scholarly journals Early Diagnosis of HIV among Infants Born to HIV-Positive Mothers on Option-B Plus in Kampala, Uganda

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Jonathan Izudi ◽  
Sylvia Auma ◽  
John Bosco Alege
Keyword(s):  
Hiv Transmission ◽  
Multinomial Logistic Regression ◽  
Cross Sectional Study ◽  
Hiv Positive ◽  
Maternal Knowledge ◽  
Hiv Diagnosis ◽  
Cross Sectional ◽  
Significance Level ◽  
Hiv Exposed Infants ◽  
Hiv Exposed

Introduction. Globally, there is delay in accessing early HIV diagnosis (EID) among HIV exposed infants (HEIs). With paucity of data on EID use at Kisenyi Health Center, this study assessed factors associated with EID use among HEIs (HIV exposed infants). Method. This was a cross-sectional study of 246 HIV-positive mother-baby pairs. Data was collected by structured questionnaire, double-entered in EpiData, and analyzed with STATA using multinomial logistic regression at 5% significance level. Results. 132 (53.7%) HEIs were not tested, 60 (24.4%) tested outside EID guideline, and 54 (21.9%) tested per the guideline. Testing per guideline was associated with maternal age above 30 years (AOR = 2.75; 95% CI: 1.20–6.34; P=0.017); testing outside the guideline was associated with maternal HIV serostatus disclosure (AOR = 2.70; 95% CI: 1.10–6.63; P=0.003) and four or more antenatal care (ANC) visits (AOR = 3.25; 95% CI: 1.23–8.59; P=0.017). However, maternal knowledge of HIV transmission was associated with testing outside the guideline (AOR = 2.90; 95% CI: 1.10–7.65; P=0.032) and per the guideline (AOR = 3.70; 95% CI: 1.39–9.88; P=0.009). Conclusion. Timely EID testing was low. Improving maternal knowledge of EID during ANC visits and positive living empowerment is critical.

scholarly journals Cervical cancer screening service utilization and associated factors among HIV positive women attending adult ART clinic in public health facilities, Hawassa town, Ethiopia: a cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Abiyu Ayalew Assefa ◽  
Feleke Hailemichael Astawesegn ◽  
Bethlehem Eshetu
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Cross Sectional Study ◽  
Partner Support ◽  
Hiv Positive ◽  
Screening Service ◽  
Hiv Diagnosis ◽  
Cross Sectional ◽  
Hiv Positive Women

Abstract Background In Ethiopia, cervical cancer is a public health concern, as it is the second most cause of cancer deaths among reproductive age women and it affects the country’s most vulnerable groups like; rural, poor, and HIV-positive women. Despite the strong evidence that cervical cancer screening results in decreased mortality from this disease, its utilization remains low. Methods An institution-based cross-sectional study was conducted from March 2 to April 1/2019 to assess the level and factors affecting utilization of cervical cancer screening among HIV positive women in Hawassa town. Quantitative data collection methods were used. Data were gathered using a structured and pretested questionnaire. Epi-Info version 7 and SPSS version 23 were used for data entry and analysis respectively. Statistically significant association of variables was determined based on Adjusted Odds ratio with its 95% confidence interval and p-value of ≤0.05. Results Of the 342 women interviewed, 40.1% (95% CI: 35.00, 45.33%) of them were screened. Having a post primary education (AOR = 5.1, 95% CI: 1.8, 14.5), less than 500 cell/mm3 CD4 count (AOR = 2.7, 95% CI: 1.2, 5.9); duration since HIV diagnosis (AOR = 4.2, 95% CI: 2.1, 8.5), partner support (AOR = 4.7, 95% CI: 2.3, 9.4), having knowledge about risk factors (AOR = 2.9 (95% CI: 1.2, 6.9) and having favorable attitude towards cervical cancer and its screening (AOR = 3.7 (95% CI: 1.8, 7.5) were associated with cervical cancer screening utilization. Conclusions The study revealed utilization of cervical cancer screening service was low among HIV positive women. Educational status, duration of HIV diagnosis, partner support, knowledge status about risk factor, CD4 count and attitude towards cervical cancer and its screening were associated with cervical cancer screening utilization. Health care workers need to provide intensive counseling services for all ART care attendants to increase utilization.

scholarly journals National-level effectiveness of ART to prevent early mother to child transmission of HIV in Namibia

