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Jones AV, Manasyan A, Xue Y, Kapesa H, Mwendafilumba K, Nalwamba L, Mzumara M, Mubiana-Mbewe M, Dionne JA. Benzathine penicillin G stockouts and other barriers to documented syphilis treatment in pregnancy in Zambia. PLoS One 2024; 19:e0304576. [PMID: 38829879 PMCID: PMC11146727 DOI: 10.1371/journal.pone.0304576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 05/15/2024] [Indexed: 06/05/2024] Open
Abstract
OBJECTIVE The prevalence of syphilis in Zambia remains high and is a critical public health concern. The Zambian Ministry of Health recommends universal screening and same-day treatment for syphilis in pregnancy, yet the syphilis screening rate is low, and treatment is poorly documented. The goal of this study was to document syphilis treatment rates and associated factors among pregnant women in care in Zambia. METHODS This retrospective cohort study included pregnant women diagnosed with syphilis according to rapid plasma reagin (RPR) screening during routine antenatal care (ANC) in Lusaka, Zambia in 2018-2019. The main outcome of interest was lack of documented BPG treatment during pregnancy. Additional information about pregnancy and neonatal outcomes, partner referral for therapy, and facility level stockout data were included. Patient characteristics were compared by treatment status using Pearson Chi-Square Test and logistic regression models were created to estimate the association between individual level-factors, facility type, and lack of BPG treatment. A Cochran-Mantel-Haenszel test was used to evaluate facility-level data with significance set at p<0.05. RESULTS Among 1,231 pregnant women who screened positive for syphilis at clinic, 643 (52%) lacked documented antibiotic treatment at the facility. BPG was the only antibiotic used to treat syphilis in the cohort and 8% of sex partners had evidence of referral for therapy. Preterm delivery rates were higher in women without documented BPG (43% vs 32%; p = 0.003). In adjusted models, only calendar year and hospital facility type were associated with lack of treatment. At the facility level, annual syphilis screening rates ranged from 37-65% and most (7/10) clinics reported at least one stockout of BPG. CONCLUSION Treatment rates for syphilis in pregnancy in Zambia were low and BPG medication stockouts at the facility level were common. A consistent supply of BPG at all ANC facilities is needed to facilitate timely treatment and improve birth outcomes.
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Affiliation(s)
- Anna V. Jones
- Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Albert Manasyan
- Department of Pediatrics, University of Alabama at Birmingham, Children’s of Alabama Hospital, Birmingham, Alabama, United States of America
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Yumo Xue
- Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Herbert Kapesa
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | | | | | - Maureen Mzumara
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | | | - Jodie A. Dionne
- Center for Women’s Reproductive Health, University of Alabama at Birmingham, University of Alabama at Birmingham Hospital, Birmingham, Alabama, United States of America
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, University of Alabama at Birmingham Hospital, Birmingham, Alabama, United States of America
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Cubas-Alarcón D, Guevara-Vásquez GM, Suclupe-Campos DO, Castro-Martínez S, Aguilar-Gamboa FR, Failoc-Rojas VE. Seroinfection of Antibodies to Toxoplasma gondii, Parvovirus B19, Treponema pallidum, and HIV in a Pregnant Attending a Medical Center in Northern Peru. Infect Dis Obstet Gynecol 2024; 2024:8844325. [PMID: 38883209 PMCID: PMC11178423 DOI: 10.1155/2024/8844325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 03/23/2024] [Accepted: 05/02/2024] [Indexed: 06/18/2024] Open
Abstract
Introduction Transplacental infections are frequent, especially in developing countries, where limited screening is performed to find infectious agents in the pregnant population. We aim to determine the clinical and epidemiological characteristics and seroinfection of antibodies against Toxoplasma, parvovirus B19, T. pallidum, and HIV in pregnant women who attended the Motupe Health Center in Lambayeque, Peru during July-August 2018. Methods A descriptive cross-sectional study was conducted in 179 pregnant women interviewed with a standardized questionnaire. ELISA was used to determine antibodies to Toxoplasma and parvovirus B19. The detection of syphilis and HIV was conducted using immunochromatography, while the detection of hepatitis B was conducted using FTA-ABS and immunofluorescence, respectively. Results Of 179 pregnant women, syphilis and HIV infections routinely included in the screening of pregnant women presented a seroinfection of 2.2 and 0.6%, respectively. Toxoplasmosis seroinfection was 25.1%, while IgM antiparvovirus B19 was 40.8%, revealing that pregnant women had an active infection at the time of study. Conclusion The level of seroinfection of toxoplasmosis reveals the risk to which pregnant women who participated in the study are exposed. The high seroinfection of parvovirus B19 could explain the cases of spontaneous abortion and levels of anemia in newborn that have been reported in Motupe, Lambayeque, Peru. However, future causality studies are necessary to determine the significance of these findings.
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Affiliation(s)
| | | | - Danny Omar Suclupe-Campos
- Microbiology Laboratory Clinical Laboratory Service School of Biological Sciences Universidad Nacional Pedro Ruiz Gallo, Lambayeque, Peru
| | | | - Franklin Rómulo Aguilar-Gamboa
- Immunology and Virology Laboratory Hospital Regional de Lambayeque, Lambayeque, Peru
- Grupo de investigación en Inmunología y Virología del Norte, Lambayeque, Peru
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Ebogo-Belobo JT, Kenmoe S, Mbongue Mikangue CA, Tchatchouang S, Robertine LF, Takuissu GR, Ndzie Ondigui JL, Bowo-Ngandji A, Kenfack-Momo R, Kengne-Ndé C, Mbaga DS, Menkem EZ, Kame-Ngasse GI, Magoudjou-Pekam JN, Kenfack-Zanguim J, Esemu SN, Tagnouokam-Ngoupo PA, Ndip L, Njouom R. Systematic review and meta-analysis of seroprevalence of human immunodeficiency virus serological markers among pregnant women in Africa, 1984-2020. World J Crit Care Med 2023; 12:264-285. [PMID: 38188451 PMCID: PMC10768416 DOI: 10.5492/wjccm.v12.i5.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/19/2023] [Accepted: 11/08/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV) is a major public health concern, particularly in Africa where HIV rates remain substantial. Pregnant women are at an increased risk of acquiring HIV, which has a significant impact on both maternal and child health. AIM To review summarizes HIV seroprevalence among pregnant women in Africa. It also identifies regional and clinical characteristics that contribute to study-specific estimates variation. METHODS The study included pregnant women from any African country or region, irrespective of their symptoms, and any study design conducted in any setting. Using electronic literature searches, articles published until February 2023 were reviewed. The quality of the included studies was evaluated. The DerSimonian and Laird random-effects model was applied to determine HIV pooled seroprevalence among pregnant women in Africa. Subgroup and sensitivity analyses were conducted to identify potential sources of heterogeneity. Heterogeneity was assessed with Cochran's Q test and I2 statistics, and publication bias was assessed with Egger's test. RESULTS A total of 248 studies conducted between 1984 and 2020 were included in the quantitative synthesis (meta-analysis). Out of the total studies, 146 (58.9%) had a low risk of bias and 102 (41.1%) had a moderate risk of bias. No HIV-positive pregnant women died in the included studies. The overall HIV seroprevalence in pregnant women was estimated to be 9.3% [95% confidence interval (CI): 8.3-10.3]. The subgroup analysis showed statistically significant heterogeneity across subgroups (P < 0.001), with the highest seroprevalence observed in Southern Africa (29.4%, 95%CI: 26.5-32.4) and the lowest seroprevalence observed in Northern Africa (0.7%, 95%CI: 0.3-1.3). CONCLUSION The review found that HIV seroprevalence among pregnant women in African countries remains significant, particularly in Southern African countries. This review can inform the development of targeted public health interventions to address high HIV seroprevalence in pregnant women in African countries.
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Affiliation(s)
- Jean Thierry Ebogo-Belobo
- Center for Research in Health and Priority Pathologies, Institute of Medical Research and Medicinal Plants Studies, Yaounde 00237, Cameroon
| | - Sebastien Kenmoe
- Department of Microbiology and Parasitology, University of Buea, Buea 00237, Cameroon
| | | | | | | | - Guy Roussel Takuissu
- Centre for Food, Food Security and Nutrition Research, Institute of Medical Research and Medicinal Plants Studies, Yaounde 00237, Cameroon
| | | | - Arnol Bowo-Ngandji
- Department of Microbiology, The University of Yaounde I, Yaounde 00237, Cameroon
| | - Raoul Kenfack-Momo
- Department of Biochemistry, The University of Yaounde I, Yaounde 00237, Cameroon
| | - Cyprien Kengne-Ndé
- Epidemiological Surveillance, Evaluation and Research Unit, National AIDS Control Committee, Douala 00237, Cameroon
| | - Donatien Serge Mbaga
- Department of Microbiology, The University of Yaounde I, Yaounde 00237, Cameroon
| | | | - Ginette Irma Kame-Ngasse
- Center for Research in Health and Priority Pathologies, Institute of Medical Research and Medicinal Plants Studies, Yaounde 00237, Cameroon
| | | | | | - Seraphine Nkie Esemu
- Department of Microbiology and Parasitology, University of Buea, Buea 00237, Cameroon
| | | | - Lucy Ndip
- Department of Microbiology and Parasitology, University of Buea, Buea 00237, Cameroon
| | - Richard Njouom
- Department of Virology, Centre Pasteur du Cameroun, Yaounde 00237, Cameroon
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Mboya E, Mizinduko M, Balandya B, Mushi J, Sabasaba A, Amani DE, Kamori D, Ruhago G, Faustine P, Maokola W, Sambu V, Nyamuhagata M, Jullu BS, Juya A, Rugemalila J, Mgomella G, Asiimwe S, Pembe AB, Sunguya B. HIV burden and the global fast-track targets progress among pregnant women in Tanzania calls for intensified case finding: Analysis of 2020 antenatal clinics HIV sentinel site surveillance. PLoS One 2023; 18:e0285962. [PMID: 37824470 PMCID: PMC10569580 DOI: 10.1371/journal.pone.0285962] [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: 05/04/2023] [Accepted: 09/28/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND For successful HIV response, updated information on the burden and progress toward HIV elimination targets are required to guide programmatic interventions. We used data from the 2020 HIV sentinel surveillance to update on the burden and factors associated with HIV infection, HIV status awareness, and ART coverage among pregnant women in Tanzania mainland. METHODOLOGY We conducted the surveillance in 159 antenatal clinics (ANC) from all 26 regions of Tanzania's mainland from September to December 2020. This cross-sectional study included all pregnant women (≥15 years) on their first ANC visit in the current pregnancy during the survey period. Routine HIV counselling and testing were done at the facility. A multivariable logistic regression model accounting for the survey design was used to examine factors associated with HIV infections. RESULTS 38,783 pregnant women were enrolled (median age (IQR) = 25 (21-30) years). HIV prevalence was 5.9% (95%CI: 5.3% - 6.6%), ranging from 1.9% in the Manyara region to 16.4% in the Njombe region. Older age, lower and no education, not being in a marital union, and living in urban or semi-urban areas were associated with higher odds of HIV infection. HIV status awareness among women who tested positive was 70.9% (95% CI: 67.5%- 74.0%). ART coverage among those aware of their status was 91.6% (86.5%- 94.9%). Overall, 66.6% (95% CI: 62.4%- 70.6%) of all pregnant women who tested positive for HIV knew their HIV status and were on ART. CONCLUSION HIV is increasingly prevalent among pregnant women in Tanzania mainland especially among older, those with lower or no formal education, those outside marital union, and pregnant women living in urban and semi-urban areas. Behind the global fast-target to end HIV/ AIDS, about a third of pregnant women living with HIV initiating ANC were not on ART. Interventions to increase HIV testing and linkage to care among women of reproductive age should be intensified.
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Affiliation(s)
- Erick Mboya
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Mucho Mizinduko
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Belinda Balandya
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Amon Sabasaba
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Davis Elias Amani
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Doreen Kamori
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - George Ruhago
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | | | | | | | - Boniphace S. Jullu
- St. Francis University College of Health and Allied Sciences, Morogoro, Tanzania
| | - Amir Juya
- Tanzania Field Epidemiology and Laboratory Training Program, Dar es Salaam, Tanzania
| | | | - George Mgomella
- Centre for Diseases Control, Country Office, Dar es Salaam, Tanzania
| | | | - Andrea B. Pembe
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Bruno Sunguya
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Sunguya B, Mboya EA, Mizinduko M, Balandya B, Sabasaba A, Amani DE, Kamori D, Ruhago G, Mkumbwa R, Faustine P, Maokola W, Sambu V, Mushi J, Nyamuhagata M, Jullu BS, Juya A, Rugemalila J, Mgomella G, Asiimwe S, Pembe AB. Epidemiology of syphilis infections among pregnant women in Tanzania: Analysis of the 2020 national representative sentinel surveillance. PLoS One 2023; 18:e0285069. [PMID: 37651360 PMCID: PMC10470872 DOI: 10.1371/journal.pone.0285069] [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: 04/14/2023] [Accepted: 08/17/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Syphilis has detrimental effects on the health of the mother and that of both fetuses and newborns exposed in utero or at delivery. Understanding its local epidemiology is essential for policies, planning, and implementation of targeted preventive interventions. Using data from the 2020 National Sentinel Surveillance of pregnant women attending antenatal clinics (ANCs) in Tanzania we determined the prevalence and determinants of syphilis among pregnant women in Tanzania mainland. METHODOLOGY The ANC surveillance was conducted in 159 ANC sites from all 26 regions of Tanzania's mainland from September to December 2020. It included all pregnant women 15 years and above on their first ANC visit in the current pregnancy during the survey period. Counseling for syphilis was done using standard guidelines at the ANC and testing was done using rapid SD Bioline HIV/Syphilis Duo test kits. Analysis was done using both descriptive statistics to determine the prevalence and characteristics of syphilis, whereas, logistic regressions were used to examine the independent association between syphilis and dependent variables. RESULTS A total of 38,783 women [median age (Interquartile range (IQR)) = 25 (21-30) years] participated in the surveillance. Of them, 582 (1.4%) tested positive for syphilis. A wide regional variation was observed with the highest burden in Kagera (4.5%) to the lowest burden in Kigoma (0.3%). The odds of syphilis infections were higher among older women and those with no formal education. Compared with primigravids, women with 1-2, those with 3-4 and those with more than four previous pregnancies had 1.8 (aOR = 1.8, 95% CI: 1.2-2.5), 2.1 (aOR = 2.1, 95% CI: 1.4-3.1) and 2.6 (aOR = 2.6, 95% CI: 1.7-3.9) higher odds of syphilis infection respectively. CONCLUSION Syphilis is still prevalent among pregnant women in Tanzania with a wide regional disparity. Efforts to prevent new infections, screen pregnant women, and treat those infected should be strategized to include all regions and renewed emphasis on regions with high burden, and importantly among women who are multipara, with a low level of education, and advanced age.
