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1.
Niger J Clin Pract ; 22(10): 1341-1348, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31607722

RESUMO

Background: To reduce the number of new HIV infections among children, retesting of HIV negative pregnant women in labor to identify new infections and instituting appropriate modified obstetrics practices (MOP) has a huge role to play. Aims and Objectives: This study evaluated the HIV sero-positivity in labor among pregnant women who earlier tested negative in antenatal clinic, associated risk factors and the corresponding rate of mother-to-child transmission of HIV infection. Methods: This was a prospective observational study where pregnant women in labor who had earlier tested HIV negative in the antenatal clinic at Imo State University Teaching Hospital Orlu, Imo state, Nigeria, were retested. The infants of the women who seroconverted were tested for HIV infection at 6 weeks using Deoxyribonucleic acid polymerase chain reaction (DNA PCR) by collecting Dried Blood Sample. This study was conducted from October 2015 to March 2016. Result: Out of the 163 patients studied, 6 demonstrated HIV seroconversion giving a seroconversion rate of 3.7%. Deliveries from the seroconverted patients were 5 live births and 1 intrauterine fetal death. All the 5 live babies tested HIV negative at 6 weeks of age. Predictors of seroconversion in late pregnancy include spouse's HIV status and number of other sexual partners. Conclusion: Retesting of HIV negative pregnant women in labor to identify new infections and instituting appropriate modified obstetrics practices has a huge role to play in the prevention of mother to child transmission of HIV infection.


Assuntos
Infecções por HIV/diagnóstico , Infecções por HIV/transmissão , Soropositividade para HIV/sangue , Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Trabalho de Parto/sangue , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/virologia , Adulto , Anticorpos Antivirais/sangue , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Soropositividade para HIV/epidemiologia , Humanos , Lactente , Recém-Nascido , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Masculino , Programas de Rastreamento/métodos , Nigéria/epidemiologia , Parto , Reação em Cadeia da Polimerase , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Estudos Prospectivos , Fatores de Risco , Soroconversão
2.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(9): 1059-1064, 2019 Sep 10.
Artigo em Chinês | MEDLINE | ID: mdl-31594146

RESUMO

Objective: To investigate the current status and influence factors of HBV intrauterine transmission (BIT) in HBsAg-positive parturients and understand the outcome of HBV transmission and response to hepatitis B vaccine immunization in children in Xi'an. Methods: An epidemiological survey was conducted in 341 HBsAg-positive parturients who gave birth in Northwest Women and Children Hospital of Shaanxi Province from January 2015 to January 2018. Serological tests were performed by using venous blood from 344 newborns within 24 hours after birth and at the age of 1 year old. A nested case-control study was conducted to analyze the infection rates of intrauterine dominate HBV infection (DBI) and intrauterine occult HBV infection (OBI) in BIT and their influencing factors in newborns. The epidemiological survey was conducted to collect the information about the outcome of HBV transmission and the positive rate of HBsAb in children at high-risk from August 2016 to October 2018. Results: The BIT rate was 46.51%(160/344) in HBsAg-positive parturients, the DBI rate was 8.14% (28/344), the OBI rate was 38.37% (132/344), and the odds ratio of DBI and BIT in neonates of HBeAg-positive parturients were respectively 2.60 (95%CI: 1.19-5.70) and 2.21 (95%CI: 1.36-3.61) times higher than that of HBeAg-negative parturients. The odds ratio of BIT in neonates with maternal peripheral blood HBV DNA load ≥200, ≥10(3) and>10(6) copies/ml were 1.99 (95%CI: 1.29-3.08), 1.73 (95%CI: 1.11-2.69) and 2.33 (95%CI: 1.33-4.10) times higher than those in neonates with maternal peripheral blood HBV DNA<200,<10(3), and ≤10(6) copies/ml respectively. The incidence of DBI in neonates of parturients with placenta previa was 14.07 times higher than that of parturients without placenta previa (95%CI: 1.23-160.76). The incidence of BIT in neonates of parturients who received no hepatitis B immunoglobulin during pregnancy was 1.60 times higher than that in neonates of those who received hepatitis B immunoglobulin (95%CI: 1.02-2.53). Follow-up results showed that HBsAg negative conversion was found in 9 of 14 children with DBI, and 24.17%(22/91) of children had OBI. The overall rate of immune response to hepatitis B vaccine was 69.23%(63/91). The immune response rate in children with OBI was only 59.09%(13/22). Conclusion: Newborns of HBsAg-positive parturients had high rate of OBI and lower rate of immune response to hepatitis B vaccine detected in follow-up, indicating a gap in hepatitis B prevention and control. HBV monitoring and intervention in HBsAg-positive women of childbearing age and hepatitis B antibody monitoring in children at high-risk are important measures to control infection source and protect susceptible population.