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0233341
Author(s):  
Andrew Agabu ◽  
Andrew L. Baughman ◽  
Christa Fischer-Walker ◽  
Michael de Klerk ◽  
Nicholus Mutenda ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
National Level ◽  
Prevalence Ratio ◽  
Dried Blood Spots ◽  
Test Results ◽  
Hiv Diagnosis ◽  
Hiv Exposed Infants ◽  
Hiv Test ◽  
Hiv Exposed ◽  
Mother To Child

Background Namibia introduced the prevention of mother to child HIV transmission (MTCT) program in 2002 and lifelong antiretroviral therapy (ART) for pregnant women (option B-plus) in 2013. We sought to quantify MTCT measured at 4–12 weeks post-delivery. Methods During Aug 2014-Feb 2015, we recruited a nationally representative sample of 1040 pairs of mother and infant aged 4–12 weeks at routine immunizations in 60 public health clinics using two stage sampling approach. Of these, 864 HIV exposed infants had DNA-PCR HIV test results available. We defined an HIV exposed infant if born to an HIV-positive mother with documented status or diagnosed at enrollment using rapid HIV tests. Dried Blood Spots samples from HIV exposed infants were tested for HIV. Interview data and laboratory results were collected on smartphones and uploaded to a central database. We measured MTCT prevalence at 4–12 weeks post-delivery and evaluated associations between infant HIV infection and maternal and infant characteristics including maternal treatment and infant prophylaxis. All statistical analyses accounted for the survey design. Results Based on the 864 HIV exposed infants with test results available, nationally weighted early MTCT measured at 4–12 weeks post-delivery was 1.74% (95% confidence interval (CI): 1.00%-3.01%). Overall, 62% of mothers started ART pre-conception, 33.6% during pregnancy, 1.2% post-delivery and 3.2% never received ART. Mothers who started ART before pregnancy and during pregnancy had low MTCT prevalence, 0.78% (95% CI: 0.31%-1.96%) and 0.98% (95% CI: 0.33%-2.91%), respectively. MTCT rose to 4.13% (95% CI: 0.54%-25.68%) when the mother started ART after delivery and to 11.62% (95% CI: 4.07%-28.96%) when she never received ART. The lowest MTCT of 0.76% (95% CI: 0.36% - 1.61%) was achieved when mother received ART and ARV prophylaxis within 72hrs for infant and highest 22.32% (95%CI: 2.78% -74.25%) when neither mother nor infant received ARVs. After adjusting for mother’s age, maternal ART (Prevalence Ratio (PR) = 0.10, 95% CI: 0.03–0.29) and infant ARV prophylaxis (PR = 0.32, 95% CI: 0.10–0.998) remained strong predictors of HIV transmission. Conclusion As of 2015, Namibia achieved MTCT of 1.74%, measured at 4–12 weeks post-delivery. Women already on ART pre-conception had the lowest prevalence of MTCT emphasizing the importance of early HIV diagnosis and treatment initiation before pregnancy. Studies are needed to measure MTCT and maternal HIV seroconversion during breastfeeding.

scholarly journals The reporting of the mode of transmission among HIV-positive men who have sex with men in Lviv oblast, Ukraine, 2014-2018

2020 ◽  
Vol 14 (11.1) ◽  
pp. 122S-127S
Author(s):  
Maryana Sluzhynska ◽  
Olga Denisiuk ◽  
Ruzanna Grigoryan ◽  
Yulia Sereda ◽  
Gennadiy Slabkiy ◽  
...  
Keyword(s):  
Urban Areas ◽  
Hiv Transmission ◽  
Cross Sectional Study ◽  
Medical Doctor ◽  
Hiv Care ◽  
Hiv Positive ◽  
Cross Sectional ◽  
Aids Epidemic ◽  
Mode Of Transmission ◽  
Sex With Men

