Browsing by Author "Padayatchi, Nesri."

Now showing 1 - 20 of 51

Addressing challenges in scaling up TB and HIV treatment integration in rural primary healthcare clinics in South Africa (SUTHI): a cluster randomized controlled trial protocol.
(Implementation Science., 2015) Naidoo, Kogieleum.; Gengiah, Santhanalakshmi.; Yende-Zuma, Fortunate Nonhlanhla.; Padayatchi, Nesri.; Barker, Pierre.; Nunn, Andrew.; Subrayen, Priashni.; Abdool Karim, Salim Safurdeen.
Abstract available in pdf.
Adherence in the treatment of patients with extensively drug-resistant tuberculosis and HIV in South Africa: a prospective cohort study.
(Lippincott Williams & Wilkins., 2014) O'Donnell, Max Roe.; Wolf, Allison.; Werner, Lise.; Horsburgh, Charles Robert.; Padayatchi, Nesri.
Abstract available in pdf.
Antiretroviral switching and bedaquiline treatment of drug-resistant tuberculosis HIV co-infection.
(Elsevier., 2019) Padayatchi, Nesri.; Daftary, Amrita.; Orrell, Catherine.; Dooley, Kelly E.; O'Donnell, Max Roe.; Amico, Kathy Rivet.; Friedland, Gerald H.
Abstract available in PDF.
Association between health systems performance and treatment outcomes in patients co-infected with MDR-TB and HIV in KwaZulu-Natal, South Africa: implications for TB programmes.
(Public Library of Science., 2014) Loveday, Marian Patricia.; Padayatchi, Nesri.; Wallengren, Kristina.; Roberts, Jacquelin.; Brust, James C. M.; Ngozo, Jacqueline.; Master, Iqbal.; Voce, Anna Silvia.
Objective: To improve the treatment of MDR-TB and HIV co-infected patients, we investigated the relationship between health system performance and patient treatment outcomes at 4 decentralised MDR-TB sites. Methods: In this mixed methods case study which included prospective comparative data, we measured health system performance using a framework of domains comprising key health service components. Using Pearson Product Moment Correlation coefficients we quantified the direction and magnitude of the association between health system performance and MDR-TB treatment outcomes. Qualitative data from participant observation and interviews analysed using systematic text condensation (STC) complemented our quantitative findings. Findings: We found significant differences in treatment outcomes across the sites with successful outcomes varying from 72% at Site 1 to 52% at Site 4 (p<0.01). Health systems performance scores also varied considerably across the sites. Our findings suggest there is a correlation between treatment outcomes and overall health system performance which is significant (r = 0.99, p<0.01), with Site 1 having the highest number of successful treatment outcomes and the highest health system performance. Although the 'integration' domain, which measured integration of MDR-TB services into existing services appeared to have the strongest association with successful treatment outcomes (r = 0.99, p<0.01), qualitative data indicated that the 'context' domain influenced the other domains. Conclusion: We suggest that there is an association between treatment outcomes and health system performance. The chance of treatment success is greater if decentralised MDR-TB services are integrated into existing services. To optimise successful treatment outcomes, regular monitoring and support are needed at a district, facility and individual level to ensure the local context is supportive of new programmes and implementation is according to guidelines.
Case series of the long-term psychosocial impact of drug-resistant tuberculosis in HIV-negative medical doctors.
(International Union against Tuberculosis and Lung Disease., 2010) Padayatchi, Nesri.; Daftary, Amrita.; Moodley, T.; Madansein, Rajhmun.; Ramjee, A.
