Evaluation of impact of long-lasting insecticide-treated bed nets and point-of-use water filters on HIV-1 disease progression in Kenya

Walson, Judd L.; Sangaré, Laura; Singa, Benson; Naulikha, Jacqueline M.; Piper, Benjamin K. S.; Yuhas, Krista; Onchiri, Frankline; Otieno, Phelgona; Mermin, Jonathan; Zeh, Clement; Richardson, Barbra A.; John‐Stewart, Grace

doi:10.1097/qad.0b013e32835ecba9

Cited by 18 publications

(39 citation statements)

References 22 publications

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“…The study was nested in a prospective cohort study in which ART-naïve, HIV-1-infected adults were enrolled to determine the impact of a point-of-care water filtration device (Lifestraw Family Filtration Device; Vestergaard Frandsen, Lausanne, Switzerland) and longlasting insecticide treated bed nets (LLINs) on HIV disease progression. 27 The filter removes particles larger than 20 nm and in controlled settings, reduces waterborne bacteria, viruses, and protozoan cysts by at least 99.9%. 28 Three hundred sixty-one individuals who received a water filtration device and LLIN between September of 2009 and July of 2010 were included in this analysis and followed for up to 2 years.…”

Section: Methodsmentioning

confidence: 99%

Water Filter Provision and Home-Based Filter Reinforcement Reduce Diarrhea in Kenyan HIV-Infected Adults and Their Household Members

Pavlinac

Naulikha

Chaba

et al. 2014

The American Society of Tropical Medicine and Hygiene

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Abstract. Among human immunodeficiency virus (HIV) -infected adults and children in Africa, diarrheal disease remains a major cause of morbidity and mortality. We evaluated the effectiveness of provision and home-based reinforcement of a point-of-use water filtration device to reduce diarrhea among 361 HIV-infected adults in western Kenya by comparing prevalence of self-reported diarrhea before and after these interventions. After provision of the filter, 8.7% of participants reported diarrhea compared with 17.2% in the 3 months before filter provision (odds ratio [OR] = 0.39, 95% confidence interval [95% CI] = 0.23-0.66, P 0.001). The association was similar among 231 participants who were already taking daily cotrimoxazole prophylaxis before being given a filter (OR = 0.47, 95% CI = 0.25-0.88, P = 0.019). Educational reinforcement was also associated with a modest reduction in self-reported diarrhea (OR = 0.50, 95% CI = 0.20-0.99, P = 0.047). Provision and reinforcement of water filters may confer significant benefit in reducing diarrhea among HIV-infected persons, even when cotrimoxazole prophylaxis is already being used.

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Section: Methodsmentioning

confidence: 99%

Water Filter Provision and Home-Based Filter Reinforcement Reduce Diarrhea in Kenyan HIV-Infected Adults and Their Household Members

Pavlinac

Naulikha

Chaba

et al. 2014

The American Society of Tropical Medicine and Hygiene

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“…The included studies had a wide variety of statistical designs and analyses, including 5 RCTs, 17,19,20,24,28 13 observational studies (OSs), 18,21–23,26,27,29–35 1 systematic review (SR), 25 and 3 health economics studies (see Table S1, Supplemental Digital Content, http://links.lww.com/QAI/A656). 36–38 …”

Section: Resultsmentioning

confidence: 99%

“…Of the 20 assessed individual studies (excluding the SR and 1 study that did not report on ART status), 18,25 14 (including 4 RCTs, 19,20,24,28 9 OS, 21,23,27,29–34 and 1 CE study 38 ) enrolled participants on ART; 6 studies included participants not on ART (1 RCT, 17 3 OS, 22,26,31,35 and 2 CE studies 36 ). Of the 19 included studies that addressed malaria-related morbidity outcomes (excluding the 3 costing and CE studies), 17 studies addressed CTX prophylaxis 17–33 ; 4 studies addressed provision and/or use of ITNs 32–35 (including 2 studies that also addressed CTX prophylaxis 32,33 and 2 that addressed ITN use alone). 34,35 The 3 health economics studies also addressed ITNs.…”

Section: Resultsmentioning

confidence: 99%

“…Of the 19 included studies that addressed malaria-related morbidity outcomes (excluding the 3 costing and CE studies), 17 studies addressed CTX prophylaxis 17–33 ; 4 studies addressed provision and/or use of ITNs 32–35 (including 2 studies that also addressed CTX prophylaxis 32,33 and 2 that addressed ITN use alone). 34,35 The 3 health economics studies also addressed ITNs.…”

Section: Resultsmentioning

confidence: 99%

“…The study's 2 primary end-points consisted of “time to CD4 cell count <350 cells per microliter” and “a composite end-point of time to CD4 cell count <350 cells per microliter and non-traumatic death.” Enrollment criteria included “HIV-1 infection, age >18, absence of a history of ART, a CD4 cell count >350 per microliter, and WHO stage I or II disease.” 35 The study addressed malaria morbidity as a secondary end-point by measuring the incidence of both “self-reported” (symptomatic) and “laboratory-confirmed malaria.” Enrollees were followed for up to 24 months. Participants in the intervention cohort (receiving LLINs and water filters) were less likely to self-report malaria within the previous 3 months compared with participants in the control cohort (RR: 0.75, 95% CI: 0.60 to 0.93).…”

