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https://www.readbyqxmd.com/read/28799825/progress-toward-elimination-of-perinatal-hiv-transmission-in-kenya-analysis-of-early-infant-diagnosis-data
#1
Dunstan Achwoka, Justin Mandala, Mutugi Muriithi, Yanwu Zeng, Mario Chen, Rebecca Dirks, Martin Sirengo, Rose Wafula, Kwasi Torpey
Interrupting vertical transmission of HIV from mothers to infants provides opportunity to transform the HIV/AIDS epidemic by eliminating new infections among children. We estimate mother-to-child transmission rates of infants born to known HIV-positive mothers offered prevention of mother-to-child transmission interventions and provide an indication of Kenya's progress toward elimination of perinatal transmission. We obtained from the Kenya National Early Infant Diagnosis (EID) database, all 131,451 DNA polymerase chain reaction test results of HIV-exposed infants aged 0-18 months who had dried blood spot samples taken between January 2008 and October 2013...
January 1, 2017: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/28797181/hiv-resistance-with-correlation-to-pmtct-regimen-in-hiv-infected-infants-in-northern-tanzania
#2
Dorothy Elizabeth Dow, Werner Schimana, Balthazar M Nyombi, Blandina T Mmbaga, Aisa M Shayo, John A Bartlett, Charles G Massambu, Emmanuel G Kifaro, Elizabeth L Turner, Todd DeMarco, Fangping Cai, Coleen Cunningham, Ann M Buchanan
Prevention of mother-to-child transmission (PMTCT) guidelines recommend that all HIV-infected pregnant woman receive antiretroviral therapy (Option B) and HIV-infected infants should initiate therapy with a protease inhibitor based regimen; however, implementation of these guidelines has lagged in many resource-limited settings. Tanzania only recently implemented these guidelines with little country specific data to inform whether HIV non-nucleoside reverse transcriptase inhibitor (NNRTI) resistance was present among infected infants under the Option A guidelines...
August 11, 2017: AIDS Research and Human Retroviruses
https://www.readbyqxmd.com/read/28796791/evaluating-turnaround-times-for-early-infant-diagnosis-samples-in-kenya-from-2011-2014-a-retrospective-analysis-of-hitsystem-program-data
#3
Catherine Wexler, An-Lin Cheng, Brad Gautney, Sarah Finocchario-Kessler, Kathy Goggin, Samoel Khamadi
Long turnaround times (TAT) for the processing and posting of results of infant HIV DNA PCR samples can hinder the success of early infant diagnosis (EID) programs. The HITSystem is an eHealth intervention that alerts staff when services are overdue or results are delayed. We conducted a retrospective analysis of 3669 HIV-exposed infants enrolled in 15 Kenya hospital EID programs and three laboratories using the HITSystem from 2011-2014. We assessed mean and median TAT from when a sample was: 1) obtained to when it was shipped to the laboratory, 2) shipped to when it was received at the laboratory, 3) received to when a result was posted, and 4) the total time from obtaining the sample (step 1) to posting the result (step 3)...
2017: PloS One
https://www.readbyqxmd.com/read/28793991/trial-of-ready-to-use-supplemental-food-and-corn-soy-blend-in-pregnant-malawian-women-with-moderate-malnutrition-a-randomized-controlled-clinical-trial
#4
Meghan Callaghan-Gillespie, Andrew A Schaffner, Patsy Garcia, Jocelyn Fry, Rachael Eckert, Shirin Malek, Indi Trehan, Chrissie Thakwalakwa, Kenneth M Maleta, Mark J Manary, Peggy C Papathakis
Background: Malnutrition during pregnancy in sub-Saharan Africa is associated with poor birth outcomes.Objective: This study compared maternal and offspring anthropometry for moderately malnourished pregnant women receiving ready-to-use supplemental food (RUSF), a fortified corn-soy blend (CSB+) with a daily multiple micronutrient antenatal supplement [United Nations International Multiple Micronutrient Preparation (UNIMMAP)], or standard of care comprising CSB+ and iron and folic acid (IFA).Design: A single-blind randomized controlled clinical trial was conducted in southern Malawi among 1828 pregnant women with moderate malnutrition, defined as a midupper arm circumference (MUAC) ≥20...
