Publications by authors named "Ruth M Bland"
How to use autoantibodies in suspected paediatric rheumatic disease.
Arch Dis Child Educ Pract Ed
August 2022
Article Synopsis
- *Unnecessary testing can result in extra investigations, specialist referrals, and increased anxiety for families.
- *The article aims to guide healthcare providers on when to request autoantibodies, which tests to conduct, and how to interpret the findings effectively.*
An evaluation of a combined psychological and parenting intervention for HIV-positive women depressed in the perinatal period, to enhance child development and reduce maternal depression: study protocol for the Insika Yomama cluster randomised controlled trial.
Trials
December 2021
Background: The combination of poverty, HIV and depression in the perinatal period represents a major public health challenge in many Southern African countries. In some areas, up to a third of HIV-positive women experience perinatal depression. Perinatal depression is associated with negative effects on parenting and key domains of child development including cognitive, behavioural and growth, especially in socio-economically disadvantaged communities.
View Article and Find Full Text PDFFifteen-minute consultation: Paediatric night sweats-when to reassure and when to investigate.
Arch Dis Child Educ Pract Ed
February 2023
Article Synopsis
- The Amagugu intervention aimed to improve health literacy among HIV-positive mothers, leading to better communication about HIV and related health topics with their children.
- A study involving 281 mothers showed overwhelming demand for more educational materials, with many reporting increased discussions around safety, health, and sexual abuse after using the intervention.
- The results suggest that parent-led health education at home is effective and should be further explored in controlled studies as part of HIV prevention strategies.
Article Synopsis
- The study investigates the relationship between breastfeeding duration and childhood obesity and blood pressure in rural South Africa, especially in the context of HIV prevalence, where breastfeeding was previously discouraged.
- Data were collected from 1,536 HIV-negative children aged 7 to 11 years, revealing 7% were overfat, 13.2% overweight, and 9.1% prehypertensive, highlighting a notable prevalence of obesity-related issues.
- Results indicated that continued breastfeeding for 6 to 11 months significantly reduced the odds of children being overfat and overweight, while maternal obesity was a strong predictor of the child's weight status.
Article Synopsis
- The study aimed to document symptoms and treatment for infants who developed fever after their first meningococcal B vaccination, and to create guidelines for clinicians.
- It involved 92 infants under 3 months who had a fever within 72 hours of vaccination, with 72% needing hospitalization. Common symptoms included poor feeding and irritability, but only one case confirmed a bacterial infection.
- The findings suggest that if infants appear well, extensive investigations for post-vaccination fever aren’t necessary, and using paracetamol around the time of vaccination is recommended, with careful observation for symptoms lasting beyond 48 hours.
Article Synopsis
- There is a lack of research on childhood mental disorders in sub-Saharan Africa, especially among vulnerable children, with few studies measuring both parent and child mental health simultaneously.
- In a study involving 1,536 HIV-negative children aged 7-11, high prevalence rates of conduct disorders (11.8%) were found, particularly among HIV-affected children who had increased odds of affective disorders.
- The research highlighted that maternal depression and anxiety, along with dysfunctional mother-child relationships, significantly increased the odds of various mental disorders in children, suggesting that interventions targeting both child behavior and parenting could be beneficial.
Fifteen-minute consultation: The child with an incidental finding of low IgA.
Arch Dis Child Educ Pract Ed
October 2018
Article Synopsis
- Low or absent immunoglobulin A (IgA) levels are commonly observed in children without suspected immunodeficiency and IgA deficiency is the most common primary immunodeficiency disorder in the UK, affecting about 1 in 600 individuals.
- Isolated IgA deficiency is often discovered incidentally during examinations for other health issues like coeliac disease.
- The article aims to outline a systematic method for understanding the history, investigation, and treatment of isolated IgA deficiency.
Article Synopsis
- The World Health Organization recommends that parents disclose their HIV status to children aged 6-12, leading to the implementation of the Amagugu intervention, which provides training and support for mothers to facilitate this process.
- A study involving 20 HIV-infected mothers revealed that concerns about children's understanding and stigma were primary reasons for non-disclosure before joining the program.
- While mothers expressed satisfaction with the intervention and reported positive responses from their children post-disclosure, they still sought further support for discussing sex-related topics and acknowledged gaps in their skills for talking to their kids about HIV.
Article Synopsis
- The study aimed to improve the disclosure of maternal HIV status to HIV-uninfected children aged 6-10 by testing the Amagugu intervention against standard care in a setting in South Africa.* -
- Involved 464 participants, with the Amagugu intervention showing significantly higher rates of HIV disclosure—87% compared to 56% in the standard group after 9 months.* -
- The Amagugu intervention consisted of six home-based counseling sessions, while standard care included just one clinic session, indicating the impact of more engaging support.*
Article Synopsis
- There is a lack of research on how children in regions affected by HIV understand death, particularly after mothers disclose their HIV status to them.
- In a study involving 281 HIV-infected mothers and their children (ages 6-10), researchers found that many children asked about death-related topics, focusing on threats, implications, and seeking clarifications.
- Results indicated that children’s concerns were linked to their mother's disclosure approach and emotional response, with improvements in their behavioral issues noted post-intervention, though no significant changes in total problem scores were observed.
