International Journal of MCH and AIDS最新文献

{"title":"COVID-19 Infection among People with HIV/AIDS in Africa: Knowledge Gaps, Public Health Preparedness and Research Priorities.","authors":"Ekere James Essien,&nbsp;Osaro Mgbere,&nbsp;Sorochi Iloanusi,&nbsp;Susan M Abughosh","doi":"10.21106/ijma.461","DOIUrl":"https://doi.org/10.21106/ijma.461","url":null,"abstract":"<p><p>The emergence of novel virus SARS-CoV-2 that causes COVID-19 has complicated Africa's public health challenges, especially with the pre-existing epidemics such as HIV/AIDS. We highlight the known evidence related to COVID-19 infections among people with HIV (PWH) with specific reference to Africa. The knowledge gaps, level of public health preparedness and the potential research priorities are also outlined. Although the epidemiology and clinical course of COVID-19 in HIV patients are evolving, existing evidence indicate that the disease outcomes are comparable to that of the general population. However, PWH with low CD4 cell counts may have worse outcomes than individuals with restored immunity, whereas old age and co-morbidities such as obesity, hypertension and diabetes can further increase their overall risk. While there may be slight disruption of HIV service delivery in selected African countries, the resilience and resourcefulness of others have helped to sustain HIV service delivery and enhanced the level of public health preparedness and fight against the pandemic. The paucity of data and research studies on HIV-COVID-19 coinfection in Africa, call for concerted efforts to address these limitations.</p>","PeriodicalId":30480,"journal":{"name":"International Journal of MCH and AIDS","volume":"10 1","pages":"113-118"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/09/5c/IJMA-10-113.PMC8020823.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25590731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Features and Outcomes of COVID-19 Infection among Pregnant Women in South Africa.","authors":"Jayati Kusari Basu,&nbsp;Lawrence Chauke,&nbsp;Terrance Magoro","doi":"10.21106/ijma.479","DOIUrl":"10.21106/ijma.479","url":null,"abstract":"<p><strong>Background and objective: </strong>Studies among COVID positive pregnant women are limited. Previous studies reported high rate of symptoms, comorbidities and poor fetal/neonatal outcome among women of different ethnicity. To date, no study was reported among pregnant African women. This study was conducted to determine the clinical features and outcomes of COVID-19 positive pregnant women in Ekurhuleni District in South Africa.</p><p><strong>Methods: </strong>Retrospective record review of 103 COVID-19 infected pregnant women during the period of April to September 2020 was done. Clinical features, symptoms, comorbidities, laboratory results, maternal and neonatal outcomes were analyzed. Descriptive statistics (mean + standard deviation, number and percentages) and inferential statistics (Chi-square test) were calculated. Ethical clearance was obtained from the Human Research Ethics Committee of the University of Witwatersrand, South Africa.</p><p><strong>Results: </strong>Majority (90%) were of African ethnicity and symptomatic (53%). The commonest symptom, comorbidity and laboratory abnormality was cough (62%), hypertension (23%) and high LDH (20%), respectively. Thrombocytopenia and lymphocytopenia occurred among 9% and 15% of the women, respectively. Although association was not significant, symptoms were more common among comorbid, HIV positive and women with abnormal results. Commonest complications were preterm labor (8%) and macerated stillbirths (6%). Six (6%) mothers died.</p><p><strong>Conclusion and global health implications: </strong>COVID positive pregnant South African women were commonly symptomatic but incidence of adverse fetal outcomes was low. High rate of preterm labor, macerated stillbirths and maternal deaths was a concern. This study has several strengths. It included all COVID positive women over a 6 months' period at all level of healthcare facilities such as clinics, community health centers/midwifery units, and district, regional and tertiary hospitals, conducted in an African country. Previous studies included mainly hospitals raising a high probability of including mainly severely ill women. The study might benefit the health care workers in other African countries.