scholarly journals Optimal breastfeeding durations for HIV-exposed infants: the impact of maternal ART use, infant mortality and replacement feeding risk

2018 ◽  
Vol 21 (4) ◽  
pp. e25107 ◽  
Author(s):  
Divya Mallampati ◽  
Rachel L MacLean ◽  
Roger Shapiro ◽  
Francois Dabis ◽  
Barbara Engelsmann ◽  
...  
Keyword(s):  
Infant Mortality ◽  
Replacement Feeding ◽  
Hiv Exposed Infants ◽  
Hiv Exposed ◽  
The Impact

scholarly journals Impact of the Umoyo mother-infant pair model on HIV-positive mothers’ social support, perceived stigma and 12-month retention of their HIV-exposed infants in PMTCT Care: Evidence from a cluster randomised control trial in Zambia

2019 ◽  
Author(s):  
Sydney Chauwa Phiri ◽  
Sandra Mudhune ◽  
Margaret L Prust ◽  
Prudence Haimbe ◽  
Hilda Shakwelele ◽  
...  
Keyword(s):  
Public Health ◽  
Social Support ◽  
Health System ◽  
T Test ◽  
Perceived Stigma ◽  
Hiv Exposed Infants ◽  
Pair Model ◽  
Hiv Exposed ◽  
The Impact ◽  
Infant Pair

Abstract Background Public health systems in resource-constrained settings have a critical role to play in the elimination of HIV transmission but are often financially constrained. This study is an evaluation of a mother-infant-pair model called “Umoyo”, which was designed to be low cost and scalable in a public health system. Facilities with the Umoyo model dedicate a clinic day to provide services to only HIV-exposed-infants (HEIs) and their mothers. Such models are in operation with reported success in Zambia but have not been rigorously tested. This work establishes whether the Umoyo model would improve 12-month retention of HEIs. Methods A cluster randomized trial including 28 facilities was conducted across two provinces of Zambia to investigate the impact on 12-month retention of HEIs in care. These facilities were offering prevention of mother to child transmission (PMTCT) services and supported by the same implementing partner. Randomization was achieved by use of the covariate constrained optimization technique. Secondary outcomes included the impact of Umoyo clinics on social support and perceived HIV stigma among mothers. For each of the outcomes, a difference-in-difference analysis was conducted at the facility level using the unweighted t-test. Results From 13 control (12-month retention at endline: 45%) and 11 intervention facilities (12-month retention at endline: 33%), it was found that Umoyo clinics had no impact on 12-month retention of HEIs in the t-test (-11%; 99% CI: -40.1%, 17.2%). Regarding social support and stigma, the un-weighted t-test showed no impact though sensitivity tests showed that Umoyo had an impact on increasing social support (0.31; 99% CI: 0.08, 0.54) and reducing perceived stigma from health care workers (-0.27: 99% CI: -0.46, -0.08). Conclusion The Umoyo approach of having a dedicated clinic day for HEIs and their mothers did not improve retention of HEIs though there are indications that it can increase social support among mothers and reduce stigma. Without further support to the underlying health system, based on the evidence generated through this evaluation, the Umoyo clinic day approach on its own is not considered an effective intervention to increase retention of HIV-exposed infants.

scholarly journals Feeding Practices among Human Immunodeficiency Virus-Exposed Infants in Ethiopia: Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Habtamu Temesgen ◽  
Ayenew Negesse ◽  
Temesgen Getaneh ◽  
Yibelu Bazezew ◽  
Dessalegn Haile ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Exclusive Breastfeeding ◽  
Meta Analysis ◽  
Feeding Practices ◽  
Mixed Feeding ◽  
Replacement Feeding ◽  
Hiv Exposed Infants ◽  
Pooled Prevalence ◽  
Immunodeficiency Virus ◽  
Hiv Exposed

