MyMedR

Fulltext Effect of antiretroviral therapy care interruptions on mortality in children living with HIV

Davies C, Johnson L, Sawry S, Chimbetete C, Eley B, Vinikoor M, et al.

AIDS, 2022 Apr 01;36(5):729-737.

PMID: 35152225 DOI: 10.1097/QAD.0000000000003194

OBJECTIVE: To evaluate the characteristics and outcomes of HIV-infected children that have care interruptions, during which the child's health status and use of medication is unknown.

DESIGN: We included data on children initiating ART between 2004 and 2016 at less than 16 years old at 16 International Epidemiologic Databases to Evaluate AIDS Southern Africa cohorts. Children were classified as loss to follow up (LTFU) if they had not attended clinic for more than 180 days. Children had a care interruption if they were classified as LTFU, and subsequently returned to care. Children who died within 180 days of ART start were excluded.

METHODS: The main outcome was all cause mortality. Two exposed groups were considered: those with a first care interruption within the first 6 months on ART, and those with a first care interruption after 6 months on ART. Adjusted hazard ratios were determined using a Cox regression model.

RESULTS: Among 53 674 children included, 23 437 (44%) had a care interruption, of which 10 629 (20%) had a first care interruption within 6 months on ART and 12 808 (24%) had a first care interruption after 6 months on ART. Increased mortality was associated with a care interruption within 6 months on ART [adjusted hazard ratio (AHR) = 1.52, 95% CI 1.12-2.04] but not with a care interruption after 6 months on ART (AHR = 1.05, 95% CI 0.77-1.44).

CONCLUSION: The findings suggest that strengthening retention of children in care in the early period after ART initiation is critical to improving paediatric ART outcomes.

Matched MeSH terms: Africa, Southern

Tracing the origins of genotype VIIh Newcastle disease in southern Africa

Abolnik C, Mubamba C, Wandrag DBR, Horner R, Gummow B, Dautu G, et al.

Transbound Emerg Dis, 2018 Apr;65(2):e393-e403.

PMID: 29178267 DOI: 10.1111/tbed.12771

It is widely accepted that Newcastle disease is endemic in most African countries, but little attention has been afforded to establishing the sources and frequency of the introductions of exotic strains. Newcastle disease outbreaks have a high cost in Africa, particularly on rural livelihoods. Genotype VIIh emerged in South-East Asia and has since caused serious outbreaks in poultry in Malaysia, Indonesia, southern China, Vietnam and Cambodia. Genotype VIIh reached the African continent in 2011, with the first outbreaks reported in Mozambique. Here, we used a combination of phylogenetic evidence, molecular dating and epidemiological reports to trace the origins and spread of subgenotype VIIh Newcastle disease in southern Africa. We determined that the infection spread northwards through Mozambique, and then into the poultry of the north-eastern provinces of Zimbabwe. From Mozambique, it also reached neighbouring Malawi and Zambia. In Zimbabwe, the disease spread southward towards South Africa and Botswana, causing outbreaks in backyard chickens in early-to-mid 2013. In August 2013, the disease entered South Africa's large commercial industry, and the entire country was infected within a year, likely through fomites and the movements of cull chickens. Illegal poultry trading or infected waste from ships and not wild migratory birds was the likely source of the introduction to Mozambique in 2011.

Matched MeSH terms: Africa, Southern/epidemiology

First record of the family Pseudochiridiidae (Arachnida, Pseudoscorpiones) from continental South America--a Pseudochiridium from a Brazilian cave

Von Schimonsky DM, Bichuette ME, Mahnert V

Zootaxa, 2014;3889(3):442-6.

PMID: 25544278 DOI: 10.11646/zootaxa.3889.3.6

The small pseudoscorpion family Pseudochiridiidae Chamberlin, 1923 comprises two genera and 12 extant species recorded from Asia (Burma, Christmas Island, Indonesia, India, Nepal, Malaysia, New Guinea, Philippines, Nicobars and Sumba), eastern, central and southern Africa (Chad, D.R. Congo, Kenya, South Africa, Tanzania), Madagascar, Seychelles (Aldabra), North America (Florida) and the Caribbean Islands of Dominican Republic and Cuba (Harvey 2013, Barba & Barroso 2013); one unidentified species is mentioned for the fauna of Mexico (Ceballos 2004). A fossil species has been described from Dominican amber by Judson (2007), who predicted the presence of this family in South America.