</p>","PeriodicalId":30480,"journal":{"name":"International Journal of MCH and AIDS","volume":"10 2","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3e/35/IJMA-10-174.PMC8264468.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39184947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of HIV Testing Uptake among Women (aged 15-49 years) in the Philippines, Myanmar, and Cambodia.","authors":"Wah W Myint,&nbsp;David J Washburn,&nbsp;Brian Colwell,&nbsp;Jay E Maddock","doi":"10.21106/ijma.525","DOIUrl":"https://doi.org/10.21106/ijma.525","url":null,"abstract":"<p><strong>Background: </strong>Many countries have been trying to eliminate Mother-to-Child transmission of the Human Immunodeficiency Virus (HIV) and achieve the 90-90-90 target goals. The targets mean that 90% of People Living with HIV (PLWHIV) know their HIV status, 90% of those who are infected receive Antiretroviral treatment (ART), and 90% of those achieve viral suppression. Despite some progress, the goals have not been met in the Philippines, Myanmar, and Cambodia, countries with relatively high or growing HIV prevalence. This study identifies the sociodemographic determinants of testing among women in these countries so that better health education and stigma reduction strategies can be developed.</p><p><strong>Methods: </strong>Descriptive and multivariable analyses were conducted using Demographic and Health Survey data conducted in the Philippines (2017), Myanmar (2015/2016), and Cambodia (2014). The outcome variable was having ever been tested for HIV. Independent variables included knowledge and attitudes about HIV and social determinants of health.</p><p><strong>Results: </strong>A significant difference in testing rates among women was observed (the Philippines: 5%, Myanmar: 19%, Cambodia: 42%). In Myanmar and Cambodia, women who had more HIV knowledge and less stigma towards PLWHIV were more likely to get tested for HIV than those who did not. Marital status, education, wealth were strong predictors for HIV testing among women. Younger women aged 15-19 and those who live in the rural areas were less likely to get HIV tested than older and those living in urban areas. Employed women were less likely to seek an HIV test than the unemployed in Myanmar and Cambodia, whereas, in the Philippines, the opposite relationship was found.</p><p><strong>Conclusion and global health implications: </strong>Women with less education and those less familiar with HIV should be targeted for HIV testing interventions. Stigma reduction and different testing strategies could facilitate early screening leading to improved HIV testing among women.</p>","PeriodicalId":30480,"journal":{"name":"International Journal of MCH and AIDS","volume":"10 2","pages":"221-230"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9f/d8/IJMA-10-221.PMC8647194.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39721011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and Racial/Ethnic, Socioeconomic, and Geographic Disparities in Maternal Mortality from Indirect Obstetric Causes in the United States, 1999-2017.","authors":"Gopal K Singh, Hyunjung Lee","doi":"10.21106/ijma.448","DOIUrl":"10.21106/ijma.448","url":null,"abstract":"<p><strong>Background: </strong>This study examines trends and inequalities in US maternal mortality from indirect obstetric causes (ICD-10 codes: O98-O99) and specific chronic conditions by maternal race/ethnicity, socioeconomic status, nativity/immigrant status, marital status, place and region of residence, and cause of death.</p><p><strong>Methods: </strong>National vital statistics data from 1999 to 2017 were used to compute maternal mortality rates by sociodemographic factors. Rate ratios and log-linear regression were used to model mortality trends and differentials.