Effect of Treated Wastewater from Anaerobic Digester Coupled with Anaerobic Baffled Reactor as Fertigation on Soil Nutrient Residues, Growth and Yield of Maize Plants

Water scarcity, wastewater management and growing food demand associated with global population increase, are among the drivers cited for water reuse in agriculture. The current study intends to contribute on the influence of treated wastewater from the anaerobic digester coupled with anaerobic baffled reactor (ABR) as a fertigation on soil nutrient residues, growth and yield attributes of maize plants by using surface drip irrigation system to apply the treated wastewater. The experiment consisted of experimental plots irrigated with treated wastewater and control plots irrigated with tap water; all with three replications. The treated wastewater was lightly alkaline with pH of 7.8±0.2 and high concentration of nutrients than tap water, but were within the acceptable levels. Fertigation with treated wastewater improved soil fertility evidenced by significant improvement (P≤0.05) in plant height, leaf area Index (LAI) and maize yield. Plant height was 1.5 times taller and LAI was about 2.5 times more in treatment than in control plots. Yield attributes in experimental plots including number of grains per cob, (97±11.3); weight of grains per cob, (80.7±7.9 g); mass of 100 grains, (35.0±3.5 g), and grain yield, (745.8±62.9 Kg/ha) were significantly higher (P≤0.05) compared to their counterpart control plots. The grain yield in experimental plots was about 37% higher than the yield in control plots. Therefore, fertigation with treated wastewater from the anaerobic digester coupled with ABR improves maize yield and is advisable in areas with water scarcity

The Uptake of Integrated Perinatal Prevention of Mother-to-Child HIV Transmission Programs in Low- and Middle-Income Countries: A Systematic Review

BACKGROUND: The objective of this review was to assess the uptake of WHO recommended integrated perinatal prevention of mother-to-child transmission (PMTCT) of HIV interventions in low- and middle-income countries. METHODS AND FINDINGS: We searched 21 databases for observational studies presenting uptake of integrated PMTCT programs in low- and middle-income countries. Forty-one studies on programs implemented between 1997 and 2006, met inclusion criteria. The proportion of women attending antenatal care who were counseled and who were tested was high; 96% (range 30-100%) and 81% (range 26-100%), respectively. However, the overall median proportion of HIV positive women provided with antiretroviral prophylaxis in antenatal care and attending labor ward was 55% (range 22-99%) and 60% (range 19-100%), respectively. The proportion of women with unknown HIV status, tested for HIV at labor ward was 70%. Overall, 79% (range 44-100%) of infants were tested for HIV and 11% (range 3-18%) of them were HIV positive. We designed two PMTCT cascades using studies with outcomes for all perinatal PMTCT interventions which showed that an estimated 22% of all HIV positive women attending antenatal care and 11% of all HIV positive women delivering at labor ward were not notified about their HIV status and did not participate in PMTCT program. Only 17% of HIV positive antenatal care attendees and their infants are known to have taken antiretroviral prophylaxis. CONCLUSION: The existing evidence provides information only about the initial PMTCT programs which were based on the old WHO PMTCT guidelines. The uptake of counseling and HIV testing among pregnant women attending antenatal care was high, but their retention in PMTCT programs was low. The majority of women in the included studies did not receive ARV prophylaxis in antenatal care; nor did they attend labor ward. More studies evaluating the uptake in current PMTCT programs are urgently needed

Integrating Prevention of Mother-to-Child HIV Transmission Programs to Improve Uptake: A Systematic Review

BACKGROUND: We performed a systematic review to assess the effect of integrated perinatal prevention of mother-to-child transmission of HIV interventions compared to non- or partially integrated services on the uptake in low- and middle-income countries. METHODS: We searched for experimental, quasi-experimental and controlled observational studies in any language from 21 databases and grey literature sources. RESULTS: Out of 28 654 citations retrieved, five studies met our inclusion criteria. A cluster randomized controlled trial reported higher probability of nevirapine uptake at the labor wards implementing HIV testing and structured nevirapine adherence assessment (RRR 1.37, bootstrapped 95% CI, 1.04-1.77). A stepped wedge design study showed marked improvement in antiretroviral therapy (ART) enrolment (44.4% versus 25.3%, p<0.001) and initiation (32.9% versus 14.4%, p<0.001) in integrated care, but the median gestational age of ART initiation (27.1 versus 27.7 weeks, p = 0.4), ART duration (10.8 versus 10.0 weeks, p = 0.3) or 90 days ART retention (87.8% versus 91.3%, p = 0.3) did not differ significantly. A cohort study reported no significant difference either in the ART coverage (55% versus 48% versus 47%, p = 0.29) or eight weeks of ART duration before the delivery (50% versus 42% versus 52%; p = 0.96) between integrated, proximal and distal partially integrated care. Two before and after studies assessed the impact of integration on HIV testing uptake in antenatal care. The first study reported that significantly more women received information on PMTCT (92% versus 77%, p<0.001), were tested (76% versus 62%, p<0.001) and learned their HIV status (66% versus 55%, p<0.001) after integration. The second study also reported significant increase in HIV testing uptake after integration (98.8% versus 52.6%, p<0.001). CONCLUSION: Limited, non-generalizable evidence supports the effectiveness of integrated PMTCT programs. More research measuring coverage and other relevant outcomes is urgently needed to inform the design of services delivering PMTCT programs

Adherence to HIV Care After Pregnancy Among Women in Sub-Saharan Africa: Falling Off the Cliff of the Treatment Cascade

Increased access to testing and treatment means HIV can be managed as a chronic illness, though successful management requires continued engagement with the healthcare system. Most of the global HIV burden is in sub-Saharan Africa where rates of new infections are consistently higher in women versus men. Pregnancy is often the point at which an HIV diagnosis is made. While PMTCT interventions significantly reduce the rate of vertical transmission of HIV, women must administer ARVs to their infants, adhere to breastfeeding recommendations, and test their infants for HIV after childbirth. Some women will be expected to remain on the ARVs initiated during the pregnancy period, while others are expected to engage in routine testing so treatment can be reinitiated when appropriate. The postpartum period presents many barriers to sustained treatment adherence and engagement in care. While some studies have examined adherence to postpartum PMTCT guidelines, few have focused on continued engagement in care by the mother, and very few examine adherence beyond the six week postpartum visit. Here, we attempt to identify gaps in the research literature and make recommendations on how to address barriers to ongoing postpartum HIV care

Women, motherhood, and living with HIV/AIDS : an introduction

This chapter sets the scene of this book. It provides a background understanding about women living with HIV/AIDS. It discusses salient issues concerning women who are mothers and the essence of having children as well as infant feeding practises. A gender lens perspective is also introduced as all chapters in the volume are argued to be situated within this approach. The chapter also introduces the book and it outlines details of all chapters which are included in the volume