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zimbabwe hiv incidence

Walter Chingwaru, Jerneja Vidmar
Zimbabwe is going through a generalised acquired immunodeficiency syndrome (AIDS) epidemic. The first five years of the epidemic (1985-1990) were characterised by lack of medicines against human immunodeficiency virus (HIV), and an exponential increase in prevalence (65-fold) and incidence (13-fold), which were fuelled by high-risk sexual behaviour. The high HIV prevalence, mortality and stigma yielded great fear and panic in the population, which are thought to have led to confusion and hopelessness, and, in turn, increased risky sexual behaviour...
August 11, 2016: Global Public Health
Severin Guy Mahiané, Oliver Laeyendecker
The study considers the problem of estimating incidence of a non remissible infection (or disease) with possibly differential mortality using data from a(several) cross-sectional prevalence survey(s). Fitting segmented polynomial models is proposed to estimate the incidence as a function of age, using the maximum likelihood method. The approach allows automatic search for optimal position of knots, and model selection is performed using the Akaike information criterion. The method is applied to simulated data and to estimate HIV incidence among men in Zimbabwe using data from both the NIMH Project Accept (HPTN 043) and Zimbabwe Demographic Health Surveys (2005-2006)...
September 26, 2016: Statistics in Medicine
Annick Bórquez, Anne Cori, Erica L Pufall, Jingo Kasule, Emma Slaymaker, Alison Price, Jocelyn Elmes, Basia Zaba, Amelia C Crampin, Joseph Kagaayi, Tom Lutalo, Mark Urassa, Simon Gregson, Timothy B Hallett
BACKGROUND: Programmatic planning in HIV requires estimates of the distribution of new HIV infections according to identifiable characteristics of individuals. In sub-Saharan Africa, robust routine data sources and historical epidemiological observations are available to inform and validate such estimates. METHODS AND FINDINGS: We developed a predictive model, the Incidence Patterns Model (IPM), representing populations according to factors that have been demonstrated to be strongly associated with HIV acquisition risk: gender, marital/sexual activity status, geographic location, "key populations" based on risk behaviours (sex work, injecting drug use, and male-to-male sex), HIV and ART status within married or cohabiting unions, and circumcision status...
September 2016: PLoS Medicine
Chloe A Teasdale, Elaine J Abrams, Mary Ann Chiasson, Jessica Justman, Kelly Blanchard, Heidi E Jones
Data suggest that pregnant women in some settings have high prevalence of HIV and other sexually transmitted infections (STI). We examined changes in sexual risk behaviors and intravaginal practices during pregnancy that may contribute to HIV and STI incidence using data from the Methods for Improved Reproductive Health in Africa study conducted in South Africa and Zimbabwe 2003-2006. We used a crossover design and modified Poisson regression to compare behaviors among HIV negative women 18-45 years during pregnant and non-pregnant periods...
September 6, 2016: Archives of Sexual Behavior
Ian Baudi, Sayuki Iijima, Nyasha Chin'ombe, Sekesai Mtapuri-Zinyowera, Shuko Murakami, Masanori Isogawa, Atsuko Hachiya, Yasumasa Iwatani, Yasuhito Tanaka
The objective of this study was to determine the prevalence of co-infection with hepatitis B virus (HBV) and human immunodeficiency virus (HIV) and the genetic characteristics of both viruses among pre-HIV-treatment patients in Harare, Zimbabwe. This cross-sectional survey involved 176 remnant plasma samples collected from consenting HIV patients (median age 35 [18-74]) between June and September 2014. HBV seromarkers were determined by high-sensitivity chemiluminescence assays. Molecular evolutionary analyses were conducted on the basal core promoter/precore (BCP/PC) and S regions of HBV, as well as part of the HIV pol region...
July 26, 2016: Journal of Medical Virology
Collin Mangenah, Webster Mavhu, Karin Hatzold, Andrea K Biddle, Getrude Ncube, Owen Mugurungi, Ismail Ticklay, Frances M Cowan, Harsha Thirumurthy
BACKGROUND: The 14 countries that are scaling up voluntary male medical circumcision (VMMC) for HIV prevention are also considering early infant male circumcision (EIMC) to ensure longer-term reductions in HIV incidence. The cost of implementing EIMC is an important factor in scale-up decisions. We conducted a comparative cost analysis of EIMC performed by nurse-midwives and doctors using the AccuCirc device in Zimbabwe. METHODS: Between August 2013 and July 2014, nurse-midwives performed EIMC on 500 male infants using AccuCirc in a field trial...