Assuntos
Hepatite B/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Estudos de Casos e Controles , Criança , China/epidemiologia , DNA Viral , Feminino , Antígenos de Superfície da Hepatite B , Vacinas contra Hepatite B , Vírus da Hepatite B , Humanos , Lactente , Recém-Nascido , Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Gravidez , Complicações Infecciosas na Gravidez/virologia
3.
MMWR Morb Mortal Wkly Rep ; 68(39): 855-859, 2019 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-31581161

RESUMO

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.§.


Assuntos
Erradicação de Doenças , Saúde Global/estatística & dados numéricos , Vigilância da População , Síndrome da Rubéola Congênita/prevenção & controle , Rubéola (Sarampo Alemão)/prevenção & controle , Feminino , Humanos , Lactente , Recém-Nascido , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/prevenção & controle , Rubéola (Sarampo Alemão)/epidemiologia , Síndrome da Rubéola Congênita/epidemiologia , Vacina contra Rubéola/administração & dosagem
4.
MMWR Morb Mortal Wkly Rep ; 68(39): 833-838, 2019 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-31581170

RESUMO

Hepatitis C virus (HCV) is transmitted primarily through parenteral exposures to infectious blood or body fluids that contain blood (e.g., via injection drug use, needle stick injuries) (1). In the last 10 years, increases in HCV infection in the general U.S. population (1) and among pregnant women (2) are attributed to a surge in injection drug use associated with the opioid crisis. Opioid use disorders among pregnant women have increased (3), and approximately 68% of pregnant women with HCV infection have opioid use disorder (4). National trends in HCV infection among pregnant women by opioid use disorder status have not been reported to date. CDC analyzed hospital discharge data from the 2000-2015 Healthcare Cost and Utilization Project (HCUP) to determine whether HCV infection trends differ by opioid use disorder status at delivery. During this period, the national rate of HCV infection among women giving birth increased >400%, from 0.8 to 4.1 per 1,000 deliveries. Among women with opioid use disorder, rates of HCV infection increased 148%, from 87.4 to 216.9 per 1,000 deliveries, and among those without opioid use disorder, rates increased 271%, although the rates in this group were much lower, increasing from 0.7 to 2.6 per 1,000 deliveries. These findings align with prior ecological data linking hepatitis C increases with the opioid crisis (2). Treatment of opioid use disorder should include screening and referral for related conditions such as HCV infection.


Assuntos
Hepatite C/epidemiologia , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Adulto , Parto Obstétrico , Feminino , Hospitalização , Humanos , Gravidez , Estados Unidos/epidemiologia , Adulto Jovem
5.
MMWR Morb Mortal Wkly Rep ; 68(40): 885-892, 2019 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-31600186

RESUMO

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.


Assuntos
Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/prevenção & controle , Coqueluche/epidemiologia , Coqueluche/prevenção & controle , Adolescente , Adulto , Vacinas contra Difteria, Tétano e Coqueluche Acelular/administração & dosagem , Feminino , Humanos , Lactente , Recém-Nascido , Vacinas contra Influenza/administração & dosagem , Pessoa de Meia-Idade , Gravidez , Estados Unidos/epidemiologia , Vacinação/estatística & dados numéricos , Adulto Jovem
6.
Rev Saude Publica ; 53: 76, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31553379

RESUMO

OBJECTIVE: To evaluate the factors associated with HIV and syphilis testing during pregnancy in Brazil. METHODS: This was an ecological study covering all Brazilian municipalities evaluated by the second cycle of the National Program for Access and Quality Improvement in Primary Care, 2013-2014. The dependent variables were based on prenatal care access: prenatal care appointments, and HIV and syphilis tests during prenatal care. The independent variables were compared with demographic and social characteristics. Bivariate analysis was performed assessing the three outcomes with the independent variables. Variables with significant associations in this bivariate analysis were fit in a Poisson multiple regression analysis with robust variance to obtain adjusted estimates. RESULT: Poisson regression analysis showed a statistically significant association with the variables "less than eight years of study" [prevalence ratio (PR) = 1.31; 95%CI 1.19-1.45; p < 0.001] and "participants of the cash transfer program" (PR = 0.80; 95%CI 0.72-0.88; p < 0.001) for the outcome of "having less than six prenatal care appointments" and individual variables. A statistically significant association was found for "participants of the cash transfer program" (PR = 1.43; 95%CI 1.19-1.72; p < 0.001) regarding the outcome from the comparison between HIV testing absence during prenatal care and demographic and social characteristics. The absence of syphilis testing during prenatal care, and demographic and social characteristics presented a statistically significant association for the education level variable "less than eight years of study" (PR =1.75; 95%CI 1.56-1.96; p < 0.001) and "participants of the cash transfer program" (PR = 1.21, 95%CI 1.07-1.36; p < 0.001). CONCLUSIONS: The individual factors were associated with prenatal care appointments and HIV and syphilis tests in Brazilian pregnant women. They show missed opportunities for diagnosing HIV and syphilis infection during prenatal care and indicate weaknesses in the quality of maternal health care services to eliminate mother-to-child transmission.


