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2.
Viruses ; 12(2)2020 02 10.
Artículo en Inglés | MEDLINE | ID: mdl-32050635

RESUMEN

In early December 2019 a cluster of cases of pneumonia of unknown cause was identified in Wuhan, a city of 11 million persons in the People's Republic of China. Further investigation revealed these cases to result from infection with a newly identified coronavirus, termed the 2019-nCoV. The infection moved rapidly through China, spread to Thailand and Japan, extended into adjacent countries through infected persons travelling by air, eventually reaching multiple countries and continents. Similar to such other coronaviruses as those causing the Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS), the new coronavirus was reported to spread via natural aerosols from human-to-human. In the early stages of this epidemic the case fatality rate is estimated to be approximately 2%, with the majority of deaths occurring in special populations. Unfortunately, there is limited experience with coronavirus infections during pregnancy, and it now appears certain that pregnant women have become infected during the present 2019-nCoV epidemic. In order to assess the potential of the Wuhan 2019-nCoV to cause maternal, fetal and neonatal morbidity and other poor obstetrical outcomes, this communication reviews the published data addressing the epidemiological and clinical effects of SARS, MERS, and other coronavirus infections on pregnant women and their infants. Recommendations are also made for the consideration of pregnant women in the design, clinical trials, and implementation of future 2019-nCoV vaccines.


Asunto(s)
Infecciones por Coronavirus , Neumonía Viral , Complicaciones Infecciosas del Embarazo , Resultado del Embarazo , Síndrome Respiratorio Agudo Grave , China/epidemiología , Coronavirus/inmunología , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/terapia , Infecciones por Coronavirus/transmisión , Brotes de Enfermedades , Femenino , Humanos , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa , Exposición Materna , Placenta/patología , Neumonía Viral/epidemiología , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/prevención & control , Complicaciones Infecciosas del Embarazo/terapia , Síndrome Respiratorio Agudo Grave/epidemiología , Síndrome Respiratorio Agudo Grave/patología , Síndrome Respiratorio Agudo Grave/transmisión , Vacunas Virales
5.
Rev Chilena Infectol ; 36(5): 616-628, 2019 Oct.
Artículo en Español | MEDLINE | ID: mdl-31859803

RESUMEN

The use of biological therapies has meant a great improvement in the management of several conditions like autoimmune, neoplastic or others diseases. Although its use has implied significant improvements in the prognosis of these diseases, it is not exempt from complications: infectious diseases as one of them. The objective of this consensus was to evaluate, from an infectious viewpoint, the safeness of the most frequently used biological therapies and give recommendations for the prevention of infections in patients treated with these drugs. These recommendations were based on the highest quality evidence available for the selected biologics. The consensus counts of 2 manuscripts. This second part is a guideline that details these recommendations through screening strategies, prophylactic therapies and vaccines indications for bacterial, mycobacterial, viral, fungal and parasitic infections, both for adults and children.


Asunto(s)
Terapia Biológica/efectos adversos , Enfermedades Transmisibles/inducido químicamente , Consenso , Emigrantes e Inmigrantes , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Complicaciones Infecciosas del Embarazo/inducido químicamente , Chile , Femenino , Hepatitis B/inducido químicamente , Hepatitis B/prevención & control , Humanos , Tamizaje Masivo , Guías de Práctica Clínica como Asunto , Embarazo , Complicaciones Infecciosas del Embarazo/prevención & control , Medición de Riesgo , Factores de Riesgo
6.
BMC Public Health ; 19(1): 1467, 2019 Nov 06.
Artículo en Inglés | MEDLINE | ID: mdl-31694607