Article Synopsis
- Subclinical mastitis (SCM) is a common condition in breastfeeding mothers that may affect the immune development of infants, but its effects and mechanisms are not fully understood.* -
- A study involving 110 samples from 44 healthy mothers found that SCM occurred in 23% of the women and was linked to higher levels of inflammatory immune markers in breast milk.* -
- The changes in breast milk during SCM create a proinflammatory environment that could significantly impact the infant's mucosal immune system in early life.*
Article Synopsis
- * Many children of HIV-positive parents face challenges during middle childhood and adolescence, including stigma and lack of health education, leading to potential psychological and social issues in the absence of parent-led discussions about health.
- * The Amagugu intervention, a home-based program delivered by lay counselors, has proven effective in supporting parents to disclose their HIV status and educate their children, resulting in increased disclosure rates, better mental health outcomes, and improved healthcare engagement and planning for affected children.
Background: Exclusive breastfeeding (EBF) is associated with early child health; its longer-term benefits for child development remain inconclusive. We examine the associations between EBF, HIV exposure, and other maternal/child factors and the cognitive and emotional-behavioural development of children aged 7-11 y.
Methods And Findings: The Vertical Transmission Study (VTS) supported EBF in HIV-positive and HIV-negative women; between 2012 and 2014, HIV-negative VTS children (332 HIV exposed, 574 HIV unexposed) were assessed in terms of cognition (Kaufman Assessment Battery for Children Second Edition [KABC-II]), executive function (Developmental Neuropsychological Assessment Second Edition [NEPSY-II]), and emotional-behavioural functioning (parent-reported Child Behaviour Checklist, [CBCL]).
This study aimed to systematically review and appraise evidence on the short-term (e.g. morbidity, mortality) and long-term (obesity and non-communicable diseases, NCDs) health consequences of catch-up growth (vs.
View Article and Find Full Text PDFShould pregnant women with unknown HIV status be offered rapid HIV testing in labour?
Arch Dis Child Fetal Neonatal Ed
January 2016
Prevention of mother-to-child Transmission and HIV Treatment programmes were scaled-up in resource-constrained settings over a decade ago, but there is still much to be understood about women's experiences of living with HIV and their HIV disclosure patterns. This qualitative study explored women's experiences of living with HIV, 6-10 years after being diagnosed during pregnancy. The area has high HIV prevalence, and an established HIV treatment programme.
View Article and Find Full Text PDFAdherence to WHO infant feeding recommendations has short-term benefits and may also help in the prevention of non-communicable diseases (NCDs). This study reviewed the evidence on whether adherence to all elements of the WHO infant feeding recommendations (comparison group those exclusively breastfed to 6 months, introduced to appropriate complementary feeding from 6 months, with continued breastfeeding to at least 24 months; exposure group characterised by non-adherence to any of the three recommendations) is associated with reduced risk of later obesity or cardiometabolic disease. The population of interest was children not classified as very low weight (weight-for-age z-score >-3.
View Article and Find Full Text PDFObjectives: Increasingly, HIV-infected parents are surviving to nurture their children. Parental HIV disclosure is beneficial, but disclosure rates to younger children remain low. Previously, we demonstrated that the 'Amagugu' intervention increased disclosure to young children; however, effects on psychological outcomes have not been examined in detail.
View Article and Find Full Text PDFObjectives: Sub-Saharan Africa has large populations of HIV-infected parents who need support to raise their HIV-uninfected children. This research evaluates the 'Amagugu Intervention' aimed at supporting mothers to disclose their own HIV diagnosis to their HIV-uninfected children.
Design: Uncontrolled pre and post-intervention evaluation.
Objective: To determine the effect of infant feeding practices on postpartum weight change among HIV-infected and -uninfected women in South Africa.
Methods: In a non-randomised intervention cohort study of antiretroviral therapy-naïve women in South Africa, infants were classified as exclusive (EBF), mixed (MF) or non-breastfed (NBF) at each visit. We analysed infant feeding cumulatively from birth to 5 months using 24-hour feeding history (collected weekly for each of the preceding 7 days).
Background: Better understanding of drug resistance patterns in HIV-infected children on antiretroviral therapy (ART) is required to inform public health policies in high prevalence settings. The aim of this study was to characterise the acquired drug resistance in HIV-infected children failing first-line ART in a decentralised rural HIV programme.
Methods: Plasma samples were collected from 101 paediatric patients (≤15 yrs of age) identified as failing ART.
Introduction: Antiretroviral drug interventions significantly reduce the risk of HIV transmission to infants through breastfeeding. We report diarrhoea prevalence and all-cause mortality at 12 months of age according to infant feeding practices, among infants born to HIV-infected and uninfected mothers in South Africa.
Methods: A non-randomised intervention cohort study that followed both HIV-infected and HIV-uninfected mothers and their infants until 18 months of age.
There is increasing evidence to support a relationship between human immunodeficiency virus (HIV-1) transmission through breastfeeding and milk host factors. We analyzed skim milk proteome to further determine the contribution of host factors to the risk of mother-to-child transmission of HIV-1. Quantitative mass spectrometry analysis was performed on nine case-control pairs of HIV+ transmitter/nontransmitter mothers, and specific biochemical assays on two selected proteins were assessed in an independent validation set of 127 samples.
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