Postpartum adherence to Option B+ until 18 months in Western Uganda

Since 2012, the WHO recommends Option B+ for the prevention of mother-to-child transmission of HIV. This approach entails the initiation of lifelong antiretroviral therapy in all HIV-positive pregnant women, also implying protection during breastfeeding for 12 months or longer. Research on long-term adherence to Option B+ throughout breastfeeding is scarce to date. Therefore, we conducted a prospective observational cohort study in Fort Portal, Western Uganda, to assess adherence to Option B+ until 18 months postpartum. In 2013, we recruited 67 HIV-positive, Option B+ enrolled women six weeks after giving birth and scheduled them for follow-up study visits after six, twelve and 18 months. Two adherence measures, self-reported drug intake and amount of drug refill visits, were combined to define adherence, and were assessed together with feeding information at all study visits. At six months postpartum, 51% of the enrolled women were considered to be adherent. Until twelve and 18 months postpartum, adherence for the respective follow-up interval decreased to 19% and 20.5% respectively. No woman was completely adherent until 18 months. At the same time, 76.5% of the women breastfed for ≥12 months. Drug adherence was associated with younger age (p<0.01), lower travel costs (p = 0.02), and lower number of previous deliveries (p = 0.04). Long-term adherence to Option B+ seems to be challenging. Considering that in our cohort, prolonged breastfeeding until ≥12 months was widely applied while postpartum adherence until the end of breastfeeding was poor, a potential risk of postpartum vertical transmission needs to be taken seriously into account for Option B+ implementation

Lack of effect of intermittent preventive treatment for malaria in pregnancy and intense drug resistance in western Uganda

Background Intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine–pyrimethamine (SP) is widely implemented in sub-Saharan Africa for the prevention of malaria in pregnancy and adverse birth outcomes. However, in areas of intense SP resistance, the efficacy of IPTp may be compromised. Methods A cross-sectional study among 915 delivering women (728 analysable live singleton deliveries) was conducted in Fort Portal, western Uganda, to assess associations of reported IPTp use, Plasmodium falciparum infection, maternal anaemia, low birth weight, and preterm delivery, and to estimate the degree of SP resistance as reflected by pfdhfr/pfdhps mutations. Results Plasmodium falciparum infection was detected by PCR in 8.9 % and by microscopy of placental blood samples in 4.0 %. Infection was significantly associated with stillbirth, early neonatal death, anaemia, low birth weight, and pre-term delivery. Eighty percent of the women had taken at least one dose of IPTp, and more than half had taken two doses. As compared to women without chemoprophylaxis against malaria, IPTp had no significant influence on the presence of P. falciparum infection (13.8 vs. 9.6 %, P = 0.31). Nor was it associated with reductions in anaemia, low birth weight or preterm delivery. P. falciparum with intense SP resistance (pfdhfr/pfdhps quintuple or sextuple mutations) were observed in 93 % (pfdhps 581G, 36 %), and the additional high resistance allele pfhdr 164L in 36 %. Conclusions In Fort Portal, Uganda, reported use of IPTp with SP does not provide an observable benefit. The molecular markers of P. falciparum indicate high grade SP resistance reaching the threshold set by WHO for the discontinuation of IPTp with SP. Alternative approaches for the prevention of malaria in pregnancy are urgently needed

Open Educational Resources (OER) und das Zentrale OER-Repositorium (ZOERR) der Hochschulen in Baden-Württemberg – zu Präsentation und Nutzung zeitgemäßer Lehr-/Lernmaterialien

Vorstellung des Konzeptes der Open Educational Resources (OER) und des Zentralen OER-Repositoriums (ZOERR) der Hochschulen in Baden-Württemberg – zu Präsentation und Nutzung zeitgemäßer Lehr-/Lernmaterialien. Text zur Veranstaltung "Digitalisierung in Griechisch und Latein an Schule und Hochschule: gegenwärtiger Stand, aktuelle Trends“ am 25. Oktober 2018 am Philologischen Seminar der Universität Tübingen.Zweitveröffentlichun

Quintus Sertorius und der Krieg in Spanien

Verschiedene Quellentraditionen berichten über den Kampf, den Quintus Sertorius gegen das Sulla-Regime in Spanien geführt hat

Das ZOERR an der Universitätsbibliothek Tübingen. Der OER-Publikationsdienst für die Hochschulen in Baden-Württemberg

Mit dem Programm Digital Innovations for Smart Teaching – Better Learning förderte das Land Baden-Württemberg von 2016 bis 2018 zehn innovative Digitalisierungsprojekte an Landeshochschulen. Eines der zehn Vorhaben war der Aufbau des heutigen ZOERR1 – des Zentralen Open-Educational-Resources-Repositoriums der Hochschulen in Baden-Württemberg. Am Ministerium für Wissenschaft und Kunst (MWK) wurde der Antrag, der von Marianne Dörr für die Universitätsbibliothek Tübingen (UB Tübingen) eingereicht wurde, als förderwürdig angesehen. Für den Förderzuschlag waren neben anderen Aspekten die Zukunftsfähigkeit des Vorhabens, die vorhandenen gut entwickelten Online-Pub-likationsdienste und die Vorerfahrungen bei der Publikation von freien Lehr- / Lernmaterialien an der UB Tübingen als maßgeblich anzusehen