Browsing by Author "Musokotwane K"

Now showing 1 - 3 of 3

Effect of Enhanced Adherence Package on Early ART Uptake Among HIV-Positive Pregnant Women in Zambia: An Individual Randomized Controlled Trial.
(2021-Mar) Mubiana-Mbewe M; Bosomprah S; Kadota JL; Koyuncu A; Kusanathan T; Mweebo K; Musokotwane K; Mulenga PL; Chi BH; Vinikoor MJ; Centre for Infectious Disease Research in Zambia, Plot 34620 Off Alick Nkhata Road, P.O. Box 34681, Lusaka, Zambia. Mwangelwa.Mbewe@cidrz.org.; Department of Biostatistics, School of Public Health, University of Ghana, Accra, Ghana.; Department of Medicine, University of Alabama at Birmingham, Birmingham, USA.; Division of Pulmonary and Critical Care Medicine, Zuckerberg San Francisco General Hospital, University of California San Francisco, San Francisco, USA.; Department of Gender Studies, University of Zambia, Lusaka, Zambia.; Centre for Infectious Disease Research in Zambia, Plot 34620 Off Alick Nkhata Road, P.O. Box 34681, Lusaka, Zambia.; Prevention, Care and Treatment Branch, U.S. Centers for Disease Control and Prevention, Lusaka, Zambia.; Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, USA.; Directorate of Public Health, Zambian Ministry of Health, Lusaka, Zambia.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
We evaluated the effect of an option B-plus Enhanced Adherence Package (BEAP), on early ART uptake in a randomized controlled trial. HIV-positive, ART naïve pregnant women in Lusaka, Zambia, were randomized to receive BEAP (phone calls/home visits, additional counseling, male partner engagement and missed-visit follow-up) versus standard of care (SOC). The primary outcome was initiating and remaining on ART at 30 days. Analysis was by intention to treat (ITT) using logistic regression. Additional per protocol analysis was done. We enrolled 454 women; 229 randomized to BEAP and 225 to SOC. Within 30 days of eligibility, 445 (98.2%) initiated ART. In ITT analysis, 82.5% BEAP versus 80.4% SOC participants reached primary outcome (crude relative risk [RR] 1.03; 95% confidence interval [CI] 0.91-1.16; Wald test statistic = 0.44; p-value = 0.66). In per protocol analysis, (92 participants (40.2%) excluded), 91.9% BEAP versus 80.4% SOC participants reached primary outcome (crude RR 1.14; 95% CI 1.02-1.29; Wald test statistic = 2.23; p-value = 0.03). Early ART initiation in pregnancy was nearly universal but there was early drop out suggesting need for additional adherence support.This trial was registered at ClinicalTrials.gov (trials number NCT02459678) on May 14, 2015.
Implementation and Operational Research: Distance From Household to Clinic and Its Association With the Uptake of Prevention of Mother-to-Child HIV Transmission Regimens in Rural Zambia.
(2015-Nov-01) Escamilla V; Chibwesha CJ; Gartland M; Chintu N; Mubiana-Mbewe M; Musokotwane K; Musonda P; Miller WC; Stringer JS; Chi BH; *Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL; †Centre for Infectious Disease Research in Zambia, Lusaka, Zambia; ‡Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC; §Institute for Global Health, Vanderbilt University, Nashville, TN; ‖Society for Family Health, Lusaka, Zambia; ¶Zambian Ministry of Community Development and Mother-Child Health, Lusaka, Zambia; #Department of Public Health, University of Zambia School of Medicine, Lusaka, Zambia; **Division of Infectious Diseases, Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC; ††Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill, NC; and ‡‡Currently at Departments of Medicine and Pediatrics, Massachusetts General Hospital; Boston, MA.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
BACKGROUND: In rural settings, HIV-infected pregnant women often live significant distances from facilities that provide prevention of mother-to-child transmission (PMTCT) services. METHODS: We offered universal maternal combination antiretroviral regimens in 4 pilot sites in rural Zambia. To evaluate the impact of services, we conducted a household survey in communities surrounding each facility. We collected information about HIV status and antenatal service utilization from women who delivered in the past 2 years. Using household Global Positioning System coordinates collected in the survey, we measured Euclidean (i.e., straight line) distance between individual households and clinics. Multivariable logistic regression and predicted probabilities were used to determine associations between distance and uptake of PMTCT regimens. RESULTS: From March to December 2011, 390 HIV-infected mothers were surveyed across four communities. Of these, 254 (65%) had household geographical coordinates documented. One hundred sixty-eight women reported use of a PMTCT regimen during pregnancy including 102 who initiated a combination antiretroviral regimen. The probability of PMTCT regimen initiation was the highest within 1.9 km of the facility and gradually declined. Overall, 103 of 145 (71%) who lived within 1.9 km of the facility initiated PMTCT versus 65 of 109 (60%) who lived farther away. For every kilometer increase, the association with PMTCT regimen uptake (adjusted odds ratio: 0.90, 95% confidence interval: 0.82 to 0.99) and combination antiretroviral regimen uptake (adjusted odds ratio: 0.88, 95% confidence interval: 0.80 to 0.97) decreased. CONCLUSIONS: In this rural African setting, uptake of PMTCT regimens was influenced by distance to health facility. Program models that further decentralize care into remote communities are urgently needed.
