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3.
Rev Chilena Infectol ; 36(5): 616-628, 2019 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-31859803

RESUMO

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.


Assuntos
Terapia Biológica/efeitos adversos , Doenças Transmissíveis/induzido quimicamente , Consenso , Emigrantes e Imigrantes , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Complicações Infecciosas na Gravidez/induzido quimicamente , Chile , Feminino , Hepatite B/induzido quimicamente , Hepatite B/prevenção & controle , Humanos , Programas de Rastreamento , Guias de Prática Clínica como Assunto , Gravidez , Complicações Infecciosas na Gravidez/prevenção & controle , Medição de Risco , Fatores de Risco
5.
Pan Afr Med J ; 33: 310, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31723373

RESUMO

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).


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/estatística & dados numéricos , Hepatite B/prevenção & controle , Complicações Infecciosas na Gravidez/prevenção & controle , Adolescente , Adulto , Camarões , Feminino , Humanos , Pessoa de Meia-Idade , Gravidez , Complicações Infecciosas na Gravidez/virologia , Cuidado Pré-Natal/métodos , Inquéritos e Questionários , Adulto Jovem
6.
BMC Public Health ; 19(1): 1467, 2019 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-31694607

RESUMO

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.


Assuntos
Antimaláricos/uso terapêutico , Malária/prevenção & controle , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Complicações Infecciosas na Gravidez/prevenção & controle , Cuidado Pré-Natal/estatística & dados numéricos , Toxoide Tetânico/uso terapêutico , Tétano/prevenção & controle , Adolescente , Adulto , Costa do Marfim , Combinação de Medicamentos , Feminino , Humanos , Recém-Nascido , Modelos Logísticos , Análise Multivariada , Gravidez , Pirimetamina/uso terapêutico , Sulfadoxina/uso terapêutico , Inquéritos e Questionários , Adulto Jovem
7.
BMC Health Serv Res ; 19(1): 747, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31651307

RESUMO

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.


Assuntos
Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Complicações Infecciosas na Gravidez/prevenção & controle , Gestantes/psicologia , Relações Profissional-Paciente , Confiança , Vacinas , Adolescente , Adulto , Atitude do Pessoal de Saúde , Família , Feminino , Pessoal de Saúde/psicologia , Humanos , Imunização , Quênia , Defesa do Paciente , Educação de Pacientes como Assunto , Gravidez , Cuidado Pré-Natal/estatística & dados numéricos , Vacinação , Adulto Jovem
8.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(9): 1055-1058, 2019 Sep 10.
Artigo em Chinês | MEDLINE | ID: mdl-31594145

RESUMO

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.


Assuntos
Hepatite B/prevenção & controle , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Complicações Infecciosas na Gravidez/prevenção & controle , Criança , China , DNA Viral , Feminino , Vírus da Hepatite B , Humanos , Gravidez
9.
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
10.
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
11.
Praxis (Bern 1994) ; 108(13): 859-862, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31571544

RESUMO

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.


Assuntos
Vacinas contra Influenza , Vacina contra Coqueluche , Complicações Infecciosas na Gravidez , Coqueluche , Feminino , Humanos , Lactente , Recém-Nascido , Vacinas contra Influenza/administração & dosagem , Vacina contra Coqueluche/administração & dosagem , Gravidez , Complicações Infecciosas na Gravidez/prevenção & controle , Vacinação , Coqueluche/prevenção & controle
12.
Can J Vet Res ; 83(4): 248-254, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31571723

RESUMO

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.


Assuntos
Síndrome Respiratória e Reprodutiva Suína/prevenção & controle , Vírus da Síndrome Respiratória e Reprodutiva Suína/classificação , Complicações Infecciosas na Gravidez/veterinária , Vacinas Virais/imunologia , Animais , Feminino , Vírus da Síndrome Respiratória e Reprodutiva Suína/imunologia , Gravidez , Complicações Infecciosas na Gravidez/prevenção & controle , Subunidades Proteicas , Suínos , Vacinas de Subunidades/imunologia , Proteínas Virais/imunologia
13.
BMC Health Serv Res ; 19(1): 760, 2019 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-31655575

RESUMO

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.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Hepatite B/prevenção & controle , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Complicações Infecciosas na Gravidez/prevenção & controle , Gestantes/psicologia , Adolescente , Adulto , Estudos Transversais , Feminino , Política de Saúde , Humanos , Gravidez , Medição de Risco , Uganda , Adulto Jovem
14.
Lakartidningen ; 1162019 Sep 27.
Artigo em Sueco | MEDLINE | ID: mdl-31573669

RESUMO

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.