Assuntos
Infecções por HIV/diagnóstico , Complicações Infecciosas na Gravidez/diagnóstico , Cuidado Pré-Natal/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Sífilis Congênita/diagnóstico , Distribuição por Idade , Brasil/epidemiologia , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Humanos , Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Distribuição de Poisson , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Cuidado Pré-Natal/métodos , Prevalência , Atenção Primária à Saúde/métodos , Qualidade da Assistência à Saúde , Análise de Regressão , Fatores Socioeconômicos , Sífilis Congênita/epidemiologia
8.
Rev Lat Am Enfermagem ; 27: e3160, 2019 Aug 19.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31432916

RESUMO

OBJECTIVE: to analyze the trend and spatial distribution of some diseases that require compulsory notification in pregnant women. METHOD: ecological study, with data from the National Notifiable Diseases Surveillance System, of the incidence of the six most frequent diseases that, require compulsory notification, in pregnant women. The Prais-Winsten model was used to analyze the trend classified as stable, decreasing and increasing, according to macro-regions. For the spatial analysis, the incidences distributed in percentiles, in choropleth maps, by Health Regions were calculated. RESULTS: the most frequent infections were syphilis, dengue, Human Immunodeficiency Virus, influenza, hepatitis and toxoplasmosis. Incidence increased by 30.8%, 30.4%, 15.4% and 2.6%, on average, for syphilis, toxoplasmosis, dengue and Human Immunodeficiency Virus, respectively. On average, the incidence of syphilis increased by 40.5% in Macro-regional North and 38% in Macro-regional Northwest. The spatial analysis showed, in the last four years, high incidence of dengue, syphilis and infection by Human Immunodeficiency Virus, which reached 180.2, 141.7 and 100.8 cases per 10,000 live births, respectively. CONCLUSION: there were increased incidences of infection in pregnant women due to syphilis, toxoplasmosis and Human Immunodeficiency Virus, with differences in their spatial distribution, indicating that these diseases should be a priority in the care of pregnant women in more affected regions.


Assuntos
Complicações Infecciosas na Gravidez/epidemiologia , Brasil/epidemiologia , Dengue/epidemiologia , Notificação de Doenças , Feminino , Infecções por HIV/epidemiologia , Hepatite/epidemiologia , Humanos , Incidência , Influenza Humana/epidemiologia , Gravidez , Análise Espaço-Temporal , Sífilis/epidemiologia , Fatores de Tempo , Toxoplasmose/epidemiologia
9.
BMC Public Health ; 19(1): 1004, 2019 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-31349838

RESUMO

BACKGROUND: Chronic hepatitis B Virus (HBV) infection affects 80-100 million people in sub-Saharan Africa and accounts for an estimated 650,000 deaths annually. The prevalence of active hepatitis B virus infection among women aged 15-64 in mid-Northern Uganda is about 5%. Lira district is among the high prevalence areas where government embarked on mass HBV screening since 2015 as a gateway for access to prevention, treatment services, and an effective response to the hepatitis B epidemic. The current proportion of pregnant women screened and the factors associated with prenatal HBVscreening in Lira are not known despite the fact that women contribute largely to both vertical and horizontal transmission of HBV. This study aimed at determining the proportion of pregnant women screened for HBV and factors associated with prenatal HBV screening in Lira district. METHODS: This was a community based cross sectional study conducted among 423 pregnant women in the sub counties of Aromo and Agweng in Lira district. Data were collected using open data kit and analysed using STATA version 14. The outcome variable was prenatal HBV screening while predictor variables were community, individual and health facility factors associated with HBV screening. Multivariable logistic regression was used to determine factors associated with prenatal HBV screening. RESULTS: Thirty five women (8.3%) had been screened for HBV during the current pregnancy. Factors associated with prenatal HBV screening in Lira included perceived risk (Adjusted Odds Ratio (AOR) 3.78, 95% CI 1.01-6.14), respondent's age (AOR = 3.98, 95% CI 1.39-5.09), husband/partner's education (AOR = 3.34, 95% CI 1.10-5.12) and past failure to access to HBV screening services at government health facilities (AOR = 6.44, 95% CI 2.10-8.02). CONCLUSION: The level of HBV screening among pregnant women in Lira was low and is mainly associated with perceived risk, age, access to HBV screening services and spousal education level. More effort is needed in creating mass awareness on the need and importance of HBV screening most especially among pregnant women.


