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Background Tuberculosis (TB) is the most common opportunistic infection in HIV-infected adults in developing countries. Isoniazid (INH) is recommended for treatment of latent TB infection, however non-adherence is common. The purpose of this study was to apply in-house prepared isoniazid (INH) urine test strips in a clinical setting, and identify predictors of positive test results in an adherence questionnaire in HIV-infected adults taking INH for prevention of TB. Methods Cross-sectional study of adherence using a questionnaire and urine test strips for detection of INH metabolites at two hospitals in Pietermaritzburg, South Africa. Participants were aged at least 18 years, HIV positive, and receiving INH for prevention of tuberculosis disease. Univariate and multivariate analyses are used to identify factors relevant to adherence. Results 301 consecutive patients were recruited. 28% of participants had negative urine tests. 32 (37.2%, 95% CI25.4, 45.0) of the 86 patients who received INH from peripheral pharmacies said the pharmacy had run out of INH at some time, compared with central hospital pharmacies (p = 0.0001). In univariate analysis, a negative test was associated with self-reported missed INH doses (p = 0.043). Each 12-hour increment since last reported dose increased the likelihood of a negative test by 34% (p = 0.0007). Belief in INH safety was associated with a positive test (p = 0.021). In multivariate analysis, patients who believed INH is important for prevention of TB disease were more likely to be negative (p = 0.0086). Conclusion Adequate drug availability at peripheral pharmacies remains an important intervention for TB prevention. Key questions may identify potentially non-adherent patients. In-house prepared urine tests strips are an effective and cheap method of objectively assessing INH adherence, and could be used an important tool in TB control programs.

The purpose of Infrastructure Operations Tools Access (IOTA) effort is to accomplish development of an advanced architecture for ISR information management. The architecture will be based on a software component framework for information dissemination. The component framework will be based on Web Services standards and include provisions for enterprise workflow management. The component framework will leverage commercial off-the-shelf (COTS) technology and government off-the-shelf (GOTS) applications to provide mechanisms for data discovery, dissemination and visualization that can be rapidly adapted to varying information requirements. In particular, Java 2 Enterprise Edition (J2EE), will be used to provide a platform-independent set of standards and tools for developing the component framework. Broadsword Gatekeeper, a GOTS application, will also be used to define middleware capabilities for data access and discovery.

In summary, a history of previous angina before a nonthrombolized AMI is a marker of increased risk of infarct extension, recurrent ischemic pain, and mitral regurgitation. However, a history of previous angina was associated with trends toward smaller infarct size in patients who had spontaneous thrombolysis.