RESUMEN

BACKGROUND: Malaria and tetanus infections among pregnant women represent two major public health problems in sub-Saharan Africa. Optimum use of Intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (IPTp-SP) and immunization against tetanus among pregnant women during antenatal care (ANC) visits are recommended strategies to prevent these issues. Despite these recommendations, many women in Africa remain deprived of these cost-effective and life-saving interventions. In this study, we aimed to examine the prevalence of women using these two services, and the association between women's uptake of IPTp-SP and tetanus toxoid (TT) with antenatal care use in Ivory Coast. METHODS: This study was based on the fifth round of Multiple Indicator Cluster Survey (MICS 5) conducted in Ivory Coast in 2016. Participants were 9583 women aged between 15 and 49 years. Outcomes were TT and Intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP). Data analysis was conducted using bivariate and multiple logistic regression. RESULTS: In this study, the prevalence of taking TT immunization and IPTp-SP drugs was 81.97 and 17.83% respectively. Of the participants who took these drugs at all, the prevalence of taking adequate doses of TT immunization was 78.75% and that of IPTp-SP was 35.46%. In the multivariable analysis model, higher age groups, 25-29 years (OR = 2.028, 95%CI = 1.120-3.669) were found to be positively associated with uptake of adequate doses of IPTp-SP drugs. Women who attended at least four ANC visits had higher odds of taking IPTp-SP drugs (OR = 1.656, 95%CI = 1.194-2.299) and TT immunization (OR = 2.347, 95%CI = 1.384-3.981), and also had higher odds of receiving adequate doses of IPTp-SP drugs (OR = 3.291, 95%CI = 2.157-5.020) and that of TT immunization (OR = 1.968, 95%CI = 1.398-2.771). The odds of taking IPTp-SP drugs were significantly higher among women with primary (OR = 2.504, 95%CI = 1.020-6.146) and secondary/higher education (OR = 3.298, 95%CI = 1.343-8.097) compared to those with no education. Also, women with higher parity had lower odds of taking TT immunization (OR = 0.218, 95%CI = 0.055-0.858) compared to those with lower parity. Findings from this study also revealed that the odds of taking adequate doses of IPTp-SP drugs were significantly lower among participants from Mandé du Nord ethnicity (OR = 0.378,95%CI = 0.145-0.983) compared to those from other ethnicities. CONCLUSION: In this study, uptake of IPTp-SP drugs was much lower than TT immunization. High number of ANC visits were found to be significantly associated with taking IPTp-SP drugs and TT immunization and also with that of taking them in adequate doses. Vaccination promotion is necessary to protect pregnant women and reduce adverse health outcomes among the newborn in Ivory Coast.


Asunto(s)
Antimaláricos/uso terapéutico , Malaria/prevención & control , Aceptación de la Atención de Salud/estadística & datos numéricos , Complicaciones Infecciosas del Embarazo/prevención & control , Atención Prenatal/estadística & datos numéricos , Toxoide Tetánico/uso terapéutico , Tétanos/prevención & control , Adolescente , Adulto , Costa de Marfil , Combinación de Medicamentos , Femenino , Humanos , Recién Nacido , Modelos Logísticos , Análisis Multivariante , Embarazo , Pirimetamina/uso terapéutico , Sulfadoxina/uso terapéutico , Encuestas y Cuestionarios , Adulto Joven
7.
Pan Afr Med J ; 33: 310, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31723373

RESUMEN

Introduction: Hepatitis B virus (HBV) infection is a major health problem worldwide owing to its high prevalence and significant morbidity and mortality. There are about 2 billion people living with HBV worldwide and over 360 million chronic carriers. The purpose of this study was to assess the knowledge and practices of pregnant women and health care workers in the ANC and maternity units on HBV infection and its transmission. Methods: About 270 women attending ANC and 31 health care workers were selected by convenience sampling. They were evaluated using a structured questionnaire to assess their knowledge and practices on HBV prevention and transmission. Results: Pregnant women in the Limbe Health District demonstrated good knowledge but adopted poor practices whereas in the Muyuka Health District, pregnant women demonstrated poor knowledge and adopted poor practices regarding the mode of transmission and prevention of HBV infection. Health care workers in both the Limbe and Muyuka Health Districts however, demonstrated good knowledge and adopted good practices. Conclusion: There was a significant relationship between the knowledge and practice of pregnant women and health care workers on Hepatitis B prevention in the Muyuka Health District (P = 0.0006).


