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Kanagasabai U, Valleau C, Cain M, Chevalier MS, Hegle J, Patel P, Benevides R, Trika JB, Angumua C, Mpingulu M, Ferdinand K, Sida F, Galloway K, Kambona C, Oluoch P, Msungama W, Katengeza H, Correia D, Duffy M, Cossa RMV, Coomer R, Ayo A, Ukanwa C, Tuyishime E, Dladla S, Drummond J, Magesa D, Kitalile J, Apondi R, Okuku J, Chisenga T, Cham HJ. Understanding Gender-Based Violence Service Delivery in CDC-Supported Health Facilities: 15 Sub-Saharan African Countries, 2017-2021. AIDS Educ Prev 2023; 35:39-51. [PMID: 37406144 DOI: 10.1521/aeap.2023.35.suppa.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
Gender-based violence (GBV) is a complex issue deeply rooted in social structures, making its eradication challenging. GBV increases the risk of HIV transmission and is a barrier to HIV testing, care, and treatment. Quality clinical services for GBV, which includes the provision of HIV postexposure prophylaxis (PEP), vary, and service delivery data are lacking. We describe GBV clinical service delivery in 15 countries supported by the President's Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Centers for Disease Control and Prevention. Through a descriptive statistical analysis of PEPFAR Monitoring, Evaluation, and Reporting (MER) data, we found a 252% increase in individuals receiving GBV clinical services, from 158,691 in 2017 to 558,251 in 2021. PEP completion was lowest (15%) among 15-19-year-olds. Understanding GBV service delivery is important for policy makers, program managers, and providers to guide interventions to improve the quality of service delivery and contribute to HIV epidemic control.
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Affiliation(s)
- Udhayashankar Kanagasabai
- Division of Global HIV and TB, Center for Global Health (CGH), U.S. Centers for Disease Control and Prevention (CDC), Atlanta Georgia
| | | | - Meagan Cain
- Division of Global HIV and TB, Center for Global Health (CGH), U.S. Centers for Disease Control and Prevention (CDC), Atlanta Georgia
| | - Michelle S Chevalier
- Division of Global HIV and TB, Center for Global Health (CGH), U.S. Centers for Disease Control and Prevention (CDC), Atlanta Georgia
| | - Jennifer Hegle
- Division of Global HIV and TB, Center for Global Health (CGH), U.S. Centers for Disease Control and Prevention (CDC), Atlanta Georgia
| | - Pragna Patel
- Division of Global HIV and TB, Center for Global Health (CGH), U.S. Centers for Disease Control and Prevention (CDC), Atlanta Georgia
| | - Regina Benevides
- Division of Global HIV and TB, Center for Global Health (CGH), U.S. Centers for Disease Control and Prevention (CDC), Atlanta Georgia
| | - Joseph B Trika
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Carrine Angumua
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Minlangu Mpingulu
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Kamanga Ferdinand
- The following authors are affiliated with their respective country's Ministry of Health: Kamanga Ferdinand (Democratic Republic of Congo), Hans Katengeza (Malawi), Raquel Maria Violeta Cossa (Mozambique), Chioma Ukanwa (Nigeria), and Tina Chisenga (Zambia)
| | - Fikirte Sida
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Katelyn Galloway
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Caroline Kambona
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Patricia Oluoch
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Wezi Msungama
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Hans Katengeza
- The following authors are affiliated with their respective country's Ministry of Health: Kamanga Ferdinand (Democratic Republic of Congo), Hans Katengeza (Malawi), Raquel Maria Violeta Cossa (Mozambique), Chioma Ukanwa (Nigeria), and Tina Chisenga (Zambia)
| | - Della Correia
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Meghan Duffy
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Raquel Maria Violeta Cossa
- The following authors are affiliated with their respective country's Ministry of Health: Kamanga Ferdinand (Democratic Republic of Congo), Hans Katengeza (Malawi), Raquel Maria Violeta Cossa (Mozambique), Chioma Ukanwa (Nigeria), and Tina Chisenga (Zambia)
| | - Rachel Coomer
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Adeola Ayo
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Chioma Ukanwa