Introduction: Men who have sex with men (MSM) are one of the key populations driving HIV/AIDS epidemic globally. To date, MSM is the only population in Ukraine where the prevalence and incidence of HIV is increasing. As HIV-positive MSM might feel uncomfortable to report homosexual intercourses as a possible mode of transmission (MoT) of HIV, they prefer being registered as patients with heterosexual or non-defined MoT. This study aimed to calculate the proportion of misclassified MoT among HIV-positive MSM registered in Lviv oblast, Ukraine, during 2014-2018. Methodology: Cross-sectional study with 127 HIV-positive MSM patients from Lviv region for the period of 2014-2018. Results: Out of 127 HIV-positive MSM included in the study, 110 (86.6%) were from urban areas. In addition, 52 patients (40.9%) were diagnosed with stage 1 HIV, 16 (12.6%) – stage 2, 19 (15%) – stage 3, and 36 (28.3%) – stage 4. CD4 count < 200 cells/μL was found in 35 (27.6%) patients. Mean time from registration to antiretroviral therapy initiation was 80 days. During the first visit to medical doctor out of those 48 patients who had previously reported “other modes” of HIV transmission, 33 patients (68.7%) disclosed homosexual MoT of HIV. The remaining 15 (31.3%) patients disclosed their homosexual MoT of HIV later – during their regular follow-up visits to the doctor. Conclusion: Special measures are needed to improve the reporting of homosexual MoT which can potentially strengthen the HIV care among MSM.

scholarly journals Pregnant women’s retention and associated health facility characteristics in the prevention of mother-to-child HIV transmission in Indonesia: cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e034418
Author(s):  
Christina Lumbantoruan ◽  
Margaret Kelaher ◽  
Michelle Kermode ◽  
Endang Budihastuti
Keyword(s):  
Antenatal Care ◽  
Health Facility ◽  
Hiv Transmission ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Hiv Positive ◽  
Pmtct Programme ◽  
Cross Sectional ◽  
Hiv Epidemic ◽  
Mother To Child

ObjectivesDespite the national effort to integrate the Prevention of Mother-to-Child Transmission (PMTCT) programme into antenatal care clinics in Indonesia, the rate of mother-to-child HIV transmission remains high. This national study was conducted to describe PMTCT programme performance and to identify health facility characteristics associated with this performance in order to inform programme planning and policy development.DesignA retrospective cross-sectional study in December 2017.SettingAll health facilities providing PMTCT programmes in Indonesia.ParticipantsAll health facilities registering at least one woman in antenatal care in 2017.InterventionPMTCT data extraction from the national reporting system on HIV/AIDS and government reports.OutcomesWomen retention in the PMTCT programme for at least 3 months and associated health facility characteristics.ResultsA total of 373 health facilities registering 6502 HIV-positive women in antenatal care were included in the analysis. One-third of women (2099) never started antiretroviral treatment. Of the 4403 women who started, 2610 (57%) were retained; 462 (10%) were not retained; and the retention status of 1252 (28%) women referred out of the health facilities was unknown. Compared with primary health centres, hospitals were more likely to retain women (OR=2.88, 95% CI 2.19 to 3.79). The odds of retention were higher in hospital types A and B (OR=3.89, 95% CI 3.19 to 4.76), located within concentrated HIV epidemic areas (OR=2.09, 95% CI 1.83 to 2.38) and a high-priority area for the HIV programme (OR=1.83, 95% CI 1.60 to 2.09). We observed no differential retention between women who initiated PMTCT under different options (B+/non-B+).ConclusionsWe observed low retention of HIV-positive pregnant women in the PMTCT programme in Indonesia in 2017. Additional efforts are needed to improve women’s retention in the PMTCT programme. Retention could be increased through the delivery of PMTCT programmes by replicating strategies implemented at hospital types A and B located in concentrated HIV epidemic areas where an HIV programme is a high priority.

scholarly journals Family functioning and dental trauma, malocclusion and anthropometry in adolescents

2021 ◽  
Vol 20 ◽  
pp. e211883
Author(s):  
Adelaine Maria de Sousa ◽  
Thais Carine Lisboa Silva ◽  
Bruna de Carvalho Vaigel ◽  
Roberto Carlos Mourão Pinho ◽  
Renata Cimões
Keyword(s):  
Multivariate Analysis ◽  
Public Schools ◽  
Family Cohesion ◽  
Maternal Education ◽  
Multinomial Logistic Regression ◽  
Dental Trauma ◽  
Cross Sectional Study ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Significance Level