Assuntos
Mortalidade Materna , Adolescente , Adulto , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/prevenção & controle , Feminino , Humanos , Morte Materna , Transtornos Mentais/mortalidade , Transtornos Mentais/prevenção & controle , Hemorragia Pós-Parto/mortalidade , Hemorragia Pós-Parto/prevenção & controle , Pré-Eclâmpsia/mortalidade , Pré-Eclâmpsia/prevenção & controle , Gravidez , Complicações na Gravidez/prevenção & controle , Complicações Infecciosas na Gravidez/mortalidade , Complicações Infecciosas na Gravidez/prevenção & controle , Complicações Neoplásicas na Gravidez/mortalidade , Complicações Neoplásicas na Gravidez/prevenção & controle , Qualidade da Assistência à Saúde , Sociedades Médicas , Suicídio/prevenção & controle , Suécia/epidemiologia , Tromboembolia/mortalidade , Tromboembolia/prevenção & controle
15.
Rev Saude Publica ; 53: 72, 2019 Sep 02.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31483008

RESUMO

OBJECTIVE: To evaluate the adherence of pregnant women to personal protective measures against mosquito bites, recommended by the Ministry of Health, and to investigate the factors associated with the non-adoption of these measures. METHODS: We interviewed 177 pregnant women between November 2016 and February 2017 in the 10 basic health units of the municipality of Propriá, state of Sergipe, two located in the rural area and eight in the urban area, during prenatal appointments, to raise information about the use of preventive measures against the vector transmission of Zika virus. Data were analyzed using descriptive statistical methods, chi-square test or Fisher's exact test, and the odds ratio was calculated. The independent variables were grouped by the analysis of principal components, and the dependents (the use of repellent, mosquito nets, garments, screens and insecticides) were analyzed using the logistic regression method. RESULTS: Among the measures recommended by the Ministry of Health, mosquito nets were the most used by pregnant women living in rural areas and with low education level, while the repellents were more used by women in the urban area and with higher education level. Women in a vulnerable socio-economic situation presented a risk 2.4 times higher for not using screens in their homes, 1.9 times higher for not changing clothes and 2.5 times higher for not using repellent than pregnant women in better economic conditions. CONCLUSIONS: The socioeconomic status of pregnant women, especially among the less privileged, influenced the use of protective measures against Zika virus, from the purchase of repellent, clothing, insecticides to other resources in the municipality of Propriá, SE.


Assuntos
Controle de Mosquitos/métodos , Complicações Infecciosas na Gravidez/prevenção & controle , Infecção por Zika virus/prevenção & controle , Adolescente , Adulto , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Repelentes de Insetos/administração & dosagem , Inseticidas/administração & dosagem , Pessoa de Meia-Idade , Mosquiteiros/estatística & dados numéricos , Gravidez , Gestantes , Fatores Socioeconômicos , Adulto Jovem , Infecção por Zika virus/epidemiologia
16.
Artigo em Inglês | MEDLINE | ID: mdl-31487845

RESUMO

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.


Assuntos
Infecções por HIV/diagnóstico , Programas de Rastreamento/estatística & dados numéricos , Fatores Socioeconômicos , Adolescente , Adulto , Feminino , Humanos , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Pessoa de Meia-Idade , Mães , Gravidez , Complicações Infecciosas na Gravidez/prevenção & controle , Cuidado Pré-Natal/estatística & dados numéricos , Testes Sorológicos , Vietnã , Adulto Jovem
17.
BMC Health Serv Res ; 19(1): 557, 2019 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-31399088

