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báo cáo hóa học:" CMV retinitis screening and treatment in a resource-poor setting: three-year experience from a primary care HIV/AIDS programme in Myanmar"

Tuyển tập các báo cáo nghiên cứu về hóa học được đăng trên tạp chí sinh học đề tài : CMV retinitis screening and treatment in a resource-poor setting: three-year experience from a primary care HIV/AIDS programme in Myanmar | Tun et al. Journal of the International AIDS Society 2011 14 41 http www.jiasociety.Org content 14 1 41 JOURNALOF THE INTERNATIONAL AIDS SOCIETY RESEARCH Open Access CMV retinitis screening and treatment in a resource-poor setting three-year experience from a primary care HIV AIDS programme in Myanmar NiNi Tun1 Nikolas London2 Moe Kyaw Kyaw3 Frank Smithuis1 Nathan Ford4 5 Todd Margolis6 W Lawrence Drew6 Susan Lewallen7 and David Heiden8 9 Abstract Background Cytomegalovirus retinitis is a neglected disease in resource-poor settings in part because of the perceived complexity of care and because ophthalmologists are rarely accessible. In this paper we describe a pilot programme of CMV retinitis management by non-ophthalmologists. The programme consists of systematic screening of all high-risk patients CD4 100 cells mm3 by AIDS clinicians using indirect ophthalmoscopy and treatment of all patients with active retinitis by intravitreal injection of ganciclovir. Prior to this programme CMV retinitis was not routinely examined for or treated in Myanmar. Methods This is a retrospective descriptive study. Between November 2006 and July 2009 17 primary care AIDS clinicians were trained in indirect ophthalmoscopy and diagnosis of CMV retinitis eight were also trained in intravitreal injection. Evaluation of training by a variety of methods documented high clinical competence. Systematic screening of all high-risk patients CD4 100 cells mm3 was carried out at five separate AIDS clinics throughout Myanmar. Results A total of 891 new patients 1782 eyes were screened in the primary area Yangon the majority of patients were male 64.3 median age was 32 years and median CD4 cell count was 38 cells mm3. CMV retinitis was diagnosed in 24 211 891 of these patients. Bilateral disease was present in 36 of patients. Patients with active retinitis were treated with weekly intravitreal injection of ganciclovir with patients typically receiving five to seven injections per eye. A total of