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Personal de Salud/estadística & datos numéricos , Hepatitis B/prevención & control , Complicaciones Infecciosas del Embarazo/prevención & control , Adolescente , Adulto , Camerún , Femenino , Humanos , Persona de Mediana Edad , Embarazo , Complicaciones Infecciosas del Embarazo/virología , Atención Prenatal/métodos , Encuestas y Cuestionarios , Adulto Joven
9.
BMC Health Serv Res ; 19(1): 760, 2019 Oct 26.
Artículo en Inglés | MEDLINE | ID: mdl-31655575

RESUMEN

BACKGROUND: With most countries in sub-Saharan Africa (SSA) lagging behind schedule to implement a comprehensive viral hepatitis elimination strategy, several barriers to accurate information and hepatitis B virus (HBV) services still exist, that are unique to different regions. In an obstetric population of a high HBV burden SSA setting without antenatal HBV services, we systematically evaluated perceptions and prevention behavioral intentions in relation to HBV and liver cancer. METHODS: Eligible consenting pregnant women were recruited from public health care facilities in the central and northern regions of Uganda, between October 2016 and December 2017. Standardized procedures and instruments based on the health belief model and theory of planned behavior were used to collect data on socio-demographic characteristics, HBV perceptions and behavioral intentions. Descriptive analysis using Chi-square tests was done to obtain distribution of respondents by levels of perceived risk of HBV and liver cancer for themselves, their child under 5 years and their spouse. Modified Poisson regression analyses were used to evaluate relationships between perception variables and different behavioral outcomes (intention to screen, vaccinate and treat HBV). RESULTS: Perceived risk (PRR = 0.95(0.90-1.00), p = 0.055) was inversely associated with intention to screen for HBV. Conversely, perceived self-efficacy showed a consistent association with intention to screen for HBV (PRR = 1.18(1.10-1.23) p = 0.005), to vaccinate (PRR = 1.20(1.05-1.36) p = 0.006) and to seek treatment for HBV (PRR = 1.40(1.18-1.67) p < 0.001). Women from the north, compared to the central region (PRR = 1.76 (1.13-2.72) p = 0.012), and those who self-identified as Catholic (PRR = 1.85 (0.99-3.56) p = 0.056), and as Protestant, (PRR = 2.22 (1.22-4.04) p = 0.002), were more likely to have higher perceived self-efficacy, compared to Muslims. Age and education were not related to perceived self-efficacy. CONCLUSION: Women in both regions hold incorrect perceptions of HBV and liver cancer risk, with women from the central reporting higher perceived risk than those from the north. High perceived self-efficacy influenced intention to participate in HBV prevention. Programs and policies geared towards enhancing HBV prevention in this sub-population may consider socio-cultural factors observed to influence prevention behaviors. These findings may guide HBV interventions aimed at improving capacity to seek HBV prevention services, thereby promoting HBV micro-elimination in this sub-population.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Hepatitis B/prevención & control , Aceptación de la Atención de Salud/psicología , Complicaciones Infecciosas del Embarazo/prevención & control , Mujeres Embarazadas/psicología , Adolescente , Adulto , Estudios Transversales , Femenino , Política de Salud , Humanos , Embarazo , Medición de Riesgo , Uganda , Adulto Joven
10.
MMWR Morb Mortal Wkly Rep ; 68(39): 855-859, 2019 Oct 04.
Artículo en Inglés | MEDLINE | ID: mdl-31581161

