203 research outputs found
What a Feeling: Learning Facial Expressions and Emotions.
People with Autism Spectrum Disorders (ASD) find it difficult to understand facial expressions. We present a new approach that targets one of the core symptomatic deficits in ASD: the ability to recognize the feeling states of others. What a Feeling is a videogame that aims to improve the ability of socially and emotionally impaired individuals to recognize and respond to emotions conveyed by the face in a playful way. It enables people from all ages to interact with 3D avatars and learn facial expressions through a set of exercises. The game engine is based on real-time facial synthesis. This paper describes the core mechanics of our learning methodology and discusses future evaluation directions
Development of nevirapine resistance in children exposed to the prevention of mother-to-child HIV-1 transmission programme in Maputo, Mozambique
Background: Single-dose nevirapine (sd-NVP) has been the main option for prevention of mother-to-child transmission (PMTCT) of HIV-1 in low-resource settings. However, sd-NVP can induce the selection of HIV-1 resistant mutations in mothers and infants. In Mozambique, there are limited data regarding the profile of NVP resistance associated mutations (RAM) in the context of PMTCT.
Objectives: To assess the prevalence and the factors associated with NVP RAM among children born to HIV-1 infected mothers enrolled in the PMTCT programme adopted in Mozambique.
Methods: One hundred and fifty seven children aged 6 to 48 weeks were sequentially included (July 2011 to March 2012) at four centres in Maputo. Genotyping of RAM was performed in samples with HIV-1 RNAâ„ 100 copies/ÎŒL (Viroseq). Sequencing was performed with ABI 3100 (Applied Biosystems). Logistic regression modelling was undertaken to identify the factors associated with NVP RAM.
Results: Seventy-nine children had their samples genotyped. Their median age was 7.0 (3â12) months and 92.4% received prophylaxis with sd-NVP at birth plus daily NVP. 35.4% of mothers received antiretrovirals (ARVs) for PMTCT. ARV RAM were detected in 43 (54.4%) of the children. 45.6% of these children had at least one NVP RAM. The most common mutations associated with NVP resistance were K103N (n = 16) and Y181C (n = 15). NVP RAM was significantly associated with mother exposure to PMTCT (crude odds ratio [OR] 30.3, 95% CI 4.93â186.34) and with motherâs CD4 count < 350 cells/mm3 (crude OR 3.08, 95% CI 1.02â9.32). In the multivariable analysis the motherâs exposure to PMTCT was the only variable significantly associated with NVP RAM (adjusted OR 48.65, 95% CI 9.33â253.66).
Conclusions: We found a high prevalence of NVP RAM among children who were exposed to the drug regimen for PMTCT in Mozambique. The mothersâ exposure to PMTCT significantly increased the risk of NVP RAM.This study was funded by the Associação para a Investigação e Desenvolvimento da Faculdade de Medicina (AIDFM). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.info:eu-repo/semantics/publishedVersio
Continuum of HIV Care in Rural Mozambique: The Implications of HIV Testing Modality on Linkage and Retention
INTRODUCTION: Context-specific improvements in the continuum of
HIV care are needed in order to achieve the UNAIDS target of
90-90-90. This study aimed to assess the linkage to and
retention in HIV care according to different testing modalities
in rural southern Mozambique. METHODS: Adults newly diagnosed
with HIV from voluntary counseling and testing (VCT),
provider-initiated (PICT) and home-based HIV testing (HBT)
services were prospectively enrolled between 2014- 2015 at the
Manhica District. Patients were passively followed-up through
chart examination .Tracing was performed at 12-months to
ascertain causes of loss to follow-up. Fine and Grey competing
risk analysis was performed to determine factors associated with
the each step of the cascade. RESULTS: Overall linkage to care
as defined by having a CD4 count at 3 months, was 43.7% (95CI%
40.8-46.6) and 25.2% of all participants initiated ART. Factors
associated with increased linkage in multivariable analysis
included testing at VCT, older age, having been previously
tested for HIV, owning a cell phone, presenting with WHO
clinical stages III/IV, self-reported illness-associated
disability in the previous month , and later calendar month of
participant recruitment. Ascertaining deaths and transfers
allowed adjustment of the rate of 12-month retention in
treatment from 75.6% (95% CI 70.2-80.5) to 84.2% (95% CI
79.2-88.5). CONCLUSIONS: HBT reached a socio-demographically
distinct population from that of clinic based testing modalities
but low linkage to care points to a need for facilitated linkage
interventions. Distinguishing between true treatment defaulting
and other causes of loss-to-follow-up can significantly change
indicators of retention in care
Reengagement of HIV-infected children lost to follow-up after active mobile phone tracing in a rural area of Mozambique
Introduction: Retention in care and reengagement of lost to follow-up (LTFU) patients are priority challenges in pediatric HIV care. We aimed to assess whether a telephone-call active tracing program facilitated reengagement in care (RIC) in the Manhiça District Hospital, Mozambique.
