scholarly journals The IMpact of Vertical HIV infection on child and Adolescent SKeletal development in Harare, Zimbabwe (IMVASK Study): a protocol for a prospective cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e031792
Author(s):  
Ruramayi Rukuni ◽  
Celia Gregson ◽  
Cynthia Kahari ◽  
Farirayi Kowo ◽  
Grace McHugh ◽  
...  

IntroductionThe scale-up of antiretroviral therapy (ART) across sub-Saharan Africa (SSA) has reduced mortality so that increasing numbers of children with HIV (CWH) are surviving to adolescence. However, they experience a range of morbidities due to chronic HIV infection and its treatment. Impaired linear growth (stunting) is a common manifestation, affecting up to 50% of children. However, the effect of HIV on bone and muscle development during adolescent growth is not well characterised. Given the close link between pubertal timing and musculoskeletal development, any impairments in adolescence are likely to impact on future adult musculoskeletal health. We hypothesise that bone and muscle mass accrual in CWH is reduced, putting them at risk of reduced bone mineral density (BMD) and muscle function and increasing fracture risk. This study aims to determine the impact of HIV on BMD and muscle function in peripubertal children on ART in Zimbabwe.Methods and analysisChildren with (n=300) and without HIV (n=300), aged 8–16 years, established on ART, will be recruited into a frequency-matched prospective cohort study and compared. Musculoskeletal assessments including dual-energy X-ray absorptiometry, peripheral quantitative computed tomography, grip strength and standing long jump will be conducted at baseline and after 1 year. Linear regression will be used to estimate mean size-adjusted bone density and Z-scores by HIV status (ie, total-body less-head bone mineral content for lean mass adjusted for height and lumbar spine bone mineral apparent density. The prevalence of low size-adjusted BMD (ie, Z-scores <−2) will also be determined.Ethics and disseminationEthical approval for this study has been granted by the Medical Research Council of Zimbabwe and the London School of Hygiene and Tropical Medicine Ethics Committee. Baseline and longitudinal analyses will be published in peer-reviewed journals and disseminated to research communities.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Martin Lange ◽  
Alexandra Löwe ◽  
Gerrit Stassen ◽  
Andrea Schaller

Abstract Background The emerging adulthood is traditionally viewed as a time of optimal health, but also as a critical life span, characterized by changing life circumstances and the establishment of an individual lifestyle. Especially university life seems to hold several challenges impeding the manifestation of a health supporting manner, as many students tend to show a poorer health behavior and a higher amount of health-related problems than comparable age groups. This, along with a steady growth of the higher education sector, brings increased attention to the university setting in the context of prevention. To date, there are few empirical longitudinal and coherent cross-sectional data on the status of students’ health literacy, health status, and health behaviors, and on the impact of the study format on students’ health. The aim of this prospective cohort study is to reduce this research gap. Methods Starting during winter semester 2020/21, the prospective cohort study collects data on health literacy, health status and health behavior on a semester-by-semester basis. All enrolled students of the IST University of Applied Sciences, regardless of study format and discipline, can participate in the study at the beginning of their first semester. The data are collected digitally via a specifically programmed app. A total of 103 items assess the subjectively perceived health status, life and study satisfaction, sleep quality, perceived stress, physical activity, diet, smoking, alcohol consumption, drug addiction and health literacy. Statistical analysis uses (1) multivariate methods to look at changes within the three health dimensions over time and (2) the association between the three health dimensions using multiple regression methods and correlations. Discussion This cohort study collects comprehensive health data from students on the course of study. It is assumed that gathered data will provide information on how the state of health develops over the study period. Also, different degrees of correlations of health behavior and health literacy will reveal different impacts on the state of students’ health. Furthermore, this study will contribute to empirically justified development of target group-specific interventions. Trial registration German Clinical Trials Register: DRKS00023397 (registered on October 26, 2020).


2020 ◽  
Vol 8 (9) ◽  
pp. e1203-e1212 ◽  
Author(s):  
Valerie McCormack ◽  
Fiona McKenzie ◽  
Milena Foerster ◽  
Annelle Zietsman ◽  
Moses Galukande ◽  
...  

2016 ◽  
Vol 34 ◽  
pp. 109-115 ◽  
Author(s):  
Boitumelo P. Phakathi ◽  
Gerhard Basson ◽  
Victor O.L. Karusseit ◽  
Steve A.S. Olorunju ◽  
Taole Mokoena

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