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https://www.readbyqxmd.com/read/29665809/generating-evidence-for-health-policy-in-challenging-settings-lessons-learned-from-four-prevention-of-mother-to-child-transmission-of-hiv-implementation-research-studies-in-nigeria
#1
Nadia A Sam-Agudu, Muktar H Aliyu, Olusegun A Adeyemi, Frank Oronsaye, Bolanle Oyeledun, Amaka G Ogidi, Echezona E Ezeanolue
BACKGROUND: Implementation research (IR) facilitates health systems strengthening and optimal patient outcomes by generating evidence for scale-up of efficacious strategies in context. Thus, difficulties in generating IR evidence, particularly in limited-resource settings with wide disease prevention and treatment gaps, need to be anticipated and addressed. Nigeria is a priority country for the prevention of mother-to-child transmission of HIV (PMTCT). This paper analyses the experiences of four PMTCT IR studies in Nigeria, and proffers solutions to major challenges encountered during implementation...
April 17, 2018: Health Research Policy and Systems
https://www.readbyqxmd.com/read/29649980/patterns-of-caesarean-section-in-hiv-infected-and-non-infected-women-in-malawi-is-caesarean-section-used-for-pmtct
#2
Lyson Tenthani, Joep J van Oosterhout, Andreas D Haas, Malango Msukwa, Nozgechi Phiri, Frank Chimbwandira, Kali Tal, Karoline Aebi-Popp, Janne Estill, Olivia Keiser
BACKGROUND: Caesarean section (CS) is not recommended for PMTCT in Malawi HIV Guidelines, contrary to most high-income countries where CS is indicated if viral suppression is sub-optimal pre-delivery. We describe patterns of CS in HIV-infected and uninfected women in Malawi and explored if insight into the use of Elective CS (ECS) for PMTCT could be obtained. METHODS: We used routinely collected data from individual medical records from 17 large health facilities in the central and southern regions of Malawi, from January 2010 to December 2013...
April 12, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29629683/near-real-time-tracking-of-gaps-in-prevention-of-mother-to-child-transmission-of-hiv-in-three-districts-of-kwazulu-natal-province-south-africa
#3
F Moyo, A Haeri Mazanderani, S Bhardwaj, O B Mhlongo, T Kufa, K Ng'oma, B A Smith, G G Sherman
BACKGROUND: Identifying and addressing gaps in the prevention of mother-to-child transmission of HIV (PMTCT) is required if South Africa (SA) is to achieve targets for eliminating MTCT (eMTCT). Potential PMTCT gaps that increase MTCT risk include late maternal HIV diagnosis, lack of or delayed antiretroviral therapy (ART) during pregnancy and breastfeeding, and lack of effective prophylaxis for HIV-exposed infants. OBJECTIVES: To investigate, in near real time, PMTCT gaps among HIV-infected infants in three districts of KwaZulu-Natal Province, SA...
March 28, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/29629654/reproductive-decision-making-among-postpartum-hiv-infected-women-in-rural-south-africa
#4
Deborah L Jones, Violeta J Rodriguez, Suat Babayigit, Antonio Chahine, Stephen M Weiss, Karl Peltzer
Despite pregnancy spacing recommendations to optimize health outcomes among mothers and neonates, unplanned pregnancy in sub-Saharan Africa is common among women living with human immunodeficiency virus (HIV) (WLHIV). This study examined factors associated with reproductive decision-making among WLHIV to inform pregnancy-planning interventions. WLHIV in rural South Africa (n = 165) were assessed at 12 months postpartum. The relative importance of factors associated with reproductive decision-making was estimated...
January 1, 2018: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/29601456/infant-hiv-free-survival-in-the-era-of-universal-antiretroviral-therapy-for-pregnant-and-breastfeeding-women-a-community-based-cohort-study-from-rural-zambia
#5
Benjamin H Chi, Wilbroad Mutale, Jennifer Winston, Winifreda Phiri, Joan T Price, Angel Mwiche, Helen Ayles, Jeffrey S A Stringer
BACKGROUND: Lifelong antiretroviral therapy (ART) is now recommended for all HIV-infected pregnant and breastfeeding women; however, few have described overall infant outcomes in this new era for the prevention of mother-to-child HIV transmission (PMTCT). METHODS: As part of an assessment of PMTCT program impact, we enrolled a prospective cohort study in four predominantly rural districts in Zambia. HIV-infected mothers and their newborns (≤30 days old) were recruited and followed at 6 weeks, 6 months, and 12 months postpartum; infant specimens were tested via HIV DNA PCR...
