scholarly journals The utility of a modified W.H.O. TB screening tool among children at a Botswana child welfare clinic

2021 ◽  
Vol 21 (1) ◽  
pp. 64-71
Author(s):  
Wame Dikobe ◽  
Mooketsi Molefi ◽  
Bornapate Nkomo ◽  
Botshelo Kgwaadira ◽  
Boingotlo Gasenelwe ◽  
...  
Keyword(s):  
Screening Tool ◽  
World Health ◽  
Resource Limited ◽  
Increased Risk ◽  
Child Welfare Clinic ◽  
Childhood Tb ◽  
History Of ◽  
Hiv Exposure ◽  
Hiv Exposed ◽  
Health Organization

Background: In high TB/HIV settings, the increased risk for TB amongst children exposed to HIV has been established through biomedical tests. Screening HIV exposed children for TB can improve early childhood TB detection and treatment. Objective: This study assessed the utility of a modified World Health Organization (WHO) tool by including HIV variables, to determine TB exposure amongst HIV exposed children presenting to a “Well Child” Clinic (CWC). Methods: Clinical data were obtained from medical records and/or from the caregivers of children presenting to CWC. Data was analyzed to explore factors associated with positive screening for TB, including being exposed to HIV and current HIV status. Results: Five percent (55/1100) screened reported a close TB contact and 21% (n=231) had positive TB symptom screen. History of close TB contact was a risk factor for positive screening for TB symptoms (OR 1.89 CI 1.05-3.4) while being HIV negative was protective (OR 0.3, Cl 0.19-0.62). HIV exposure was associated with increased risk of TB exposure (OR 2.9 CI 1.61-5.19). Conclusion: Integrating HIV variables in the existing WHO screening tool for childhood TB can be useful in early detec- tion and treatment of TB in HIV exposed children in resource limited settings. Keywords: Childhood TB screening; HIV Exposure screening; TB/HIV integration.

scholarly journals The utility of a modified W.H.O. TB screening tool among children at a Botswana child welfare clinic

2021 ◽  
Vol 21 ◽  
pp. 64-71
Author(s):  
Wame Dikobe ◽  
Mooketsi Molefi ◽  
Bornapate Nkomo ◽  
Botshelo Kgwaadira ◽  
Boingotlo Gasenelwe ◽  
...  
Keyword(s):  
Screening Tool ◽  
World Health ◽  
Resource Limited ◽  
Increased Risk ◽  
Child Welfare Clinic ◽  
Childhood Tb ◽  
History Of ◽  
Hiv Exposure ◽  
Hiv Exposed ◽  
Health Organization

Background: In high TB/HIV settings, the increased risk for TB amongst children exposed to HIV has been established through biomedical tests. Screening HIV exposed children for TB can improve early childhood TB detection and treatment. Objective: This study assessed the utility of a modified World Health Organization (WHO) tool by including HIV variables, to determine TB exposure amongst HIV exposed children presenting to a “Well Child” Clinic (CWC). Methods: Clinical data were obtained from medical records and/or from the caregivers of children presenting to CWC. Data was analyzed to explore factors associated with positive screening for TB, including being exposed to HIV and current HIV status. Results: Five percent (55/1100) screened reported a close TB contact and 21% (n=231) had positive TB symptom screen. History of close TB contact was a risk factor for positive screening for TB symptoms (OR 1.89 CI 1.05-3.4) while being HIV negative was protective (OR 0.3, Cl 0.19-0.62). HIV exposure was associated with increased risk of TB exposure (OR 2.9 CI 1.61-5.19). Conclusion: Integrating HIV variables in the existing WHO screening tool for childhood TB can be useful in early detec- tion and treatment of TB in HIV exposed children in resource limited settings. Keywords: Childhood TB screening; HIV Exposure screening; TB/HIV integration.