Section: Resultsmentioning

confidence: 99%

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Impact of Cotrimoxazole and Insecticide-Treated Nets for Malaria Prevention on Key Outcomes Among HIV-Infected Adults in Low- and Middle-Income Countries

Hassani

Marston

2015

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background HIV-infected adults are at increased risk of severe malaria and death. Malaria prevention in people living with HIV (PLHIV) consists of several interventions, including cotrimoxazole (CTX) prophylaxis and insecticide-treated nets (ITNs). We conducted a systematic review of the available evidence. Methods MEDLINE, EmBase, Global Health, CINAHL, SOCA, and African Index Medicus were used to identify articles relevant to the CTX prophylaxis and ITNs interventions from 1995 to July 2014. For each individual study, we assessed the quality of evidence and the impact of the 2 interventions on the outcomes of mortality, morbidity, retention in care, quality of life, and/or prevention of ongoing HIV transmission. For each outcome, we summarized the quality of the overall body of evidence, the expected impact, and costing and cost-effectiveness (CE). Findings The overall quality of evidence regarding malaria-related morbidity was rated as “good” for CTX prophylaxis and “fair” for ITN use; the expected “impact” of these interventions on morbidity was rated “high” and “uncertain,” respectively. Three studies that addressed the costing and CE of ITN provision for malaria prevention in PLHIV consisted of 2 full “level 1” and 1 partial “level 2” economic evaluations. Conclusions CTX prophylaxis is effective in reducing malaria-related morbidity among PLHIV. Limited evidence is available with respect to the impact and the CE of ITN use and/or provision in this population.

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Interventions promoting uptake of water, sanitation and hygiene (WASH) technologies in low‐ and middle‐income countries: An evidence and gap map of effectiveness studies

Chirgwin

Cairncross

Zehra

et al. 2021

Campbell Systematic Reviews

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Background Lack of access to and use of water, sanitation and hygiene (WASH) cause 1.6 million deaths every year, of which 1.2 million are due to gastrointestinal illnesses like diarrhoea and acute respiratory infections like pneumonia. Poor WASH access and use also diminish nutrition and educational attainment, and cause danger and stress for vulnerable populations, especially for women and girls. The hardest hit regions are sub‐Saharan Africa and South Asia. Sustainable Development Goal (SDG) 6 calls for the end of open defecation, and universal access to safely managed water and sanitation facilities, and basic hand hygiene, by 2030. WASH access and use also underpin progress in other areas such as SDG1 poverty targets, SDG3 health and SDG4 education targets. Meeting the SDG equity agenda to “leave none behind” will require WASH providers prioritise the hardest to reach including those living remotely and people who are disadvantaged. Objectives Decision makers need access to high‐quality evidence on what works in WASH promotion in different contexts, and for different groups of people, to reach the most disadvantaged populations and thereby achieve universal targets. The WASH evidence map is envisioned as a tool for commissioners and researchers to identify existing studies to fill synthesis gaps, as well as helping to prioritise new studies where there are gaps in knowledge. It also supports policymakers and practitioners to navigate the evidence base, including presenting critically appraised findings from existing systematic reviews. Methods This evidence map presents impact evaluations and systematic reviews from the WASH sector, organised according to the types of intervention mechanisms, WASH technologies promoted, and outcomes measured. It is based on a framework of intervention mechanisms (e.g., behaviour change triggering or microloans) and outcomes along the causal pathway, specifically behavioural outcomes (e.g., handwashing and food hygiene practices), ill‐health outcomes (e.g., diarrhoeal morbidity and mortality), nutrition and socioeconomic outcomes (e.g., school absenteeism and household income). The map also provides filters to examine the evidence for a particular WASH technology (e.g., latrines), place of use (e.g., home, school or health facility), location (e.g., global region, country, rural and urban) and group (e.g., people living with disability). Systematic searches for published and unpublished literature and trial registries were conducted of studies in low‐ and middle‐income countries (LMICs). Searches were conducted in March 2018, and searches for completed trials were done in May 2020. Coding of information for the map was done by two authors working independently. Impact evaluations were critically appraised according to methods of conduct and reporting. Systematic reviews were critically appraised using a new approach to assess theory‐based, mixed‐methods evidence synthesis. Results There has been an enormous growth in impact evaluations and systematic reviews of WASH ...

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Evaluation of impact of long-lasting insecticide-treated bed nets and point-of-use water filters on HIV-1 disease progression in Kenya

Abstract: Provision of a long-lasting insecticide-treated bed net and water filter was associated with a delay in CD4 cell count decline and may be a simple, practical and cost-effective strategy to delay HIV-1 progression in many resource-limited settings.

Cited by 18 publications

References 22 publications

Water Filter Provision and Home-Based Filter Reinforcement Reduce Diarrhea in Kenyan HIV-Infected Adults and Their Household Members

Water Filter Provision and Home-Based Filter Reinforcement Reduce Diarrhea in Kenyan HIV-Infected Adults and Their Household Members

Impact of Cotrimoxazole and Insecticide-Treated Nets for Malaria Prevention on Key Outcomes Among HIV-Infected Adults in Low- and Middle-Income Countries

Interventions promoting uptake of water, sanitation and hygiene (WASH) technologies in low‐ and middle‐income countries: An evidence and gap map of effectiveness studies

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