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Facha W, Tadesse T, Wolka E, Astatkie A. A qualitative study on reasons for women's loss and resumption of Option B plus care in Ethiopia. Sci Rep 2024; 14:21440. [PMID: 39271746 PMCID: PMC11399287 DOI: 10.1038/s41598-024-71252-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 08/26/2024] [Indexed: 09/15/2024] Open
Abstract
Loss to follow-up (LTFU) from Option B plus, a lifelong antiretroviral therapy (ART) for pregnant women living with human immunodeficiency virus (HIV), irrespective of their clinical stage and CD4 count, threatens the elimination of vertical transmission of the virus from mothers to their infants. However, evidence on reasons for LTFU and resumption after LTFU to Option B plus care among women has been limited in Ethiopia. Therefore, this study explored why women were LTFU from the service and what made them resume or refuse resumption after LTFU in Ethiopia. An exploratory, descriptive qualitative study using 46 in-depth interviews was employed among purposely selected women who were lost from Option B plus care or resumed care after LTFU, health care providers, and mother support group (MSG) members working in the prevention of mother-to-child transmission unit. A thematic analysis using an inductive approach was used to analyze the data and build subthemes and themes. Open Code Version 4.03 software assists in data management, from open coding to developing themes and sub-themes. We found that low socioeconomic status, poor relationship with husband and/or family, lack of support from partners, family members, or government, HIV-related stigma, and discrimination, lack of awareness on HIV treatment and perceived drug side effects, religious belief, shortage of drug supply, inadequate service access, and fear of confidentiality breach by healthcare workers were major reasons for LTFU. Healthcare workers' dedication to tracing lost women, partner encouragement, and feeling sick prompted women to resume care after LTFU. This study highlighted financial burdens, partner violence, and societal and health service-related factors discouraged compliance to retention among women in Option B plus care in Ethiopia. Women's empowerment and partner engagement were of vital importance to retain them in care and eliminate vertical transmission of the virus among infants born to HIV-positive women.
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Affiliation(s)
- Wolde Facha
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
| | - Takele Tadesse
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Eskinder Wolka
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Ayalew Astatkie
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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Menbere F, Teshome B, G Hana E, Godie Y. Outcome of HIV exposed infants towards prevention of mother to child transmission (PMTCT) program and its associated factors in selected health facilities of Addis Ababa, Ethiopia, 2020. Retrospective cross sectional study. Pediatr Neonatol 2024; 65:457-463. [PMID: 38413270 DOI: 10.1016/j.pedneo.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 05/29/2023] [Accepted: 07/18/2023] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Globally, an estimated 36.9 million (31.1-43.9 million) people were living with HIV in 2017, of whom 17.8 million were women and 1.8 million (1.3-2.4 million) children under 15 years of age. Ethiopia has developed an HIV/AIDS prevention, care, and treatment strategic plan in an investment case approach that has been implemented from 2015 to 2020. The study aim was to assess the outcome and risk factors for HIV-exposed infants receiving Prevention of Mother to Child Transmission (PMTCT) follow-up. METHOD A cross-sectional retrospective study was done. All HIV-exposed infants who were on follow-up in the ART and (PMTCT) clinics of St Paul's Hospital Millennium Medical College, Yekatit 12 Hospital Medical College, and Selam Health Center beginning from September 2016 to January 2019 were included. Data collection was done using a well-designed questionnaire and a review of mothers' and infants' medical record charts and HMIS log book. Descriptive and logistic regression analysis was performed to assess the association between dependent and independent variables. Differences are considered statistically significant at p < 0.05, and their strength is presented using an odds ratio and 95% confidence interval. RESULT Among the 302 enrolled HIV-exposed infants, 27 (8.9%) were diagnosed as HIV positive. Maternal ART initiation during labor and delivery (AOR = 3.468, 95% CI: 1.22, 13.34, p = 0.04), frequent hospital admission of the infant (AOR = 17.49, 95% CI: 5.41, 56.2, p = 0.001), and mixed feeding option (AOR = 8.25, 95% CI: 2.212, 30.77, p = 0.02) were the major factors associated with positive HIV serostatus among HIV-exposed infants. CONCLUSION and Recommendation: The level of HIV infection among infants born to HIV-positive mothers is high as compared to the national and WHO goals. Exclusive breastfeeding should be advocated for all HIV-exposed infants, especially in resource-limited settings like Ethiopia due to the increased prevalence of diarrheal illness.
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Affiliation(s)
- Fasil Menbere
- Department of Pediatric and Child Health, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Blen Teshome
- Department of Pediatric and Child Health, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Ewenat G Hana
- Department of Public Health, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Yohannes Godie
- Department of Pediatric and Child Health, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia.
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Orji ML, Oluchukwu OEC, Agboeze J, Onyire NB, Nnaji TN, Nweke SO, Nwali MI. Correlates of mother-to child-transmission of HIV infection in a tertiary hospital in Ebonyi state, Nigeria. J Public Health (Oxf) 2024; 46:412-418. [PMID: 38869098 DOI: 10.1093/pubmed/fdae092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 05/14/2024] [Accepted: 05/23/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND Nigeria has the largest global burden of HIV new infections in children despite global and national concerted efforts at the reduction of mother-to-child transmission of HIV. The goal of this study was to determine the associations between maternal characteristics, practices and mother-to-child transmission of HIV infection among mothers living with HIV. METHODS This is a hospital-based descriptive cross-sectional study. Information was obtained using interviewer-administered questionnaire from the 240 participants. Data were analyzed with SPSS version 26, and P < 0.05 was considered statistically significant. RESULTS Out of the 240 mothers recruited, 129 (53.8%) were within 25-35 years of age, with a mean age of 31.08 ± 5.65. A total of 35 (14.6%) of the participants had at least a child with HIV infection. Maternal ART status before childbirth (AOR = 0.02, 95%CI = 0.01-0.05, P = < 0 .001) was the singular determinant of having a child with HIV infection. Mothers who delivered outside the health facility were about four-fold at risk of having an infected child (AOR = 3.89, 95%CI = 1.82-8.50, P = 0.070). CONCLUSION The prevalence rate of mother-to-child transmission of HIV is high. Routine HIV testing services and the provision of accessible and affordable reproductive health services are recommended for all women of childbearing age.
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Affiliation(s)
- Maria-Lauretta Orji
- Department of Paediatrics, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, PMB 102 480001, Nigeria
| | - Oyim-Elechi Cecilia Oluchukwu
- Department of Paediatrics, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, PMB 102 480001, Nigeria
| | - Joseph Agboeze
- Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, PMB 102 480001, Nigeria
| | - Nnamdi Benson Onyire
- Department of Paediatrics, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, PMB 102 480001, Nigeria
| | - Theresa Nwamaka Nnaji
- Department of Paediatrics, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, PMB 102 480001, Nigeria
| | - Sunday Ogo Nweke
- Department of Paediatrics, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, PMB 102 480001, Nigeria
| | - Matthew Igwe Nwali
- Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, PMB 102 480001, Nigeria
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Belachew TW, Erega BB, Ewunetu M, Gelaye K, Yimer TS, Ferede WY. Level of option B plus drug adherence for preventing mother-to-child transmission of HIV and associated factors among HIV-positive women in the awi zone, amhara region, northwest Ethiopia,2020. Heliyon 2024; 10:e35319. [PMID: 39161839 PMCID: PMC11332886 DOI: 10.1016/j.heliyon.2024.e35319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 07/25/2024] [Accepted: 07/26/2024] [Indexed: 08/21/2024] Open
Abstract
Introduction Adherence to Option B+ antiretroviral medication (ART) is essential for the successful implementation of the Prevention of Mother-to-Child Transmission (PMTCT) program. However, poor adherence to Option B + PMTCT drugs among women results in increased viral load and mother-to-child transmission and reduces immunological and clinical outcomes. Objective The objective of the study was to assess the level of Option B plus drug adherence for preventing mother-to-child transmission of HIV and associated factors among HIV positive women in selected government health facilities of Awi zone, Amhara region, Northwest Ethiopia,2020. Methods This institutional-based cross-sectional study was conducted from March 1 to April 30 among 358 HIV-positive women (pregnant and lactating mothers). A multistage sampling procedure was used to select the study participants. Data were collected using a structured questionnaire through interviews. The collected data were entered into EPI Data 3.1 statistical software for data management and analyzed using SPSS version 25 statistical package. The associations between variables were analyzed using bivariate and multivariable logistic regression models. A p-value ≤0.05 at the 95 % confidence interval was considered statistically significant. Results Out of the 358 participants, adherence to Option B + PMTCT was 83.24 %. The study revealed that counselling [AOR = 4.4, 95 % CI: 1.60-12.29], partner support involvement [AOR = 3.0, 95 % CI: 1.17-7.92], and time taken to reach from home to the facility [AOR = 3.1, 95 % CI: 1.51-6.52] were significantly associated with the level of adherence to Option B + PMTCT. Conclusion This study showed that the level of Option B + PMTCT drug adherence was lower than the nationally recommended adherence level. Good counselling, partner support, and reduced travel time from home to the facility were associated with adherence to Option B + PMTCT drugs. Therefore, counselling is crucial for increasing adherence to Option B + PMTCT drugs. Accessible health facilities reduce travel burdens, encourage regular clinic visits, and enhance adherence to PMTCT drugs. Partners can provide reminders, attend appointments, offer emotional support, and explore alternatives such as mobile clinics or medication delivery services.
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Affiliation(s)
- Tegegne Wale Belachew
- Department of Midwifery College of Medicine and Health Sciences, Debre Tabor University, Ethiopia
| | - Besfat Berihun Erega
- Department of Midwifery College of Medicine and Health Sciences, Debre Tabor University, Ethiopia
| | - Mesafint Ewunetu
- Department of Midwifery College of Medicine and Health Sciences, Bahir Dar University, Ethiopia
| | - Kihinetu Gelaye
- Department of Midwifery College of Medicine and Health Sciences, Bahir Dar University, Ethiopia
| | - Tigist Seid Yimer
- Department of Midwifery College of Medicine and Health Sciences, Debre Tabor University, Ethiopia
| | - Wassie Yazie Ferede
- Department of Midwifery College of Medicine and Health Sciences, Debre Tabor University, Ethiopia
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Xu F, Xiong Y, Gu M, Wan L, Wang Y. Interventions to prevent mother-to-child transmission in breastfeeding mothers with HIV: a systematic review and meta-analysis of randomized controlled trials. Rev Inst Med Trop Sao Paulo 2024; 66:e45. [PMID: 39082484 PMCID: PMC11295290 DOI: 10.1590/s1678-9946202466045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 05/23/2024] [Indexed: 08/04/2024] Open
Abstract
This study aimed to systematically review interventions to prevent mother-to-child transmission of HIV during breastfeeding. We conducted a systematic review and meta-analysis using specific criteria to identify randomized controlled trials that focused on pregnant and breastfeeding women living with HIV and their children from birth to 2 years of age. We extensively searched electronic databases, including Web of Science, Scopus, PubMed, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Google Scholar up to October 24, 2023. After screening 3,110 titles and abstracts, we reviewed 306 full texts. Of these, we assessed the quality and risk of bias of fifty-five articles, ultimately identifying seven studies. Four of these studies, which focused on antiretroviral therapy (ART), were included in the meta-analysis. There was little heterogeneity in study methodology and pooled estimates. The postnatal HIV transmission rate was found to be 0.01 (95%CI: 0.00 - 0.02). Therefore, the risk of mother-to-child transmission among breastfeeding mothers with HIV was significantly lower in the intervention groups than in the placebo groups. Analysis of funnel plots and Egger's test (p = 0.589) showed no evidence of publication bias. In addition to the four articles, two studies compared different ART regimens and one study compared the administration of high-dose vitamin A to the mother or the child. The results suggest that the use of ART significantly reduces the risk of postnatal HIV transmission compared with placebo. However, the effectiveness of different ART regimens or other therapies, including high-dose vitamin A, is unclear.
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Affiliation(s)
- Fangping Xu
- Jiangxi Maternal and Child Health Hospital, Obstetrical Department, Jiangxi, Nanchang, China
| | - Ying Xiong
- Jiangxi Maternal and Child Health Hospital, Obstetrical Department, Jiangxi, Nanchang, China
| | - Min Gu
- Jiangxi Maternal and Child Health Hospital, Obstetrical Department, Jiangxi, Nanchang, China
| | - Lingling Wan
- Jiangxi Maternal and Child Health Hospital, Obstetrical Department, Jiangxi, Nanchang, China
| | - Yun Wang
- Jiangxi Maternal and Child Health Hospital, Obstetrical Department, Jiangxi, Nanchang, China
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Belete NK, Megersa ND, Hebo SH, Animut MD, Tariku EZ. Feeding modalities, HIV transmission and its predictors among HIV-exposed infants visited Gamo and Gofa zones public health facilities, Southern Ethiopia: a retrospective follow up study. BMC Pediatr 2024; 24:410. [PMID: 38926639 PMCID: PMC11202369 DOI: 10.1186/s12887-024-04894-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 06/19/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Despite the highest (88%) Prevention of Mother-To-Child Transmission (PMTCT) of HIV coverage in Eastern Africa, 50% of new HIV infections in children aged 0-14 years occur in the region. OBJECTIVE The aim of this study was to assess the feeding modalities, the rate of HIV transmission and its predictors among HIV exposed infants (HIV-EIs) visited Gamo and Gofa Zones public health facilities, Southern Ethiopia from January 2013 to February 2019. METHOD AND MATERIALS Institution-based retrospective follow up study was employed among 450 HIV-EIs having DNA/PCR test results. All infant-mother pair records in selected health facilities were reviewed using a standard data extraction tool from March to July 2019. HIV transmission probabilities were assessed by Kaplan-Meier time-to-event analysis method and log-rank tests were used to compare the risk among different groups. The Cox-proportional hazards model, adjusted on infant feeding modalities and other co-variants was used to identify predictors of HIV transmission, and statistical significance was declared at a p-value of < 0.05. RESULTS In total, 383 complete records were analyzed. In the study, 85.6% (95%CI: 81.6%, 89.1%) of HIV-EIs were exclusively breastfed in the first six months. The 18 months probability of infant HIV transmission was 64 (16.7%) (95%CI: 13.1%-20.8%). The risk of HIV-transmission was higher among infants who were delivered at the hospital than health centers/health posts (AHR = 3.07; 95%CI: 1.19, 7.95); discontinued Cotrimoxazole prophylaxis in at least one visit (AHR = 6.32; 95%CI: 3.35, 11.94); did not exclusively breastfeed (AHR = 3.07; 95%CI: 1.72, 5.47) and came from urban areas (AHR = 5.90; 95%CI: 1.40, 24.85). CONCLUSIONS The study showed that HIV-EIs had a greater rate of 18 months HIV transmission than the national pooled prevalence. The risk of transmission is higher among infants who do not breastfeed exclusively for the first 6 months, and the risk increases with the number of months spent by breastfeeding. Therefore, strengthening counselling on safer feeding options and Cotrimoxazole prophylaxis use; provision of quality PMTCT service with special focus in hospitals and urban residents were recommended.
