Time trends in management of HIV-positive pregnant women in Northern Tanzania: A registry-based study

Rebnord, Tormod; Østbye, Truls; Mmbaga, Blandina T.; Lie, Rolv Terje; Daltveit, Anne Kjersti

doi:10.1371/journal.pone.0184362

Cited by 6 publications

(13 citation statements)

References 12 publications

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“…In Northern Pará, the risk of HIV by MTCT is directly associated with the number of families enrolled in Single Registry for Social Programs and people having less than an elementary schooling level. In India and Tanzania, poor pregnant women living with HIV had low adherence to antenatal care and follow-up treatment of their babies (Rebnord et al, 2017;Suryavanshi et al, 2018). In Africa, pregnant women with high schooling levels were more aware of prevention of HIV by MTCT during antenatal care, postpartum and during breastfeeding (Dlamini and Mokoboto-Zwane, 2019;Darteh et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

“…In Africa, pregnant women with high schooling levels were more aware of prevention of HIV by MTCT during antenatal care, postpartum and during breastfeeding (Dlamini and Mokoboto-Zwane, 2019;Darteh et al, 2021). On the other hand, although pregnant women in Tanzania who lived with HIV had a high level of knowledge about prevention of HIV by MTCT, stigma and social prejudice were associated with low prenatal frequency and ART adherence (Rebnord et al, 2017). Thus, much more than to promote health accessibility equity to combat HIV by MTCT, it is necessary to fight the stigma and social prejudice against people living with HIV.…”

Section: Discussionmentioning

confidence: 99%

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Spatial variability of mother-to-child human immunodeficiency virus transmission in a province in the Brazilian Rainforest: An ecological study

et al. 2022

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The mother-to-child transmission (MTCT) of the human immunodeficiency virus (HIV) remains a serious public health problem in the Brazilian Rainforest. This study aimed to spatially analyze this type of infection between 2007 and 2018 in Pará, which is the second-largest Brazilian state in the Brazilian Rainforest and also has the highest MTCT of HIV in Brazil. We analyzed the incidence rates of HIV (including the acquired immunodeficiency syndrome (AIDS) by MTCT as the main route of infection in children younger than 13 years old and whose mothers live in Pará. We employed spatial autocorrelation, spatial scanning, and geographic-weighted spatial regression techniques. In the period of this study, 389 new HIV/AIDS were noted, with territorial expansion of the incidence rates in the municipalities in northern and southern Pará having the highest rates. São Francisco do Pará had high spatial risk and high-spatiotemporal risk clusters comprising municipalities in western and south-western Pará between 2013 and 2016. The spatial variability of HIV/AIDS incidence rates was found to be common in the number of men and women with formal jobs; unemployed ≥18 years old people; elementary school pupils; and families enrolled in the “Single Registry for Social Programs”. The social equity approach in Pará guarantee pregnant women access to preventive, diagnostic and treatment health services and their children should be supported to eliminate the MTCT of HIV in Pará.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Spatial variability of mother-to-child human immunodeficiency virus transmission in a province in the Brazilian Rainforest: An ecological study

et al. 2022

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“…Although pregnant women are usually tested during the first antenatal care visit, we could not determine how many this applied to as the registry does not include any information about the timing of the HIV test. Further details about the birth registry and recruitment are described elsewhere [ 29 , 30 ].…”