RESUMO

BACKGROUND: Male partner involvement has been shown to increase mothers' uptake of Prevention of Mother-to-Child Transmission of HIV (PMTCT) and improve maternal and infant HIV treatment outcomes. Currently, male involvement in PMTCT is measured primarily through men's attendance at HIV testing and counselling which may not be a true reflection of their engagement. This study therefore set out to explore the meaning of male partner involvement and propose a definition and theoretical model of this concept in PMTCT in Uganda. METHODS: Eight focus group discussions and five in-depth interviews were conducted with couples at three public health facilities and community members in the health facility catchment areas in Uganda. The study employed a grounded theory approach underpinned by the pragmatic philosophical paradigm. Data were analyzed using the constant comparative method, performing three levels of open, axial, and selective coding. RESULTS: Of the 61 participants, 29 (48%) were male and the majority 39 (63.9%) were in long term marital relationships, while about half were self-employed 29 (47.5%). Three themes emerged for the meaning of male involvement in PMTCT (a) HIV treatment support (b) economic support and (c) psychosocial support. HIV treatment support included adherence support, couples' HIV counseling and testing, and clinic attendance during and after pregnancy. Participants expressed that men were engaged in PMTCT when they offered economic support by providing basic needs and finances or when they included their female partners in financial planning for the family. Psychosocial support arose from the female participants who defined male involvement as family support, perceived societal recognition and emotional support. Emotional support also included the absence of harm resulting from women's disclosure of HIV test results to their male partner. CONCLUSIONS: This study proposes a new definition for male partner involvement in PMTCT in Uganda. The definition extends beyond men's clinic attendance and HIV testing and counselling. Further research should seek to develop and validate tools to accurately measure male partner involvement as the next step in the development of interventions to improve PMTCT outcomes.


Assuntos
Teoria Fundamentada , Infecções por HIV/prevenção & controle , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Complicações Infecciosas na Gravidez/prevenção & controle , Parceiros Sexuais/psicologia , Adulto , Aconselhamento , Feminino , Grupos Focais , Humanos , Masculino , Gravidez , Uganda
18.
Emerg Microbes Infect ; 8(1): 1066-1075, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31339458

RESUMO

Hepatitis E virus (HEV) can lead to high mortality during pregnancy. This study was to investigate the adverse pregnancy outcomes caused by different HEV genotypes and their prevention by HEV 239 vaccine in rabbits. Forty-two female rabbits were randomly and equally divided into 7 groups (A-G). HEV 239 vaccine and a placebo were administered to groups E (10 µg×2), F (5 µg×2) and G (1 mL of PBS×2) before copulation. After pregnancy, 1 mL of 1.5×106 copies/mL rabbit HEV3 was inoculated to groups A, E, F and G, swine HEV4/human HEV3 to groups B/C, and group D was a negative control. Anti-HEV antibody, HEV RNA, and alanine aminotransferase (ALT)/aspartate aminotransferase (AST) levels were monitored. Pregnant rabbits infected by HEV manifested HEV infection symptoms including fecal virus shedding, ALT/AST elevation, and histopathological changes, and adverse pregnancy outcomes. Immunized pregnant rabbits in groups E and F showed no HEV infection symptoms and adverse outcomes. The newborn rabbits delivered by pregnant rabbits with/without immunization showed without/with HEV infection symptoms. This study demonstrated that multiple genotypes of HEV infection can cause adverse outcomes and HEV 239 vaccine can prevent HEV-related adverse outcomes in pregnant rabbits.


Assuntos
Vírus da Hepatite E/fisiologia , Hepatite E/prevenção & controle , Complicações Infecciosas na Gravidez/prevenção & controle , Resultado da Gravidez , Vacinas contra Hepatite Viral/administração & dosagem , Animais , Modelos Animais de Doenças , Feminino , Anticorpos Anti-Hepatite/imunologia , Hepatite E/imunologia , Hepatite E/fisiopatologia , Hepatite E/virologia , Vírus da Hepatite E/classificação , Vírus da Hepatite E/genética , Vírus da Hepatite E/imunologia , Humanos , Masculino , Gravidez , Complicações Infecciosas na Gravidez/imunologia , Complicações Infecciosas na Gravidez/fisiopatologia , Complicações Infecciosas na Gravidez/virologia , Coelhos , Eliminação de Partículas Virais
19.
Hu Li Za Zhi ; 66(4): 79-86, 2019 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-31342504