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Affiliation(s)
- Bruno Sunguya
- Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania
| | | | - Mucho Mizinduko
- Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania
| | - Belinda Balandya
- Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania
| | - Amon Sabasaba
- Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania
| | - Davis Elias Amani
- Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania
| | - Doreen Kamori
- Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania
| | - George Ruhago
- Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania
| | - Rebecca Mkumbwa
- Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania
| | | | | | | | | | | | - Boniphace S. Jullu
- St. Francis University College of Health and Allied Sciences, Morogoro, Tanzania
| | - Amir Juya
- Tanzania Field Epidemiology and Laboratory Training Program, Dar es Salaam, Tanzania
| | | | | | | | - Andrea B. Pembe
- Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania
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Adem Beriso J, Lemessa F, Fereda A, Kaso AW. Magnitude of syphilis and associated factors among pregnant women attending ANC in public facilities in Shashamene town, Oromia Region, Ethiopia. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2023. [DOI: 10.1016/j.cegh.2023.101288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023] Open
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Ozim CO, Mahendran R, Amalan M, Puthussery S. Prevalence of human immunodeficiency virus (HIV) among pregnant women in Nigeria: a systematic review and meta-analysis. BMJ Open 2023; 13:e050164. [PMID: 36858473 PMCID: PMC9980359 DOI: 10.1136/bmjopen-2021-050164] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
OBJECTIVE To estimate prevalence of HIV infection in Nigeria and to examine variations by geopolitical zones and study characteristics to inform policy, practice and research. METHODS We conducted a comprehensive search of bibliographic databases including PubMed, CINAHL, PsycINFO, Global Health, Academic Search Elite and Allied and Complementary Medicine Database (AMED) and grey sources for studies published between 1 January 2008 and 31 December 2019. Studies reporting prevalence estimates of HIV among pregnant women in Nigeria using a diagnostic test were included. Primary outcome was proportion (%) of pregnant women living with HIV infection. A review protocol was developed and registered (PROSPERO 2019 CRD42019107037). RESULTS Twenty-three studies involving 72 728 pregnant women were included. Ten studies were of high quality and the remaining were of moderate quality. Twenty-one studies used two or more diagnostic tests to identify women living with HIV. Overall pooled prevalence of HIV among pregnant women was 7.22% (95% CI 5.64 to 9.21). Studies showed high degree of heterogeneity (I2 =97.2%) and evidence of publication bias (p=0.728). Pooled prevalence for most individual geopolitical zones showed substantial variations compared with overall prevalence. North-Central (6.84%, 95% CI 4.73 to 9.79) and South-West zones (6.27%, 95% CI 4.75 to 8.24) had lower prevalence whereas South-East zone (17.04%, 95% CI 9.01 to 29.86) had higher prevalence. CONCLUSIONS While robust national prevalence studies are sparse in Nigeria, our findings suggest 7 in every 100 pregnant women are likely to have HIV infection. These figures are consistent with reported prevalence rates in sub-Saharan African region. WHO has indicated much higher prevalence in Nigeria compared with our findings. This discrepancy could potentially be attributed to varied methodological approaches and regional focus of studies included in our review. The magnitude of the issue highlights the need for targeted efforts from local, national and international stakeholders for prevention, diagnosis, management and treatment.
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Affiliation(s)
- Christian Onyedikachi Ozim
- Maternal and Child Health Research Centre, Institute for Health Research, University of Bedfordshire, Luton, UK
| | | | - Mahendran Amalan
- School of Mathematical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Shuby Puthussery
- Maternal and Child Health Research Centre, Institute for Health Research, University of Bedfordshire, Luton, UK
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Wangara F, Estill J, Kipruto H, Wools-Kaloustian K, Chege W, Manguro G, Keiser O. Sub optimal HIV status ascertainment at antenatal clinics and the impact on HIV prevalence estimates: A cross sectional study. PLoS One 2022; 17:e0278450. [PMID: 36454873 PMCID: PMC9714869 DOI: 10.1371/journal.pone.0278450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 11/16/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND While many countries including Kenya transitioned from sentinel surveillance to the use of routine antenatal care (ANC) data to estimate the burden of HIV, countries in Sub Saharan Africa reported several challenges of this transition, including low uptake of HIV testing and sub national / site-level differences in HIV prevalence estimates. In Kenya voluntary HIV testing is offered to all 1st ANC clients. However, some women may decline testing. We aim to predict the HIV positivity (as a proxy of prevalence) at ANC assuming 100% uptake of HIV testing and compare this to the observed positivity. METHODS Using a cross sectional study design, we examine routine data on HIV testing among all women attending ANC in Kwale County, Kenya, for the period January 2015 to December 2019.We used a generalized estimating equation with binomial distribution to model the observed HIV prevalence as explained by HIV status ascertainment. We then used marginal standardization to predict the HIV prevalence at 100% HIV status ascertainment and make recommendations to improve the utility of ANC routine data for HIV surveillance. RESULTS HIV testing at ANC was at 91.3%, slightly above the global target of 90%. If there was 100% HIV status ascertainment at ANC, the HIV prevalence would be 2.7% (95% CI 2.3-3.2). This was 0.3% lower than the observed prevalence. Across the yearly predictions, there was no difference between the observed and predicted values except for 2018 where the HIV prevalence was underestimated with an absolute bias of -0.2 percent. This implies missed opportunities for identifying new HIV infections in the year 2018. CONCLUSIONS Imperfect HIV status ascertainment at ANC overestimates HIV prevalence among women attending ANC in Kwale County. However, the use of ANC routine data may underestimate the true population prevalence. There is need to address both community level and health facility level barriers to the uptake of ANC services.
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Affiliation(s)
- Fatihiyya Wangara
- Institute of Global Health, University of Geneva, Geneva, Switzerland
- Department of Health Services, County Government of Kwale, Kwale, Kenya
- * E-mail:
| | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Hillary Kipruto
- Health Systems & Services, World Health Organization, Harare, Zimbabwe
| | - Kara Wools-Kaloustian
- Department of Medicine, Indiana University, Indianapolis, Indiana, United States of America
| | - Wendy Chege
- National AIDS Control Council, Ministry of Health, Nairobi, Kenya
| | | | - Olivia Keiser
- Institute of Global Health, University of Geneva, Geneva, Switzerland
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Minja AA, Larson E, Aloyce Z, Araya R, Kaale A, Kaaya SF, Kamala J, Kasmani MN, Komba A, Mwimba A, Ngakongwa F, Siril H, Smith Fawzi MC, Somba M, Sudfeld CR, Figge CJ. Burden of HIV-related stigma and associated factors among women living with depression accessing PMTCT services in Dar es Salaam, Tanzania. AIDS Care 2022; 34:1572-1579. [PMID: 35277109 PMCID: PMC9464265 DOI: 10.1080/09540121.2022.2050174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 03/01/2022] [Indexed: 01/26/2023]
Abstract
HIV-related stigma represents a potent risk factor for a range of poor health outcomes, including mental health symptoms, treatment non-adherence, and substance use. Understanding the role of HIV-related stigma in promoting healthcare outcomes is critical for vulnerable populations, such as pregnant women living with HIV, in contexts with continued high rates of HIV and associated stigma, such as sub-Saharan Africa. The current study examined a range of risk and protective factors for HIV-related stigma with 742 pregnant women (M age = 29.6 years) living with depression and HIV accessing prevention of mother-to-child transmission of HIV (PMTCT) services in Dar es Salaam, Tanzania. Risk factors included depressive symptoms, ART non-adherence, intimate partner violence, food insecurity, and alcohol problems. Protective factors included disclosure of HIV status, social support, an appreciative relationship with their partner, hope, and self-efficacy. Findings highlight key psychosocial and behavioral determinants of HIV-related stigma for pregnant women living with HIV in Tanzania, and can inform perinatal care programming and interventions to optimize mental health and adherence outcomes.
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Affiliation(s)
- Anna Agape Minja
- Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Elysia Larson
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston MA, USA
| | - Zenaice Aloyce
- Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Anna Kaale
- Africa Academy for Public Health, Dar es Salaam, Tanzania
| | - Sylvia F Kaaya
- Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Janeth Kamala
- Africa Academy for Public Health, Dar es Salaam, Tanzania
| | | | - Amina Komba
- Africa Academy for Public Health, Dar es Salaam, Tanzania
| | | | - Fileuka Ngakongwa
- Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Hellen Siril
- Management and Development for Health, Dar es Salaam, Tanzania
| | - Mary C Smith Fawzi
- Department of Global Health and Social Medicine, Harvard Medical School, Boston MA, USA
| | - Magreat Somba
- Africa Academy for Public Health, Dar es Salaam, Tanzania
| | - Christopher R Sudfeld
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston MA, USA
| | - Caleb J Figge
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston MA, USA
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AKAKPO AS, LARABOU A, SAKA B, TÉCLESSOU JN, SINGO A, DAGNRA A, KOMBATÉ K, PITCHÉ P. [Trends of HIV and syphilis prevalence among pregnant women in antenatal clinics in Togo: Analysis of sentinel serosurveillance results between 2008 and 2016]. MEDECINE TROPICALE ET SANTE INTERNATIONALE 2022; 2:mtsi.v2i3.2022.152. [PMID: 36284561 PMCID: PMC9557824 DOI: 10.48327/mtsi.v2i3.2022.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 06/07/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION The aim of our work was to analyse the trends of HIV infection and syphilis among pregnant women in prenatal consultation (PNC) in healthcare facilities in Togo. METHODS This was an analytical retrospective study, covering the period from 2008 to 2016 and focusing on pregnant women aged 15 to 49 seen in PNC for the first time in maternal and child health services in Togo. RESULTS During the study period, 41,536 pregnant women were registered in 2008, 2009, 2010, 2014 and 2016, respectively 8079, 8572, 8430, 7920 and 8535.The mean age of the patients was 26 ± 6 year in 2008, 2009 and 2010. The overall HIV prevalence decreased from 3.4% in 2008 to 2.9% in 2016 (p = 0.0145). It fell from 1% in 2008 to 0.5% in 2016 and from 3.6% in 2008 to 1.4% in 2016 (p < 0.0001) among 15-19 year-old and 20-24 year-old respectively. HIV prevalence in rural areas is two times lower than in urban areas between 2008 and 2016 with a statistically significant difference. The prevalence of syphilis decreased significantly from 2008 (1.3%) to 2016 (0.6%), (p < 0.0001). It is low and not associated with age in 2008; 0.2% and 0.4% in 2016 respectively in the 15 to 19 and 20 to 24 age groups. This prevalence is significantly low between 2008 and 2016 in both urban and rural areas. CONCLUSION Our study documents a relatively low prevalence of syphilis and HIV among pregnant women in Togo, with a significant decrease among adolescents and young women, attesting to the effectiveness of the increased screening and comprehensive prevention of sexually transmitted infections (STIs) and HIV, including the antiretroviral treatment as prevention (TASP) approach, and the neonatal syphilis elimination programme in the country.
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Affiliation(s)
- Abla Séfako AKAKPO
- Service de dermato-vénéréologie, Centre hospitalier universitaire Sylvanus Olympio, Université de Lomé, Togo
| | - Aminou LARABOU
- Service de dermato-vénéréologie, Centre hospitalier universitaire Sylvanus Olympio, Université de Lomé, Togo
| | - Bayaki SAKA
- Service de dermato-vénéréologie, Centre hospitalier universitaire Sylvanus Olympio, Université de Lomé, Togo
| | - Julienne Noude TÉCLESSOU
- Service de dermato-vénéréologie, Centre hospitalier universitaire Campus, Université de Lomé, Togo
| | - Assetina SINGO
- Programme national de Lutte contre le Sida et les Infections sexuellement transmissibles, Ministère de la Santé publique, Lomé, Togo
| | - Anoumou DAGNRA
- Programme national de Lutte contre le Sida et les Infections sexuellement transmissibles, Ministère de la Santé publique, Lomé, Togo
| | - Koussake KOMBATÉ
- Service de dermato-vénéréologie, Centre hospitalier universitaire Campus, Université de Lomé, Togo
| | - Palokinam PITCHÉ
- Service de dermato-vénéréologie, Centre hospitalier universitaire Sylvanus Olympio, Université de Lomé, Togo
- Conseil national de Lutte contre le Sida et les Infections sexuellement transmissibles, Lomé, Togo
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HIV Prevalence among Injury Patients Compared to Other High-Risk Groups in Tanzania. TRAUMA CARE 2022. [DOI: 10.3390/traumacare2030041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Sixty-eight percent of persons infected with HIV live in Africa, but as few as 67% of those know their infection status. The emergency department (ED) might be a critical access point to HIV testing. This study sought to measure and compare HIV prevalence in an ED injury population with other clinical and nonclinical populations across Tanzania. Adults (≥18 years) presenting to Kilimanjaro Christian Medical Center ED with acute injury of any severity were enrolled in a trauma registry. A systematic review and meta-analysis was conducted to compare HIV prevalence in the trauma registry with other population groups. Further, 759 injury patients were enrolled in the registry; 78.6% were men and 68.2% consented to HIV counseling and testing. The HIV prevalence was 5.02% (tested), 6.25% (self-report), and 5.31% (both). The systematic review identified 79 eligible studies reporting HIV prevalence (tested) in 33 clinical and 12 nonclinical population groups. Notable groups included ED injury patients (3.53%, 95% CI), multiple injury patients (10.67%, 95% CI), and people who inject drugs (17.43%, 95% CI). These findings suggest that ED injury patients might be at higher HIV risk compared to the general population, and the ED is a potential avenue to increasing HIV testing among young adults, particularly men.