Aim: The aim of the study was to investigate perceived family cohesion and adaptability and its association with trauma, malocclusion and anthropometry in school adolescents. Methods: Cross-sectional study with a representative sample of 921 adolescents from 13 to 19 years old of both sexes, enrolled in state public schools of a northeastern Brazilian municipality. A questionnaire with sociodemographic questions, the FACES III scale was applied and a clinical oral examination (dental trauma and malocclusion) and anthropometric (BMI by age) were performed. For statistical analysis, was evaluated by the Chi-square test. The variables that presented significance in the bivariate analysis of up to 25% were taken to the multivariate analysis (multinomial logistic regression), variables that presented significance in bivariate analysis of up to 25% were taken to multivariate analysis and all conclusions were drawn considering the significance level of 5%. Results: As a result, it was identified that displaced families were associated with low maternal education, agglutinated families associated with the absence of caries. Rigid families were associated with marked overjet and caries. The prevalence of dental trauma (37.5%) was considered high. Conclusion: It was concluded that family cohesion and adaptability were associated with oral health and socioeconomic factors.

scholarly journals Feasibility of Using Infant Testing during Immunization to Estimate HIV  Mother-to-Child-Transmission Rates in Zambia

2020 ◽  
Author(s):  
Joseph Simbaya ◽  
Patricia Funjika ◽  
Arthur Moonga ◽  
John Mwale ◽  
Chipepo Kankasa
Keyword(s):  
Exclusive Breastfeeding ◽  
Immunization Coverage ◽  
Antibody Test ◽  
High Volume ◽  
Hiv Positive ◽  
Cross Sectional ◽  
Hiv Exposed Infants ◽  
Mtct Rate ◽  
Immunization Services ◽  
Hiv Exposed

Abstract Background : This study piloted the feasibility of infant testing in immunization services as a strategy for estimating MTCT rates among the population of HIV exposed infants in Zambia. Methods : The study recruited a cross-sectional sample of 8,042 caregiver-baby pairs in 38 high volume immunization sites in 7 towns across 3 provinces of Zambia. All mothers who brought their children below the age of one year for immunization at the study facilities were invited to participate in the study. All consenting mothers were interviewed and blood drawn from their babies for; rapid HIV antibody test to determine exposure and DNA PCR test for samples of all HIV-exposed babies to determine HIV infection. Results : Of 8,042 recruited caregiver-baby pairs, 1,409 (17.5 %) babies were HIV-exposed. Approximately 90.2 percent of all mothers of HIV exposed infants reported that they attended ANC visits more than two times and facility based deliveries stood at 91.6 percent. Exclusive breastfeeding among HIV exposed infants reduced with increase in age of infant; it was highest at 6 weeks (82.2 %) followed by 10 weeks (74.0 %) and 14 weeks (58.2 %) . MTCT rates were relatively lower than what was reported before at 4.7 percent among Penta 1 seekers, 2.8 percent among Penta 2 seekers, 2.1 percent among Penta 3 seekers and 5.0 percent among Measles vaccination seekers. The overall MTCT rate stood at 3.8 percent. About 48.1 percent of HIV positive babies were male compared to 51.9 percent females. Babies of mothers below the age of 25 years accounted almost half (51.9 %) of all HIV infected babies in the study. Reported exclusive breastfeeding among HIV positive babies was 77.8 percent for Penta 1 seekers, 75.0 percent for Penta 2 seekers and 100 percent for Penta 3 seekers. Conclusion: The study succeeded in estimating MTCT rates using infant testing in immunization services, demonstrating that it is feasible to use routine infant testing in immunization services as a strategy for estimating MTCT rates among the population of HIV-exposed infants in countries with high HIV burden and immunization coverage.

scholarly journals Feasibility of using infant testing during immunization to estimate HIV mother-to-child-transmission rates in Zambia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Joseph Simbaya ◽  
Patricia Funjika ◽  
Arthur Moonga ◽  
John Mwale ◽  
Chipepo Kankasa
Keyword(s):  
Exclusive Breastfeeding ◽  
Immunization Coverage ◽  
Antibody Test ◽  
High Volume ◽  
Hiv Positive ◽  
Cross Sectional ◽  
Hiv Exposed Infants ◽  
Immunization Services ◽  
Nationally Representative ◽  
Hiv Exposed

