scholarly journals The impact of the evolving HIV response on the epidemiology of tuberculosis in South African children and adolescents

2021 ◽  
Author(s):  
Karen du Preez ◽  
Muhammad Osman ◽  
James A Seddon ◽  
Pren Naidoo ◽  
H Simon Schaaf ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Control Strategies ◽  
Substantial Contribution ◽  
Hiv Positive ◽  
Tuberculosis Control ◽  
Tuberculosis Case ◽  
Infection Age ◽  
Treatment Register ◽  
The Impact ◽  
Age And Sex

Abstract Background Few studies have evaluated tuberculosis control in children and adolescents. We used routine tuberculosis surveillance data to quantify age- and HIV-stratified trends over time and investigate the relationship between tuberculosis, HIV, age and sex. Methods All children and adolescents (0-19 years) routinely treated for drug-susceptible tuberculosis in South Africa and recorded in a de-duplicated national electronic tuberculosis treatment register (2004-2016) were included. Age- and HIV-stratified tuberculosis case notification rates (CNRs) were calculated in four age bands: 0-4, 5-9, 10-14 and 15-19 years. The association between HIV infection, age and sex in children and adolescents with TB was evaluated using multivariable logistic regression. Results Of 719,400 children and adolescents included, 339,112 (47%) were 0-4-year-olds. The overall tuberculosis CNR for 0-19-year-olds declined by 54% between 2009 and 2016 (incidence rate ratio [IRR]=0.46, 95% confidence interval [CI] 0.45-0.47). Trends varied by age and HIV, with the smallest reductions (2013-2016) in HIV-positive 0-4-year-olds (IRR=0.90, 95%CI 0.85-0.95) and both HIV-positive (IRR=0.84, 95%CI 0.80-0.88) and HIV-negative (IRR=0.89, 95%CI 0.86-0.92) 15-19-year-olds. Compared to 0-4-year-old males, odds of HIV co-infection among 15-19-year-olds were nearly twice as high in females (adjusted odd’s ratio [aOR]=2.49, 95%CI 2.38-2.60) than in males (aOR=1.35, 95%CI 1.29-1.42). Conclusions South Africa’s national response to the HIV epidemic has made a substantial contribution to the observed declining trends in tuberculosis CNRs in children and adolescents. The slow decline of tuberculosis CNRs in adolescents and young HIV-positive children is concerning. Understanding how tuberculosis affects children and adolescents beyond conventional age bands and by sex, can inform targeted tuberculosis control strategies.

scholarly journals Modeling the Impact of Tuberculosis Control Strategies in Highly Endemic Overcrowded Prisons

PLoS ONE ◽  
2008 ◽  
Vol 3 (5) ◽  
pp. e2100 ◽  
Author(s):  
Judith Legrand ◽  
Alexandra Sanchez ◽  
Francoise Le Pont ◽  
Luiz Camacho ◽  
Bernard Larouze
Keyword(s):  
Control Strategies ◽  
Tuberculosis Control ◽  
The Impact

scholarly journals Management of mental health disorders and central nervous system sequelae in HIV-positive children and adolescents

2014 ◽  
Vol 15 (3) ◽  
pp. 81-96 ◽  
Author(s):  
R Nassen ◽  
K Donald ◽  
K Walker ◽  
S Paruk ◽  
M Vujovic ◽  
...  
Keyword(s):  
Mental Health ◽  
Central Nervous System ◽  
Nervous System ◽  
Mental Disorders ◽  
Children And Adolescents ◽  
Mental Health Disorders ◽  
Hiv Positive ◽  
Increased Risk ◽  
Health Disorders ◽  
The Impact

HIV-positive children and adolescents are at increased risk of both central nervous system (CNS) sequelae and mental disorders owing to a number of factors, including the impact of HIV infection on the brain, social determinants of health (e.g. poverty and orphanhood) and psychosocial stressors related to living with HIV. Every effort should be made to identify perinatally HIV-infected children and initiate them on antiretroviral therapy early in life. HIV clinicians should ideally screen for mental health and neurocognitive problems, as part of the routine monitoring of children attending antiretroviral clinics. This guideline is intended as a reference tool for HIV clinicians to support the early identification, screening and management of mental health disorders and/or CNS impairment in children and adolescents. This guideline covers mental disorders (section 1) and HIV-associated neurocognitive disorders (section 2) among children and adolescents.  