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Tsega NT, Abebe B, Ebabu T, Asmare T, Kassa M, Haile TT, Seyoum AT, Endalew M, Wondie KY. Sexually transmitted infections and associated factors during pregnancy in Gondar city, Northwest Ethiopia, 2021: A multicenter study. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Rosser BRS, Mkoka DA, Rohloff CT, Mgopa LR, Ross MW, Lukumay GG, Mohammed I, Massae AF, Mkonyi E, Mushy SE, Mwakawanga DL, Kohli N, Trent ME, Wadley J, Bonilla ZE. Tailoring a sexual health curriculum to the sexual health challenges seen by midwifery, nursing and medical providers and students in Tanzania. Afr J Prim Health Care Fam Med 2022; 14:e1-e9. [PMID: 35695444 PMCID: PMC9210149 DOI: 10.4102/phcfm.v14i1.3434] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/31/2022] [Accepted: 04/05/2022] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Tanzania is a country experiencing multiple sexual health challenges, but providers receive no formal training in sexual health. AIM This study aimed to assess (1) what sexual health challenges are commonly seen in clinics in Tanzania, (2) which are raised by patients, (3) which are not addressed and (4) which topics to prioritise for a sexual health curriculum. SETTING Healthcare settings in Tanzania. METHODS Participants were 60 experienced and 61 student doctors, nurses and midwives working in Dar es Salaam. The authors conducted 18 focus groups stratified by profession (midwifery, nursing or medicine) and experience (practitioners vs. students). RESULTS Providers identified six common sexual health concerns: (1) Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) and sexually transmissible infection (STI) (especially syphilis and gonorrhoea), (2) sexual violence (including intimate partner violence and female genital mutilation), (3) early and unwanted pregnancy (including early sexual debut and complications from abortion), (4) sexual dysfunctions, (5) key population concerns (e.g. lesbian, gay, bisexual, transgender (LGBT); sex work) and (6) non-procreative sexual behaviour (including pornography and masturbation in males and oral and anal sex practices in heterosexual couples). Across professions, few differences were observed. Homosexuality, sex work, masturbation and pornography were identified as taboo topics rarely discussed. Most participants (81%) wanted one comprehensive sexual health curriculum delivered across disciplines. CONCLUSION A sexual health curriculum for health students in Tanzania needs to address the most common sexual health concerns of patients. In addition to teaching sexual science and clinical care, skills training in how to address taboo topics is recommended. Students endorsed almost all sexual health topics, which suggests that a comprehensive curriculum is appropriate.
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Affiliation(s)
- B R Simon Rosser
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, United States of America.
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Vueba AN, Almendra R, Santana P, Faria C, do Céu Sousa M. Prevalence of HIV and hepatitis B virus among pregnant women in Luanda (Angola): geospatial distribution and its association with socio-demographic and clinical-obstetric determinants. Virol J 2021; 18:239. [PMID: 34863183 PMCID: PMC8642931 DOI: 10.1186/s12985-021-01698-7] [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: 06/08/2021] [Accepted: 11/11/2021] [Indexed: 11/10/2022] Open
Abstract
Background HIV and HBV infections remain responsible for high rate of morbidity and mortality in many African Countries, affecting women and newborns. This study aims to analyze the spatial pattern of HIV and HBV infections in pregnant women in Luanda, Angola, and the statistical association between HIV and HBV and socio-economic characteristics, hygiene, and health status. Methods Detection of anti-HIV antibodies (total anti-HIV-1, anti-HIV-2 and HIV-1 p24 antigen) and Hepatitis B antigens (HBsAg, HBeAg) and antibodies (anti-HBc Total II, HBc IgM, Anti-HBsT II) was performed by Enzyme Linked Fluorescent Assay (ELFA) in serum samples of 878 pregnant women attended at the Lucrecia Paim Maternity Hospital (LPMH). Data were collected by questionnaire after written consent, and spatial distribution was assessed through a Kernel Density Function. The potential risk factors associated with HIV HBV infection were evaluated using bivariate and multivariate binomial logistic regression analysis. Results Anti-HIV antibodies were positive in 118 samples (13.4%) and HBV infection were positive in 226 (25.7%). The seroprevalence of HIV/HBV coinfection was of 6.3%. The results showed that the seroprevalence of HBV was similar in most municipalities: 25.8% in Belas; 26.6% in Viana; 27.6% in Luanda; 19.2% in Cacuaco; and 15.6% Cazenga. For HIV, the seroprevalence was also close ranges among the municipalities: 10.0% in Belas; 14.5% in Viana 14.9% in Luanda and 12.5% in Cazenga. However, the seroprevalence in municipality of in Cacuaco was lower (5.8%) and bivariate and multivariate analysis showed a lower risk for HIV in this area (OR 0.348, CI 0.083–0.986; OR 0.359, CI 0.085–1.021). The multivariate analysis had also showed a significant increased risk for HIV in women with 2 or 3 births (OR 1.860, CI 1.054–3.372). Conclusions Our results underlined the need to improve the screening and clinical follow-up of HIV and HBV in Angola, as well the educational campaigns to prevent not only the morbidity and mortality associated with these diseases, but also their transmission, mainly in women in reproductive age and pregnant, encouraging the pre-natal consultations in order to avoid mother-to-child transmission. Supplementary Information The online version contains supplementary material available at 10.1186/s12985-021-01698-7.
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Affiliation(s)
| | - Ricardo Almendra
- Centre of Studies on Geography and Spatial Planning (CEGOT), University of Coimbra, Coimbra, Portugal
| | - Paula Santana
- Centre of Studies on Geography and Spatial Planning (CEGOT), University of Coimbra, Coimbra, Portugal.,Centre of Studies on Geography and Spatial Planning (CEGOT), Department of Geography and Tourism, University of Coimbra, Coimbra, Portugal
| | - Clarissa Faria
- Faculty of Pharmacy, University of Coimbra (FFUC), Coimbra, Portugal.,Center for Neuroscience and Cell Biology (CNC), University of Coimbra, Coimbra, Portugal
| | - Maria do Céu Sousa
- Faculty of Pharmacy, University of Coimbra (FFUC), Coimbra, Portugal. .,Center for Neuroscience and Cell Biology (CNC), University of Coimbra, Coimbra, Portugal.
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Enbiale M, Getie A, Haile F, Tekabe B, Misekir D. Magnitude of syphilis sero-status and associated factors among pregnant women attending antenatal care in Jinka town public health facilities, Southern Ethiopia, 2020. PLoS One 2021; 16:e0257290. [PMID: 34506600 PMCID: PMC8432762 DOI: 10.1371/journal.pone.0257290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 08/30/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Syphilis is one of the leading causes of perinatal morbidity and mortality and is one of the most important public health problems. There was no study showing syphilis serostatus and its related factors among pregnant women in the current study area. This study was aimed to assess the magnitude of syphilis serostatus and associated factors among pregnant women attending antenatal care in Jinka town public health facilities. METHOD Institution based cross-sectional study design was conducted in Jinka town public health facilities, southern Ethiopia from the 1st July to the 1st September, 2020. A systematic sampling technique was used to select 629 study subjects. Data were collected using a structured questionnaire through face-to-face interviews and records were reviewed to check syphilis test results. Data were coded and entered by using Epi-data version 4.432 and analyzed using SPSS version 25. The binary logistic regression model was used to investigate factors associated with syphilis. A p-value of < 0.05 at multivariable analysis was considered statistically significant. RESULT In this study, syphilis sero-prevalence among pregnant women attending antenatal care clinics was 4.8% (95% CI: 3.12, 6.48). Rural residence [AOR: 2.873; 95%CI (1.171, 7.050)], alcohol use [AOR: 3.340; 95% CI (1.354, 8.241)] and having multiple sexual partner [AOR: 5.012; 95% CI (1.929, 13.020)] were statistically significantly associated with syphilis. CONCLUSION Sero-prevalence of syphilis was high. Being a rural residence, having multiple sexual partners, alcohol use were factors associated with syphilis. Therefore, substantial efforts have to be made to provide regular health education for pregnant women at the antenatal clinic on the avoidance of risky behaviors and the risk of syphilis on their pregnancy.
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Affiliation(s)
- Mulusew Enbiale
- School of Public Health, Arba Minch University, Arba Minch, Ethiopia
| | - Asmare Getie
- School of Nursing, Arba Minch University, Arba Minch, Ethiopia
| | - Frehiwot Haile
- School of Public Health, Arba Minch University, Arba Minch, Ethiopia
| | - Beemnet Tekabe
- School of Public Health, Arba Minch University, Arba Minch, Ethiopia
| | - Direslgn Misekir
- School of Public Health, Arba Minch University, Arba Minch, Ethiopia
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Geremew H, Geremew D. Sero-prevalence of syphilis and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis. Syst Rev 2021; 10:223. [PMID: 34384495 PMCID: PMC8359573 DOI: 10.1186/s13643-021-01786-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 08/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Syphilis remained a major cause of reproductive morbidity and poor pregnancy outcomes in developing countries. Previously, studies showed inconsistent results and failed to show the actual picture of the diseases in Ethiopia. Thus, the aim of this meta-analysis was, first, to determine the updated pooled prevalence of syphilis among pregnant women in Ethiopia and, second, to assess its associated factors. METHODS A comprehensive search was made on PubMed, Google scholar, Science Direct, and African Journals Online databases to identify relevant articles. A random effects model was used to estimate pooled syphilis prevalence and odds ratio (OR) with the respective 95% confidence intervals (CIs) using STATA 14 statistical software. I2 statistics and Egger's regression test in conjunction with funnel plot was used to determine heterogeneity and publication bias among included studies respectively. RESULT We identified 13 suitable studies in this analysis. Accordingly, the pooled prevalence of syphilis among pregnant women in Ethiopia was 2.32% (95% CI, 1.68-2.97). Specifically, syphilis prevalence was 2.53% (95% CI, 1.92-3.14%) and 1.90% (95% CI, 0.40-3.40%) as per the treponemal and non-ytreponemal diagnostic test, respectively. On the other hand, regional analysis indicated that 4.06% (95% CI, 2.86-5.26) in Southern Nations Nationalities and Peoples (SNNP), 2.16% (95% CI, 1.57-2.75) in Amhara and 1.46% (95% CI, 0.69-2.23) in Oromia region. Being married (OR, 0.37 (95% CI, 0.12-0.91%)) was less likely to develop syphilis. On the other hand, women with history of multiple sexual partner (OR, 2.98 (95% CI, 1.15-7.70)) and women with history of previous sexually transmitted infection (STI) (OR, 4.88 (95% CI, 1.35-17.62)) have higher risk to develop syphilis. Besides, the pooled syphilis-HIV coinfection was 0.80% (95% CI, 0.60-1.01%). CONCLUSION This study provides evidence of relatively high prevalence of syphilis among pregnant women in Ethiopia. Therefore, it is recommended to further ramping up of current intervention measures to prevent future generations. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020211650.
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Affiliation(s)
- Habtamu Geremew
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Demeke Geremew
- Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, University of Gondar, P.o.Box: 196, Gondar, Ethiopia.
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Isara A, Baldeh AK. Prevalence of sexually transmitted infections among pregnant women attending antenatal clinics in West Coast Region of The Gambia. Afr Health Sci 2021; 21:585-592. [PMID: 34795711 PMCID: PMC8568222 DOI: 10.4314/ahs.v21i2.13] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Sexually Transmitted Infections (STI) are the second most common cause of healthy life years lost by women in the 15 - 44 years age group in Africa. AIM/OBJECTIVE To determine the prevalence of STIs among pregnant women attending antenatal care (ANC) clinics in the West Coast Region of The Gambia. MATERIALS AND METHODS Blood, urine, and high vaginal swabs samples from 280 pregnant women attending ANC in Brikama District Hospital, Brikama, and Bandung Maternity and Child Health Hospital, Bandung were examined. Serum samples were tested for HIV using western blot technique and for syphilis using the Venereal Disease Research Laboratory (VDRL) test, and rapid plasma regimen. Candida albicans, Group B Streptococcus and Neisseria gonorrhoea were identified using Analytical Profile Index (API). Direct urine microscopy was used to identify C. albicans and Trichomonas vaginalis while Chlamydia trachomatis was identified using Direct Fluorescent Antibody (DFA) test. RESULTS The overall prevalence of STIs was 53.6%. The pathogenic agents isolated were Candida albicans (31.8%), Streptococcus agalactiae (15.0%), Treponema pallidum (6.8%), HIV (5.7%), Trichomonas vaginalis (3.9%), Neisseria gonorrhoea (1.8%) and Chlamydia trachomatis (0.7%). STIs were more prevalent among women in the younger age group of 15 - 24 years (54.7%), unemployed (54.0%), Primipara (62.3%), and in the third trimester of pregnancy (72.7%). CONCLUSION A high prevalence of STIs was found among pregnant women attending ANC in the West Coast region of The Gambia. Public health intervention programmes should be strengthened to promote the sexual and reproductive health of pregnant women in The Gambia.
