212 results match your criteria: "Makerere University Johns Hopkins University Research Collaboration[Affiliation]"

Background: Immunisation in pregnancy against pertussis can reduce severe disease in infancy. There are few data on the safety and immunogenicity of vaccines given to pregnant women living with HIV and their infants. We aimed to describe the safety and immunogenicity of a tetanus-diphtheria-acellular pertussis (TdaP) vaccine containing genetically detoxified pertussis toxin given to pregnant women living with HIV and the effect of the vaccine on infant whole-cell pertussis vaccine responses.

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Our objective was to assess human immunodeficiency virus (HIV) knowledge and sexual behaviors in 294 perinatally HIV-infected youth aged 18 to 25 years from a psychosocial support group in Kampala using a self-administered survey. Seventy-nine percent reported an undetectable viral load, 9.5% detectable, and 12% did not know.

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Article Synopsis
  • HEU (HIV-exposed uninfected) children face a higher risk of hospitalization and mortality compared to HUU (HIV-unexposed uninfected) children, prompting a closer look at their health outcomes.
  • A study of 1486 children revealed that HEU children had significantly higher rates of hospitalization mortality and were more prone to wasting and stunting.
  • Despite similar illness severity and resource use in hospitals, HEU children had longer stays and a two-fold increased risk of dying within 30 days of hospitalization compared to HUU peers.
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  • The study focuses on the timing of the first sexual experience among female youths in Rwanda to aid reproductive health policies and interventions.
  • Using secondary data from the Rwanda Demographic and Health Survey, it estimates the median age of first sexual encounter and examines its determinants.
  • Results show that many young women had their first sexual experience before 25, with a median age of 18, and factors like education, marital status, and media access significantly influence the timing.
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A risk- and needs-based strategy HIV prevention for adolescent girls and young women, WHO African Region.

Bull World Health Organ

December 2024

Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute, University of KwaZulu Natal, 719 Umbilo Road, Durban4001, South Africa.

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Introduction: Viral suppression is a critical component for preventing mother-to-child transmission of HIV(MTCT). Mothers' perceptions of viral load suppression is crucial in the attainment of successful outcomes in preventing mother to child transmission of HIV. We therefore aimed to explore the experiences and perceptions of women on viral suppression.

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Approaches and processes for paediatric chest X-ray classification used in the SHINE TB treatment-shortening trial.

Int J Tuberc Lung Dis

November 2024

Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa.

INTRODUCTIONSHINE (Shorter Treatment for Minimal Tuberculosis in Children) was the first Phase 3 paediatric TB treatment-shortening trial. Robust chest X-ray (CXR) classification methods were integral to excluding severe disease for trial eligibility and to retrospectively adjudicating TB status at baseline. We describe and critically evaluate the CXR classification approaches and processes used in the SHINE trial.

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Article Synopsis
  • Chest X-ray (CXR) misinterpretation poses a significant challenge to accurately diagnosing tuberculosis (TB) in children, and implementing external quality assurance (EQA) can improve the skills of CXR readers.
  • In a study across six resource-limited countries, 60.8% of eligible CXRs were selected for re-reading under EQA, showing a decrease in discordant interpretations over time and a 100% sensitivity in clinician readings following EQA.
  • The primary challenges faced included the transfer of CXRs and the workload of re-readers, indicating that while EQA can enhance diagnosis, operational issues need to be addressed for success.
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Rates of HIV acquisition remain high among adolescent girls and young women (AGYW) in sub-Saharan Africa. We explored South African, Ugandan, and Zimbabwean AGYW's experiences in a crossover trial of two HIV prevention products: Daily oral pre-exposure prophylaxis pills and a monthly dapivirine vaginal ring. A subset of participants (n = 25) across all sites completed up to three serial in-depth interviews (SIDIs).

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Background: Safety data from randomized trials of antiretrovirals in pregnancy are scarce. We evaluated maternal bone and renal data from the International Maternal Pediatric Adolescent AIDS Clinical Trials Network 2010 trial, which compared the safety and efficacy of 3 antiretroviral therapy regimens started in pregnancy: dolutegravir + emtricitabine/tenofovir alafenamide (DTG + FTC/TAF), dolutegravir + emtricitabine/tenofovir disoproxil fumarate (DTG + FTC/TDF), and efavirenz/emtricitabine/tenofovir disoproxil fumarate (EFV/FTC/TDF).

Methods: A subset of participants underwent dual-energy X-ray absorptiometry scans at postpartum week 50 only.

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Objective: Tenofovir alafenamide (TAF)-based antiretroviral therapy (ART) regimens have been associated with adverse changes in lipid and glucose profiles compared with tenofovir disoproxil fumarate (TDF)-based ART, but data in pregnancy is limited. We evaluated metabolic markers in pregnant women with HIV after starting TAF- vs TDF-based ART.