- The following authors are affiliated with their respective country's Ministry of Health: Kamanga Ferdinand (Democratic Republic of Congo), Hans Katengeza (Malawi), Raquel Maria Violeta Cossa (Mozambique), Chioma Ukanwa (Nigeria), and Tina Chisenga (Zambia)
| | - Elysee Tuyishime
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Sibongile Dladla
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Jennifer Drummond
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Daniel Magesa
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Jane Kitalile
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Rose Apondi
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Jackson Okuku
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Tina Chisenga
- The following authors are affiliated with their respective country's Ministry of Health: Kamanga Ferdinand (Democratic Republic of Congo), Hans Katengeza (Malawi), Raquel Maria Violeta Cossa (Mozambique), Chioma Ukanwa (Nigeria), and Tina Chisenga (Zambia)
| | - Haddi J Cham
- Division of Global HIV and TB, Center for Global Health (CGH), U.S. Centers for Disease Control and Prevention (CDC), Atlanta Georgia
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Kanagasabai U, Aholou T, Chevalier MS, Tobias JL, Okuku J, Shiraishi RW, Sheneberger R, Pande YC, Chifuwe C, Mamane LE, Njika G, Obongo C, Thorsen VC. Reaching Youth Through Faith Leaders: Evaluation of the Faith Matters! Initiative. AIDS Educ Prev 2023; 35:82-99. [PMID: 37406142 DOI: 10.1521/aeap.2023.35.suppa.82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
Faith leaders can be uniquely positioned to guide and support young people on health issues, particularly HIV/AIDS and sexual violence. Faith Matters!, a 2-day training workshop for faith leaders, was delivered in September 2021 in Zambia. Sixty-six faith leaders completed a questionnaire at baseline, 64 at posttraining, and 59 at 3-month follow-up. Participants' knowledge, beliefs, and comfort communicating about HIV/AIDS and sexual violence were assessed. More faith leaders accurately identified common places where sexual violence occurs at the 3-month point compared to baseline: at church (2 vs. 22, p = .000), the fields (16 vs. 29, p = .004), parties (22 vs. 36, p = .001), and clubs (24 vs. 35, p = .034). More faith leaders stated that they engaged in conversations that supported people living with HIV (48 at baseline vs. 53, p = .049 at 3-month follow-up). These findings can inform future HIV/AIDS initiatives focusing on increasing the capacity among communities of faith.
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Affiliation(s)
- Udhayashankar Kanagasabai
- Division of Global HIV and Tuberculosis (TB), Center for Global Health (CGH), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Tiffiany Aholou
- Division of Global HIV and Tuberculosis (TB), Center for Global Health (CGH), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Michelle S Chevalier
- Division of Global HIV and Tuberculosis (TB), Center for Global Health (CGH), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - James L Tobias
- Division of Global HIV and Tuberculosis (TB), Center for Global Health (CGH), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Jackson Okuku
- Division of Global HIV & TB, CGH, CDC, Lusaka, Zambia
| | - Ray W Shiraishi
- Division of Global HIV and Tuberculosis (TB), Center for Global Health (CGH), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | | | | | - Clifton Chifuwe
- Executive Director and Global Master Trainer at the Centre for Peace Research and Advocacy, Zambia
| | - Lauren Erickson Mamane
- Division of Global HIV and Tuberculosis (TB), Center for Global Health (CGH), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
- Office of the Director, CGH, CDC, Atlanta, Georgia
| | | | - Chris Obongo
- Regional Measurement Specialist and Global Master Trainer at PATH, Kenya
| | - Viva C Thorsen
- Division of Global HIV and Tuberculosis (TB), Center for Global Health (CGH), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
