scholarly journals Evaluation of the Relationship between Clinical Outcome of Early Neonatal Sepsis and HIV Exposure in Homa bay County Referral Hospital, Western Kenya

2020 ◽  
Vol 3 (4) ◽  
pp. 139-145
Author(s):  
Mulongo Naulikha Jacqueline ◽  
◽  
O Adoka Samson ◽  
Obonyo Charles ◽  
◽  
...  
Keyword(s):  
Neonatal Sepsis ◽  
Referral Hospital ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Western Kenya ◽  
Maternal Hiv ◽  
Hiv Exposure ◽  
Early Neonatal Sepsis ◽  
Hiv Exposed ◽  
The Relationship

Background: Maternal HIV is the leading cause of both maternal and child morbidity in Sub-Saharan Africa and very little is known about the relationship of HIV exposure and early neonatal sepsis. Objective: To describe the association between maternal HIV and probable or confirmed early neonatal sepsis in Homa Bay County Referral Hospital, Western Kenya. Design: Hospital based cross- sectional study. Study Setting: Homa Bay County Referral Hospital. Subjects/Participants: One hundred and forty two (142) neonates aged 24 hours to 96 hours. Results: Data purposively collected included, characteristics of women and newborns at enrollment, by maternal HIV status and HIV- positive women and their newborns, prevalence of probable or confirmed sepsis, factors in association between maternal HIV infection and probable sepsis in newborns and associations between HIV exposure and probable or confirmed sepsis among newborns and HIV-exposed newborns, 0(0.00%) HIV-positive by 24-hours PCR, prevalence of positive culture 1.6% in HIV-exposed, 1.7% HIV-unexposed with a prevalence ratio: 1.11 (95% CI: 0.05, 8.00) p-value = 0.8615. There was no statistical relationship between clinical outcomes of early neonatal sepsis to HIV exposure. Conclusion: There was no association between maternal HIV and probable or confirmed early neonatal sepsis in Homa Bay County Referral Hospital, Western Kenya.

scholarly journals Defective monocyte enzymatic function and an inhibitory immune phenotype in HIV-exposed uninfected African infants in the era of highly active anti-retroviral therapy

2021 ◽  
Author(s):  
Louise Afran ◽  
Kondwani C Jambo ◽  
Wilfred Nedi ◽  
David J.C Miles ◽  
Anmol Kiran ◽  
...  
Keyword(s):  
B Cell ◽  
Sub Saharan Africa ◽  
Haemophilus Influenzae Type ◽  
Cell Phenotype ◽  
Bacterial Disease ◽  
Enzymatic Function ◽  
Increased Risk ◽  
Hiv Exposure ◽  
Hiv Exposed ◽  
Exposed Uninfected

HIV-Exposed Uninfected (HEU) infants are a rapidly expanding population in Sub Saharan Africa and are highly particularly susceptible to disease caused by encapsulated bacteria in the first year of life. The mechanism of this increased risk is still poorly understood and we therefore, investigated if HIV exposure dysregulates HEU infant immunity and if this is amplified by human herpes infection (HHV). Here, we compared monocyte enzymatic function, innate and adaptive immune cell phenotype, and vaccine-induced antibody responses between HEU and HUU infants. We demonstrate altered monocyte phagosomal function and B cell subset homeostasis, and lower vaccine-induced anti-Haemophilus influenzae type b (Hib) and anti-Tetanus Toxoid (TT) IgG titers in HEU compared to HUU infants. There was no difference in the prevalence of HHV infection between HEU and HUU infants. Our findings suggest that even in the era of ART-mediated viral suppression, HIV exposure dysregulates monocyte and B cell function during a vulnerable period of immune maturation in infancy. This may contribute to the high rates of bacterial disease and pneumonia in HEU infants.

scholarly journals Rates of refusal of clinical autopsies among HIV-positive decedents and an overview of autopsies in Uganda

2021 ◽  
Vol 6 ◽  
pp. 302
Author(s):  
Olivie C. Namuju ◽  
Richard Kwizera ◽  
Robert Lukande ◽  
Katelyn A. Pastick ◽  
Jonee M. Taylor ◽  
...  
Keyword(s):  
Family Satisfaction ◽  
Referral Hospital ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Next Of Kin ◽  
Perceived Benefit ◽  
Immunodeficiency Virus ◽  
Sub Saharan ◽  
Acceptance Rates ◽  
National Referral Hospital