March 27, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29595649/next-generation-sequencing-provides-an-added-value-in-determining-drug-resistance-and-viral-tropism-in-cameroonian-hiv-1-vertically-infected-children
#6
Joseph Fokam, Maria C Bellocchi, Daniele Armenia, Aubin J Nanfack, Luca Carioti, Fabio Continenza, Desire Takou, Edith S Temgoua, Charlotte Tangimpundu, Judith N Torimiro, Paul N Koki, Charles N Fokunang, Giulia Cappelli, Alexis Ndjolo, Vittorio Colizzi, Francesca Ceccherini-Silberstein, Carlo-Federico Perno, Maria M Santoro
With limited and low-genetic barrier drugs used for the prevention of mother-to-child transmission (PMTCT) of HIV in sub-Saharan Africa, vertically transmitted HIV-1 drug-resistance (HIVDR) is concerning and might prompt optimal pediatric strategies.The aim of this study was to ascertain HIVDR and viral-tropism in majority and minority populations among Cameroonian vertically infected children.A comparative analysis among 18 HIV-infected children (7 from PMTCT-exposed mothers and 11 from mothers without PMTCT-exposure) was performed...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29595094/paediatric-hiv-1-infection-updated-strategies-of-prevention-mother-to-child-transmission
#7
Alessandra Lumaca, Luisa Galli, Maurizio de Martino, Elena Chiappini
INTRODUCTION: HIV-1 epidemiology is changing and prevention of mother-to-child transmission (PMTCT) strategies have been continuously optimized over time. However, the correct management of infected women during pregnancy is crucial for PMTCT and cases of vertical transmission continue to occur. OBJECTIVE: To review the most recent evidence regarding the prevention of MTCT in resource-rich and resource-limited settings, focalizing on new possible approaches. RESULTS: New issues regard the optimal antiretroviral therapy regimen for pregnant women with good immunological control, the use of intrapartum zidovudine (ZDV) in pregnant women with low viral load, the optimization of prophylaxis in the settings where breastfeeding is recommended and use of combined neonatal prophylaxis (CNP) in infants at high-risk for MTCT...
March 29, 2018: Journal of Chemotherapy
https://www.readbyqxmd.com/read/29575943/prevalence-of-prenatal-and-postpartum-depression-and-associated-factors-among-hiv-infected-women-in-public-primary-care-in-rural-south-africa-a-longitudinal-study
#8
Karl Peltzer, Violeta J Rodriguez, Tae Kyoung Lee, Deborah Jones
This study aimed to assess the longitudinal prevalence of prenatal and postnatal depression and associated factors among HIV-infected women in rural South Africa. In a longitudinal, cluster-randomized, prevention of mother to child transmission (PMTCT) intervention trial, 681 HIV-infected prenatal women in 12 community health centres in Mpumalanga province, South Africa, were recruited in 2015 by consecutive sampling at 8-24 weeks pregnancy and followed up at 32 weeks prenatally, and 6 and 12 months postpartum (retention rate = 59...
March 25, 2018: AIDS Care
https://www.readbyqxmd.com/read/29567853/roles-played-by-community-cadres-to-support-retention-in-pmtct-option-b-in-four-african-countries-a-qualitative-rapid-appraisal
#9
Donela Besada, Ameena Goga, Emmanuelle Daviaud, Sarah Rohde, Jacqueline Rose Chinkonde, Susie Villeneuve, Guy Clarysse, Nika Raphaely, Steve Okokwu, Nathan Tumwesigye, Nathalie Daries, Tanya Doherty
OBJECTIVES: To explore the roles of community cadres in improving access to and retention in care for PMTCT (prevent mother-to-child transmission of HIV) services in the context of PMTCT Option B+ treatment scale-up in high burden low-income and lower-middle income countries. DESIGN/METHODS: Qualitative rapid appraisal study design using semistructured in-depth interviews and focus group discussions (FGDs) between 8 June and 31 July 2015. SETTING AND PARTICIPANTS: Interviews were conducted in the offices of Ministry of Health Staff, Implementing partners, district offices and health facility sites across four low-income and lower-middle income countries: Cote D'Ivoire, Democratic Republic of Congo (DRC), Malawi and Uganda...
March 22, 2018: BMJ Open
https://www.readbyqxmd.com/read/29566724/utilization-of-prevention-of-mother-to-child-transmission-pmtct-services-among-pregnant-women-in-hiv-care-in-uganda-a-24-month-cohort-of-women-from-pre-conception-to-post-delivery
#10
Rhoda K Wanyenze, Kathy Goggin, Sarah Finocchario-Kessler, Jolly Beyeza-Kashesya, Deborah Mindry, Josephine Birungi, Mahlet Woldetsadik, Glenn J Wagner
OBJECTIVE: We assessed the uptake of prevention of mother-to-child transmission (PMTCT) services in a cohort of HIV infected women in care at The AIDS Support Organization Jinja and Kampala in Uganda, who were trying to conceive, over a period of 24 months, to inform the strengthening of PMTCT service access for women in care. RESULTS: Of the 299 women 127 (42.5%) reported at least one pregnancy within 24 months; 61 women (48.0%) delivered a live child. Of the 55 who had a live birth at the first pregnancy, 54 (98...