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Abadan SS, Hawryluk L, Montandon M, Flowers N, Schueller J, Eakle R, Patel P, Chevalier MS, Rana S, Amzel A. Preexposure Prophylaxis Among Pregnant and Lactating People in 18 PEPFAR-Supported Countries: A Review of HIV Strategies and Guidelines. Glob Health Sci Pract 2022; 10:e2200129. [PMID: 36951281 PMCID: PMC9771465 DOI: 10.9745/ghsp-d-22-00129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 10/25/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Pregnant and lactating people (PLP) experience heightened risk of acquiring HIV, which adversely impacts their health and increases the risk for vertical HIV transmission. Preexposure prophylaxis (PrEP), as part of a combination prevention package, including condoms, sexually transmitted infection prevention, and regular HIV testing, is a safe, efficacious method to prevent HIV infections among PLP and their infants. This article examines the evolution of strategies and guidance on PrEP services for PLP from 18 countries supported by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR). METHODS The 18 countries implement PEPFAR-supported prevention of vertical transmission of HIV and PrEP programs. We reviewed a total of 18 national HIV strategic plans, 28 national HIV guidelines, and 54 PEPFAR country operational plans (COPs) published in 2013-2020. We compared documents from 2013 to 2017 to those from 2017 to 2020 to assess for differences after the release of the 2017 World Health Organization recommendations supporting the use of PrEP by PLP at substantial risk of acquiring HIV. RESULTS National HIV guidelines and PEPFAR COPs that endorsed PrEP for PLP through any categorization increased from 41% to 73% and 11% to 83%, respectively, in the pre-2017 and post-2017 periods. While many documents approved PrEP but not specifically for PLP (10 national strategic plans, 6 national guidelines, and 28 COPs), none of the documents explicitly prohibited PrEP for PLP. CONCLUSION National HIV guidelines and PEPFAR COPs expanded inclusion of PLP in PrEP eligibility when comparing the pre-2017 and the post-2017 groups. However, policy gaps remain as only 36% (4/11) of the post-2017 national HIV guidelines included PLP as a specific priority population for PrEP. Inclusive national HIV strategic plans and guidelines on PrEP for PLP, together with effective program implementation, remain critical for reducing new infections in PLP and eliminating vertical transmission of HIV.
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Affiliation(s)
| | - Liz Hawryluk
- U.S. Agency for International Development, Washington, DC, USA
| | | | - Nicole Flowers
- U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jane Schueller
- U.S. Agency for International Development, Washington, DC, USA
| | - Robyn Eakle
- U.S. Agency for International Development, Washington, DC, USA
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Pragna Patel
- U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Sangeeta Rana
- U.S. Agency for International Development, Washington, DC, USA
| | - Anouk Amzel
- U.S. Agency for International Development, Washington, DC, USA.
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Kanagasabai U, Selenic D, Chevalier MS, Drammeh B, Qualls M, Shiraishi RW, Bock N, Benech I, Mili FD. Evaluation of the WHO global database on blood safety. Vox Sang 2020; 116:197-206. [PMID: 32996609 DOI: 10.1111/vox.13001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 08/11/2020] [Accepted: 08/20/2020] [Indexed: 01/29/2023]
Abstract
OBJECTIVE While the Global Database on Blood Safety (GDBS) helps to monitor the status of adequate and safe blood availability, its presence alone does not serve as a solution to existing challenges. The objective of this evaluation was to determine the GDBS usefulness in improving the availability of adequate safe blood and its ability to function as a surveillance system. METHODS The GDBS was evaluated using methods set out by the Centers for Disease Control and Prevention (CDC) Guidelines for assessing surveillance systems. Six recommended tasks were used to evaluate if the GDBS met the requirements of a surveillance system in a public health context. RESULTS The majority of stakeholders engaged with GDBS found it was unique and useful. The GDBS answered all six questions essential for determining a blood safety surveillance system's usefulness. The GDBS fully met the needs to six of the eleven attributes used for evaluating the usefulness of a surveillance system. CONCLUSION The GDBS is a unique global activity that provides vital data on safety of blood transfusion services across countries and regions. However, aspects of the GDBS such as timeliness of reporting and improvement of WHO Member States national blood information systems could enhance its effectiveness and potential to serve as a global surveillance system for blood safety.