</p><p><strong>Results: </strong>During 1999-2017, maternal mortality from indirect causes showed an upward trend; the annual rates increased by 11.2% for the overall population, 12.9% for non-Hispanic Whites, and 9.4% for non-Hispanic Blacks. The proportion of all maternal deaths due to indirect causes increased from 12.0% in 1999 to 26.9% in 2017. Maternal mortality from CVD increased sharply over time, from 0.40/100,000 live births in 1999 to 1.82 in 2017. During 2013-2017, compared to non-Hispanic Whites, non-Hispanic Blacks had 83% higher, Hispanics 51% lower, and Asian/Pacific Islanders 55% lower mortality from indirect causes. Non-Hispanic White women with <12 years of education had 4.4 times higher mortality than those with a college degree. Unmarried, US-born, and women living in rural areas and deprived areas had 90%, 80%, 60%, and 97% higher maternal mortality risks than married, immigrant, and women in urban areas and affluent areas, respectively. Maternal mortality from infectious diseases, including HIV, was 4.1 times greater and from respiratory diseases 2.9 greater among non-Hispanic Black women compared to non-Hispanic White women.</p><p><strong>Conclusions and global health implications: </strong>While maternal mortality from direct obstetric causes has declined during the past two decades, maternal deaths due to indirect causes, particularly from pre-existing medical conditions, including CVD and metabolic disorders, have increased. Understanding complex interactions among social determinants, indirect causes, and proximate/direct causes is important to reducing maternal mortality and improving maternal health.</p>","PeriodicalId":30480,"journal":{"name":"International Journal of MCH and AIDS","volume":"10 1","pages":"43-54"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/03/6f/IJMA-10-43.PMC7792750.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38750970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of Sociodemographic and Clinical Factors with Late Presentation for Early Infant HIV Diagnosis (EID) Services in Kenya.","authors":"Agnes Langat,&nbsp;Tegan L Callahan,&nbsp;Isabella Yonga,&nbsp;Boniface Ochanda,&nbsp;Anthony Waruru,&nbsp;Lucy W Ng'anga,&nbsp;Abraham Katana,&nbsp;Brian Onyango,&nbsp;Benson Singa,&nbsp;Stephen Oyule,&nbsp;George Githuka,&nbsp;Lennah Omoto,&nbsp;Jane Muli,&nbsp;Thorkild Tylleskar,&nbsp;Surbhi Modi","doi":"10.21106/ijma.537","DOIUrl":"https://doi.org/10.21106/ijma.537","url":null,"abstract":"<p><strong>Background: </strong>Understanding the missed opportunities in early infant HIV testing within the PMTCT program is essential to address any gaps. The study set out to describe the clinical and sociodemographic characteristics of the infants presenting late for early infant diagnosis in Kenya.</p><p><strong>Methods: </strong>We abstracted routinely collected clinical and sociodemographic characteristics, in a cross-sectional study, on all HIV-infected infants with a positive polymerase chain reaction (PCR) test from 1,346 President's Emergency Plan for AIDS Relief (PEPFAR) supported health facilities for the period October 2016 to September 2018. We used multivariate logistic regression to examine the association of sociodemographic and clinical characteristics with late (>2 months after birth) presentation for infant HIV testing.</p><p><strong>Results: </strong>Of the 4,011 HIV-infected infants identified, the median infant age at HIV diagnosis was 3 months [interquartile range (IQR), 1-16 months], and two-thirds [2,669 (66.5%)] presented late for infant HIV testing. Factors that were associated with late presentation for infant testing were: maternal ANC non-attendance, adjusted odds ratio (aOR) 1.41 (95% confidence interval (CI) 1.18 -1.69); new maternal HIV diagnosis, aOR 1.45, (95%CI 1.24 -1.7); and lack of maternal antiretroviral therapy(ART), aOR 1.94, (95% CI 1.64 - 2.30). There was a high likelihood of identifying HIV-infected infants among infants who presented for medical services in the outpatient setting (aOR 18.9; 95% CI 10.2 - 34.9) and inpatient setting (aOR 12.2; 95% CI 6.23-23.9) compared to the infants who presented late in maternity.</p><p><strong>Conclusion and global health implications: </strong>Gaps in early infant HIV testing suggest the need to increase maternal pre-pregnancy HIV diagnosis, timely antenatal care, early infant diagnosis services, early identification of mothers who seroconvert during pregnancy or breastfeeding and improved HIV screening in outpatient and inpatient settings. Early referral from the community and access to health facilities should be strengthened by the implementation of national PMTCT guidelines.