scholarly journals Child mortality associated with maternal HIV status: a retrospective analysis in Rwanda, 2005-2015

2021 ◽  
Vol 6 (5) ◽  
pp. e004398
Author(s):  
Eric Remera ◽  
Frédérique Chammartin ◽  
Sabin Nsanzimana ◽  
Jamie Ian Forrest ◽  
Gerald E Smith ◽  
...  
Keyword(s):  
Higher Education ◽  
Child Mortality ◽  
Scale Up ◽  
Mortality Rates ◽  
Hiv Treatment ◽  
Hiv Status ◽  
Multivariable Logistic Regression Model ◽  
Live Births ◽  
Maternal Hiv ◽  
Hiv Negative

IntroductionChild mortality remains highest in regions of the world most affected by HIV/AIDS. The aim of this study was to assess child mortality rates in relation to maternal HIV status from 2005 to 2015, the period of rapid HIV treatment scale-up in Rwanda.MethodsWe used data from the 2005, 2010 and 2015 Rwanda Demographic Health Surveys to derive under-2 mortality rates by survey year and mother’s HIV status and to build a multivariable logistic regression model to establish the association of independent predictors of under-2 mortality stratified by mother’s HIV status.ResultsIn total, 12 010 live births were reported by mothers in the study period. Our findings show a higher mortality among children born to mothers with HIV compared with HIV negative mothers in 2005 (216.9 vs 100.7 per 1000 live births) and a significant reduction in mortality for both groups in 2015 (72.0 and 42.4 per 1000 live births, respectively). In the pooled reduced multivariable model, the odds of child mortality was higher among children born to mothers with HIV, (adjusted OR, AOR 2.09; 95% CI 1.57 to 2.78). The odds of child mortality were reduced in 2010 (AOR 0.69; 95% CI 0.59 to 0.81) and 2015 (AOR 0.35; 95% CI 0.28 to 0.44) compared with 2005. Other independent predictors of under-2 mortality included living in smaller families of 1–2 members (AOR 5.25; 95% CI 3.59 to 7.68), being twin (AOR 4.93; 95% CI 3.51 to 6.92) and being offspring from mothers not using contraceptives at the time of the survey (AOR 1.6; 95% CI 1.38 to 1.99). Higher education of mothers (completed primary school: (AOR 0.74; 95% CI 0.64 to 0.87) and secondary or higher education: (AOR 0.53; 95% CI 0.38 to 0.74)) was also associated with reduced child mortality.ConclusionsThis study shows an important decline in under-2 child mortality among children born to both mothers with and without HIV in Rwanda over a 10-year span.

scholarly journals At-home HIV self-testing during COVID: implementing the GetaKit project in Ottawa

2021 ◽  
Author(s):  
Patrick O’Byrne ◽  
Alexandra Musten ◽  
Lauren Orser ◽  
Gauri Inamdar ◽  
Marie-Odile Grayson ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Scale Up ◽  
Vaccine Trial ◽  
Hiv Treatment ◽  
Baseline Survey ◽  
Healthcare Settings ◽  
Self Testing ◽  
Self Test ◽  
The University ◽  
Hiv Negative

Abstract Setting In March 2020, COVID-19 shuttered access to many healthcare settings offering HIV testing and there is no licensed HIV self-test in Canada. Intervention A team of nurses at the University of Ottawa and Ottawa Public Health and staff from the Ontario HIV Treatment Network (OHTN) obtained Health Canada’s Special Access approval on April 23, 2020 to distribute bioLytical’s INSTI HIV self-test in Ottawa; we received REB approval on May 15, 2020. As of July 20, 2020, eligible participants (≥18 years old, HIV-negative, not on PrEP, not in an HIV vaccine trial, living in Ottawa, no bleeding disorders) could register via www.GetaKit.ca to order kits. Outcomes In the first 6 weeks, 637 persons completed our eligibility screener; 43.3% (n = 276) were eligible. Of eligible participants, 203 completed a baseline survey and 182 ordered a test. These 203 participants were an average of 31 years old, 72.3% were white, 60.4% were cis-male, and 55% self-identified as gay. Seventy-one percent (n = 144) belonged to a priority group for HIV testing. We have results for 70.9% (n = 129/182) of participants who ordered a kit: none were positive, 104 were negative, 22 were invalid, and 2 “preferred not to say”; 1 participant reported an unreadiness to test. Implications Our results show that HIV self-testing is a pandemic-friendly strategy to help ensure access to sexual health services among persons who are good candidates for HIV testing. It is unsurprising that no one tested positive for HIV thus far, given the 0.08% positivity rate for HIV testing in Ottawa. As such, we advocate for scale-up of HIV self-testing in Canada.