Methods: Telephone tracing of LTFU children was performed from July 2016 to March 2017. Both ART (antiretroviral treatment) and preART patients were included in this study. LTFU was defined as not attending the clinic for â„120âdays after last attended visit. Reengagement was determined 3âmonths after an attempt to contact. Results: A total of 144 children initially identified as LTFU entered the active tracing program and 37 were reached by means of telephone tracing. RIC was 57% (95% CI, 39â72%) among children who could be reached versus 18% (95% CI, 11â26%) of those who could not be reached (pâ=â0.001). Conclusion: Telephone tracing could be an effective tool for facilitating reengagement in pediatric HIV care. However, the difficulty of reaching patients is an obstacle that can undermine the program
Radiological findings in young children investigated for tuberculosis in Mozambique
INTRODUCTION: Chest radiography remains a critical tool for
diagnosing intrathoracic tuberculosis (TB) in young children who
are unable to expectorate. We describe the radiological findings
in children under 3 years of age investigated for TB in the
district of Manhica, southern Mozambique, an area with a high
prevalence of TB and HIV. METHODS: Digital antero-posterior and
lateral projections were performed and reviewed by two
independent readers, using a standardized template. Readers
included a local pediatrician and a pediatric radiologist
blinded to all clinical information. International consensus
case definitions for intra-thoracic TB in children were applied.
RESULTS: A total of 766 children were evaluated of whom 43
(5.6%) had TB. The most frequent lesion found in TB cases was
air space consolidation (65.1%), followed by suggestive hilar
lymphadenopathy (17.1%) and pleural effusion (7.0%). Air space
consolidation was significantly more common in TB cases than in
non-TB cases (odds ratio 8.9; 95% CI: 1.6-50.5), as were hilar
lymphadenopathy (OR 17.2; 95% CI: 5.7-52.1). The only case with
miliary infiltrates and 3 with pleural effusions occurred in
HIV-infected children. CONCLUSION: Frequent air space
consolidation complicates radiological distinction between TB
and bacterial pneumonia in young children, underscoring the need
for epidemiological contextualization and consideration of all
relevant signs and symptoms
External Quality Assessment Programme for Early Infant Diagnosis of HIV-1, Mozambique, 2011â2014
This study evaluated a National External Quality Scheme Program for early infant diagnosis of HIV. Fourteen laboratory technicians participated and nine testing panel cycles were sent between 2011 and 2014. The response rate was 100% for the first eight panels, and the number of technicians with a test score of 100% increased during the first three panels. Based on the evaluations of the technicians, the quality of testing for early infant diagnosis of HIV improved over time in the laboratories
Shifts in age pattern, timing of childbearing and trend in fertility level across six regions of Nigeria: Nigeria Demographic and Health Surveys from 2003â2018
Background
Nigeriaâs population is projected to increase from 200 million in 2019 to 450 million in 2050 if the fertility level remains at the current level. Thus, we examined the shifts in the age pattern of fertility, timing of childbearing and trend in fertility levels from 2003 and 2018 across six regions of Nigeria.
Method
This study utilised the 2003, 2008, 2013, and 2018 Nigeria Demographic and Health Survey datasets. Each survey was a cross-sectional population-based design, and a two-stage cluster sampling technique was used to select women aged 15â49 years. The changes in the timing of childbearing were examined by calculating the corresponding mean ages at the birth of different birth orders for each birth order separately to adjust the Quantum effect for births. The Gompertz Relational Model was used to examine the age pattern of fertility and refined fertility level.
Result
In Nigeria, it was observed that there was a minimal decline in mean children ever born (CEB) between 2003 and 2018 across all maternal age groups except aged 20â24 years. The pattern of mean CEB by the age of mothers was the same across the Nigeria regions except in North West. Nigeriaâs mean number of CEB to women aged 40â49 in 2003, 2008, 2013 and 2018 surveys was 6.7, 6.6, 6.3 and 6.1, respectively. The mean age (years) at first birth marginally increased from 21.3 in 2003 to 22.5 in 2018. In 2003, the mean age at first birth was highest in South East (24.3) and lowest in North East (19.4); while South West had the highest (24.4) and both North East and North West had the lowest (20.2) in 2018. Similar age patterns of fertility existed between 2003 and 2018 across the regions. Nigeriaâs estimated total fertility level for 2003, 2008, 2013 and 2018 was 6.1, 6.1, 5.9 and 5.7, respectively.
Conclusion
The findings showed a reducing but slow fertility declines in Nigeria. The decline varied substantially across the regions. For a downward change in the level of fertility, policies that will constrict the spread of fertility distribution across the region in Nigeria must urgently be put in place
Awareness of cervical cancer and willingness to be vaccinated against human papillomavirus in Mozambican adolescent girls
Sub-Saharan Africa concentrates the largest burden of cervical
cancer worldwide. The introduction of the HPV vaccination in
this region is urgent and strategic to meet global health
targets. This was a cross-sectional study conducted in
Mozambique prior to the first round of the HPV vaccine
demonstration programme. It targeted girls aged 10-19 years old
identified from schools and households. Face-to-face structured
interviews were conducted. A total of 1,147 adolescents were
enrolled in three selected districts of the country. Most girls
[84% (967/1147)] had heard of cervical cancer, while 76%
believed that cervical cancer could be prevented. However only
33% (373/1144) of girls recognized having ever heard of HPV.
When girls were asked whether they would accept to be vaccinated
if a vaccine was available in Mozambique, 91% (1025/1130)
answered positively. Girls from the HPV demonstration districts
showed higher awareness on HPV and cervical cancer, and
willingness to be vaccinated. This study anticipates high
acceptability of the HPV vaccine in Mozambique and high
awareness about cervical cancer, despite low HPV knowledge.
These results highlight that targeted health education programs
are critical for acceptance of new tools, and are encouraging
for the reduction of cervical cancer related mortality and
morbidity in Mozambique
- âŠ