A Holistic framework to integrate HIV and cardiovascular disease care in sub-saharan Africa

Rahim, Faraan; Jain, Bhav; Bloomfield, Gerald S.; Jain, Pankaj; Rugakingira, Anzibert; Thielman, Nathan M.; Sakita, Francis; Hertz, Julian T.

doi:10.1097/qad.0000000000003604

Cited by 2 publications

(1 citation statement)

References 47 publications

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“…We recommend that prominent global HIV organizations, such as The Global Fund and The U.S. President’s Emergency Plan for AIDS Relief, consider allocating funds towards strengthening health infrastructure to mitigate the dual burden of HIV and CVD throughout the region. In particular, integrated care for HIV and CVD has shown early promise and may therefore merit investment [ 55 ].…”

Section: Discussionmentioning

confidence: 99%

Longitudinal ECG changes among adults with HIV in Tanzania: A prospective cohort study

Rahim,

Sakita,

Coaxum

et al. 2023

PLOS Glob Public Health

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The prevalence of cardiovascular disease (CVD) is rising among people with HIV (PWH) in sub-Saharan Africa (SSA). Despite the utility of the electrocardiogram (ECG) in screening for CVD, there is limited data regarding longitudinal ECG changes among PWH in SSA. In this study, we aimed to describe ECG changes over a 6-month period in a cohort of PWH in northern Tanzania. Between September 2020 and March 2021, adult PWH were recruited from Majengo HIV Care and Treatment Clinic (MCTC) in Moshi, Tanzania. Trained research assistants surveyed participants and obtained a baseline ECG. Participants then returned to MCTC for a 6-month follow-up, where another ECG was obtained. Two independent physician adjudicators interpreted baseline and follow-up ECGs for rhythm, left ventricular hypertrophy (LVH), bundle branch blocks, ST-segment changes, and T-wave inversion, using standardized criteria. New ECG abnormalities were defined as those that were absent in a patient’s baseline ECG but present in their 6-month follow-up ECG. Of 500 enrolled participants, 476 (95.2%) completed follow-up. The mean (± SD) age of participants was 45.7 (± 11.0) years, 351 (73.7%) were female, and 495 (99.8%) were taking antiretroviral therapy. At baseline, 248 (52.1%) participants had one or more ECG abnormalities, the most common of which were LVH (n = 108, 22.7%) and T-wave inversion (n = 89, 18.7%). At six months, 112 (23.5%) participants developed new ECG abnormalities, including 40 (8.0%) cases of new T-wave inversion, 22 (4.6%) cases of new LVH, 12 (2.5%) cases of new ST elevation, and 11 (2.3%) cases of new prolonged QTc. Therefore, new ECG changes were common over a relatively short 6-month period, which suggests that subclinical CVD may develop rapidly in PWH in Tanzania. These data highlight the need for additional studies on CVD in PWH in SSA and the importance of routine CVD screening in this high-risk population.

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Section: Discussionmentioning

confidence: 99%

Longitudinal ECG changes among adults with HIV in Tanzania: A prospective cohort study

Rahim,

Sakita,

Coaxum

et al. 2023

PLOS Glob Public Health

Self Cite

View full text Add to dashboard Cite

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Expanding healthcare access in rural sub-Saharan Africa

Anand,

Ayodele,

Ashraf

et al. 2024

Perspect Public Health

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While healthcare delivery in sub-Saharan Africa (SSA) has made notable strides, the benefits of improved access predominantly favour urban areas, leaving rural communities largely underserved. A multitude of barriers contribute to this disparity, including inadequate funding, a shortage of trained medical professionals, insufficient transportation, underdeveloped infrastructure, and entrenched educational and cultural beliefs. As rural SSA populations grapple with escalating burdens in infectious diseases such as HIV, malaria, tuberculosis, and heightened risks during childbirth and pregnancy, it becomes imperative to confront these obstacles in healthcare delivery and enhance healthcare provision in these regions.

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A Holistic framework to integrate HIV and cardiovascular disease care in sub-saharan Africa

Cited by 2 publications

References 47 publications

Longitudinal ECG changes among adults with HIV in Tanzania: A prospective cohort study

Longitudinal ECG changes among adults with HIV in Tanzania: A prospective cohort study

Expanding healthcare access in rural sub-Saharan Africa

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