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Affiliation(s)
| | | | | | | | - Eshetu Zerihun Tariku
- School of Public Health, Arba Minch University, Arba Minch, Ethiopia
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
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Facha W, Tadesse T, Wolka E, Astatkie A. Magnitude and risk factors of mother-to-child transmission of HIV among HIV-exposed infants after Option B+ implementation in Ethiopia: a systematic review and meta-analysis. AIDS Res Ther 2024; 21:39. [PMID: 38849895 PMCID: PMC11157738 DOI: 10.1186/s12981-024-00623-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 05/20/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Mother-to-child transmission (MTCT) of the human immunodeficiency virus (HIV) remains a major public health challenge in Ethiopia. The objective of this review was to assess the pooled magnitude of MTCT of HIV and its risk factors among mother-infant pairs who initiated antiretroviral therapy (ART) after Option B+ in Ethiopia. METHODS A systematic search of literature from PubMed, Hinari, African Journals Online (AJOL), Science Direct, and Google Scholar databases was conducted from June 11, 2013 to August 1, 2023. The authors used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to guide the article selection process and reporting. Observational studies that reported the magnitude and/or risk factors on MTCT of HIV among mother-infant pairs who initiated ART after the implementation of Option B+ in Ethiopia were included. We applied a random-effect model meta-analysis to estimate the overall pooled magnitude and risk factors of MTCT of HIV. A funnel plot and Egger's regression test were employed to check publication bias, and heterogeneity was assessed using I2 statistics. The protocol was registered in the PROSPERO database with registration ID number CRD42022325938. RESULT Eighteen published articles on the magnitude of MTCT and 16 published articles on its risk factors were included in this review. The pooled magnitude of MTCT of HIV after the Option B+ program in Ethiopia was 4.05% (95% CI 3.09, 5.01). Mothers who delivered their infants at home [OR: 9.74; (95% CI: 6.89-13.77)], had not been on ART intervention [OR: 19.39; (95% CI: 3.91-96.18)], had poor adherence to ART [OR: 7.47; (95% CI: 3.40-16.45)], initiated ART during pregnancy [OR: 5.09; (95% CI: 1.73-14.97)], had WHO clinical stage 2 and above [OR: 4.95; (95% CI: 1.65-14.88]], had a CD4 count below 350 at enrolment [OR: 5.78; (95% CI: 1.97-16.98], had no or low male partner involvement [OR: 5.92; (95% CI: 3.61-9.71]] and whose partner was not on ART [OR: 8.08; (95% CI: 3.27-19.93]] had higher odds of transmitting HIV to their infants than their counterparts. CONCLUSION This review showed that the pooled magnitude of MTCT of HIV among mother-infant pairs who initiated ART after the Option B + program in Ethiopia is at the desired target of the WHO, which is less than 5% in breastfeeding women. Home delivery, lack of male partner involvement, advanced HIV-related disease, lack of PMTCT intervention, and poor ARV adherence were significant risk factors for MTCT of HIV in Ethiopia.
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Affiliation(s)
- Wolde Facha
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, P.O.BOX 136, Wolaita Sodo, Ethiopia.
| | - Takele Tadesse
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, P.O.BOX 136, Wolaita Sodo, Ethiopia
| | - Eskinder Wolka
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, P.O.BOX 136, Wolaita Sodo, Ethiopia
| | - Ayalew Astatkie
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, P.O.BOX: 1560, Hawassa, Ethiopia
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Musiime V, Rujumba J, Kakooza L, Namisanvu H, Atuhaire L, Naguti E, Beinomugisha J, Kiggwe A, Nkinzi S, Segawa I, Matsiko N, Babirekere-Iriso E, Musoke P. HIV prevalence among children admitted with severe acute malnutrition and associated factors with mother-to-child HIV transmission at Mulago Hospital, Uganda: A mixed methods study. PLoS One 2024; 19:e0301887. [PMID: 38626109 PMCID: PMC11020493 DOI: 10.1371/journal.pone.0301887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 03/25/2024] [Indexed: 04/18/2024] Open
Abstract
BACKGROUND Despite global efforts to eliminate mother-to-child-transmission of HIV (MTCT), many children continue to become infected. We determined the prevalence of HIV among children with severe acute malnutrition (SAM) and that of their mothers, at admission to Mwanamugimu Nutrition Unit, Mulago Hospital, Uganda. We also assessed child factors associated with HIV-infection, and explored factors leading to HIV-infection among a subset of the mother-child dyads that tested positive. METHODOLOGY We conducted a cross-sectional evaluation within the REDMOTHIV (Reduce mortality in HIV) clinical trial that investigated strategies to reduce mortality among HIV-infected and HIV-exposed children admitted with SAM at the Nutrition Unit. From June 2021 to December 2022, we consecutively tested children aged 1 month to 5 years with SAM for HIV, and the mothers who were available, using rapid antibody testing upon admission to the unit. HIV-antibody positive children under 18 months of age had a confirmatory HIV-DNA PCR test done. In-depth interviews (IDIs) were conducted with mothers of HIV positive dyads, to explore the individual, relationship, social and structural factors associated with MTCT, until data saturation. Quantitative data was analyzed using descriptive statistics and logistic regression in STATAv14, while a content thematic approach was used to analyze qualitative data. RESULTS Of 797 children tested, 463(58.1%) were male and 630(79.1%) were ≤18months of age; 76 (9.5%) tested positive. Of 709 mothers, median (IQR) age 26 (22, 30) years, 188(26.5%) were HIV positive. Sixty six of the 188 mother-infant pairs with HIV exposure tested positive for HIV, an MTCT rate of 35.1% (66/188). Child age >18 months was marginally associated with HIV-infection (crude OR = 1.87,95% CI: 1.11-3.12, p-value = 0.02; adjusted OR = 1.72, 95% CI: 0.96, 3.09, p-value = 0.068). The IDIs from 16 mothers revealed associated factors with HIV transmission at multiple levels. Individual level factors: inadequate information regarding prevention of MTCT(PMTCT), limited perception of HIV risk, and fear of antiretroviral drugs (ARVs). Relationship level factors: lack of family support and unfaithfulness (infidelity) among sexual partners. Health facility level factors: negative attitude of health workers and missed opportunities for HIV testing. Community level factors: poverty and health service disruptions due to the COVID-19 pandemic. CONCLUSION In this era of universal antiretroviral therapy for PMTCT, a 10% HIV prevalence among severely malnourished children is substantially high. To eliminate vertical HIV transmission, more efforts are needed to address challenges mothers living with HIV face intrinsically and within their families, communities and at health facilities.
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Affiliation(s)
- Victor Musiime
- Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
- Research Department, Joint Clinical Research Centre, Kampala, Uganda
| | - Joseph Rujumba
- Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Lawrence Kakooza
- Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Henriator Namisanvu
- Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Loice Atuhaire
- Mwanamugimu Nutrition Unit, Directorate of Paediatrics and Child Care, Mulago National Referral Hospital, Kampala, Uganda
| | - Erusa Naguti
- Mwanamugimu Nutrition Unit, Directorate of Paediatrics and Child Care, Mulago National Referral Hospital, Kampala, Uganda
| | - Judith Beinomugisha
- Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Andrew Kiggwe
- Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Sharafat Nkinzi
- Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Ivan Segawa
- Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Nicholas Matsiko
- Research Department, Joint Clinical Research Centre, Kampala, Uganda
| | - Esther Babirekere-Iriso
- Mwanamugimu Nutrition Unit, Directorate of Paediatrics and Child Care, Mulago National Referral Hospital, Kampala, Uganda
| | - Philippa Musoke
- Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
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Adekanmbi AF, Akodu SO, Ogunlesi TA, Ogunfowora OB, Jagun OE, Ayeni VA, Ojo OT, Ogbaro DD. Evaluation of Prevention of Mother to Child Transmission Programme at a Tertiary Healthcare Facility in Southwestern Nigeria. Jpn J Infect Dis 2023; 76:295-301. [PMID: 37394463 DOI: 10.7883/yoken.jjid.2022.606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Most children acquire human immunodeficiency virus (HIV) infection through mother-to-child transmission (MTCT). The risk of MTCT of HIV is generally 15%-40% without prophylaxis. MTCT has been responsible for approximately 370,000 infant HIV infections worldwide, with Nigeria accounting for 30% of cases. The study evaluated the effectiveness of a prevention program for MTCT of HIV infection by determining the rate of MTCT of HIV in infants who underwent the program by reviewing health records of mother-infant pairs at the Olabisi Onabanjo University Teaching Hospital. This cross-sectional study conducted over 12 years used medical records of 545 mother-infant pairs. The rate of MTCT of HIV infection was 2.9% in this study compared to 7.1% reported by the center earlier. The rate of MTCT of HIV infection was the lowest among mother-infant pairs who received prophylaxis. Ages at recruitment are a strong determinant of the risk of infection. Late usage of the MTCT prevention service is a risk for HIV infection in exposed infants.
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Affiliation(s)
| | - Samuel Olufemi Akodu
- Department of Paediatrics, Olabisi Onabanjo University Teaching Hospital, Nigeria
| | | | | | - Olusoji Edward Jagun
- Department of Obstetrics and Gynaecology, Olabisi Onabanjo University Teaching Hospital, Nigeria
| | | | - Omotola Toyin Ojo
- Department of Haematology and Blood Transfusions, Olabisi Onabanjo University Teaching Hospital, Nigeria
| | - Daniel Damilare Ogbaro
- Department of Haematology and Blood Transfusions, Olabisi Onabanjo University Teaching Hospital, Nigeria
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Onambele AAS, Yuya F, Schouame AA, Nolna SK, Socpa A. Low antiretroviral therapy uptake and low early retention among pregnant women who tested positive for human immunodeficiency virus in informal health centers in urban and semi-rural settings in Cameroon: a prospective cohort study. Front Public Health 2023; 11:1188749. [PMID: 37601184 PMCID: PMC10432685 DOI: 10.3389/fpubh.2023.1188749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/29/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction Despite the efforts of Cameroon's Ministry of Public Health against informal health centers (IHCs) because of their illegitimacy, the number of IHCs is increasing in Cameroon. Most of these IHCs have antenatal care services and screen pregnant women for HIV. However, nothing is known about the subsequent outcomes of those who tested positive for HIV. This study aimed to assess the initiation of antiretroviral therapy (ART) in ART-naïve pregnant women screened HIV positive in IHCs within three months of diagnosis and their ART retention at three months post-initiation. In addition, we sought to identify the factors associated with ART non-initiation in this population. Methods May 01, 2019 to August 31, 2020, we carried out a prospective cohort study of ART-naïve pregnant women who attended their first antenatal care visit and screened HIV positive at IHCs in the cities of Douala and Ebolowa in Cameroon. Standardized questionnaires were used to interview consenting participants at three points: the day of the delivery of the antenatal HIV test result, three months later, and three months after ART initiation. The data collected were entered into KoboCollect and analyzed using SPSS V23.0 software. The Chi-square test was used to compare proportions, Kaplan Meier techniques and Cox proportional hazards regression was used to estimate retention in ART and identify factors associated with ART non-retention, respectively. Results and discussion A total of 85 ART-naïve pregnant women living with HIV were enrolled in the study. The median age and gestational age at the first antenatal care visit were 29 years (interquartile range (IQR), 2333.5) and 28weeks of amenorrhea (IQR, 2032), respectively. Only 34% (29/85) initiated ART, and 65.5% (19/29) of the initiators were retained in ART three months later. Lack of perceived self-efficacy to initiate ART (adjust Hazard Ratio = 5.57, 90% CI: 1.29 to 24.06), increased the probability of not be retaining in ART by any time during three months post initiation. Given the low ART uptake and the low retention in care among pregnant women living with HIV screened in IHCs, PMTCT policies in Cameroon should pay greater attention to this population, to facilitate their continuum of PMTCT care.
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Affiliation(s)
- Audrey Amboua Schouame Onambele
- Department of Public Health, School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon
- Institut de Recherche pour le Développement France, Yaoundé, Cameroon
| | | | | | - Sylvie Kwedi Nolna
- Capacity for Leadership Excellence and Research (CLEAR), Yaoundé, Cameroon
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Antoine Socpa
- Center for Applied Social Sciences, Research and Training (CASS-RT), Yaoundé, Cameroon
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11
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Gutema G, Tola HH, Fikadu D, Leta D, Bejiga B, Tura JB, Abdella S, Mamo H. Positivity rate, trend and associated risk factors of mother-to-child transmission of HIV among HIV-exposed infants. BMC Pediatr 2023; 23:283. [PMID: 37280581 DOI: 10.1186/s12887-023-04074-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 05/16/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Mother-To-Child-Transmission (MTCT) of Human Immunodeficiency Virus (HIV) occurs during pregnancy, delivery and breastfeeding, and cause infection among several new-borns. However, there is limited recent evidence on the burden of MTCT of HIV in Ethiopia from a large-scale data. Thus, this study aimed to determine the positivity rate, trend and associated risk factors of MTCT among HIV-exposed infants. METHODOLOGY A cross-sectional study was conducted among 5,679 infants whose specimen referred to Ethiopian Public Health Institute HIV referral laboratory for Early Infant Diagnosis (EID) from January 01, 2016, to December 31, 2020. Data were extracted from the national EID database. Frequencies and percentages were used to summarize the data on characteristics of infants. Logistic regression analysis was employed to identify factors associated with positivity rate of MTCT of HIV. Level of significance was set at 5%. RESULTS The mean age of the infants was 12.6 (± 14.6) weeks with an age range of 4 to 72 weeks. Half of the infants (51.4%) were female. The positivity rate of MTCT decreased from 2.9% in 2016 to 0.9% in 2020 with five-year average positivity rate of 2.6%. HIV test after six weeks (Adjusted odds ratio (AOR) = 2.7; 95% confidence interval (CI): (1.8-4.0,)); p < 0.001), absence of prevention of mother-to-child-transmission (PMTCT) service (AOR = 4.6; 95% CI: (2.9-7.4)); p = 0.001), nevirapine prophylaxis not received (AOR = 2.0; 95% CI: (1.3-3.2)); p < 0.001), and unknown ART status of the mother at delivery (AOR = 11; 95% CI: (5.5-22.1)); p < 0.001) were significantly associated with MTCT of HIV. CONCLUSION The positivity rate of MTCT of HIV was showing declining tendency gradually in the study period. Strengthening PMTCT service, early HIV screening and starting ART for pregnant women, and early infant diagnosis are required to reduce the burden of HIV infection among infants exposed to HIV.
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Affiliation(s)
- Gadissa Gutema
- HIV/AIDS Research Team, TB and HIV/AIDS Research Directorate, Ethiopian Public Health Institute, PO Box 1242, Addis Ababa, Ethiopia.
- Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, PO Box 1176, Addis Ababa, Ethiopia.
| | | | - Dinka Fikadu
- TB Research Team, TB and HIV/AIDS Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Dereje Leta
- HIV/AIDS Research Team, TB and HIV/AIDS Research Directorate, Ethiopian Public Health Institute, PO Box 1242, Addis Ababa, Ethiopia
| | - Birra Bejiga
- HIV/AIDS Research Team, TB and HIV/AIDS Research Directorate, Ethiopian Public Health Institute, PO Box 1242, Addis Ababa, Ethiopia
| | - Jaleta Bulti Tura
- HIV/AIDS Research Team, TB and HIV/AIDS Research Directorate, Ethiopian Public Health Institute, PO Box 1242, Addis Ababa, Ethiopia
| | - Saro Abdella
- HIV/AIDS Research Team, TB and HIV/AIDS Research Directorate, Ethiopian Public Health Institute, PO Box 1242, Addis Ababa, Ethiopia
| | - Hassen Mamo
- Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, PO Box 1176, Addis Ababa, Ethiopia
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Figueredo VSL, Monteiro DLM, Batista RFL, Gama MEA, Campos ASF, Pinto AGCF. Vertical transmission of HIV to neonates in a reference hospital in Northeastern Brazil from 2013 to 2017. Rev Inst Med Trop Sao Paulo 2023; 65:e34. [PMID: 37283409 DOI: 10.1590/s1678-9946202365034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 04/06/2023] [Indexed: 06/08/2023] Open
Abstract
The aim of this study was to estimate the rate of Mother-to-child Transmission (MTCT) of HIV to neonates in a reference university hospital in Sao Luis city, the capital of Maranhao State (MA), evaluating MTCT-associated factors. A retrospective cohort study based on data from the Notifiable Diseases Data System (SINAN) was carried out and included all HIV-exposed neonates notified from 2013 to 2017 by the university hospital. The study population comprised 725 HIV-exposed neonates, of whom 672 neonates were exposed and uninfected, and 53 were exposed and infected. The estimated rate of MTCT in the period of 2013 to 2017 was 7.3%. Most pregnant women were ≥ 20 years old (86.9%), reported ≥ 8 years of schooling (53.2%), reported full-time or independent paid work (46.9%) and were residents in other cities of the state (61.7%). Regarding healthcare, 86.3% received prenatal care, 74.6% received Antiretroviral Therapy (ART) as prophylaxis during pregnancy, 81.8% received ART prophylaxis during childbirth and 78.1% underwent cesarean section. Among the neonates, 92.8% received ART prophylaxis and 94.3% were not breastfed. Despite these variables, the 7.3% MTCT rate found in this study makes it clear that the interventions recommended by the Ministry of Health were not fully adopted.
