{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T04:45:10Z","timestamp":1779943510665,"version":"3.53.1"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2011,8,15]],"date-time":"2011-08-15T00:00:00Z","timestamp":1313366400000},"content-version":"vor","delay-in-days":226,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"funder":[{"DOI":"10.13039\/100002269","name":"Pacific Vision Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of the International AIDS Society"],"published-print":{"date-parts":[[2011,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Cytomegalovirus retinitis is a neglected disease in resource\u2010poor 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\u2010ophthalmologists. The programme consists of systematic screening of all high\u2010risk patients (CD4 &lt;100 cells\/mm<jats:sup>3<\/jats:sup>) 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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\u2010risk patients (CD4 &lt;100 cells\/mm<jats:sup>3<\/jats:sup>) was carried out at five separate AIDS clinics throughout Myanmar.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>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\/mm<jats:sup>3<\/jats:sup>. 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 1296 injections were administered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A strategy of management of CMV retinitis at the primary care level is feasible in resource\u2010poor settings. With appropriate training and support, CMV retinitis can be diagnosed and treated by AIDS clinicians (non\u2010ophthalmologists), just like other major opportunistic infections.<\/jats:p><\/jats:sec>","DOI":"10.1186\/1758-2652-14-41","type":"journal-article","created":{"date-parts":[[2011,8,16]],"date-time":"2011-08-16T06:46:35Z","timestamp":1313477195000},"page":"41-41","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["CMV retinitis screening and treatment in a resource\u2010poor setting: three\u2010year experience from a primary care HIV\/AIDS programme in Myanmar"],"prefix":"10.1002","volume":"14","author":[{"given":"NiNi","family":"Tun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolas","family":"London","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moe Kyaw","family":"Kyaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Smithuis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Ford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd","family":"Margolis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W Lawrence","family":"Drew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Lewallen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Heiden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,8,15]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0040334"},{"key":"e_1_2_9_3_1","unstructured":"Essential Prevention and Care Interventions for Adults and Adolescents Living with HIV in Resource\u2010Limited Settings.HIV\/AIDS Programme: Strengthening health services to fight HIV\/AIDSGeneva: World Health Organization Department of HIV\/AIDS; 2008 1\u2010110."},{"key":"e_1_2_9_4_1","unstructured":"KaplanJE BensonC HolmesKH BrooksJT PauA MasurH:Guidelines for prevention and treatment of opportunistic infections in HIV\u2010infected adults and adolescents: recommendations from CDC the National Institutes of Health and the HIV Medicine Association of the Infectious Diseases Society of America.MMWR Recomm Rep2009 58(RR\u20104):1\u2010207 quiz CE201\u2010204."},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.iae.0000249575.38830.45"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2007.07.002"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e3181a254c2"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.121.1.99"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/168.3.557"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-004-1160-2"},{"issue":"1","key":"e_1_2_9_11_1","first-page":"55","article-title":"Pathology and causes of death in a group of 128 predominantly HIV\u2010positive patients in Botswana, 1997\u20101998","volume":"6","author":"Ansari NA","year":"2002","journal-title":"Int J Tuberc Lung Dis"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/eye.1999.228"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.125.3.399"},{"key":"e_1_2_9_14_1","volume-title":"Epidemiological Fact Sheet on HIV and AIDS: Core Data on Epidemiology and Response, Myanmar","author":"WHO\/UNAIDS\/UNICEF","year":"2008"},{"key":"e_1_2_9_15_1","first-page":"437","volume-title":"Management of virus infections (cytomegalovirus, herpes simplex virus, varicella\u2010zoster virus). 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