RESUMEN

Rubella is a leading cause of vaccine-preventable birth defects. Although rubella virus infection usually causes a mild febrile rash illness in children and adults, infection during pregnancy, especially during the first trimester, can result in miscarriage, fetal death, stillbirth, or a constellation of birth defects known as congenital rubella syndrome (CRS). A single dose of rubella-containing vaccine (RCV) can provide lifelong protection (1). In 2011, the World Health Organization (WHO) updated guidance on the use of RCV and recommended capitalizing on the accelerated measles elimination activities as an opportunity to introduce RCV (1). The Global Vaccine Action Plan 2011-2020 (GVAP) includes a target to achieve elimination of rubella in at least five of the six WHO regions by 2020 (2). This report on the progress toward rubella and CRS control and elimination updates the 2017 report (3), summarizing global progress toward the control and elimination of rubella and CRS from 2000 (the initiation of accelerated measles control activities) and 2012 (the initiation of accelerated rubella control activities) to 2018 (the most recent data) using WHO immunization and surveillance data. Among WHO Member States,* the number with RCV in their immunization schedules has increased from 99 (52% of 191) in 2000 to 168 (87% of 194) in 2018†; 69% of the world's infants were vaccinated against rubella in 2018. Rubella elimination has been verified in 81 (42%) countries. To make further progress to control and eliminate rubella, and to reduce the equity gap, introduction of RCV in all countries is important. Likewise, countries that have introduced RCV can achieve and maintain elimination with high vaccination coverage and surveillance for rubella and CRS. The two WHO regions that have not established an elimination goal (African [AFR] and Eastern Mediterranean [EMR]) should consider establishing a goal.§.


Asunto(s)
Erradicación de la Enfermedad , Salud Global/estadística & datos numéricos , Vigilancia de la Población , Síndrome de Rubéola Congénita/prevención & control , Rubéola (Sarampión Alemán)/prevención & control , Femenino , Humanos , Lactante , Recién Nacido , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/prevención & control , Rubéola (Sarampión Alemán)/epidemiología , Síndrome de Rubéola Congénita/epidemiología , Vacuna contra la Rubéola/administración & dosificación
11.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(9): 1055-1058, 2019 Sep 10.
Artículo en Chino | MEDLINE | ID: mdl-31594145

RESUMEN

The new research of intrauterine transmission of HBV includes intrauterine dominant infection and occult infection. Intrauterine dominant infection of HBV is the traditional intrauterine infection. Although intrauterine infection of HBV has been studied for decades, the intervention effects on HBV infection are very limited. As a result, mother to child transmission has become the main route of the transmission of HBV. With the development of science and technology, people's understand of intrauterine occult infection of HBV has been deepened, and the definition of intrauterine transmission of HBV has been further completed and expanded. The study of intrauterine occult infection of HBV will play an important role in prevention and control of hepatitis B in China through filling in a gap in the field of prevention and control of vertical transmission of HBV, exploring new research perspective and providing guideline for related decision-making.


Asunto(s)
Hepatitis B/prevención & control , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Complicaciones Infecciosas del Embarazo/prevención & control , Niño , China , ADN Viral , Femenino , Virus de la Hepatitis B , Humanos , Embarazo
12.
Praxis (Bern 1994) ; 108(13): 859-862, 2019 Sep.
Artículo en Alemán | MEDLINE | ID: mdl-31571544

RESUMEN

Vaccination During Pregnancy Abstract. Vaccinations administered to women during pregnancy can provide protection against serious infectious diseases for the mother, for the newborn, or both. Two vaccines are routinely recommended during pregnancy: Influenza and Pertussis. While the influenza vaccine protects mainly the pregnant mother, who is at an increased risk for severe affection, the pertussis vaccine is an effective protection to infants who are at particularly high risk of pertussis complications and mortality in the first three months of life.