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Affiliation(s)
- Vaneça Santos Leal Figueredo
- Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
- Universidade Federal do Maranhão, São Luís, Maranhão, Brazil
| | - Denise Leite Maia Monteiro
- Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
- Centro Universitário Serra dos Órgãos, Teresópolis, Rio de Janeiro, Brazil
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Ruiz-Algueró M, Izquierdo R, Suárez-García I, Moreno C, Alejos B, Rava M, Moreno S, Montero Alonso M, Gutiérrez F, Gutierrez Cuellar I, Curran A, Hernando V, Jarrín I. Unplanned pregnancies and social and partner support during pregnancy in Spanish women living with HIV. HIV Med 2023; 24:727-737. [PMID: 36810955 DOI: 10.1111/hiv.13469] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 02/01/2023] [Indexed: 02/23/2023]
Abstract
OBJECTIVES To describe prevalence and factors associated with unplanned pregnancies, and social and partner support during pregnancy among women from the Cohort of the Spanish HIV/AIDS Research Network (CoRIS). METHODS We included all women recruited in CoRIS from 2004 to 2019, aged 18-50 years at recruitment who were pregnant during 2020. We designed a questionnaire, organized into the following domains: sociodemographic characteristics, tobacco and alcohol consumption, pregnancy and reproductive health, and social and partner support. The information was gathered via telephone interviews conducted from June to December 2021. We calculated prevalence of unplanned pregnancies as well as odds ratios (ORs) of association and 95% confidence intervals (CIs) according to sociodemographic, clinical and reproductive characteristics. RESULTS Among 53 women who were pregnant during 2020, 38 (71.7%) answered the questionnaire. Median age at pregnancy was 36 years [interquartile range (IQR) 31-39], 27 (71.1%) women were born outside of Spain, mainly in sub-Saharan Africa (39.5%) and 17 (44.7%) were employed. Thirty-four (89.5%) women had been through previous pregnancies and 32 (84.2%) had experienced previous abortions/miscarriages. Seventeen (44.7%) women had shared with their clinician their desire to get pregnant. Thirty-four (89.5%) pregnancies were natural and four used assisted reproductive techniques (in vitro fertilizations; one additionally used oocyte donation). Of 34 women with natural pregnancies, pregnancy was unplanned in 21 (61.8%) and 25 (73.5%) had information on how to become pregnant avoiding HIV transmission to the baby and partner. Women who did not seek advice from their physician about becoming pregnant had a significantly increased risk of unplanned pregnancy (OR = 71.25, 95% CI: 8.96-566.67). Overall, 14 (36.8%) women reported having low social support during pregnancy and 27 (71.0%) had good/very good support by their partner. CONCLUSIONS Most pregnancies were natural and unplanned and very few women had talked with their clinician about their desire to become pregnant. A high proportion of women reported low social support during pregnancy.
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Affiliation(s)
- Marta Ruiz-Algueró
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Rebeca Izquierdo
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Ines Suárez-García
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Infectious Diseases Unit, Department of Internal Medicine, Hospital Universitario Infanta Sofía, Madrid, Spain
- Universidad Europea de Madrid, Madrid, Spain
| | - Cristina Moreno
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Belen Alejos
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | - Marta Rava
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Santiago Moreno
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Infectious Diseases Unit, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Marta Montero Alonso
- Infectious Diseases Unit, Hospital Universitario y Politécnico de La Fe, Valencia, Spain
| | - Felix Gutiérrez
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Infectious Diseases Unit, Hospital General Universitario De Elche, Alicante, Spain
- University Miguel Hernandez, Alicante, Spain
| | | | - Adrián Curran
- Infectious Diseases Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Victoria Hernando
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Inma Jarrín
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
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Sagaro GG, Angeloni U, Marotta C, Nittari G, Rezza G, Silenzi A, Battineni G, Amenta F. The Magnitude of Cardiovascular Disease Risk Factors in Seafarers from 1994 to 2021: A Systematic Review and Meta-Analysis. J Pers Med 2023; 13:jpm13050861. [PMID: 37241030 DOI: 10.3390/jpm13050861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/09/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023] Open
Abstract
OBJECTIVES The incidence of acute cardiac events is one of the main reasons for medical consultation, disembarkation, repatriation, and death among seafarers at sea. Managing cardiovascular risk factors, particularly those that can be modified, is the key to preventing cardiovascular disease. Therefore, this review estimates the pooled prevalence of major CVD risk factors among seafarers. METHODS We conducted a comprehensive search of studies published between 1994 and December 2021 in four international databases, namely PubMed/Medline, Scopus, Google Scholar, and Web of Science (WOS). Each study was evaluated for methodological quality using the Joanna Briggs Institute (JBI) critical appraisal tool for prevalence studies. The DerSimonian-Laird random-effects model with logit transformations was used to estimate the pooled prevalence of major CVD risk factors. The results were reported in accordance with the Preferred Items for Systematic Review and Meta-analysis (PRISMA) guidelines. RESULTS Out of all 1484 studies reviewed, 21 studies with 145,913 study participants met the eligibility criteria and were included in the meta-analysis. In the pooled analysis, the prevalence of smoking was found to be 40.14% (95% CI: 34.29 to 46.29%) with heterogeneity between studies (I2 = 98%, p < 0.01). The prevalence of hypertension, overweight, obesity, diabetes mellitus, and alcohol consumption was 45.32%, 41.67%, 18.60%, 12.70%, and 38.58%, respectively. However, the sensitivity analysis after excluding studies showed a pooled prevalence of hypertension, overweight, obesity, and diabetes mellitus of 44.86%, 41.87%, 15.99%, and 16.84%, respectively. The subgroup analysis demonstrated that smoking prevalence among seafarers had decreased significantly after 2013. CONCLUSION This study demonstrated that CVD risk factors, particularly hypertension, overweight, smoking, alcohol consumption, and obesity, are prevalent among seafarers. These findings may serve as a guide for shipping companies and other responsible bodies in order to prevent CVD risk factors among seafarers. PROSPERO Registration: CRD42022300993.
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Affiliation(s)
- Getu Gamo Sagaro
- Telemedicine and Telepharmacy Center, School of Medicinal and Health Products Sciences, University of Camerino, 62032 Camerino, Italy
- School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Sodo 138, Ethiopia
| | - Ulrico Angeloni
- General Directorate of Health Prevention, Ministry of Health, 00144 Rome, Italy
| | - Claudia Marotta
- General Directorate of Health Prevention, Ministry of Health, 00144 Rome, Italy
| | - Giulio Nittari
- Telemedicine and Telepharmacy Center, School of Medicinal and Health Products Sciences, University of Camerino, 62032 Camerino, Italy
| | - Giovanni Rezza
- General Directorate of Health Prevention, Ministry of Health, 00144 Rome, Italy
| | - Andrea Silenzi
- General Directorate of Health Prevention, Ministry of Health, 00144 Rome, Italy
| | - Gopi Battineni
- Telemedicine and Telepharmacy Center, School of Medicinal and Health Products Sciences, University of Camerino, 62032 Camerino, Italy
| | - Francesco Amenta
- Telemedicine and Telepharmacy Center, School of Medicinal and Health Products Sciences, University of Camerino, 62032 Camerino, Italy
- Research Department, International Radio Medical Center (C.I.R.M.), 00144 Rome, Italy
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15
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Masenga SK, Mweene BC, Luwaya E, Muchaili L, Chona M, Kirabo A. HIV-Host Cell Interactions. Cells 2023; 12:1351. [PMID: 37408185 DOI: 10.3390/cells12101351] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/04/2023] [Accepted: 05/05/2023] [Indexed: 07/07/2023] Open
Abstract
The development of antiretroviral drugs (ARVs) was a great milestone in the management of HIV infection. ARVs suppress viral activity in the host cell, thus minimizing injury to the cells and prolonging life. However, an effective treatment has remained elusive for four decades due to the successful immune evasion mechanisms of the virus. A thorough understanding of the molecular interaction of HIV with the host cell is essential in the development of both preventive and curative therapies for HIV infection. This review highlights several inherent mechanisms of HIV that promote its survival and propagation, such as the targeting of CD4+ lymphocytes, the downregulation of MHC class I and II, antigenic variation and an envelope complex that minimizes antibody access, and how they collaboratively render the immune system unable to mount an effective response.
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Affiliation(s)
- Sepiso K Masenga
- HAND Research Group, School of Medicine and Health Sciences, Mulungushi University, Livingstone Campus, Livingstone 10101, Zambia
- Vanderbilt University Medical Center, Department of Medicine, Division of Clinical Pharmacology, Room 536 Robinson Research Building, Nashville, TN 37232-6602, USA
| | - Bislom C Mweene
- HAND Research Group, School of Medicine and Health Sciences, Mulungushi University, Livingstone Campus, Livingstone 10101, Zambia
| | - Emmanuel Luwaya
- HAND Research Group, School of Medicine and Health Sciences, Mulungushi University, Livingstone Campus, Livingstone 10101, Zambia
| | - Lweendo Muchaili
- HAND Research Group, School of Medicine and Health Sciences, Mulungushi University, Livingstone Campus, Livingstone 10101, Zambia
| | - Makondo Chona
- HAND Research Group, School of Medicine and Health Sciences, Mulungushi University, Livingstone Campus, Livingstone 10101, Zambia
| | - Annet Kirabo
- Vanderbilt University Medical Center, Department of Medicine, Division of Clinical Pharmacology, Room 536 Robinson Research Building, Nashville, TN 37232-6602, USA
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16
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Ahidan A, Buende S, Osei L, Hcini N, Elenga N. “Sociodemographic characteristics of children born to HIV-infected mothers in Western French Guiana”. J Infect Public Health 2023; 16:870-876. [PMID: 37054500 DOI: 10.1016/j.jiph.2023.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/20/2023] [Accepted: 03/26/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND French Guiana is the French department most affected by HIV. The situation in Western French Guiana is complicated by the transborder context and isolation of many patients. This study aims to describe the epidemiological characteristics of children born to mothers living with HIV followed in Western French Guiana. METHODS This was a retrospective and descriptive study. All children born to HIV-infected mothers between 2014 and 2018 were included. Data were collected using a survey sheet to generate an Excel database. RESULTS We recorded 177 newborns exposed to maternal HIV, four of whom (2.26 %) were infected. The majority of women (87 %) were of foreign origin, and only 7 % had conventional health insurance coverage. The infection was discovered during pregnancy in 20 % of women. Overall 21.71 % of newborns were preterm and 22.5 % hypotrophic. All neonates had received antiretroviral prophylaxis for four weeks, either as monotherapy (AZT) (67.43 %) or triple therapy (AZT/3TC/NVP) (25.71 %). Twenty-two neonates had at least one neonatal illness: transient respiratory distress (9 cases), asphyxia (3 cases), hyaline membrane disease (8 cases), and there were two cases with birth defects: clubfoot (1 case) and heart disease (1 case). The follow-up rate at 24 months was 65 % and 35 % of cases were lost to follow-up. The most common biological anomalies were anemia (69.14 %), hyperlacticaemia (23 %), and neutropenia (9.14 %). CONCLUSION The prevalence of mother-to child transmission of HIV was high; a quarter of maternal infections were discovered during pregnancy. The mother's socio-economic situation was often precarious and follow-up interruptions common.
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Oguntade RT, Ojewole EB, Ogunrombi MO. Unintended pregnancies among HIV-positive women in sub-Saharan Africa: a scoping review protocol. Syst Rev 2023; 12:12. [PMID: 36681857 PMCID: PMC9862844 DOI: 10.1186/s13643-023-02168-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 12/29/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Unintended pregnancies pose a severe threat to the well-being of HIV-positive women and their unborn children. Factors contributing to the high incidence of unintended pregnancies include contraceptive failure, low uptake of contraceptives, and misuse of contraceptives. Despite various contraceptive options, an increased incidence of unintended pregnancies is rampant among HIV-positive women in the region of sub-Saharan Africa. This study seeks to present evidence of unintended pregnancies among women living with HIV in sub-Saharan Africa, including those using contraceptives. METHOD This study entails a scoping review to survey and interrogate the literature to provide evidence for the incidence of unintended pregnancies among HIV-positive women in sub-Saharan Africa. A proposed framework by Arksey and O'Malley will guide this scoping review. Peer-reviewed articles which address the research questions will constitute the main search. Electronic databases such as EBSCOhost, Cochrane Library, World of Science, World Health Organization (WHO) library databases, Science Direct, Google Scholar PubMed, and gray literature search will be involved. Reference list from studies included will also be searched. The investigation of articles will be done employing keywords from the studies included. The inclusion and exclusion criteria will guide two separate reviewers with the screening of abstracts and full papers. To summarize the findings from this review, thematic content analysis will be done using NVivo version 11. DISCUSSION We expect that this review will add to the current body of knowledge on the incidence of unintended pregnancies among HIV-positive women, identify gaps for further future research, and show evidence that may contribute to strengthening the health system's regulations, guidelines, and policies that may help prevent unintended pregnancies among HIV-positive women. SYSTEMATIC REVIEW REGISTRATION 10.17605/OSF.IO/EY3R5.
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Affiliation(s)
- Racheal Tomilola Oguntade
- Discipline of Pharmaceutical Sciences, College of Health Sciences, University of Kwa-Zulu Natal, Durban, South Africa.
| | - Elizabeth Bolanle Ojewole
- Discipline of Pharmaceutical Sciences, College of Health Sciences, University of Kwa-Zulu Natal, Durban, South Africa
| | - Modupe Olufunmilayo Ogunrombi
- Department of Clinical Pharmacology, School of Medicine, Sefako Makgatho Health Sciences University, Ga-Rankuwa, South Africa
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Lorestani RC, Rostamian M, Akya A, Rezaeian S, Afsharian M, Habibi R, Bozorgomid A, Kazemisafa N, Jafari S, Yeilaghi S, Salehi MM, Namdari H, Ghadiri K. Prevention of mother-to-child transmission of HIV in Kermanshah, west of Iran from 2014 to 2021. BMC Pediatr 2023; 23:29. [PMID: 36653794 PMCID: PMC9850679 DOI: 10.1186/s12887-022-03829-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 12/28/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND This study aimed to evaluate the implementation of the prevention of mother-to-child transmission (PMTCT) of the HIV-PMTCT program in Kermanshah, west of Iran, from 2014 to 2021. METHODS The data of all HIV-infected mothers and their infants who were monitored by the Kermanshah behavioral diseases counseling center was extracted and recorded in a checklist. RESULTS Out of 95 included infant, 45 (47.4%) were girls and 50 (52.6%) were boys. The mothers were mostly infected with HIV via their infected spouse. The pregnancies of 77 cases (82.1%) were in accordance with the national guideline. The average length of treatment for this group was 185 days. Of the 18 mothers who did not receive treatment, nine were diagnosed during childbirth and nine had no available information. All infants born from infected mothers underwent after-birth-antiretroviral prophylaxis, and all remained healthy. There was no statistically significant relationship between the birth weight and height of neonates with maternal age, maternal last viral load, disease stage, education, and maternal CD4 levels. Only a statistically significant relationship was observed between the duration of treatment and the infants' weight. CONCLUSION The results suggest the feasibility and effectiveness of the PMTCT program for HIV-positive mothers in Kermanshah. It seems that if pregnant HIV-positive women are diagnosed early and covered by a good prevention program on time, the risk of HIV to their babies will be reduced, significantly.
