Evidence map›Paper›PMID 31709410›Full record

ArticleEClinicalMedicine2019

Targeting the HIV Epidemic in South Africa: The Need for Testing and Linkage to Care in Emergency Departments.

Bhakti Hansoti, George Mwinnyaa, Elizabeth Hahn, Aditi Rao, John Black, Victoria Chen, Kathryn Clark, William Clarke, Anna L Eisenberg, Reinaldo Fernandez and 13 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in EClinicalMedicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 3 pooled it
3.2field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 3 syntheses or guidelines pooled it, 30 citations in OpenAlex.

  1. Pooled it
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  12. Cochleovestibular findings linked to COVID-19: A scoping review for clinical care planning in South Africa.The South African journal of communication disorders = Die Suid-Afrikaanse tydskrif vir Kommunikasieafwykings · 2022
    Article
  13. Article
  14. Article
  15. Correlates and cascade of HIV care in patients with psychiatric disorders in the Eastern Cape province, South Africa.The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa · 2022
    Article
  16. Article
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  18. Safeguarding gains in the sexual and reproductive health and AIDS response amidst COVID-19: The role of African civil society.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2020
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors at 7 institutions in 2 countries.

Bhakti HansotiThe Johns Hopkins University, 1800 Orleans St, Baltimore, MD 21287, USA.
George MwinnyaaThe Johns Hopkins University, 1800 Orleans St, Baltimore, MD 21287, USA.
Elizabeth HahnThe Johns Hopkins University, 1800 Orleans St, Baltimore, MD 21287, USA.
Aditi RaoThe Johns Hopkins University, 1800 Orleans St, Baltimore, MD 21287, USA.
John BlackFaculty of Health Sciences, Walter Sisulu University, Umtata Part 1, Mthatha, South Africa.
Victoria ChenThe Johns Hopkins University, 1800 Orleans St, Baltimore, MD 21287, USA.
Kathryn ClarkThe Johns Hopkins University, 1800 Orleans St, Baltimore, MD 21287, USA.
William ClarkeThe Johns Hopkins University, 1800 Orleans St, Baltimore, MD 21287, USA.
Anna L EisenbergDivision of Intramural Research, National Institute of Allergy and Infectious Diseases, 31 Center Dr # 7A03, Bethesda, MD 20892, USA.
Reinaldo FernandezThe Johns Hopkins University, 1800 Orleans St, Baltimore, MD 21287, USA.
Joshua IruedoFaculty of Health Sciences, Walter Sisulu University, Umtata Part 1, Mthatha, South Africa.
Oliver LaeyendeckerThe Johns Hopkins University, 1800 Orleans St, Baltimore, MD 21287, USA.
Roshen MaharajFaculty of Health Sciences, Walter Sisulu University, Umtata Part 1, Mthatha, South Africa.
Pamela MdaNelson Mandela Hospital Clinical Research Unit, Sisson St, Fort Gale, Mthatha 5100, South Africa.
Jernelle MillerThe Johns Hopkins University, 1800 Orleans St, Baltimore, MD 21287, USA.
Nomzamo MvandabaFaculty of Health Sciences, Walter Sisulu University, Umtata Part 1, Mthatha, South Africa.
Yandisa NyanisaFaculty of Health Sciences, Walter Sisulu University, Umtata Part 1, Mthatha, South Africa.
Steven J ReynoldsThe Johns Hopkins University, 1800 Orleans St, Baltimore, MD 21287, USA.
Andrew D ReddThe Johns Hopkins University, 1800 Orleans St, Baltimore, MD 21287, USA.
Sofia RyanThe Johns Hopkins University, 1800 Orleans St, Baltimore, MD 21287, USA.
David F SteadFaculty of Health Sciences, Walter Sisulu University, Umtata Part 1, Mthatha, South Africa.
Lee A WallisDivision of Emergency Medicine, University of Cape Town, Main Rd, Observatory, Cape Town 7925, South Africa.
Thomas C QuinnThe Johns Hopkins University, 1800 Orleans St, Baltimore, MD 21287, USA.
Johns Hopkins University · USWalter Sisulu University · ZALivingstone Hospital · ZAFrere Hospital · ZANational Institute of Allergy and Infectious Diseases · USNelson Mandela Academic Hospital · ZAUniversity of Cape Town · ZA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Eastern Cape province of South Africa has one of the highest burdens of HIV in the world. Emergency Departments (EDs) can serve as optimal clinical sites for the identification of new HIV infections and entry into care. We sought to determine the current burden of HIV disease among ED patients in the Eastern Cape.

methodsWe conducted a prospective cross-sectional observational study in the EDs of three Hospitals in the Eastern Cape province of South Africa from June 2017 to July 2018. All adult, non-critical patients presenting to the ED were systematically approached and offered a Point-Of-Care (POC) HIV test in accordance with South African guidelines. All HIV-positive individuals had their blood tested for the presence of antiretroviral therapy (ART) and the presence of viral suppression (≤ 1000 copies/ml). HIV incidence was estimated using a multi-assay algorithm, validated for a subtype C epidemic.

findingsOf the 2901 patients for whom HIV status was determined (either known HIV-positive or underwent POC HIV testing), 811 (28.0%) were HIV positive, of which 234 (28.9%) were newly diagnosed. HIV prevalence was higher in Mthatha [34% (388/1134) at Mthatha Regional Hospital and 28% (142/512) at Nelson Mandela Academic Hospital], compared to Port Elizabeth [22% (281/1255) at Livingstone Hospital]. HIV incidence was estimated at 4.5/100 person-years (95% CI: 2.4, 6.50) for women and 1.5 (CI 0.5, 2.5) for men. Of all HIV positive individuals tested for ART (585), 54% (316/585) tested positive for the presence of ARTs, and for all HIV positive participants with viral load data (609), 49% (299/609) were found to be virally suppressed.

interpretationOur study not only observed a high prevalence and incidence of HIV among ED patients but also highlights significant attrition along the HIV care cascade for HIV positive individuals. Furthermore, despite developing an optimal testing environment, we were only able to enrol a small sub-set of the ED population. Given the high HIV prevalence and high attrition in the ED population, HIV services in the ED should also develop strategies that can accommodate large testing volumes and ART initiation.

Indexed as

Emergency medicineHIV and traumaHIV in menHIV testingSouth Africa

Identifiers

PMID31709410
PMCPMC6833451
OpenAlexW2969914916

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.