Matched MeSH terms: Africa, Southern

Feasibility of local condom production examined

AIDS Anal Afr, 1999 Jun-Jul;10(1):13.

PMID: 12295121

Matched MeSH terms: Africa, Southern

The geographical distribution of endomyocardial fibrosis

Shaper AG

Pathol Microbiol (Basel), 1970;35(1):26-35.

PMID: 5472024

Matched MeSH terms: Africa, Southern

People living with HIV / AIDS talk about their families

World AIDS Day Newsl, 1994;?(2):3.

PMID: 12287964

PIP: Five positive and negative experiences of families dealing with AIDS are recounted. Imrat in Malaysia is an HIV-infected son who was not rejected by his family. Prudence of Botswana is an infected widow with five children who had a less positive experience with her in-laws, while Eric of Sweden considers his friends to constitute his family. His relationships with friends have only strengthened since his HIV-positive status became known. Mary of Zimbabwe, however, was infected with HIV by her husband. She was formerly angry at him for having brought home the virus, but they have since stop quarreling and are focusing upon building a stronger relationship. Finally, the brief story of Juan in Colombia is told. Thirty-two years old, married, and with a 17-month old daughter, Juan did not tell his wife that he was actively bisexual. Once infected with HIV, Juan's wife threw him out, more because he had sex with men than because of his HIV serostatus.

Matched MeSH terms: Africa, Southern

Fulltext A biregional survey and review of first-line treatment failure and second-line paediatric antiretroviral access and use in Asia and southern Africa

TREAT Asia Pediatric HIV Observational Database (TApHOD), International Epidemiologic Databases to Evaluate AIDS (IeDEA) Southern Africa Paediatric Group

J Int AIDS Soc, 2011 Feb 09;14:7.

PMID: 21306608 DOI: 10.1186/1758-2652-14-7

BACKGROUND: To better understand the need for paediatric second-line antiretroviral therapy (ART), an ART management survey and a cross-sectional analysis of second-line ART use were conducted in the TREAT Asia Paediatric HIV Observational Database and the IeDEA Southern Africa (International Epidemiologic Databases to Evaluate AIDS) regional cohorts.

METHODS: Surveys were conducted in April 2009. Analysis data from the Asia cohort were collected in March 2009 from 12 centres in Cambodia, India, Indonesia, Malaysia, and Thailand. Data from the IeDEA Southern Africa cohort were finalized in February 2008 from 10 centres in Malawi, Mozambique, South Africa and Zimbabwe.

RESULTS: Survey responses reflected inter-regional variations in drug access and national guidelines. A total of 1301 children in the TREAT Asia and 4561 children in the IeDEA Southern Africa cohorts met inclusion criteria for the cross-sectional analysis. Ten percent of Asian and 3.3% of African children were on second-line ART at the time of data transfer. Median age (interquartile range) in months at second-line initiation was 120 (78-145) months in the Asian cohort and 66 (29-112) months in the southern African cohort. Regimens varied, and the then current World Health Organization-recommended nucleoside reverse transcriptase combination of abacavir and didanosine was used in less than 5% of children in each region.

CONCLUSIONS: In order to provide life-long ART for children, better use of current first-line regimens and broader access to heat-stable, paediatric second-line and salvage formulations are needed. There will be limited benefit to earlier diagnosis of treatment failure unless providers and patients have access to appropriate drugs for children to switch to.

Matched MeSH terms: Africa, Southern

IBFAN Africa training initiatives: code implementation and lactation management

Mbuli A

Mothers Child, 1994;13(1):5.

PMID: 12287932

Matched MeSH terms: Africa, Southern

Positive policies towards spontaneous settlements

Oestereich J

Ekistics, 1981 Jan;48(286):14-8.

PMID: 12143625

Matched MeSH terms: Africa, Southern

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