Prolonged elevation of viral loads in HIV-1-infected children in a region of intense malaria transmission in Northern Uganda: A prospective cohort study

Introduction: Malaria and HIV-1 infection cause significant morbidity and mortality in children in sub-Saharan Africa. Recurrent malaria infection increases HIV-1 viral load in adults and increases the rate of progression of HIV-1 infection to AIDS. The effect of malaria on viral loads in children living with AIDS (CLWA) is not clearly known. Methods: One hundred thirty five afebrile HIV-1 positive children having negative blood slides for malaria were recruited at Apac Hospital and followed up for one year. They were monitored for development of Plasmodium falciparum malaria, which was treated with chloroquine (CQ) + sulfadoxine-pyrimethamine (SP) and the children followed up for 28 days. HIV-1 viral loads were measured over three time-points: at enrolment (no malaria), during an episode of malaria, and at a visit about 8 weeks (range 6-19 weeks) after the malaria visit when the child had neither parasites nor any intervening malaria episodes (post-malaria). Primary analyses were restricted to children who on follow up had HIV-1 viral loads measured at the three relevant time-points. Results: Malaria increased HIV-1 viral load significantly in CLWA. Low parasitemia (200-4000/Cl) transiently increased viral load by 0.42 log (95% CI 0.29-0.78, p = 0.0002), higher than that reported in adults. These patients’ viral loads returned to levels similar to those at baseline after treatment. In 13 patients with high parasitemia (>4000/Cl), the mean increase in viral load was 0.53 log (95% CI 0.14 to 0.51),

Investigating Math Self-Efficacy and Math Anxiety Regarding Gender, A-Level Math Entry Grade and Mathematics Achievement

Although mathematics is perceived as an indispensable pre-cursor to success in modern society, many students still grapple with a genuine fear of mathematics and feel anxious when engaging in mathematical tasks. One of the affective factors that can affect math anxiety is learners’ belief in their own ability which is termed self-efficacy. In this study we aimed to investigate how math anxiety and math self-efficacy varied across gender, A-level math entry grade and recent mathematics score and how math anxiety and math self-efficacy related in the context of students in Mayuge District, Uganda. We collected data from 60 advanced level (A-level) mathematics students from two secondary schools in Mayuge District. Their study of mathematics was not compulsory but rather by choice. The participants filled a Mathematics Self-Efficacy and Anxiety Questionnaire (MSEAQ). Data were analyzed using descriptive statistics, independent sample t tests, one-way ANOVA, Pearson’s Linear Correlation Coefficient (PLCC) and linear regression. Descriptive statistics indicated a high level of math self-efficacy and a low level of math anxiety among the students. Independent sample t tests revealed no gender differences in math self-efficacy and math anxiety and ANOVA suggested no differences in math self-efficacy and math anxiety for the A-level math entry grades and recent mathematics scores. PLCC revealed a strong significant negative linear correlation between math self-efficacy and math anxiety with r = -0.782. Meanwhile, regression analysis suggested that math self-efficacy explained 60% of math anxiety among A-level students in Mayuge District. A recommendation was made. Keywords: Entry Grade, Gender, Math Achievement, Math Anxiety, Math Self-Efficacy DOI: 10.7176/JEP/11-26-05 Publication date:September 30th 202

Fertility desires and unmet need for family planning among HIV infected individuals in two HIV clinics with differing models of family planning service delivery

This article discusses eliminating family planning (FP) unmet need among HIV-infected individuals (PLHIV) is critical to elimination of mother-to-child HIV transmission.Background: Eliminating family planning (FP) unmet need among HIV-infected individuals (PLHIV) is critical to elimination of mother-to-child HIV transmission. We assessed FP unmet need among PLHIV attending two clinics with differing models of FP services. Nsambya Home Care provided only FP information while Mulago HIV clinic provided information and contraceptives onsite. Methods: In a cross-sectional study conducted between February-June 2011, we documented pregnancies, fertility desires, and contraceptive use among 797 HIV-infected men and women (408 in Mulago and 389 in Nsambya). FPunmet need was calculated among women who were married, unmarried but had sex within the past month, did not desire the last or future pregnancy at all or wished to postpone for ≥ two years and were not using contraceptives. Multivariable analyses for correlates of FP unmet need were computed for each clinic. Results: Overall, 40% (315) had been pregnant since HIV diagnosis; 58% desired the pregnancies. Of those who were not pregnant, 49% (366) did not desire more children at all; 15.7% wanted children then and 35.3% later. The unmet need for FP in Nsambya (45.1%) was significantly higher than that in Mulago at 30.9% (p = 0.008). Age 40+ compared to 18–29 years (OR = 6.05; 95% CI: 1.69, 21.62 in Mulago and OR = 0.21; 95% CI: 0.05, 0.90 in Nsambya), other Christian denominations (Pentecostal and Seventh Day Adventists) compared to Catholics (OR = 7.18; 95% CI: 2.14, 24.13 in Mulago and OR = 0.23; 95% CI: 0.06, 0.80 in Nsambya), and monthly expenditure > USD 200 compared to < USD40 in Nsambya (OR = 0.17; 95% CI: 0.03, 0.90) were associated with FP unmet need. Conclusions: More than half of the pregnancies in this population were desired. Unmet need for FP was very high at both clinics and especially at the clinic which did not have contraceptives onsite. Lower income and younger women were most affected by the lack of contraceptives onsite. Comprehensive and aggressive FP programs are required for fertility support and elimination of FP unmet need among PLHIV, even with integration of FP information and supplies into HIV clinics

Viral Load detection using dried blood spots in a cohort of HIV-1 infected children in Uganda: correlations with clinical and immunological criteria for treatment failure

Correlations between clinical/immunological treatment failure and viral load (VL) detected by dried blood spot (DBS) sampling were explored in HIV-1-infected children in Uganda. Of 104 children on combined antiretroviral treatment (cART), 12.5% experienced clinical and/or immunological failure, while 28.8%, 44.2%, and 26.9% had VLs of 5,000 copies/ml, respectively. Clinical/immunological failure poorly predicted virological failure