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Kapiga S, Hansen CH, Downs JA, Sichalwe S, Hashim R, Mngara J, van Dam GJ, Corstjens PLAM, Kingery JR, Peck RN, Grosskurth H. The burden of HIV, syphilis and schistosome infection and associated factors among adults in the fishing communities in northwestern Tanzania. Trop Med Int Health 2021; 26:204-213. [PMID: 33159819 DOI: 10.1111/tmi.13520] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To quantify the burden of HIV, syphilis and schistosome infection and associated risk factors among adults living in seven fishing communities of Lake Victoria in northwest Tanzania. METHODS Cross-sectional study conducted between 2015 and 2016 in the selected communities. In each community, we randomly selected a sample of adults from the general population and from three putative risk groups including the following: (i) fishermen, (ii) fish processors and traders, and (iii) women working in the recreational facilities. Participants were interviewed to obtain information about potential risk factors, and venous blood was collected for detection of HIV, syphilis and schistosome infections. We used logistic regression models to quantify the associations between potential risk factors and HIV, and also between schistosome infection and HIV. RESULTS We enrolled 1128 people from selected fishing communities. The overall prevalence of HIV, syphilis and schistosome infection was 14.2%, 15.6% and 83.1%, respectively. Female recreational facility workers had the highest prevalence of HIV (30.4%) and syphilis (24%). The odds of being HIV infected were generally higher in all age categories. Transactional sex was commonly reported and especially receiving gifts for sex was found to be strongly associated with HIV (adjusted OR = 2.50; 95% CI: 1.44-4.34, P = 0.008). Confirmed serological syphilis was associated with increased odds of having HIV infection. HIV was not associated with schistosome infection in a combined dataset and when we examined this separately for men and women alone. CONCLUSIONS We observed a high burden of HIV, syphilis and schistosome infections in the fishing communities. Targeted efforts to treat and control infections have the potential to improve health among their residents.
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Affiliation(s)
- Saidi Kapiga
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
- Department of Infectious Diseases Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Christian H Hansen
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK
| | - Jennifer A Downs
- Department of Medicine, Weill Bugando School of Medicine, Mwanza, Tanzania
- Center for Global Health, Weill Cornell Medicine, New York, NY, USA
| | - Simon Sichalwe
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
| | - Ramadhan Hashim
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
| | - Julius Mngara
- National Institute for Medical Research, Mwanza, Tanzania
| | - Govert J van Dam
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Paul L A M Corstjens
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, the Netherlands
| | - Justin R Kingery
- Department of Medicine, Weill Bugando School of Medicine, Mwanza, Tanzania
- Center for Global Health, Weill Cornell Medicine, New York, NY, USA
| | - Robert N Peck
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
- Department of Medicine, Weill Bugando School of Medicine, Mwanza, Tanzania
- Center for Global Health, Weill Cornell Medicine, New York, NY, USA
| | - Heiner Grosskurth
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
- MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK
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Rosser BRS, Mgopa L, Leshabari S, Ross MW, Lukumay GG, Massawe A, Mkonyi E, Mohammed I, Mushy S, Mwakawanga D, Trent M, Wadley J. Legal and Ethical Considerations in the Delivery of Sexual Health Care in Tanzania. AFRICAN JOURNAL OF HEALTH, NURSING AND MIDWIFERY 2020; 3:84-102. [PMID: 34723251 PMCID: PMC8553133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Tanzania is a country with multiple sexual health challenges including high rates of HIV/STIs, early sexual debut, forced sex, sexual dysfunction, and teen pregnancy. Training in sexual health care is limited, while courses on how to address the ethical aspects of sexual health are non-existent. To address this gap, this paper explores legal and ethical challenges to providing sexual health care in Tanzania. First, we describe the sexuo-cultural and epidemiologic challenges, and the key laws regulating sexual health. Six case studies identify ethical dilemmas in healthcare delivery. They are: (a) how to address sexual and intimate partner violence; (b) treatment of illegal or stigmatized key populations; (c) treatment of couples in HIV serodiscordant, non-monogamous, and/or polygamous relationships; (d) requests for and participation in illegal healthcare; (e) treatment of women and children in the presence of their husbands and fathers; and (f) addressing child sexual abuse. We apply the ethical principles of autonomy, justice, beneficence and non-malfeasance. A second challenge is ensuring confidentiality in a setting where medical record keeping practices vary widely, and violations to confidentiality are perceived as common. Finally, we identify a set of best practices in sexual healthcare delivery tailored to the Tanzanian context.
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Affiliation(s)
- B R Simon Rosser
- University of Minnesota, School of Public Health, 1300 S. 2 St. #300 Minneapolis, MN, USA
| | - Lucy Mgopa
- Muhimbili University of Health and Allied Sciences (MUHAS), School of Public Health and Social Sciences, PO Box 65015, Dar es Salaam, Tanzania
| | - Sebalda Leshabari
- Muhimbili University of Health and Allied Sciences (MUHAS), School of Public Health and Social Sciences, PO Box 65015, Dar es Salaam, Tanzania
| | - Michael W Ross
- University of Minnesota, School of Public Health, 1300 S. 2 St. #300 Minneapolis, MN, USA
| | - Gift Gadiel Lukumay
- Muhimbili University of Health and Allied Sciences (MUHAS), School of Public Health and Social Sciences, PO Box 65015, Dar es Salaam, Tanzania
| | - Agnes Massawe
- Muhimbili University of Health and Allied Sciences (MUHAS), School of Public Health and Social Sciences, PO Box 65015, Dar es Salaam, Tanzania
| | - Ever Mkonyi
- University of Minnesota, School of Public Health, 1300 S. 2 St. #300 Minneapolis, MN, USA
| | - Inari Mohammed
- University of Minnesota, School of Public Health, 1300 S. 2 St. #300 Minneapolis, MN, USA
| | - Stella Mushy
- Muhimbili University of Health and Allied Sciences (MUHAS), School of Public Health and Social Sciences, PO Box 65015, Dar es Salaam, Tanzania
| | - Dorkas Mwakawanga
- Muhimbili University of Health and Allied Sciences (MUHAS), School of Public Health and Social Sciences, PO Box 65015, Dar es Salaam, Tanzania
| | - Maria Trent
- Johns Hopkins Medicine, 615 N. Wolfe St., Baltimore, MD 21205, Washington, DC, USA
| | - James Wadley
- Lincoln University, School of Adult and Continuing Education, 1570 Baltimore Pike, Lincoln University, PA, USA
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Haule A, Msemwa B, Mgaya E, Masikini P, Kalluvya S. Prevalence of syphilis, neurosyphilis and associated factors in a cross-sectional analysis of HIV infected patients attending Bugando Medical Centre, Mwanza, Tanzania. BMC Public Health 2020; 20:1862. [PMID: 33276749 PMCID: PMC7718654 DOI: 10.1186/s12889-020-09984-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 11/26/2020] [Indexed: 12/02/2022] Open
Abstract
Background HIV-syphilis co-infection can enhance the rapid progression of early or late latent syphilis to neurosyphilis and can cause catastrophic neurological complications. In studies in Mwanza, syphilis affects ~ 8% of healthy outpatients and studies done in the 1990s have suggested that up to 23.5% of HIV-syphilis co-infected patients also have neurosyphilis. Methodology This was a cross sectional study in which adult HIV infected patients who were hospitalized or attending the outpatient Care and Treatment Clinic (CTC) were interviewed using a structured questionnaire and screened for syphilis using serum Treponema Pallidum Hemagglutination Assay (TPHA). Blood was also taken for CD4+ T cells and viral load. Those who were found to have syphilis underwent neurological examination for any neurologic deficit and were offered a lumbar puncture. Results The prevalence of syphilis in HIV infected patients was found to be 9.6%. The majority of patients were female (72.5%) and median age was 42 years [interquartile range, 32–50]. Most patients were on ART (99.4%). In the study population of 1748 participants, 9.6% were TPHA positive; the majority (89.2%) reported not knowing their syphilis status and not previously been treated. One hundred and forty-one participants with syphilis had neurological examinations performed. Four of these had abnormal findings that necessitated a lumbar puncture. Neurosyphilis was confirmed in one patient (0.7%). Conclusion The high prevalence of syphilis in HIV infected patients indicates that there is a need to increase efforts in targeting this population to reduce sexually transmitted infections. Screening for syphilis should be done for all HIV patients given the high prevalence of the infection and the risk that aggressive forms of neurosyphilis can occur despite recovery of CD4+ T cell counts in untreated syphilis.
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Affiliation(s)
- Adeodatus Haule
- Department of Medicine, Catholic University of Health and Allied Sciences Bugando, Mwanza, Tanzania.
| | - Betrand Msemwa
- Laboratory, Catholic University of Health and Allied Sciences Bugando, Mwanza, Tanzania
| | - Evarista Mgaya
- Department of Ophthalmology, Bugando Medical Centre, Mwanza, Tanzania
| | - Peter Masikini
- Department of Medicine, Catholic University of Health and Allied Sciences Bugando, Mwanza, Tanzania
| | - Samuel Kalluvya
- Department of Medicine, Catholic University of Health and Allied Sciences Bugando, Mwanza, Tanzania
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Sebastião CS, Neto Z, Jandondo D, Mirandela M, Morais J, Brito M. HIV, hepatitis B virus, hepatitis C virus, and syphilis among pregnant women attending antenatal care in Luanda, Angola: Seroprevalence and risk factors. J Med Virol 2020; 92:3265-3270. [PMID: 32515502 DOI: 10.1002/jmv.26148] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/20/2020] [Accepted: 06/07/2020] [Indexed: 01/17/2023]
Abstract
Infectious diseases during pregnancy remain a public health concern, especially in a resource-limited setting. The study aimed to determine the seroprevalence and determinants of HIV and co-infection with hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis among pregnant women attending antenatal care in Luanda, the capital city of Angola. A cross-sectional study was conducted with 1612 pregnant women screened for HIV during antenatal care. HIV-reactive were also screened for the HBV, HCV, and syphilis using immunoassay kits. A logistic regression model, adjusted odds ratios (AOR) and their 95% confidence interval (CI) were calculated with a level of significance set at 5%. The overall seroprevalence of HIV was 2.6%. About 13% of HIV-positive pregnant women were coinfected. From which, 7.5% were reactive to HBV and 5% to syphilis. There was no reactivity to HCV. Pregnant women younger aged than 25 years were significantly protected from HIV-infection (AOR, 0.43 [95% CI, 0.20-0.91], P = .026). The co-infection was 1.3 times (AOR, 0.04-41.0) in younger aged than 25 years, 7.0 times (AOR, 0.50-99.2) to residents in urbanized areas, and 1.4 times (AOR, 0.10-20.9) in pregnant women with a high educational level. In conclusion, infectious diseases are a public health burden among pregnant women in Luanda. However, include an integrated antenatal screening mainly in urbanized areas is crucial to reduce the spread of infectious diseases in different communities of Angola.
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Affiliation(s)
- Cruz S Sebastião
- Molecular Biology Laboratory, Instituto Nacional de Investigação em Saúde, Luanda, Angola
- Department of Laboratory, Centro de Investigação em Saúde de Angola, Luanda, Angola
- Instituto Superior de Ciências da Saúde, Universidade Agostinho Neto, Luanda, Angola
- Laboratory of Immunobiology and Pathogenesis of CEDOC, NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Zoraima Neto
- Molecular Biology Laboratory, Instituto Nacional de Investigação em Saúde, Luanda, Angola
| | - Domingos Jandondo
- Molecular Biology Laboratory, Instituto Nacional de Investigação em Saúde, Luanda, Angola
| | - Marinela Mirandela
- Molecular Biology Laboratory, Instituto Nacional de Investigação em Saúde, Luanda, Angola
| | - Joana Morais
- Molecular Biology Laboratory, Instituto Nacional de Investigação em Saúde, Luanda, Angola
- Department of Laboratory, Centro de Investigação em Saúde de Angola, Luanda, Angola
- Faculdade de Medicina, Universidade Agostinho Neto, Luanda, Angola
| | - Miguel Brito
- Department of Laboratory, Centro de Investigação em Saúde de Angola, Luanda, Angola
- Health and Technology Research Center, Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Lisboa, Portugal
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Mother's Knowledge on HIV, Syphilis, Rubella, and Associated Factors in Northern Tanzania: Implications for MTCT Elimination Strategies. Int J Pediatr 2020; 2020:7546954. [PMID: 32695189 PMCID: PMC7368220 DOI: 10.1155/2020/7546954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 05/05/2020] [Indexed: 11/17/2022] Open
Abstract
Background Infections transmitted from mother to child (MTCT) during pregnancy, childbirth, and breastfeeding contribute significantly to the high infant and childhood morbidity and mortality in sub-Saharan African countries. The most significant and preventable of these include HIV, syphilis, and rubella. To achieve elimination, mothers need to be aware of and to understand effective preventive measures against these infections. Lack of comprehensive knowledge on transmission and prevention of MTCT infections is one of the factors hindering achievement of the elimination goals for these infections. The aim of this study was to assess the knowledge of HIV, syphilis, rubella, and associated factors among mothers in the Kilimanjaro region of Tanzania. Methods We conducted a community-based cross-sectional study in three districts of the Kilimanjaro region from September to October 2016. The study involved mothers with children up to five years of age. Data collection involved the use of a questionnaire, administered by face-to-face interviews. Logistic regression analysis was used to assess predictors of mothers' knowledge on MTCT infections. Results A total of 618 mothers were recruited, with a mean age of 29.6 (SD 7.6) years. The overall knowledge on MTCT infections was low. The highest level of knowledge on MTCT infections was regarding HIV (89.2%). Fewer mothers had knowledge of syphilis (27.8%). Rubella was the least known; only 12% of mothers were aware of rubella infection. District of residence and having knowledge of syphilis were predictors for rubella knowledge, while for syphilis knowledge, significant predictors were age group, occupation, and those having knowledge on HIV and rubella. Predictors for HIV knowledge were residential district, having a mobile phone, and those having knowledge of syphilis and rubella. Conclusions This study confirmed that mothers have low overall knowledge on MTCT infections. To achieve the MTCT elimination goals, targeted interventions to improve knowledge among women of childbearing age are recommended.