Background. Infant and young child feeding in the context of human immunodeficiency virus- (HIV-) infected mothers has significant challenges due to the risk of transmission of the virus via breastfeeding. In Ethiopia, a number of independent studies have been conducted to assess the feeding practice of HIV-exposed infants. But, there is no concrete evidence to show the national figure in Ethiopia. Hence, this review and meta-analysis aims to estimate the pooled prevalence of feeding practices among HIV exposed infants in Ethiopia. Methods. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed. Articles were searched through search engines in PubMed, Cochrane Library, Google Scholar, and direct Google search. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument adapted for cross-sectional study design was used for quality assessment. The random effects model was used to estimate the pooled prevalence of infant feeding practices. Heterogeneity and publication bias were assessed. Trim and fill analysis was performed. Additionally, meta-regression was also performed. Results. In this review, a total of 26, 22, and 22 studies and 7413, 6224, and 6222 study participants for exclusive breastfeeding, replacement feeding, and mixed feelings were included, respectively. The overall pooled prevalence of exclusive breastfeeding, replacement feeding, and mixed feeding of HIV exposed infant was 63.99 % (95% Confidence Interval (CI): 52.32, 75.66), 16.13% (95% CI: 11.92, 20.32), and 20.95% (95% CI: 11.35, 30.58)) in Ethiopia, respectively. Conclusion and Recommendations. In Ethiopia, almost three in five HIV-exposed infants were exclusively breastfed. But still, mixed feeding during the period of first 6 months was practiced in almost one-fifth of the exposed infants in Ethiopia. Additionally, replacement feeding was also practiced even though not recommended for developing countries. Therefore, the government of Ethiopia should strengthen the health institutions to implement the existing infant feeding strategies and guidelines to increase exclusive breastfeeding for the first 6 months and to avoid mixed feeding during the periods of six months.

scholarly journals Causes and Predictors of Mortality among HIV-Exposed Infants in Rural North-Central Nigeria: Results of a Simple Verbal Autopsy Survey

2020 ◽  
Author(s):  
Chamberline E. Ozigbu ◽  
Salome Erekaha ◽  
Eric E. Chinaeke ◽  
Tongdiyen L. Jasper ◽  
Gift Nwanne ◽  
...  
Keyword(s):  
Infant Mortality ◽  
Verbal Autopsy ◽  
Causes Of Death ◽  
Birth Asphyxia ◽  
Monitoring And Evaluation ◽  
Hiv Diagnosis ◽  
North Central ◽  
Predictors Of Mortality ◽  
Hiv Exposed Infants ◽  
Hiv Exposed

Abstract Background HIV-exposed infants (HEI) who die before diagnosis or treatment initiation, or who die in spite of being HIV-free constitute missed opportunities for reducing infant mortality. Verbal autopsy (VA) has been successfully applied in the collection of data to determine symptoms and circumstances surrounding death among infants, children and adults among populations that lack vital registration systems. There is little available data on rates and causes of death among HIV-exposed infants (HEI) in Nigeria. We used VA to characterize attributable causes and predictors of mortality among HEI in rural North-Central Nigeria.Methods Pregnant women living with HIV and HEI were enrolled at rural primary healthcare facilities and followed-up for 12 months, post-delivery. A simple 21-item VA instrument was used to collect infant mortality information from mothers, other family members, mentor mothers, and/or healthcare workers. Attributable causes of death were determined by physician coding. Multivariate logistic regression was performed to determine independent predictors of mortality.Results Data from 455 HIV-exposed infected and uninfected fetus/infant-mother pairs were analyzed. All mothers received anti-retroviral therapy. Seventy-five (16.5%) fetuses/infants died during gestation and within 12 months post-delivery. Forty (53.3%) deaths occurred in utero . The 12-month infant mortality risk among HEI in our study was 88.7/1,000. Among the 35 live-born infants, birth asphyxia (6/17, 35.3%) and sepsis (7/18, 38.9%) were the most common causes of death in the neonatal and post-neonatal periods, respectively. Unadjusted estimates showed that a greater proportion of deceased infants had mothers who did not deliver at a health facility (53.3 vs 31.8%, p=0.003), and who were newly HIV-diagnosed during pregnancy (69.3 vs 50.8%, p=0.029). Infants receiving nevirapine prophylaxis within 72 hours were less likely to have died (aOR = 0.40, 95% CI: 0.2-0.9).Conclusions Early HIV diagnosis and treatment among women of child-bearing age, maternal access to facility delivery and timely infant antiretroviral prophylaxis should be programmatically strengthened to reduce HEI mortality. Additionally, robust monitoring and evaluation systems are needed to track and record deaths among HEI.