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Affiliation(s)
- Roya Chegene Lorestani
- grid.412112.50000 0001 2012 5829Infectious Diseases Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mosayeb Rostamian
- grid.412112.50000 0001 2012 5829Infectious Diseases Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alisha Akya
- grid.412112.50000 0001 2012 5829Infectious Diseases Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahab Rezaeian
- grid.412112.50000 0001 2012 5829Infectious Diseases Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mandana Afsharian
- grid.412112.50000 0001 2012 5829Infectious Diseases Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Reza Habibi
- grid.412112.50000 0001 2012 5829Clinical Research Development Center, Dr. Kermanshahi Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Arezoo Bozorgomid
- grid.412112.50000 0001 2012 5829Infectious Diseases Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Narges Kazemisafa
- grid.412112.50000 0001 2012 5829School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Somayeh Jafari
- grid.412112.50000 0001 2012 5829Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Soliman Yeilaghi
- grid.412112.50000 0001 2012 5829Infectious Diseases Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran ,grid.412112.50000 0001 2012 5829Expert Advice Center for Behavioral Diseases, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mansour Mohammad Salehi
- grid.412112.50000 0001 2012 5829Expert Advice Center for Behavioral Diseases, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hiva Namdari
- grid.412112.50000 0001 2012 5829Expert Advice Center for Behavioral Diseases, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Keyghobad Ghadiri
- grid.412112.50000 0001 2012 5829Infectious Diseases Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Gessesse NA, Gela GB, Aweke AM, Balcha WF. Male partners involvement in human immune deficiency virus testing and counseling during prenatal care visits in Bichena town Westcentral Ethiopia: a cross-sectional study. BMC Res Notes 2022; 15:327. [PMID: 36266661 PMCID: PMC9583477 DOI: 10.1186/s13104-022-06215-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 09/15/2022] [Accepted: 09/19/2022] [Indexed: 11/10/2022] Open
Abstract
Objective Transmission of the Human immune deficiency virus (HIV) from mother to child remains a significant problem in developing countries. Male partners’ involvement in HIV testing and counseling is a major entry point for the prevention of mother-to-child transmission (PMTCT) of HIV. This study aimed to assess male partners’ involvement in HIV testing and counseling during prenatal care visits in Bichena town, Westcentral Ethiopia. Results A community-based cross-sectional study design was conducted from October 1/2018 to June 15/2019 among 406 male partners. Less than half (41.38%) [95% CI: 36.20–46.10%] of the male partners were involved in HIV testing and counseling. In multivariable analysis male partners who are found in the age group of 20–29 years, secondary, and diploma and above educational level, good knowledge of the services provided in the prenatal care visits, male partners whose wife had ≥ 4 prenatal care visits, good knowledge of mother to child transmission (MTCT) and PMTCT of HIV, entering the prenatal care room together with his wife, discussing maternal health issue with health care providers, and travel < 15 min to reach a nearby health facility were associated with male partners involvement in HIV testing and counseling. Supplementary Information The online version contains supplementary material available at 10.1186/s13104-022-06215-9.
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Affiliation(s)
- Nigusu Ayalew Gessesse
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, P.Box:079, Bahir Dar, Ethiopia
| | - Getahun Belay Gela
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, P.Box:079, Bahir Dar, Ethiopia
| | - Amlaku Mulat Aweke
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, P.Box:079, Bahir Dar, Ethiopia
| | - Wondu Feyisa Balcha
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, P.Box:079, Bahir Dar, Ethiopia.
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Adugna Wubneh C, Dessalegn Mekonnen B, Wesenyeleh Delelegn M, Asmare Atalell K. Adherence to option B+ and its association with disclosure status and counseling among HIV-positive pregnant and lactating women in Ethiopia: systematic review and meta-analysis. Public Health 2022; 211:105-113. [PMID: 36058198 DOI: 10.1016/j.puhe.2022.07.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 05/22/2022] [Accepted: 07/20/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVES This systematic review and meta-analysis aimed to assess the pooled estimate of option B+ level of adherence and its association with disclosure status and counseling among pregnant and lactation women in Ethiopia after option B+ implementation. STUDY DESIGN Systematic review and meta-analysis. METHODS We searched Web of Science, MEDLINE, PUBMED, Scopus, Embase, CINAHL, and Google Scholar databases for studies reporting adherence to option B+ and its association with disclosure status and counseling among pregnant and lactating women in Ethiopia. Heterogeneity was assessed by forest plot, Cochran's Q test, and I2 test. A random effects model was calculated to estimate the pooled prevalence of adherence toward option B+. RESULTS We included eight studies, which gives a total of 1852 pregnant and lactating women in this systematic review and meta-analysis. The overall pooled estimate of good adherence toward option B+ antiretroviral therapy (ART) drug among pregnant and lactating women in Ethiopia was 84.23% (95% confidence interval [CI]: 80.79-87.66). Women who have disclosed their HIV status to their partner (adjusted odds ratio = 4.48, 95% CI: 1.86-10.76) and got counseling during the antenatal period (adjusted odds ratio = 5.02, 95% CI: 2.43-10.34) had a positive association with good adherence to option B+ ART drugs. CONCLUSION Four of five pregnant and lactating women have good adherence to option B+ ART drugs in Ethiopia. Therefore, promoting HIV disclosure status to partners and enhancing counseling services should be strengthened to improve adherence toward option B+ among pregnant and lactating women.
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Affiliation(s)
- Chalachew Adugna Wubneh
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, P.O.BOX: 196, Gondar, Ethiopia.
| | - Birye Dessalegn Mekonnen
- Department of Nursing, Teda Health Science College, Gondar, Ethiopia, P.O.BOX: 790, Gondar, Ethiopia.
| | - Mekdess Wesenyeleh Delelegn
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, P.O.BOX: 196, Gondar, Ethiopia.
| | - Kendalem Asmare Atalell
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, P.O.BOX: 196, Gondar, Ethiopia.
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Fernández-Luis S, Fuente-Soro L, Nhampossa T, Lopez-Varela E, Augusto O, Nhacolo A, Vazquez O, Saura-Lázaro A, Guambe H, Tibana K, Ngeno B, Juga AJC, Cowan JG, Urso M, Naniche D. Prompt HIV diagnosis and antiretroviral treatment in postpartum women is crucial for prevention of mother to child transmission during breastfeeding: Survey results in a high HIV prevalence community in southern Mozambique after the implementation of Option B+. PLoS One 2022; 17:e0269835. [PMID: 35917332 PMCID: PMC9345360 DOI: 10.1371/journal.pone.0269835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 05/27/2022] [Indexed: 11/18/2022] Open
Abstract
Objective World Health Organization recommends promoting breastfeeding without restricting its duration among HIV-positive women on lifelong antiretroviral treatment (ART). There is little data on breastfeeding duration and mother to child transmission (MTCT) beyond 24 months. We compared the duration of breastfeeding in HIV-exposed and HIV-unexposed children and we identified factors associated with postpartum-MTCT in a semi-rural population of Mozambique. Methods This cross-sectional assessment was conducted from October-2017 to April-2018. Mothers who had given birth within the previous 48-months in the Manhiça district were randomly selected to be surveyed and to receive an HIV-test along with their children. Postpartum MTCT was defined as children with an initial HIV positive result beyond 6 weeks of life who initiated breastfeeding if they had a first negative PCR result during the first 6 weeks of life or whose mother had an estimated date of infection after the child’s birth. Cumulative incidence accounting for right-censoring was used to compare breastfeeding duration in HIV-exposed and unexposed children. Fine-Gray regression was used to assess factors associated with postpartum-MTCT. Results Among the 5000 mother-child pairs selected, 69.7% (3486/5000) were located and enrolled. Among those, 27.7% (967/3486) children were HIV-exposed, 62.2% (2169/3486) were HIV-unexposed and for 10.0% (350/3486) HIV-exposure was unknown. Median duration of breastfeeding was 13.0 (95%CI:12.0–14.0) and 20.0 (95%CI:19.0–20.0) months among HIV-exposed and HIV-unexposed children, respectively (p<0.001). Of the 967 HIV-exposed children, 5.3% (51/967) were HIV-positive at the time of the survey. We estimated that 27.5% (14/51) of the MTCT occurred during pregnancy and delivery, 49.0% (2551) postpartum-MTCT and the period of MTCT remained unknown for 23.5% (12/51) of children. In multivariable analysis, mothers’ ART initiation after the date of childbirth was associated (aSHR:9.39 [95%CI:1.75–50.31], p = 0.001), however breastfeeding duration was not associated with postpartum-MTCT (aSHR:0.99 [95%CI:0.96–1.03], p = 0.707). Conclusion The risk for postpartum MTCT was nearly tenfold higher in women newly diagnosed and/or initiating ART postpartum. This highlights the importance of sustained HIV screening and prompt ART initiation in postpartum women in Sub-Saharan African countries. Under conditions where HIV-exposed infants born to mothers on ART receive adequate PMTCT, extending breastfeeding duration may be recommended.
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Affiliation(s)
- Sheila Fernández-Luis
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
- * E-mail:
| | - Laura Fuente-Soro
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Tacilta Nhampossa
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- Instituto Nacional de Saúde (INS), Maputo, Mozambique
| | - Elisa Lopez-Varela
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Orvalho Augusto
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Ariel Nhacolo
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Olalla Vazquez
- Hospital Clínico Universitario de Santiago de Compostela, Santiago, Spain
| | - Anna Saura-Lázaro
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Helga Guambe
- Ministério da Saúde de Moçambique (MISAU), Maputo, Mozambique
| | - Kwalila Tibana
- Ministério da Saúde de Moçambique (MISAU), Maputo, Mozambique
| | - Bernadette Ngeno
- U.S Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | | | | | - Marilena Urso
- U.S Centers for Disease Control and Prevention (CDC), Maputo, Mozambique
| | - Denise Naniche
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
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Faustine R, Moshi FV. Exclusive breastfeeding practice among HIV infected mothers in the southern highlands of Tanzania; assessing the prevalence and factors associated with the practice, an analytical cross-sectional survey. AIDS Res Ther 2022; 19:29. [PMID: 35761241 PMCID: PMC9235179 DOI: 10.1186/s12981-022-00451-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 06/01/2022] [Indexed: 12/03/2022] Open
Abstract
Background There is no other better way to safeguard an infant’s health in the first 6 months of life than exclusive breastfeeding (EBF). Breast milk is valuable in all aspects of an infant’s physical and mental growth as well as immune development. The study aimed to assess the prevalence and factors associated with EBF practice among HIV-infected mothers in the Southern Highlands of Tanzania. Method A hospital-based analytical cross-sectional study was conducted among lactating HIV-infected mothers. A random sampling procedure was used to obtain 372 HIV-infected mothers of infants from 6 to 12 months of age who were still breastfeeding at the time of data collection. An interviewer-administered structured questionnaire was used for data collection. Bivariate and multivariable logistic regression was used to assess factors associated with EBF practice. Statistical package for social science (SPSS volume 20) software was used for data entry and analysis. Results The prevalence of EBF practice was 58.1% at 95% Confidence Interval of 52.9% to 63.1%. More than half of the respondents 199 (53.5%) had adequate knowledge while 173(46.5%) had inadequate knowledge about EBF. After adjusting for confounders, factors associated with EBF practice were knowledge about EBF [Adequate knowledge (AOR = 5.11 at 95% CI 3.2–8.17, p < 0.001)], ANC visits [Adequate (AOR = 1.76 at 95% CI 1.09–2.82, p = 0.002)], Income per day [1 0r more USD (AOR = 1.83 at 95% CI 1.14–2.94, p = 0.013)], positive perception of EBF [ positive perception (AOR = 3.51 at 95% CI 2.25–5.47, p < 0.001) and having ever experienced a breast problem AOR = 3.91 at 95% CI 1.89–8.08, p < 0.001. Conclusion More than half of interviewed mothers with HIV practiced EBF. The EBF practice among HIV lactating mothers was significantly influenced by adequate knowledge of EBF, positive perception toward EBF, adequate ANC visits, and having never experienced breast problems. Strengthening adherence to ANC routine visits, counseling on breastfeeding, and improving mothers’ knowledge about exclusive breastfeeding would contribute to the enhancement of EBF practice in this region. An innovative interventional study is recommended to develop more effective strategies to improve EBF knowledge and practice among HIV-infected mothers.
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Atlaw D, Sahiledengle B, Degno S, Mamo A, Gudisa Z, Zenbaba D, Shiferaw Z, Gezahegn H. Utilization of provider-initiated HIV testing and counselling in Ethiopia: a systematic review and meta-analysis. Trop Med Health 2022; 50:29. [PMID: 35436943 PMCID: PMC9016945 DOI: 10.1186/s41182-022-00420-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 04/08/2022] [Indexed: 11/17/2022] Open
Abstract
Background Provider-initiated HIV testing, and counseling (PITC) is a service in which health professionals provide HIV testing to all patients in health facilities. Provider-initiated HIV testing, and counseling is an important opportunity for early screening of individuals, and it is fundamental for both HIV treatment and prevention. Although there are studies conducted in different parts of Ethiopia, their findings are variable. Therefore, this systematic review and meta-analysis aimed to summarize the pooled utilization of PITC in Ethiopia. Method All studies conducted on utilization of provider-initiated HIV testing and counseling at outpatient departments (OPD), inpatient departments (IPD), antenatal clinic care (ANC), and tuberculosis (TB) clinics in Ethiopia are eligible for these meta-analyses. A systematic search of the literature was conducted by the authors to identify all relevant primary studies. The databases used to search for studies were PubMed, Science Direct, POPLINE, HENARI, Google Scholar, and Scopus. The extracted data were imported into STATA version 14 software for statistical analysis. The risk of bias was assessed using the Joana Briggs Institute (JBI) criteria for prevalence studies. The heterogeneity among all included studies was assessed by I2 statistics and the Cochran’s Q test. Pooled utilization along with its corresponding 95% CI was presented using a forest plot. Result About 1738 studies were retrieved from initial electronic searches using international databases and Google, and a total of 10,676 individual clients were included in the meta-analysis. The pooled utilization of PITC in Ethiopia using the random effects model was estimated to be 78.9% (95% CI 73.87–83.85) with a significant level of heterogeneity (I2 = 98.5%; P < 0.001). Subgroup analysis conducted on PITC showed the highest percentage among studies conducted in Addis Ababa (93.5%), while lower utilization was identified from a study conducted in the Tigray Region (35%). Limitation of the study The drawbacks of this review and meta-analysis were being reported with significant heterogeneity, and the protocol was not registered. Conclusion About 21% of health facility clients missed opportunities for PITC in Ethiopia. Supplementary Information The online version contains supplementary material available at 10.1186/s41182-022-00420-9.
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Melis T, Fikadu Y. Magnitude and determinants of male partner involvement in PMTCT service utilization of pregnant women attending public health facilities of Ethiopia, 2021: a systematic review and meta-analysis. AIDS Res Ther 2022; 19:8. [PMID: 35172839 PMCID: PMC8848825 DOI: 10.1186/s12981-022-00436-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 02/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Infant antiretroviral prophylaxis has an important role in reduction of Human immune virus transmission from mother to child during the postpartum period. Male partner involvement was considered as a priority aforementioned area needs to be enhanced in Prevention of Mother-To Child Transmission (PMTCT). PMTCT service utilization can minimize the risk of the transmission of HIV from mother to child and related mortalities. Adequate utilization and adherence to this service has been challenging for some of the women if their partners are not aware or do partners do not support the women. The aim of this study is to assess the magnitude and determinants of male involvement in PMTCT service in Ethiopia. METHODS AND MATERIALS We had conducted an extensive search of literature as indicated in the guideline of reporting systematic review and meta-analysis (PRISMA). We had used PubMed, Google Scholar, and cross reference for searching articles. We had used the Joanna Briggs Institute (JBI) Meta-Analysis of Statistics Assessment and Review Instrument for critical appraisal of studies. Met-analysis and meta-regression were computed to present the pooled prevalence and determinants of male partner involvement with a 95% confidence interval using Revman. RESULTS Among a total of 338 studies, 11 studies were included in this analysis. The estimated pooled magnitude of male partner involvement was 40% (95% CI: 29.11-50.69). Knowledge of husband on PMTCT (2.30, 95% CI 1.75, 3.02), perceived responsibility for the women (4.22, 95% CI 2.31, 7.71), being government employee (2.89, 95% CI 2.02, 4.12), cultural barriers (3.44, 95% CI 2.54, 4.65) and educational status of husband (2.4, 95% CI 1.79, 3.50) were the determinants of pooled estimates of male partner involvement in PMTCT activities. CONCLUSION The pooled prevalence of male partner involvement was lower than the study conducted in sub Saharan Africa. Knowledge of husband on PMTCT, perceived responsibility for women, occupational status, cultural barriers and educational status of husband were determinants of male partner involvement. Therefore, the existing strategies to improve male involvement should be strengthened.