Background: Human immunodeficiency virus (HIV)-related mortality remains high in sub-Saharan Africa. Clinical autopsies can provide invaluable information to help ascertain the cause of death. We aimed to determine the rate and reasons for autopsy refusal amongst families of HIV-positive decedents in Uganda. Methods: We consented the next-of-kin for post-mortem examinations among Ugandan decedents with HIV from 2017-2020 at Kiruddu National Referral Hospital. For those who refused autopsies, reasons were recorded. Results: In this analysis, 165 decedents with HIV were included from three selected wards at Kiruddu National Referral Hospital.  Autopsy was not performed in 45% of the deceased patients; the rate of autopsy refusal was 36%. The most common reasons for autopsy refusal were time constraints (30%), family satisfaction with clinical diagnosis (15%), fear of disfigurement of the remains (15%), and lack of perceived benefit (15%). By seeking consent from multiple family members and clearly explaining to them the purpose of performing the autopsy, we found a reduction in the rate of autopsy refusal among relatives of the deceased patients at this hospital compared to previous studies at the same site (36% vs. 60%). Conclusions: We found lower rates of autopsy refusal compared to previous studies at the same site. This underscores the importance of clearly explaining the purpose of autopsies as they increase active sensitization about their relevance and dispel myths related to autopsies among the general population. Good, culturally sensitive, and timely explanations to the family of the benefits of autopsy increase the rate of obtaining permission. Building capacity for performing autopsies by training more pathologists and increasing laboratory resources to decrease the turn-around-time for autopsy reports and extending these services to peripheral health facilities could improve autopsy acceptance rates.

Characteristics and outcomes of HIV-exposed infants in Homa Bay County, Kenya, 2015

2020 ◽  
Vol 50 (2) ◽  
pp. 154-156
Author(s):  
Lawrence K Gitonga ◽  
Waqo G Boru ◽  
Lilly Muthoni ◽  
Jacob Odhiambo ◽  
James Ransom
Keyword(s):  
Antenatal Care ◽  
Retrospective Review ◽  
Hiv Positive ◽  
Early Infant Diagnosis ◽  
Western Kenya ◽  
Replacement Feeding ◽  
Hiv Exposed Infants ◽  
Care Services ◽  
Early Infant ◽  
Hiv Exposed

Homa Bay County in south-western Kenya has a low uptake of antenatal care services and the highest prevalence of HIV in the country. We present the findings of a retrospective review of HIV-exposed infants (HEI) who sought early infant diagnosis services in the county throughout 2015. HEI who were breastfed >6 months, had replacement feeding and did not receive prophylaxis were 2–6 times more likely to be HIV-positive.

scholarly journals Prevalence of Anemia and Its Associated Factors in Antiretroviral-Treated HIV/AIDS-Positive Adults from 2013 to 2018 at Debre Berhan Referral Hospital, Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Yared Asmare Aynalem ◽  
Wondimeneh Shibabaw Shiferaw ◽  
Zeleke Woldiye
Keyword(s):  
Associated Factors ◽  
Opportunistic Infections ◽  
Referral Hospital ◽  
Sub Saharan Africa ◽  
Clinical Staging ◽  
Hiv Positive ◽  
Aids Patients ◽  
Debre Berhan ◽  
Prevalence Of Anemia ◽  
Hiv Aids

Introduction. Anemia was defined as a hemoglobin level of less than or equal to 13.9 g/dl for male and less than or equal to 12.2 g/dl for female adults. It is one of the most common hematological abnormalities in people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and is a determining factor for disease progression and death. Among the countries in sub-Saharan Africa, Ethiopia is one of the most affected nations by HIV. Therefore, this study aimed to assess the prevalence of anemia and its associated factors among HIV-positive adults that had received antiretroviral treatment (ART) at Debre Berhan Referral Hospital. Methods. An institution-based, descriptive, cross-sectional study was conducted involving 263 adults with HIV/AIDS that had undergone ART at Debre Berhan Referral Hospital, Ethiopia. Data were collected from patient charts using systematic sampling with a pretested data extraction tool and entered using EpiData 3.1. Variables having a p value ≤0.25 in the bivariate were fitted to a multivariable regression model with a 95% confidence interval. p values ≤0.05 were considered statistically significant in the multivariate analysis. Results. Among the 263 HIV-positive patients, 237 (90.11%) were included in the final analysis. The overall prevalence of anemia was 26.2%. Factors that were significantly associated with anemia were past opportunistic infections, patients being in WHO clinical stage III and IV, and a BMI <18.5. Conversely, those patients who took anti-TB medication were less likely to have anemia. Conclusion. Our study shows that the severity of anemia among HIV/AIDS patients that had undergone ART is lower than most studies conducted in Ethiopia. We also found that opportunistic infection, WHO clinical staging, anti-TB treatment, and low BMI were significantly associated with anemia. Therefore, routine screening of patient nutritional status and opportunistic infections may be useful in predicting and controlling anemia in HIV/AIDS patients.