August 9, 2017: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28783807/comparative-safety-of-antiretroviral-treatment-regimens-in-pregnancy
#5
Rebecca Zash, Denise L Jacobson, Modiegi Diseko, Gloria Mayondi, Mompati Mmalane, Max Essex, Chipo Petlo, Shahin Lockman, Joseph Makhema, Roger L Shapiro
Importance: Maternal antiretroviral treatment (ART) started before conception may increase the risk for adverse birth outcomes among women with human immunodeficiency virus (HIV) infection, but whether the risk differs by ART regimen is unknown. Objective: To compare the risk for selected birth outcomes by maternal ART regimen. Design, Setting, and Participants: This observational birth outcomes surveillance study compared all live births and stillbirths with a gestational age of at least 24 weeks in 8 geographically dispersed government hospitals throughout Botswana (approximately 45% of births nationwide)...
August 7, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28767616/impact-of-birth-hiv-pcr-testing-on-the-uptake-at-follow-up-early-infant-diagnosis-services-in-cape-town-south-africa
#6
Lorna Dunning, Max Kroon, Lezanne Fourie, Andrea Ciaranello, Landon Myer
INTRODUCTION: PCR testing at birth ('birth-testing') is suggested by new World Health Organization guidelines for rapid diagnosis of infants infected with HIV in utero. However, there are few data on the implementation of this approach in sub-Saharan Africa and whether birth-testing affects uptake of subsequent routine early infant diagnosis (EID) testing at 6-10 weeks of age is unknown. METHODS: We reviewed 575 consecutive infants undergoing targeted high-risk birth-testing in Cape Town, South Africa, and matched those testing HIV-negative at birth (n=551) to HIV-exposed infants who did not receive birth-testing (n=551)...
July 27, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28759772/maternal-hiv-infection-associated-with-reduced-transplacental-transfer-of-measles-antibodies-and-increased-susceptibility-to-disease
#7
Sabelle Jallow, Clare L Cutland, Alexis K Masbou, Peter Adrian, Shabir A Madhi
BACKGROUND: Transplacental transfer of measles antibodies from mother to fetus is important in protecting against measles during early infancy. Changes in population immunity against measles in adults, including waning of immunity among HIV-infected pregnant women, could affect passive immunity acquired in utero by newborns. OBJECTIVES: To evaluate the effect of maternal HIV infection on transplacental transfer of measles antibody in mother-newborn dyads in a setting of high maternal HIV prevalence...
July 20, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/28758568/mother-to-child-hiv-transmission-prevention-programs-in-a-sub-saharan-african-setting-the-gabonese-experience
#8
Armel Mintsa-Ndong, Corneille Ndong-Ella, Roselyne K Boussougou, Léatitia M Busugu, Alexandre Mba, Franck A Agwambouet, Nicolas Barro, Joel F Djoba Siawaya
In many developing countries, mothers' awareness remains a challenge despite the scaling up of antenatal care and programs preventing mother-to-child (MTC) HIV transmission. The present study was done in Libreville, Gabon where all antenatal care (delivery included) is free of charge. Here we assessed the timing of antenatal antiretroviral (ARV) prophylaxis initiation, HIV-exposed infants' age at their first postnatal HIV check visit and investigated the association between mothers' awareness or knowledge on their ARV therapy and infants' HIV infection...
January 1, 2017: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/28734808/-congenital-cytomegalovirus-infection-manifesting-as-neonatal-respiratory-distress-in-an-hiv-exposed-uninfected-newborn
#9
A Pham, H El Mjati, N Nathan, F Kieffer, D Mitanchez
BACKGROUND: Cytomegalovirus (CMV) is one of the most common intrauterine infections, affecting approximately 1% of all live births. There are few reports on congenital CMV infections manifesting as isolated pneumonitis. CASE REPORT: We report a case of congenital CMV with neonatal respiratory distress affecting an HIV-exposed uninfected infant. This infant required noninvasive ventilation beginning within the first 15min of life. The initial chest X-ray showed diffuse bilateral ground-glass opacifications...
July 19, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28732085/point-of-care-screening-for-hepatitis-b-virus-infection-in-pregnant-women-at-an-antenatal-clinic-a-south-african-experience
#10
Nafiisah Chotun, Wolfgang Preiser, Christoffel Johannes van Rensburg, Pedro Fernandez, Gerhard Barnard Theron, Dieter Glebe, Monique Ingrid Andersson
BACKGROUND & AIMS: Elimination of HIV and syphilis mother-to-child transmission (MTCT) has received much attention but little consideration has been given to the possibility of elimination of HBV MTCT. In sub-Saharan Africa, HBV vertical transmission continues to be reported and it remains an important public health problem. This study aimed to assess the feasibility of screening pregnant women for HBV using a point-of-care (POC) test and implementing interventions to prevent HBV MTCT...