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Tiruneh GA, Dagnew EZ. Prevalence of HIV infection and associated factors among infants born to HIV-positive mothers in health institutions, northwest Ethiopia, 2021. WOMEN'S HEALTH 2022; 18:17455057221117407. [PMID: 35946947 PMCID: PMC9373172 DOI: 10.1177/17455057221117407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Mother-to-child transmission of the HIV remains the main source of HIV
infection in children. Targeting pregnant women attending antenatal care
follow-up provides a unique opportunity for implementing prevention of
mother-to-child transmission programs against HIV infection in newborn
babies. Objective: The objective of this study was to assess the prevalence of HIV infection and
associated factors among infants born to HIV-positive mothers in the
prevention of mother-to-child transmission clinic in the Gondar city health
institutions, Northwest Ethiopia, 2021. Methods: Documents were reviewed at the facility. Infants who had been exposed to HIV
were enrolled in the study from 1 May–20 June 2021 prevention of
mother-to-child transmission service in Gondar health institutions. To
collect data from the charts, a structured data extraction tool was
developed. The data were entered and analyzed with SPSS version 25 software.
Both bivariate and multivariate logistic regression models were fitted to
identify factors associated with HIV infection. The crude and adjusted odds
ratios with a 95% confidence interval were calculated to determine the
significance level. Result: The prevalence of HIV infection among infants born to HIV-positive mothers at
the prevention of mother-to-child transmission level was found to be 8.1%
(95% confidence interval = 7.3–12.9). Mixed infant feeding practice
(adjusted odds ratio = 5.15, 95% confidence interval = 1.82–14.56), mothers’
lack of education (adjusted odds ratio = 3.43, 95% confidence
interval = 2.26–5.0), absence of antenatal care follow-up (adjusted odds
ratio = 1.82, 95% confidence interval = 1.17–4.02), and home delivery
(adjusted odds ratio = 2.24, 95% confidence interval = 2.10–7.45) were
statistically significantly associated with infants’ HIV infection. Conclusion: The prevalence of HIV infection in babies born to HIV-positive mothers was
found to be high. Significant factors include mixed infant feeding practice,
mothers’ lack of education, antenatal care follow-up, and home delivery. We
also proposed that skilled delivery care and community education could
reduce HIV transmission from mother to child.
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Affiliation(s)
- Gebrehiwot Ayalew Tiruneh
- Department of Midwifery, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Emawayish Zeleke Dagnew
- Department of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Balis B, Assefa N, Egata G, Bekele H, Getachew T, Ayana GM, Raru TB, Taye Merga B. Knowledge about vertical transmission of HIV and associated factors among women living with HIV or AIDS attending antiretroviral therapy clinic, Western Ethiopia. WOMEN'S HEALTH 2022; 18:17455065211070675. [PMID: 35001747 PMCID: PMC8744184 DOI: 10.1177/17455065211070675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: The United Nations Program on HIV or AIDS has committed to eliminating the
vertical transmission of human immunodeficiency virus. However, significant
number of newborn and children are acquiring HIV every year. Therefore, the
aim of this study was to assess knowledge of mother on vertical transmission
of HIV and associated factors among non-pregnant women receiving
antiretroviral therapy in the West Wollega, Western Ethiopia. Methods: A facility-based cross-sectional study design was used on a sample of 422
non-pregnant women attending antiretroviral therapy clinic in West Wollega
from 26 February to 26 March 2019. Systematic sampling was used to select
the study participants. Pretested and structured interviewer-administered
questionnaires and telephone interview were used to collect the data.
Multivariable logistic regression model was used to identify factors
associated with the knowledge of mother on vertical transmission of HIV.
Odds ratio along with 95% confidence interval were estimated to measure the
strength of the association. Level of statistical significance was declared
at p-value less than 0.05. Result: Out of total participants, 94.1% (95% confidence interval: (91.7%, 96.2%)) of
them were knowledgeable about vertical transmission of HIV. Urban resident
(adjusted odds ratio: 2.36, 95% confidence interval: (1.27, 4.39)), primary
school (adjusted odds ratio: 2.94, 95% confidence interval: (1.11, 7.83)),
secondary school (adjusted odds ratio: 3.39, 95% confidence interval: (1.53,
7.55)), being on antiretroviral therapy for greater than 2 years (adjusted
odds ratio: 2.67, 95% confidence interval: 1.02, 6.99)), and having child
living with HIV (adjusted odds ratio: 1.54, 95% confidence interval: (1.07,
3 .83)) were significantly associated with the knowledge of mother on
vertical transmission of HIV. Conclusion: The study indicated that 5.9% of the women lack knowledge about vertical
transmission of HIV. This knowledge associated with sociodemographic
factors, such as residence, educational status, experiences of having child
living with HIV, and being on antiretroviral therapy for greater than
2 years. Thus, interventions toward the elimination of new newborn HIV
infections should consider these factors.
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Affiliation(s)
- Bikila Balis
- School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Nega Assefa
- School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Gudina Egata
- School of Public Health, College of Health and Medical Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Habtamu Bekele
- School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Tamirat Getachew
- School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Galana Mamo Ayana
- School of Public Health, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Temam Beshir Raru
- School of Public Health, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Bedasa Taye Merga
- School of Public Health, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
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Tulelo PM, Mulaudzi FM. Indigenous neonatal feeding and bathing practices of caregivers in Vhembe District, Limpopo province. Health SA 2021; 26:1632. [PMID: 34917404 PMCID: PMC8661288 DOI: 10.4102/hsag.v26i0.1632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 09/15/2021] [Indexed: 11/30/2022] Open
Abstract
Bac kground Caregivers are offered health information on neonatal care before they are discharged from the healthcare facilities after giving birth. However, they continue to feed and bath neonates in ways that are informed by indigenous traditions. Notably, these ways include the provision of supplementary feeds before 6 months and bathing the neonate as early as possible, which are practices that contradict the World Health Organization (WHO) recommendations of neonatal care. Objectives This study aimed to explore and describe the indigenous neonatal feeding and bathing practices of caregivers in Vhembe District, Limpopo province. Setting This study was conducted in Limpopo province at Vhembe District, Makhado Municipality. Methodology A qualitative, explorative and descriptive enquiry was used to conduct 18 semi-structured individual interviews to explore and describe their indigenous neonatal feeding and bathing practices. Purposive and snowball sampling methods were used to select participants. Creswell’s method of data analysis was used to analyse data. Ethical principles were maintained. Results Two themes with sub-themes resulted from data analysis presenting indigenous neonatal feeding practices and indigenous neonatal bathing practices. Conclusion This study revealed that caregivers use indigenous neonatal feeding and bathing practices across age groups and social standing. Younger mothers receive guidance from older women in their families or community. Midwives should know the indigenous neonatal feeding and bathing practices of the communities they serve to offer relevant culture-sensitive health education. Contributions This study contributes to the creation of knowledge about indigenous neonatal care practices amongst mothers and caregivers.
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Affiliation(s)
- Patience M Tulelo
- Department of Nursing Science, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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Osório D, Munyangaju I, Nacarapa E, Muhiwa A, Nhangave AV, Ramos JM. Mother-to-child transmission of HIV infection and its associated factors in the district of Bilene, Gaza Province-Mozambique. PLoS One 2021; 16:e0260941. [PMID: 34890430 PMCID: PMC8664209 DOI: 10.1371/journal.pone.0260941] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 03/13/2021] [Indexed: 11/26/2022] Open
Abstract
Background Mother-to-child transmission of HIV infection is a significant problem in Mozambique. This study aims to determine the risk factors associated with mother-to-child transmission of HIV in rural Mozambique. Methods Retrospective case-control study in a rural area of Bilene District, on the coast of southern Mozambique, performed from January 2017 to June 2018. The analysis considered the clinical data of HIV exposed children with definitive HIV positive results and their respective infected mothers (cases), and the data of HIV exposed children with definitive HIV negative results and their respective infected mothers (controls) registered in At Risk Child Clinics from 1st January 2017 to 30th June 2018 at the Macia and Praia de Bilene health facilities in Bilene district, Gaza province–Mozambique. Results Ninety pregnant women with HIV were involved in the study, including 30 who had transmitted the infection to their children and 60 who had not. Statistical analysis, adjusted for maternal age and gestational age at first antenatal care visit, showed that independent risk factors for transmission were gestational age at first visit (adjusted odds ratio [aOR] 1.19, 95% confidence interval [CI] 1.05–1.36), non-adherence to combination antiretroviral therapy (56.7% vs. 5%; aOR 14.12, 95% CI 3.15–63.41); a viral load of 1000 copies/mL or more (90% vs. 5%; aOR: 156, 95% CI 22.91–1,062) and female sex of the neonate (80% vs. 51.7%; aOR: 4.43, 95% CI 1.33–15.87). Conclusion A high viral load and non-adherence to antiretroviral therapy are important predictors of mother-to-child HIV transmission.
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Affiliation(s)
- Dulce Osório
- General Medicine Department, Macia Health Center, Macia, Gaza, Mozambique
| | - Isabelle Munyangaju
- Tinpswalo Association – Vincentian Association to Fight AIDS and TB, Maputo, Gaza, Mozambique
- * E-mail:
| | - Edy Nacarapa
- Tinpswalo Association – Vincentian Association to Fight AIDS and TB, Maputo, Gaza, Mozambique
- Internal Medicine Department, Carmelo Hospital, Chokwe, Gaza, Mozambique
| | - Argentina Muhiwa
- Tinpswalo Association – Vincentian Association to Fight AIDS and TB, Maputo, Gaza, Mozambique
| | | | - Jose Manuel Ramos
- Internal Medicine Department, General University Hospital of Alicante and University Miguel Hernandez de Elche, Alicante, Spain
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Tadewos K, Adimasu M, Tachbele E. Mother-to-Child Transmission of HIV and Associated Factors Among Exposed Infants in Pastoralist Health Facilities, South Omo Zone, Ethiopia, 2020 - A Retrospective Cross-Sectional Study. HIV AIDS (Auckl) 2021; 13:1015-1023. [PMID: 34916853 PMCID: PMC8668224 DOI: 10.2147/hiv.s332904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 11/29/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Although HIV/AIDS is affecting all age groups, it is a primary cause of illness and deaths among children globally. A significant bulk of HIV infections in children under the age of 15 were as a result of vertical transmission, where it accounts for 95% of childhood HIV infections in Ethiopia. OBJECTIVE To assess the proportion of mother-to-child transmission (MTCT) of HIV and associated factors among exposed infants on follow-up in pastoralist health facilities, South Omo, Ethiopia. METHODOLOGY A retrospective, cross-sectional study was employed among 228 HIV-exposed infants. Medical records of HIV-exposed infant-mother pairs in the study institutions were extracted. The confirmatory HIV serostatus of every infant was taken at the end of 24 months. Data were entered in Epi Data 4.2 version and exported to SPSS version 25 for final analysis. Multivariable logistic regression analysis was used to identify significant predictor variables at P-value < 0.05. RESULTS A total of 228 records were included in the analysis. The rate of HIV transmission was 5.3% (95% CI: 2.6-8.3%). Not receiving antiretroviral prophylaxis at birth (AOR = 5.8, 95% CI: 1.02-33.53), absence of maternal antiretroviral prior to current pregnancy (AOR = 5.6, 95% CI: 1.14-28.1), and mother's advanced World Health Organization clinical stage of HIV (AOR: 10.5, 95% CI: 1.4-81) were associated with MTCT of HIV. CONCLUSION This study identified a high proportion of MTCT among exposed infants in the study area. Not receiving antiretrovirals prior to pregnancy and advanced WHO clinical stage of HIV, and not getting antiretroviral prophylaxis at birth resulted in higher risk of MTCT of HIV. Hence, health workers and policy-makers should offer antiretroviral prophylaxis, put mothers on antiretroviral therapy and limit the stage of HIV at lower WHO clinical stages.
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Affiliation(s)
- Kidist Tadewos
- Department of Nursing, Wolaita Soddo University, Wolaita Soddo, Ethiopia
| | - Mekonen Adimasu
- Department of Nursing, Addis Ababa University, Addis Ababa, Ethiopia
| | - Erdaw Tachbele
- Department of Nursing, Addis Ababa University, Addis Ababa, Ethiopia
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Getachew B, Solomon S, Ramet BT, Mezgebu T, Ewnetu DB, MacDonald N. Feeding Experiences of HIV-Exposed Preterm Infants Among Mothers Living with HIV in Addis Ababa, Ethiopia: A Qualitative Study. HIV AIDS-RESEARCH AND PALLIATIVE CARE 2021; 13:973-981. [PMID: 34754246 PMCID: PMC8572019 DOI: 10.2147/hiv.s333537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 10/15/2021] [Indexed: 11/23/2022]
Abstract
Introduction Providing adequate nutrition to preterm infants who are born to HIV-positive mothers is more challenging due to the mother’s underlying health and nutrition status. The understanding of these issues and active participation of the mothers have a significant role in giving continuous care for HIV-exposed preterm infant. Hence, this study aimed to explore the experience of HIV-positive mothers’ feeding practice of their preterm infants, and health workers to identify barriers and facilitators of feeding HIV-exposed preterm infants. Methods A phenomenological qualitative study design was conducted in Addis Ababa, Ethiopia, between May 1, 2016 and March 31, 2017. Mothers who gave birth to HIV-exposed preterm infants at the study sites’ follow-up clinic were traced and invited by the healthcare providers to voluntarily participate in this study. Fifteen in-depth interviews with mothers of HIV-exposed preterm infants and seven key informant interviews with health professionals and policymakers were carried out. The interviews were transcribed and translated and then manually analyzed thematically. Results The health education given during antenatal care (ANC) did not consider the feeding practice needs for HIV-exposed preterm infants. Child health status, desire to have a healthy infant, financial constraints and family support were among the influential factors in the feeding practice of HIV-exposed preterm infants mentioned by the study participants. HIV-exposed preterm infant feeding procedure neither has a guideline nor is clearly mentioned in the national HIV guidelines. Conclusion The desire to have a healthy infant was a major facilitator for feeding of HIV-exposed premature infants. However, financial constraints majorly limited the option to be only exclusive breastfeeding. This became even more problematic for the mother if the premature infant became ill and could not breastfeed well.