March 22, 2018: BMC Research Notes
https://www.readbyqxmd.com/read/29558896/challenges-and-successes-in-the-implementation-of-option-b-to-prevent-mother-to-child-transmission-of-hiv-in-southern-swaziland
#11
David Etoori, Bernhard Kerschberger, Nelly Staderini, Mpumelelo Ndlangamandla, Bonisile Nhlabatsi, Kiran Jobanputra, Simangele Mthethwa-Hleza, Lucy Anne Parker, Sifiso Sibanda, Edwin Mabhena, Munyaradzi Pasipamire, Serge Mathurin Kabore, Barbara Rusch, Christine Jamet, Iza Ciglenecki, Roger Teck
BACKGROUND: Universal antiretroviral therapy (ART) for all pregnant/ breastfeeding women living with Human Immunodeficiency Virus (HIV), known as Prevention of mother-to child transmission of HIV (PMTCT) Option B+ (PMTCTB+), is being scaled up in most countries in Sub-Saharan Africa. In the transition to PMTCTB+, many countries face challenges with proper implementation of the HIV care cascade. We aimed to describe the feasibility of a PMTCTB+ approach in the public health sector in Swaziland...
March 20, 2018: BMC Public Health
https://www.readbyqxmd.com/read/29554917/-he-does-not-have-to-wait-under-a-tree-perceptions-of-men-women-and-health-care-workers-on-male-partner-involvement-in-prevention-of-mother-to-child-transmission-of-human-immunodeficiency-virus-services-in-malawi
#12
Alinane L Nyondo-Mipando, Angela F Chimwaza, Adamson S Muula
BACKGROUND: The perception of male involvement (MI) in maternal child health services is multifaceted and differs among varying programs and populations. In the Prevention of Mother to Child Transmission (PMTCT) context, MI includes men's attendance at antenatal care (ANC) clinics, undertaking an HIV tests within the ANC and financial and psychological support. Contexualising the definition of MI is fundamental in the development of MI in PMTCT policy and interventions. The objective of this study was to explore the perceptions of men, women and health care workers on male partner involvement in PMTCT services in Malawi...
March 20, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29529282/the-investment-case-for-hepatitis-b-and-c-in-south-africa-adaptation-and-innovation-in-policy-analysis-for-disease-program-scale-up
#13
Robert Hecht, Lindsey Hiebert, Wendy C Spearman, Mark W Sonderup, Teresa Guthrie, Timothy B Hallett, Shevanthi Nayagam, Homie Razavi, Shan Soe-Lin, Kgomotso Vilakazi-Nhlapo, Yogan Pillay, Stephen Resch
Even though WHO has approved global goals for hepatitis elimination, most countries have yet to establish programs for hepatitis B and C, which account for 320 million infections and over a million deaths annually. One reason for this slow response is the paucity of robust, compelling analyses showing that national HBV/HCV programs could have a significant impact on these epidemics and save lives in a cost-effective, affordable manner. In this context, our team used an investment case approach to develop a national hepatitis action plan for South Africa, grounded in a process of intensive engagement of local stakeholders...
February 26, 2018: Health Policy and Planning
https://www.readbyqxmd.com/read/29508682/individual-and-community-level-determinants-of-antenatal-hiv-testing-in-zimbabwe
#14
Martin Marufu Gazimbi, Monica Akinyi Magadi
This study contributes to the dialogue on the prevention of mother-to-child HIV transmission (PMTCT) through the use of HIV and antenatal care (ANC) integrated services. The determinants of antenatal HIV testing in Zimbabwe were explored. Multilevel logistic regression models were applied to data for 8471 women from 406 clusters who gave birth in the 5 years preceding Zimbabwe Demographic and Health Surveys conducted in 2005/6 and 2010/11. The uptake of antenatal HIV testing was found to be determined by a wide range of individual-level factors relating to women's economic and demographic status, as well as HIV-related factors, including HIV awareness and stigma within the community...
March 6, 2018: Journal of Biosocial Science
https://www.readbyqxmd.com/read/29499704/hiv-status-disclosure-to-male-partners-among-rural-nigerian-women-along-the-prevention-of-mother-to-child-transmission-of-hiv-cascade-a-mixed-methods-study
#15
Angela Odiachi, Salome Erekaha, Llewellyn J Cornelius, Christopher Isah, Habib O Ramadhani, Laura Rapoport, Nadia A Sam-Agudu
BACKGROUND: HIV status disclosure to male partners is important for optimal outcomes in the prevention of mother-to-child transmission of HIV (PMTCT). Depending on timing of HIV diagnosis or pregnancy status, readiness to disclose and disclosure rates may differ among HIV-positive women. We sought to determine rates, patterns, and experiences of disclosure among Nigerian women along the PMTCT cascade. METHODS: HIV-positive women in rural North-Central Nigeria were purposively recruited according to their PMTCT cascade status: pregnant-newly HIV-diagnosed, pregnant-in care, postpartum, and lost-to-follow-up (LTFU)...