Immunogenicity and Safety of the Measles Vaccine in HIV-Infected Children: An Updated Systematic Review

2019 ◽  
Author(s):  
Nicky J Mehtani ◽  
Lori Rosman ◽  
William J Moss
Keyword(s):  
Latin American ◽  
Prevalence Ratio ◽  
Vaccine Safety ◽  
World Health ◽  
Measles Vaccine ◽  
Serious Adverse Events ◽  
Increased Risk ◽  
Hiv Exposed ◽  
Health Organization ◽  
Reported Data

Abstract Children infected with human immunodeficiency virus (HIV) are at increased risk of measles morbidity and mortality. We searched abstracts from the PubMed, Embase, and Latin American and Caribbean Center on Health Sciences Information databases for articles published from the earliest date available through September 26, 2017. The primary outcome of interest was serological responses to measles vaccine, stratified by HIV infection status. A total of 2,858 potentially eligible articles were identified, and the final review included 12 studies published between 1992 and 2013, 9 of which reported data on vaccine safety. The studies we included represented 3,573 children, of whom at least 335 were infected with HIV, 788 were HIV-exposed but not infected, and 1,478 were unexposed to HIV. Four of the 12 studies found statistically significant reductions in seropositivity among HIV-infected children compared with HIV-uninfected children within 4 months of vaccination (prevalence ratio range, 0.44–0.70), and forest plots provided visual trends of decreasing immunity over time among HIV-infected children in 2 additional studies. No vaccine-related deaths or serious adverse events were reported. This updated review demonstrated limitations of the existing published literature but supported evidence of reduced immunogenicity of measles vaccine among HIV-infected children, supporting the World Health Organization recommendation to revaccinate HIV-infected children against measles following immune reconstitution with combination antiretroviral therapy.

Management of RBC-Transfusion Dependence

Hematology ◽  
2007 ◽  
Vol 2007 (1) ◽  
pp. 398-404 ◽  
Author(s):  
Magda Melchert ◽  
Alan F. List
Keyword(s):  
Natural History ◽  
Important Variable ◽  
World Health ◽  
Primary Therapy ◽  
Endogenous Erythropoietin ◽  
Fda Approval ◽  
Increased Risk ◽  
History Of ◽  
Health Organization ◽  
Rbc Transfusion

Abstract Strategies for the management of anemia in patients with myelodysplastic syndrome (MDS) have evolved following the U.S. Food and Drug Administration (FDA) approval of three new therapeutics from one of symptom amelioration with red blood cell (RBC) transfusions to one of active treatment. Most patients develop transfusion-dependent anemia over the course of their disease, however, and its adverse consequence on the natural history of disease has only recently been appreciated. Although severe anemia contributes to symptoms of fatigue and reduced quality of life, transfusion dependence increases the risk of organ complications from iron overload coupled with an increased risk of leukemia transformation. Among World Health Organization categories without elevation in bone marrow myeloblasts, an incremental rise in RBC transfusion burden is associated with a proportionate reduction in both overall survival and leukemia-free survival, implying that anemia severity is an important variable limiting the otherwise favorable natural history of patients with lower risk disease. Moreover, therapeutic strategies that successfully restore effective erythropoiesis, such as erythropoetic stimulating agents, immunomodulatory agents, immunosuppressive therapies, or hypomethylating agents, may favorably affect the natural history of this disease, creating perhaps a new urgency for the initiation of erythropoietic promoters that have durable clinical benefit. Selection of primary therapy for the management of anemia should consider four response determinants: age, RBC transfusion burden and duration, endogenous erythropoietin production, and karyotype.

scholarly journals Recommended First-Line Antiretroviral Therapy Regimens and Risk of Diabetes Mellitus in HIV-Infected Adults in Resource-Limited Settings

2019 ◽  
Vol 6 (10) ◽  
Author(s):  
Ninutcha Paengsai ◽  
Gonzague Jourdain ◽  
Nicolas Salvadori ◽  
Apichat Tantraworasin ◽  
Jean Yves Mary ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Antiretroviral Therapy ◽  
Reference Group ◽  
Multivariable Analysis ◽  
Antiretroviral Drugs ◽  
World Health ◽  
First Line ◽  
Resource Limited ◽  
Increased Risk ◽  
Health Organization