BACKGROUND: Health care workers (HCWs) are at greater risk for tuberculosis (TB), including multidrug-resistant TB (MDR-TB), compared to the general population. The psychosocial impact of nosocomial TB on HCWs has received little attention in the literature. METHODS: A retrospective medical record review from 1999 to 2003 found 15 HCWs who were treated for drug-resistant TB at a specialist hospital in South Africa. Five human immunodeficiency virus (HIV) negative doctors with no predisposing factors for drug resistance are included in this case series. We collectively present their clinical case histories based on medical records from 2000 to 2005, and explore the long-term psychosocial impact of TB from interviews conducted in 2009. RESULTS: Four doctors had primary MDR-TB and one had primary resistance to multiple first-line drugs. Time from symptom onset to commencement of effective treatment ranged from 8 to 39 weeks. Time for bacteriological confirmation of drug-resistant TB ranged from 6 to 24 weeks. All were cured within 3 years of initial presentation. Content analysis of follow-up interviews revealed five main themes: 1) prolonged morbidity, 2) psychological impact, 3) poor infection control, 4) weak support structures and 5) attrition from the field. CONCLUSION: Themes emergent from this case series encourage prioritisation of TB infection control education and practice to minimise HCW morbidity and prevent HCW attrition from high-burden resource-constrained settings.
Cellular therapy in Tuberculosis.
(Elsevier., 2015) Parida, Shreemanta K.; Madansein, Rajhmun.; Singh, Nalini.; Padayatchi, Nesri.; Master, Iqbal.; Naidu, Kantharuben.; Zumla, Alimuddin.; Maeurer, Markus.
Abstract available in pdf.
Changes to antiretroviral drug regimens during integrated TB-HIV treatment: results of the SAPiT trial.
(International Medical Press., 2014) Naidoo, Anushka.; Naidoo, Kogieleum.; Yende-Zuma, Fortunate Nonhlanhla.; Gengiah, Tanuja Narayansamy.; Padayatchi, Nesri.; Gray, Andrew Lofts.; Bamber, Sheila.; Nair, Gonasagrie.; Abdool Karim, Salim Safurdeen.
Background—Frequency of drug changes in combination antiretroviral therapy among patients starting both tuberculosis (TB) and human immunodeficiency virus (HIV) therapy, as a result of treatment-limiting toxicity or virological failure, is not well established. Methods—Patients in the Starting Antiretroviral Therapy at Three Points in Tuberculosis (SAPiT) trial were randomized to initiate antiretroviral therapy either early or late during TB treatment or after completion of TB treatment. Drug changes due to toxicity (defined as due to grade 3 or 4 adverse events) or virological failure (defined as viral load > 1000 copies/ml on two occasions, taken at least 4 weeks apart) were assessed in these patients. Results—A total of 501 TB-HIV co-infected patients were followed for a mean of 16.0 (95% confidence interval (CI): 15.5 to 16.6) months after antiretroviral therapy (ART) initiation. The standard first-line ARVs used, were efavirenz, lamivudine and didanosine. Individual drug switches for toxicity occurred in 14 patients (incidence rate: 2.1 per 100 person-years; 95% (CI): 1.1 to 3.5), and complete regimen changes due to virological failure in 25 patients (incidence rate: 3.7 per 100 person-years; CI: 2.4 to 5.5). The most common treatment limiting toxicities were neuropsychiatric effects (n=4; 0.8%), elevated transaminase levels and hyperlactatemia (n= 3; 0.6%), and peripheral neuropathy (n=2; 0.4%). Complete regimen change due to treatment failure was more common in patients with CD4+ cell count <50cells/mm3 (p<0.001) at ART initiation and body mass index greater than 25 kg/m2 (p=0.01) at entry into the study. Conclusion—Both drug switches and complete regimen change were uncommon in patients cotreated for TB-HIV with the chosen regimen. Patients with severe immunosuppression need to be monitored carefully, as they were most at risk for treatment failure requiring regimen change.
Clofazimine in the treatment of extensively drug-resistant tuberculosis with HIV coinfection in South Africa: a retrospective cohort study.
(Oxford University Press., 2014) Padayatchi, Nesri.; Gopal, Murali.; Naidoo, Rowena.; Werner, Lise.; Naidoo, Kimesh.; Master, Iqbal.; O'Donnell, Max Roe.
Abstract available in pdf.
A community officer’s perspective of a rural hospital in KwaZulu-Natal.
(South African Medical Association / Health & Medical Publications Group., 2012) Perumal, Rubeshan.; Padayatchi, Nesri.
No abstract available.