Characteristics and outcomes of HIV-exposed infants in Homa Bay County, Kenya, 2015

2020 ◽  
Vol 50 (2) ◽  
pp. 154-156
Author(s):  
Lawrence K Gitonga ◽  
Waqo G Boru ◽  
Lilly Muthoni ◽  
Jacob Odhiambo ◽  
James Ransom
Keyword(s):  
Antenatal Care ◽  
Retrospective Review ◽  
Hiv Positive ◽  
Early Infant Diagnosis ◽  
Western Kenya ◽  
Replacement Feeding ◽  
Hiv Exposed Infants ◽  
Care Services ◽  
Early Infant ◽  
Hiv Exposed

Homa Bay County in south-western Kenya has a low uptake of antenatal care services and the highest prevalence of HIV in the country. We present the findings of a retrospective review of HIV-exposed infants (HEI) who sought early infant diagnosis services in the county throughout 2015. HEI who were breastfed >6 months, had replacement feeding and did not receive prophylaxis were 2–6 times more likely to be HIV-positive.

scholarly journals HIV-exposed infants with EBV infection have a reduced persistence of the immune response to the HBV vaccine

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Silvia Baroncelli ◽  
Clementina Maria Galluzzo ◽  
Giuseppe Liotta ◽  
Mauro Andreotti ◽  
Stefano Orlando ◽  
...  
Keyword(s):  
Humoral Response ◽  
Educational Status ◽  
Infant Growth ◽  
African Countries ◽  
Hbv Vaccine ◽  
Hiv Exposed Infants ◽  
Barr Virus ◽  
Ebv Infection ◽  
Hiv Exposed ◽  
The Impact

Abstract Background In sub-Saharan African countries Epstein Barr virus (EBV) infection occurs in early childhood. We aim to investigate the factors associated with EBV acquisition and the impact of EBV infection on the humoral response to HBV vaccination in infants born from HIV-positive, antiretroviral-treated mothers in Malawi. Methods A total of 149 HIV-exposed infants were included in this longitudinal study. EBV anti-VCA IgG were measured using an ELISA assay. The EBV seroconversion was correlated with the maternal viro-immunological conditions, with infant growth and immunological vulnerability, and with the humoral response to the HBV vaccine. Results No infant was EBV-positive at 6 months (n. 52 tested). More than a third of infants (49/115 or 42.6 %) on study beyond 6 months seroconverted at 12 months. At 24 months, out of 66 tested infants, only 13 remained EBV-uninfected, while 53 (80.3 %) acquired EBV infection, rising the total proportion of EBV seroconversion to 88.7 % (102/115 infants). EBV seroconversion was significantly associated with a low maternal educational status but had no impact on infant growth or vulnerability to infections. Reduced HBsAb levels and accelerated waning of antibodies were associated with early EBV seroconversion. Conclusions We found a heterogeneous timing of acquisition of EBV with the majority of infants born from HIV + mothers acquiring infection after 6 months. Anti-HBs levels were lower and appeared to wane faster in infants acquiring EBV infection.

scholarly journals Postnatal Cytomegalovirus Exposure in Infants of Antiretroviral-Treated and Untreated HIV-Infected Mothers

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Sarah A. Meyer ◽  
Daniel J. Westreich ◽  
Emily Patel ◽  
Elizabeth P. Ehlinger ◽  
Linda Kalilani ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Postnatal Growth ◽  
Hiv Exposed Infants ◽  
Breastfed Infants ◽  
Postnatal Transmission ◽  
Growth Faltering ◽  
Hiv Exposed ◽  
The Impact ◽  
The Relationship ◽  
Hiv 1

HIV-1 and CMV are important pathogens transmitted via breastfeeding. Furthermore, perinatal CMV transmission may impact growth and disease progression in HIV-exposed infants. Although maternal antiretroviral therapy reduces milk HIV-1 RNA load and postnatal transmission, its impact on milk CMV load is unclear. We examined the relationship between milk CMV and HIV-1 load (4–6 weeks postpartum) and the impact of antiretroviral treatment in 69 HIV-infected, lactating Malawian women and assessed the relationship between milk CMV load and postnatal growth in HIV-exposed, breastfed infants through six months of age. Despite an association between milk HIV-1 RNA and CMV DNA load (0.39 log10rise CMV load per log10rise HIV-1 RNA load, 95% CI 0.13–0.66), milk CMV load was similar in antiretroviral-treated and untreated women. Higher milk CMV load was associated with lower length-for-age (−0.53, 95% CI: −0.96, −0.10) and weight-for-age (−0.40, 95% CI: −0.67, −0.13)Z-score at six months in exposed, uninfected infants. As the impact of maternal antiretroviral therapy on the magnitude of postnatal CMV exposure may be limited, our findings of an inverse relationship between infant growth and milk CMV load highlight the importance of defining the role of perinatal CMV exposure on growth faltering of HIV-exposed infants.

