Background: The World Health Organization recommends isoniazid preventive therapy (IPT) for people living with HIV (PLHIV) to prevent tuberculosis (TB), including pregnant women. Recent trial results suggest increased adverse pregnancy outcomes associated with IPT during pregnancy. Data are limited regarding programmatic IPT use in pregnant PLHIV.
Methods: We assessed previous programmatic IPT during pregnancy among HIV-infected mothers on enrollment to an infant TB prevention trial in Kenya. Pregnancy IPT use was assessed by the estimated conception date assuming 38 weeks of gestation. Correlates of initiation and completion were analyzed by relative risk regression, using generalized linear models with log link and Poisson family adjusted for IPT initiation year.
Results: Between August 15, 2016, to June 6, 2018, 300 HIV-infected women enrolled at 6 weeks postpartum. Two hundred twenty-four (74.7%) women reported previous IPT, of whom 155/224 (69.2%) had any pregnancy IPT use. Forty-five (29.0%) initiated preconception extending into early pregnancy, 41 (26.5%) initiated and completed during pregnancy, and 69 (44.5%) initiated in pregnancy and extended into early postpartum. The median gestational age at IPT pregnancy initiation was 15.1 weeks (interquartile range 8.3-28.4). Pregnancy/early postpartum IPT initiation was associated with new pregnancy HIV diagnosis [adjusted relative risk 1.9 95% confidence interval (CI): 1.6 to 2.2, P < 0.001]. Six-month IPT completion rates were high [147/160 (91.9%)] among women with sufficient time to complete before trial enrollment and similar among preconception or during pregnancy initiators [adjusted relative risk 0.93 (95% confidence interval: 0.83 to 1.04, P = 0.19)].
Conclusions: Programmatic IPT use was high in pregnant PLHIV, with frequent periconception and early pregnancy initiation. Programmatic surveillance could provide further insights on pregnancy IPT implementation and maternal and infant safety outcomes.
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http://dx.doi.org/10.1097/QAI.0000000000002086 | DOI Listing |
Healthcare (Basel)
January 2025
Department of Nursing Sciences, Faculty of Basic Medical and Health Sciences, Walter Sisulu University, Nelson Mandela Drive Campus, Mthatha 5117, South Africa.
Malaria in pregnancy is a global health problem because it causes anemia in the mother and may result in abortion, stillbirth, uterine growth retardation, and low birth weight in the newborn. The purpose of this study was to assess the effects of HEI on knowledge and adherence to intermittent preventive treatment of malaria among pregnant women at secondary health facilities in Benue State, Nigeria. This quasi-experimental study included pre-, intervention, and post-intervention.
View Article and Find Full Text PDFNarra J
December 2024
Doctoral Program of Development Extension and Community Empowerment, School of Postgraduate Studies, Universitas Sebelas Maret, Surakarta, Indonesia.
Tuberculosis (TB) remains a significant global health challenge, especially for children. The aim of this scoping review was to investigate the role of mothers in preventing childhood TB transmission and highlight effective strategies and associated barriers. A systematic literature search was conducted using PubMed, Web of Science, and Scopus, covering articles up to January 17, 2024.
View Article and Find Full Text PDFWest Afr J Med
August 2024
Department of Haematology and Immunology, University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu, Nigeria.
Background: There are reports of a high prevalence of maternal peripheral and placental malarial parasitaemia (MP) in southeastern Nigeria following the two-dose regimen of sulphadoxine-pyrimethamine (SP) for intermittent preventive treatment (IPT) of malaria in pregnancy.
Objective: To compare the effectiveness of monthly versus two-dose regimens of SP for IPT of malaria in pregnancy in Enugu, south-eastern Nigeria.
Methods: A randomized controlled trial involving antenatal clinic attendees at the University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu, Nigeria.
Asian J Psychiatr
January 2025
School of Nursing, The University of Hong Kong, Hong Kong. Electronic address:
Background: Several interventions have been investigated addressing perinatal depression; however, interventions have not been compared using both direct and indirect evidence. This study compared the relative effectiveness of all interventions that prevent depression (objective 1) or treat depression symptoms (objective 2) in perinatal women.
Methods: Eight databases searched from their inception to March 2024.
Pan Afr Med J
September 2024
Centre for Malaria Elimination, Institute of Tropical Medicine, Mount Kenya University, Thika, Kenya.
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