Change in HIV-related characteristics of children hospitalised with infectious diseases in Western Cape, South Africa, 2008–2021: a time trend analysis

Abstract Introduction With the scaling up of vertical HIV transmission prevention programmes, the HIV‐related population profile of children in South Africa has shifted. We described temporal changes in HIV‐related characteristics of children, aged ≤3 years (up to the third birthday), with infectious disease hospitalisations across the Western Cape province. Methods We used routinely collected electronic data to identify children born in the Western Cape with infectious disease hospital records for lower respiratory tract infections, diarrhoea, meningitis and tuberculous meningitis, from 2008 to 2021. Linked maternal and child unique identifiers were used to extract pregnancy, HIV‐related, laboratory, pharmacy and hospitalisation data. We described temporal changes in child HIV exposure and acquisition status, timing of maternal HIV diagnosis and antiretroviral therapy (ART) start, infant exposure to maternal ART and timing thereof, and maternal CD4 and HIV viral load closest to delivery. We used logistic and multinomial regression to assess changes in characteristics between the Pre‐Option B+ (2008–2013), Option B+ (2013–2016) and Universal ART periods (2016–2021). Results Among 52,811 children aged ≤3 years with hospitalisations, the proportion living with HIV dreased from 7.0% (2008) to 1.1% (2021), while those exposed to HIV and uninfected increased from 14.0% (2008) to 16.1% (2021) with a peak of 18.3% in 2017. Among mothers with HIV (n = 9873), the proportion diagnosed with HIV and starting ART before pregnancy increased from 20.2% to 69.2% and 5.8% to 59.0%, respectively, between 2008 and 2021. Children hospitalised during the Universal ART period had eight times higher odds (Odds Ratio: 8.41; 95% CI: 7.36–9.61) of exposure to maternal ART versus children admitted Pre‐Option B+. Among mothers of children exposed to HIV and uninfected with CD4 records (n = 7523), the proportion with CD4 <350 cells/μl decreased from 90.6% (2008) to 27.8% (2021). Conclusions In recent years, among children hospitalised with infectious diseases, there were fewer children with perinatally acquired HIV, while an increased proportion of those without HIV acquisition are exposed to maternal HIV and ART. There is a need to look beyond paediatric HIV prevalence and consider child exposure to HIV and ART among children without HIV, when assessing the HIV epidemic's impact on child health services

'Have you seen Bloomberg?': satellite news channels as agents of the new visibility

With the proliferation of transnational television flows, viewers can see their national affairs, traditionally covered predominantly by national news, portrayed by cross-border news channels. This article examines how transnational satellite news coverage of national events enhances nations' global visibility, and influences national public debate over national narratives. An analysis of the public debates in Spain and France over transnational channels' coverage of the March 2004 terror bombings in Madrid and the October 2005 French riots, respectively, provides the basis for discussing the implications of the `new visibility' (Thompson, 2005) of nations, in today's media age. The analysis demonstrates how transnational networks' coverage of these events generated estrangement, de-familiarized and cast doubt on national narratives and commonsensical discourses of us/them, thereby offering viewers an alternative distance from their national unit and encouraging a self-reflexive process of introspection and critical discussion. This process may open up the possibility for a more inclusive national space and strengthen democratic culture, but at the same time it triggers instabilities, which might contribute to citizens' loss of trust in the news media — a dangerous scenario for democracy

Organization renewal through entrepreneurial initiatives: When the seed changes the soil

The literature on innovation/change predicts that entrepreneurial initiatives will be killed by the established organizational system. The general answer is to put innovations in separate units. This is not possible for corporate entrepreneurship initiatives, however. In this action research study, we focus on corporate entrepreneurship initiatives’ strategies for survival. We collected data by following 11 corporate entrepreneurship initiatives as they were pursued. We summarize their effort in three transformation mechanisms: aligning with purpose, creating trust, and creating attachment with autonomy. The data indicate that these factors not only contributed to the success of the initiatives but also to renewing the organizational system