March 2, 2018: Reproductive Health
https://www.readbyqxmd.com/read/29497335/fertility-intentions-of-prenatal-and-postpartum-hiv-positive-women-in-primary-care-in-mpumalanga-province-south-africa-a-longitudinal-study
#16
Karl Peltzer, Sibusiso Sifunda, Lissa N Mandell, Violeta J Rodriguez, Tae Kyoung Lee, Ryan Cook, Stephen M Weiss, Deborah L Jones
Introduction: This study aimed to assess fertility intentions (planning to have more children in the future) and associated factors among pregnant and postpartum HIV positive women in rural South Africa. Methods: In a longitudinal study, as part of a prevention of mother to child transmission (PMTCT) intervention trial, 699 HIV positive prenatal women, were systematically recruited and followed up at 6 months and 12 months postpartum (retention rate = 59.5%). Results: At baseline, 32...
2018: HIV/AIDS: Research and Palliative Care
https://www.readbyqxmd.com/read/29482337/the-mother-s-carnet-de-sant%C3%A3-health-booklet-in-cameroon-a-tool-for-preventing-mother-to-child-transmission-of-hiv
#17
Josiane Tantchou, Annick Tijou-Traoré
In the global effort against HIV and AIDS, prevention of mother-to-child transmission of HIV (PMTCT) in resource-poor countries is an issue of international importance. In Cameroon, a widely disseminated protocol defines the process to be followed by all pregnant women within the public health system before and after screening, whatever the result. The protocol as a representation of professional practices can be discerned in inscriptions made in files, registers and the carnet de santé that we use here as the cornerstone of our analysis...
February 27, 2018: Anthropology & Medicine
https://www.readbyqxmd.com/read/29479861/where-have-all-the-children-gone-high-hiv-prevalence-in-infants-attending-nutrition-and-inpatient-entry-points
#18
Charles Kiyaga, Brittany Urick, Youyi Fong, Christopher Okiira, Nicolette Nabukeera-Barungi, Denis Nansera, Emmanuel Ochola, Julius Nteziyaremye, Victor Bigira, Isaac Ssewanyana, Peter Olupot-Olupot, Trevor Peter, Anisa Ghadrshenas, Lara Vojnov
INTRODUCTION: Despite notable progress towards PMTCT, only 50% of HIV-exposed infants in sub-Saharan Africa were tested within the first 2 months of life and only 30% of HIV-infected infants are on antiretroviral treatment. This study assessed HIV prevalence in infants and children receiving care at various service entry points in primary healthcare facilities in Uganda. METHODS: A total of 3600 infants up to 24 months of age were systematically enrolled and tested at four regional hospitals across Uganda...
February 2018: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/29474175/health-utility-of-pregnant-women-living-with-hiv-aids-prevention-of-mother-to-child-transmission-of-hiv-pmtct-programs-in-yunnan-province-a-cross-sectional-study
#19
Xiaowen Wang, Guangping Guo, Xiumin Liang, Ling Zhou, Jiarui Zheng, Shaoqin Li, Hongzhuan Luo, Yuyan Yang, Liyuan Yang, Ting Tan, Jun Yu, Lin Lu
BACKGROUND: Health utility (HU) is essential to understanding the effects of HIV infection as a chronic disease. No HU data on pregnant women living with human immunodeficiency virus (HIV) in Yunnan Province are available. This study aims to construct a database on HU and explore factors associated with HU by pregnant women living with HIV/acquired immunodeficiency syndrome (AIDS) who were enrolled in the Prevention of mother-to-child transmission of HIV (PMTCT) programs in Yunnan Province...
July 3, 2017: Value in Health Regional Issues
https://www.readbyqxmd.com/read/29458337/hiv-1-transmission-and-survival-according-to-feeding-options-in-infants-born-to-hiv-infected-women-in-yaound%C3%A3-cameroon
#20
Anne Esther Njom Nlend, Annie Carole Nga Motaze, Arsene Sandie, Joseph Fokam
BACKGROUND: Evidence of 24-months survival in the frame of prevention of mother-to-child transmission (PMTCT) cascade-care is scare from routine programs in sub-Saharan African (SSA) settings. Specifically, data on infant outcomes according to feeding options remain largely unknown by month-24, thus limiting its breath for public-health recommendations toward eliminating new pediatric HIV-1 infections and improving care. We sought to evaluate HIV-1 vertical transmission and infant survival rates according to feeding options...
February 19, 2018: BMC Pediatrics
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