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Affiliation(s)
| | - Semaria Solomon
- St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | | | - Tirumebet Mezgebu
- St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Kasede AN, Tylleskär T, Mukunya D, Tumuhamye J, Ndeezi G, Arach AAO, Waako P, Tumwine JK. Incidence of home delivery among women living with HIV in Lira, Northern Uganda: a prospective cohort study. BMC Pregnancy Childbirth 2021; 21:763. [PMID: 34758766 PMCID: PMC8579617 DOI: 10.1186/s12884-021-04222-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 10/13/2021] [Indexed: 11/11/2022] Open
Abstract
Background Home delivery has been associated with mother-to-child transmission of HIV and remains high among HIV-infected women. Predictors for home delivery in the context of HIV have not been fully studied and understood in Northern Uganda. We therefore aimed to find out the incidence and risk factors for home delivery among women living with HIV in Lira, Northern Uganda. Methods This prospective cohort study was conducted between August 2018 and January 2020 in Lira district, Northern Uganda. A total of 505 HIV infected women receiving antenatal care at Lira regional referral hospital were enrolled consecutively and followed up at delivery. We used a structured questionnaire to obtain data on exposures which included: socio-demographic, reproductive-related and HIV-related characteristics. Data was analysed using Stata version 14.0 (StataCorp, College Station, Texas, U.S.A.). We estimated adjusted risk ratios using Poisson regression models to ascertain risk factors for the outcome of interest which was home delivery (which is delivering an infant outside a health facility setting under the supervision of a non-health worker). Results The incidence of home delivery among women living with HIV was 6.9% (95%CI: 4.9–9.5%). Single women were more likely to deliver at home (adjusted risk ratio = 4.27, 95%CI: 1.66–11). Women whose labour started in the night (night time onset of labour ARR = 0.39, 95%CI: 0.18–0.86) and those that were adherent to their ART (ARR = 0.33, 95%CI: 0.13–0.86) were less likely to deliver at home. Conclusion Home delivery remains high among women living with HIV especially those that do not have a partner. We recommend intensified counselling on birth planning and preparedness in the context of HIV and PMTCT especially for women who are: separated, divorced, widowed or never married and those that are not adherent to their ART. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04222-5.
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Affiliation(s)
- Agnes Napyo Kasede
- Busitema University Faculty of Health Sciences, Department of Public Health, P.O. Box 236, Tororo, Uganda. .,College of Health Sciences, Department of Paediatrics and Child Health, Makerere University, P.O. Box 7072, Kampala, Uganda. .,Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, P.O. Box 7800, 5020, Bergen, Norway.
| | - Thorkild Tylleskär
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, P.O. Box 7800, 5020, Bergen, Norway
| | - David Mukunya
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, P.O. Box 7800, 5020, Bergen, Norway
| | - Josephine Tumuhamye
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, P.O. Box 7800, 5020, Bergen, Norway
| | - Grace Ndeezi
- College of Health Sciences, Department of Paediatrics and Child Health, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Anna Agnes Ojok Arach
- College of Health Sciences, Department of Paediatrics and Child Health, Makerere University, P.O. Box 7072, Kampala, Uganda.,Department of Nursing and Midwifery, Lira University, P. O. Box 1035, Lira, Uganda
| | - Paul Waako
- Busitema University Faculty of Health Sciences, Department of Public Health, P.O. Box 236, Tororo, Uganda
| | - James K Tumwine
- College of Health Sciences, Department of Paediatrics and Child Health, Makerere University, P.O. Box 7072, Kampala, Uganda
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Astuti DA, Hakimi M, Prabandari YS, Laksanawati IS, Triratnawati A. The Prevention of Mother-to-Child HIV/AIDS Transmission at Public Health Centers: A Phenomenology Study. Open Nurs J 2021. [DOI: 10.2174/1874434602115010195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective:
Mothers with HIV are likely to transmit the virus to their babies during pregnancy, delivery, or through breastfeeding. According to studies, the risk of mother-to-child HIV transmission among mothers that do not receive any form of treatment during pregnancy is approximately 15-45%. In Indonesia, the lack of a prevention program for HIV led to the provision of antiretroviral therapy (ART) for the prevention of mother-to-child transmission (PMTCT). The policies, financial facilities, the healthcare system, and human resources, including health workers, are factors that influence the PMTCT. This research discusses the perceptions of several doctors and midwives regarding the prevention of mother-to-child transmission at public health centers. Furthermore, information regarding policies and implementation of the PMTCT program at public health centers in Yogyakarta was qualitatively collected through semi-structured interviews.
Methods:
This research involved 6 participants, comprising of 3 heads of public health centers and 3 midwives as the HIV/AIDS program managers. A total of 5 themes were selected for the interview, namely policies of mandatory HIV testing for pregnant mothers, inadequate knowledge of the virus, need for PMTCT training, infrastructure and facilities, and HIV retesting.
Results:
Pregnant mothers are at potential risk of exposing health workers to HIV. They are also prone to contracting the virus due to poor educational background and less exposure to health information. Therefore, midwives need Prongs 3 and 4 to avoid contracting the virus while assisting pregnant mothers. Presently, there is a shortage of health promotion media for PMTCT, which include both electronic and print educational media. Therefore, the implementation of HIV testing in Indonesia is mandatory for pregnant mothers at their first antenatal care (ANC). However, despite the importance of conducting this test before labor, there is no regulation to ensure its implementation.
Conclusion:
The success of HIV mitigation is closely associated with the participation of academicians, policymakers, and community networks in providing collaborative planning strategies for the reduction of its spread, and evaluation of the mitigation result.
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Factors Associated with Condom Knowledge, Attitude, and Use among Black Heterosexual Men in Ontario, Canada. ScientificWorldJournal 2021; 2021:8862534. [PMID: 34566521 PMCID: PMC8463252 DOI: 10.1155/2021/8862534] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 04/03/2021] [Accepted: 04/21/2021] [Indexed: 11/26/2022] Open
Abstract
African, Caribbean, and Black (ACB) men living in Canada share a heightened risk of HIV infection and the associated risk factors such as suboptimal use of family planning services such as condom use. In this study, we assessed the factors associated with knowledge, attitude, and condom use among ACB men in Ontario. Methods. This was a cross-sectional study that surveyed heterosexual ACB men regardless of their residency status living in Ontario (n = 430). This is a part of a larger mixed methods study informed by critical race theory, intersectionality, and community-based participatory research (CBPR). Outcome variables were knowledge of condom use, attitude towards condom use, and actual use of condom during the last 12 months. Results. Of 430 participants, 77.70% has good knowledge of condom use as a protection against HIV transmission, 31.77% had positive attitude towards condom use, and 62.43% reported using condom regularly with casual partners during the last 12 months. Men who were currently married had more positive attitude towards condom use compared with their unmarried counterparts (odds ratio = 1.46, 95% CI = 1.20, 1.78). Canadian residents were found to have higher odds of having correct knowledge of condom (odds ratio = 1.31, 95% CI = 1.11, 1.55), and positive attitude towards condom use (odds ratio = 1.44, 95%CI = 1.09, 1.92). Men who visited sexual health clinics showed a positive association with having correct knowledge of condom (odds ratio = 1.78, 95% CI = 1.30, 2.44) and reported experiences of difficulty in accessing sexual health. This showed a negative association towards condom use (odds ratio = 0.45, 95% CI = 0.21, 0.97]. Conclusion. A considerable percentage of heterosexual ACB men did not have correct knowledge regarding the protective effect of condom use against HIV and positive attitude towards the use of condom. Several sociodemographic and healthcare-related factors were significantly associated with knowledge, attitude, and use of condom.
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Ashipala DO, Shikukumwa G, Joel MH. Knowledge, attitudes and practices of HIV-positive mothers regarding the benefits of exclusive breastfeeding at a regional hospital in the north east of Namibia. Afr Health Sci 2021; 21:1074-1082. [PMID: 35222569 PMCID: PMC8843288 DOI: 10.4314/ahs.v21i3.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background In sub-Saharan Africa, over 1,000 newborns are infected with HIV every day, despite available medical interventions. Mother-to-child transmission (MTCT) remains one of the primary sources of HIV infection in children and without interventions 40% of babies born from HIV-positive mothers would be infected with the virus. It is estimated that 300 000 children become infected with HIV worldwide, whilst 1.5 million children die when their mothers opt for other choices instead of breastfeeding. Objective The purpose of the study was to assess and describe the knowledge, attitudes and practices of HIV-positive mothers regarding the benefits of exclusive breastfeeding at Rundu Intermediate Hospital, Kavango East Region in Namibia. Method The study was a descriptive cross-sectional survey that used convenience sampling, as the researcher sought to use subjects available during the time of study to select 79 HIV positive mothers. Results Participants in this study (94%; n=51) had good knowledge of the benefit of exclusive breastfeeding and that the benefits of breastfeeding outweigh the risk of HIV transmission from mother to child. The results confirmed that (77.2%; n=42) of the mothers opted to take ART with the babies until they stop breastfeeding. Conclusion HIV positive mothers had good knowledge, attitudes and practices regarding the benefits of exclusive breastfeeding. A significant number of mothers were, however, not sure about breastfeeding exclusively for 6 months as they would stop if offered free formula milk for the baby. Support by the fathers and others in the community is vital.
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Affiliation(s)
- Daniel Opotamutale Ashipala
- Department of General Nursing Science, School of Nursing, Faculty of Health Science, University of Namibia (UNAM), Rundu, Namibia
| | - Getruida Shikukumwa
- Department of General Nursing Science, School of Nursing, Faculty of Health Science, University of Namibia (UNAM), Rundu, Namibia
| | - Medusalem Hangula Joel
- Department of General Nursing Science, School of Nursing, Faculty of Health Science, University of Namibia (UNAM), Rundu, Namibia
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Gebre MN, Feyasa MB, Dadi TK. Levels of mother-to-child HIV transmission knowledge and associated factors among reproductive-age women in Ethiopia: Analysis of 2016 Ethiopian Demographic and Health Survey Data. PLoS One 2021; 16:e0256419. [PMID: 34411168 PMCID: PMC8375988 DOI: 10.1371/journal.pone.0256419] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 08/06/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The world community has committed to eliminating the mother-to-child transmission of human immunodeficiency virus. Even though different studies have been done in Ethiopia, to the knowledge of the investigators, the Ethiopian women's level of knowledge on the mother-to-child transmission of human immunodeficiency virus is not well studied and the existing evidence is inconclusive. The current study is aimed to study the Ethiopian women's level of knowledge on the mother-to-child transmission of human immunodeficiency virus and its associated factors using the 2016 Ethiopian Demographic and Health Survey Data. METHODS Data of 15,683 women were extracted from the 2016 Ethiopia Demographic and Health Survey. Descriptive statistics and multilevel ordinal logistic regression were respectively used for the descriptive and analytical studies. RESULTS 41.1% [95% CI: 39.5%, 42.7%] of the Ethiopian reproductive-age women have adequate knowledge of the mother-to-child transmission of human immunodeficiency virus. 77%, 84% and 87.8% of the women respectively know that human immunodeficiency virus can be transmitted during pregnancy, delivery, and breastfeeding. There are wider regional variations in the women's level of knowledge of the mother-to-child transmission of human immunodeficiency virus. Being an urban resident, having better educational status, being from a wealthy household, owning of mobile phone, frequency of listening to the radio, frequency of watching television, and being visited with field workers were significantly associated with having adequate knowledge of the mother-to-child transmission of human immunodeficiency virus. CONCLUSION Despite all collective measures put in a place by different stakeholders to prevent the mother-to-child transmission of HIV in Ethiopia, a large proportion of the Ethiopian women do not know about the mother-to-child transmission of the disease. Stakeholders working on HIV prevention and control should give due emphasis to promoting mobile phone technology and other media like radio and television by giving due focus to rural residents and poor women to promote the current low level of the knowledge. Emphasis should also be given to the information, education, and communication of the mother-to-child transmission of the disease through community-based educations.
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Affiliation(s)
- Mamo Nigatu Gebre
- Department of Epidemiology, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
| | - Merga Belina Feyasa
- Department of Statistics, College of Natural & Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Teshome Kabeta Dadi
- Department of Epidemiology, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
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Gebremedhin T, Alamneh TS, Hagos A, Desalegn B, Worku N. A multilevel analysis of determinants of PMTCT service utilisation among women during the antepartum, intrapartum and postpartum period in Ethiopia. BMC Pregnancy Childbirth 2021; 21:483. [PMID: 34217253 PMCID: PMC8254229 DOI: 10.1186/s12884-021-03896-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 05/04/2021] [Indexed: 11/10/2022] Open
Abstract
Background Mother-to-child transmission (MTCT) is the largest source of HIV infection in children below the age of 15 years, and more than 90% of pediatric HIV are infected through mother to child transmission. Without treatment, one-half of those infected children will die before the age of 2 years. Despite this, there is limited evidence on PMTCT and its determinants. Therefore, this study aimed to determine the factors affecting the PMTCT service utilisation in Ethiopia. Methods A two-stage stratified sampling technique was used to identify 4081 women from 2016 Ethiopian Demographic and Health Survey (EDHS). A multilevel mixed-effect binary logistic regression analysis was used to identify the individual and community level factors associated with PMTCT services utilisation. In the final model, a p-value of < 0.05 and Adjusted Odds Ratio (AOR) with 95% confidence interval (CI) were used to declare statistically significant factors with the utilisation. Results Overall, 21.9% (95% CI, 20.6–23.2) of the women were utilized PMTCT services. Educational status; primary (AOR: 1.65, 95% CI: 1.27–2.13), secondary (AOR: 1.52, 95% CI: 1.03–2.24) and higher school (AOR: 2.48, 95% CI: 1.45–4.22), poorer (AOR: 1.62, 95% CI: 1.12–2.37), middle (AOR: 1.82, 95% CI: 1.10–3.02), richer (AOR: 2.44, 95% CI: 1.42–4.21) and richest (AOR: 4.45, 95% CI: 2.43–8.14) wealth status and orthodox religion follower (AOR: 1.62, 95% CI: 1.22–2.16) were the individual level factors. Moreover, having basic (AOR: 1.66, 95% CI: 1.34–2.06) and comprehensive (AOR: 1.73, 95% CI: 1.38–2.18) knowledge on HIV prevention methods, having knowledge on MTCT of HIV (AOR: 2.69, 95% CI: 2.16–3.36) were also factors at individual level. Whereas, rural residence (AOR: 0.52, 95% CI: 0.32–0.85) was the community level factors that affects the utilization. Conclusions Less than one-fourth of the mothers had utilised the PMTCT services in Ethiopia. To increase the utilisation of the services, the health care providers should give emphases on counselling, awareness creation, and strengthen the existing frontline integrated health care services in the country.
