scholarly journals HIV-Associated Tuberculosis in the Newborn and Young Infant

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
M. Adhikari ◽  
P. Jeena ◽  
R. Bobat ◽  
M. Archary ◽  
K. Naidoo ◽  
...  
Keyword(s):  
Vertical Transmission ◽  
Social Impact ◽  
Social Issues ◽  
Transmission Rate ◽  
Young Infant ◽  
Perinatal Outcomes ◽  
Sub Saharan Africa ◽  
Resource Limited ◽  
Vertical Transmission Rate ◽  
Sub Saharan

Each year, approximately 250 000 women die during pregnancy, delivery, or postpartum. Maternal mortality rates due to tuberculosis (TB) and HIV in Sub-Saharan Africa now supersede obstetric-related causes of mortality. The majority of cases occur in population-dense regions of Africa and Asia where TB is endemic. The vertical transmission rate of tuberculosis is 15%, the overall vertical transmission rate of HIV in resource-limited settings with mono- or dual-ARV therapy varies from 1.9% to 10.7%. If the millennium development goals are to be achieved, both HIV and TB must be prevented. The essential aspect of TB prevention and detection in the newborn is the maternal history and a positive HIV status in the mother. Perinatal outcomes are guarded even with treatment of both diseases. Exclusive breast feeding is recommended. The community and social impact are crippling. The social issues aggravate the prognosis of these two diseases.

scholarly journals Growth Trajectories of HIV Exposed and HIV Unexposed Infants. A Prospective Study in Gweru, Zimbabwe

2021 ◽  
Vol 8 ◽  
pp. 2333794X2199033
Author(s):  
Lucy Mabaya ◽  
Hilda Tendisa Matarira ◽  
Donald Moshen Tanyanyiwa ◽  
Cuthbert Musarurwa ◽  
Johannes Mukwembi
Keyword(s):  
Transmission Rate ◽  
Growth Patterns ◽  
Sub Saharan Africa ◽  
Childbearing Age ◽  
Hiv Exposed Infants ◽  
Vertical Transmission Rate ◽  
Sub Saharan ◽  
Hiv Exposed ◽  
Nutritional Monitoring ◽  
A Prospective Study

Background: With the increasing HIV seroprevalence among women of childbearing age in sub-Saharan Africa, limited data on growth outcomes of HIV exposed infants under current policies of universal maternal antiretroviral therapy exist. Methods: The longitudinal growth patterns of 114 HIV exposed and unexposed infants were assessed and compared. The prevalence and factors associated with malnutrition were established. Infants under prevention of mother to child transmission care were recruited at 6 weeks post-delivery as were their HIV unexposed counterparts. Weight and length measurements were recorded at birth, 6 and 16 weeks postpartum. Results: HIV vertical transmission rate was 8.8%. HIV exposed infants had significantly lower mean birth weights compared to HIV unexposed infants (2.9 ± 0.3; 3.2 ± 0.5; P < .001) respectively. Mean weight/length-for-age z-scores for HIV exposed, uninfected (HEU) infants were significantly below those of the HIV unexposed infants during follow up. By 6 weeks of age, 28.5% of HEU infants were malnourished while no malnutrition was evident in HIV unexposed infants. A gestational age <37 weeks (OR: 3.83; 95% CI: 1.03-14.30; P = .045) and HIV exposure (OR: 1.62; 95% CI: 0.17-15.73; P = .017) substantially increased the risk of stunting. Conclusion: Growth deficits were witnessed in HIV exposed infants compared to HIV unexposed infants. There is need for early nutritional monitoring and support among HIV exposed infants.

scholarly journals Building sustainable research capacity at higher learning institutions in Tanzania through mentoring of the Young Research Peers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Emmanuel Balandya ◽  
Bruno Sunguya ◽  
Daniel W. Gunda ◽  
Benson Kidenya ◽  
Tumaini Nyamhanga ◽  
...  
Keyword(s):  
Undergraduate Students ◽  
Professional Education ◽  
Research Training ◽  
Peer To Peer ◽  
Sub Saharan Africa ◽  
Ongoing Research ◽  
Scientific Presentation ◽  
Resource Limited ◽  
Sub Saharan ◽  
Young Researchers