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Affiliation(s)
- Udhayashankar Kanagasabai
- Epidemic Intelligence Service, CDC, Atlanta, GA, USA.,Division of Global HIV/AIDS and Tuberculosis, Center for Global Health, CDC, Atlanta, GA, USA
| | - Dejana Selenic
- Division of Global HIV/AIDS and Tuberculosis, Center for Global Health, CDC, Atlanta, GA, USA
| | - Michelle S Chevalier
- Division of Global HIV/AIDS and Tuberculosis, Center for Global Health, CDC, Atlanta, GA, USA
| | - Bakary Drammeh
- Division of Global HIV/AIDS and Tuberculosis, Center for Global Health, CDC, Atlanta, GA, USA
| | - Michael Qualls
- Division of Global HIV/AIDS and Tuberculosis, Center for Global Health, CDC, Atlanta, GA, USA
| | - Ray W Shiraishi
- Division of Global HIV/AIDS and Tuberculosis, Center for Global Health, CDC, Atlanta, GA, USA
| | - Naomi Bock
- Division of Global HIV/AIDS and Tuberculosis, Center for Global Health, CDC, Atlanta, GA, USA
| | - Irene Benech
- Division of Global HIV/AIDS and Tuberculosis, Center for Global Health, CDC, Atlanta, GA, USA
| | - Fatima D Mili
- Division of Global HIV/AIDS and Tuberculosis, Center for Global Health, CDC, Atlanta, GA, USA
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Kanagasabai U, Chevalier MS, Drammeh B, Mili FD, Qualls ML, Bock N, Benech I, Nelson LJ, Alemnji G, Watts DH, Kimani D, Selenic D. Trends and Gaps in National Blood Transfusion Services - 14 Sub-Saharan African Countries, 2014-2016. MMWR Morb Mortal Wkly Rep 2018; 67:1392-1396. [PMID: 30571674 PMCID: PMC6342551 DOI: 10.15585/mmwr.mm6750a4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Ensuring availability of safe blood products through recruitment of voluntary, nonremunerated, blood donors (VNRDs) and prevention of transfusion-transmissible infections (TTIs), including human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis, is important for public health (1,2). During 2004-2016, the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) provided approximately $468 million in financial support and technical assistance* to 14 sub-Saharan African countries† with high HIV prevalence to strengthen national blood transfusion services (NBTSs)§ and improve blood safety and availability. CDC analyzed these countries' 2014-2016 blood safety surveillance data to update previous reports (1,2) and summarize achievements and programmatic gaps as some NBTSs begin to transition funding and technical support from PEPFAR to local ministries of health (MOHs) (2,3). Despite a 60% increase in blood supply since 2004 and steady declines in HIV prevalence (to <1% among blood donors in seven of the 14 countries), HIV prevalence among blood donors still remains higher than that recommended by the World Health Organization (WHO) (4). PEPFAR support has contributed to significant reductions in HIV prevalence among blood donors in the majority of PEPFAR-supported countries, and linking donors who screen HIV-positive to confirmatory testing and indicated treatment, as well as further reducing TTIs, remains a public health priority (5).
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Jean Baptiste AE, Chevalier MS, Polo E, Noel E, Hulland EN, Archer WR. Trends in hepatitis B and hepatitis C seroprevalence among blood donors - Haiti, 2005-2014. ACTA ACUST UNITED AC 2018; 13:150-157. [PMID: 30613210 DOI: 10.1111/voxs.12427] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background and Objectives Data on the seroprevalence of viral hepatitis are limited in Haiti; consequently, the epidemiology is poorly described. This study aims to provide a descriptive analysis of hepatitis B virus (HBV) and hepatitis C virus (HCV) seroprevalence of blood donations in Haiti. Materials and Methods Using Haiti's National Blood Safety Program and Haitian Red Cross reports from 2005 to 2014, we analysed the results of screening tests of donor serum samples to assess HBV and HCV seroprevalence among adults aged 17 to 65 years. Results A total of 198 758 donor samples were screened from 2005 to 2014, of which 0·56% were positive for antibody to hepatitis C virus (anti-HCV) and 3·80% were positive for hepatitis B surface antigen. Over the 10-year study period, anti-HCV seroprevalence among blood donors increased by 31% from 0.66% to 0.86% (95% CI: 1·01-1·70); however, this trend was not uniform over time, with a significant decrease from 0·66% in 2005 to 0·39% in 2009 (95% CI: 0·43- 0·82) and 0·43% in 2012 (95% CI: 0·50-0·90). Conversely, HBV decreased significantly by 13% from 3·95% in 2005 to 3·42% in 2014 (95% CI: 0·77-0·97), a trend that was also observed in 2012 and 2013. Conclusion The significant, uniform decrease in HBV seroprevalence in more recent years may represent the positive impact of public health interventions in preventing the transmission of blood-borne infections. More research is needed to understand why the trends in HCV transmission are non-uniform and to investigate the significant increase in more recent years.