Methods: We analyzed data within the IMPAACT 2010/VESTED trial, which demonstrated better pregnancy outcomes in pregnant women randomized to initiate TAF/Emtricitabine/Dolutegravir (TAF/FTC+DTG; n=217) or TDF/FTC+DTG (n=215).

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Objectives: Blood transfusion is an important mode of infectious disease transmission in low- and middle-income countries (LMICs). This study describes a model to determine the prevalence of transfusion-transmitted infections (TTIs) and the associated burden of disease.

Methods: A five-step model was developed to determine the TTI-related burden of disease measured by disability-adjusted life years (DALYs).

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Article Synopsis
  • The study aimed to investigate blood glucose outcomes in people with HIV (PWH) who have pre-diabetes and are starting treatment with dolutegravir compared to those with normal glucose levels.
  • Researchers conducted a matched cohort study with 44 PWH with pre-diabetes and 88 with normal glucose, measuring changes in fasting and 2-hour blood glucose levels at various points over 48 weeks.
  • Results showed that while those with normal glucose experienced an increase in fasting blood glucose, those with pre-diabetes saw a significant decrease, indicating improvement in glucose metrics, questioning the need for intensive glucose monitoring in the initial months of dolutegravir treatment.
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Pregnant and lactating persons in sub-Saharan Africa face a heightened risk of HIV acquisition, due to biological and behavioral factors, combined with limited access to prevention and treatment services. Oral pre-exposure prophylaxis (PrEP) and the dapivirine vaginal ring are promising tools for HIV prevention, and the ring's recent approval in multiple African countries represents a significant advancement in expanding access to HIV prevention. In a nested qualitative study within the MTN-042 trial, we explored the acceptability of study products among pregnant persons in the second and early third trimesters.

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Twice-Yearly Lenacapavir or Daily F/TAF for HIV Prevention in Cisgender Women.

N Engl J Med

October 2024

From the Desmond Tutu HIV Centre (L.-G.B., K.G., G.N., Y.S.) and the Department of Medicine, Vuka Research Clinic (A.M.W.), University of Cape Town, Cape Town, the Department of Epidemiology and Prevention, Centre for the AIDS Programme of Research in South Africa (Q.A.K.), Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal (I.H., L.E.M., D.M., M.N., D.P.), the Department of Obstetrics and Gynaecology, Wits Maternal, Adolescent, and Child Health Research Unit, University of the Witwatersrand (M.J.), Africa Health Research Institute (L.L.), and the HIV and Other Infectious Diseases Research Unit, South African Medical Research Council (V.N., L.N., S.P., N.S., E.S.), Durban, Setshaba Research Centre, Tshwane City (K.A.), the Department of Medical Microbiology, School of Medicine, Faculty of Health Sciences, University of Pretoria (K.A.), and the Aurum Institute, Pretoria Clinical Research Site (Z.Z.), Pretoria, the Foundation for Professional Development, Ndevana Community Research Site (J.B.), and Synergy Biomed Research Institute (M. Malahleha), East London, the Clinical Research Division, the Aurum Institute, Rustenburg (W.B.), Qhakaza Mbokodo Research Clinic (P.K.) and La Verna Hospital (P.K.), Ladysmith, Madibeng Centre for Research, Brits (C.E.L.), the Aurum Institute (M. Manentsa) and Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, School of Public Health, University of the Witwatersrand (N.N., T.P.-P.), Johannesburg, the Perinatal HIV Research Unit, Kliptown-Aeroton Clinical Research Site, University of the Witwatersrand, Soweto (R.P.), and the Aurum Institute, Klerksdorp Clinical Research Site, Klerksdorp (P.S.) - all in South Africa; Gilead Sciences, Foster City, CA (M.D., R.E., Y.Z., A.K., C.C.C., J.M.B.); the Department of Epidemiology, Columbia University Mailman School of Public Health, New York (Q.A.K.); the Department of Medicine, Vanderbilt University, Nashville (W.B.); Africa Medical and Behavioral Sciences Organization, Kalisizo (G.K.), the Department of Epidemiology and Biostatistics, Makerere University School of Public Health (N.K., F.M.K.), and Makerere University-Johns Hopkins University Research Collaboration (F.M.K.), Kampala - all in Uganda; the Department of Epidemiology, School of Public Health, University of Washington, Seattle (T.P.-P.); and Gilead Sciences, Cambridge, United Kingdom (C.D.).

Background: There are gaps in uptake of, adherence to, and persistence in the use of preexposure prophylaxis for human immunodeficiency virus (HIV) prevention among cisgender women.

Methods: We conducted a phase 3, double-blind, randomized, controlled trial involving adolescent girls and young women in South Africa and Uganda. Participants were assigned in a 2:2:1 ratio to receive subcutaneous lenacapavir every 26 weeks, daily oral emtricitabine-tenofovir alafenamide (F/TAF), or daily oral emtricitabine-tenofovir disoproxil fumarate (F/TDF; active control); all participants also received the alternate subcutaneous or oral placebo.

