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paediatric hiv

Heloise Buys, Rudzani Muloiwa, Colleen Bamford, Brian Eley
BACKGROUND: Klebsiella pneumoniae (KP) is a significant paediatric bloodstream pathogen in children. There is little data from Africa. In this study we describe the epidemiology of multi-drug resistant Klebsiella pneumoniae bloodstream infection (KPBSI) at Red Cross War Memorial Children's Hospital, Cape Town, South Africa. METHODS: We conducted a retrospective cross-sectional study of KPBSI from 1 January 2006 to 31 December 2011 using conventional descriptive and inferential statistical methods...
October 17, 2016: BMC Infectious Diseases
Adellah Sariah, Joan Rugemalila, Magreat Somba, Anna Minja, Margareth Makuchilo, Edith Tarimo, David Urassa, Helen Siril
BACKGROUND: The specific age to which an HIV infected child can be disclosed to is stipulated to begin between ages 4 and 6 years. It has also been documented that before disclosure of HIV positive status to the infected child. Health care providers should consider children's cognitive-developmental ability. However, observation and situation analysis show that, health care providers still feel uncomfortable disclosing the HIV positive status to the infected child. The aim of the study was to explore healthcare providers' experiences in disclosure of HIV-positive status to the infected child...
October 13, 2016: BMC Public Health
Alasdair Bamford, Emma C Manno, Maria Jose Mellado, Vana Spoulou, Laura Marques, Henriette J Scherpbier, Tim Niehues, Agnieszka Oldakowska, Paolo Rossi, Paolo Palma
BACKGROUND: Current national immunisation schedules differ between countries in terms of vaccine formulation, timing of vaccinations and immunisation programme funding and co-ordination. As a result, some HIV infected paediatric population may be left susceptible to vaccine preventable infections. Vaccines used in healthy population should be subjected to high quality ethical research and be explicitly validated for use in children with special vaccination needs such as those infected with HIV...
October 7, 2016: Vaccine
A Dramowski, A Whitelaw, M F Cotton
BACKGROUND: In most African countries the prevalence and effects of paediatric healthcare-associated infection (HCAI) and human immunodeficiency virus (HIV) infection are unknown. AIM: To investigate the burden, spectrum, risk factors, and impact of paediatric HCAI by prospective clinical surveillance at a South African referral hospital. METHODS: Continuous prospective clinical and laboratory HCAI surveillance using Centers for Disease Control and Prevention (CDC)/National Healthcare Safety Network (NHSN) definitions was conducted at Tygerberg Children's Hospital, South Africa, from May 1(st) to October 31(st) in 2014 and 2015...
September 1, 2016: Journal of Hospital Infection
Carole Ian McAteer, Nhan-Ai Thi Truong, Josephine Aluoch, Andrew Roland Deathe, Winstone M Nyandiko, Irene Marete, Rachel Christine Vreeman
INTRODUCTION: HIV-related stigma impacts the quality of life and care management of HIV-infected and HIV-affected individuals, but how we measure stigma and its impact on children and adolescents has less often been described. METHODS: We conducted a systematic review of studies that measured HIV-related stigma with a quantitative tool in paediatric HIV-infected and HIV-affected populations. RESULTS AND DISCUSSION: Varying measures have been used to assess stigma in paediatric populations, with most studies utilizing the full or variant form of the HIV Stigma Scale that has been validated in adult populations and utilized with paediatric populations in Africa, Asia and the United States...
2016: Journal of the International AIDS Society
Sophie Desmonde, Tessa Goetghebuer, Claire Thorne, Valériane Leroy
PURPOSE OF REVIEW: The number of HIV-exposed but uninfected (HEU) infants exposed to both HIV and multiple antiretroviral drugs in utero and during prolonged breastfeeding is increasing in low-income countries where HIV prevalence is the highest. We review recent evidence on the effects of perinatal/postnatal exposure to maternal HIV and combined antiretroviral therapy (cART) on health outcomes of HEU children (mitochondrial and metabolic toxicity, adverse pregnancy outcomes, neurodevelopment, growth, infectious morbidity, and mortality)...