scholarly journals HIV treatment cascade among people who inject drugs in Ukraine

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244572
Author(s):  
Yana Sazonova ◽  
Roksolana Kulchynska ◽  
Yuliia Sereda ◽  
Marianna Azarskova ◽  
Yulia Novak ◽  
...  
Keyword(s):  
Harm Reduction ◽  
People Who Inject Drugs ◽  
Scale Up ◽  
Linkage To Care ◽  
Hiv Treatment ◽  
Hiv Positive ◽  
Hiv Status ◽  
Opioid Agonist ◽  
Treatment Cascade ◽  
Hiv Treatment Cascade

The HIV treatment cascade is an effective tool to track progress and gaps in the HIV response among key populations. People who inject drugs (PWID) remain the most affected key population in Ukraine with HIV prevalence of 22% in 2015. We performed secondary analysis of the 2017 Integrated Bio-Behavioral Surveillance (IBBS) survey data to construct the HIV treatment cascade for PWID and identify correlates of each indicator achievement. The biggest gap in the cascade was found in the first “90”, HIV status awareness: only 58% [95% CI: 56%-61%] of HIV-positive PWID reported being aware of their HIV-positive status. Almost 70% [67%-72%] of all HIV-infected PWID who were aware of their status reported that they currently received antiretroviral therapy (ART). Almost three quarters (74% [71%-77%]) of all HIV-infected PWID on ART were virally suppressed. Access to harm reduction services in the past 12 months and lifetime receipt of opioid agonist treatment (OAT) had the strongest association with HIV status awareness. Additionally, OAT patients who were aware of HIV-positive status had 1.7 [1.2–2.3] times the odds of receiving ART. Being on ART for the last 6 months or longer increased odds to be virally suppressed; in contrast, missed recent doses of ART significantly decreased the odds of suppression. The HIV treatment cascade analysis for PWID in Ukraine revealed substantial gaps at each step and identified factors contributing to achievement of the outcomes. More intensive harm reduction outreach along with targeted case finding could help to fill the HIV awareness gap among PWID in Ukraine. Scale up of OAT and community-level linkage to care and ART adherence interventions are viable strategies to improve ART coverage and viral suppression among PWID.

scholarly journals Placental Malaria histological features and the burden of congenital malaria among HIV/ malaria co-infected mothers in Benin City, Edo State

2021 ◽  
Vol 48 (1) ◽  
pp. 12-19
Author(s):  
Fidelis E. Eki-udoko ◽  
Ayebo Sadoh ◽  
Michael O. Ibadin ◽  
Augustine I. Omoigberale
Keyword(s):  
Peripheral Blood ◽  
Placental Malaria ◽  
Blood Film ◽  
Hiv Positive ◽  
Hiv Status ◽  
Chronic Type ◽  
Hiv Positive Mothers ◽  
Maternal Hiv ◽  
Congenital Malaria ◽  
Hiv Negative