Vulnerable newborn types: analysis of subnational, population-based birth cohorts for 541 285 live births in 23 countries, 2000-2021.
(2023-May-08) Erchick DJ; Hazel EA; Katz J; Lee ACC; Diaz M; Wu LSF; Yoshida S; Bahl R; Grandi C; Labrique AB; Rashid M; Ahmed S; Roy AD; Haque R; Shaikh S; Baqui AH; Saha SK; Khanam R; Rahman S; Shapiro R; Zash R; Silveira MF; Buffarini R; Kolsteren P; Lachat C; Huybregts L; Roberfroid D; Zeng L; Zhu Z; He J; Qiu X; Gebreyesus SH; Tesfamariam K; Bekele D; Chan G; Baye E; Workneh F; Asante KP; Kaali EB; Adu-Afarwuah S; Dewey KG; Gyaase S; Wylie BJ; Kirkwood BR; Manu A; Thulasiraj RD; Tielsch J; Chowdhury R; Taneja S; Babu GR; Shriyan P; Ashorn P; Maleta K; Ashorn U; Mangani C; Acevedo-Gallegos S; Rodriguez-Sibaja MJ; Khatry SK; LeClerq SC; Mullany LC; Jehan F; Ilyas M; Rogerson SJ; Unger HW; Ghosh R; Musange S; Ramokolo V; Zembe-Mkabile W; Lazzerini M; Rishard M; Wang D; Fawzi WW; Minja DTR; Schmiegelow C; Masanja H; Smith E; Lusingu JPA; Msemo OA; Kabole FM; Slim SN; Keentupthai P; Mongkolchati A; Kajubi R; Kakuru A; Waiswa P; Walker D; Hamer DH; Semrau KEA; Chaponda EB; Chico RM; Banda B; Musokotwane K; Manasyan A; Pry JM; Chasekwa B; Humphrey J; Black RE; Department of Statistics, Kintampo Health Research Centre, Kintampo, Ghana.; Centre for Medical Parasitology, Department for Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.; Infectious Diseases Research Collaboration, Kampala, Uganda.; Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa.; Department of Obstetrics & Gynaecology, University of Colombo, Colombo, Sri Lanka.; Section of Infectious Diseases, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA.; Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland.; Health Specialist PMTCT and Pediatric AIDS, UNICEF, Lusaka, Zambia.; Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.; Aravind Eye Care System, Madurai, India.; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.; Research Unit for Environmental Sciences and Management, North-West University, Potchefstroom, South Africa.; Institute for Global Health Sciences and Department of Obstetrics and Gynecology, University of California San Francisco, San Francisco, California, USA.; College Graduate of Studies, University of South Africa, Johannesburg, South Africa.; IntraHealth International, Dhaka, Bangladesh.; Projahnmo Research Foundation, Dhaka, Bangladesh.; Nepal Nutrition Intervention Project - Sarlahi (NNIPS), Kathmandu, Nepal.; Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.; Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.; JiVitA Maternal and Child Health Research Project, Rangpur, Bangladesh.; Department of Health Policy Planning and Management, Makerere University School of Public Health, New Mulago Hospital Complex, Kampala, Uganda.; Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, New York, USA.; Division of Birth Cohort Study, Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, Guangzhou, China.; Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.; Kintampo Health Research Centre, Research and Development Division, Kintampo, Ghana.; Medicine Department, Faculty of Medicine, University of Namur, Namur, Belgium.; Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan.; Poverty, Health and Nutrition Division, International Food Policy Research Institute, Washington, DC, USA.; Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium.; Argentine Society of Paediatrics, Ciudad Autónoma de Buenos Aires, Argentina.; Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland.; Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Department of Nutrition and Food Science, University of Ghana, Accra, Ghana.; University of Alabama at Birmingham, Birmingham, Alabama, USA.; Department of Global Health, Milken Institute School of Public Health, Washington, DC, USA.; Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar.; Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.; ASEAN Institute for Health Development, Mahidol University, Salaya, Thailand.; Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA.; Division of Global Health Equity & Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.; Department of Disease Control, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK.; Department of Infectious Diseases, University of Melbourne, Doherty Institute, Melbourne, Victoria, Australia.; Department of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.; Institute