Assuntos
Hepatite B/diagnóstico , Complicações Infecciosas na Gravidez/diagnóstico , Diagnóstico Pré-Natal/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Feminino , Hepatite B/epidemiologia , Humanos , Pessoa de Meia-Idade , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Prevalência , Fatores de Risco , Uganda/epidemiologia , Adulto Jovem
10.
BMC Infect Dis ; 19(1): 655, 2019 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-31337339

RESUMO

BACKGROUND: Although significant improvement in efficacy measured by a sustained virological response, the high acquisition costs of direct-acting antivirals limit the access for patients and influence the costs of healthcare resource utilisation in hepatitis C. It is important to have the latest estimates of prevalence, especially in high-risk groups, for cost of illness, cost-effectiveness and budget impact studies. METHODS: Original studies on the estimates of the prevalence among general and high-risk groups in the European Union/European Economic Area (EU/EEA) were retrieved from Medline and Embase for the period from 2015 to 2018. All included studies were evaluated for risk of selection bias and summarised together in a narrative form. Results from previous reviews and updated searches were compared per country among different populations, respectively. RESULTS: Among the 3871 studies identified, 46 studies were included: 20 studies were used for the estimate of the general population; 3 for men who have sex with men (MSM); 6 for prisoners; and 17 for people who inject drugs (PWID). Compared with the results reported in previous systematic reviews, the updated estimates were lower than previously in most available countries. Anti-HCV general population prevalence estimates ranged from 0.54 to 1.50% by country. The highest prevalence of anti-HCV was found among PWID (range of 7.90-82.00%), followed by prisoners (7.00-41.00%), HIV-positive MSM (1.80-7.10%), HIV-negative MSM (0.20-1.80%), pregnant women (0.10-1.32%) and first-time blood donors (0.03-0.09%). CONCLUSIONS: Our study highlights the heterogeneity in anti-HCV prevalence across different population groups in EU/EEA. The prevalence also varies widely between European countries. There are many countries that are not represented in our results, highlighting the need for the development of robust epidemiological studies.


Assuntos
Hepatite C/epidemiologia , Adulto , Doadores de Sangue/estatística & dados numéricos , Europa (Continente)/epidemiologia , União Europeia , Feminino , Anticorpos Anti-Hepatite C/sangue , Homossexualidade Masculina , Humanos , Masculino , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/virologia , Gestantes , Prevalência , Prisioneiros/estatística & dados numéricos , Minorias Sexuais e de Gênero/estatística & dados numéricos
11.
Braz J Infect Dis ; 23(4): 218-223, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31344355

RESUMO

HIV-1 mother-to-child transmission (HIV-1 MTCT), is an important cause of children mortality worldwide. Brazil has been traditionally praised by its HIV/Aids program, which provides free-of-charge care for people living with HIV-1. Using public epidemiology and demographic databases, we aimed at modeling HIV-1 MTCT prevalence in Brazil through the years (1994-2016) and elaborate a statistical model for forecasting, contributing to HIV-1 epidemiologic surveillance and healthcare decision-making. We downloaded sets of live births and mothers' data alongside HIV-1 cases notification in children one year old or less. Through time series modeling, we estimated prevalence along the years in Brazil, and observed a remarkable decrease of HIV-1 MTCT between 1994 (10 cases per 100,000 live births) and 2016 (five cases per 100,000 live births), a reduction of 50%. Using our model, we elaborated a prognosis for each Brazilian state to help HIV-1 surveillance decision making, indicating which states are in theory in risk of experiencing a rise in HIV-1 MTCT prevalence. Ten states had good (37%), nine had mild (33%), and eight had poor prognostics (30%). Stratifying the prognostics by Brazilian region, we observed that the Northeast region had more states with poor prognosis, followed by North and Midwest, Southeast and South with one state of poor prognosis each. Brazil undoubtedly advanced in the fight against HIV-1 MTCT in the past two decades. We hope our model will help indicating where HIV-1 MTCT prevalence may rise in the future and support government decision makers regarding HIV-1 surveillance and prevention.