Section: Methodsmentioning

confidence: 99%

Time trends in perinatal outcomes among HIV-positive pregnant women in Northern Tanzania: A registry-based study

et al. 2023

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Introduction Maternal HIV infection is associated with increased risk of having a preterm delivery, low birth weight baby, small for gestational age baby and stillbirth. Maternal use of combination antiretroviral treatment is also associated with preterm delivery and low birth weight, although the effects vary by the type of drugs and timing of initiation. Objective To examine time trends in adverse perinatal outcomes among HIV-positive compared with HIV-negative women. Design Registry-based cohort study. Setting Northern Tanzania, 2000–2018. Study sample Mother-baby pairs of singleton deliveries (n = 41 156). Methods Perinatal outcomes of HIV-positive women were compared with HIV-negative women during time periods representing shifts in prevention of mother-to-child transmission guidelines. Monotherapy was used as first-line therapy before 2007 while combination antiretroviral treatment was routinely used from 2007. Log binomial and quantile regression were used to analyze the data. Main outcome measures Preterm delivery, low birth weight, perinatal death, stillbirth, low Apgar score, transfer to neonatal care unit and small for gestational age. Results Overall, maternal HIV infection was associated with a higher risk of low birth weight and small for gestational age. Moreover, this pattern became more pronounced over time for low birth weight, the last time period being an exception. For other outcomes we found none or only a small overall association with maternal HIV infection, although a trend towards higher risk over time in HIV-positive compared with HIV-negative women was observed for preterm delivery and perinatal death. Quantile regression showed an increase in birth weight in babies born to HIV-negative women over time and a corresponding decline in birth weight in babies born to HIV-positive women. Conclusion Unfavourable trends in some of the selected perinatal outcomes were seen for HIV-positive compared with HIV-negative women. Potential side-effects of combination antiretroviral treatment in pregnancy should be further explored.

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“…In Tanzania neonatal mortality decreased from 33/1000 in 2000 to 21/1000 in 2017 [2]. However, vital birth statistics are not available [8,9], and estimates are inaccurate as almost half of the deliveries in Tanzania take place outside birth facilities. In a rural area with a low proportion of deliveries in hospital, this selection may preclude interpretation of temporal trends in mortality rates.…”

Section: Introductionmentioning

confidence: 99%

Increased perinatal survival and improved ventilation skills over a five-year period: An observational study

Størdal¹,

Eilevstjønn²,

Mduma³

et al. 2020

PLoS ONE

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Background and aim The Helping Babies Breathe program gave major reductions in perinatal mortality in Tanzania from 2009 to 2012. We aimed to study whether this effect was sustained, and whether resuscitation skills changed with continued frequent training. Methods We analysed prospective data covering all births (n = 19,571) at Haydom Lutheran Hospital in Tanzania from July 2013-June 2018. Resuscitation training was continued during this period. All deliveries were monitored by an observer recording the timing of events and resuscitation interventions. Heart rate was recorded by dry-electrode ECG and bag-maskventilation by sensors attached to the resuscitator device. We analyzed changes over time in outcomes, use of resuscitation interventions and performance of resuscitation using binary regression models with the log-link function to obtain adjusted relative risks. Results With introduction of user fees for deliveries since 2014, the number of deliveries decreased by 30% from start to the end of the five-year period. An increase in low heart rate at birth and need for bag-mask-ventilation indicate a gradual selection of more vulnerable newborns delivered in the hospital over time. Despite this selection, newborn deaths <24 hours did not change significantly and was maintained at an average of 8.8/1000 live births. The annual reductions in relative risk for perinatal death adjusted for vulnerability factors was 0.84 (95%CI 0.76-0.94). During the five-year period, longer duration of bag-mask ventilation sequences without interruption was observed. Delivered tidal volumes were increased and mask leak was decreased during ventilation. The time to initiation or total duration of ventilation did not change significantly.

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Time trends in management of HIV-positive pregnant women in Northern Tanzania: A registry-based study

Cited by 6 publications

References 12 publications

Spatial variability of mother-to-child human immunodeficiency virus transmission in a province in the Brazilian Rainforest: An ecological study

Spatial variability of mother-to-child human immunodeficiency virus transmission in a province in the Brazilian Rainforest: An ecological study

Time trends in perinatal outcomes among HIV-positive pregnant women in Northern Tanzania: A registry-based study

Increased perinatal survival and improved ventilation skills over a five-year period: An observational study

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