Abstract Background Sustainability of research culture in Sub-Saharan Africa is threatened in part by the lack of a critical mass of young researchers with the requisite skills and interest to undertake research careers. This paper describes an intensive mentorship programme combining hierarchical (vertical) and peer-to-peer (horizontal) mentoring strategies among young researchers in a resource limited setting in Sub-Saharan Africa. Methods A consortium of three partnering large Tanzanian health training institutions (MUHAS, CUHAS and KCMUCo) and two collaborating US institutions (UCSF and Duke University) was formed as part of the five-year Transforming Health Professions Education in Tanzania (THET) project, funded by the NIH through Health Professional Education Partnership Initiative (HEPI). Within THET, the Community of Young Research Peers (CYRP) was formed, comprising of inter-professional and cross-institutional team of 12 Master-level Young Research Peers and 10 co-opted fellows from the former MEPI-Junior Faculty (MEPI-JF) project. The Young Peers received mentorship from senior researchers from the consortium through mentored research awards and research training, and in turn provided reciprocal peer-to-peer mentorship as well as mentorship to undergraduate students. Results At the end of the first 2 years of the project, all 12 Young Peers were proceeding well with mentored research awards, and some were at more advanced stages. For example, three articles were already published in peer reviewed journals and two other manuscripts were in final stages of preparation. All 12 Young Peers participated in CYRP-wide thematic training workshops on mentoring and secondary data analysis; 11 had undertaken at least three research training short courses in identified areas of need; 9 joined at least one other ongoing research project; 5 made at least one scientific presentation, and 5 participated in at least one submitted grant application. Half of the Young Peers have enrolled in PhD programmes. A collective total of 41 undergraduate students were actively mentored by the Young Peers in research. Conclusion The CYRP has demonstrated to be an effective model for dual vertical and horizontal mentorship in research to young investigators in resource-limited settings. This model is recommended to educators working on developing research competence of early career researchers, particularly in Sub-Saharan Africa.

scholarly journals Opportunities and Challenges in Realizing Universal Access to Obstetric Ultrasound in Sub-Saharan Africa

2017 ◽  
Vol 03 (02) ◽  
pp. E52-E59 ◽  
Author(s):  
Sikolia Wanyonyi ◽  
Charles Mariara ◽  
Sudhir Vinayak ◽  
William Stones
Keyword(s):  
Universal Access ◽  
Perinatal Outcomes ◽  
Sub Saharan Africa ◽  
Future Research ◽  
Obstetric Ultrasound ◽  
Integral Component ◽  
Challenges And Opportunities ◽  
Potential Benefits ◽  
The Subject ◽  
Sub Saharan

AbstractThe potential benefits of obstetric ultrasound have yet to be fully realized in sub-Saharan Africa (SSA), despite the region bearing the greatest burden of poor perinatal outcomes. We reviewed the literature for challenges and opportunities of universal access to obstetric ultrasound and explored what is needed to make such access an integral component of maternity care in order to address the massive burden of perinatal morbidity and mortality in SSA. Original peer-reviewed literature was searched in various electronic databases using a ‘realist’ approach. While the available data were inconclusive, they identify many opportunities for potential future research on the subject within the region that can help build a strong case to justify the provision of universal access to ultrasound as an integral component of comprehensive antenatal care.

scholarly journals Vertical Transmission Rate of HIV from Seropositive Mothers Followed in the Different Care Centers in Kinshasa from 2010 to 2015

OALib ◽  
2018 ◽  
Vol 05 (08) ◽  
pp. 1-7
Author(s):  
Divine Chuga ◽  
Ben Ilunga Bulanda ◽  
Jean Yves Debels Kabasele ◽  
Médard Omakoy Okonda ◽  
Berry Ikolango Bongenya ◽  
...  
Keyword(s):  
Vertical Transmission ◽  
Transmission Rate ◽  
Vertical Transmission Rate

scholarly journals Vertical Transmission and Discordance of Cytomegalovirus in Twin Pregnancies

2021 ◽  
Vol 11 ◽  
Author(s):  
Jill Hutton ◽  
Paul J. Rowan
Keyword(s):  
Vertical Transmission ◽  
Transmission Rate ◽  
Monozygotic Twin ◽  
Dizygotic Twin ◽  
Cmv Infection ◽  
Vertical Transmission Rate ◽  
Congenital Cmv Infection ◽  
Twin Pregnancies ◽  
Congenital Cmv ◽  
Singleton Pregnancies