Community-based care vs. centralised hospitalisation for MDR-TB patients, KwaZulu-Natal, South Africa.
(International Union Against Tuberculosis and Lung Disease., 2015) Loveday, Marian Patricia.; Wallengren, Kristina.; Brust, James C. M.; Roberts, Jacquelin.; Voce, Anna Silvia.; Margot, Bruce.; Ngozo, Jacqueline.; Master, Iqbal.; Cassell, Gail H.; Padayatchi, Nesri.
Abstract available in pdf.
Comparing early treatment outcomes of MDR-TB in a decentralised setting with a centralised setting in KwaZulu-Natal, South Africa.
(International Union against Tuberculosis and Lung Disease., 2012) Loveday, Marian Patricia.; Wallengren, Kristina.; Voce, Anna Silvia.; Margot, Bruce.; Reddy, T.; Master, Iqbal.; Brust, James C. M.; Chaiyachati, K.; Padayatchi, Nesri.
Setting—In KwaZulu-Natal, South Africa, a TB and HIV endemic setting, prolonged hospitalisation for the treatment of the growing number of MDR-TB patients is not possible or effective. Objective—We compared early treatment outcomes in patients with MDR-TB, with and without HIV co infection, at a central, urban, referral hospital with four decentralised rural sites. Design—This is an operational, prospective cohort study of patients between 1 July 2008 to 30 November 2009, where culture conversion, time-to-culture-conversion, survival and predictors of these outcomes were analysed. Results—Of the 860 patients with MDR-TB, 419 were at the decentralised sites and 441 at the central hospital. Overall, 71% were HIV co-infected.
The contrasting cultures of HIV and tuberculosis care.
(Wolters Kluwer., 2014) Daftary, Amrita.; Calzavara, Liviana.; Padayatchi, Nesri.
Abstract available in pdf.
Drug-resistant tuberculosis control in South Africa: scientific advances and health system strengthening are complementary.
(Informa., 2014) Padayatchi, Nesri.; Loveday, Marian Patricia.; Naidu, Naressa.
Abstract available in pdf.
Effect of rifampicin and efavirenz on moxifloxacin concentrations when co-administered in patients with drug-susceptible TB.
(Oxford University Press., 2017) Naidoo, Anushka.; Chirehwa, Maxwell.; McIlleron, Helen.; Naidoo, Kogieleum.; Essack, Sabiha Yusuf.; Yende-Zuma, Fortunate Nonhlanhla.; Kimba-Phongi, Eddy.; Adamson, John.; Govender, Katya.; Padayatchi, Nesri.; Denti, Paolo.
Abstract available in pdf.
Evaluation of time to detection of mycobacterium tuberculosis in broth culture as a determinant for end points in treatment trials.
(American Society for Microbiology., 2010) Weiner, Marc.; Prihoda, Thomas J.; Burman, William.; Johnson, John L.; Goldberg, Stefan.; Padayatchi, Nesri.; Duran, Paula.; Engle, Melissa.; Muzanye, Grace.; Mugerwa, Roy D.; Sturm, Adriaan Willem.
Development of new treatments for tuberculosis is hampered by the lack of an accurate surrogate end point and the high degree of efficacy of current 6-month regimens. Sputum culture status after 2 months of therapy, a binary test, is widely used for phase IIB trials but has only moderate accuracy for predicting failure/relapse (12) and requires large sample sizes (4, 8). Changes in the number of colonies found in dilutions of sputum applied to solid medium is an end point that has been used to assess activities of single drugs and doses in phase IIA (early-bactericidal-activity) studies (10) and has also been suggested as an end point for phase IIB trials (15). Though promising, quantitative culture on solid medium involves prolonged sputum collections and intensive laboratory techniques and has been difficult to standardize at multiple sites. Time to detection in broth culture (TTD) is a potential end point that has a good correlation with quantitative culture on solid medium (11, 13). An initial small study had suggested a correlation between a shorter time to detection (an indication of higher numbers of viable bacilli) and poor treatment outcomes (9). In this study, TTD was evaluated as a marker of regimen potency. Preliminary results have been reported elsewhere (16).