 Background: It is well documented that sub-Saharan Africa bears the highest burden of both malaria and HIV. Coinfection with both diseases is also well documented. Malaria parasites infecting the placenta lead to inflammation, intervillous fibrin deposition and infarction. This pathologic effect of malaria on the placental has led to the staging of placental malaria histology. These pathologic features may reflect different levels in the breach of the integrity of the placenta which may predispose to transmission of congenital malaria and possibly HIV. But few if any have examined the association of maternal placental malaria histology stages in HIV positive and negative mothers and the effects of these on their newborns (congenital malaria). Methods: Subjects were 162 newborns of HIV/malaria co-infected mothers and Controls were 162 newborns of HIV negative malaria infected mothers. Blood film for malaria parasites was done on cord blood and peripheral blood on days 1, 3 and 7 in the newborns. Maternal peripheral blood film for malaria parasite was done at delivery and placental tissue was obtained for confirmation of placental malaria by histology. Diagnosis of malaria in blood films was by light microscopy. Results: The placental malaria histology in HIV positive mothers were predominantly the chronic type (51.9%) and past type (54.6%) in HIV negative mothers respectively. Congenital malaria was significantly more in chronic types of placental malaria histology irrespective of maternal HIV status (p=0.017 in subjects and p= 0.000 in controls respectively) Conclusion: Babies born to mothers are at increased risk for congenital malaria if their placental malaria histology is of the chronic type compared to the other types (active and past) irrespective of maternal HIV status. This risk (chronic type) is highest in mothers with HIV; therefore, all babies born to HIV positive mothers should be screened for congenital malaria and managed as appropriate.

scholarly journals Factors are not the same for risk of stopping exclusive breast-feeding and introducing different types of liquids and solids in HIV-affected communities in Ghana

2016 ◽  
Vol 116 (1) ◽  
pp. 115-125 ◽  
Author(s):  
Grace S. Marquis ◽  
Anna Lartey ◽  
Rafael Perez-Escamilla ◽  
Robert E. Mazur ◽  
Lucy Brakohiapa ◽  
...  
Keyword(s):  
Infant Feeding ◽  
Breast Feeding ◽  
Hiv Status ◽  
Maternal Characteristics ◽  
Exclusive Breast Feeding ◽  
Daily Diet ◽  
Maternal Hiv ◽  
Health And Development ◽  
Weight For Age ◽  
Hiv Negative

AbstractExclusive breast-feeding (EBF) for 6 months supports optimal infant growth, health and development. This paper examined whether maternal HIV status was associated with EBF and other infant feeding practices. Pregnant women were enrolled after HIV counselling, and their babies were followed up for up to 1 year. Data on household socio-economics and demographics, maternal characteristics and infants’ daily diet were available for 482 infants and their mothers (150 HIV-positive (HIV-P), 170 HIV-negative (HIV-N) and 162 HIV-unknown (HIV-U)). Survival analyses estimated median EBF duration and time to introduction of liquids and foods; hazards ratios (HR) used data from 1–365 and 1–183 d, adjusting for covariates. Logistic regression estimated the probability of EBF for 6 months. Being HIV-P was associated with a shorter EBF duration (139 d) compared with HIV-N (163 d) and HIV-U (165 d) (P=0·004). Compared with HIV-N, being HIV-P was associated with about a 40 % higher risk of stopping EBF at any time point (HR 1·39; 95 % CI 1·06, 1·84; P=0·018) and less than half as likely to complete 6 months of EBF (adjusted OR 0·42; 95 % CI 0·22, 0·81; P=0·01). Being HIV-P tended to be or was associated with a higher risk of introducing non-milk liquids (HR 1·34; 95 % CI 0·98, 1·83; P=0·068), animal milks (HR 2·37; 95 % CI 1·32, 4·24; P=0·004) and solids (HR 1·56; 95 % CI 1·10, 2·22; P=0·011) during the first 6 months. Weight-for-age Z-score was associated with EBF and introducing formula. Different factors (ethnicity, food insecurity, HIV testing strategy) were associated with the various feeding behaviours, suggesting that diverse interventions are needed to promote optimal infant feeding.

scholarly journals Maternal HIV Infection as a Risk Factor for Primary Epstein-Barr Virus Infection in Kenyan Infants