Asunto(s)
Vacunas contra la Influenza , Vacuna contra la Tos Ferina , Complicaciones Infecciosas del Embarazo , Tos Ferina , Femenino , Humanos , Lactante , Recién Nacido , Vacunas contra la Influenza/administración & dosificación , Vacuna contra la Tos Ferina/administración & dosificación , Embarazo , Complicaciones Infecciosas del Embarazo/prevención & control , Vacunación , Tos Ferina/prevención & control
13.
Can J Vet Res ; 83(4): 248-254, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31571723

RESUMEN

The objective of the present study was to evaluate the efficacy of a commercial porcine reproductive and respiratory syndrome virus (PRRSV) subunit vaccine against heterologous PRRSV-1 and PRRSV-2 challenge in late-term pregnant gilts. Gilts were vaccinated intramuscularly 56 and 35 days antepartum (on days 58 and 79 of gestation) and challenged intranasally 21 days antepartum (on day 93 of gestation) with PRRSV-1 or PRRSV-2. Regardless of the challenge strain's genotype, the vaccinated gilts carried their pregnancies to term and farrowed between days 114 and 115 of gestation. All the unvaccinated gilts aborted, between days 105 and 110 of gestation. The vaccinated gilts had a significantly lower level (P < 0.05) of PRRSV viremia and significantly higher levels (P < 0.05) of virus-neutralizing antibodies and interferon-γ-secreting cells compared with the unvaccinated gilts. The mean number of PRRSV-positive cells per area of fetal tissue examined did not differ significantly between the litters from the vaccinated and unvaccinated gilts. The data presented here indicate that vaccination in late-term pregnancy with PRRSV subunit vaccine is efficacious against reproductive failure due to heterologous PRRSV-1 and PRRSV-2 infection.


Asunto(s)
Síndrome Respiratorio y de la Reproducción Porcina/prevención & control , Virus del Síndrome Respiratorio y Reproductivo Porcino/clasificación , Complicaciones Infecciosas del Embarazo/veterinaria , Vacunas Virales/inmunología , Animales , Femenino , Virus del Síndrome Respiratorio y Reproductivo Porcino/inmunología , Embarazo , Complicaciones Infecciosas del Embarazo/prevención & control , Subunidades de Proteína , Porcinos , Vacunas de Subunidad/inmunología , Proteínas Virales/inmunología
14.
Lakartidningen ; 1162019 Sep 27.
Artículo en Sueco | MEDLINE | ID: mdl-31573669

RESUMEN

MM-ARG, the Swedish maternal maternity mortality group within SFOG (Swedish Society of Obstetrics and Gynecology) has, since 2008, surveyed and analysed maternal deaths in Sweden with the aim to find and give feedback on lessons learned to the medical professions.  MM-ARG consists of obstetricians, midwives and anesthetists and the strength of the working model is that the profession itself takes responsibility for the scrutiny.  A summary of 67 known maternal deaths from 2007‒2017 is presented. Direct causes of death are dominated by hypertensive disease/preeclampsia, followed by thromboembolic disease, sepsis and obstetric bleeding. Indirect death, where a known or unknown underlying disease is exacerbated by pregnancy, is dominated by cardiovascular disease. This review shows that the diagnostics and clinical management could be improved. Besides obstetrics/gynecology, maternal mortality affects other specialties and thus holds important lessons to many.


Asunto(s)
Mortalidad Materna , Adolescente , Adulto , Enfermedades Cardiovasculares/mortalidad , Enfermedades Cardiovasculares/prevención & control , Femenino , Humanos , Muerte Materna , Trastornos Mentales/mortalidad , Trastornos Mentales/prevención & control , Hemorragia Posparto/mortalidad , Hemorragia Posparto/prevención & control , Preeclampsia/mortalidad , Preeclampsia/prevención & control , Embarazo , Complicaciones del Embarazo/prevención & control , Complicaciones Infecciosas del Embarazo/mortalidad , Complicaciones Infecciosas del Embarazo/prevención & control , Complicaciones Neoplásicas del Embarazo/mortalidad , Complicaciones Neoplásicas del Embarazo/prevención & control , Calidad de la Atención de Salud , Sociedades Médicas , Suicidio/prevención & control , Suecia/epidemiología , Tromboembolia/mortalidad , Tromboembolia/prevención & control
15.
BMC Health Serv Res ; 19(1): 747, 2019 Oct 24.
Artículo en Inglés | MEDLINE | ID: mdl-31651307

