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Despite the evidence of the disproportionate burden of tobacco use among people with HIV (PWH), little effort has been made to design and test smoking cessation interventions for PWH in resource-limited countries. We assessed the feasibility, acceptability, and preliminary effects of a video-based smoking cessation intervention consisting of eleven 3-8-minute sessions among PWH in Nepal, a lower-middle-income country. Guided by the phased-based model, our 3-month intervention focused on setting the quit date, smoking cessation, and abstinence maintenance. We screened 103 PWH over three weeks for our single-arm trial, with 53 considered eligible and 48 recruited (91%). Forty-six participants watched all video clips, while two watched 7-9. All participants were retained at a 3-month follow-up. The 1-week point prevalence abstinence (self-report supported with expired carbon monoxide levels < 5ppm) at 3-month follow-up was 39.6%. Most (90%) participants reported "very much" or "much" comfort with watching the videos on their smartphones, and all would recommend the intervention to other PWH who smoke. Overall, our pilot trial demonstrated the feasibility, acceptability, and high-level efficacy of the video-based smoking cessation intervention highlighting its potential for scaling up in Nepal and other resource-limited countries., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Early diagnosis of cryptococcal meningitis among people living with HIV (PLHIV) is crucial for its therapeutic success. The objective of this study was to diagnose cryptococcal meningitis in PLHIV cases using the available laboratory techniques for its confirmation in resource limited setting. This cross-sectional prospective study was conducted among 72 PLHIV with clinical suspicion of meningitis. Each cerebrospinal fluid (CSF) sample received at the National Public Health Laboratory, Kathmandu was processed for India ink staining, cryptococcal antigen lateral flow assay, and fungal culture following standard protocols. The laboratory-confirmed cryptococcal meningitis cases were between 24 and 69 years of age (median age 39 years) with 87.5% (12/14) of cases being male. Cryptococcus was detected in 22.22% (16/72) by any of the three tests, 19.44% (14/72) by cryptococcal antigen lateral flow assay, 16.66% (12/72) by India ink staining, and 8.33% (6/72) by culture. High percentage of cryptococcal meningitis among PLHIV warrants early microbiological diagnosis for better case management. Cryptococcal antigen detection immunoassay should be the priority test for laboratory diagnosis of cryptococcal meningitis in PLHIV. Alternatively, very simple and economic India ink staining of CSF specimens could be used in resource limited settings., (© 2022 Wiley-VCH GmbH.)

Backgrounds: Intestinal Parasitic Infection (IPI) plays a vital role in the prognosis of People Living with HIV/AIDS (PLHA). Aims and Objectives: In this study, we aimed to measure the prevalence and associated factors of IPI among PLHA and non-HIV patients attending Sukraraj Tropical and Infectious Disease Hospital, Teku, Kathmandu. Materials and Methods: A cross-sectional study was conducted among 193 PLHA and 111 non-HIV patients having either of gastrointestinal disorders. Direct smear, Formalin ethyl acetate sedimentation and Kinyoun's modified acid fast staining methods were applied to detect intestinal parasites from stool samples and CD4 T-cell counts of PLHA was recorded from ART centre of hospital. Results: The overall prevalence of IPI was found to be 16.12% (19.17% in PLHA and 10.81% in non-HIV subjects). Prevalence was higher in PLHA (p<0.06) in which poly parasitic infection was common (24%) with the protozoa predominating over helminths. CD4 T-cell counts <200/μl (p<0.06) and diarrhoea (p<0.06) were associated with increased IPI in PLHA. Cryptosporidium parvum was found in 19.05% cases of PLHA having CD4 T-cell counts <200/μl. Conclusions: The higher prevalence of opportunistic protozoa among PLHA indicates the need of routine parasitic investigation using sensitive methods so that it will be helpful for the proper therapeutic management. [ABSTRACT FROM AUTHOR]