Publications by authors named "E Kalk"
High incidence of tuberculosis in young children living with HIV in the Western Cape, South Africa.
J Acquir Immune Defic Syndr
January 2025
Background: Data on tuberculosis (TB) incidence and risk factors among children living with HIV (CLHIV) in the universal ART era are limited.
Methods: We analysed routinely-collected data on TB diagnoses for CLHIV age ≤5 years, born 2018-2022, in the Westen Cape, South Africa. We examined factors associated with TB diagnosis, with death and loss to follow-up as competing events.
Background: Although prior studies of tuberculosis-preventive treatment (TPT) for pregnant people with human immunodeficiency virus (PPWH) report conflicting adverse pregnancy outcome (APO) risks, international guidelines recommend TPT for PPWH.
Methods: We used a microsimulation model to evaluate 5 TPT strategies among PPWH receiving antiretroviral therapy in South Africa: No TPT; 6 months of isoniazid (6H) or 3 months of isoniazid-rifapentine (3HP) during pregnancy (Immediate 6H or Immediate 3HP) or post partum (Deferred 6H or Deferred 3HP). The primary outcomes were maternal, fetal/infant, and combined deaths from causes potentially influenced by TPT (maternal tuberculosis, maternal hepatotoxicity, stillbirth, low birth weight [LBW], and infant tuberculosis).
Article Synopsis
- Lack of comprehensive data on congenital disorders (CDs) in South Africa affects resource distribution and detection of risks from harmful pregnancy exposures.
- A study using the Western Cape Pregnancy Exposure Registry analyzed data from 2016 to 2022, finding a confirmed prevalence of major CDs at 7.2 per 1,000 births, which increased to 9.2 when including missed diagnoses.
- Factors such as older maternal age and diabetes raised CD prevalence, while HIV status and other conditions did not significantly impact rates; improving neonatal checks and records could enhance CD detection.
Article Synopsis
- * A study in Cape Town, South Africa showed seroprevalence of SARS-CoV-2 rose from 39.19% in July 2020 to 67.8% by November 2021, with poorer communities experiencing higher rates and mortality.
- * Seropositivity before the Omicron wave offered strong protection against severe disease, suggesting that effective seroprevalence research is essential for understanding true infection rates and directing public health interventions.
Using the Data Evaluation and Preparation for HIV-Exposed Uninfected Child Cohorts project's standardized child HIV exposure definitions, 64%, 64% and 90% of children exposed to HIV in utero could be classified as HIV-uninfected with moderate or high certainty at the ages of 1 and 3 years and at the time of first infectious disease hospitalization, respectively. These definitions can be applied retrospectively to routine datasets with linked mother-child data.
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