2017: PloS One
https://www.readbyqxmd.com/read/28723871/optimal-anti-retroviral-prophylaxis-in-infants-at-high-risk-of-acquiring-human-immunodeficiency-virus-a-systematic-review
#11
Sara Beste, Shaffiq Essajee, George Siberry, Alisse Hannaford, Jasmeen Dara, Nandita Sugandhi, Martina Penazzato
INTRODUCTION: The risk of perinatal HIV infection can be dramatically reduced through maternal antiretroviral therapy (ART) and infant antiretroviral (ARV) postnatal prophylaxis. The 2013 WHO guidelines recommended four to six weeks of nevirapine or zidovudine as post-natal prophylaxis, with possible extension to 12 weeks for high-risk breastfed infants. A systematic review was undertaken to determine if there is evidence for the WHO to recommend enhanced or extended prophylaxis for high-risk infants...
July 18, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28718488/infectious-disease-morbidity-and-growth-among-young-hiv-exposed-uninfected-children-in-jamaica
#12
Russell B Pierre, Toni-Anne Fulford, Kaye Lewis, Paulette Palmer, Christine Walters, Celia D C Christie
Objective: There is a growing body of data that demonstrates increased infectious disease outcomes for HIV-exposed uninfected (HIV-EU) infants as compared to their HIV-unexposed (HU) counterparts. We hypothesized that these HIV-EU infants are at greater risk for infectious morbidity and mortality when compared to the general childhood population. We therefore aimed to characterize infections and growth outcomes among HIV-EU infants in Jamaica during their first two years of life. By identifying these outcomes, specific interventions could be implemented to mitigate this risk of morbidity and mortality...
December 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/28717383/what-influences-feeding-decisions-for-hiv-exposed-infants-in-rural-kenya
#13
Helen M Nabwera, Joyline Jepkosgei, Kelly W Muraya, Amin S Hassan, Catherine S Molyneux, Rehema Ali, Andrew M Prentice, James A Berkley, Martha K Mwangome
BACKGROUND: Infant feeding in the context of human immunodeficiency virus (HIV) poses unique challenges to mothers and healthcare workers in balancing the perceived risks of HIV transmission and nutritional requirements. We aimed to describe the decision-making processes around infant feeding at a rural HIV clinic in Kenya. METHODS: We used a qualitative study design. Between March and August 2011, we conducted in-depth interviews (n = 9) and focus group discussions (n = 10) with purposively selected hospital and community respondents at Kilifi County Hospital, Kenya...
2017: International Breastfeeding Journal
https://www.readbyqxmd.com/read/28715460/early-infant-diagnosis-of-hiv-1-infection-in-luanda-angola-using-a-new-dna-pcr-assay-and-dried-blood-spots
#14
Francisco Martin, Claudia Palladino, Rita Mateus, Anna Bolzan, Perpétua Gomes, José Brito, Ana Patrícia Carvalho, Yolanda Cardoso, Cristovão Domingos, Vanda Sofia Lôa Clemente, Nuno Taveira
BACKGROUND: Early diagnosis and treatment reduces HIV-1-related mortality, morbidity and size of viral reservoirs in infants infected perinatally. Commercial molecular tests enable the early diagnosis of infection in infants but the high cost and low sensitivity with dried blood spots (DBS) limit their use in sub-Saharan Africa. OBJECTIVES: To develop and validate a sensitive and cheap qualitative proviral DNA PCR-based assay for early infant diagnosis (EID) in HIV-1-exposed infants using DBS samples...
2017: PloS One
https://www.readbyqxmd.com/read/28711526/xpert-hiv-1-point-of-care-test-for-neonatal-diagnosis-of-hiv-in-the-birth-testing-programme-of-a-maternity-hospital-a-field-evaluation-study
#15
Karl-Günter Technau, Louise Kuhn, Ashraf Coovadia, Pamela M Murnane, Gayle Sherman
BACKGROUND: Point-of-care testing (POCT) among HIV-exposed infants might improve linkage to care relative to laboratory-based testing (LABT). We evaluated HIV-1 POCT at birth in the context of universal LABT in a maternity hospital and describe our implementation experience. METHODS: We did a field evaluation study between Oct 1, 2014, and April 30, 2016, at the urban Rahima Moosa Mother and Child Hospital (RMMCH), Johannesburg, South Africa. We aimed to sample consecutive neonates at birth with POCT (Cepheid Xpert HIV-1 Qualitative test) and compared results with those of LABT (Roche COBAS TaqMan HIV-1 Qualitative test) with respect to performance in terms of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and Cohen's κ coefficient, result return, antiretroviral treatment (ART) initiation, and coverage...