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Affiliation(s)
- Tsegaye Gebremedhin
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tesfa Sewunet Alamneh
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Asebe Hagos
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Beimnet Desalegn
- School of Public Health, College of Medicine and Health Science, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Nigusu Worku
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
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Klutsey DA, Amankwah‐Poku M, Oppong Asante K. To disclose or not to disclose? Caregivers experiences of disclosure of HIV status of children living with HIV in Accra, Ghana. LIFESTYLE MEDICINE 2021. [DOI: 10.1002/lim2.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
| | | | - Kwaku Oppong Asante
- Department of Psychology University of Ghana, Legon Accra Ghana
- Department of Psychology University of the Free State Bloemfontein South Africa
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Hunduma F, Gebrehanna E, Adugna Debela F. Determinants of Mother-to-Child Transmission of HIV in Public Hospitals of West Shewa Zone, Central Ethiopia: Case-Control Study. HIV AIDS-RESEARCH AND PALLIATIVE CARE 2021; 13:435-443. [PMID: 33889029 PMCID: PMC8057808 DOI: 10.2147/hiv.s299585] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/26/2021] [Indexed: 11/30/2022]
Abstract
Background Mother-to-child transmission (MTCT) of human immune deficiency virus (HIV) is the infection of baby by HIV that originated from an HIV-positive mother during pregnancy and breast feeding. Without intervention, the transmission rate of HIV ranges from 15–45%, which can be reduced to below 5% with effective intervention. In Ethiopia, the final mother-to-child transmission rate was 15% in 2016, which was much higher than the target of the country to reduce transmission to lower than 5% by 2020. The study aims to identify determinants of transmission of HIV from mother to child in the West Shewa Zone. Methods An unmatched case–control study, among children less than 5 years who tested HIV positive and negative, at the end of PMTC follow-up, N=96 (24 cases, 72 controls) was conducted during June to August 2019, focusing on PCR done during the last 2 years (June 2017 to July 2019), in public hospitals. Data were collected using a structured questionnaire and data abstraction forms from mothers of exposed infants, medical records of mothers and children. Results The majority of cases (17, 70.8%) were not included in the option B+ program, but only 11.1% of controls were not included. Home delivery (adjusted odds ratio (AOR)=6.047, confidence interval (CI)=1.549–29.230), non-inclusion into option B+ (AOR=18.0, 95% CI=5.0–68.1), and partner non-involvement to HIV care (AOR=7.3, 95% CI=1.14–37.459) had higher odds of transmitting HIV, while a mother-to-mother support program decreases the chance of transmission by 86.5% (AOR=0.135, 95% CI=0.11–0.396) when compared to their counterparts. Conclusion Mother-to-mother support programs have a protective effect, while non-inclusion to option B+, partner non-involvement in HIV care, home delivery, and poor antenatal care (ANC) practices were determinant factors of HIV transmission from mother to child. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/ByMEDD3UCK8
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Affiliation(s)
- Fufa Hunduma
- Department of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Ewenat Gebrehanna
- Department of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Fanna Adugna Debela
- Department of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Gaitho D, Kinoti F, Mwaniki L, Kemunto D, Ogoti V, Njigua C, Kubo E, Langat A, Mecha J. Factors associated with the timely uptake of initial HIV virologic test among HIV-exposed infants attending clinics within a faith-based HIV program in Kenya; a cross-sectional study. BMC Public Health 2021; 21:569. [PMID: 33757463 PMCID: PMC7986293 DOI: 10.1186/s12889-021-10587-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 03/08/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Early infant diagnosis (EID) of HIV, followed by effective care including antiretroviral therapy (ART), reduces infant mortality by 76% and HIV progression by 75%. In 2015, 50% of 1.2 million HIV-exposed infants (HEI) in 21 priority countries received a virologic test within the recommended 2 months of birth. We sought to identify factors associated with timely uptake of virologic EID among HEI and gain insight into missed opportunities. METHODS This was a cross-sectional study that used de-identified data from electronic medical records of 54 health facilities within the Christian Health Association of Kenya (CHAK) HIV Project database. All HEI who had their first HIV virologic test done between January 2015 and December 2017 were included in the study and categorized as either having the test within or after 8 weeks of birth. Multivariate linear mixed effects regression model was used to determine factors associated with uptake of the first HIV EID polymerase chain reaction (PCR). Predictor variables studied include sex, birth weight, the entry point into care, provision of ART prophylaxis for the infant, maternal ART at time of EID, mode of delivery, and place of delivery. RESULTS We included 2020 HEI of whom 1018 (50.4%) were female. A majority, 1596 (79.0%) had their first HIV PCR within 2 months of birth at a median age of 6.4 weeks (interquartile range 6-7.4). Overall, HIV positivity rate at initial test among this cohort was 1.2%. Delayed HIV PCR testing for EID was more likely to yield a positive result [adjusted odds ratio (aOR) = 1.29 (95% confidence interval (CI) 1.09-1.52) p = 0.003]. Infants of mothers not on ART at the time of HIV PCR test and infants who had not received prophylaxis to prevent vertical HIV transmission had significant increased odds of a delayed initial test [aOR = 1.27 (95% CI = 1.18-1.37) p = < 0.0001] and [aOR = 1.43 (95% CI 1.27-1.61) p = < 0.001] respectively. CONCLUSION An initial HIV PCR test done after 8 weeks of birth is likely to yield a positive result. Barriers to accessing ART for treatment among HIV-infected pregnant and breastfeeding women, and prophylaxis for the HEI were associated with delayed EID. In order to ensure timely EID, programs need to incorporate both facility and community strategy interventions to ensure all pregnant women seek antenatal care and deliver within health facilities.
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Affiliation(s)
- Douglas Gaitho
- Christian Health Association of Kenya (CHAK), P.O. Box 30690 – 00100, GPO, Nairobi, Kenya
| | - Freda Kinoti
- Department of Clinical Medicine & Therapeutics, University of Nairobi, P.O. Box 19676 – 00202, Nairobi, Kenya
| | - Lawrence Mwaniki
- Christian Health Association of Kenya (CHAK), P.O. Box 30690 – 00100, GPO, Nairobi, Kenya
| | - Diana Kemunto
- Christian Health Association of Kenya (CHAK), P.O. Box 30690 – 00100, GPO, Nairobi, Kenya
| | - Victor Ogoti
- Christian Health Association of Kenya (CHAK), P.O. Box 30690 – 00100, GPO, Nairobi, Kenya
| | - Catherine Njigua
- Christian Health Association of Kenya (CHAK), P.O. Box 30690 – 00100, GPO, Nairobi, Kenya
| | - Elizabeth Kubo
- Christian Health Association of Kenya (CHAK), P.O. Box 30690 – 00100, GPO, Nairobi, Kenya
| | - Agnes Langat
- Division of Global HIV and TB, Centers for Disease Control and Prevention Kenya, P.O. Box 606 – 00621, Village Market, Nairobi, Kenya
| | - Jared Mecha
- Department of Clinical medicine & Therapeutics, College of Health Sciences – University of Nairobi, P.O. Box 19676 – 00202, Nairobi, Kenya
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Liyeh TM. Determinant factor of married women's knowledge on vertical transmission of HIV in Mecha district, Ethiopia; a community-based study. PLoS One 2020; 15:e0242659. [PMID: 33264295 PMCID: PMC7710110 DOI: 10.1371/journal.pone.0242659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 11/09/2020] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Mother-to-child transmission (MTCT) of HIV infection remains a major public health problem and constitutes the most important cause of HIV infection in children. Knowledge of married women on MTCT of HIV is very important for successful intervention toward prevention of mother-to-child transmission (PMTCT) and achieving the goal of eliminating the new HIV infection. The objective of the study was to assess knowledge of married women on MTCT of HIV and associated factors in Mecha district Northwest Ethiopia. METHODS A community based cross sectional study was conducted involving 520 married women from January 1 to February 30 /2017 in Mecha district. Interviewer administered questionnaires were used to collect the data. The collected data was entered, cleaned and checked using Epi Data version 3.1 and then analyzed with SPSS version 20. Bivariate and multivariable logistic regression was computed for all explanatory variables to identify determinant factors at 95% confidence interval. Explanatory variables having P-value <0.05 taken as a predictor for knowledge of married women on mother to child transmission of HIV. RESULT This study was carried out among a total of 520 married reproductive age group women with a response rate of 98%. From the total of 510 respondents, 160(31.4%) of women were knowledgeable on vertical transmission of HIV (MTCT). Women who were knowledgeable on MTCT of HIV was positively associated with urban residence (AOR = 1.75, 95% CI: 1.05-2.92), women who had history of ANC follow up (AOR = 2.68, 95% CI: 1.17-6.13), women who were pregnant during the study period (AOR = 1.86, 95%CI: 1.10-3.13) and those who had discussions with their husband about HIV/AIDS/ MTCT (AOR = 2.40, 95% CI: 1.52-.3.80). CONCLUSION AND RECOMMENDATION The finding from this study revealed that knowledge of married women on MTCT of HIV was low. This may contribute to increase the spread of MTCT of HIV. Therefore, giving more attention and emphasis on continuous education regarding MTCT of HIV is highly recommended.
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Affiliation(s)
- Tewachew Muche Liyeh
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
- * E-mail:
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Saleemi MA, Ahmad B, Benchoula K, Vohra MS, Mea HJ, Chong PP, Palanisamy NK, Wong EH. Emergence and molecular mechanisms of SARS-CoV-2 and HIV to target host cells and potential therapeutics. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2020; 85:104583. [PMID: 33035643 PMCID: PMC7536551 DOI: 10.1016/j.meegid.2020.104583] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 09/24/2020] [Accepted: 10/01/2020] [Indexed: 02/07/2023]
Abstract
The emergence of a new coronavirus, in around late December 2019 which had first been reported in Wuhan, China has now developed into a massive threat to global public health. The World Health Organization (WHO) has named the disease caused by the virus as COVID-19 and the virus which is the culprit was renamed from the initial novel respiratory 2019 coronavirus to SARS-CoV-2. The person-to-person transmission of this virus is ongoing despite drastic public health mitigation measures such as social distancing and movement restrictions implemented in most countries. Understanding the source of such an infectious pathogen is crucial to develop a means of avoiding transmission and further to develop therapeutic drugs and vaccines. To identify the etiological source of a novel human pathogen is a dynamic process that needs comprehensive and extensive scientific validations, such as observed in the Middle East respiratory syndrome (MERS), severe acute respiratory syndrome (SARS), and human immunodeficiency virus (HIV) cases. In this context, this review is devoted to understanding the taxonomic characteristics of SARS-CoV-2 and HIV. Herein, we discuss the emergence and molecular mechanisms of both viral infections. Nevertheless, no vaccine or therapeutic drug is yet to be approved for the treatment of SARS-CoV-2, although it is highly likely that new effective medications that target the virus specifically will take years to establish. Therefore, this review reflects the latest repurpose of existing antiviral therapeutic drug choices available to combat SARS-CoV-2.
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Affiliation(s)
- Mansab Ali Saleemi
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University, Lakeside Campus, Subang Jaya, Selangor Darul Ehsan 47500, Malaysia
| | - Bilal Ahmad
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University, Lakeside Campus, Subang Jaya, Selangor Darul Ehsan 47500, Malaysia
| | - Khaled Benchoula
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Lakeside Campus, Subang Jaya, Selangor Darul Ehsan 47500, Malaysia
| | - Muhammad Sufyan Vohra
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Lakeside Campus, Subang Jaya, Selangor Darul Ehsan 47500, Malaysia
| | - Hing Jian Mea
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University, Lakeside Campus, Subang Jaya, Selangor Darul Ehsan 47500, Malaysia
| | - Pei Pei Chong
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University, Lakeside Campus, Subang Jaya, Selangor Darul Ehsan 47500, Malaysia
| | - Navindra Kumari Palanisamy
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh Campus, Sungai Buloh, Selangor, Malaysia
| | - Eng Hwa Wong
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Lakeside Campus, Subang Jaya, Selangor Darul Ehsan 47500, Malaysia.
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Belachew A, Tewabe T, Malede GA. Prevalence of vertical HIV infection and its risk factors among HIV exposed infants in East Africa: a systematic review and meta-analysis. Trop Med Health 2020; 48:85. [PMID: 33088209 PMCID: PMC7572247 DOI: 10.1186/s41182-020-00273-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 09/30/2020] [Indexed: 11/10/2022] Open
Abstract
Background Human immunodeficiency virus (HIV) is one of the most important global health problems. More than one and half million of children are living with HIV in the world, and majority of them are found in sub-Saharan Africa. There are primary fragmented study findings, and no review was conducted with regard to vertical HIV infection in East Africa. Therefore, this review aimed to assess the prevalence of vertical HIV infection and its risk factors among HIV-exposed infants in East Africa. Main body Eligible studies were retrieved by relevant search terms in CINHAL, Pub-MED, Google Scholar, EMBASE, Web of Science, SCOPUS, Cochrane, African Journals Online databases, and Ethiopian University research repositories. Data were extracted with Microsoft Excel and analyzed with Stata version 11 software. The random effect model was used to estimate the pooled prevalence of vertical HIV infection in East Africa. The variation between studies was quantified with an I 2 statistic test. Furthermore, sub-group and meta-regression analyses were done to identify the sources of heterogeneity between the studies. The publication bias was assessed by Egger test. This systematic review and meta-analysis have included a total of 33 research articles. The overall pooled prevalence of vertical HIV infection in East Africa was 7.68% with a 95% confidence interval [CI]: (6.23, 9.12) with a heterogeneity of I 2 = 86.8 with a p value < 0.001. In subgroup analysis, the pooled prevalence of vertical HIV infection in cross-sectional studies was 6.58%, while in cohort studies were 9.37%. Mixed feeding, AOR = 6.22 (1.02, 11.41); home delivery, AOR = 2 (1.01, 3); mothers took ART less than 4 weeks, AOR = 1.92 (1.79, 2.06); and infants who have not received ARV prophylaxis, AOR = 2.02 (1.05, 2.98) were the associated factors for vertical HIV infection for exposed infants. Conclusions The pooled prevalence of the mother to child transmission of HIV is way more than the desired target of the World Health Organization, which is less than 5% in breastfeeding populations. Thus, strengthening the prevention of vertical HIV transmission, promotion of exclusive breastfeeding, timely initiation of ART prophylaxis for HIV exposed infants, encouragement of hospital delivery, and the start of ART at the time of diagnosis of every HIV-positive person may all reduce the transmission of vertical HIV infection.
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Affiliation(s)
- Amare Belachew
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tilahun Tewabe
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Gizat Abinet Malede
- Department of Laboratory Science, Bahir Dar Health Science College, Bahir Dar, Ethiopia
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Bhatta M, Dutta N, Nandi S, Dutta S, Saha MK. Mother-to-child HIV transmission and its correlates in India: systematic review and meta-analysis. BMC Pregnancy Childbirth 2020; 20:509. [PMID: 32887567 PMCID: PMC7473816 DOI: 10.1186/s12884-020-03193-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 08/19/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND In India, preventing mother-to-child transmission (PMTCT) of Human Immunodeficiency Virus (HIV) remains one of the foremost challenge in community health. Countrywide MTCT of HIV is estimated to be > 10,000 annually. Aims of present study are to find out the prevalence of HIV and correlates of HIV transmission among children given birth by HIV infected mother through systematic review along with meta-analysis. METHODS All avaiable articles are retrieved using MEDLINE, Cochrane Library, Science Direct, EMBASE, Google Scholar and PUBMED following guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) are applied to critically reviewing the selected articles. STATA 13.0 is used to preparation of forest plot for Meta-analysis. For assessment of heterogeneity and publication biases I2 statistics along with Begg and Mazumdar's test and Egger's tests are used. Odds ratio (OR) along with forest plots have been showing with 95% confidence interval (CI). RESULTS All together 10 studies including 1537 pairs of mothers and new births are assessed in present meta-analysis. Present analysis revealed the prevalence of HIV due to MTCT in India as 8.76% (95% CI; 5.76, 12.31). Analysis of subgroups exhibit a higher pooled prevalence in eastern region of India, 10.83% (95% CI: 5.9, 17.81) and lower in in Western region in India, 6.37% (95% CI: 4.65, 8.49). Status of MTCT before and after initiation of universal ART are 10.23% (95% CI 6.61, 14.55) and 7.93% (95% CI 4.18, 12.76) respectively. Associated factors with MTCT of HIV include absence of maternal prevention of MTCT intervention, OR = 10.82 (95% CI: 5.28, 22.17), lacking in administration of infant ARV (antiretroviral), OR = 8.21 (95% CI: 4.82, 14.0) and absence of medical facility during childbirth OR = 3.73 (95% CI: 1.67, 8.33). CONCLUSIONS In India, pooled HIV prevalence of MTCT as high as 8.78% (95% CI; 5.76, 12.31) among babies born to infected mothers warrants urgent need of focused intervention for providing ART (PMTCT intervention), ensuring proper infant ARV prophylaxis, and avoiding delivery without proper medical facility to pregnant women with HIV for reduction of occurrence in HIV transmission from mothers to children.
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Affiliation(s)
- Mihir Bhatta
- Division of Virology, ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India
| | - Nalok Dutta
- Division of Virology, ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India
| | - Srijita Nandi
- Division of Virology, ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India
| | - Shanta Dutta
- Division of Bacteriology, ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India
| | - Malay Kumar Saha
- Division of Virology, ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India.