September 2016: Current Opinion in HIV and AIDS
Doortje 't Hart, Merian Musinguzi, Richard Ochen, Juliet Katushabe, Joseph Rujumba
Inequities in access to HIV prevention and treatment for children remain a global challenge and a black spot to effective HIV prevention and response especially in many HIV endemic countries like Uganda. In Uganda while about 51% of the adults living with HIV are on antiretrovirals, only 39% of the children aged 0-14 years accessed the needed HIV care in 2014. In this article, it is argued that much focus on health system interventions with little regard to bridging the gap between health facilities, where much of the care is provided, and the communities, where children are conceived, born and cared for, contributes to and sustains this inequality...
July 2, 2016: Vulnerable Children and Youth Studies
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
Susan Purchase, Jayne Cunningham, Monika Esser, Donald Skinner
The burden of paediatric HIV in South Africa is extremely high. Antiretrovirals (ARVs) are now widely accessible in the country and the clinical emphasis has shifted from initiation of treatment to retention in care. This study describes the cumulative virological failure rate amongst children on ARVs in a peri-urban clinic, and suggests ways in which clinics and partners could improve treatment outcomes. The study was conducted by the non-profit organisation HOPE Cape Town Association. A retrospective file audit determined the cumulative virological failure rate, that is, the sum of all children with a viral load >1000 copies/ml, children on monotherapy, children who had stopped treatment, children lost to follow-up (LTFU) and children who had died...
September 2016: African Journal of AIDS Research: AJAR
Claire Thorne, Anna Turkova, Giuseppe Indolfi, Elisabetta Venturini, Carlo Giaquinto
OBJECTIVE: To characterise children, adolescents and young adults infected with HIV/HCV vertically or before age 18 years and living in Europe regarding mode of acquisition, HCV genotype, clinical status and treatment. DESIGN: Retrospective, cross-sectional study using pooled data from 11 European paediatric HIV cohorts METHODS:: Patients aged > 18 months and < 25 years, with HIV/HCV acquired vertically or in childhood, were included. Anonymised individual-patient data were collected using a standard protocol and modified HIV Cohorts Data Exchange Protocol...
September 24, 2016: AIDS
Lukas Muri, Anna Gamell, Alex J Ntamatungiro, Tracy R Glass, Lameck B Luwanda, Manuel Battegay, Hansjakob Furrer, Christoph Hatz, Marcel Tanner, Ingrid Felger, Thomas Klimkait, Emilio Letang
OBJECTIVE: To investigate the prevalence and determinants of virologic failure (VF) and acquired drug resistance-associated mutations (DRM) in HIV-infected children and adolescents in rural Tanzania. DESIGN: Prospective cohort study with cross-sectional analysis. METHODS: All children ≤18 years attending the paediatric HIV Clinic of Ifakara and on antiretroviral treatment (ART) for ≥12 months were enrolled. Participants with VF were tested for HIV-DRM...
September 24, 2016: AIDS
A L Slogrove, L Frigati, D M Gray
With improved prevention of mother to child transmission of HIV, paediatric HIV disease is less common. However, the number of HIV exposed but uninfected infants is growing. Exposure to maternal HIV impacts infant respiratory health through an increase in known risk factors such as increased preterm birth and low birth weight, suboptimal breastfeeding, increased psychosocial stressors and increased exposure to infective pathogens. Exposure to the HIV virus and altered maternal immune environment result in immunologic changes in the infant that may contribute to respiratory disease risk...
August 19, 2016: Paediatric Respiratory Reviews
Carla J Chibwesha, Benjamin H Chi
No abstract text is available yet for this article.
October 2016: Lancet HIV
Jennifer Cohn, Katherine Whitehouse, Julia Tuttle, Kristin Lueck, Trang Tran
BACKGROUND: Many HIV-positive children in low-income and middle-income countries remain undiagnosed. Although HIV testing in children at health facilities is recommended by WHO, it is not well implemented. This systematic review and meta-analysis examines the case-finding benefit of HIV screening in children aged 0-5 years in low-income and middle-income countries. METHODS: We did this systematic review and meta-analysis in accordance with an a-priori protocol. We searched PubMed, MEDLINE, WHO Global Index Medicus, Web of Science, Médecins Sans Frontières, Cochrane, Embase, CABS Abstracts, and LILACS databases for articles published between Jan 1, 2004, and April 30, 2016, that reported the quantitative prevalence of HIV detected through screening in four key contexts (paediatric inpatient settings, paediatric outpatient settings, nutrition centres, and expanded programme on immunisation centres) in paediatric populations in low-income and middle-income countries...
