Infectious Diseases - Research Publications

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Author: Biggs, Beverley-Ann × Author: LEMOH, CHRISTOPHER × End date: 2009 × Start date: 2000 ×

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    Working with West African migrant communities on HIV prevention in Australia
    Lemoh, C ; Biggs, B-A ; Hellard, M (CSIRO Publishing, 2008-11-18)
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    Isolated core antibody hepatitis B in sub-Saharan African immigrants
    Gibney, KB ; Torresi, J ; Lemoh, C ; Biggs, BA (WILEY, 2008-09)
    Chronic hepatitis B virus (HBV) infection is a major health problem in sub-Saharan Africa, where prevalence is > or =8%, and is increasingly seen in African immigrants to developed countries. A retrospective audit of the medical records of 383 immigrants from sub-Saharan Africa attending the infectious diseases clinics at the Royal Melbourne Hospital was performed from 2003 to 2006. The HBV, human immunodeficiency virus (HIV) and hepatitis C virus (HCV) serological results are reported, with a focus on the isolated core antibody HBV pattern (detection of anti-HBc without detection of HBsAg or anti-HBs). Two-thirds (118/174, 68%) of those tested had evidence of HBV infection with detectable anti-HBc. Chronic HBV infection (serum HBsAg detected) was identified in 38/174 (22%) and resolved HBV infection (both serum anti-HBs and anti-HBc detected) in 45/174 (26%). The isolated core antibody pattern was identified in 35/174 (20%), of whom only 1/35 (3%) had detectable serum HBV DNA on PCR testing, indicating occult chronic HBV (OCHB). Only 8/56 (14%) patients with negative anti-HBc had serological evidence of vaccination (serum anti-HBs detected). HIV infection was detected in 26/223 (12%). HCV antibodies were detected in 10/241 (4%), of whom 8 (80%) had detectable HCV RNA. Viral co-infection was detected in only 2/131 (1.5%) patients tested for all three viruses. The isolated core antibody HBV pattern was common among sub-Saharan African patients in our study. These patients require assessment for OCHB infection and monitoring for complications of HBV.
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    Sudanese women living in Victoria, Australia: health-information seeking behaviours and the availability, effectiveness and appropriateness of HIV/AIDS information
    PALMER, RK ; LEMOH, C ; Tham, R ; Hakim, S ; BIGGS, B (Radcliffe Medical Media, 2009)
    The aim of this study was to understand the perceptions of Sudanese women regarding their potential vulnerability to HIV infection and their preferred sources of HIV-related information. The study was designed in consultation with members of the Sudanese community in Victoria, Australia. Semistructured interviews were undertaken with 11 Sudanese-born women who had migrated from Sudan and who were resident in Victoria. Thematic analysis revealed several key points: • The women considered that an important factor increasing their vulnerability to HIV infection was lack of access to education and awareness. • The women believed that this lack of access was largely due to socio-cultural barriers to information seeking, inadequate types of information sources, timing of information dissemination, and lack of culturally appropriate information. • The women suggested that HIV information would be most effectively disseminated to their communities by providing members who were already held in high regard by Victoria’s Sudanese community with culturally appropriate and accurate information. Verbal and visual sources of information were identified as the preferred media. There was a particular preference for information sessions and educational seminars. The nature of the vulnerabilities to HIV infection perceived by these Sudanese-born women living in Victoria, their active participation in this study, and the widespread positive response of the city’s Sudanese community, suggest a culturally appropriate HIV public health education campaign would be welcomed if it was to be implemented with the involvement of the community. The lack of HIV awareness that was identified in this study suggests that there is an increasing need to implement adequate and appropriately targeted HIV education and harm reduction strategies.
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    Delayed diagnosis of HIV infection in Victoria 1994 to 2006
    Lemoh, C ; Guy, R ; Yohannes, K ; Lewis, J ; Street, A ; Biggs, B ; Hellard, M (CSIRO PUBLISHING, 2009)
    BACKGROUND: The identification of factors associated with delayed diagnosis of HIV infection in Victoria, Australia was the aim of the present study. METHODS: Demographic and epidemiological characteristics of cases notified to the Victorian HIV surveillance database between 1 January 1994 and 31 December 2006 were analysed. Delayed diagnosis was defined as: CD4 count below 200 cells mm(-3) at HIV diagnosis or diagnosis of AIDS earlier than 3 months after HIV diagnosis. RESULTS: Diagnosis of HIV was delayed in 627 (22.6%) of 2779 cases. Of these, 528 (84.2%) had either a high-risk exposure or were born in a high-prevalence country. The most common exposure was male homosexual contact in 64.3% of cases. Independent risk factors for delayed diagnosis were: older age at diagnosis (30-39 years odds ratio [OR] 2.15, > or = 50 years OR 7.50, P < 0.001), exposure via routes other than male homosexual sex or injecting drug use (heterosexual sex OR 2.51, P < 0.001, unknown/other route OR 4.24, P < 0.001); birth in Southern/Eastern Europe (OR 2.54), South-east Asia (OR 2.70) or the Horn of Africa/North Africa (OR 3.71, P < 0.001), and male gender (OR 0.47 for females, P < 0.001). CONCLUSION: Delay in the diagnosis of HIV infection is common in Victoria, but potentially avoidable in the majority of cases. Most people with delayed diagnosis had a history of male homosexual contact, injecting drug use, birth in a high-prevalence country or sexual contact with such individuals. An accurate sexual history, together with knowledge of their country of birth, should identify most individuals who should be offered an HIV test.