</p>","PeriodicalId":30480,"journal":{"name":"International Journal of MCH and AIDS","volume":"10 2","pages":"210-220"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b7/e4/IJMA-10-210.PMC8679597.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39626281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographic, Health Care Access, Racial Discrimination, and Socioeconomic Determinants of Maternal Mortality in Georgia, United States.","authors":"Elizabeth Armstrong-Mensah,&nbsp;Damilola Dada,&nbsp;Amber Bowers,&nbsp;Aruba Muhammad,&nbsp;Chisom Nnoli","doi":"10.21106/ijma.524","DOIUrl":"https://doi.org/10.21106/ijma.524","url":null,"abstract":"<p><p>Over the past decade, the United States has been taking steps to reduce its rising maternal mortality rate. However, these steps have yet to produce positive results in the state of Georgia, which tops the list of all 50 states with the highest maternal mortality rate of 46.2 maternal deaths per 100,000 live births for all women, and a maternal mortality rate of 66.6 deaths per 100,000 live births for African American women. In Georgia, several social determinants of health such as the physical environment, economic stability, health care access, and the quality of maternal care contribute to the high maternal mortality rate. Addressing these determinants will help to reduce the state's maternal mortality rate. This commentary discusses the relationship between social determinants of health and maternal mortality rates in Georgia. It also proposes strategies for reversing the trend. We conducted an ecological study of the relationship between social determinants of health and maternal mortality in Georgia. We searched PubMed and Google Scholar and reviewed 80 English articles published between 2005 and 2021. We identified five key social determinants associated with high maternal mortality rates in Georgia - geographic location of obstetric services, access to health care providers, socioeconomic status, racism, and discrimination. We found that expanding Medicaid coverage, reducing maternal health care disparities among the races, providing access to maternal care for women in rural areas, and training a culturally competent health workforce, will help to reduce Georgia's high maternal mortality rate.</p>","PeriodicalId":30480,"journal":{"name":"International Journal of MCH and AIDS","volume":"10 2","pages":"278-286"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d5/52/IJMA-10-278.PMC8679596.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39626283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening Maternal Death Surveillance Systems for Evidence-Based Decision Making in Sub-Saharan Africa: The Case of the Center Region in Cameroon.","authors":"Anastasia Y Bongajum,&nbsp;Pascal Foumane,&nbsp;Charlotte O Moussi,&nbsp;Noel Vogue,&nbsp;Hycinth S Banseka,&nbsp;Jujlius M Nwobegahay,&nbsp;Martina L Baye","doi":"10.21106/ijma.517","DOIUrl":"https://doi.org/10.21106/ijma.517","url":null,"abstract":"<p><strong>Background: </strong>The article seeks to document the experience of implementing Maternal Death Surveillance and Response (MDSR) in the Center Region of Cameroon. The paper raises awareness on the need for implementing MDSR, shares progress and lessons learned and reflects on the implications for public health practice.</p><p><strong>Methods: </strong>A desk research involving the collection and analysis of secondary data using tables with specific themes in excel, following the review of existing resources at the Regional Delegation of Public Health-Center from the year 2016 to 2019.</p><p><strong>Results: </strong>The findings depict the existence of MDSR policies and sub-regional committees. Although, the number of regional maternal death notifications increased from 19 to 188 deaths between 2016 and 2019, the implementation of death review recommendations was only estimated at 10% in 2019. While 66% of deaths occurred in Yaoundé, 72% of these were deaths reported to have occurred in tertiary institutions out of which 75% were attributed to late referrals. Hemorrhage constituted 70/144 (48.6%) of the known direct causes of death. Maternal death related co-factors such as the use of partograph during labor had a high non-response rate (84%) and represents a weakness in the data set.