Abstract Background This study piloted the feasibility of infant testing in immunization services as a strategy for estimating MTCT rates among the population of HIV exposed infants at national and subnational levels in Zambia. Methods The study recruited a cross-sectional nationally representative sample of 8042 caregiver-baby pairs in 38 high volume immunization sites in 7 towns across 3 provinces of Zambia. All mothers who brought their children below the age of one year for immunization at the study facilities were invited to participate in the study. All consenting mothers were interviewed and blood drawn from their babies for; rapid HIV antibody test to determine exposure and DNA PCR test for samples of all HIV-exposed babies to determine HIV infection. Results Of 8042 recruited caregiver–baby pairs, 1409 (17.5%) babies were HIV-exposed. Approximately 90.2% of all mothers of HIV exposed infants reported that they attended ANC visits more than two times and facility based deliveries stood at 91.6%. Exclusive breastfeeding among HIV exposed infants reduced with increase in age of infant; it was highest at 6 weeks (82.2%) followed by 10 weeks (74.0%) and 14 weeks (58.2%). MTCT rates were relatively lower than what was reported before in subnational studies and stood at 4.7% among Penta 1 seekers, 2.8% among Penta 2 seekers, 2.1% among Penta 3 seekers and 5.0% among Measles vaccination seekers. The overall MTCT rate stood at 3.8%. About 48.1% of HIV positive babies were male compared to 51.9% females. Babies of mothers below the age of 25 years accounted for almost half (51.9%) of all HIV infected babies in the study. Reported exclusive breastfeeding among HIV positive babies was 77.8% for Penta 1 seekers, 75.0% for Penta 2 seekers and 100% for Penta 3 seekers. Conclusions The study succeeded in estimating the MTCT rates using infant testing in immunization services, thereby demonstrating that it is feasible to use routine infant testing in immunization services as a strategy for estimating MTCT rates among the population of HIV-exposed infants in countries with high HIV burden and immunization coverage.

scholarly journals Factors associated with the timely uptake of initial HIV virologic test among HIV-exposed infants attending clinics within a faith-based HIV program in Kenya; a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Douglas Gaitho ◽  
Freda Kinoti ◽  
Lawrence Mwaniki ◽  
Diana Kemunto ◽  
Victor Ogoti ◽  
...  
Keyword(s):  
Positive Result ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Sectional Study ◽  
Initial Test ◽  
Cross Sectional ◽  
Factors Associated ◽  
Hiv Exposed Infants ◽  
Hiv Exposed ◽  
Pcr Test

Abstract Background Early infant diagnosis (EID) of HIV, followed by effective care including antiretroviral therapy (ART), reduces infant mortality by 76% and HIV progression by 75%. In 2015, 50% of 1.2 million HIV-exposed infants (HEI) in 21 priority countries received a virologic test within the recommended 2 months of birth. We sought to identify factors associated with timely uptake of virologic EID among HEI and gain insight into missed opportunities. Methods This was a cross-sectional study that used de-identified data from electronic medical records of 54 health facilities within the Christian Health Association of Kenya (CHAK) HIV Project database. All HEI who had their first HIV virologic test done between January 2015 and December 2017 were included in the study and categorized as either having the test within or after 8 weeks of birth. Multivariate linear mixed effects regression model was used to determine factors associated with uptake of the first HIV EID polymerase chain reaction (PCR). Predictor variables studied include sex, birth weight, the entry point into care, provision of ART prophylaxis for the infant, maternal ART at time of EID, mode of delivery, and place of delivery. Results We included 2020 HEI of whom 1018 (50.4%) were female. A majority, 1596 (79.0%) had their first HIV PCR within 2 months of birth at a median age of 6.4 weeks (interquartile range 6–7.4). Overall, HIV positivity rate at initial test among this cohort was 1.2%. Delayed HIV PCR testing for EID was more likely to yield a positive result [adjusted odds ratio (aOR) = 1.29 (95% confidence interval (CI) 1.09–1.52) p = 0.003]. Infants of mothers not on ART at the time of HIV PCR test and infants who had not received prophylaxis to prevent vertical HIV transmission had significant increased odds of a delayed initial test [aOR = 1.27 (95% CI = 1.18–1.37) p = < 0.0001] and [aOR = 1.43 (95% CI 1.27–1.61) p = < 0.001] respectively. Conclusion An initial HIV PCR test done after 8 weeks of birth is likely to yield a positive result. Barriers to accessing ART for treatment among HIV-infected pregnant and breastfeeding women, and prophylaxis for the HEI were associated with delayed EID. In order to ensure timely EID, programs need to incorporate both facility and community strategy interventions to ensure all pregnant women seek antenatal care and deliver within health facilities.

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