Abstract Objective The use of some antiretroviral drugs has been associated with a higher risk of diabetes mellitus (DM) in HIV-infected patients, but the risk associated with antiretroviral drug combinations remains unclear. We investigated the association between first-line antiretroviral therapy (ART) regimens, recommended by the World Health Organization (WHO) in 2016, and the risk of DM in adults. Method We selected all HIV-infected adults within the Thai National AIDS Program who started a first-line ART regimen consisting the following between October 2006 and September 2013: zidovudine+lamivudine+nevirapine; tenofovir disoproxil fumarate (TDF)+lamivudine+nevirapine; zidovudine+lamivudine+efavirenz; TDF+lamivudine/emtricitabine+efavirenz; zidovudine+lamivudine+ritonavir-boosted lopinavir (LPV/r); or TDF+lamivudine+LPV/r. Diagnosis of DM was defined as having at least 2 of the following characteristics: fasting plasma glucose ≥126 mg/dl, 2010 WHO ICD-10 codes E11-E14, or prescription of antidiabetic drugs. To identify ART regimens associated with DM, we used competing risks regression models that considered mortality without DM as a competing event and adjusted for sex, age, pancreas disease, and stratified by groups defined by a score summarizing the propensity to receive a specific first-line ART regimen. Results Data from 35 710 adults (49.1% male; median age, 35.0 years; median follow-up, 2.0 years) were included. In the multivariable analysis with zidovudine+lamivudine+nevirapine as the reference group, a higher risk of DM was observed with TDF+lamivudine/emtricitabine+efavirenz (adjusted sub-distribution hazard ratio [aSHR], 1.6; 95% confidence interval [CI], 1.3–1.9), zidovudine+lamivudine+efavirenz (aSHR, 2.0; 95% CI, 1.7–2.3), and TDF+lamivudine+LPV/r (aSHR, 2.7; 95% CI, 1.9–3.9). Conclusions Several of the WHO recommended ART regimens, particularly tenofovir + lamivudine +LPV/r and regimens containing efavirenz, may be associated with an increased risk of DM.

scholarly journals 2529. Child HIV Exposure and CMV Seroprevalence in Botswana: No Associations with 24-Month Growth and Neurodevelopment

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S879-S879
Author(s):  
Natasha Onalenna Moraka ◽  
Sikhulile Moyo ◽  
Maryanne Ibrahim ◽  
Gloria Mayondi ◽  
Jean Leidner ◽  
...  
Keyword(s):  
Child Growth ◽  
World Health ◽  
Neurodevelopmental Outcomes ◽  
Women Living With Hiv ◽  
Increased Risk ◽  
Z Scores ◽  
Hiv Exposure ◽  
Hiv Exposed ◽  
Living With Hiv ◽  
Cmv Status

Abstract Background HIV-exposed but uninfected (HEU) children are at increased risk for poorer growth outcomes compared with HIV-unexposed/uninfected (HUU) children. Mechanisms underlying the poorer growth and delays in development of HEU children compared HUU children are not fully understood. We sought to define the relationship between child CMV status and HIV− exposure status and determine if a correlation existed between CMV status and growth (and neurodevelopmental) outcomes by 24 months of age in Botswana. Methods We used existing data and samples from the observational Botswana Tshipidi study, pregnant women living with HIV (WLHIV) and those without HIV, as well as their infants were enrolled and followed prospectively through 2 years postpartum. We tested 18-month child plasma samples from all available children for anti-HCMV IgG. We evaluated the association between positive (vs. negative) child CMV status at 18 months, and child growth, using the World Health Organization’s Growth Standard adjusted for age and sex and neurodevelopment at 24 months of age, using the Bayley Scales of Child Development (BSID) III. Results Of 317 children tested for CMV IgG at 18 months, 215 (67.8%) tested positive. Significantly higher proportions of HUU children had positive CMV serology (82.6%) compared with HEU children (47.4%, P < 0.01); 96.7% of HUU vs. 10.5% of HEU children breastfed. Child CMV infection was not associated with head circumference, weight-for-age, weight-for-height, nor height-for-age z-scores at 24 months. BSID III scores in receptive and expressive language, fine and gross motor, and cognitive domains at 24 months of age also did not differ by child CMV status. Conclusion We observed high rates of CMV seropositivity in 18-month-old children in Botswana with significantly higher CMV seropositivity among HUU children likely owing to breastfeeding. Positive CMV serostatus was not associated with child growth or neurodevelopmental outcomes at 24 months. Disclosures All authors: No reported disclosures.