2022 ◽  
Vol 11 ◽  
Author(s):  
Gabriela Samayoa-Reyes ◽  
Sidney O. Ogolla ◽  
Ibrahim I. Daud ◽  
Conner Jackson ◽  
Katherine R. Sabourin ◽  
...  
Keyword(s):  
Risk Factor ◽  
Viral Load ◽  
Breast Milk ◽  
Hiv Infection ◽  
Post Partum ◽  
P Value ◽  
Hiv Status ◽  
Significant Difference ◽  
Maternal Hiv ◽  
Hiv Negative

Human immunodeficiency virus (HIV) infection is known to be associated with EBV shedding in saliva suggesting an increased risk of EBV transmission to infants born to mothers with HIV at an earlier age. In this study we investigated (i) whether maternal HIV status was a risk factor for EBV in blood at delivery or for shedding in saliva and breast milk of 6- and 10-weeks post-partum mothers, (ii) if there was a difference in EBV strains shed between HIV+ and HIV- mothers, and (iii) if maternal HIV status was a determinant of EBV viral load in their infants. Samples were collected as part of a prospective cohort study that followed HIV-positive (HIV+) and HIV-negative (HIV-) pregnant women in Western Kenya through delivery and post-partum period. EBV viral load in blood was found to be significantly higher in mothers with HIV (p-value = 0.04). Additionally, a statistically significant difference was observed between EBV viral load in saliva samples and HIV status where HIV+ mothers had a higher EBV viral load in saliva at 6-weeks post-partum compared to HIV- mothers (p-value < 0.01). The difference in EBV shedding in breast milk was not found to be statistically significant. Furthermore, no difference in frequency of EBV strain was attributable to HIV- or HIV+ mothers. Interestingly, we found that infants born to HIV+ mothers had a higher EBV viral load at the time of their first EBV detection in blood than infants born to HIV- mothers and this was independent of age at detection. Overall, our study suggests that HIV infected mothers shed more virus in saliva than HIV-negative mothers and infants born to HIV+ mothers were at risk for loss of control of primary EBV infection as evidenced by higher EBV viral load following primary infection.

scholarly journals Comparison of child mortality by characteristics at birth in England and in Sweden using linked administrative data

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Anna Zylbersztejn ◽  
Ruth Gilbert ◽  
Anders Hjern ◽  
Pia Hardelid
Keyword(s):  
Risk Factors ◽  
Early Childhood ◽  
Child Mortality ◽  
Early Life ◽  
Congenital Malformations ◽  
Mortality Rates ◽  
Birth Cohorts ◽  
Policy Makers ◽  
Live Births ◽  
Administrative Health Databases

ABSTRACT ObjectivesEngland has one of the highest child mortality rates in Western Europe, while Sweden has one of the lowest. These differences suggest that improvements in early life mortality should be achievable in England. However, policy makers need to know when in the life course to target interventions to prevent the largest number of deaths in early life, e.g. by addressing the prevalence of risk factors at birth (such as preterm birth or low birthweight), or improving the care of babies after birth. This study aims to compare child mortality in England and in Sweden using whole country birth cohorts based on linked administrative health databases in order to determine whether the disparities are driven by risk factors operating before or after birth. ApproachWe created birth cohorts from a national birth register (Sweden) and a hospital admission database (England). These were linked to longitudinal hospital data and death registration data. All singleton live births for 2003-2012 were included and followed from birth up to five years. We compared mortality in England and in Sweden using Cox proportional hazard model with characteristics at birth (gestation, birthweight, gender, maternal age, congenital malformations), socio-economic status and country as covariates. ResultsThe study cohort comprised 1,047,192 children in Sweden and 6,117,693 children in England. 2,820 of cohort children died in Sweden (0.3%) and 28,434 in England (0.5%). Preliminary results showed that under-5 mortality was almost twice as high in England as in Sweden (5.1 deaths per 1000 live births, 95% confidence interval (CI): 5.0/1000-5.2/1000 vs 3.0/1000, 95% CI: 2.9/1000-3.2/1000). Mortality rates were 45% higher in England during infancy, but only 15% higher in early-childhood (1-4 years). Children with congenital malformations were at similar risk of death in England (33.9/1000, 95% CI: 32.9/1000-34.8/1000) as in Sweden (32.7/1000, 95% CI: 29.5/1000-35.8/1000). The prevalence of congenital malformations, however, was twice as high in England (5.1% vs 2.6%). ConclusionsOur preliminary results suggest that the disparities in early-childhood mortality were partly driven by increased prevalence of congenital malformations in England relative to Sweden, as mortality rates within this group were comparable. Individual-level data from birth cohorts constructed using linked administrative health databases enable comparing mortality among children with the same combinations of risk factors at birth. Such analyses can inform policy makers whether resources to prevent early-life mortality are most effectively targeted at improving the health of pregnant women, neonatal care, or supporting families with young children.

