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Hiv in children

Helga Naburi, Phares Mujinja, Charles Kilewo, Till Bärnighausen, Nicola Orsini, Karim Manji, Gunnel Biberfeld, David Sando, Pascal Geldsetzer, Guerino Chalamila, Anna Mia Ekström
BACKGROUND: Mother-to-child transmission (MTCT) of HIV remains a major source of new HIV infections in children. Prevention of mother-to-child transmission of HIV (PMTCT) using lifelong antiretroviral treatment (ART) for all pregnant and breastfeeding women living with HIV (Option B+) is the major strategy for eliminating paediatric HIV. Ensuring that patients are satisfied with PMTCT services is important for optimizing uptake, adherence and retention in treatment. METHODS: We conducted a facility based quantitative cross-sectional survey in Dar-es-Salaam, Tanzania, between March and April 2014, when the country was transitioning to the implementation of PMTCT Option B+...
2016: PloS One
Stephen R Connor, Julia Downing, Joan Marston
CONTEXT: The need for children's palliative care (CPC) globally is unknown. In order to understand the scope of the need and to advocate to meet it, more accurate estimates are needed. OBJECTIVES: To create an accurate global estimate of the worldwide need for CPC based on a representative sample of countries from all regions of the world and all World Bank income groups. METHODS: This work builds on previously published methods developed by the International Children's Palliative Care Network, UNICEF, and WHO and tested in three African countries...
October 17, 2016: Journal of Pain and Symptom Management
Aditya H Gaur, Hilda Kizito, Wasana Prasitsueubsai, Natella Rakhmanina, Mohammed Rassool, Rana Chakraborty, Jagmohan Batra, Pope Kosalaraksa, Wicharn Luesomboon, Danielle Porter, Yongwu Shao, Michael Myers, Lillian Ting, Devi SenGupta, Erin Quirk, Martin S Rhee
BACKGROUND: The prodrug tenofovir alafenamide is associated with improved renal and bone safety compared with tenofovir disoproxil fumarate. We aimed to assess safety, pharmacokinetics, and efficacy of this single-tablet, fixed-dose combination of elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide in HIV-infected, treatment-naive adolescents. METHODS: We did a 48 week, single-arm, open-label trial in treatment-naive adolescents with HIV from ten hospital clinics in South Africa, Thailand, Uganda, and the USA...
October 17, 2016: Lancet HIV
J A Bohn, B M Kassaye, D Record, B C Chou, I L Kraft, J C Purdy, K A Hilton, D A Miller, S Getachew, A Addissie, J A Robison
BACKGROUND: Global childhood mortality rates remain high. Millennium Development Goal 4 focused efforts on reducing rates by two-thirds between 1990 and 2015. In Ethiopia, child mortality rates dropped 71 % from 1990 to 2015, however it is estimated that 184,000 Ethiopian children die each year. There is limited information about pediatric hospital admissions in Ethiopia. Our aims were to examine the temporal relationship of mortality to admission, describe the demographics, and identify cause mortality of children admitted to the Zewditu Memorial Hospital (ZMH)...
October 21, 2016: BMC Pediatrics
Mary Norval, Anna K Coussens, Robert J Wilkinson, Liza Bornman, Robyn M Lucas, Caradee Y Wright
In this review, reports were retrieved in which vitamin D status, as assessed by serum 25-hydroxyvitamin D [25(OH)D] levels, was measured in South African population groups with varied skin colours and ethnicities. Healthy children and adults were generally vitamin D-sufficient [25(OH)D level >50 nmol/L] but the majority of those aged above 65 years were deficient. A major role for exposure to solar ultraviolet radiation (UVR) in determining 25(OH)D levels was apparent, with the dietary contribution being minor...
October 18, 2016: International Journal of Environmental Research and Public Health
Madhukar Pai, Mark P Nicol, Catharina C Boehme
Rapid and accurate diagnosis is critical for timely initiation of anti-tuberculosis (TB) treatment, but many people with TB (or TB symptoms) do not have access to adequate initial diagnosis. In many countries, TB diagnosis is still reliant on sputum microscopy, a test with known limitations. However, new diagnostics are starting to change the landscape. Stimulated, in part, by the success and rollout of Xpert MTB/RIF, an automated, molecular test, there is now considerable interest in new technologies. The landscape looks promising with a pipeline of new tools, particularly molecular diagnostics, and well over 50 companies actively engaged in product development, and many tests have been reviewed by WHO for policy endorsement...