October 2016: Lancet HIV
Ingrid Peterson, Naor Bar-Zeev, Neil Kennedy, Antonia Ho, Laura Newberry, Miguel A San Joaquin, Mavis Menyere, Maaike Alaerts, Gugulethu Mapurisa, Moses Chilombe, Ivan Mambule, David G Lalloo, Suzanne T Anderson, Thembi Katangwe, Nigel Cunliffe, Nico Nagelkerke, Meredith McMorrow, Marc-Allain Widdowson, Neil French, Dean Everett, Robert S Heyderman
BACKGROUND:  We used four years of paediatric severe acute respiratory illness (SARI) sentinel surveillance in Blantyre, Malawi to identify factors associated with clinical severity and co-viral clustering. METHODS:  From January 2011 to December 2014, 2363 children aged 3 months to 14 years presenting to hospital with SARI were enrolled. Nasopharyngeal aspirates were tested for influenza and other respiratory viruses. We assessed risk factors for clinical severity and conducted clustering analysis to identify viral clusters in children with co-viral detection...
September 13, 2016: Journal of Infectious Diseases
E Keane, A L Funk, Y Shimakawa
BACKGROUND: The risk of mother-to-child transmission of hepatitis B virus (HBV) has been quoted as 70-90% among women positive for hepatitis B surface antigen (HBsAg) and e antigen (HBeAg), and 5-30% among HBsAg-positive HBeAg-negative women. These risks are derived from Asia; little is known about sub-Saharan Africa. AIM: To determine the risk of mother-to-child transmission in sub-Saharan Africa, according to maternal HBeAg and type of prophylaxis. METHODS: We searched Medline, Global Health, Embase, African Journals Online and African Index Medicus...
November 2016: Alimentary Pharmacology & Therapeutics
R R Lilian, B Mutasa, J Railton, W Mongwe, J A McINTYRE, H E Struthers, R P H Peters
South Africa's paediatric antiretroviral therapy (ART) programme is managed using a monitoring and evaluation tool known as TIER.Net. This electronic system has several advantages over paper-based systems, allowing profiling of the paediatric ART programme over time. We analysed anonymized TIER.Net data for HIV-infected children aged <15 years who had initiated ART in a rural district of South Africa between 2005 and 2014. We performed Kaplan-Meier survival analysis to assess outcomes over time. Records of 5461 children were available for analysis; 3593 (66%) children were retained in care...
September 9, 2016: Epidemiology and Infection
M-H Tsai, M Muenchhoff, E Adland, A Carlqvist, J Roider, D K Cole, A K Sewell, J Carlson, T Ndung'u, P J R Goulder
BACKGROUND: In contrast to adult HIV infection, where slow disease progression is strongly linked to immune control of HIV mediated by protective HLA class I molecules such as HLA-B*81:01, the mechanisms by which a minority of HIV-infected children maintain normal-for-age CD4 counts and remain clinically healthy appear to be HLA class I-independent and are largely unknown. To better understand these mechanisms, we here studied a HIV-infected South African female, who remained a non-progressor throughout childhood...
2016: Retrovirology
Lisa Van de Wijer, Arnt F A Schellekens, David M Burger, Judith R Homberg, Quirijn de Mast, Andre J A M van der Ven
The non-nucleoside reverse transcriptase inhibitor efavirenz is part of the WHO guidelines for preferred first-line treatment of HIV-1-infected adults, pregnant and lactating women, and children. Efavirenz is well known to cause CNS toxicity. Although good data for CNS toxicity are available for adults, the opposite is true for children. Paediatric studies on this topic frequently suffer from small sample sizes or absence of thorough neuropsychiatric assessments. In this Personal View, we focus on two knowledge gaps of CNS toxicity of efavirenz in children...
May 2016: Lancet Infectious Diseases
Y A Sofolahan-Oladeinde, J I Iwelunmor, D F Conserve, A Gbadegesin, C O Airhihenbuwa
Healthcare experiences among women living with HIV/AIDS (WLHA), determine their utilisation of sexual and reproductive health services, which ultimately influences their decisions on childbearing. This study aimed to understand the importance of healthcare support in the childbearing decision-making processes of WLHA, and its impact on eliminating new paediatric HIV infections. We conducted in-depth interviews between July and August 2012 with 15 WLHA receiving clinical HIV care at a teaching hospital in Lagos...
August 31, 2016: Global Public Health
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