</p><p><strong>Conclusion and global health implications: </strong>Across the board, stakeholder engagement towards MDSR was increased through continuous awareness-raising, dissemination of surveillance tools, the institutionalization of the District Health Information Software (DHIS 2) and the \"No Name No Blame\" policy. However, the reporting and investigation of deaths for informed decisions remain a daunting challenge. For a resource-scarce setting with limited access to blood banks, the application of life-saving cost-effective interventions such as the use of partographs and the institution of a functional referral system among health units is likely to curb the occurrence of deaths from hemorrhage and other underlying causes. The success of these will require a robust strengthening of the health system.</p>","PeriodicalId":30480,"journal":{"name":"International Journal of MCH and AIDS","volume":"10 2","pages":"258-268"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fc/9b/IJMA-10-258.PMC8647191.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39582113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics of Children with HIV Initiated on Antiretroviral Treatment at HIV Clinics in Bloemfontein, South Africa.","authors":"Andrew Walubo,&nbsp;Refuoe Baleni,&nbsp;Hillary Mukudu,&nbsp;Henry Kambafwile,&nbsp;Mukesh Dheda,&nbsp;Thanduxolo Thengwa,&nbsp;Tshepang Jiane","doi":"10.21106/ijma.471","DOIUrl":"https://doi.org/10.21106/ijma.471","url":null,"abstract":"<p><strong>Background and objective: </strong>Over the past 15 years, there have been three major updates to the South African national guidelines for the management of human immunodeficiency virus (HIV) in children. The purpose of this study is to describe the clinical characteristics of children who were initiated on antiretroviral therapy (ART) in Bloemfontein, South Africa, following these national treatment guidelines.</p><p><strong>Methods: </strong>Clinical information during initiation of ART in children aged 0-13 years was obtained from five HIV clinics in Bloemfontein from 2004 to 2019 as part of the establishment of an antiretroviral (ARV) pediatric registry at the University of the Free State. Data were analyzed for patient demographics, clinical presentation (World Health Organization (WHO) HIV-staging, growth rate and comorbid conditions), types of investigations done, and medicines prescribed.</p><p><strong>Results: </strong>The number of children initiated on ART increased from 168 in the period 2004-2009 to 349 (107.8%) in 2010-2014, and then dropped to 162 in the period 2015-2019. The increase in 2010-2014 was mainly in the <2 years age group by 54.8%, and in the 5 to 10 years age group by 344.4%. In the same period, the number of children with severe illness (WHO HIV-stage 4) decreased by 20.7%, while those with mild to moderate illness (WHO HIV-stage 2 and 3) increased by 17.3%. HIV infection was more severe in children under two years as more patients in this age group presented with WHO HIV-stages 3 and 4, severe underweight (below 3^rd percentile), severely suppressed CD4 count (< 25%), and a high viral load (> 1000 copies/ml). There was increased use of ABC/3TC/LPVr in the < 3-year age group and ABC/3TC/EFV in the > 3-year age group. There was reduced use of the stavudine and other regimens.</p><p><strong>Conclusion and global health implications: </strong>More children were started on ART and safer ARV drugs. Children under 2 years were the most debilitated by HIV, and there was an increase in HIV prevalence among children > 5 years. New strategies for the prevention and management of HIV among children in these two age groups are needed.</p>","PeriodicalId":30480,"journal":{"name":"International Journal of MCH and AIDS","volume":"10 1","pages":"146-155"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a3/32/IJMA-10-146.PMC8285671.