October 2016: Microbiology Spectrum
G Abongomera, A Cook, V Musiime, C Chabala, M Lamorde, J Abach, M Thomason, V Mulenga, A Kekitiinwa, R Colebunders, C Kityo, A S Walker, D M Gibb
A high level of adherence to antiretroviral treatment is essential for optimal clinical outcomes in HIV infection, but measuring adherence is difficult. We investigated whether responses to a questionnaire eliciting caregiver beliefs in medicines were associated with adherence of their child (median age 2.8 years), and whether this in turn was associated with viral suppression. We used the validated beliefs in medicine questionnaire (BMQ) to measure caregiver beliefs, and medication event monitoring system caps to measure adherence...
October 19, 2016: AIDS and Behavior
Karidia Diallo, Surbhi Modi, Mackenzie Hurlston, Rachel Suzanne Beard, John N Nkengasong
Early diagnosis of HIV infection in infants and children remains a challenge in resource-limited settings, with approximately half of all HIV-exposed infants receiving virological testing for HIV by the recommended age of two months in 2015. In order to reduce morbidity and mortality among HIV-infected children and to close the treatment gap for HIV-infected children, there is an urgent need to evaluate existing programmatic and laboratory practices for early infant diagnosis and introduce strategies to improve identification of HIV-exposed infants and ensure access to systematic, early HIV testing with early linkage to treatment for HIV-infected infants...
October 19, 2016: AIDS Research and Human Retroviruses
Thahira Jamal Mohamed, Sirinya Teeraananchai, Stephen J Kerr, Wanatpreeya Phongsamart, Nik Khairulddin Nik Yusoff, Rawiwan Hansudewechakul, Penh Sun Ly, Lam Van Nguyen, Tavitiya Sudjaritruk, Pagakrong Lumbiganon, Viet Chau Do, Nia Kurniati, Nagalingeswaran Kumarasamy, Dewi Kumara Wati, Moy Siew Fong, Revathy Nallusamy, Azar Kariminia, Annette Sohn
<b>Background.</b> We sought to assess the impact of routine HIV viral load (VL) monitoring on the incidence of switching from a first- to a second-line antiretroviral therapy (ART) regimen, and to describe factors associated with switch. <b>Methods.</b> Data from a regional cohort of 16 clinical programs in 6 Asian countries were analyzed. Second-line switch was defined as a change from a non-nucleoside reverse transcriptase inhibitor (NNRTI) to a protease inhibitor (PI) or vice versa, and >1 of the following: 1) reported treatment failure by local criteria, 2) switch of >1 additional drug, or 3) a preceding HIV viral load (VL) ≥1,000 copies/mL...
October 19, 2016: AIDS Research and Human Retroviruses
Martin Kuete, HongFang Yuan, Aude Laure Tchoua Kemayou, Emmanuel Ancel Songo, Fan Yang, XiuLan Ma, ChengLiang Xiong, HuiPing Zhang
BACKGROUND: Integration of family planning services (FPS) into human immunodeficiency virus (HIV) care for HIV-infected women is an important aspect of the global prevention of mother-to-child transmission (PMTCT) strategy. We assessed the integration of FPS into routine care of HIV-infected mothers by evaluating the uptake and barriers of contraception and PMTCT services. METHODS: We conducted an interventional study using the interrupted time series approach in the health care facilities located in Yaounde, Cameroon...
2016: Patient Preference and Adherence
Keertan Dheda, Kwok Chiu Chang, Lorenzo Guglielmetti, Jennifer Furin, H Simon Schaaf, Dumitru Chesov, Aliasgar Esmail, Christoph Lange
Globally there is a burgeoning epidemic of drug mono-resistant tuberculosis (TB), multi-drug-resistant TB (MDR-TB), and extensively drug-resistant TB (XDR-TB). Almost 20% of all TB strains worldwide are resistant to at least 1 major TB drug including isoniazid. In several parts of the world there is an increasing incidence of MDR-TB, and alarmingly almost a third of MDR-TB cases globally are resistant to either a fluoroquinolone or aminoglycocide. This trend cannot be ignored because DR-TB is associated with greater morbidity compared to drug-sensitive TB, it accounts for almost 25% of global TB mortality, is extremely costly to treat, consuming substantial portions of budgets allocated to national TB programmes in TB endemic countries, and is a major threat to healthcare workers who are already in short supply in resource-poor settings...
October 15, 2016: Clinical Microbiology and Infection
Qingyan Ma, Lai Sze Tso, Zachary C Rich, Brian J Hall, Rachel Beanland, Haochu Li, Mellanye Lackey, Fengyu Hu, Weiping Cai, Meg Doherty, Joseph D Tucker
INTRODUCTION: Qualitative research on antiretroviral therapy (ART) adherence interventions can provide a deeper understanding of intervention facilitators and barriers. This systematic review aims to synthesize qualitative evidence of interventions for improving ART adherence and to inform patient-centred policymaking. METHODS: We searched 19 databases to identify studies presenting primary qualitative data on the experiences, attitudes and acceptability of interventions to improve ART adherence among PLHIV and treatment providers...