for Global Nutrition, Department of Nutrition, University of California, Davis, California, USA.; Child Health Research Foundation, Dhaka, Bangladesh.; The Aga Khan University, Karachi, Pakistan.; Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, Virginia, USA.; Division of Global Health, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.; Indian Institute of Public Health, Public Health Foundation of India, Bengaluru, India.; Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.; University Obstetrics Unit, De Soysa Hospital for Women, Colombo, Sri Lanka.; Ariadne Labs, Brigham and Women's Hospital and Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.; University of Ghana School of Public Health, Accra, Ghana.; College of Medicine and Public Health, Ubon Ratchathani University, Ubon Ratchathani, Thailand.; Gertrude H Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, USA.; Institute for Global Health Sciences, Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA.; Ifakara Health Institute, Dar es Salaam, Tanzania.; National Institute for Medical Research, Dar es Salaam, Tanzania.; Department of Food Technology, Safety and Health, Ghent University, Ghent, Belgium.; School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi.; National Institute of Perinatology, Maternal-Fetal Medicine Department, Mexico City, Mexico.; School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.; Department of Obstetrics and Gynecology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.; Department of Obstetrics and Gynecology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.; Institute for Maternal and Child Health - IRCCS 'Burlo Garofolo', WHO Collaborating Centre for Maternal and Child Health, Trieste, Italy.; National Institute for Medical Research, Tanga Centre, Tanga, Tanzania.; Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China.; Centre for Health Research and Development, Society for Applied Studies, Delhi, India.; Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.; HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa.; Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.; Ministry of Health Zanzibar, Zanzibar, Tanzania.; Department of Biological Sciences, School of Natural Sciences, University of Zambia, Lusaka, Zambia.; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.; Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
OBJECTIVE: To examine prevalence of novel newborn types among 541 285 live births in 23 countries from 2000 to 2021. DESIGN: Descriptive multi-country secondary data analysis. SETTING: Subnational, population-based birth cohort studies (n = 45) in 23 low- and middle-income countries (LMICs) spanning 2000-2021. POPULATION: Liveborn infants. METHODS: Subnational, population-based studies with high-quality birth outcome data from LMICs were invited to join the Vulnerable Newborn Measurement Collaboration. We defined distinct newborn types using gestational age (preterm [PT], term [T]), birthweight for gestational age using INTERGROWTH-21st standards (small for gestational age [SGA], appropriate for gestational age [AGA] or large for gestational age [LGA]), and birthweight (low birthweight, LBW [<2500 g], nonLBW) as ten types (using all three outcomes), six types (by excluding the birthweight categorisation), and four types (by collapsing the AGA and LGA categories). We defined small types as those with at least one classification of LBW, PT or SGA. We presented study characteristics, participant characteristics, data missingness, and prevalence of newborn types by region and study. RESULTS: Among 541 285 live births, 476 939 (88.1%) had non-missing and plausible values for gestational age, birthweight and sex required to construct the newborn types. The median prevalences of ten types across studies were T+AGA+nonLBW (58.0%), T+LGA+nonLBW (3.3%), T+AGA+LBW (0.5%), T+SGA+nonLBW (14.2%), T+SGA+LBW (7.1%), PT+LGA+nonLBW (1.6%), PT+LGA+LBW (0.2%), PT+AGA+nonLBW (3.7%), PT+AGA+LBW (3.6%) and PT+SGA+LBW (1.0%). The median prevalence of small types (six types, 37.6%) varied across studies and within regions and was higher in Southern Asia (52.4%) than in Sub-Saharan Africa (34.9%). CONCLUSIONS: Further investigation is needed to describe the mortality risks associated with newborn types and understand the implications of this framework for local targeting of interventions to prevent adverse pregnancy outcomes in LMICs.