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39211096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Framework for Protecting Pregnant Women in the Era of COVID-19 Pandemic.","authors":"Deepa Dongarwar,&nbsp;Veronica B Ajewole,&nbsp;Kiydra Harris,&nbsp;Emmanuella Oduguwa,&nbsp;Theresa U Ofili,&nbsp;Collins Onyenaka,&nbsp;Sade Arnold,&nbsp;Jorhn Broussard,&nbsp;Joan Ishioye,&nbsp;Jasmine Marshal,&nbsp;Jamila Mayoya,&nbsp;Danchau Le,&nbsp;Mouch Fadel,&nbsp;Omonike A Olaleye,&nbsp;Hamisu M Salihu","doi":"10.21106/ijma.419","DOIUrl":"https://doi.org/10.21106/ijma.419","url":null,"abstract":"<p><p>The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent for the coronavirus disease 2019 (COVID-19) pandemic, highlighted and compounded problems while posing new challenges for the pregnant population. Although individual organizations have provided disparate information, guidance, and updates on managing the pregnant population during the current COVID-19 pandemic, it is important to develop a collective model that highlights all the best practices needed to protect the pregnant population during the pandemic. To establish a standard for ensuring safety during the pandemic, we present a framework that describes best practices for the management of the pregnant population during the ongoing COVID-19 pandemic.</p>","PeriodicalId":30480,"journal":{"name":"International Journal of MCH and AIDS","volume":"10 1","pages":"109-112"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e7/73/IJMA-10-109.PMC8039866.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38884672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Trained Non-Medical Staff to Improve Access to HIV Testing Services in Africa: Implementation of the World Health Organization Opt-out Approach in Cameroon.","authors":"Charles Kouanfack,&nbsp;Skinner Nguefack Lekelem,&nbsp;Fala Bede,&nbsp;Claude Ngwayu Nkfusai,&nbsp;Yvette Micha Nouafo,&nbsp;Christian Tchokonte,&nbsp;Nicaise Tsomo Zephirin,&nbsp;Pierre Joseph Fouda","doi":"10.21106/ijma.426","DOIUrl":"https://doi.org/10.21106/ijma.426","url":null,"abstract":"<p><strong>Background: </strong>The Joint United Nations Programme on HIV/AIDS (UNAIDS) in 2019 estimated that 450,000 to 50,000 people in Cameroon were living with HIV, yet only 79% knew their HIV status which is far from the 90% target for 2020. To address this situation, Cameroon adopted the \"Opt-out\" strategy of the World Health Organization (WHO) and use of trained non-medical cadre (psychosocial agents) to reach out to more people with HIV testing services (HTS). This describes the implementation and outcomes of this strategy by reviewing the activity of a typical day in the Yaoundé Central Hospital (YCH) in Cameroon.</p><p><strong>Methods: </strong>HTS were offered to hospitalized and ambulatory patients (including their companions) in different departments of the YCH. Following screening for recent HIV testing, those with unknown HIV status that gave consent or did not explicitly refuse testing (as per the \"Opt-out Strategy\"), were counseled and tested for HIV. Testing followed the \"National HIV Rapid Testing Algorithm\" using rapid diagnostic test kits. Results were either positive, negative or indeterminate. Patients with positive HIV results were linked to the Care and Treatment Center for treatment initiation.</p><p><strong>Results: </strong>Of the 350 patients screened and offered HTS using non-medical cadre (psychosocial agents), 193 (55.1%) were hospitalized and 157 (44.9%) came for outpatient visits. The age of participants ranged from 14 to 92 years and the yield of HIV testing in the sample population was 5.1% (6.2% for hospitalized patients and 3.8% for outpatient clinics). Statistics revealed that five HIV-positive patients had never been offered HTS before the study. The study revealed that HTS acceptance rate among hospitalized patients was 69.6% and that all new positive patients started antiretroviral treatment on the same day.</p><p><strong>Conclusion and global health implications: </strong>It is feasible to use trained non-medical staff for HIV testing services (HTS). Task-shifting by using trained psychosocial agents can help in case identification and linkage to HIV treatment services.</p>","PeriodicalId":30480,"journal":{"name":"International Journal of MCH and AIDS","volume":"10 1","pages":"119-127"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a8/ce/IJMA-10-119.PMC8039867.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38884673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}