2016: Journal of the International AIDS Society
Stanzi M le Roux, Jennifer Jao, Kirsty Brittain, Tamsin K Phillips, Seun Olatunbosun, Agnes Ronan, Allison Zerbe, Elaine J Abrams, Landon Myer
OBJECTIVE: Tenofovir (TDF) affects bone health and is widely used in pregnancy but data are limited on the effects of TDF exposure in utero. We examined the association between duration of in utero TDF exposure and linear growth in HIV-exposed, uninfected (HEU) infants. DESIGN: A prospective cohort of pregnant women initiating TDF-containing regimens at primary care services in Cape Town, South Africa were enrolled and followed with their breastfeeding infants through 12 months postpartum...
October 14, 2016: AIDS
Isabelle Viel-Thériault, Roseline Thibeault, Francois D Boucher, Jean-Philippe Drolet
Paradoxical immune reconstitution inflammatory syndrome is a well-described entity even in immunocompetent children, principally in association with Mycobacterium tuberculosis infections. Central nervous system involvement is a potential life-threatening form, sometimes refractory to standard treatment. We report the case of an HIV-negative refugee teenager, who presented with brain tuberculomas and pseudoabscesses responsive only to thalidomide.
November 2016: Pediatric Infectious Disease Journal
Felix Cyamatare Rwabukwisi, Bethany L Hedt-Gauthier, Muhayimpundu Ribakare, Joyce Mukamana, Yvonne Gatesi, Sara Stulac, Peter Drobac, Cheryl L Amoroso, Neil Gupta
Of 277 HIV-infected children in rural Rwanda enrolled in a community-based accompaniment program, 95.0% were retained in care 5 years after treatment initiation, with only 9 (3.3%) deaths and 3 (1.1%) defaults. Of 235 (84.8%) children with a documented viral load result, 201 (85.5%) demonstrated viral load suppression (<1000 copies/mL).
November 2016: Pediatric Infectious Disease Journal
Bikas K Arya, Sangeeta Das Bhattacharya, Catherine G Sutcliffe, Swapan Kumar Niyogi, Subhasish Bhattacharyya, Sunil Hemram, William J Moss, Samiran Panda, Ranjan Saurav Das, Sutapa Mandal, Dennis Robert, Pampa Ray
BACKGROUND: In addition to reducing Haemophilus influenzae type b (Hib) disease in vaccinated individuals, the Hib conjugate vaccine (HibCV) has indirect effects; it reduces Hib disease in unvaccinated individuals by decreasing carriage. Human immunodeficiency virus (HIV)-infected children are at increased risk for Hib disease and live in families where multiple members may have HIV. The aim of this study is to look at the impact of 2 doses of the HibCV on nasopharyngeal carriage of Hib in HIV-infected Indian children (2-15 years) and the indirect impact on carriage in their parents...
November 2016: Pediatric Infectious Disease Journal
Engi F Attia, Robert F Miller, Rashida A Ferrand
PURPOSE OF REVIEW: The incidence of pulmonary infections has declined dramatically with improved access to antiretroviral therapy (ART) and cotrimoxazole prophylaxis, but chronic lung disease (CLD) is an increasingly recognized but poorly understood complication in adolescents with perinatally acquired HIV. RECENT FINDINGS: There is a high prevalence of chronic respiratory symptoms, abnormal spirometry and chest radiographic abnormalities among HIV-infected adolescents in sub-Saharan Africa, wherein 90% of the world's HIV-infected children live...
October 7, 2016: Current Opinion in Infectious Diseases
Ivan Manhiça, Nilesh Bhatt, Nália Ismael, Egidio Nhavene, Beatriz Grinsztejn, Valdileia Veloso, Cremildo Maueia, Orvalho Augusto, Ilesh Jani, Eduardo Samo Gudo
No abstract text is available yet for this article.
October 6, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Fatemeh Nooshabadi, Hee-Jeong Yang, Yunfeng Cheng, Madeleine S Durkee, Hexin Xie, Jianghong Rao, Jeffrey D Cirillo, Kristen C Maitland
Tuberculosis is a pulmonary disease with an especially high mortality rate in immuno-compromised populations, specifically children and HIV positive individuals. The causative agent, Mycobacterium tuberculosis (Mtb), is a very slow growing and difficult organism to work with, making both diagnosis and development of effective treatments cumbersome. We utilize a fiber-optic fluorescence microendoscope integrated with a whole-body imaging system for in vivo Mtb detection. The system exploits an endogenous enzyme of Mtb (β-lactamase, or BlaC) using a BlaC-specific NIR fluorogenic substrate...
October 18, 2016: Journal of Biophotonics
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
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