RESUMO

Influenza vaccinations may decrease the risk of contracting influenza and its complications significantly in pregnant women and effectively help infants less than six months of age avoid hospitalization. Based on scientific evidence supporting the safety and benefits of the influenza vaccination for pregnant women and fetuses, the epidemic prevention policy of both the World Health Organization and Taiwan's Ministry of Health and Welfare recommend that pregnant women receive the influenza vaccination. However, low acceptance of the influenza vaccine among pregnant women is an ongoing concern in Taiwan. Nursing staffs play a key role in implementing the influenza vaccination program for pregnant women. Therefore, strengthening the professional competency and service effectiveness of nursing staffs may be expected to significantly improve the vaccination coverage rate. This article offers practical methods for achieving this, including promoting nursing staffs' professional knowledge and positive attitudes regarding influenza vaccinations for pregnant women, improving nursing staffs' related education and skills in communication with pregnant women and their families, and improving the implementation of the notification mechanism for disseminating accurate information regarding the vaccine and vaccine adverse events. Our ultimate goal is to enhance the confidence and willingness of pregnant women with regard to receiving influenza vaccinations in order to promote the health of mothers and their fetuses.


Assuntos
Adaptação Psicológica , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Recursos Humanos de Enfermagem/psicologia , Complicações Infecciosas na Gravidez/prevenção & controle , Gestantes/psicologia , Feminino , Humanos , Lactente , Pesquisa em Avaliação de Enfermagem , Gravidez , Taiwan
20.
BMJ ; 366: l4151, 2019 07 10.
Artigo em Inglês | MEDLINE | ID: mdl-31292120

RESUMO

OBJECTIVE: To determine whether any association exists between exposure to 2009 pandemic H1N1 (pH1N1) influenza vaccination during pregnancy and negative health outcomes in early childhood. DESIGN: Retrospective cohort study. SETTING: Population based birth registry linked with health administrative databases in the province of Ontario, Canada. PARTICIPANTS: All live births from November 2009 through October 2010 (n=104 249) were included, and children were followed until 5 years of age to ascertain study outcomes. MAIN OUTCOME MEASURES: Rates of immune related (infectious diseases, asthma), non-immune related (neoplasms, sensory disorders), and non-specific morbidity outcomes (urgent or inpatient health services use, pediatric complex chronic conditions) were evaluated from birth to 5 years of age; under-5 childhood mortality was also assessed. Propensity score weighting was used to adjust hazard ratios, incidence rate ratios, and risk ratios for potential confounding. RESULTS: Of 104 249 live births, 31 295 (30%) were exposed to pH1N1 influenza vaccination in utero. No significant associations were found with upper or lower respiratory infections, otitis media, any infectious diseases, neoplasms, sensory disorders, urgent and inpatient health services use, pediatric complex chronic conditions, or mortality. A weak association was observed between prenatal pH1N1 vaccination and increased risk of asthma (adjusted hazard ratio 1.05, 95% confidence interval 1.02 to 1.09) and decreased rates of gastrointestinal infections (adjusted incidence rate ratio 0.94, 0.91 to 0.98). These results were unchanged in sensitivity analyses accounting for any potential differential healthcare seeking behavior or access between exposure groups. CONCLUSIONS: No associations were observed between exposure to pH1N1 influenza vaccine during pregnancy and most five year pediatric health outcomes. Residual confounding may explain the small associations observed with increased asthma and reduced gastrointestinal infections. These outcomes should be assessed in future studies.


Assuntos
Saúde da Criança , Vírus da Influenza A Subtipo H1N1 , Vacinas contra Influenza/efeitos adversos , Influenza Humana/prevenção & controle , Pandemias/prevenção & controle , Complicações Infecciosas na Gravidez/prevenção & controle , Efeitos Tardios da Exposição Pré-Natal , Adulto , Asma/epidemiologia , Pré-Escolar , Feminino , Gastroenteropatias/epidemiologia , Humanos , Lactente , Recém-Nascido , Ontário/epidemiologia , Gravidez , Pontuação de Propensão , Sistema de Registros , Estudos Retrospectivos , Adulto Jovem
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