Influence of maternal HIV infection on fetal thymus size

2019 ◽  
Vol 48 (1) ◽  
pp. 67-73
Author(s):  
Clara L. Gasthaus ◽  
Ralf Schmitz ◽  
Kerstin Hammer ◽  
Kathrin Oelmeier de Murcia ◽  
Maria K. Falkenberg ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Fetal Outcome ◽  
Hiv Positive ◽  
Control Group ◽  
Fetal Thymus ◽  
Hiv Positive Mothers ◽  
Maternal Hiv ◽  
Maternal Hiv Infection ◽  
Hiv Exposed ◽  
Thymus Size

AbstractObjectiveTo reveal the effect of a maternal human immunodeficiency virus (HIV) infection on the fetal thymus size.MethodsThe sonographic fetal thymus size was measured retrospectively in 105 pregnancies with maternal HIV infection and in 615 uncomplicated singleton pregnancies. The anteroposterior thymic and the intrathoracic mediastinal diameter were determined in the three-vessel view and their quotient, the thymic-thoracic ratio (TT ratio), was calculated. The study group was subdivided into three groups by the maternal viral load on the date of ultrasound (<50 cop./mL, 50–1000 cop./mL, >1000 cop./mL). Furthermore, an association between prognostic factors of the HIV infection such as the lymphocyte count, CD4/CD8 ratio, HIV medication and the thymus size, was investigated using correlation analyses.ResultsFetal thymus size in pregnancies of HIV-positive mothers showed to be noticeably larger than in uncomplicated pregnancies. The mean TT ratio in the HIV-positive group was 0.389 and in the control group 0.345 (P < 0.001). There was no association between any maternal HIV parameter or medication and the size of the thymus gland.ConclusionMaternal HIV infection was associated with an increased fetal thymus size. Further consequences of intrauterine HIV exposure for fetal outcome and the development of the immune system of HIV-exposed uninfected (HEU) infants must be discussed.

scholarly journals Egocentric Networks and HIV in Pregnant and Breastfeeding Women Attending Antenatal Care in Lusaka, Zambia

2021 ◽  
Vol 6 (2) ◽  
Keyword(s):  
Antenatal Care ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Hiv Status ◽  
Main Partner ◽  
Multiple Variables ◽  
Social And Sexual Networks ◽  
Hiv Acquisition ◽  
The Relationship ◽  
Hiv Negative

Human immunodeficiency virus (HIV) has a disproportionate effect on pregnant and breastfeeding women in sub-Saharan Africa. This study used egocentric social network analysis (SNA) to compare the social and sexual networks of HIV-negative and HIV-positive women attending an antenatal care (ANC) clinic in Lusaka, Zambia. In order to assess risk and protective factors for HIV acquisition and transmission, variables included self (ego) sociodemographic characteristics, main partner characteristics, features of the relationship between ego and her main partner, alter attributes, alter-ego ties, and alter-alter ties. Associations between the independent variables and ego HIV status were identified using bivariate tests. Logistic regression analyses were performed to assess the relationship between predictors and ego HIV status when multiple variables were included in the same model. Overall, 219 participating women (69 HIV-positive, 150 HIV-negative) nominated 1095 alters. Compared to HIV-negative egos, HIV-positive egos were older, had main partners who were more likely to consume alcohol before sex, disclosed their HIV status to fewer alters, had fewer alters with whom they had daily interactions, and had more alters who were HIV-positive or HIV-unknown. Number of alters who were HIV-positive or HIV-unknown and non-disclosure of HIV status were the greatest risks (with the effect of HIV-positive or HIV-unknown being of a slightly greater magnitude than non-disclosure of HIV status), which places breastfeeding women, their partners and their infants at risk of preventable HIV infection.

scholarly journals Prevalence of HIV and Associated Risk Factors Among Infants Born to HIV Positive Mothers Attending Entebbe Regional Referral Hospital.