Assuntos
Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , HIV-1 , Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Adolescente , Adulto , Brasil/epidemiologia , Criança , Feminino , Previsões , Humanos , Modelos Lineares , Pessoa de Meia-Idade , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Prevalência , Fatores de Tempo , Adulto Jovem
12.
Pan Afr Med J ; 33: 9, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31303954

RESUMO

Introduction: Bacterial vaginosis (BV) is the most common cause of vaginal discharge in women of child bearing age. Bacterial vaginosis has emerged as a global health issue due to the adverse outcome in pregnancy and in the puerperium. The study determined the prevalence of BV and outcome of delivery among pregnant women. Methods: Socio-demographic data and vaginal swab samples were obtained from 362 consecutive pregnant women with abnormal vaginal discharge attending antenatal clinic in Ekiti State University Teaching Hospital, Ado-Ekiti. Data were analysed using SPSS statistical software 21 and association between variables was compared using Chi square. Results: The prevalence of BV among pregnant women with abnormal vaginal discharge in this study was 16.6%. Age group 25-34yrs, multiparity and higher education were significantly associated with BV, p < 0.05. Symptoms such as vulvar itching, dyspareunia, lower abdominal pains and characteristic of vaginal discharge such as colour and consistency were significantly associated with BV, p < 0.05. Women with bacterial vaginosis significantly had prelabour rupture of fetal membrane and their babies were born prematurely with low birth weight and Apgar score of less than 5 at one minute, p < 0.05. However, there was no difference statistically in rate of admission into special care baby unit among the women, p > 0.05. Conclusion: The findings of this study suggest that there should be screening for BV in pregnant women presenting with abnormal vaginal discharge so that they could be treated accordingly. This will mitigate the complications arising from bacterial vaginosis.


Assuntos
Complicações Infecciosas na Gravidez/epidemiologia , Resultado da Gravidez , Nascimento Prematuro/epidemiologia , Vaginose Bacteriana/epidemiologia , Adulto , Índice de Apgar , Estudos Transversais , Feminino , Ruptura Prematura de Membranas Fetais/epidemiologia , Humanos , Recém-Nascido de Baixo Peso , Programas de Rastreamento/métodos , Nigéria/epidemiologia , Gravidez , Complicações Infecciosas na Gravidez/microbiologia , Prevalência , Centros de Atenção Terciária , Vaginose Bacteriana/complicações , Vaginose Bacteriana/diagnóstico , Adulto Jovem
13.
BMC Infect Dis ; 19(1): 602, 2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31291901

RESUMO

BACKGROUND: Hepatitis B virus (HBV) is a hepatotropic deoxyribonucleic acid (DNA) virus which causes death. More than 300 million people have chronic liver infections globally and about 600,000 people die annually from acute or chronic complications of hepatitis B infection. Recent studies conducted in Ethiopia showed moderate endemicity (3-7.8%) of HBV among pregnant women. However, there is paucity of information on sero- prevalence of HBV and associated factors among pregnant women at Gambella town. The aim of this study is to assess sero-prevalence of hepatitis surface antigen (HBsAg) and associated factors among pregnant women in Gambella Hospital. METHODS: Hospital based cross-sectional study was conducted in a total of 253 pregnant women from March 10-April 15, 2017. Socio-demographic characteristics and risk factors were collected through face to face interview using structured questionnaire. HBV infection was determined using Eugene strip test. Logistic regression analysis was used to determine association between HBsAg sero-positivity and various factors. Findings were presented using 95% CI of Crude Odds Ratios (COR) and Adjusted Odds Ratios (AOR). RESULT: The overall sero- prevalence of HBV infection was 7.9% (95% CI, 4.7-11.9), which indicates intermediate endemicity. History of abortion (AOR = 3.56:1: 95% CI, 1.24-10.22), occupation (AOR = 8.36:95% CI, 1.67-41.96) and multiple sexual partner (AOR = 17.38: 95% CI, 4.48-67.49) had statistical significant association with HBsAg sero-positivity. CONCLUSION: HBV sero-prevalence in pregnant women shows intermediate endemicity. Hence health education on having single sexual partner and risk factors of abortion should be given. In addition, routine screening and immunization of pregnant women for HBV infection should be strengthen.