July 12, 2017: Lancet HIV
https://www.readbyqxmd.com/read/28704472/prevention-of-mother-to-child-transmission-of-hiv-option-b-cascade-in-rural-tanzania-the-one-stop-clinic-model
#16
Anna Gamell, Lameck Bonaventure Luwanda, Aneth Vedastus Kalinjuma, Leila Samson, Alex John Ntamatungiro, Maja Weisser, Winfrid Gingo, Marcel Tanner, Christoph Hatz, Emilio Letang, Manuel Battegay
BACKGROUND: Strategies to improve the uptake of Prevention of Mother-To-Child Transmission of HIV (PMTCT) are needed. We integrated HIV and maternal, newborn and child health services in a One Stop Clinic to improve the PMTCT cascade in a rural Tanzanian setting. METHODS: The One Stop Clinic of Ifakara offers integral care to HIV-infected pregnant women and their families at one single place and time. All pregnant women and HIV-exposed infants attended during the first year of Option B+ implementation (04/2014-03/2015) were included...
2017: PloS One
https://www.readbyqxmd.com/read/28683718/rate-of-hiv-transmission-and-associated-factors-among-hiv-exposed-infants-in-selected-health-facilities-of-east-and-west-gojjam-zones-northwest-ethiopia-retrospective-cohort-study
#17
Nurilign Abebe Moges, Getachew Mullu Kassa, Dube Jara Boneya
BACKGROUND: In 2014, there were 170,000 new HIV-infected children globally. The rate of HIV transmission from mother to child in Ethiopia was 18%. Though there are a number of HIV-related studies conducted in Ethiopia, there is a scarcity of evidence on the rate of mother to child transmission. So, the aim of this study was to determine the rate of HIV transmission and associated factors among HIV-exposed infants in selected health facilities in East and West Gojjam Zones, Northwest Ethiopia...
July 6, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28674031/the-role-of-sapa-and-yfga-in-susceptibility-to-antibody-mediated-complement-dependent-killing-and-virulence-of-salmonella-enterica-typhimurium
#18
Edna M Ondari, Jennifer N Heath, Elizabeth J Klemm, Gemma Langridge, Lars Barquist, David A Goulding, Simon Clare, Gordon Dougan, Robert A Kingsley, Calman A MacLennan
The ST313 pathovar of S Typhimurium contributes to a high burden of invasive disease among African infants and HIV-infected adults. It is characterized by genome degradation (loss of coding capacity) and has increased resistance to antibody-dependent complement-mediated killing compared with enterocolitis-causing strains of S Typhimurium. Vaccination is an attractive disease-prevention strategy and leading candidates focus on the induction of bactericidal antibodies. Antibody-resistant strains arising through further gene deletion could compromise such a strategy...
July 3, 2017: Infection and Immunity
https://www.readbyqxmd.com/read/28657963/maternal-hiv-infection-is-an-important-health-determinant-in-non-hiv-infected-infants
#19
María Rupérez, Raquel González, Sonia Maculuve, Llorenç Quintó, Elisa López-Varela, Orvalho Augusto, Anifa Vala, Arsénio Nhacolo, Esperança Sevene, Denise Naniche, Clara Menéndez
OBJECTIVE: To assess morbidity and mortality in HIV-exposed uninfected (HEU) children to help guiding appropriate clinical care and effective preventive interventions. DESIGN: This is a longitudinal study comparing two cohorts of children; one born to HIV-infected women and the other born to HIV-uninfected women. METHODS: We have analyzed prospectively obtained information on nutritional status, morbidity and mortality from 966 HEU and 909 HIV-unexposed infants followed up until their first 18 months of life at a referral health facility in southern Mozambique...
July 17, 2017: AIDS
https://www.readbyqxmd.com/read/28653969/changes-in-fertility-at-the-population-level-in-the-era-of-art-in-rural-malawi
#20
Estelle McLean, Alison Price, Menard Chihana, Ndoliwe Kayuni, Milly Marston, Olivier Koole, Basia Zaba, Amelia Crampin
INTRODUCTION: HIV reduces fertility through biological and social pathways, and antiretroviral treatment (ART) can ameliorate these effects. In northern Malawi, ART has been available since 2007 and lifelong ART is offered to all pregnant or breastfeeding HIV-positive women. METHODS: Using data from the Karonga Health and Demographic Surveillance Site in Malawi from 2005 to 2014, we used total and age-specific fertility rates and Cox regression to assess associations between HIV and ART use and fertility...
August 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
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