RESUMEN

BACKGROUND: Pregnant women and newborns are at high risk for infectious diseases. Altered immunity status during pregnancy and challenges fully vaccinating newborns contribute to this medical reality. Maternal immunization is a strategy to protect pregnant women and their newborns. This study aimed to find out how patient-provider relationships affect maternal vaccine uptake, particularly in the context of a lower middle- income country where limited research in this area exists. METHODS: We conducted semi-structured, in-depth narrative interviews of both providers and pregnant women from four sites in Kenya: Siaya, Nairobi, Mombasa, and Marsabit. Interviews were conducted in either English or one of the local regional languages. RESULTS: We found that patient trust in health care providers (HCPs) is integral to vaccine acceptance among pregnant women in Kenya. The HCP-patient relationship is a fiduciary one, whereby the patients' trusts is primarily rooted in the provider's social position as a person who is highly educated in matters of health. Furthermore, patient health education and provider attitudes are crucial for reinstating and fostering that trust, especially in cases where trust was impeded by rumors, community myths and misperceptions, and religious and cultural factors. CONCLUSION: Patient trust in providers is a strong facilitator contributing to vaccine acceptance among pregnant women in Kenya. To maintain and increase immunization trust, providers have a critical role in cultivating a positive environment that allows for favorable interactions and patient health education. This includes educating providers on maternal immunizations and enhancing knowledge of effective risk communication tactics in clinical encounters.


Asunto(s)
Aceptación de la Atención de Salud/psicología , Complicaciones Infecciosas del Embarazo/prevención & control , Mujeres Embarazadas/psicología , Relaciones Profesional-Paciente , Confianza , Vacunas , Adolescente , Adulto , Actitud del Personal de Salud , Familia , Femenino , Personal de Salud/psicología , Humanos , Inmunización , Kenia , Defensa del Paciente , Educación del Paciente como Asunto , Embarazo , Atención Prenatal/estadística & datos numéricos , Vacunación , Adulto Joven
16.
MMWR Morb Mortal Wkly Rep ; 68(40): 885-892, 2019 Oct 11.
Artículo en Inglés | MEDLINE | ID: mdl-31600186

RESUMEN

INTRODUCTION: Vaccinating pregnant women with influenza vaccine and tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) can reduce influenza and pertussis risk for themselves and their infants. METHODS: Surveillance data were analyzed to ascertain influenza-associated hospitalization among pregnant women and infant hospitalization and death associated with influenza and pertussis. An Internet panel survey was conducted during March 27-April 8, 2019, among women aged 18-49 years who reported being pregnant any time since August 1, 2018. Influenza vaccination before or during pregnancy was assessed among respondents with known influenza vaccination status who were pregnant any time during October 2018-January 2019 (2,097). Tdap receipt during pregnancy was assessed among respondents with known Tdap status who reported a live birth by their survey date (817). RESULTS: From 2010-11 to 2017-18, pregnant women accounted for 24%-34% of influenza-associated hospitalizations per season among females aged 15-44 years. From 2010 to 2017, a total of 3,928 pertussis-related hospitalizations were reported among infants aged <2 months (annual range = 262-743). Maternal influenza and Tdap vaccination coverage rates reported as of April 2019 were 53.7% and 54.9%, respectively. Among women whose health care providers offered vaccination or provided referrals, 65.7% received influenza vaccine and 70.5% received Tdap. The most commonly reported reasons for nonvaccination were believing the vaccine is not effective (influenza; 17.6%) and not knowing that vaccination is needed during each pregnancy (Tdap; 37.9%), followed by safety concerns for the infant (influenza =15.9%; Tdap = 17.1%). CONCLUSIONS AND IMPLICATIONS FOR PUBLIC HEALTH PRACTICE: Many pregnant women do not receive the vaccines recommended to protect themselves and their infants, even when vaccination is offered. CDC and provider organizations' resources are available to help providers convey strong, specific recommendations for influenza and Tdap vaccination that are responsive to pregnant women's concerns.