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Affiliation(s)
- A E Jean Baptiste
- Division of Global HIV/AIDS and TB (DGHT), Center for Global Health (CGH), Centers for Disease Control and Prevention (CDC), Port-au-Prince, Haϊti
| | | | - E Polo
- National Blood Safety Program, Ministry of Public Health and Population, Port-au-Prince, Haϊti
| | - E Noel
- National Blood Safety Program, Ministry of Public Health and Population, Port-au-Prince, Haϊti
| | - E N Hulland
- Division of Global Health Protection, CGH, CDC, Atlanta, GA, USA
| | - W R Archer
- Global Immunization Division, CGH, CDC, Atlanta, GA, USA
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Chevalier MS, Biggerstaff BJ, Basavaraju SV, Ocfemia MCB, Alsina JO, Climent-Peris C, Moseley RR, Chung KW, Rivera-García B, Bello-Pagán M, Pate LL, Galel SA, Williamson P, Kuehnert MJ. Use of Blood Donor Screening Data to Estimate Zika Virus Incidence, Puerto Rico, April-August 2016. Emerg Infect Dis 2017; 23:790-795. [PMID: 28263141 PMCID: PMC5403024 DOI: 10.3201/eid2305.161873] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Puerto Rico has been heavily impacted by Zika virus, a mosquitoborne flavivirus that emerged in the Americas during 2015. Although most persons with Zika virus show no symptoms, the virus can cause neurologic and other complications, including fetal microcephaly. Local Zika virus transmission in Puerto Rico has been reported since December 2015. To prevent transfusion-associated transmission, local blood collection ceased in March 2016 but resumed in April 2016 after Zika virus screening of blood donations became available. Using data from screening of blood donations collected by the 2 largest blood centers in Puerto Rico during April 3-August 12, 2016, and assuming a 9.9-day duration of viremia, we estimated that 469,321 persons in Puerto Rico were infected during this period, for an estimated cumulative incidence of 12.9%. Results from blood donation screening during arboviral outbreaks can supplement routine clinical and surveillance data for improved targeting of prevention efforts.
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Chevalier MS, King CC, Ellington S, Wiener J, Kayira D, Chasela CS, Jamieson DJ, Kourtis AP. Maternal and neonatal outcomes among women with HIV infection and their infants in Malawi. Int J Gynaecol Obstet 2017; 137:282-289. [PMID: 28258582 DOI: 10.1002/ijgo.12136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 01/11/2017] [Accepted: 02/28/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To describe maternal and neonatal morbidity and mortality among women with HIV infection and their infants. METHODS A secondary analysis was undertaken of data obtained in the BAN Study, a trial of postnatal antiretrovirals among pregnant women with HIV infection enrolled in 2004-2010. Mothers and infants had 13 scheduled visits through 48 weeks of follow-up. Serious maternal morbidity and mortality were examined at delivery (n=2791), from delivery to 6 weeks later (n=2369) and from 7 to 48 weeks (n=1980). Neonatal morbidity and mortality were examined (n=2685). RESULTS Of 2791 deliveries, 169 (6.1%) were by cesarean (153 emergency). Compared with women with vaginal delivery, those with cesarean delivery had lower prenatal HIV viral loads (P=0.016) and increased odds of pre-eclampsia/eclampsia (odds ratio [OR] 10.8, 95% CI 4.4-26.8). Women with cesarean delivery also had increased odds of serious infection with 14 days of delivery (OR 3.0, 95% CI 1.3-7.4) and severe anemia (grade 3 or 4) by 6 weeks (OR 6.7, 95% CI 2.3-19.1). Infants born by cesarean had increased odds of a low 5-minute Apgar score (OR 8.1, 95% CI 3.5-18.6) and admission to an intensive care unit (OR 5.4, 95% CI 3.7-7.8). CONCLUSION Odds of serious maternal and neonatal morbidity were higher after cesarean than vaginal delivery, despite lower maternal viral loads.