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Aylie NS, Dadi LS, Alemayehu E, Mekonn MA. Determinants of Fertility Desire among Women Living with HIV in the Childbearing Age Attending Antiretroviral Therapy Clinic at Jimma University Medical Center, Southwest Ethiopia: A Facility-Based Case-Control Study. Int J Reprod Med 2020; 2020:6504567. [PMID: 32851055 PMCID: PMC7441441 DOI: 10.1155/2020/6504567] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 07/23/2020] [Accepted: 07/31/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND High fertility and aspiration to have more children are a normal phenomenon in many developing countries including Ethiopia. The desire of people living with HIV/AIDS (PLWHA) to have children can have significant public health implications. Despite the growing number of women living with HIV/AIDS, the issues of fertility and childbearing intention have not been widely studied in Ethiopia. OBJECTIVE To identify determinants of fertility desire among women living with HIV in the childbearing age attending antiretroviral therapy clinic at Jimma University Medical Center, Southwest Ethiopia. METHODS A facility-based case-control study was conducted in March 2019. Cases were women living with HIV who had fertility desire, and controls were those who had not. Data was collected using a face-to-face interview using a pretested questionnaire. The data was entered into EpiData 3.1 and exported to SPSS Version 24 for analysis. Bivariate and multivariable logistic regression analyses were used to identify candidate and independent determinants of fertility desire, respectively. Independent determinants associated with fertility desire were assessed using AORs with their corresponding 95% CIs at P value < 0.05 cutoff point. Results. Three hundred forty-four (115 cases and 229 controls) were included into the study with a 100% response rate. Age categories 15-24 (AOR: 4.1; 95% CI: 2.0, 8.4) and 25-34 (AOR: 2.3; 95% CI: 1.3, 4.2) years, not using family planning (AOR: 2.3; 95% CI: 1.4, 4.0), and having a sexual partner (AOR: 1.9; 95% CI: 1.1, 3.2) were independent predictors of fertility desire. CONCLUSIONS Age of women, family planning, and sexual partner were found to be the independent predictors of fertility desire among women living with HIV/AIDS. Policymakers and health care providers who are working on an ART clinic should try to consider the effects of these factors for women living with HIV while developing HIV/AIDS interventions and discussing on sexual and reproductive health issues with their clients, respectively.
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Affiliation(s)
- Nigusie Shifera Aylie
- Nursing Department, College of Health Science Mizan-Tepi Unversity, Mizan-Aman, Ethiopia
| | - Lelisa Sena Dadi
- Epidemiology Department, Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | - Eshetu Alemayehu
- Epidemiology Department, Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | - Mengistu Ayenew Mekonn
- Epidemiology Department, College of Health Science Mizan-Tepi Unversity, Mizan-Aman, Ethiopia
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Nguyen RN, Ton QC, Tran QH, Nguyen TKL. <p>Mother-to-Child Transmission of HIV and Its Predictors Among HIV-Exposed Infants at an Outpatient Clinic for HIV/AIDS in Vietnam</p>. HIV AIDS (Auckl) 2020; 12:253-261. [PMID: 32765117 PMCID: PMC7371555 DOI: 10.2147/hiv.s259592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 06/28/2020] [Indexed: 11/26/2022] Open
Abstract
Background Mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV) is decreasing worldwide; however, achieving the MTCT elimination target of 2% by 2020 and 0% by 2030 is challenging in resource-limited countries. The purpose of this study is to determine the evolution of the HIV transmission rate in infants from 2007 to 2018 and to identify the risk factors of HIV transmission among HIV-exposed infants in Vietnam. Patients and Methods A prospective cohort study of 608 HIV-exposed infants was conducted at the Pediatric Outpatient Clinic (pOPC) of the Women and Children Hospital of An Giang, Vietnam between September 2007 and December 2019. A follow-up registration book was used to collect data, which were entered into Microsoft Excel and analyzed by SPSS version 22.0. Both bivariate and multivariate analyses were carried out to identify associations. Results A total of 608 HIV-exposed infant were enrolled in the study, of which 472 were included in the final analysis. The median age of infants at enrollment to follow-up was 6.3 weeks (interquartile range [IQR]=6.0–6.9 weeks). A total of 42 infants out of 472 were infected with HIV, giving an overall MTCT rate of 8.9% (95% confidence interval (CI)=6.4–12.0). The transmission rate decreased from 27.9% in 2007 to 0% in 2018. Absence of maternal ARV (antiretrovirals) intervention before or during pregnancy (AOR=40.6, 95% CI=5.5–308) and absence of ARV prophylaxis for HIV-exposed infants (AOR=3.4, 95% CI=1.1–10.3) were significantly and independently associated with MTCT of HIV in this study. Conclusion There is a significant progress on the reduction of MTCT rate in An Giang, Vietnam. Absence of ART interventions for mothers and infants are significant factors associated with HIV transmission. Providing free ARV and increasing the coverage of ARV intervention for pregnant women are keys for reducing the MTCT rate in the future.
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Affiliation(s)
- Rang Ngoc Nguyen
- Department of Pediatrics, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
- Women and Children Hospital of an Giang, An Giang, Vietnam
- Correspondence: Rang Ngoc Nguyen Tel +84 913106404 Email
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Mandewo W, Muchuchuti C, Shoko O, Timire C, Takarinda KC, Harries AD, Tweya H, Tapera T, Nyathi S, Chadambuka A, Chimwaza A, Mahomva A. Prevention of mother-to-child transmission activities after one-off clinical mentorship training in selected health facilities, Zimbabwe: 2014-2018. Pan Afr Med J 2020; 36:146. [PMID: 32874410 PMCID: PMC7436647 DOI: 10.11604/pamj.2020.36.146.19542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 06/17/2020] [Indexed: 11/11/2022] Open
Abstract
This was a cross-sectional study describing HIV testing uptake and ART initiation for pregnant women and HIV-exposed infants after one-off clinical mentorship training in 2013 for nurses in 56 peripheral health-facilities, Zimbabwe. Between 2014-2018, 92% of 106411 pregnant women were HIV tested and 98% of HIV-positive women initiated antiretroviral therapy (ART). There were 15846 HIV-exposed infants, of whom 96% had dried blood spots collected for virologic diagnosis and 51% of those diagnosed HIV-positive initiated ART. In conclusion, this one-off clinical mentorship training in 2013 was associated with consistently high HIV testing and ART initiation in pregnant women and their children.
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Affiliation(s)
- Winnie Mandewo
- Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), Harare, Zimbabwe
| | - Cephas Muchuchuti
- Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), Harare, Zimbabwe
| | - Obey Shoko
- Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), Harare, Zimbabwe
| | - Collins Timire
- International Union Against Tuberculosis and Lung Disease, Harare, Zimbabwe.,International Union Against Tuberculosis and Lung Disease, Paris, France.,AIDS & TB Department, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Kudakwashe Collin Takarinda
- International Union Against Tuberculosis and Lung Disease, Harare, Zimbabwe.,International Union Against Tuberculosis and Lung Disease, Paris, France.,AIDS & TB Department, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Anthony David Harries
- International Union Against Tuberculosis and Lung Disease, Paris, France.,London School of Hygiene and Tropical Medicine, London, UK
| | - Hannock Tweya
- International Union Against Tuberculosis and Lung Disease, Paris, France.,The Lighthouse Trust, Lilongwe, Malawi
| | | | - Saziso Nyathi
- Health Services Department, City of Bulawayo, Zimbabwe
| | | | - Anesu Chimwaza
- AIDS & TB Department, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Agnes Mahomva
- Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), Harare, Zimbabwe
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Neurological Aspects of HIV-1/HTLV-1 and HIV-1/HTLV-2 Coinfection. Pathogens 2020; 9:pathogens9040250. [PMID: 32231144 PMCID: PMC7238008 DOI: 10.3390/pathogens9040250] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/15/2020] [Accepted: 03/27/2020] [Indexed: 02/06/2023] Open
Abstract
Simultaneous infection by human immunodeficiency viruses (HIV) and human T-lymphotropic viruses (HTLV) are not uncommon since they have similar means of transmission and are simultaneously endemic in many populations. Besides causing severe immune dysfunction, these viruses are neuropathogenic and can cause neurological diseases through direct and indirect mechanisms. Many pieces of evidence at present show that coinfection may alter the natural history of general and, more specifically, neurological disorders through different mechanisms. In this review, we summarize the current evidence on the influence of coinfection on the progression and outcome of neurological complications of HTLV-1/2 and HIV-1.
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Wagnew F, Eshetie S, Alebel A, Tesema C, Kibret GD, Gebrie A, Dessie G, Abajobir AA. Burden of anemia and its association with HAART in HIV infected children in Ethiopia: a systematic review and meta-analysis. BMC Infect Dis 2019; 19:1032. [PMID: 31801471 PMCID: PMC6894299 DOI: 10.1186/s12879-019-4656-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 11/22/2019] [Indexed: 11/15/2022] Open
Abstract
Background Anemia is a common problem in HIV (human immunodeficiency virus) infected patients, and is associated with decreased functional capacity and quality of life. Ethiopia is one of the countries which has expanded highly active antiretroviral treatment (HAART) over the past years. The effect of HAART on anemia among HIV remains inconsistent and inconclusive, particularly in children. This study thus aimed to synthesize the prevalence of anemia among HIV infected Ethiopian children and its association with HAART initiation. Methods MEDLINE/PubMed, EMBASE, PsycINFO, Web of Science and Google scholar were used to identify 12 eligible studies reporting an association between anemia and HIV using a priori set criteria. PRISMA guideline was used to systematically review and meta-analysis these studies. Details of sample size, magnitude of effect sizes, including odds ratio (OR) and standard errors were extracted. Random-effects model was used to calculate the pooled estimates using STATA/SE version-14. I2 and meta-bias statistics assessed heterogeneity and publication bias of the included studies. Sub-group analyses, based on study designs, were also carried out. Results In Ethiopia, the overall prevalence of anemia in HIV infected children was 22.3% (95% CI: 18.5–26.0%). The OR of anemia-HIV/AIDS comorbidity was 0.4 (95% CI, 0.2–0.5) in HAART initiated children as compared to non-initiated counterparts. Meta-bias and funnel plot detected no publication bias. Conclusion On aggregate, anemia is a common comorbidity in pediatric HIV patients. HAART was significantly associated with a reduced anemia-HIV/AIDS comorbidity. Prompt start of HAART might help decreasing the prevalence of anemia and its subsequent complications.
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Affiliation(s)
- Fasil Wagnew
- College of Health Science, Debre Markos University, Debre Markos, Ethiopia.
| | - Setegn Eshetie
- College of Health Science, University of Gondar, Gondar, Ethiopia
| | - Animut Alebel
- College of Health Science, Debre Markos University, Debre Markos, Ethiopia.,Faculity of health, University of Technology Sidney, Sidney, Australia
| | - Cheru Tesema
- College of Health Science, Debre Markos University, Debre Markos, Ethiopia.,Faculity of health, University of Technology Sidney, Sidney, Australia
| | - Getiye Dejenu Kibret
- College of Health Science, Debre Markos University, Debre Markos, Ethiopia.,Faculity of health, University of Technology Sidney, Sidney, Australia
| | - Alemu Gebrie
- College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Getenet Dessie
- College of Health Sciences, Bahirdar University, Bahirdar, Ethiopia
| | - Amanuel Alemu Abajobir
- Faculty of Medicine, The University of Queensland, Brisbane, Australia.,African Population and Health Research Center, Maternal and Child Wellbeing Unit, Nairobi, Kenya
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Atnafu Gebeyehu N, Yeshambel Wassie A, Abebe Gelaw K. Acceptance Of HIV Testing And Associated Factors Among Pregnant Women Attending Antenatal Care In Gunino Health Center, Southern Ethiopia 2019: An Institutional Based Cross-Sectional Study. HIV AIDS (Auckl) 2019; 11:333-341. [PMID: 31819664 PMCID: PMC6897068 DOI: 10.2147/hiv.s226077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 10/24/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Acceptance of human immune virus testing is an entry point of intervention to end mother to child transmission of the virus among pregnant women. METHODS Institutional based cross-sectional study design with a sample size of 340 was conducted from May 20 to June 15, 2019. The data were collected by using systematic random sampling technique of interviewer administered questionnaire. Those candidate variables at bivariate analysis with a p-value <0.25 were moved to the multivariate logistic regression model to control for potential confounding variables, and P-value <0.05 at multivariate analysis was considered as cutoff point. RESULT Among the total of 340 pregnant women who participated with a response rate of 96%, 234 (68.8%) accepted testing. The odds of acceptance of human immune virus testing was higher among respondents who had awareness about mother to child transmission (AOR=2.602, 95%; CI:1.408-4.809) than their counterparts. It was also higher among respondents who had perceived the benefit of testing (AOR=1.838, 95%; CI:1.089-3.104) than those who did not perceive the benefit of testing. Participants who were knowledgeable about the prevention of mother to child transmission were more likely to accept testing (AOR=1.715, 95%; CI:1.030-2.855) than their counterparts. Besides, the odds of acceptance of testing among pregnant women who attended two and above antenatal appointments were higher (AOR= 2.485, 95%; CI:1.462-4.224) than participants who attended only one appointment. Participants who had no formal education (AOR=0.393, 95%; CI:0.160-0.967) and had a primary level of education (AOR=0.357,95%; CI:0.152-0.842) were less likely to accept human immune virus testing than women who had a diploma and above level of educational status. CONCLUSION Acceptance of human immune virus testing among pregnant women attending antenatal care clinics was relatively low. Antenatal caregivers should place emphasis on reducing barriers to testing, like lack of awareness, knowledge, and educational background.
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Affiliation(s)
- Natnael Atnafu Gebeyehu
- Department of Midwifery, College of Health Science and Medicine,Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Addisu Yeshambel Wassie
- Department of Midwifery, College of Health Science and Medicine,Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Kelemu Abebe Gelaw
- Department of Midwifery, College of Health Science and Medicine,Wolaita Sodo University, Wolaita Sodo, Ethiopia
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He Y, Zhang J, Shen G, Liu L, Zhao Q, Lu X, Yang H, Hong D. Aromatase inhibitors and risk of cardiovascular events in breast cancer patients: a systematic review and meta-analysis. BMC Pharmacol Toxicol 2019; 20:62. [PMID: 31665091 PMCID: PMC6820915 DOI: 10.1186/s40360-019-0339-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 09/20/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Cardiovascular events (CVEs) was considered as one of the primary cause to reduce the quality of life in breast cancer patients with aromatase inhibitors (AIs) treatment, which has not been sufficiently addressed. The aim of this study was to assess the correlation between risk of CVEs and AIs in patients with breast cancer. METHODS Included studies were obtained from the databases of Embase, Pubmed, Cochrane Library, Clinical Trials.gov, and reference lists. The main outcome measures were overall incidence, odds ratios (ORs), and 95% confidence intervals (CIs). Furthermore, the association and the risk differences among different tumor types, AIs,ages,or treatment regimens were conducted. Fixed-effect or random-effect models were applied in the statistical analyses according to the heterogeneity. Our analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. RESULTS Seventeen studies, which included 44,411 subjects, were included in our analyses. The overall incidence of CVEs in AIs group was 13.02% (95% CI: 8.15-20.17%) and almost all of the high-grade CVEs occurred in patients treated with AIs. The pooled ORs of CVEs was 0.9940 (95% CI: 0.8545-1.1562). Under sub-group analysis, the incidence of CVEs related to exemestane was higher than that of controls (OR = 1.1564, 95% CI: 1.0656-1.2549), but no statistical differences in risk of CVEs were found in other sub-group analysis. No evidence of publication bias was found for incidence of CVEs in our meta-analysis by a funnel plot. CONCLUSIONS These results suggest that patients with breast cancer treated with AIs do not have a significant risk of developing CVEs in comparison with the controls, and exemestane might not be considered as the alternative AI to the breast cancer patients from the perspective of CVEs. Further studies are recommended to investigate this association and the risk differences among different tumor types, AIs or treatment regimens.
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Affiliation(s)
- Yang He
- Department of Pharmacy, the First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, People's Republic of China.,College of Medicine, Zhejiang University, 866 Yuhangtang Road, Hangzhou, 310003, People's Republic of China
| | - Jianhua Zhang
- Department of Management, the Logistics Service Center of Municipal Government, Hangzhou, 310019, People's Republic of China
| | - Guofang Shen
- Loma Linda University School of Pharmacy, Loma Linda, CA, 92354, USA
| | - Lin Liu
- Department of Pharmacy, the First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, People's Republic of China
| | - Qingwei Zhao
- Department of Pharmacy, the First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, People's Republic of China
| | - Xiaoyang Lu
- Department of Pharmacy, the First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, People's Republic of China
| | - Hongyu Yang
- Department of Pharmacy, the First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, People's Republic of China.
| | - Dongsheng Hong
- Department of Pharmacy, the First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, People's Republic of China.
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