Assuntos
Hepatite B/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Adolescente , Adulto , Estudos Transversais , Etiópia/epidemiologia , Feminino , Hepatite B/sangue , Antígenos de Superfície da Hepatite B/sangue , Vírus da Hepatite B/imunologia , Hospitais , Humanos , Gravidez , Complicações Infecciosas na Gravidez/sangue , Fatores de Risco , Estudos Soroepidemiológicos , Inquéritos e Questionários , Adulto Jovem
14.
Rev Soc Bras Med Trop ; 52: e20180532, 2019 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-31340359

RESUMO

INTRODUCTION: Although congenital syphilis is preventable, its incidence has increased in Brazil. METHODS: In this ecological study, a Bayesian spatio-temporal model was used to estimate the attributable fraction of congenital syphilis cases due to the lack of prenatal care recorded between 2010 and 2015 in the state of São Paulo, Southeast Brazil. RESULTS: For the year 2016, it was estimated that between 79.4% and 95.3% of the congenital syphilis cases among women who did not have prenatal care could have been prevented. CONCLUSIONS: A significant proportion of congenital syphilis cases can be prevented if prenatal care coverage is expanded.


Assuntos
Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Complicações Infecciosas na Gravidez/epidemiologia , Cuidado Pré-Natal , Sífilis Congênita/epidemiologia , Teorema de Bayes , Brasil/epidemiologia , Notificação de Doenças , Feminino , Sistemas de Informação em Saúde , Humanos , Incidência , Gravidez , Características de Residência
15.
Rev Soc Bras Med Trop ; 52: e20190105, 2019 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-31340371

RESUMO

INTRODUCTION: Clinical and epidemiological data on suspected congenital Zika syndrome (CZS) cases from southern Mato Grosso (MT) in Brazil during the Zika virus (ZIKV) outbreak in 2015-2016 were evaluated. METHODS: This is a descriptive case series study of newborns whose mothers were suspected cases of ZIKV infections during their pregnancies. The medical records of all the suspected CZS cases (mothers and newborns) treated by the specialized ambulatory service from June 2015 to August 2016 were analyzed. RESULTS: Twenty suspected CZS cases were included in these analyses. They were categorized into four groups based on the clinical and laboratory findings: confirmed cases (n=1), highly probable cases (n=13), moderately probable cases (n=5), and somewhat probable cases (n=1). The mothers tested negative for STORCH (syphilis, toxoplasmosis, other infections, rubella, cytomegalovirus infection, and herpes simplex) and other important congenital infections; however, specific ZIKV tests were not performed during the study period. Microcephaly was observed in the majority of these newborns, and all the patients showed altered cranial computed tomography image findings. Extracranial abnormalities such as arthrogryposis, and otological and ophthalmological manifestations were also observed. CONCLUSIONS: Although ZIKV was not confirmed to cause the congenital malformations, this study demonstrated that the clinical and epidemiological findings associated with a STORCH exclusion strengthened the CZS diagnosis. The suspected cases in MT occurred simultaneously with the first CZS cases reported in Brazil, suggesting ZIKV circulation in the study region during the same period.


Assuntos
Microcefalia/virologia , Complicações Infecciosas na Gravidez/virologia , Infecção por Zika virus/diagnóstico , Infecção por Zika virus/epidemiologia , Zika virus/isolamento & purificação , Adolescente , Adulto , Brasil/epidemiologia , Surtos de Doenças , Feminino , Humanos , Recém-Nascido , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/epidemiologia , Fatores Socioeconômicos , Adulto Jovem , Infecção por Zika virus/complicações , Infecção por Zika virus/congênito
16.
J Assoc Physicians India ; 67(4): 20-22, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31309789

RESUMO

Background: Hepatitis E Virus (HEV) infection is a major concern regarding morbidity and mortality among pregnant women especially in developing countries. The objective of this study was to determine the characteristics and obstetric outcomes in pregnant women with Acute Hepatitis E Virus Infection in tertiary care hospital of Himachal Pradesh. Methods: Prospective observational study has been done in the department of Obstetrics and Gynaecology and department of Medicine and Emergency Medicine among all the pregnant women who were sero-positive for hepatitis E viral marker in two consecutive years. Information regarding basic characteristics of pregnant women and obstetric outcome has been collected. Results: Among 30 pregnant women with hepatitis E viral infection, a case fatality ratio of 8.0% for hepatitis E infection was found. 13.3% of the pregnancies ended up as intra uterine death. Most common age group affected was below 25 years. Mode of delivery among 70% of the women was normal vaginal delivery though 30% women delivered prematurely. Conclusions: This prospective case series of 30 pregnant women with acute hepatitis E viral infection, indicate poor maternal, obstetric and foetal outcome among pregnant women with hepatitis E viral infection.