Organization of restrictive quarantine measures to prevent especially dangerous infections

2020 ◽  
pp. 6-11
Author(s):  
Petr Ilyin
Keyword(s):  
Infectious Diseases ◽  
Clinical Symptoms ◽  
International Health ◽  
World Health ◽  
The World ◽  
History Of ◽  
Entire History ◽  
Health Organization ◽  
Former Ussr ◽  
Health Regulations

Especially dangerous infections (EDIs) belong to the conditionally labelled group of infectious diseases that pose an exceptional epidemic threat. They are highly contagious, rapidly spreading and capable of affecting wide sections of the population in the shortest possible time, they are characterized by the severity of clinical symptoms and high mortality rates. At the present stage, the term "especially dangerous infections" is used only in the territory of the countries of the former USSR, all over the world this concept is defined as "infectious diseases that pose an extreme threat to public health on an international scale." Over the entire history of human development, more people have died as a result of epidemics and pandemics than in all wars combined. The list of especially dangerous infections and measures to prevent their spread were fixed in the International Health Regulations (IHR), adopted at the 22nd session of the WHO's World Health Assembly on July 26, 1969. In 1970, at the 23rd session of the WHO's Assembly, typhus and relapsing fever were excluded from the list of quarantine infections. As amended in 1981, the list included only three diseases represented by plague, cholera and anthrax. However, now annual additions of new infections endemic to different parts of the earth to this list take place. To date, the World Health Organization (WHO) has already included more than 100 diseases in the list of especially dangerous infections.

Gambaran Pengetahuan Remaja Tentang Ca Serviks Dan Perilaku Pencegahan Ca Serviks Di Sma Negeri Tebing Tinggi Empat Lawang Tahun 2016

2019 ◽  
Vol 6 (1) ◽  
Author(s):  
Yuni Kurniati Yuni Kurniati
Keyword(s):  
Cervical Cancer ◽  
World Health Organization ◽  
Cancer Incidence ◽  
World Health ◽  
Cervical Cancer Incidence ◽  
Cross Sectional ◽  
History Of ◽  
Unhealthy Diet ◽  
Birth Control Pills ◽  
Health Organization