ObjectiveThe objectives are to estimate the vertical transmission rate in twins relative to singleton pregnancies, to evaluate whether discordance within twin pairs is rare, and to characterize concordance within monozygotic and dizygotic twin pairs in relation to hereditability.MethodsWe first sought to estimate the vertical transmission rate of congenital CMV infection in twins by gathering cohort-based studies of congenital CMV in which vertical transmission in both singleton and twin pregnancies was reported. This also allowed us to compare singleton and twin infection rates. From the above studies and other large cohorts of congenitally infected infants, the percentage of discordantly infected twin pairs determined whether this is a rare phenomenon. Theorizing discordance is not rare, we then analyzed data from cases with twin outcomes for congenital CMV infection, according to whether the twins were monozygotic or dizygotic, and calculated their corresponding concordance rates to estimate the broad-sense heritability. Lastly, we described other factors that might affect vertical transmission.ResultsFrom five articles following at-risk pregnancies, the rate of vertical transmission in twin pregnancies is 58.7% (95% CI 43.3-72.3%) whereas in singleton pregnancies it is 31.4% (95% CI: 29.0-34.0%) p = 0.0002. Of ten studies of larger cohorts of infants with congenital CMV infection, 21 of 42 twin pairs with at least one twin infected were discordant for congenital CMV (50.0%, 95% CI: 34.4–65.6%) indicating discordance of congenital CMV infection in twin pairs is not rare. Of 28 studies covering 37 twin pairs where at least one twin had congenital CMV, and zygosity was known, eleven of thirteen monozygotic twin pairs (84.6%; 95% CI: 53.7-97.3%) were concordant for CMV infection, and nine of twenty-four dizygotic twin pairs (37.5%; 95% CI: 19.6-59.2%) were concordant for infection giving an estimated hereditability of 94.2%. Within these 37 twin pairs, factors such as primary or recurrent maternal infection, prematurity, growth discordance, and sex are described; however, in many of these cases these factors are unknown.ConclusionThe rate of vertical transmission of congenital CMV is higher for twins than singletons. Discordance of congenital CMV in twins is not rare and suggests a possible genetic susceptibility to congenital CMV.

scholarly journals Rates and predictors of adherence and retention for antiretroviral therapy among HIV-positive adults in Enugu, Nigeria

2019 ◽  
Vol 31 (3) ◽  
pp. 202-211
Author(s):  
Onyinye Hope Chime
Keyword(s):  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Related Factors ◽  
Art Programs ◽  
Adherence To Medication ◽  
Behavioural Modification ◽  
Resource Limited ◽  
Sub Saharan ◽  
Living With Hiv ◽  
Predictors Of Adherence

BackgroundHIV infection and AIDS are majorpublic health challenges in Nigeria, a country with one of the highest rates of new infection in sub-Saharan Africa and the second largest HIV epidemic in the world.Non-adherence to medication and defaulting from treatment are the two major challenges faced by anti-retroviral therapy (ART) programs in resource-constrained settings. This study was undertaken to determine the rate and predictors of adherence to medication and retention among people living with HIVin Enugu State, Nigeria.MethodsThis was a cross-sectionalretrospective study conducted among adults living with HIV(PLHIV) receiving ARTs in eightcomprehensive health facilities in Enugu, Nigeria. We used self-reported adherence and recorded clinic visits to assess adherence and retention, respectively. Descriptive statistics (frequencies, proportions, mean and standard deviation) and regression analysis were then conducted to identify the association between adherence, retention and demographic and health-related factors. ResultsThe mean age of respondents was 38.5±9.8 years. Predictors of good adherence to medication includedbeing male(adjusted odds ratio [AOR]:2.08; 95% confidence interval [CI]:1.12–3.85), having been on anti-retroviral medications for more than 5 years (AOR:1.92; 95% CI: 1.17–3.16), the non-consumption of alcohol(AOR: 3.67; 95% CI: 2.01–6.70),not usingtraditional medicine (AOR: 2.76; 95% CI:1.33–5.73) and having a baseline CD4count exceeding 500 cells/μl (AOR: 5.67; 95% CI: 1.32–24.32).Adequate retention was predicted by being resident in the urban area (AOR: 1.90; 95% CI: 1.17–3.06). Being away from home (41.8%) and forgetfulness (35.0%) were reported as the major reasons for missing medication.ConclusionThe rates of adherence and retention found in this study were similar to those reported forother resource-limited settings. Health education and behavioural modification interventions should be intensified to reduce the consumption of alcohol and the use of traditional medicine by people living with HIV. Identifying other factors may help to design effective strategies to ensure that people living with HIV adhere to their medications and remain in care.