scholarly journals HIV Disclosure in Children in a Tertiary Hospital in Southern Nigeria–Child’s Perspective

2020 ◽  
pp. 16-27
Author(s):  
A. U. Eneh ◽  
R. O. Ugwu ◽  
N. I. Paul
Keyword(s):  
Health Care ◽  
Children And Adolescents ◽  
Health Care Providers ◽  
Primary Caregiver ◽  
Hiv Disclosure ◽  
Family Characteristics ◽  
Hiv Positive ◽  
Care Providers ◽  
Port Harcourt ◽  
The Impact

Background: Disclosure of HIV status to children is essential for disease management. Studies on disclosure in children have largely described it from the health provider’s perspective or caregiver’s perspective. Caregivers’ and children’s reports about children’s feelings and distress can however differ. Understanding the disclosure process from the perspective of HIV-positive children will therefore better portray the impact it had on them. Aim: The aim of the study was to explore from the child’s perspective the process of disclosure, the impact it had on them, how they have coped and suggestions on how they think it could be done better. Methods: A cross-sectional study of HIV-infected children and adolescents aged 8–18 years who are aware of their status attending paediatric HIV clinic at the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Nigeria from April 2015 to March 2016. Data were collected using an open-ended questionnaire administered by a Paediatric health care provider. Information sought included: Biodata (age, gender), educational levels of the child, family characteristics (primary caregiver, orphan status), age at disclosure, process of disclosure, the impact of the disclosure, how they have coped, what they did not like about the way they were told and suggested better ways of telling the children. Results: Seventy-eight HIV-positive children and adolescents were interviewed. Their ages ranged from 8 – 18 yrs with a mean age of 14.74±2.23 years. Forty (51.3%) were males, 50 (64.1%) were in secondary schools, 43 (55.1%) were orphans and the mode of transmission was vertical in 70 (89.7%). In majority 33 (42.3%), the biologic mother was the primary caregiver. Majority of the children 34 (43.6%) had their status disclosed to them between 13 and 14 years. The mother alone did the disclosure in 30 (38.5%). Thirty-six (46.2%) were already aware of their status before disclosure. Disclosure was a one-off event without discussions in 48 (61.5%). The commonest immediate reactions was depression 48 (61.5%). The majority 48(61.5%) became more prayerful as a coping strategy. All 78 (100%) agreed that disclosure has positively impacted on their taking their ARV drugs and clinic attendance. Concerning suggestions from the children, 36 (46.2%) said the most appropriate age for disclosure should be 12-13 years, 54 (69.2%) suggest that both parents should do the disclosure while 60 (76.9%) said that the children should be told how they got infected. Their major concern was having to take drugs for life 60 (76.9%). Conclusion: Disclosure process is suboptimal. Understanding the disclosure process from the perspective of HIV-infected children, therefore, is critical to developing interventions to improve disclosure. Most of the parent’s fears of negative impact of status disclosure may be exaggerated. There is need for health care providers to develop a plan with the caregivers of HIV-infected children on the optimal disclosure process and how to anticipate and resolve questions the children may have following disclosure.

scholarly journals Nasopharyngeal Meningococcal Carriage among Children and Adolescents in Turkey in 2018: An Unexpected High Serogroup X Carriage

Children ◽  
2021 ◽  
Vol 8 (10) ◽  
pp. 871
Author(s):  
Mahmut Can Kizil ◽  
Omer Kilic ◽  
Mehmet Ceyhan ◽  
Merve Iseri Nepesov ◽  
Adem Karbuz ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Control Strategies ◽  
Age Groups ◽  
Antibiotic Use ◽  
Age Group ◽  
Upper Respiratory Tract ◽  
Carriage Rate ◽  
Significant Difference ◽  
Tract Infections ◽  
The Impact