scholarly journals International financial organisations and global child mortality rates

2021 ◽  
Author(s):  
Elias Nosrati
Keyword(s):  
Child Mortality ◽  
Large Scale ◽  
Causal Effect ◽  
Mortality Rates ◽  
Policy Reforms ◽  
Live Births ◽  
Child Deaths ◽  
The World ◽  
Aggregate Effect ◽  
The International Monetary Fund

This paper makes a contribution to the sociology and political economy of "successful societies" by investigating how children’s health across the world is impacted by multilateral financial organisations. In particular, I assess the causal effect of domestic policy reforms mandated by the International Monetary Fund (IMF) on child mortality rates across 176 countries between 1990 and 2017 using instrumental variables. I find that IMF programmes cause up to 90 excess under-5 deaths per 1,000 live births (95% CI: 50–130). This aggregate effect appears to be driven by large-scale privatisation reforms, which cause up to 132 excess child deaths per 1,000 live births (95% CI: 72–191).

scholarly journals Under-two child mortality according to maternal HIV status in Rwanda: assessing outcomes within the National PMTCT Program

2011 ◽  
Vol 9 (1) ◽  
Author(s):  
P Mugwaneza ◽  
NU Wa Shema ◽  
H Ruton ◽  
A Rukundo ◽  
A Lyambabaje ◽  
...  
Keyword(s):  
Child Mortality ◽  
Pmtct Program ◽  
Hiv Status ◽  
Maternal Hiv

scholarly journals Baseline Socio-Demographic and Mortality Profile of a Peri-urban Coastal Community in Karachi, Pakistan Before the Introduction of a Comprehensive Maternal, Newborn and Child Health Intervention Package

2021 ◽  
Author(s):  
Muhammad Ilyas ◽  
Kanwal Nayani ◽  
Ameer Muhammad ◽  
Yasir Shafiq ◽  
Benazir Baloch ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Child Health ◽  
Neonatal Mortality ◽  
Child Mortality ◽  
Mortality Rates ◽  
Evidence Based ◽  
Intervention Package ◽  
Newborn And Child Health ◽  
Live Births ◽  
And Child Health

Abstract Objective Pakistan has the highest neonatal mortality rate and one of the highest under-5 mortality rates in the world, at 42 deaths and 74 deaths per thousand live births respectively. We undertook implementation of an evidence-based maternal, newborn and child health (MNCH) intervention package to reduce under-five mortality in Rehri Goth, a peri-urban coastal community on the outskirts of Karachi, Pakistan. This paper aims to present the socio-demographic and under-5 mortality profile of Rehri Goth prior to implementation of the intervention package. We conducted a detailed census of all households on socio-demographic variables. ResultsOver the course of the census period, 6,962 households were visited. The total population of Rehri Goth was found to be 42,980. The male to female ratio was 52:48. Among adults aged 15 years and above, 67.1% had no formal education. The neonatal mortality and under-five mortality rates were 59 and 109 deaths per 1,000 live births respectively. Rehri Goth has a baseline child mortality rate that is higher than the national average in Pakistan. This provides an opportunity to deliver an evidence-based, targeted MNCH package to reduce child mortality.

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