scholarly journals Impact of Umoyo mother-infant pair clinics on HIV-positive mothers’ social support, perceived stigma and 12-month retention of their HIV-exposed infants in PMTCT Care: Evidence from a cluster randomised control trial in Zambia

2019 ◽  
Author(s):  
Sydney Chauwa Phiri ◽  
Sandra Mudhune ◽  
Margaret L Prust ◽  
Prudence Haimbe ◽  
Hilda Shakwelele ◽  
...  
Keyword(s):  
Public Health ◽  
Social Support ◽  
Health System ◽  
T Test ◽  
Randomised Control Trial ◽  
Perceived Stigma ◽  
Hiv Exposed Infants ◽  
Hiv Exposed ◽  
The Impact ◽  
Infant Pair

Abstract Background Public health systems in resource constrained settings have a critical role to play in the elimination of vertical HIV transmission but are unable to carry out some of the promising interventions such as mother-to-mother peer support programs due to financial constraints. This study is an evaluation of a mother-infant-pair clinic called Umoyo, which was designed to be scalable in a public health system due to the relatively low costs required. Umoyo clinics dedicate a clinic day to provide services to only HIV-exposed-infants (HEIs) and their mothers. Such models are in operation with reported success in Zambia but have not been rigorously tested. Methods A cluster randomized trial including 28 facilities was conducted across two provinces of Zambia to investigate 12-month retention of HEIs in care. These were facilities that were offering prevention of mother to child transmission (PMTCT) services and supported by the same implementing partner. Random allocation was achieved by use of the covariate constrained optimization technique. The primary outcome of interest was to establish whether Umoyo clinic days would improve 12-month retention of HEIs. Secondary outcomes included the impact of Umoyo clinics on social support and perceived HIV stigma among mothers. For each of the outcomes, a difference-in-difference analysis was conducted at the facility level using unweighted t-test. Results From 13 control and 11 intervention facilities, it was found that Umoyo clinics had no impact on 12-month retention of HEIs in the t-test (-11%; 99% CI: -40.1%, 17.2%). Regarding social support and stigma, the un-weighted t-test showed no impact though sensitivity tests showed that Umoyo had an impact on increasing social support and reducing perceived stigma from health care workers. Conclusion The Umoyo approach of having a dedicated clinic day for HEIs and their mothers did not improve retention of HEIs though there are indications that it can increase social support among mothers and reduce stigma. Without further support to the underlying health system, based on the evidence generated through this evaluation, the Umoyo clinic day approach on its own is not considered an effective intervention to increase retention of HIV-exposed infants.Trial Registration Pan African Clinical Trial Registry (PACTR201702001970148) Prospectively registered on January 13, 2017. URL https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=1970

Monitoring birth defect rates in a cohort of perinatally HIV-exposed infants

2005 ◽  
Author(s):  
Glenn Copeland ◽  
Nilsa Mack ◽  
Yolande Moore ◽  
Eve Mokotoff
Keyword(s):  
Birth Defect ◽  
Hiv Exposed Infants ◽  
Hiv Exposed

Measuring Effectiveness Of Economic Growth On Reducing Infant Mortality Rate In Tamilnadu

2019 ◽  
Vol 118 (4) ◽  
pp. 129-141
Author(s):  
Mr. Y. EBENEZER
Keyword(s):  
Economic Growth ◽  
Mortality Rate ◽  
Infant Mortality ◽  
Negative Relationship ◽  
Infant Mortality Rate ◽  
Domestic Product ◽  
Per Capita ◽  
The Impact ◽  
Adf Test ◽  
Bound Test

                   This paper deals with economic growth and infant mortality rate in Tamilnadu. The objects of this paper are to test the relationship between Per capita Net State Domestic Product and infant mortality rate and also to measure the impact of Per capita Net State Domestic Product on infant mortality rate in Tamil Nadu. This analysis has employed the ADF test and ARDL approach. The result of the study shows that IMR got reduced and Per capita Net State Domestic Product increased during the study period. This analysis also revealed that there is a negative relationship between IMR and the economic growth of Tamilnadu. In addition, ARDL bound test result has concluded that per capita Net State Domestic Product of Tamilnadu has long run association with IMR.

Sign in / Sign up

Export Citation Format

Share Document