Asunto(s)
Gripe Humana/epidemiología , Gripe Humana/prevención & control , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/prevención & control , Tos Ferina/epidemiología , Tos Ferina/prevención & control , Adolescente , Adulto , Vacunas contra Difteria, Tétanos y Tos Ferina Acelular/administración & dosificación , Femenino , Humanos , Lactante , Recién Nacido , Vacunas contra la Influenza/administración & dosificación , Persona de Mediana Edad , Embarazo , Estados Unidos/epidemiología , Vacunación/estadística & datos numéricos , Adulto Joven
17.
BMC Res Notes ; 12(1): 586, 2019 Sep 18.
Artículo en Inglés | MEDLINE | ID: mdl-31533837

RESUMEN

OBJECTIVE: The aim of this study was to explore the prevalence of congenital HIV infection of neonates at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) between 2015 and 2017, as well as compare the HIV PCR positive and HIV PCR negative neonates. RESULTS: A total number of 1443 HIV exposed neonates was examined for the study period out of a total of 5029 admissions (HIV exposure 28.6%) The study found that the rate of HIV transmission at birth was 2.52%. The majority of infants had low birth weight and were also born prematurely. These results show that, despite the introduction of the extended mother to child transmission programme, HIV transmission is high.


Asunto(s)
Auditoría Clínica/estadística & datos numéricos , Infecciones por VIH/transmisión , Transmisión Vertical de Enfermedad Infecciosa/estadística & datos numéricos , Centros de Atención Terciaria , Auditoría Clínica/métodos , Auditoría Clínica/normas , Estudios Transversales , Femenino , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , Humanos , Lactante , Recién Nacido , Enfermedades del Recién Nacido/diagnóstico , Enfermedades del Recién Nacido/epidemiología , Enfermedades del Recién Nacido/prevención & control , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Masculino , Tamizaje Neonatal/métodos , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/prevención & control , Estudios Retrospectivos , Sudáfrica/epidemiología
18.
Eur J Obstet Gynecol Reprod Biol ; 241: 88-93, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31479991

RESUMEN

OBJECTIVE: Pregnancy-related urinary tract infections (UTI) is the leading cause of obstetrical ward admissions and is responsible for poor maternal and perinatal outcomes. This study aimed to reduce the incidence of UTI by improving the knowledge and preventive practices of pregnant women through the implementation of a health education package. STUDY DESIGN: A health education package consisting of a seminar, sending of weekly text messages, and distribution of educational leaflets on UTI awareness and prevention was implemented in various rural health units in Pampanga, Philippines. A structured questionnaire was used to assess the pre- and post-intervention knowledge and preventive practices of pregnant women. Whereas, urinalysis results from the various rural health units were used to assess the incidence of UTI among the respondents. RESULTS: Significant improvement (p <  0.001) was observed regarding the participant's knowledge and water intake after the intervention. Although there was no significant change (p =  0.16) in their hygiene statistically, all participants had improvements in hygiene practices after the intervention. The number of pregnant women who were positive for UTI also decreased significantly (p <  0.001) following the intervention. CONCLUSION: The implemented health education package was able to reduce the incidence of pregnancy-related UTI by improving the knowledge and preventive practices of pregnant women.


Asunto(s)
Educación en Salud/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , Complicaciones Infecciosas del Embarazo/prevención & control , Infecciones Urinarias/prevención & control , Adolescente , Adulto , Femenino , Educación en Salud/métodos , Humanos , Incidencia , Filipinas/epidemiología , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Atención Prenatal , Infecciones Urinarias/epidemiología , Adulto Joven
19.
BMC Health Serv Res ; 19(1): 627, 2019 Sep 04.
Artículo en Inglés | MEDLINE | ID: mdl-31484515