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Weldesenbet H, Asrat D, Weldeamanuel Y. The prevalence and associated factors of Treponema pallidum among HIV-positive and HIV-negative individuals who attended voluntary counseling and testing center of St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia: A cross-sectional study design. SAGE Open Med 2020; 8:2050312120904604. [PMID: 32110402 PMCID: PMC7026812 DOI: 10.1177/2050312120904604] [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: 09/16/2018] [Accepted: 12/23/2019] [Indexed: 11/30/2022] Open
Abstract
Background: Treponema pallidum and HIV are among the most common public health problems in Ethiopia. These infections are interrelated. Treponema pallidum causes genital ulcer which enhances HIV transmission and complicates HIV by causing severe ulcer among HIV-positive individuals. Although Treponema pallidum and HIV have a similar route of transmission, screening services for Treponema pallidum are not available in most of the voluntary counseling and testing centers. Objectives: This study aimed to assess the seroprevalence of Treponema pallidum and sociodemographic factors among HIV-positive and HIV-negative individuals from the voluntary counseling and testing center of St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia. Methods: In this research, a cross-sectional study was conducted and a total of 292 consecutive samples were collected from the voluntary counseling and testing center of St. Paul’s Hospital Millennium Medical College. Data were collected using an interviewer-administered questionnaire. A blood specimen was tested for the presence of Treponema pallidum using rapid plasma reagin and a rapid test kit for HIV. The data were entered and analyzed using SPSS version 20. Results: The overall prevalence of Treponema pallidum was 5/292 (1.7%). All HIV-positive clients were negative for Treponema pallidum. None of the risk factors were significantly associated with Treponema pallidum. Conclusion: In this study, the prevalence of Treponema pallidum was 5/292 (1.7%). None of the study participants were co-infected with Treponema pallidum and HIV. Recommendation: There was a lack of association between syphilis and HIV in this study, but still the prevalence of Treponema pallidum among voluntary counseling and testing center clients is a public health problem. Therefore, Treponema pallidum infection control strategies should be designed in parallel with HIV control strategy and actions should be taken to avert the problem, including the provision of better health education and screening services at voluntary counseling and testing centers parallel with HIV.
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Affiliation(s)
- Habtamu Weldesenbet
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Daniel Asrat
- Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yimtubezinash Weldeamanuel
- Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Healthy Options: study protocol and baseline characteristics for a cluster randomized controlled trial of group psychotherapy for perinatal women living with HIV and depression in Tanzania. BMC Public Health 2020; 20:80. [PMID: 31959151 PMCID: PMC6971937 DOI: 10.1186/s12889-019-7907-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 11/07/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Perinatal women accessing prevention of mother-to-child transmission of HIV (PMTCT) services are at an increased risk of depression; however, in Tanzania there is limited access to services provided by mental health professionals. This paper presents a protocol and baseline characteristics for a study evaluating a psychosocial support group intervention facilitated by lay community-based health workers (CBHWs) for perinatal women living with HIV and depression in Dar es Salaam. METHODS A cluster randomized controlled trial (RCT) is conducted comparing: 1) a psychosocial support group intervention; and 2) improved standard of mental health care. The study is implemented in reproductive and child health (RCH) centers providing PMTCT services. Baseline characteristics are presented by comparing sociodemographic characteristics and primary as well as secondary outcomes for the trial for intervention and control groups. The trial is registered under clinicaltrials.gov (NCT02039973). RESULTS Among 742 women enrolled, baseline characteristics were comparable for intervention and control groups, although more women in the control group had completed secondary school (25.2% versus 18.2%). Overall, findings suggest that the population is highly vulnerable with over 45% demonstrating food insecurity and 17% reporting intimate partner violence in the past 6 months. CONCLUSIONS Baseline characteristics for the cluster RCT were comparable for intervention and control groups. The trial will examine the effectiveness of a psychosocial support group intervention for the treatment of depression among women living with HIV accessing PMTCT services. A reduction in the burden of depression in this vulnerable population has implications in the short-term for improved HIV-related outcomes and for potential long-term effects on child growth and development. TRIAL REGISTRATION The trial is registered under clinicaltrials.gov (NCT02039973). Retrospectively registered on January 20, 2014.
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Chotta NAS, Mgongo M, Msuya SE, Nyombi BM, Uriyo JG, Stray-Pedersen B, Stray-Pedersen A. Prevalence and factors associated with HIV and syphilis infection among children aged 0-36 months in Kilimanjaro, Tanzania: a community-based cross-sectional study. Trop Med Health 2019; 47:53. [PMID: 31832013 PMCID: PMC6868844 DOI: 10.1186/s41182-019-0183-4] [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: 07/10/2019] [Accepted: 10/07/2019] [Indexed: 11/16/2022] Open
Abstract
Background Childhood mortality is high in sub-Saharan Africa. Mother-to-child transmission (MTCT) of HIV and congenital syphilis are among significant causes. Dual elimination of these two infections is one of the international goals. Community-based studies on the burden of HIV and syphilis among children will contribute to fine-tuning the interventions to achieve the elimination goal. This study aims to describe the prevalence of HIV and syphilis among children aged 0–36 months and associated factors in northern Tanzania. Methods This was a community-based cross-sectional study, which was conducted in all the seven districts of Kilimanjaro region. Multistage sampling was used, and a total of 2452 children aged 0 to 36 months and their primary caretakers were enrolled. Interviews were conducted with the mother/caretaker, and dried blood samples were collected from the children and processed for laboratory diagnosis of HIV and syphilis. HIV ELISA was first performed on all the samples. Positive samples of children < 18 months were confirmed using PCR. Results The prevalence of HIV among 2452 children aged 0–36 months was 1.7% (n = 42). There was a significant difference in the distribution of HIV by age of the child, maternal antenatal attendance, and breastfeeding history. The prevalence of syphilis was 0.4% (n = 10). Five of the children were more than 1 year old. All children with a positive test for syphilis were from Moshi rural district, and their mothers consumed alcohol. No child was co-infected with HIV and syphilis. Conclusions Though the prevalence of the two infections was low, detecting syphilis in children suggests a missed opportunity in screening women during pregnancy. The region may be on track with the goal to achieve dual elimination of mother-to-child transmitted HIV and syphilis. However, efforts are needed to reduce missed opportunities for screening women for syphilis and HIV early in pregnancy and retesting at 3rd trimester/delivery. Strategies to improve testing for HIV-exposed children are needed.
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Affiliation(s)
- Nikolas A S Chotta
- 1Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Better Health for African Mothers and Children, P.O. Box 8418, Moshi, Tanzania
| | - Melina Mgongo
- 1Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Better Health for African Mothers and Children, P.O. Box 8418, Moshi, Tanzania
| | - Sia E Msuya
- Better Health for African Mothers and Children, P.O. Box 8418, Moshi, Tanzania.,3Department of Community Health, Institute of Public Health, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania.,4Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania
| | - Balthazar M Nyombi
- 5Department of Health Laboratory Sciences, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania
| | - Jacqueline G Uriyo
- 1Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,6Division of Women, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Babill Stray-Pedersen
- 1Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Better Health for African Mothers and Children, P.O. Box 8418, Moshi, Tanzania.,6Division of Women, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Arne Stray-Pedersen
- 7Department of Forensic Medicine, Institute of Public Health, University of Oslo, Oslo, Norway
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Depression and anxiety among pregnant women living with HIV in Kilimanjaro region, Tanzania. PLoS One 2019; 14:e0224515. [PMID: 31671160 PMCID: PMC6822761 DOI: 10.1371/journal.pone.0224515] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 10/15/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Mental health disorders in pregnant women living with HIV are associated with poor maternal and child outcomes, and undermine the global goals of prevention of mother-to-child transmission of HIV (PMTCT). This study aimed to determine prevalence of depression and anxiety and identify factors associated with these common mental health disorders among HIV-infeced pregnant women in Tanzania. METHODS We enrolled 200 pregnant women living with HIV from antenatal care clinics in the Kilimanjaro region. Women were eligible if they were in the second or third trimester of pregnancy and had been in PMTCT care for a minimum of one month. Data were collected via interviewer administered surveys. Participants self reported depression symptoms (Edinburgh Postnatal Depression Scale, EPDS) and anxiety symptoms (Brief Symptom Index, BSI). Multivariate logistic regression models examined factors associated with depression, anxiety, and comorbid depression and anxiety. RESULTS 25.0% of women met screening criteria for depression (EPDS ≥10). Depression was significantly associated with being single (aOR = 4.2, 95% CI = 1.1-15.5), food insecurity (aOR = 2.4, 95% CI = 1.0-6.4), and HIV shame (aOR = 1.2, 95% CI = 1.1-1.3). 23.5% of participants met screening criteria for anxiety (BSI ≥1.01). Anxiety was associated with being single (aOR = 3.6, 95%CI = 1.1-11.1), HIV shame (aOR = 1.1, 95% CI = 1.1-1.2) and lifetime experience of violence (aOR = 2.3, 95% CI = 1.0-5.1). 17.8% of the sample met screening criteria for both depression and anxiety. Comorbid depression and anxiety was associated with being single (aOR = 4.5, 95%CI = 1.0-19.1), HIV shame (aOR = 1.2, 95%CI = 1.1-1.3) and lifetime experience of violence (aOR = 3.4, 95% CI = 1.2-9.6). CONCLUSION Depression and anxiety symptomatology was common in this sample of pregnant women living with HIV, with a sizable number screening positive for comorbid depression and anxiety. In order to successfully engage women in PMTCT care and support their well-being, strategies to screen for mental health disorders and support women with mental illnesses are needed.
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Ng'wamkai G, Msigwa KV, Chengula D, Mgaya F, Chuma C, Msemwa B, Silago V, Majigo M, Mshana SE, Mirambo MM. Treponema pallidum infection predicts sexually transmitted viral infections (hepatitis B virus, herpes simplex virus-2, and human immunodeficiency virus) among pregnant women from rural areas of Mwanza region, Tanzania. BMC Pregnancy Childbirth 2019; 19:392. [PMID: 31664945 PMCID: PMC6820934 DOI: 10.1186/s12884-019-2567-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 10/22/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Sexually transmitted infections (STIs) is a global health problem with increased risk and morbidities during pregnancy. This study investigated the magnitude of viral STIs among pregnant women from three rural hospitals/clinics providing antenatal care in Mwanza region, Tanzania. METHODS Between February and May 2018, a total of 499 pregnant women were enrolled and tested for Human immunodeficiency virus (HIV), Herpes simplex virus-2 (HSV-2), Hepatitis B virus (HBV) and Hepatitis C virus (HCV) using rapid immunochromatographic tests and for syphilis using non-treponemal and treponemal antibody test. RESULTS The median age of enrolled women was 25 (IQR: 22-31) years. Seventy eight (15.6, 95% CI: 12-18) of women tested had at least one sexually transmitted viral infection. Specific prevalence of HIV, HBV, HCV, HSV-2 IgG and HSV-2 IgM were found to be 25(5.0%), 29(5.8%), 2(0.4%), 188(37.7%) and 24(4.8%), respectively. The odds of having viral infection was significantly high among women with positive T. pallidum serostatus (adjusted odd ratio (aOR): 3.24, 95%CI; 1.2-85). By multivariable logistic regression analysis, history of STIs predicted HSV-2 IgM seropositivity (aOR: 3.70, 95%CI: 1.43-9.62) while parity (aOR: 1.23, 95%CI: 1.04-1.46) predicted HBV infection and syphilis positive results (aOR: 8.63, 95%CI: 2.81-26.45) predicted HIV infection. CONCLUSION A significant proportion of pregnant women in rural areas of Mwanza region has at least one sexually transmitted viral infection which is independently predicted by positive T. pallidum serostatus. The strengthening and expansion of ANC screening package to include screening of STIs will ultimately reduce the viral STIs among pregnant women hence reduce associated morbidities and mortalities.
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Affiliation(s)
- Gilbert Ng'wamkai
- Department of Obstetrics and Gynecology, Bugando Medical Centre, P.O. Box 370, Mwanza, Tanzania
| | - Kalista V Msigwa
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Damas Chengula
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Frank Mgaya
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Clotilda Chuma
- Department of Obstetrics and Gynecology, Bugando Medical Centre, P.O. Box 370, Mwanza, Tanzania
| | - Betrand Msemwa
- Institute of Allied Health Sciences, Catholic University of Health and Allied sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Vitus Silago
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Mtebe Majigo
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Mariam M Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied sciences, P.O. Box 1464, Mwanza, Tanzania.
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Hussen S, Tadesse BT. Prevalence of Syphilis among Pregnant Women in Sub-Saharan Africa: A Systematic Review and Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2019; 2019:4562385. [PMID: 31392211 PMCID: PMC6662498 DOI: 10.1155/2019/4562385] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 06/20/2019] [Accepted: 06/27/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Syphilis is one of the most imperative STIs, caused by the spirochete Treponema pallidum. During pregnancy it is associated with disastrous health outcomes in the newborn. In sub-Saharan Africa, study findings on the prevalence of syphilis among pregnant women are highly dispersed and inconsistent. The aim of the current review is to conduct a systematic review and meta-analysis of syphilis in sub-Saharan Africa among pregnant women. DESIGN Systematic review and meta-analysis. DATA SOURCES Databases including MEDLINE, PubMed, Cochrane Library, Google Scholar, and HINARI and reference lists of previous prevalence studies were systematically searched for relevant literature from January 1999 to November 2018. Results were presented in forest plot, tables, and figures. Random-effects model was used for the meta-analysis. For the purpose of this review, a case of syphilis was defined as positive treponemal or nontreponemal tests among pregnant women. DATA EXTRACTION Our search gave a total of 262 citations from all searched databases. Of these, 44 studies fulfilling the inclusion criteria and comprising 175,546 subjects were finally included. RESULTS The pooled prevalence of syphilis among pregnant women in sub-Saharan Africa was 2.9% (95%CI: 2.4%-3.4%). East and Southern African regions had a higher syphilis prevalence among pregnant women (3.2%, 95% CI: 2.3%-4.2% and 3.6%, 95%CI: 2.0%-5.1%, respectively) than the sub-Saharan African pooled prevalence. The prevalence of syphilis among pregnant women in most parts of the region seemed to have decreased over the past 20 years except for the East African region. However, prevalence did not significantly differ by region and time period. CONCLUSION This review showed a high prevalence of syphilis in sub-Saharan Africa among pregnant women. The evidence suggests strengthening the screening program during pregnancy as part of the care package during antenatal care visits. Programs focusing on primary prevention of syphilis in women should also be strengthened.