ABSTRACT   According to the World Health Organization (WHO), every two minutes a woman dies of cervical cancer in develoving countries. In Indonesia, new cases of cervical cancer is 40-45 cases of day. It is estimated every hour, a women died of cervical center. At the general hospital center Dr. Mohammad Hoesin Palembang, the incidence of women who had cervical cancer incidence year 2011 women who had cervical cancer incidence are 34 people (48,2%). The following factors increase the chance of cervical cancer in women is infection of Human Papilloma Virus (HPV), sexsual behavior, family history of cervical cancer, age, mechanism of how oral contraceptives, smoking, income or socioeconomic status, race , unhealthy diet, the cell abnormal, parity, use of the drug DES (Dietilsbestrol), and birth control pills. The purpose of this study is known of adolescents about cervical cancer in SMA Tebing Tinggi Empat Lawang year 2016. This study used Analytic Survey with Cross Sectional approach. The population in this study were all young women students in SMA Tebing Tinggi Empat Lawang with the number of 171 respondents. The results showed there were 171 respondents (37.5%) of respondents were knowledgeable, and (62.52%) of respondents who are knowledgeable unfavorable. These results indicate that knowledgeable either less than those less knowledgeable in both the SMA Tebing Tinggi Empat Lawang Year 2016. From these results, it is expected that more teens can know about cervical cancer so that it can add a lot of insight and knowledge.     ABSTRAK   Menurut data World Health Organization (WHO), setiap dua menit wanita meninggal dunia karena kanker serviks dinegara berkembang. Di Indonesia, kasus baru kanker serviks 40-45 kasus perhari. Di perkirakan setiap satu jam, seorang perempuan meninggal dunia karena kanker serviks. Di rumah sakit umum pusat Dr. Mohammad Hoesin Palembang, angka kejadian ibu yang mengalami kanker serviks pada tahun 2011 ibu yang mengalami kejadian kanker serviks terdapat 34 orang (48,2%). Faktor-faktor berikut meningkat kan peluang kanker serviks pada wanita yaitu infeksi Human Papiloma virus (HPV), perilaku seks, riwayat keluarga kanker serviks, umur ,mekanisme bagaimana kontrasepsi peroral, merokok, pendapatan atau status social ekonomi, ras, diet tidak sehat, adanya sel abnormal, paritas, menggunakan obat DES (Dietilsbestrol),dan pil KB. Tujuan penelitian ini adalah Diketahuinya pengetahuan remaja tentang Ca Cerviks di SMA Negeri Tebing Tinggi Empat Lawang Tahun 2016. Penelitian ini menggunakan metode survey  analitik dengan pendekatan cross sectional. Populasi pada penelitian ini adalah semua siswi remaja putri di SMA Negeri Tebing Tinggi Empat Lawang dengan jumlah 171 responden.Hasil penelitian menunjukkan dari 171 responden terdapat(37.5 %) responden yang berpengetahuan baik, dan (62.52  %) responden yang berpengetahuan kurang baik. Hasil penelitian ini menunjukan bahwa yang berpengetahuan baik lebih sedikit dibandingkan dengan  yang berpengetahuan kurang baik di SMA Negeri Tebing Tinggi Empat Lawang Tahun 2016. Dari hasil penelitian ini, Diharapkan remaja bisa lebih banyak mengetahui tentang caserviks sehingga dapat menambah banyak wawasan dan pengetahuan.    

Antidiabetics: Structural Diversity of Molecules with a Common Aim

2018 ◽  
Vol 25 (18) ◽  
pp. 2140-2165 ◽  
Author(s):  
Jelena B. Popovic-Djordjevic ◽  
Ivana I. Jevtic ◽  
Tatjana P. Stanojkovic
Keyword(s):  
Structural Diversity ◽  
World Health ◽  
Common Disease ◽  
Peroxisome Proliferator ◽  
Epidemic Disease ◽  
Peroxisome Proliferator Activated Receptor ◽  
Increased Risk ◽  
Dipeptidyl Peptidase Iv Inhibitors ◽  
Glucagon Like Peptide 1 ◽  
Health Organization

Background: Diabetes mellitus type 2 (DMT2) is an endocrine disease of global proportions which is currently affecting 1 in 12 adults in the world, with still increasing prevalence. World Health Organization (WHO) declared this worldwide health problem, as an epidemic disease, to be the only non-infectious disease with such categorization. People with DMT2 are at increased risk of various complications and have shorter life expectancy. The main classes of oral antidiabetic drugs accessible today for DMT2 vary in their chemical composition, modes of action, safety profiles and tolerability. Methods: A systematic search of peer-reviewed scientific literature and public databases has been conducted. We included the most recent relevant research papers and data in respect to the focus of the present review. The quality of retrieved papers was assessed using standard tools. Results: The review highlights the chemical structural diversity of the molecules that have the common target-DMT2. So-called traditional antidiabetics as well as the newest and the least explored drugs include polypeptides and amino acid derivatives (insulin, glucagon-like peptide 1, dipeptidyl peptidase-IV inhibitors, amylin), sulfonylurea derivatives, benzylthiazolidine- 2,4-diones (peroxisome proliferator activated receptor-γ agonists/glitazones), condensed guanido core (metformin) and sugar-like molecules (α-glucosidase and sodium/ glucose co-transporter 2 inhibitors). Conclusion: As diabetes becomes a more common disease, interest in new pharmacological targets is on the rise.