July 2016: Global Health, Science and Practice
Mufuta Tshimanga, Tonderayi Mangwiro, Owen Mugurungi, Sinokuthemba Xaba, Munyaradzi Murwira, Danuta Kasprzyk, Daniel E Montaño, Daisy Nyamukapa, Basile Tambashe, Pesanai Chatikobo, Patricia Gundidza, Gerald Gwinji
BACKGROUND: The World Health Organization (WHO) and the Joint United Nations Program on HIV/AIDS promote MC (male circumcision) as a key HIV prevention strategy where HIV prevalence and incidence are high and MC prevalence is low. In Zimbabwe, to achieve the 1.26 million circumcisions needed to be performed by 2015 to achieve optimal MC coverage, a new approach was needed. The primary objective of the current trial was to assess the performance (safety, procedure time, and cost) of the PrePex device compared to forceps-guided surgical circumcision...
2016: PloS One
Tinashe K Nyazika, Faith Masanganise, Ferry Hagen, Mutsawashe F Bwakura-Dangarembizi, Ismail M H Ticklay, Valerie J Robertson
Cryptococcal meningitis is a leading infectious disease worldwide as a result of the high burden of HIV and AIDS, although its cumulative incidence is very low in children compared with that in adults. Very few studies involving the disease in children have been reported including sub-Saharan Africa, with the highest prevalence of HIV-infected children in the world. We summarize 5 cases of children diagnosed with cryptococcal meningitis at a tertiary hospital in Harare, Zimbabwe, between October 1, 2013, and September 30, 2014...
September 2016: Pediatric Infectious Disease Journal
James R Hargreaves, Sibongile Mtetwa, Calum Davey, Jeffrey Dirawo, Samson Chidiya, Clemens Benedikt, Sue Naperiela Mavedzenge, Ramona Wong-Gruenwald, Dagmar Hanisch, Tapiwa Magure, Owen Mugurungi, Frances M Cowan
BACKGROUND: HIV epidemiology and intervention uptake among female sex workers (FSW) in sub-Saharan Africa remain poorly understood. Data from outreach programs are a neglected resource. METHODS: Analysis of data from FSW consultations with Zimbabwe's National Sex Work program, 2009-2014. At each visit, data were collected on sociodemographic characteristics, HIV testing history, HIV tests conducted by the program and antiretroviral (ARV) history. Characteristics at first visit and longitudinal data on program engagement, repeat HIV testing, and HIV seroconversion were analyzed using a cohort approach...
May 1, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Angela M Crook, Anna Turkova, Victor Musiime, Mutsa Bwakura-Dangarembizi, Sabrina Bakeera-Kitaka, Patricia Nahirya-Ntege, Margaret Thomason, Peter Mugyenyi, Philippa Musoke, Adeodata Kekitiinwa, Paula Munderi, Kusum Nathoo, Andrew J Prendergast, A Sarah Walker, Diana M Gibb
BACKGROUND: There are few data on tuberculosis (TB) incidence in HIV-infected children on antiretroviral therapy (ART). Observational studies suggest co-trimoxazole prophylaxis may prevent TB, but there are no randomized data supporting this. The ARROW trial, which enrolled HIV-infected children initiating ART in Uganda and Zimbabwe and included randomized cessation of co-trimoxazole prophylaxis, provided an opportunity to estimate the incidence of TB over time, to explore potential risk factors for TB, and to evaluate the effect of stopping co-trimoxazole prophylaxis...
2016: BMC Medicine
Dixon Chibanda, Frances Cowan, Lorna Gibson, Helen A Weiss, Crick Lund
BACKGROUND: In 2014 close to 10 million people living with HIV (PLWH) in sub-Saharan Africa were on highly active anti-retroviral therapy (HAART). The incidence of non-communicable diseases has increased markedly in PLWH as mortality is reduced due to use of HAART. Common mental disorders (CMD) are highly prevalent in PLWH. We aimed to determine factors associated with probable CMD and depression, assessed by 2 locally validated screening tools in a population with high prevalence of HIV in Harare, Zimbabwe...