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Affiliation(s)
- Siraj Hussen
- School of Laboratory Science, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Birkneh Tilahun Tadesse
- Department of Pediatrics and Child Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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Chotta NAS, Mgongo M, Uriyo JG, Msuya SE, Stray-Pedersen B, Stray-Pedersen A. Awareness and Factors Associated with Health Care Worker's Knowledge on Rubella Infection: A Study after the Introduction of Rubella Vaccine in Tanzania. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101676. [PMID: 31091685 PMCID: PMC6571888 DOI: 10.3390/ijerph16101676] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 05/11/2019] [Accepted: 05/12/2019] [Indexed: 11/16/2022]
Abstract
Background Congenital rubella syndrome is a global health problem. The incidence is much higher in Africa and Southeast Asia than the rest of the world, especially in countries where universal rubella vaccination has not been implemented. Healthcare worker's knowledge on rubella infection and the rubella vaccine is of utmost importance in achieving and maintaining vaccination coverage targets. This study aimed to assess health care workers knowledge on rubella infection in Kilimanjaro Tanzania, after the introduction of a rubella vaccination. Methods This was a health facility-based cross sectional study. It was conducted in three districts of the Kilimanjaro region between August and October 2016. The study involved eligible health care workers in selected health facilities. An interview guide was used for collecting information by face-to-face interviews. Multivariate analysis was used to assess factors associated with rubella knowledge among healthcare workers. Results A total of 126 health care workers were interviewed. An acceptable level of knowledge was considered if all five questions about rubella were correctly answered. Only 26.4% (n = 31) answered all questions correctly. In multivariate analysis education level and working department were predictors of rubella knowledge; health care workers with an advanced diploma had an adjusted odds ratio (AOR) of 7.7 (95% Confidence interval; CI: 1.4, 41.0), those with a university degree (AOR: 10; 95% CI: 2.4; 42.5) and health care workers in the outpatient department (AOR: 0.06; 95% CI: 0.04; 0.29). Conclusions Our study confirmed that health care worker's knowledge on rubella infection was low in the areas where rubella vaccination had been introduced. We recommend continuous education and supportive supervision post vaccine introduction in order to increase healthcare worker's knowledge on rubella infection, congenital rubella syndrome and prevention through sustained high vaccination coverage.
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Affiliation(s)
- Nikolas A S Chotta
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0863 Oslo, Norway.
| | - Melina Mgongo
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0863 Oslo, Norway.
- Better Health for African Mother and Child, P.O. Box 8418, Moshi, Tanzania.
| | - Jacqueline G Uriyo
- Better Health for African Mother and Child, P.O. Box 8418, Moshi, Tanzania.
| | - Sia E Msuya
- Better Health for African Mother and Child, P.O. Box 8418, Moshi, Tanzania.
- Department of Community Health, Institute of Public Health, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania.
- Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania.
| | - Babill Stray-Pedersen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0863 Oslo, Norway.
- Better Health for African Mother and Child, P.O. Box 8418, Moshi, Tanzania.
| | - Arne Stray-Pedersen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0863 Oslo, Norway.
- Department of Forensic Sciences, Oslo University Hospital, 0863 Oslo, Norway.
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Biadgo B, Hassen A, Getaneh M, Tesfa H, Jaleta KN, Eshetu T, Kasew D, Melku M. Syphilis and human immunodeficiency virus infections among pregnant women attending antenatal care clinic of Gondar family guidance association, Northwest Ethiopia: implication for prevention of mother to child transmission. Reprod Health 2019; 16:27. [PMID: 30832694 PMCID: PMC6399918 DOI: 10.1186/s12978-019-0691-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 02/20/2019] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Sexually transmitted infections constitute a major public health problem worldwide. Syphilis and HIV infections cause various adverse pregnancy outcomes. Therefore, the aim of this study was to determine the seroprevalence of HIV and syphilis infections among pregnant women at Gondar Family Guidance Association clinic, northwest Ethiopia. METHODS A retrospective study was conducted using sociodemographic and laboratory data obtained from registration books of Gondar Family Guidance Association clinic from January 2011 to April 2015. A binary logistic regression model was fit to identify factors associated with HIV and syphilis infections. Odds ratios with 95% confidence intervals were calculated to determine the strength of association between factors associated with HIV and syphilis infections. A p-value ≤0.05 was considered statistically significant. RESULTS A total of 3504 pregnant women were included in the study from January 2011 to April 2015. The seroprevalence of HIV, and syphilis were 145 (4.1%) and 66(1.9%), respectively. Twenty-three (0.66%) women were co-infected. Age group 20-29 years (AOR: 3.86; 95% CI: 1.36-10.89), age group ≥30 years (AOR: 6.08; 95% CI: 2.04-18.14) compared to age < 20 year, and HIV-infection (AOR: 14.6; 95% CI: 8.49-25.18) were significantly associated with syphilis infection. There was a decline in trend seroprevalence of HIV from 5.2% in 2011 to 2.1% in 2015; and decline in syphilis seroprevalence from 2.6% in 2011 to 1.6% in 2015 but not statistically significant. CONCLUSION The data showed that syphilis and HIV infections are still critical public health concerns among pregnant women. Screening of all pregnant women for these infections is valuable. Further community-based studies to identify risk factors are necessary.
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Affiliation(s)
- Belete Biadgo
- School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O Box 196, Gondar, Ethiopia
| | - Ahmed Hassen
- School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O Box 196, Gondar, Ethiopia
| | - Mekuriaw Getaneh
- School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O Box 196, Gondar, Ethiopia
| | - Habtie Tesfa
- School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O Box 196, Gondar, Ethiopia
| | - Kefyalew N. Jaleta
- School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O Box 196, Gondar, Ethiopia
| | - Tegegne Eshetu
- School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O Box 196, Gondar, Ethiopia
| | - Dessie Kasew
- School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O Box 196, Gondar, Ethiopia
| | - Mulugeta Melku
- School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O Box 196, Gondar, Ethiopia
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Geremew D, Tajebe F, Ambachew S, Endalamaw A, Eshetie S. Seroprevalence of HIV among pregnant women in Ethiopia: a systematic review and meta-analysis. BMC Res Notes 2018; 11:908. [PMID: 30567589 PMCID: PMC6299960 DOI: 10.1186/s13104-018-4022-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Accepted: 12/15/2018] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE This systematic review and meta-analysis aimed to determine the pooled prevalence of HIV among pregnant women in Ethiopia. RESULT PubMed, EMBASE, Science Direct and Google scholar databases were searched to retrieve 15 relevant articles based on the inclusion criteria. A total of 13,746 participants were included in the original studies and considered in this analysis. Among subjects, 717 were infected with HIV only, and 12 were HIV-HBV co-infected pregnant women. In this meta-analysis, the pooled prevalence of HIV among pregnant women in Ethiopia was 5.74% (95% CI 3.96-7.53%). Regional analysis showed that 9.50% (95% CI 7.76-11.23%) in Amhara, 4.80% (95% CI 3.12-6.49%) in Addis Ababa, 2.14% (95% CI - 0.54 to 4.82%) in SNNP and 4.48% (95% CI 2.56-6.41%) in Oromia region. Besides, six studies reported HIV-HBV co-infection and the pooled prevalence was 0.68% (95% CI 0.27-1.08%) among pregnant women in Ethiopia.
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Affiliation(s)
- Demeke Geremew
- Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, University of Gondar, P.o.Box: 196, Gondar, Ethiopia
| | - Fitsumbrhan Tajebe
- Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, University of Gondar, P.o.Box: 196, Gondar, Ethiopia
| | - Sintayehu Ambachew
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Aklilu Endalamaw
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Setegn Eshetie
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
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Guerra AB, Siravenha LQ, Laurentino RV, Feitosa RNM, Azevedo VN, Vallinoto ACR, Ishak R, Machado LFA. Seroprevalence of HIV, HTLV, CMV, HBV and rubella virus infections in pregnant adolescents who received care in the city of Belém, Pará, Northern Brazil. BMC Pregnancy Childbirth 2018; 18:169. [PMID: 29769062 PMCID: PMC5956583 DOI: 10.1186/s12884-018-1753-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 04/19/2018] [Indexed: 11/15/2022] Open
Abstract
Background Prenatal tests are important for prevention of vertical transmission of various infectious agents. The objective of this study was to describe the prevalence of human immunodeficiency virus (HIV), human T-lymphotropic virus (HTLV), hepatitis B virus (HBV), cytomegalovirus (CMV), rubella virus and vaccination coverage against HBV in pregnant adolescents who received care in the city of Belém, Pará, Brazil. Methods A cross-sectional study was performed with 324 pregnant adolescents from 2009 to 2010. After the interview and blood collection, the patients were screened for antibodies and/or antigens against HIV-1/2, HTLV-1/2, CMV, rubella virus and HBV. The epidemiological variables were demonstrated using descriptive statistics with the G, χ2 and Fisher exact tests. Results The mean age of the participants was 15.8 years, and the majority (65.4%) had less than 6 years of education. The mean age at first intercourse was 14.4 years, and 60.8% reported having a partner aged between 12 and 14 years. The prevalence of HIV infection was 0.3%, and of HTLV infection was 0.6%. Regarding HBV, 0.6% of the participants had acute infection, 9.9% had a previous infection, 16.7% had vaccine immunity and 72.8% were susceptible to infection. The presence of anti-HBs was greater in adolescent between 12 and 14 years old (28.8%) while the anti-HBc was greater in adolescent between 15 and 18 years old (10.3%). Most of the adolescents presented the IgG antibody to CMV (96.3%) and rubella (92.3%). None of the participants had acute rubella infection, and 2.2% had anti-CMV IgM. Conclusions This study is the first report of the seroepidemiology of infectious agents in a population of pregnant adolescents in the Northern region of Brazil. Most of the adolescents had low levels of education, were susceptible to HBV infection and had IgG antibodies to CMV and rubella virus. The prevalence of HBV, HIV and HTLV was similar to that reported in other regions of Brazil. However, the presence of these agents in this younger population reinforces the need for good prenatal follow-up and more comprehensive vaccination campaigns against HBV due to the large number of women susceptible to the virus.
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Affiliation(s)
- Aubaneide Batista Guerra
- Reference Unit Specialized in Maternal-Child and Adolescent Care, Belém, Pará, Brazil.,Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Augusto Correa 1, Guamá, 66, Belém, Pará, 075-110, Brazil.,Biology of Infectious and Parasitic Agents Graduate Program, Federal University of Pará, Belém, Pará, Brazil
| | - Leonardo Quintão Siravenha
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Augusto Correa 1, Guamá, 66, Belém, Pará, 075-110, Brazil.,Biology of Infectious and Parasitic Agents Graduate Program, Federal University of Pará, Belém, Pará, Brazil
| | - Rogério Valois Laurentino
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Augusto Correa 1, Guamá, 66, Belém, Pará, 075-110, Brazil.,Biology of Infectious and Parasitic Agents Graduate Program, Federal University of Pará, Belém, Pará, Brazil
| | - Rosimar Neris Martins Feitosa
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Augusto Correa 1, Guamá, 66, Belém, Pará, 075-110, Brazil
| | - Vânia Nakauth Azevedo
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Augusto Correa 1, Guamá, 66, Belém, Pará, 075-110, Brazil
| | - Antonio Carlos Rosário Vallinoto
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Augusto Correa 1, Guamá, 66, Belém, Pará, 075-110, Brazil.,Biology of Infectious and Parasitic Agents Graduate Program, Federal University of Pará, Belém, Pará, Brazil
| | - Ricardo Ishak
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Augusto Correa 1, Guamá, 66, Belém, Pará, 075-110, Brazil.,Biology of Infectious and Parasitic Agents Graduate Program, Federal University of Pará, Belém, Pará, Brazil
| | - Luiz Fernando Almeida Machado
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Augusto Correa 1, Guamá, 66, Belém, Pará, 075-110, Brazil. .,Biology of Infectious and Parasitic Agents Graduate Program, Federal University of Pará, Belém, Pará, Brazil.