2021 ◽  
Author(s):  
◽  
KEEFA WAMALA ◽  
Ronald Nuwamanya ◽  
Moses Muwanga
Keyword(s):  
Risk Factors ◽  
Referral Hospital ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Regional Referral Hospital ◽  
Hiv Exposed Infants ◽  
Hiv Positive Mothers ◽  
Hiv Exposed ◽  
Associated Risk Factors ◽  
Mother To Child

Background: Uganda has an estimated 1.4 million people living with HIV with about 52,000 infections occurring every year. In 2018, 160,000 children were reported to have become infected with HIV. Globally, HIV exposed infants have delayed access to Early Infant Diagnosis (EID) of HIV, thus hampering efforts towards zero new infections. In Uganda, the prevalence of HIV among infants is not recorded, peak mortality for infants born with HIV occurs between 2 and 3 months of age. Vertical transmission of HIV from mother to child is the second commonest route of transmission of HIV in Uganda accounting for 18% of all new infections. This study assessed the prevalence of HIV and associated risk factors among infants born to HIV positive mothers attending Entebbe regional referral hospital. Methodology: a cross-sectional study was conducted at a paediatric ward and Mother-Child Health (MCH) General Department of Entebbe Regional Referral Hospital. The study included 78 HIV-exposed infants whose blood samples were collected and analyzed to know their HIV status and data about risk factors was also collected. Data were collected using questionnaires from mothers. Data were then entered into an Excel spreadsheet and analysed by SPSS Version 20. Results: The prevalence of HIV infection among HIV exposed infants is 5.1%.  Delay in child diagnosis, breastfeeding was the factors that increased the risk of mother-to-child transmission of HIV in this study. Conclusion and recommendations: Having such a significant figure greater than the proposed WHO recommendation of less than 5% new infections in infants in the era of the world’s pledge to eliminate MTCT of HIV is unbearable therefore, interventions need to be done to lower this prevalence

scholarly journals Neonatal Tetanus Immunity in Nigeria: The Effect of HIV Infection on Serum Levels and Transplacental Transfer of Antibodies

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Muhammad Faruk Bashir ◽  
Hassan Abdullahi Elechi ◽  
Mohammed Garba Ashir ◽  
Adamu Ibrahim Rabasa ◽  
David Nadeba Bukbuk ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Serum Levels ◽  
Neonatal Tetanus ◽  
Hiv Positive ◽  
Serum Samples ◽  
Transplacental Transfer ◽  
Maternal Hiv ◽  
Maternal Hiv Infection ◽  
Hiv Exposed ◽  
Tetanus Antibodies

Background. Tetanus toxoid immunisation of pregnant mother has remained the most effective strategy in eliminating neonatal tetanus. Impaired production and/or transplacental transfer of antibodies may affect the effectiveness of this strategy. We studied the effect of maternal HIV infection on serum levels and transplacental transfer of anti-tetanus antibodies.Methods. A total of 162 mother-baby paired serum samples were taken and analysed for anti-tetanus antibody levels using ELISA. Maternal HIV status was also determined by double ELISA technique. Maternal TT vaccination status was also documented.Results. Thirty-eight (23.5%) mothers and 41 (25.3%) babies were seronegative, out of whom 8 mothers were HIV positive and 9 babies were HIV exposed. HIV infected mothers and HIV exposed infants were, respectively, 16.27 times (OR = 16.27, 95% CI = 3.28 to 80.61) and 33.75 times (OR = 33.75, 95% CI = 4.12 to 276.40) more likely to be seronegative for anti-tetanus antibody. Similarly, HIV positive mother-newborn pairs were 7.46 times more likely to have a poor transplacental transfer of tetanus antibodies (OR = 7.46, 95% CI = 1.96 to 28.41).Conclusions. Maternal HIV infection is associated with impaired maternofoetal transfer of anti-tetanus antibodies and seronegativity among mothers and their newborns. Hence, this may hinder efforts to eliminate neonatal tetanus.

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