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Author: search.filters.author.Karat, Aaron S.Has files: No

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    The Impact Study: A Cluster-randomised Clinical and Health Economic Feasibility Study of a Theory-based Manualised Intervention to Support People With Tuberculosis Disease During Treatment
    (American Thoracic Society, 2023-05-01) Lipman, M.C.I.; Walker, E.; Moon, Z.; Weng, J.J.Y.; Abubakar, I.; Campbell, C.; Clarke, C.; Copas, A.; Costello, P.; Darvell, M.; Horne, Rebecca; Hunter, R.; Jones, A.; Karat, Aaron S.; Kielmann, Karina; Kilic, A.; Kunst, H.; Mandelbaum, M.; Stagg, H.R.
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    Fatigue after stroke: Frequency and effect on daily life
    (Taylor & Francis, 2011-10-07) Crosby, Gail A.; Munshi, Sunil; Karat, Aaron S.; Worthington, Esme; Lincoln, Nadina B.
    Purpose: An audit was conducted to assess the frequency of fatigue after stroke, to determine the impact on daily life, and whether it was discussed with clinicians. Method: Patients were recruited from Nottingham University Hospitals NHS Trust stroke service. Patients were interviewed about their fatigue, and the Fatigue Severity Subscale (FSS-FAI), Brief Assessment Schedule for Depression Cards (BASDEC), Barthel Index and Nottingham Extended Activities of Daily Living (EADL) Scale were administered. Results: 64 patients were recruited, with a mean age 73.5 years (SD 14.0, range 37–94 years), 37 (58%) as in-patients and 27 (42%) as outpatients. There were 41 (64%) who reported significant levels of fatigue and 31 (48%) with significant fatigue on the Fatigue Severity Scale. Demographic and clinical variables were not significantly related to fatigue (p > 0.05), apart from gender, with women reporting significantly more fatigue than men (p = 0.006). There was a moderate correlation between the BASDEC and FSS (rs = 0.41, p = 0.002). Of the 41 participants who reported fatigue, 33 (81%) had not discussed this with their clinician. Conclusions: Fatigue was a common problem after stroke. There was a lack of awareness in both patients and clinicians and little advice being given to patients with fatigue.
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    Cryptococcal-related mortality despite fluconazole preemptive treatment in a cryptococcal antigen (CrAg) screen-and-treat programme
    (Oxford University Press, 2019-06-08) Wake, Rachel M.; Govender, Nelesh P.; Omar, Tanvier; Nel, Carolina; Mazanderani, Ahmad Haeri; Karat, Aaron S.; Ismail, Nazir A.; Tiemessen, Caroline T.; Jarvis, Joseph N.; Harrison, Thomas S.
    Background. Cryptococcal antigen (CrAg) screening and treatment with preemptive fluconazole reduces the incidence of clinically evident cryptococcal meningitis in individuals living with advanced human immunodeficiency virus (HIV) disease. However, mortality remains higher in CrAg-positive than in CrAg-negative patients with similar CD4+ T-lymphocyte counts.
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    Tuberculosis from transmission in clinics in high HIV settings may be far higher than contact data suggest
    (International Union Against Tuberculosis and Lung Disease, 2020-04-01) McCreesh, Nicky; Grant, Alison D.; Yates, Tom A.; Karat, Aaron S.; White, Richard G.
    Background: In South Africa, it is estimated that only 0.5-6% of people’s contacts occur in clinics. Both people with infectious tuberculosis and people with increased susceptibility to disease progression may spend more time in clinics however, increasing the importance of clinic-based transmission to overall disease incidence.
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    Algorithm-guided empirical tuberculosis treatment for people with advanced HIV (TB Fast Track): An open-label, cluster-randomised trial
    (Elsevier, 2019-11-11) Grant, Alison D.; Charalambous, Salome; Tlali, Mpho; Karat, Aaron S.; Dorman, Susan E.; Hoffmann, Christopher J.; Johnson, Suzanne; Vassall, Anna; Churchyard, Gavin J.; Fielding, Katherine L.
    Background Tuberculosis, which is often undiagnosed, is the major cause of death among HIV-positive people. We aimed to test whether the use of a clinical algorithm enabling the initiation of empirical tuberculosis treatment by nurses in primary health-care clinics would reduce mortality compared with standard of care for adults with advanced HIV disease.
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    Lessons learnt conducting minimally invasive autopsies in private mortuaries as part of HIV and tuberculosis research in South Africa
    (International Union Against Tuberculosis and Lung Disease, 2019-12-21) Karat, Aaron S.; Omar, T.; Tlali, M.; Charalambous, S.; Chihota, V. N.; Churchyard, G. J.; Fielding, K. L.; Martinson, N. A.; McCarthy, K. M.; Grant, A. D.
    Current estimates of the burden of tuberculosis (TB) disease and cause-specific mortality in human immunodeficiency virus (HIV) positive people rely heavily on indirect methods that are less reliable for ascertaining individual-level causes of death and on mathematical models. Minimally invasive autopsy (MIA) is useful for diagnosing infectious diseases, provides a reasonable proxy for the gold standard in cause of death ascertainment (complete diagnostic autopsy) and, used routinely, could improve cause-specific mortality estimates. From our experience in performing MIAs in HIV-positive adults in private mortuaries in South Africa (during the Lesedi Kamoso Study), we describe the challenges we faced and make recommendations for the conduct of MIA in future studies or surveillance programmes, including strategies for effective communication, approaches to obtaining informed consent, risk management for staff and efficient preparation for the procedure.