Assuntos
Vírus da Hepatite E , Hepatite E/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Feminino , Hepatite E/diagnóstico , Humanos , Índia/epidemiologia , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Resultado da Gravidez , Estudos Prospectivos , Centros de Atenção Terciária
17.
J Vet Diagn Invest ; 31(4): 634-639, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31179891

RESUMO

A cluster of 4 bovine abortions caused by Coxiella burnetii occurred in a dairy herd in Uruguay during a 2-mo period. Case 1 consisted of a placenta from an aborted cow; cases 2-4 were fetuses and their placentas. Grossly, the placenta from one aborted cow had moderate, diffuse reddening of the cotyledons and loss of translucency of the intercotyledonary areas. No gross lesions were observed in the other 3 placentas. Microscopically, 2 of 4 placentas had fibrinonecrotizing placentitis with abundant intratrophoblastic gram-negative coccobacilli. C. burnetii was identified intralesionally by immunohistochemistry (IHC) in all 4 placentas, and by PCR and DNA sequencing in 3 placentas analyzed by these techniques. One fetus had mild neutrophilic alveolitis with multinucleate syncytial cells; no gross or microscopic lesions were observed in the other 2 fetuses examined. The lungs of the 3 fetuses were negative for C. burnetii by IHC. Tests performed to investigate other possible causes of abortions in the 4 cases were negative. C. burnetii causes Q fever in humans and coxiellosis in animals. Clusters of abortions in cattle by C. burnetii have not been reported previously, to our knowledge; this bacterium has been considered an opportunistic pathogen associated only with sporadic abortion in cattle. We present herein a cluster of 4 bovine abortions caused by C. burnetii in a dairy farm during a period of 2 mo and a review of the literature on C. burnetii infection in cattle.


Assuntos
Aborto Animal/microbiologia , Doenças dos Bovinos/microbiologia , Coxiella burnetii/isolamento & purificação , Complicações Infecciosas na Gravidez/veterinária , Febre Q/veterinária , Aborto Animal/epidemiologia , Animais , Bovinos , Coxiella burnetii/genética , Feminino , Feto/microbiologia , Feto/patologia , Humanos , Imuno-Histoquímica , Placenta/microbiologia , Placenta/patologia , Reação em Cadeia da Polimerase/veterinária , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/microbiologia , Febre Q/complicações , Febre Q/epidemiologia , Febre Q/microbiologia , Uruguai/epidemiologia
18.
BMC Infect Dis ; 19(1): 496, 2019 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-31170921

RESUMO

BACKGROUND: HIV testing serves as a critical gateway for linkage and retention to care services, particularly in sub-Saharan African countries with high burden of HIV infections. However, the current progress towards addressing the first cascade of the 90-90-90 programme is largely contributed by women. This study aimed to map evidence on the intervention strategies to improve HIV uptake among men in sub-Saharan Africa. METHODS: We conducted a scoping review guided by Arksey and O'Malley's (2005) framework and Levac et al. (2010) recommendation for methodological enhancement for scoping review studies. We searched for eligible articles from electronic databases such as PubMed/MEDLINE; American Doctoral Dissertations via EBSCO host; Union Catalogue of Theses and Dissertations (UCTD); SA ePublications via SABINET Online; World Cat Dissertations; Theses via OCLC; and Google Scholar. We included studies from January 1990 to August 2018. We used the PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. The Mixed Method Appraisal Tool version 2018 was used to determine the methodological quality of the included studies. We further used NVivo version 11 to aid with content thematic analysis. RESULTS: This study revealed that teaching men about HIV; Community-Based HIV testing; Home-Based HIV testing; Antenatal Care HIV testing; HIV testing incentives and HIV Self-testing are important strategies to improving HIV testing among men in sub-Saharan Africa. The need for improving programmes aimed at giving more information to men about HIV that are specifically tailored for men, especially given their poor uptake of HIV testing services was also found. This study further revealed the need for implementing Universal Test and Treat among HIV positive men found through community-based testing strategies, while suggesting the importance of restructuring home-based HIV testing visits to address the gap posed by mobile populations. CONCLUSION: The community HIV testing, as well as, HIV self-testing strategies showed great potential to increase HIV uptake among men in sub-Saharan Africa. However, to address poor linkage to care, ART should be initiated soon after HIV diagnosis is concluded during community testing services. We also recommend more research aimed at addressing the quality of HIV self-testing kits, as well as, improving the monitoring systems of the distributed HIV self-testing kits.