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Affiliation(s)
- Michelle S Chevalier
- Division of Global HIV and Tuberculosis, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Caroline C King
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sascha Ellington
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jeffrey Wiener
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Dumbani Kayira
- University of North Carolina Project Malawi, Lilongwe, Malawi
| | - Charles S Chasela
- Epidemiology and Strategic Information, Human Sciences Research Council, Pretoria, South Africa
| | - Denise J Jamieson
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Athena P Kourtis
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Chevalier MS, Kuehnert M, Basavaraju SV, Bjork A, Pitman JP. Progress Toward Strengthening National Blood Transfusion Services - 14 Countries, 2011-2014. MMWR Morb Mortal Wkly Rep 2016; 65:115-9. [PMID: 26866413 DOI: 10.15585/mmwr.mm6505a4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Blood transfusion is a life-saving medical intervention; however, challenges to the recruitment of voluntary, unpaid or otherwise nonremunerated whole blood donors and insufficient funding of national blood services and programs have created obstacles to collecting adequate supplies of safe blood in developing countries (1). Since 2004, the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) has provided approximately $437 million in bilateral financial support to strengthen national blood transfusion services in 14 countries in sub-Saharan Africa and the Caribbean* that have high prevalence rates of human immunodeficiency virus (HIV) infections. CDC analyzed routinely collected surveillance data on annual blood collections and HIV prevalence among donated blood units for 2011-2014. This report updates previous CDC reports (2,3) on progress made by these 14 PEPFAR-supported countries in blood safety, summarizes challenges facing countries as they strive to meet World Health Organization (WHO) targets, and documents progress toward achieving the WHO target of 100% voluntary, nonremunerated blood donors by 2020 (4). During 2011-2014, overall blood collections among the 14 countries increased by 19%; countries with 100% voluntary, nonremunerated blood donations remained stable at eight, and, despite high national HIV prevalence rates, 12 of 14 countries reported an overall decrease in donated blood units that tested positive for HIV. Achieving safe and adequate national blood supplies remains a public health priority for WHO and countries worldwide. Continued success in improving blood safety and achieving WHO targets for blood quality and adequacy will depend on national government commitments to national blood transfusion services or blood programs through increased public financing and diversified funding mechanisms for transfusion-related activities.
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Chung WM, Smith JC, Weil LM, Hughes SM, Joyner SN, Hall EM, Ritch J, Srinath D, Goodman E, Chevalier MS, Epstein L, Hunter JC, Kallen AJ, Karwowski MP, Kuhar DT, Smith C, Petersen LR, Mahon BE, Lakey DL, Schrag SJ. Active Tracing and Monitoring of Contacts Associated With the First Cluster of Ebola in the United States. Ann Intern Med 2015; 163:164-73. [PMID: 26005809 DOI: 10.7326/m15-0968] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Following hospitalization of the first patient with Ebola virus disease diagnosed in the United States on 28 September 2014, contact tracing methods for Ebola were implemented. OBJECTIVE To identify, risk-stratify, and monitor contacts of patients with Ebola. DESIGN Descriptive investigation. SETTING Dallas County, Texas, September to November 2014. PARTICIPANTS Contacts of symptomatic patients with Ebola. MEASUREMENTS Contact identification, exposure risk classification, symptom development, and Ebola. RESULTS The investigation identified 179 contacts, 139 of whom were contacts of the index patient. Of 112 health care personnel (HCP) contacts of the index case, 22 (20%) had known unprotected exposures and 37 (30%) did not have known unprotected exposures but interacted with a patient or contaminated environment on multiple days. Transmission was confirmed in 2 HCP who had substantial interaction with the patient while wearing personal protective equipment. These HCP had 40 additional contacts. Of 20 community contacts of the index patient or the 2 HCP, 4 had high-risk exposures. Movement restrictions were extended to all 179 contacts; 7 contacts were quarantined. Seven percent (14 of 179) of contacts (1 community contact and 13 health care contacts) were evaluated for Ebola during the monitoring period. LIMITATION Data cannot be used to infer whether in-person direct active monitoring is superior to active monitoring alone for early detection of symptomatic contacts. CONCLUSION Contact tracing and monitoring approaches for Ebola were adapted to account for the evolving understanding of risks for unrecognized HCP transmission. HCP contacts in the United States without known unprotected exposures should be considered as having a low (but not zero) risk for Ebola and should be actively monitored for symptoms. Core challenges of contact tracing for high-consequence communicable diseases included rapid comprehensive contact identification, large-scale direct active monitoring of contacts, large-scale application of movement restrictions, and necessity of humanitarian support services to meet nonclinical needs of contacts. PRIMARY FUNDING SOURCE None.