2016: BMC Psychiatry
Jared M Baeten, Thesla Palanee-Phillips, Elizabeth R Brown, Katie Schwartz, Lydia E Soto-Torres, Vaneshree Govender, Nyaradzo M Mgodi, Flavia Matovu Kiweewa, Gonasagrie Nair, Felix Mhlanga, Samantha Siva, Linda-Gail Bekker, Nitesha Jeenarain, Zakir Gaffoor, Francis Martinson, Bonus Makanani, Arendevi Pather, Logashvari Naidoo, Marla Husnik, Barbra A Richardson, Urvi M Parikh, John W Mellors, Mark A Marzinke, Craig W Hendrix, Ariane van der Straten, Gita Ramjee, Zvavahera M Chirenje, Clemensia Nakabiito, Taha E Taha, Judith Jones, Ashley Mayo, Rachel Scheckter, Jennifer Berthiaume, Edward Livant, Cindy Jacobson, Patrick Ndase, Rhonda White, Karen Patterson, Donna Germuga, Beth Galaska, Katherine Bunge, Devika Singh, Daniel W Szydlo, Elizabeth T Montgomery, Barbara S Mensch, Kristine Torjesen, Cynthia I Grossman, Nahida Chakhtoura, Annalene Nel, Zeda Rosenberg, Ian McGowan, Sharon Hillier
Background Antiretroviral medications that are used as prophylaxis can prevent acquisition of human immunodeficiency virus type 1 (HIV-1) infection. However, in clinical trials among African women, the incidence of HIV-1 infection was not reduced, probably because of low adherence. Longer-acting methods of drug delivery, such as vaginal rings, may simplify use of antiretroviral medications and provide HIV-1 protection. Methods We conducted a phase 3, randomized, double-blind, placebo-controlled trial of a monthly vaginal ring containing dapivirine, a non-nucleoside HIV-1 reverse-transcriptase inhibitor, involving women between the ages of 18 and 45 years in Malawi, South Africa, Uganda, and Zimbabwe...
February 22, 2016: New England Journal of Medicine
I Chitsike, N Ndlovu, P Kuona, A M Nyakabau, W Kadzatsa, I Ticklay, G Chimhini, E Chokonunga
OBJECTIVE: To document the pattern of cancer in children (0-14 years) registered in the Zimbabwe National Cancer Registry from 2000-2009. DESIGN: Retrospective descriptive analysis. METHODS: Analysis of data from the Zimbabwe National Cancer Registry for the period 2000-2009. SETTING: The Zimbabwe National Cancer Registry. RESULTS: Childhood Cancer constituted 3.8% of all malignancies recorded at the cancer registry during the study period...
January 2014: Central African Journal of Medicine
Tonderai Mapako, Mart P Janssen, David A Mvere, Jean C Emmanuel, Simbarashe Rusakaniko, Maarten J Postma, Marinus van Hulst
BACKGROUND: Various models for estimating the residual risk (RR) of transmission of infections by blood transfusion have been published mainly based on data from high-income countries. However, to obtain the data required for such an assessment remains challenging for most developing settings. The National Blood Service Zimbabwe (NBSZ) adapted a published incidence-window period (IWP) model, which has less demanding data requirements. In this study we assess the impact of various definitions of blood donor subpopulations and models on RR estimates...
June 2016: Transfusion
J R Hargreaves, S Mtetwa, C Davey, J Dirawo, S Chidiya, C Benedikt, Mavedzenge S Naperiela, R Wong-Gruenwald, D Hanisch, T Magure, O Mugurungi, F M Cowan
BACKGROUND: HIV epidemiology and intervention uptake among female sex workers (FSW) in sub-Saharan Africa remain poorly understood. Data from outreach programmes are a neglected resource. METHODS: Analysis of data from FSW consultations with Zimbabwe's National Sex Work programme, 2009-14. At each visit, data were collected on socio-demographic characteristics, HIV testing history, HIV tests conducted by the programme and antiretroviral (ARV) history. Characteristics at first visit and longitudinal data on programme engagement, repeat HIV testing and HIV sero-conversion were analysed using a cohort approach...