Evolution of drug resistance in Mycobacterium tuberculosis: a review on the molecular determinants of resistance and implications for personalized care.
(Oxford University Press., 2018) Dookie, Navisha.; Rambaran, Santhuri.; Padayatchi, Nesri.; Mahomed, Sharana.; Naidoo, Kogieleum.
Abstract available in pdf.
Evolution of extensively drug-resistant tuberculosis over four decades: whole genome sequencing and dating analysis of Mycobacterium tuberculosis isolates from KwaZulu-Natal.
(Public Library of Science., 2015) Cohen, Keira A.; Abeel, Thomas.; McGuire, Abigail Manson.; Desjardins, Christopher A.; Munsamy, Vanisha.; Shea, Terrance P.; Walker, Bruce J.; Bantubani, Nonkqubela.; Almeida, Deepak V.; Alvarado, Lucia.; Chapman, Sinéad B.; Mvelase, Nomonde R.; Duffy, Eamon Y.; Fitzgerald, Michael G.; Govender, Pamla.; Gujja, Sharvari.; Hamilton, Susanna.; Howarth, Clinton.; Larimer, Jeffrey D.; Maharaj, Kashmeel.; Pearson, Matthew D.; Priest, Margaret E.; Zeng, Qiandong.; Padayatchi, Nesri.; Grosset, Jacques H.; Young, Sarah K.; Wortman, Jennifer.; Mlisana, Koleka Patience.; O'Donnell, Max Roe.; Birren, Bruce W.; Bishai, William R.; Pym, Alexander S.; Earl, Ashlee M.
Abstract available in pdf.
Expanding HIV surveillance to include TB patients in resource-limited settings with a generalized epidemic.
(International Union against Tuberculosis and Lung Disease., 2009) Padayatchi, Nesri.; Stiefvater, E.; Naidoo, Kogieleum.; Naidoo, Kantharuben.; Ndung'u, Peter Thumbi.; Abdool Karim, Quarraisha.
Screening of antenatal clinic attendees is central to monitoring the human immunodeficiency virus (HIV) epidemic. However, recent evidence suggests that declining fertility rates are affecting the reliability of antenatal clinic surveys as the epidemic matures. Population-based HIV surveys, while ideal, are resource-intensive, necessitating newer, cost-effective approaches. Unlinked anonymous testing for HIV in sputum of tuberculosis (TB) patients serves as reliable proxy for estimating the burden of symptomatic HIV disease and is a potential adjunct to current surveillance efforts. Unlinked anonymous testing for HIV surveillance in KwaZulu-Natal, South Africa, the epicentre of the global epidemic, is justified, as data from the largest urban TB referral clinic indicate that only 22% of TB patients uptake voluntary HIV testing.
Genomic and functional analyses of mycobacterium tuberculosis strains implicate ald in D-cycloserine resistance.
(Nature Publishing Group., 2016) Desjardins, Christopher A.; Cohen, Keira A.; Munsamy, Vanisha.; Abeel, Thomas.; Maharaj, Kashmeel.; Walker, Bruce J.; Shea, Terrance P.; Almeida, Deepak V.; Manson, Abigail L.; Salazar, Alex.; Padayatchi, Nesri.; O’Donnell, Max Roe.; Mlisana, Koleka Patience.; Wortman, Jennifer.; Birren, Bruce W.; Grosset, Jacques H.; Earl, Ashlee M.; Pym, Alexander S.
Abstract available in PDF file.
High mortality rates in men initiated on anti-retroviral treatment in KwaZulu-Natal, South Africa.
(Public Library of Science., 2017) Naidoo, Kogieleum.; Hassan-Moosa, Razia.; Yende-Zuma, Fortunate Nonhlanhla.; Govender, Dhineshree.; Padayatchi, Nesri.; Dawood, Halima.; Adams, Rochelle Nicola.; Govender, Aveshen.; Chinappa, Tilagavathy.; Abdool Karim, Salim Safurdeen.; Abdool Karim, Quarraisha.
Abstract available in pdf.