scholarly journals A 3D-printed magnetic digital microfluidic diagnostic platform for rapid colorimetric sensing of carbapenemase-producing Enterobacteriaceae

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Pojchanun Kanitthamniyom ◽  
Pei Yun Hon ◽  
Aiwu Zhou ◽  
Mohammad Yazid Abdad ◽  
Zhi Yun Leow ◽  
...  
Keyword(s):  
Point Of Care ◽  
Resistance Mechanism ◽  
Turnaround Time ◽  
World Health ◽  
Colorimetric Sensing ◽  
Resource Limited ◽  
Reaction Chambers ◽  
Technological Platform ◽  
Health Organization ◽  
Digital Microfluidic

AbstractCarbapenemase-producing Enterobacteriaceae (CPE) are a group of drug-resistant Gram-negative pathogens that are classified as a critical threat by the World Health Organization (WHO). Conventional methods of detecting antibiotic-resistant pathogens do not assess the resistance mechanism and are often time-consuming and laborious. We have developed a magnetic digital microfluidic (MDM) platform, known as MDM Carba, for the identification of CPE by measuring their ability to hydrolyze carbapenem antibiotics. MDM Carba offers the ability to rapidly test CPE and reduce the amount of reagents used compared with conventional phenotypic testing. On the MDM Carba platform, tests are performed in droplets that function as reaction chambers, and fluidic operations are accomplished by manipulating these droplets with magnetic force. The simple droplet-based magnetic fluidic operation allows easy system automation and simplified hands-on operation. Because of the unique “power-free” operation of MDM technology, the MDM Carba platform can also be operated manually, showing great potential for point-of-care testing in resource-limited settings. We tested 27 bacterial isolates on the MDM Carba platform, and the results showed sensitivity and specificity that were comparable to those of the widely used Carba NP test. MDM Carba may shorten the overall turnaround time for CPE identification, thereby enabling more timely clinical decisions for better clinical outcomes. MDM Carba is a technological platform that can be further developed to improve diagnostics for other types of antibiotic resistance with minor modifications.

scholarly journals Newborns at risk of Covid-19 ― lessons from the last year

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Malika D. Shah ◽  
Ola Didrik Saugstad
Keyword(s):  
Horizontal Transmission ◽  
Mode Of Delivery ◽  
Newborn Infants ◽  
World Health ◽  
Premature Delivery ◽  
Mortality And Morbidity ◽  
Skin Contact ◽  
Cord Clamping ◽  
Increased Risk ◽  
Health Organization

Abstract After more than 1 year of the SARS-CoV-2 pandemic, a great deal of knowledge on how this virus affects pregnant women, the fetus and the newborn has accumulated. The gap between different guidelines how to handle newborn infants during this pandemic has been minimized, and the American Academy of Pediatrics (AAP)’s recommendations are now more in accordance with those of the World Health Organization (WHO). In this article we summarize present knowledge regarding transmission from mother to the fetus/newborn. Although both vertical and horizontal transmission are rare, SARS-CoV-2 positivity is associated with an increased risk of premature delivery and higher neonatal mortality and morbidity. Mode of delivery and cord clamping routines should not be affected by the mother’s SARS-CoV-2 status. Skin to skin contact, rooming in and breastfeeding are recommended with necessary hygiene precautions. Antibodies of infected or vaccinated women seem to cross both the placenta and into breast milk and likely provide protection for the newborn.

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