13 research outputs found
Male Circumcision at Different Ages in Rwanda: A Cost-Effectiveness Study
Agnes Binagwaho and colleagues predict that circumcision of newborn boys would be effective and cost-saving as a long-term strategy to prevent HIV in Rwanda
Under-two child mortality according to maternal HIV status in Rwanda: assessing outcomes within the National PMTCT Program
Introduction: We sought to compare risk of death among children aged under-2 years born to HIV positive mother (HIV-exposed) and to HIV negative mother (HIV non-exposed), and identify determinants of under-2 mortality among the two groups in Rwanda. Methods: In a stratified, two-stage cluster sampling design, we selected mother-child pairs using national Antenatal Care (ANC) registers. Household interview with each mother was conducted to capture socio-demographic data and information related to pregnancy, delivery and post-partum. Data were censored at the date of child death. Using Cox proportional hazard model, we compared the hazard of death among HIV-exposed children and HIV nonexposed children. Results: Of 1,455 HIV-exposed children, 29 (2.0%; 95% CI: 1.3%-2.7%) died by 6 months compared to 18 children of the 1,565 HIV non-exposed children (1.2%; 95% CI: 0.6%-1.7%). By 9 months, cumulative risks of death were 3.0% (95%; CI: 2.2%-3.9%) and 1.3% (96%; CI: 0.7%-1.8%) among HIV-exposed and HIV non-exposed children, respectively. By 2 years, the hazard of death among HIVexposed children was more than 3 times higher (aHR:3.5; 95% CI: 1.8-6.9) among HIV-exposed versus non-exposed children. Risk of death by 9-24 months of age was 50% lower among mothers who attended 4 or more antenatal care (ANC) visits (aHR: 0.5, 95% CI: 0.3-0.9), and 26% lower among families who had more assets (aHR: 0.7, 95% CI: 0.5-1.0). Conclusion: Infant mortality was independent of perinatal HIV exposure among children by 6 months of age. However, HIV-exposed children were 3.5 times more likely to die by 2 years. Fewer antenatal visits, lower household assets and maternal HIV seropositive status were associated with increased mortality by 9-24 months.Key words: HIV, PMTCT, maternal HIV infection, infant mortality, child mortality, under-five mortality, Rwand
Effect of cytomegalovirus infection on breastfeeding transmission of HIV and on the health of infants born to HIV-infected mothers
Cytomegalovirus (CMV) infection can be acquired in utero or postnatally through horizontal transmission and breastfeeding. The effect of postnatal CMV infection on postnatal HIV transmission is unknown
Evaluating Nurses' Implementation of an Infant-Feeding Counseling Protocol for HIV-Infected Mothers: The Ban Study in Lilongwe, Malawi
A process evaluation of nursesâ implementation of an infant-feeding counseling protocol was conducted for the Breastfeeding, Antiretroviral and Nutrition (BAN) Study, a prevention of mother-to-child transmission of HIV clinical trial in Lilongwe, Malawi. Six trained nurses counseled HIV-infected mothers to exclusively breastfeed for 24 weeks postpartum and to stop breastfeeding within an additional four weeks. Implementation data were collected via direct observations of 123 infant feeding counseling sessions (30 antenatal and 93 postnatal) and interviews with each nurse. Analysis included calculating a percent adherence to checklists and conducting a content analysis for the observation and interview data. Nurses were implementing the protocol at an average adherence level of 90% or above. Although not detailed in the protocol, nurses appropriately counseled mothers on their actual or intended formula milk usage after weaning. Results indicate that nurses implemented the protocol as designed. Results will help to interpret the BAN Studyâs outcomes
Plasma Micronutrient Concentrations Are Altered by Antiretroviral Therapy and Lipid-Based Nutrient Supplements in Lactating HIV-Infected Malawian Women
Background: Little is known about the influence of antiretroviral therapy with or without micronutrient supplementation on the micronutrient concentrations of HIV-infected lactating women in resource-constrained settings
Adherence to extended postpartum antiretrovirals is associated with decreased breast milk HIV-1 transmission
Estimate association between postpartum antiretroviral adherence and breastmilk HIV-1 transmissio
Sensitivity of some African heavy rainfall events to microphysics and planetary boundary layer schemes: impacts on localised storms
Highâresolution numerical weather prediction (NWP) simulations of heavy rainfall events are known to be strongly sensitive to the choice of the subâgrid scale parameterization schemes. In the African continent, studies on such a choice at the convectiveâresolving scales are not numerous. By exploiting a stateâofâtheart NWP model, the Weather Research and Forecasting (WRF) model, the sensitivity of the simulation of three heavy rainfall events in subâSaharan Africa to the microphysical (MP) and planetary boundary layer (PBL) schemes is studied. Validating the numerical outputs against rainfall satellite estimates, ground based weather stations, radiosonde profiles and satelliteâderived cloud top temperature maps with an objectâbased tool, the best performing setup is identified. In terms of heavy rainfall forecast location, it is found that the PBL scheme has a larger impact than the MP, which is shown to control the cloud top temperature simulation. Among the schemes considered, the best performances are reached with a 6âclass singleâmoment microphysical scheme and a nonâlocal planetary boundary layer scheme which properly includes the vertical mixing by the large eddies in the atmosphere
Effectiveness of neonatal, adolescent, and adult MC in Rwanda, 2008.
a<p>The incidence rates are multiplied by cohorts of 150,000, minus the number of infections that occurred previously.</p
Savings for neonatal, adolescent, and adult MC in Rwanda, 2008.
<p>Savings for neonatal, adolescent, and adult MC in Rwanda, 2008.</p