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Affiliation(s)
- Wendy M. Chung
- From Dallas County Department of Health and Human Services and Texas Health Resources, Dallas, Texas; Centers for Disease Control and Atlanta, Georgia; and Texas Department of State Health Services, Austin, Texas
| | - Jessica C. Smith
- From Dallas County Department of Health and Human Services and Texas Health Resources, Dallas, Texas; Centers for Disease Control and Atlanta, Georgia; and Texas Department of State Health Services, Austin, Texas
| | - Lauren M. Weil
- From Dallas County Department of Health and Human Services and Texas Health Resources, Dallas, Texas; Centers for Disease Control and Atlanta, Georgia; and Texas Department of State Health Services, Austin, Texas
| | - Sonya M. Hughes
- From Dallas County Department of Health and Human Services and Texas Health Resources, Dallas, Texas; Centers for Disease Control and Atlanta, Georgia; and Texas Department of State Health Services, Austin, Texas
| | - Sibeso N. Joyner
- From Dallas County Department of Health and Human Services and Texas Health Resources, Dallas, Texas; Centers for Disease Control and Atlanta, Georgia; and Texas Department of State Health Services, Austin, Texas
| | - Emily M. Hall
- From Dallas County Department of Health and Human Services and Texas Health Resources, Dallas, Texas; Centers for Disease Control and Atlanta, Georgia; and Texas Department of State Health Services, Austin, Texas
| | - Julia Ritch
- From Dallas County Department of Health and Human Services and Texas Health Resources, Dallas, Texas; Centers for Disease Control and Atlanta, Georgia; and Texas Department of State Health Services, Austin, Texas
| | - Divya Srinath
- From Dallas County Department of Health and Human Services and Texas Health Resources, Dallas, Texas; Centers for Disease Control and Atlanta, Georgia; and Texas Department of State Health Services, Austin, Texas
| | - Edward Goodman
- From Dallas County Department of Health and Human Services and Texas Health Resources, Dallas, Texas; Centers for Disease Control and Atlanta, Georgia; and Texas Department of State Health Services, Austin, Texas
| | - Michelle S. Chevalier
- From Dallas County Department of Health and Human Services and Texas Health Resources, Dallas, Texas; Centers for Disease Control and Atlanta, Georgia; and Texas Department of State Health Services, Austin, Texas
| | - Lauren Epstein
- From Dallas County Department of Health and Human Services and Texas Health Resources, Dallas, Texas; Centers for Disease Control and Atlanta, Georgia; and Texas Department of State Health Services, Austin, Texas
| | - Jennifer C. Hunter
- From Dallas County Department of Health and Human Services and Texas Health Resources, Dallas, Texas; Centers for Disease Control and Atlanta, Georgia; and Texas Department of State Health Services, Austin, Texas
| | - Alexander J. Kallen
- From Dallas County Department of Health and Human Services and Texas Health Resources, Dallas, Texas; Centers for Disease Control and Atlanta, Georgia; and Texas Department of State Health Services, Austin, Texas
| | - Mateusz P. Karwowski
- From Dallas County Department of Health and Human Services and Texas Health Resources, Dallas, Texas; Centers for Disease Control and Atlanta, Georgia; and Texas Department of State Health Services, Austin, Texas
| | - David T. Kuhar
- From Dallas County Department of Health and Human Services and Texas Health Resources, Dallas, Texas; Centers for Disease Control and Atlanta, Georgia; and Texas Department of State Health Services, Austin, Texas
| | - Charnetta Smith
- From Dallas County Department of Health and Human Services and Texas Health Resources, Dallas, Texas; Centers for Disease Control and Atlanta, Georgia; and Texas Department of State Health Services, Austin, Texas
| | - Lyle R. Petersen
- From Dallas County Department of Health and Human Services and Texas Health Resources, Dallas, Texas; Centers for Disease Control and Atlanta, Georgia; and Texas Department of State Health Services, Austin, Texas
| | - Barbara E. Mahon
- From Dallas County Department of Health and Human Services and Texas Health Resources, Dallas, Texas; Centers for Disease Control and Atlanta, Georgia; and Texas Department of State Health Services, Austin, Texas
| | - David L. Lakey
- From Dallas County Department of Health and Human Services and Texas Health Resources, Dallas, Texas; Centers for Disease Control and Atlanta, Georgia; and Texas Department of State Health Services, Austin, Texas
| | - Stephanie J. Schrag
- From Dallas County Department of Health and Human Services and Texas Health Resources, Dallas, Texas; Centers for Disease Control and Atlanta, Georgia; and Texas Department of State Health Services, Austin, Texas
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Abstract
Ebola virus is one of the most deadly pathogens known to infect humans. The current Ebola outbreak in West Africa is unprecedented in magnitude and duration and, as of November 30, 2014, shows no signs of abating. For the first time, cases of Ebola virus disease have been diagnosed in the US, originating from patients who traveled during the incubation period. The outbreak has generated worldwide concern. It is clear that U.S. physicians need to be aware of this disease, know when to consider Ebola and how to care for the patient as well as protect themselves. Children comprise a small percentage of all cases globally, likely because of their lower risk of exposure given social and cultural practices. Limited evidence is available on pediatric disease course and prognosis. In this article, we present an overview of the pathogen, its epidemiology and transmission, clinical and laboratory manifestations, treatment and infection control procedures, with an emphasis on what is known about Ebola virus disease in the pediatric population.