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Amsalu A, Ferede G, Assegu D. High seroprevalence of syphilis infection among pregnant women in Yiregalem hospital southern Ethiopia. BMC Infect Dis 2018; 18:109. [PMID: 29510664 PMCID: PMC5840736 DOI: 10.1186/s12879-018-2998-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 02/16/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite availability of effective treatment and the implementation of focused antenatal care (ANC), still the prevalence of syphilis persists in Ethiopia. Yet, data is not found in southern Ethiopia. Therefore, this study was conducted to determine the seroprevalence and associated factors of syphilis among pregnant women in Yiregalem Hospital, Southern Ethiopia. METHODS A cross-sectional study was conducted among pregnant women from October 2015 to August 2016. Data on socio-demography and obstetric conditions of pregnant women were collected using a structured questionnaire. Serum samples were screened for syphilis using rapid plasma regain (RPR) test and those found seropositive were further confirmed by Treponema pallidum haemagglutination assay (TPHA) test following the manufacturer's instruction. HIV results were reviewed from records. The data were analyzed using SPSS version 20 software. RESULTS Of 494 pregnant women, 204(41.3%) were first ANC visit attenders. Of these, 123(60.3%) were after the 12th gestational week. Sero-prevalence of syphilis and HIV was found to be 5.1% (25/494; 95 CI, 3.2-7.1%) and 10.3% (51/494; 95 CI, 7.7-13.2%), respectively. The overall prevalence of syphilis and HIV co-infection was 2.2% (11/494). Women with HIV infection were significantly more likely to be syphilis-seropositive (AOR = 10.3, 95%CI, 4.213-25.185) than HIV negatives. CONCLUSIONS High seroprevalence of syphilis particularly among HIV positive women and late first ANC visit attenders in the study area calls for further ramping up of current intervention measures. Like integration of syphilis testing and treatment to the already established HIV prevention program and creating awareness about early ANC visit and follow-up.
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Affiliation(s)
- Anteneh Amsalu
- Department of Medical Microbiology, University of Gondar, P.O.Box 196, Gondar, Ethiopia
| | - Getachew Ferede
- Department of Medical Microbiology, University of Gondar, P.O.Box 196, Gondar, Ethiopia
| | - Demissie Assegu
- Department of Medical Laboratory Sciences, Hawassa University, Hawassa, Ethiopia
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Bull S, Thomas DS, Nyanza EC, Ngallaba SE. Tanzania Health Information Technology (T-HIT) System: Pilot Test of a Tablet-Based System to Improve Prevention of Mother-to-Child Transmission of HIV. JMIR Mhealth Uhealth 2018; 6:e16. [PMID: 29335236 PMCID: PMC5789159 DOI: 10.2196/mhealth.8513] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 11/01/2017] [Accepted: 11/16/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The prevention of mother-to-child transmission (PMTCT) of HIV requires innovative solutions. Although routine monitoring is effective in some areas, standardized and easy-to-scale solutions to identify and monitor pregnant women, test them for HIV, and treat them and their children is still lacking. Mobile health (mHealth) offers opportunities for surveillance and reporting in rural areas of low- and middle-income countries. OBJECTIVE The aim of this study was to document the preliminary impacts of the Tanzania Health Information Technology (T-HIT) system mHealth intervention aimed at health workers for PMTCT care delivery and capacity building in a rural area of Tanzania. METHODS We developed T-HIT as a tablet-based system for an electronic data collection system designed to capture and report PMTCT data during antenatal, delivery, and postnatal visits in Misungwi, Tanzania. T-HIT was tested by health workers in a pilot randomized trial comparing seven sites using T-HIT assigned at random to seven control sites; all sites maintained standard paper record-keeping during the pilot intervention period. We compared numbers of antenatal visits, number of HIV tests administered, and women testing positive across all sites. RESULTS Health workers recorded data from antenatal visits for 1530 women; of these, 695 (45.42%) were tested for HIV and 3.59% (55/1530) tested positive. Health workers were unable to conduct an HIV test for 103 women (6.73%, 103/1530) because of lack of reagent, which is not captured on paper logs. There was no difference in the activity level for testing when comparing sites T-HIT to non-T-HIT sites. We observed a significant postintervention increase in the numbers of women testing positive for HIV compared with the preintervention period (P=.04), but this was likely not attributable to the T-HIT system. CONCLUSIONS T-HIT had a high degree of acceptability and feasibility and is perceived as useful by health workers, who documented more antenatal visits during the pilot intervention compared with a traditional system of paper logs, suggesting potential for improvements in antenatal care for women at risk for HIV.
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Affiliation(s)
- Sheana Bull
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Deborah Sk Thomas
- Department of Geography & Environmental Sciences, University of Colorado Denver, Denver, CO, United States
| | - Elias C Nyanza
- School of Public Health, Catholic University of Health and Allied Sciences, Mwanza, United Republic Of Tanzania
| | - Sospatro E Ngallaba
- School of Public Health, Catholic University of Health and Allied Sciences, Mwanza, United Republic Of Tanzania
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Niama RF, Loukabou Bongolo NC, Bayonne Kombo ES, Yengo R, Mayengue PI, Mandingha Kosso EB, Louzolo I, Macosso L, Dzeret G, Dzabatou Babeaux ASP, Puruehnce MF, Parra HJ. Syphilis and HIV infections among pregnant women attending antenatal clinics in Republic of Congo. Pan Afr Med J 2017; 28:8. [PMID: 29138654 PMCID: PMC5681004 DOI: 10.11604/pamj.2017.28.8.13097] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Accepted: 07/16/2017] [Indexed: 11/29/2022] Open
Abstract
Introduction HIV and syphilis during pregnancy remain a public health concern especially in developing countries. Pregnant women attending antenatal clinics sites for the first time between September and December 2011 and who accepted to participate in the study were enrolled. The objective was to estimate the syphilis and HIV infection rate in this population. Methods A study was conducted in 44 selected ANCs from 12 departments (5 urban and 7 rural). Pregnant women who accepted to participate in the study, attending selected sentinel ANCs sites for the first time between September and December 2011 were enrolled. To detect HIV antibodies, two consecutive ELISA assays were used (Genscreen Ultra HIV Ag/Ac, (BioRad, France) and Enzygnostic Intergral II (Siemens, GMBH, Marbug-Germany). In case of discordant results, the Western blot test II, HIV1 and 2 (Bio-Rad, Marne la Coquette, France) was used as the reference method. The RPR (Bio-Scan, Karnataka, India) test was performed to detect syphilis infection. The RPR positive results were confirmed using the TPHA test (Biotech, Cambridge, UK). Data were analyzed using SPSS 17.0 software. Results A total of 2979 pregnant women attending ANCs were enrolled. The global HIV infection rate was estimated to be 3.6% (CI: 95%; 3.0-4.4). As expected, HIV prevalence was significantly higher in women aged above 25 years (4.4% (3.4-5.6), p = 0.026) and those attending urban ANCs (5.04%, p < 0.01). Also, women living in the urban area are more at risk to be infected (5.04 VS 2.38, p < 0.01). The RPR test was positive in 117 pregnant women (3.92%). The risk for syphilis occurrence was significantly higher among the single women compared to the married ones (4.4% VS 2.7%; p < 0.01). It was also estimated that the HIV and syphilis coinfection occurred in 22 cases (0.73%). Conclusion The prevalence's of syphilis and HIV were relatively low. Marital status and sentinel site location were a risk factor associated with HIV and syphilis infections respectively. Therefore, substantial effort is needed to reinforce prevention strategies in this population to prevent mother-to-child and further horizontal transmissions of these infections.
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Affiliation(s)
- Roch Fabien Niama
- Laboratoire National de Santé Publique, 120 avenue du Général Charles de Gaule, BP: 120 Brazzaville, Congo.,Faculté des Sciences et Techniques, Université Marien Ngouabi, Brazzaville, République du Congo
| | | | | | - Ruth Yengo
- Laboratoire National de Santé Publique, 120 avenue du Général Charles de Gaule, BP: 120 Brazzaville, Congo
| | - Pembe Issamou Mayengue
- Laboratoire National de Santé Publique, 120 avenue du Général Charles de Gaule, BP: 120 Brazzaville, Congo.,Faculté des Sciences et Techniques, Université Marien Ngouabi, Brazzaville, République du Congo
| | - Etoka-Beka Mandingha Kosso
- Laboratoire National de Santé Publique, 120 avenue du Général Charles de Gaule, BP: 120 Brazzaville, Congo
| | - Igor Louzolo
- Laboratoire National de Santé Publique, 120 avenue du Général Charles de Gaule, BP: 120 Brazzaville, Congo
| | - Lucette Macosso
- Laboratoire National de Santé Publique, 120 avenue du Général Charles de Gaule, BP: 120 Brazzaville, Congo
| | - Ghislain Dzeret
- Laboratoire National de Santé Publique, 120 avenue du Général Charles de Gaule, BP: 120 Brazzaville, Congo
| | | | - Marie-Francke Puruehnce
- Ministère de la Santé et de la Population, Programme National de Lutte Contre le Sida (PNLS), Brazzaville, Congo
| | - Henri Joseph Parra
- Laboratoire National de Santé Publique, 120 avenue du Général Charles de Gaule, BP: 120 Brazzaville, Congo
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Pereira GFM, Sabidó M, Caruso A, Benzaken AS. Transitioning from antenatal surveillance surveys to routine HIV testing: a turning point in the mother-to-child transmission prevention programme for HIV surveillance in Brazil. BMC Infect Dis 2017; 17:469. [PMID: 28679418 PMCID: PMC5499045 DOI: 10.1186/s12879-017-2540-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 06/09/2017] [Indexed: 11/29/2022] Open
Abstract
Background In Brazil, due to the rapid increase in programmes for the prevention of mother-to-child transmission (PMTCT), routine programme data are widely available. The objective of this study was to assess the utility of programmatic data to replace HIV surveillance based on the antenatal care (ANC) surveillance survey (SS). Methods We analysed ANC SS data from 219 maternity service clinics. PMTCT variables were extracted from the ANC SS data collection form, which allowed us to capture and compare the ANC SS data and PMTCT HIV test results for each pregnant woman who completed the ANC SS. Both the PMTCT programme and the ANC SS tested for HIV using sequential ELISA and western blot for confirmation. We assessed the completeness (% missing) of the PMTC data included in the ANC SS. Results Of the 36,713 pregnant women who had ANC SS HIV tests performed, 30,588 also underwent PMTCT HIV testing. The HIV prevalence rate from routine PMTCT testing was 0.36%, compared to 0.38% from the ANC SS testing (relative difference −0.05%; absolute difference −0.02%). The relative difference in prevalence rates between pregnant women in northern Brazil and pregnant women central-west Brazil was −0.98 and 0.66, respectively. Of the 29,856 women who had HIV test results from both the PMTCT and ANC SS, the positive percent agreement of the PMTCT versus the surveillance test was 84.1% (95% confidence interval [CI]: 74.8–91.0), and the negative percent agreement was 99.9% (95% CI: 99.9–100.0). The PMTCT HIV testing uptake was 86.4%. The ANC SS HIV prevalence was 0.33% among PMTCT non-refusers and 0.59% among refusers, with a percent bias of −10.80% and a differential prevalence ratio of 0.56. Syphilis and HIV testing results were complete in 98% and 97.6% of PMTCT reports, respectively. The reported HIV status for the women at clinic entry was missing. Conclusions Although there were consistent HIV prevalence estimates from the PMTCT data and the ANC SS, the overall positive percent agreement of 84.1% falls below the World Health Organization benchmark of 94.7%. Therefore, Brazil must continue to reinforce data collection practices and ensure the quality of recently introduced rapid HIV testing before replacing the PMTCT data with surveillance techniques. However, some regions with better results could be prioritized to pilot the use of PMTCT data for surveillance.
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Affiliation(s)
- Gerson Fernando Mendes Pereira
- Department of STI, AIDS and Viral Hepatitis, Secretary for Health Surveillance, Ministry of Health Brazil, SAF Sul, Trecho 02, Bloco F, Torre 1, Edifício Premium, Auditório, Brasília DF, CIE CEP 70070-600, Brazil.
| | - Meritxell Sabidó
- Department of STI, AIDS and Viral Hepatitis, Secretary for Health Surveillance, Ministry of Health Brazil, SAF Sul, Trecho 02, Bloco F, Torre 1, Edifício Premium, Auditório, Brasília DF, CIE CEP 70070-600, Brazil.,TransLab. Department of Medical Sciences, Universitat de Girona, Catalonia, Spain.,CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Alessandro Caruso
- Department of STI, AIDS and Viral Hepatitis, Secretary for Health Surveillance, Ministry of Health Brazil, SAF Sul, Trecho 02, Bloco F, Torre 1, Edifício Premium, Auditório, Brasília DF, CIE CEP 70070-600, Brazil
| | - Adele Schwartz Benzaken
- Department of STI, AIDS and Viral Hepatitis, Secretary for Health Surveillance, Ministry of Health Brazil, SAF Sul, Trecho 02, Bloco F, Torre 1, Edifício Premium, Auditório, Brasília DF, CIE CEP 70070-600, Brazil
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Manyahi J, Msigwa Y, Mhimbira F, Majigo M. High sero-prevalence of hepatitis B virus and human immunodeficiency virus infections among pregnant women attending antenatal clinic at Temeke municipal health facilities, Dar es Salaam, Tanzania: a cross sectional study. BMC Pregnancy Childbirth 2017; 17:109. [PMID: 28388879 PMCID: PMC5383970 DOI: 10.1186/s12884-017-1299-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 03/29/2017] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) and Human immunodeficiency virus (HIV) infection in pregnancy is associated with direct effect of pregnancy and potential viral transmission from mother to newborn. In Tanzania very little in known on prevalence of HBV infection and their associated factors among pregnant women in lower health facilities. The main objective of the study was to determine the prevalence of HBsAg, HIV and HBV-HIV co-infection among pregnant women attending antenatal clinics in Dar es Salaam. METHODS This cross sectional study was conducted in three Temeke municipal health-care facilities between May 2014 and June 2014. A total of 249 pregnant women attending antenatal clinic (ANC) were consecutively enrolled in the study. A data collection tool was used to extract socio-demographic characteristics from ANC card. Commercial ARCHITECT® ci4100™ was used to assess HBsAg status and liver function (Alanine amino-transferase (ALAT). HIV status was determined by anti-HIV antibody test. RESULTS Of 249 pregnant women enrolled the median age was 25 years (IQR 22-30) and most of them were married (72.4%). The overall prevalence of HBsAg and HIV were 8.03% (95% CI: 5.0-12.1%) and 17.2% (95% CI: 12.8-22.5%), respectively. HBV/HIV co-infection rate was 2.8% (95% CI; 1.3-5.4%). HBsAg positive rate was significantly high in women who were HIV positive (p < 0.05). Being employed /student were less associated with HBV infection (aOR 0.35, 95% CI 0.13-0.95). Only 3 (15%) of pregnant women with HBsAg positive had abnormal ALAT. CONCLUSIONS High prevalence of HBV and HIV infections among pregnant women were reported in this setting thus calls for the national expansion of the integration of prevention of mother-to-child transmission (PMTCT) services for HBV infection.