scholarly journals Frequency of Pneumocystis jirovecii in sputum from HIV and TB patients in Namibia

2014 ◽  
Vol 8 (03) ◽  
pp. 349-357 ◽  
Author(s):  
Vincent Nowaseb ◽  
Esegiel Gaeb ◽  
Marcin G Fraczek ◽  
Malcolm D Richardson ◽  
David W Denning
Keyword(s):  
Pneumocystis Pneumonia ◽  
Sub Saharan Africa ◽  
Pneumocystis Jirovecii ◽  
Aids Patients ◽  
Limited Region ◽  
Minimum Frequency ◽  
Resource Limited ◽  
Smear Negative ◽  
Sub Saharan ◽  
Hiv Aids

Introduction: The opportunistic fungus Pneumocystis jirovecii causes Pneumocystis pneumonia (PcP), which is a life-threatening infection in HIV/AIDS patients. The seemingly low prevalence of P. jirovecii pneumonia in sub-Saharan Africa has been a matter of great debate because many HIV/AIDS patients reside in this region. The lack of suitable diagnostic practices in this resource limited-region has been added to the uncertainty of PcP prevalence. Only a few studies have evaluated the utility of easily obtainable samples such as expectorated sputum for diagnosis of PcP. Thus, the aim of the current study was to evaluate the effectiveness of expectorated sputum for the routine diagnosis of PcP in a resource-limited sub-Saharan African setting. Methodology: Randomly collected sputum samples were analysed by microscopy after Grocott’s methenamine silver (GMS) stain staining and by qPCR to determine the minimum frequency of detectable P. jirovecii. Results: A total of 475 samples were analysed. Twenty five (5.3%) samples were positive for P. jirovecii, i.e., 17 (3.6%) using both qPCR and GMS staining and eight (1.7%) using qPCR only. P. jirovecii was present in 8/150 (5.3%) HIV-positive and tuberculosis (TB) smear-negative patients, and in 12/227 (5.3%) TB smear-negative patients with an unknown HIV status. The minimum frequency of PcP was 3.6% in Namibian HIV and TB patients, while the actual frequency is likely to be 5.3%. Conclusion: This study demonstrated that expectorated sputum can be used routinely for the diagnosis of PcP by GMS, although qPCR is more sensitive, and it requires less time and skill.

Legal History and Historiography in Colonial Sub-Saharan Africa

2018 ◽  
Author(s):  
Richard Waller
Keyword(s):  
Cultural History ◽  
Legal History ◽  
Social Impact ◽  
Customary Law ◽  
Sub Saharan Africa ◽  
Court Records ◽  
Sub Saharan ◽  
Distribution Of Power ◽  
Judicial Procedures ◽  
Criminal Matters

Increasingly, the study of law in colonial Africa has moved out of the domain of legal scholarship per se, where it had its origins in the 1940s, and into that of social and cultural history; it has also shifted from a rules-based approach, primarily concerned with legal codes and judicial institutions, to one that focuses on process and explores the complex relationship between law and culture. As the field has expanded, it has divided into sub-branches. Some remain within the scope of legal history, defined as the study of how legal codes and judicial procedures have developed and changed and of the issues of principle that arose; others are more concerned with the social impact of law, how the establishment of colonial legal regimes, including customary law and the courts where cases could be heard, presented new dilemmas and opportunities and altered the distribution of power in African communities. Beyond this, historians have also used legal records, especially court records, as social documents without being directly concerned with their particular legal and judicial contexts. Once their limitations and the difficulties of interpretation that they present have been understood, such records offer potentially rich insights into family and household affairs as well as into more obviously civil or criminal matters.

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