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Affiliation(s)
- Athena P. Kourtis
- National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA
| | - Kristie Appelgren
- National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA
| | | | - Anita McElroy
- National Center for Emerging and Zoonotic Infections, Centers for Disease Control and Prevention, Atlanta, GA
- Division of Infectious Diseases, Department of Pediatrics, Emory University, Atlanta, GA
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Smith CL, Hughes SM, Karwowski MP, Chevalier MS, Hall E, Joyner SN, Ritch J, Smith JC, Weil LM, Chung WM, Schrag S, Santibañez S. Addressing needs of contacts of Ebola patients during an investigation of an Ebola cluster in the United States - Dallas, Texas, 2014. MMWR Morb Mortal Wkly Rep 2015; 64:121-3. [PMID: 25674993 PMCID: PMC4584687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The first imported case of Ebola virus disease (Ebola) diagnosed in the United States was confirmed on September 30, 2014; two health care workers who cared for this patient subsequently developed Ebola. Since then, local, state, and federal health officials have continued to prepare for future imported cases, including developing strategies to identify and monitor persons who have had contact with an Ebola patient. This report describes some of the needs of persons who were contacts of Ebola patients in Texas. It is based on requests received from contacts in the course of daily contact tracing interactions and on how those needs were met through community partnerships. Meeting the needs of contacts of the Ebola patients was essential to successful contact tracing, which is critical to interrupting transmission. Although a formal needs assessment of contacts was not conducted, this report provides important information for preparing for an importation of Ebola. Anticipating the nonclinical needs of persons under public health surveillance includes addressing potential concerns about housing, transportation, education, employment, food, and other household needs. Ensuring necessary supports are in place for persons who are asked to refrain from entering public venues can impact their willingness to comply with voluntary and mandated quarantine orders. Engagement with a wide range of community partners, including businesses, schools, charitable foundations, community and faith-based organizations, and mental health resources would enhance public health emergency preparedness for Ebola by readying resources to meet these potential needs.
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Affiliation(s)
- Charnetta L. Smith
- Epidemic Intelligence Service, CDC,Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC,CDC Dallas Ebola Investigation Team,Corresponding author: Charnetta L. Smith, , 404-639-4653
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Woolridge DP, Vazquez-Laslop N, Markham PN, Chevalier MS, Gerner EW, Neyfakh AA. Efflux of the natural polyamine spermidine facilitated by the Bacillus subtilis multidrug transporter Blt. J Biol Chem 1997; 272:8864-6. [PMID: 9083003 DOI: 10.1074/jbc.272.14.8864] [Citation(s) in RCA: 77] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Multidrug transporters pump structurally dissimilar toxic molecules out of cells. It is not known, however, if detoxification is the primary physiological function of these transporters. The chromosomal organization of the gene encoding the Bacillus subtilis multidrug transporter Blt suggests a specific function for this protein; it forms a single operon with another gene, bltD, whose protein product is identified here as a spermine/spermidine acetyltransferase, an enzyme catalyzing a key step in spermidine degradation. Overexpression of the Blt transporter in B. subtilis leads not only to the multidrug-resistance phenotype but also to the efflux of large amounts of spermidine into the medium; this efflux is supressed by an inhibitor of Blt, reserpine. Taken together, these results strongly suggest that the natural function of the Blt transporter is the efflux of spermidine, whereas multiple drugs may be recognized by Blt merely opportunistically.
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Affiliation(s)
- D P Woolridge
- Departments of Biochemistry and Radiation Oncology, The University of Arizona Health Science Center, Tucson, Arizona 85724, USA
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