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Affiliation(s)
- Joel Manyahi
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
| | - Yohannes Msigwa
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Mtebe Majigo
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Sama CB, Feteh VF, Tindong M, Tanyi JT, Bihle NM, Angwafo FF. Prevalence of maternal HIV infection and knowledge on mother-to-child transmission of HIV and its prevention among antenatal care attendees in a rural area in northwest Cameroon. PLoS One 2017; 12:e0172102. [PMID: 28199373 PMCID: PMC5310783 DOI: 10.1371/journal.pone.0172102] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Accepted: 01/31/2017] [Indexed: 11/29/2022] Open
Abstract
Background In 2010, an estimated 141 new HIV infections occurred per day in Cameroon and reports suggest an upsurge of these rates by 2020 if current trends continue. Mother—to—child transmission (MTCT) of HIV is a major public health challenge, and maternal knowledge on HIV transmission during pregnancy and its prevention is important in curtailing paediatric HIV acquisition. Objectives We aimed at establishing the prevalence of maternal HIV infection as well as assessing knowledge on HIV, MTCT and prevention of MTCT (PMTCT) of HIV among pregnant women in a rural area of Cameroon. Methods This study was conducted in two phases: a 29 month retrospective analysis of 1866 deliveries within three rural health facilities in the Babessi sub—division, Northwest Cameroon and a 1 month prospective phase wherein 150 consenting pregnant women attending antenatal care (ANC) at the study centres were consecutively recruited. Results Overall, the prevalence of maternal HIV infection was 5.0% (100/2016). All (100%) of the interviewed pregnant women were aware of HIV infection and most (76.7%) had adequate knowledge on its routes of transmission. Meanwhile, only 79.3% (119/150) of them were aware of MTCT with slightly above a third (37.0%) having adequate knowledge on the periods of transmission. The proportions of women correctly stating: during pregnancy, during labour/delivery and during breastfeeding as possible periods of MTCT of HIV were 63.0%, 60.5% and 89.1% respectively. A majority (76.3%) of these women had inadequate knowledge on PMTCT of HIV. Conclusion The overall prevalence of maternal HIV warrants strengthening of current intervention strategies including scaling—up of PMTCT measures. Among others, intensification of HIV—related ANC services to improve the pregnant women’s awareness and knowledge on MTCT and its prevention are vital steps in curbing the growing burden of paediatric HIV.
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Affiliation(s)
- Carlson-Babila Sama
- Islamic Medicalized Health Centre, Babessi, Northwest Region, Cameroon
- Galactic Corps Research Group (GCRG), Buea, Southwest Region, Cameroon
- * E-mail:
| | - Vitalis F. Feteh
- Mboppi Baptist Hospital Douala, Douala, Cameroon
- Health and Human Development (2HD) Research Group, Douala, Cameroon
| | - Maxime Tindong
- Galactic Corps Research Group (GCRG), Buea, Southwest Region, Cameroon
- Health and Human Development (2HD) Research Group, Douala, Cameroon
- School of Public Health, Université Libre de Bruxelles, Bruxelles, Belgium
| | - John T. Tanyi
- Konye Sub–Divisional Hospital, Konye, Southwest Region, Cameroon
| | - Nestor Mbinkar Bihle
- Galactic Corps Research Group (GCRG), Buea, Southwest Region, Cameroon
- Babessi Sub–Divisional Hospital, Babessi, Northwest Region, Cameroon
| | - Fru F. Angwafo
- Gynaeco-Obstetric and Paediatric Hospital, Yaoundé, and Department of Surgery, University Teaching Hospital, Yaoundé, Cameroon
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Kamuhabwa AA, Gordian R, Mutagonda RF. Implementation of co-trimoxazole preventive therapy policy for malaria in HIV-infected pregnant women in the public health facilities in Tanzania. Drug Healthc Patient Saf 2016; 8:91-100. [PMID: 28008284 PMCID: PMC5167525 DOI: 10.2147/dhps.s119073] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background In 2011, Tanzania adopted a policy for provision of daily co-trimoxazole prophylaxis to HIV-infected pregnant women for prevention of malaria and other opportunistic infections. As per the policy, HIV-infected pregnant women should not be given sulfadoxine-pyrimethamine (SP) for intermittent preventive therapy. The challenges associated with this policy change and the extent to which the new policy for prevention of malaria in pregnant women coinfected with HIV was implemented need to be assessed. Aim To assess the implementation of malaria-preventive therapy policy among HIV-infected pregnant women in the public health facilities in Dar es Salaam, Tanzania. Methodology The study was conducted in Kinondoni Municipality, Dar es Salaam, Tanzania, from January 2015 to July 2015. Three hundred and fifty-three HIV-infected pregnant women who were attending antenatal clinics (ANCs) and using co-trimoxazole for prevention of malaria were interviewed. Twenty-six health care workers working at the ANCs were also interviewed regarding provision of co-trimoxazole prophylaxis to pregnant women. A knowledge scale was used to grade the level of knowledge of health care providers. Focus group discussions were also conducted with 18 health care workers to assess the level of implementation of the policy and the challenges encountered. Results Twenty-three (6.5%) pregnant women with known HIV serostatus were using co-trimoxazole for prevention of opportunistic infections even before they became pregnant. Out of the 353 HIV-infected pregnant women, eight (2.5%) were coadministered with both SP and co-trimoxazole. Sixty (16.7%) pregnant women had poor adherence to co-trimoxazole prophylaxis. Out of the 26 interviewed health care providers, 20 had high level of knowledge regarding malaria-preventive therapy in HIV-infected pregnant women. Lack of adequate supply of co-trimoxazole in health facilities and inadequate training of health care providers were among the factors causing poor implementation of co-trimoxazole prophylaxis for prevention of malaria in HIV-infected pregnant women. Conclusion There is a need to continue sensitization of pregnant women and communities about the importance of early attendance to the ANCs for testing of HIV and provision of co-trimoxazole prophylaxis. Availability of co-trimoxazole in the health facilities, regular training, and sensitization of health care providers are necessary for effective implementation of this policy.
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Affiliation(s)
- Appolinary Ar Kamuhabwa
- Department of Clinical Pharmacy and Pharmacology, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Richard Gordian
- Department of Clinical Pharmacy and Pharmacology, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Ritah F Mutagonda
- Department of Clinical Pharmacy and Pharmacology, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Arunda MO, Choudhry V, Ekman B, Asamoah BO. Under-five mortality and maternal HIV status in Tanzania: analysis of trends between 2003 and 2012 using AIDS Indicator Survey data. Glob Health Action 2016; 9:31676. [PMID: 27329937 PMCID: PMC4916291 DOI: 10.3402/gha.v9.31676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 05/04/2016] [Accepted: 05/24/2016] [Indexed: 12/25/2022] Open
Abstract
Background Mortality among children under five remains a significant health challenge across sub-Saharan Africa. HIV/AIDS is one of the leading contributors to the relatively slow decline in under-five mortality in this region. In Tanzania, HIV prevalence among under-five children is high and 90% of all infections are due to mother-to-child transmission. Objectives The study aimed to examine the association between maternal HIV-positive status and under-five mortality in Tanzania. It also aimed to estimate the proportions and trends of under-five mortality attributable to maternal HIV/AIDS in Tanzania between 2003 and 2012. Design Binomial logistic regression was used to analyze cross-sectional survey data from the Tanzania AIDS Indicator Surveys to examine the association between maternal HIV positivity and under-five mortality between 2003 and 2012. Results After controlling for confounders, the adjusted odds ratios were 1.5 (95% CI 1.1–1.9) in 2003–2004, 4.6 (95% CI 2.7–7.8) in 2007–2008, and 2.4 (95% CI 1.2–4.6) in 2011–2012. The maternal HIV-attributable mortality risk percent of under-five children was 3.7 percent in 2003–2004, 11.3 percent in 2007–2008 and 5.6% in 2011–2012. Conclusion Maternal HIV positivity is associated with under-five mortality in Tanzania, making maternal HIV serostatus a relevant determinant of whether a child will survive up to five years of age or not. The impact of maternal HIV/AIDS attributable mortality risk has a significant contribution to the overall under-five mortality in Tanzania. The continued monitoring of HIV and mortality trends is important for policy development and design of interventions.
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Affiliation(s)
- Malachi Ochieng Arunda
- International Master Programme in Public Health, Faculty of Medicine, Lund University, CRC, Jan Waldenströms gata 35, 205 02 Malmö, Sweden;
| | - Vikas Choudhry
- Social Medicine and Global Health, Department of Clinical Sciences, Malmo, Lund University, Sweden
| | - Björn Ekman
- Social Medicine and Global Health, Department of Clinical Sciences, Malmo, Lund University, Sweden
| | - Benedict Oppong Asamoah
- Social Medicine and Global Health, Department of Clinical Sciences, Malmo, Lund University, Sweden
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Ghoma-Linguissi LS, Ebourombi DF, Sidibe A, Kivouele TS, Vouvoungui JC, Poulain P, Ntoumi F. Factors influencing acceptability of voluntary HIV testing among pregnant women in Gamboma, Republic of Congo. BMC Res Notes 2015; 8:652. [PMID: 26545975 PMCID: PMC4635544 DOI: 10.1186/s13104-015-1651-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Accepted: 10/29/2015] [Indexed: 11/24/2022] Open
Abstract
Background This study was carried out to identify factors affecting the acceptability of voluntary HIV testing among pregnant women in a semi-rural city, Gamboma, Republic of Congo. Methods A cross-sectional study was conducted between January and September 2012. Pregnant women attending antenatal heath care at an integrated health center were enrolled after informed consent and followed through voluntary HIV testing. Results Among 136 participants, 98 women (72 %) accepted voluntary HIV testing after pre-test counseling. Women with basic education, those who cited blood transfusion as a mode of transmission and prevention of mother-to-child transmission (MTCT) were more likely to accept testing as well those informed about free HIV testing. Interestingly, pregnant women who had heard about HIV/AIDS from hospital setting were less likely to accept testing. Conclusions Our data indicate that increasing general education on HIV transmission/prevention modes is crucial for increasing acceptability of screening. Furthermore, HIV/AIDS knowledge disseminated to patients in hospital settings should be carefully monitored. Lastly, scaling-up MTCT services along with a better and larger community information, may address accessibility barriers observed in the present study.
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Affiliation(s)
| | - Dagene Fruinovy Ebourombi
- Fondation Congolaise pour la Recherche Médicale, Cité OMS, villa D6, Djoué, Brazzaville, Republic of Congo.
| | - Anissa Sidibe
- Fondation Congolaise pour la Recherche Médicale, Cité OMS, villa D6, Djoué, Brazzaville, Republic of Congo.
| | - Thomas Serge Kivouele
- Fondation Congolaise pour la Recherche Médicale, Cité OMS, villa D6, Djoué, Brazzaville, Republic of Congo.
| | - Jeannhey Christevy Vouvoungui
- Fondation Congolaise pour la Recherche Médicale, Cité OMS, villa D6, Djoué, Brazzaville, Republic of Congo. .,Faculty of Sciences and Techniques, Marien Ngouabi University, Brazzaville, Republic of Congo.
| | - Pierre Poulain
- Fondation Congolaise pour la Recherche Médicale, Cité OMS, villa D6, Djoué, Brazzaville, Republic of Congo.
| | - Francine Ntoumi
- Fondation Congolaise pour la Recherche Médicale, Cité OMS, villa D6, Djoué, Brazzaville, Republic of Congo. .,Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Republic of Congo. .,Faculty of Sciences and Techniques, Marien Ngouabi University, Brazzaville, Republic of Congo. .,Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany.
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Oyeyemi OT, Fadipe O, Oyeyemi IT. Trichomonas vaginalis infection in Nigerian pregnant women and risk factors associated with sexually transmitted infections. Int J STD AIDS 2015; 27:1187-1193. [PMID: 26438604 DOI: 10.1177/0956462415611292] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 09/21/2015] [Indexed: 11/15/2022]
Abstract
Trichomoniasis poses a public health threat to pregnant women and neonatal health. This study evaluated Trichomonas vaginalis and other common sexually transmitted infections (STIs) status in pregnant women, and risk factors associated with them. The study was cross-sectional and descriptive and a total of 198 pregnant women were recruited for T. vaginalis screening by microscopic examination. Questionnaires were also administered to 108 pregnant women to access information related to socio-demography and other factors associated with STI transmission. The overall prevalence of T. vaginalis was 18.7%. While prevalence of T. vaginalis was neither age nor parity dependent (p > 0.05), women in their first trimester showed significantly higher prevalence of trichomoniasis compared to women in their second and third trimesters (p < 0.05). The frequency of STIs was lowest (18.2%) and highest (71.4%) in age groups ≥ 39 and 15-20 years, respectively. Low levels of education, multiple sexual partners, lack of knowledge on partners' STI history, and having sex under the influence of alcohol or drugs were risk factors of for STIs (p < 0.05). We found a high prevalence of T. vaginalis in pregnant women, with those at an early gestational age at greater risk. The improved education of women on safe sex and the need to know partners' STI status are advocated.
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Affiliation(s)
- Oyetunde T Oyeyemi
- Department of Biosciences and Biotechnology, Babcock University, Ilishan-Remo, Ogun State, Nigeria
| | - Olamide Fadipe
- Department of Biosciences and Biotechnology, Babcock University, Ilishan-Remo, Ogun State, Nigeria
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