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Article Synopsis
  • Limited data exists on red blood cell (RBC) alloimmunization in cancer patients in sub-Saharan Africa, prompting a study at the Uganda Cancer Institute to assess its frequency among transfused patients.
  • The randomized trial involved 277 participants receiving either leucoreduced or non-leucoreduced blood transfusions, with no participants developing allo-antibodies after transfusion.
  • The findings suggest that RBC alloimmunization may not be a concern for cancer patients in SSA, indicating a need for further research into routine antibody screening in this population.
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Background: Chest X-ray (CXR) interpretation is challenging for the diagnosis of paediatric TB. We assessed the performance of a three half-day CXR training module for healthcare workers (HCWs) at low healthcare levels in six high TB incidence countries.

Methods: Within the TB-Speed Decentralization Study, we developed a three half-day training course to identify normal CXR, CXR of good quality and identify six TB-suggestive features.

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Introduction: Pregnant adolescents face multiple adverse experiences that vary by context due to pregnancy-related stigma. We explored experiences of pregnancy-related stigma and psychosocial issues among adolescents living in rural eastern Uganda.

Methods: We conducted in-depth semi-structured interviews with 15 adolescents (15-19 years old) who were pregnant (>3 months) or had recently given birth (<3 months) at Tororo District Hospital in Uganda.

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We evaluated correlates of adherence to PrEP, including daily oral tenofovir disoproxil fumarate in combination emtricitabine (oral FTC/TDF) and the monthly dapivirine ring (ring)among adolescent girls and young women (AGYW) in the MTN-034/REACH study. We enrolled 247 AGYW aged 16-21 years in South Africa, Uganda and Zimbabwe (ClinicalTrials.gov: NCT03074786).

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Effects of Combination Antiretroviral Therapy and Nutritional Rehabilitation on Growth in Children Aged 6-36 Months with Severe Acute Malnutrition in IMPAACT Protocol P1092.

J Pediatric Infect Dis Soc

August 2024

Makerere University Johns Hopkins University Research Collaboration and Department of Paediatrics and Child Health, College of Health Sciences, Makerere University, Kampala, Uganda.

Article Synopsis
  • Antiretroviral therapy (ART) improves survival and growth in children living with HIV, particularly for those with severe nonedematous acute malnutrition (SAM) when combined with nutritional support.
  • A study involving 52 children with HIV aged 6 to 36 months across four Sub-Saharan African countries showed significant growth improvements in children with SAM after 48 weeks of ART and nutritional rehabilitation.
  • Despite these gains, children with SAM remained shorter and lighter than their peers without SAM, indicating the need for ongoing monitoring and support.
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Introduction: Despite the scale-up of Option B+, long-term retention of women in HIV care during pregnancy and the postpartum period remains an important challenge. We compared adherence to clinic appointments and antiretroviral therapy (ART) at 6 weeks, 6, and and 24 months postpartum among pregnant women living with HIV and initiating Option B+. Women were randomized to a peer group support, community-based drug distribution and income-generating intervention called "Friends for Life Circles" (FLCs) versus the standard of care (SOC).

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Background: There is increasing interest in utilising two-drug regimens for HIV treatment with the goal of reducing toxicity and improve acceptability. The D3 trial evaluates the efficacy and safety of DTG/3TC in children and adolescents and includes a nested pharmacokinetics(PK) substudy for paediatric drug licensing.

Methods: D3 is an ongoing open-label, phase III, 96-week non-inferiority randomised controlled trial(RCT) conducted in South Africa, Spain, Thailand, Uganda and the United Kingdom.

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Vaccine value profile for Klebsiella pneumoniae.

Vaccine

July 2024

South Africa Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Johannesburg, South Africa.

Klebsiella pneumoniae causes community- and healthcare-associated infections in children and adults. Globally in 2019, an estimated 1.27 million (95% Uncertainty Interval [UI]: 0.

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  • The study investigates the effectiveness of the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in identifying lung cancer in people living with HIV (PLWH) compared to healthy individuals.
  • Using data from PLWH receiving treatment in Uganda, researchers found that NLR and PLR levels were significantly higher in lung cancer cases than in controls without lung cancer.
  • The analysis revealed that NLR had a sensitivity of 87.5% and specificity of 100%, while PLR showed a sensitivity of 75% and specificity of 87.2%, indicating that these ratios can help distinguish lung cancer in PLWH, especially when respiratory symptoms are present.
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  • Oral PrEP is recommended for at-risk pregnant cisgender women, but it may negatively impact bone health, which is already affected by pregnancy.
  • The study followed 499 young women using PrEP and measured bone mineral density (BMD) over 24 months, noting that 67% of pregnant women continued using PrEP.
  • Results showed that women on PrEP during pregnancy had significantly lower BMD compared to non-pregnant women or pregnant women who didn't use PrEP, and adherence to PrEP decreased during pregnancy.
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