December 15, 2015: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Susanne F Awad, Sema K Sgaier, Gertrude Ncube, Sinokuthemba Xaba, Owen M Mugurungi, Mutsa M Mhangara, Fiona K Lau, Yousra A Mohamoud, Laith J Abu-Raddad
BACKGROUND: The voluntary medical male circumcision (VMMC) program in Zimbabwe aims to circumcise 80% of males aged 13-29 by 2017. We assessed the impact of actual VMMC scale-up to date and evaluated the impact of potential alterations to the program to enhance program efficiency, through prioritization of subpopulations. METHODS AND FINDINGS: We implemented a recently developed analytical approach: the age-structured mathematical (ASM) model and accompanying three-level conceptual framework to assess the impact of VMMC as an intervention...
2015: PloS One
Kathryn E Lancaster, Cynthia Kwok, Anne Rinaldi, Josaphat Byamugisha, Tulani Magwali, Prisca Nyamapfeni, Robert A Salata, Charles S Morrison
OBJECTIVE: To describe pregnancy outcomes among HIV-infected women and examine factors associated with live birth among those receiving and not receiving combination antiretroviral therapy (cART). METHODS: The present analysis included women with HIV from Uganda and Zimbabwe who participated in a prospective cohort study during 2001-2009. Incident pregnancies and pregnancy outcomes were recorded quarterly. The Kaplan-Meier method was used to estimate incident pregnancy probabilities; factors associated with live birth were evaluated by Poisson regression with generalized estimating equations...
December 2015: International Journal of Gynaecology and Obstetrics
Webster Mavhu, Natasha Larke, Karin Hatzold, Getrude Ncube, Helen A Weiss, Collin Mangenah, Owen Mugurungi, Juliet Mufuka, Christopher A Samkange, Judith Sherman, Gerald Gwinji, Frances M Cowan, Ismail Ticklay
BACKGROUND: Early infant male circumcision (EIMC) is a potential key HIV prevention intervention, providing it can be safely and efficiently implemented in sub-Saharan Africa. Here, we present results of a randomized noninferiority trial of EIMC comparing the AccuCirc device with Mogen clamp in Zimbabwe. METHODS: Between January and June 2013, eligible infants were randomized to EIMC through either AccuCirc or Mogen clamp conducted by a doctor, using a 2:1 allocation ratio...
August 15, 2015: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Daniel Low-Beer, Rand L Stoneburner
OBJECTIVE: To investigate distinctive communications through social networks which may be associated with population behaviour changes and HIV prevalence declines in Uganda compared to other countries. METHODS: We undertook a comparative analysis of demographic and HIV behavioural data collected in Demographic and Health Surveys (DHS III) in Uganda, Kenya, Tanzania, Malawi, Zambia and Zimbabwe as well as Knowledge, Attitudes and Behaviours (KABP) surveys in Uganda in 1989 and 1995...
May 2004: African Journal of AIDS Research: AJAR
Jeanne M Marrazzo, Gita Ramjee, Barbra A Richardson, Kailazarid Gomez, Nyaradzo Mgodi, Gonasagrie Nair, Thesla Palanee, Clemensia Nakabiito, Ariane van der Straten, Lisa Noguchi, Craig W Hendrix, James Y Dai, Shayhana Ganesh, Baningi Mkhize, Marthinette Taljaard, Urvi M Parikh, Jeanna Piper, Benoît Mâsse, Cynthia Grossman, James Rooney, Jill L Schwartz, Heather Watts, Mark A Marzinke, Sharon L Hillier, Ian M McGowan, Z Mike Chirenje
BACKGROUND: Reproductive-age women need effective interventions to prevent the acquisition of human immunodeficiency virus type 1 (HIV-1) infection. METHODS: We conducted a randomized, placebo-controlled trial to assess daily treatment with oral tenofovir disoproxil fumarate (TDF), oral tenofovir-emtricitabine (TDF-FTC), or 1% tenofovir (TFV) vaginal gel as preexposure prophylaxis against HIV-1 infection in women in South Africa, Uganda, and Zimbabwe. HIV-1 testing was performed monthly, and plasma TFV levels were assessed quarterly...
February 5, 2015: New England Journal of Medicine
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