Assuntos
Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Programas de Rastreamento , Participação do Paciente/estatística & dados numéricos , Adulto , África ao Sul do Saara/epidemiologia , Atitude Frente a Saúde , Demografia/estatística & dados numéricos , Prática Clínica Baseada em Evidências , Feminino , Geografia , HIV , Infecções por HIV/transmissão , Humanos , Masculino , Programas de Rastreamento/métodos , Programas de Rastreamento/organização & administração , Programas de Rastreamento/estatística & dados numéricos , Programas Nacionais de Saúde/organização & administração , Programas Nacionais de Saúde/normas , Programas Nacionais de Saúde/estatística & dados numéricos , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/prevenção & controle , Testes Sorológicos
19.
BMC Infect Dis ; 19(1): 519, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31195988

RESUMO

BACKGROUND: There have been a number of studies about seroprevalence of HEV among pregnant women in Africa. However, the finding of seroprevalence of HEV infection among pregnant women is variable and inconsistent. Therefore; this systematic review intended to provide the pooled seroprevalence of HEV among pregnant women in Africa. METHODS: We searched, Pub Med, Science direct, African online journals and Google scholar electronic data bases and all available references until August 30, 2018. We included cross sectional studies and cohort studies. The search was further limited studies done in African pregnant women. Statistical analysis done by using Stata (version 11) software. The overall pooled prevalence of HEV presented by using the forest plot with 95% CI. The methodological qualities of included studies were assessed using Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instruments. RESULT: The pooled seroprevalence of HEV among pregnant women in Africa was 29.13% (95% CI 14.63-43.63). The highest seroprevalence was 84.3% in Egypt and the lowest 6.6% reported in Gabon. There was highest heterogeneity level where I2 = 99.7%; P < 0.0001.The observed heterogeneity attributed to geographic location/ region, country, assay method used in each study and year of study published. Moreover, HEV seroprevalence varies between countries and within countries. The HEV infection among African pregnant women seems to have a decreasing trend over time. CONCLUSION: The seroprevalence of HEV among pregnant women in Africa is high. The seroprevalence of HEV among pregnant women differ with geographic location and assay method. Therefore, it is recommended to conduct further research on commercial ELISA kit sensitivity and specificity, molecular tests, incidence, morbidity and mortality and vertical transmission of HEV from mother to infant in Africa. TRIAL REGISTRATION: CRD42018084963 .


Assuntos
Hepatite E/diagnóstico , Complicações Infecciosas na Gravidez/diagnóstico , África/epidemiologia , Anticorpos Antivirais/sangue , Bases de Dados Factuais , Feminino , Hepatite E/epidemiologia , Vírus da Hepatite E/imunologia , Humanos , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Prevalência
20.
Infect Dis Obstet Gynecol ; 2019: 7808179, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31186607

RESUMO

Background: High rates of bacterial vaginosis (BV) have been described in nonpregnant South African women. Studies of BV in South African pregnant women are sparse. Diagnosis and prompt treatment of BV in pregnancy are expected to have a positive impact on pregnancy outcomes and HIV prevention. This study was undertaken to determine the prevalence of BV in pregnant women in a high HIV burden periurban setting in KwaZulu-Natal and explore how to enhance BV diagnosis in this setting where syndromic management of sexually transmitted diseases is the standard of care. Methods: In this cross-sectional study, consenting HIV uninfected pregnant women were examined for abnormal vaginal discharge; nurses determined the vaginal pH and collected a vaginal swab for Gram-stain and Nugent scoring. Findings: Among 750 HIV uninfected pregnant women, 280 (37.3%; 95%CI 33.9-40.9) tested positive for BV. Using a vaginal pH > 4.4, 65% of women with BV were correctly identified, while an abnormal vaginal discharge correctly identified a significantly lower proportion (52.9%) of women with BV (p=0.005). The sensitivity, specificity, and positive and negative predictive values of vaginal pH testing were 65.9% (95%CI 60.0 - 71.5%), 61.4% (95%CI 56.8 - 65.9%), and 50.1% and 75.4%, respectively. The 20-24 year-old pregnant women were twice more likely to test positive for BV than the adolescent pregnant women (43.6% vs 21.1%) (p = 0.037) and BV was not associated with the duration of a sexual relationship, frequency of unprotected sex during pregnancy, number of lifetime sex partners, or the partner's age. Conclusion: There is a high burden of primarily asymptomatic BV in HIV uninfected pregnant women in this periurban setting. Both the sensitivity and specificity of vaginal pH testing are superior to the symptomatic diagnosis of BV but not good enough to be used as a screening tool.


Assuntos
Complicações Infecciosas na Gravidez/epidemiologia , Vaginose Bacteriana/epidemiologia , Adolescente , Adulto , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Prevalência , Vaginose Bacteriana/diagnóstico , Adulto Jovem
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