the Aare Musulumi of Yorubaland, Edo, and Delta States, Alhaji Daud Akinola, Chief Imam of Ibadanland, Sheikh AbdulGaniyy Abubakri Agbotomokekere, the Grand Mufti of Ibadanland, Sheikh Abdul Fatai Alaga, and other Muslim leaders also paid condolence visits to the governor.
Similarly, the Oyo State Judiciary led by the Chief Justice of the state, Justice Muntar Abimbola, and the General Officer Commanding, 2 Div, Nigerian Army, Ibadan, Major General Anthony Omozoje, were also at the Makinde residence to condole with the governor.
Speaking while receiving the PDP entourage, which included the National Organising Secretary, Col. Austin Akobundu (retd); Deputy National Secretary; National Financial Secretary, Alhaji Abdullahi MaiBasira; National Woman Leader, Hajia Mariya Waziri; National Publicity Secretary, Mr. Kola Ologbondiyan, as well a leader of the PDP from Osun State, Hon. Soji Adagunodo, Governor Makinde said the family remains grateful to God for the life Mama lived.
He said: “I want to thank you most sincerely for this condolence visit. I want to say, on behalf of myself, my wife, immediate family, and extended family, we are very grateful and appreciative of this visit. This happened yesterday morning and you are here this morning. It shows that you truly love me. So, I want to say thank you.
“Actually, we were preparing for my mummy’s 81st birthday, which would have been on the November 7, exactly three weeks from yesterday. But who are we to question God?
“We are grateful to God for the life she lived. To us, she was an epitome of love, humility. She was tough. If you see that trait in some of us, it came from her. And we also thank God that it was not like we were carrying her from one hospital to the other. She died peacefully in her sleep. So, we thank God for what He has done.”
Governor Makinde, who also took the opportunity to appreciate the PDP NWC for the confidence it had in him to lead the Ondo State governorship campaign, said what the outcome of the election meant was that the party would have to go back to the drawing board, adding that the campaign council will submit a report as soon as practicable.
“I will also like to use this opportunity to thank the National Working Committee of our great party for the opportunity you gave to us to lead the campaign in Ondo State. We can’t question God for the outcome of that election. What it means is that we have to go back to the drawing board. We will be submitting a report of those areas where we fell short, to the NWC as soon as practicable.
“I really want to use this opportunity to thank all of you who were there in Akure for the love of our party and for the support that you gave to our candidate in Ondo State.
“Once again, my Chairman, I am appreciative of this visit and I thank you and all the members of the NWC of our party.”
Earlier, the PDP national chairman said that the visit was to condole with the governor and the family for the loss of their mother.
He said: “A time like this is the time you know those who care and those who are with you. Unfortunately, we have two situations on our hands. We lost the chairman of the party in Zamfara. Obviously, we divided ourselves; the Deputy National Chairman of the party left for Zamfara yesterday morning for the burial of our late chairman of the party. And I and the rest of us in the National Working Committee leadership decided yesterday to come to Ibadan today.
“We are here by the grace of God to console you and the rest of the members of your family. We have no other way to do it than to join you in prayers.
“It is a very painful experience that you have to go through, sometimes alone. I know what it is because I have experienced it. It is only God that can fill the vacuum in your heart because the care of a mother is quite different from that of a father.
“So, on behalf of the leadership of our party, we are here to console you on this condolence visit. The Lord will strengthen you. And because you are one of our best and doing good works for the people of Oyo State and at this time that you are giving out your best, suddenly, God who gives has taken your beloved mother.
“We are here to share the pain and sorrow with you and to let you know we will continue in prayers during this period, even as we prepare for the funeral. After the funeral, we will continue to pray for you, your immediate and larger family. It is important for us to do so, having worked with you and having seen you as a man who is compassionate and cares for others.
“Today, we are here with you and we pray that God will energise you at this period and stretch His right hand of righteousness to touch every one of the members of the family to bear this great loss.
“Therefore, as members of the National Working Committee, we pray that God will keep you now and thereafter to make you continue to do the good work for the people of Oyo State
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