RESUMEN

BACKGROUND: In countries where hepatitis B virus (HBV) is endemic, including Senegal, the World Health Organization recommends systematic HBV screening of pregnant women and vaccination at birth to prevent mother-to-child transmission (MTCT). This study investigated healthcare workers' (HCW) knowledge and practices regarding HBV prevention and care in the rural region of Fatick in Senegal, as well as challenges they faced in implementing prevention activities related to HBV MTCT. METHODS: A mixed-methods survey was conducted between May-July 2017 among 112 HCW working in 15 healthcare facilities in two districts of the Fatick region using face-to-face questionnaires and semi-structured interviews. Descriptive statistics and chi-square/Mann-Whitney tests were used to analyze quantitative data, while qualitative data were analyzed thematically. RESULTS: The study population included 87 HCW in the quantitative component (83% women, median age [interquartile range, IQR] = 35 [31-40] years) and 11 in the qualitative component. A knowledge gap was observed in key areas of HBV infection: only 24, 51 and 38%, respectively, correctly reported that early HBV acquisition is associated with a high risk of developing chronic infection, that perinatal transmission is one of the main modes of HBV transmission in Senegal, and that three to four doses of HBV vaccine are required to ensure immunization in children. Despite good acceptability of systematic screening of pregnant women and vaccination at birth, only 48% of HCW mainly involved in prenatal care and 71% of those involved exclusively in vaccination routinely performed these two key interventions. HCW reported several structural barriers that may hinder their implementation: a lack of training in HBV and in counseling, poor availability of rapid diagnostic tests (RDT), high costs of both screening and treatment, a lack of adequate information on treatment options and missed opportunities for vaccination at birth. CONCLUSIONS: HCW working in the Fatick region may be insufficiently trained and supported to effectively implement HBV prevention strategies. Our findings suggest an urgent need to strengthen MTCT prevention in this region, by improving HCW knowledge in key areas of HBV infection, providing RDT and antiviral treatment at low cost, and enhancing community-based interventions for the timely vaccination of newborns.


Asunto(s)
Personal de Salud/psicología , Vacunas contra Hepatitis B/administración & dosificación , Hepatitis B/prevención & control , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Complicaciones Infecciosas del Embarazo/prevención & control , Adulto , Actitud del Personal de Salud , Femenino , Hepatitis B/tratamiento farmacológico , Humanos , Recién Nacido , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , Población Rural , Senegal/epidemiología , Vacunación/estadística & datos numéricos
20.
Artículo en Inglés | MEDLINE | ID: mdl-31487845

RESUMEN

Although HIV (human immunodeficiency virus) testing for all women has been promoted by Vietnam's Ministry of Health since 2000, test acceptance rates in this country were reported to be less than 30% in the community. This country has been facing the barriers to approach the national services towards transmission prevention from mother to child including HIV testing during antenatal care (ANC) towards mothers. Here, we aim to assess the socioeconomic inequalities in HIV testing during ANC among Vietnamese women. This study used available data from the Vietnam Multiple Indicator Cluster Survey 2014. Overall, the prevalence of HIV testing during antenatal care was 30% and the concentrate index (CCI) was 0.1926. There was significant inequality between women classified as poor and rich, and when stratified by social characteristics, inequality was found in women aged 15-49 years (CCI: 0.4), living in rural areas (CCI: 0.3), belonging to ethnic minorities (CCI: 0.5) and having primary or less education (CCI: 0.4). In the multivariate logistic regression analysis, ethnicity and socioeconomic status were significant factors associated with HIV testing during ANC. We found the prevalence of HIV testing during ANC was low, and its inequalities were associated with age, living area, ethnicity, education, and economic status.


Asunto(s)
Infecciones por VIH/diagnóstico , Tamizaje Masivo/estadística & datos numéricos , Factores Socioeconómicos , Adolescente , Adulto , Femenino , Humanos , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Persona de Mediana Edad , Madres , Embarazo , Complicaciones Infecciosas del Embarazo/prevención & control , Atención Prenatal/estadística & datos numéricos , Pruebas Serológicas , Vietnam , Adulto Joven
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