Meningococcal carriage studies and transmission modeling can predict IMD epidemiology and used to define invasive meningococcal disease (IMD) control strategies. In this multicenter study, we aimed to evaluate the prevalence of nasopharyngeal Neisseria meningitidis (Nm) carriage, serogroup distribution, and related risk factors in Turkey. Nasopharyngeal samples were collected from a total of 1267 children and adolescents and were tested with rt-PCR. Nm carriage was detected in 96 participants (7.5%, 95% CI 6.1–9.0), with the peak age at 13 years (12.5%). Regarding age groups, Nm carriage rate was 7% in the 0–5 age group, was 6.9%in the 6–10 age group, was 7.9% in the 11–14 age group, and was 9.3% in the 15–18 age group. There was no statistically significant difference between the groups (p > 0.05). The serogroup distribution was as follows: 25% MenX, 9.4% MenA, 9.4% MenB, 2.1% MenC, 3.1% MenW, 2.1% for MenY, and 48.9% for non-groupable. The Nm carriage rate was higher in children with previous upper respiratory tract infections and with a high number of household members, whereas it was lower in children with antibiotic use in the last month (p < 0.05 for all). In this study, MenX is the predominant carriage strain. The geographical distribution of Nm strains varies, but serogroup distribution in the same country might change in a matter of years. Adequate surveillance and/or a proper carriage study is paramount for accurate/dynamic serogroup distribution and the impact of the proposed vaccination.

The impact of speech therapy on asthma and allergic rhinitis control in mouth breathing children and adolescents

2010 ◽  
Vol 0 (0) ◽  
Author(s):  
Silvia M. A. Campanha ◽  
Maria J. F. Fontes ◽  
Paulo A. M. Camargos ◽  
Lincoln M. S. Freire (in memorian)
Keyword(s):  
Allergic Rhinitis ◽  
Children And Adolescents ◽  
Speech Therapy ◽  
Mouth Breathing ◽  
The Impact

scholarly journals Power Hardware-in-the-Loop-Based Performance Analysis of Different Converter Controllers for Fast Active Power Regulation in Low-Inertia Power Systems

Energies ◽  
2021 ◽  
Vol 14 (11) ◽  
pp. 3274
Author(s):  
Jose Rueda Torres ◽  
Zameer Ahmad ◽  
Nidarshan Veera Kumar ◽  
Elyas Rakhshani ◽  
Ebrahim Adabi ◽  
...  
Keyword(s):  
Performance Evaluation ◽  
Power Systems ◽  
Real Time ◽  
Control Strategies ◽  
Active Power ◽  
Power Electronic ◽  
Hardware In The Loop ◽  
Digital Controllers ◽  
Power Regulation ◽  
The Impact

Future electrical power systems will be dominated by power electronic converters, which are deployed for the integration of renewable power plants, responsive demand, and different types of storage systems. The stability of such systems will strongly depend on the control strategies attached to the converters. In this context, laboratory-scale setups are becoming the key tools for prototyping and evaluating the performance and robustness of different converter technologies and control strategies. The performance evaluation of control strategies for dynamic frequency support using fast active power regulation (FAPR) requires the urgent development of a suitable power hardware-in-the-loop (PHIL) setup. In this paper, the most prominent emerging types of FAPR are selected and studied: droop-based FAPR, droop derivative-based FAPR, and virtual synchronous power (VSP)-based FAPR. A novel setup for PHIL-based performance evaluation of these strategies is proposed. The setup combines the advanced modeling and simulation functions of a real-time digital simulation platform (RTDS), an external programmable unit to implement the studied FAPR control strategies as digital controllers, and actual hardware. The hardware setup consists of a grid emulator to recreate the dynamic response as seen from the interface bus of the grid side converter of a power electronic-interfaced device (e.g., type-IV wind turbines), and a mockup voltage source converter (VSC, i.e., a device under test (DUT)). The DUT is virtually interfaced to one high-voltage bus of the electromagnetic transient (EMT) representation of a variant of the IEEE 9 bus test system, which has been modified to consider an operating condition with 52% of the total supply provided by wind power generation. The selected and programmed FAPR strategies are applied to the DUT, with the ultimate goal of ascertaining its feasibility and effectiveness with respect to the pure software-based EMT representation performed in real time. Particularly, the time-varying response of the active power injection by each FAPR control strategy and the impact on the instantaneous frequency excursions occurring in the frequency containment periods are analyzed. The performed tests show the degree of improvements on both the rate-of-change-of-frequency (RoCoF) and the maximum frequency excursion (e.g., nadir).

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