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Journal articles on the topic 'Children of AIDS patients – Africa'

Author: Grafiati

Published: 4 June 2021

Last updated: 14 February 2022

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1

Murthy, Jayabalan. "HIV & AIDS in Africa: Implications and challenges for African Churches." REFLEXUS - Revista Semestral de Teologia e Ciências das Religiões 9, no. 14 (April 12, 2016): 317. http://dx.doi.org/10.20890/reflexus.v9i14.291.

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Este artigo apresenta a ideia geral sobre HIV & AIDS, explora como o estigma e discriminação degradam as condições de vida do PLWHA. O artigo apresenta também as implicações e desafios desta situação para as Igrejas Africanas. HIV & AIDS são frequentemente considerados como a punição de Deus de transgressões sexuais, ou até mesmo a forma que Deus usa para eliminar os elementos pecaminosos da sociedade. A sociedade considera os portadores de HIV & AIDS como pecadores por causa da doença, ou a doença os faz pecadores. Como fica, então, a situação de crianças e pessoas que não estão envolvidas em atividades imorais. As atitudes das pessoas que se consideram justas levam-nas a pensar e crer que os portadores de HIV & AIDS não são justos. Devido a este tipo de julgamento da parte da igreja e da sociedade os portadores de HIV & AIDS são estigmatizados e discriminados pela igreja e pela sociedade. This paper deals with the general idea about HIV & AIDS and further explores how stigma and discrimination worsen the life PLWHA and finally implications and challenges for African Churches. HIV & AIDS is often considered to be God’s punishment for sexual transgressions, or even God’s way of eradicating sinful elements from society. The society considers HIV & AIDS patients as sinners, because of their disease, or their disease made them sinners. This brings us to question about Children and those not involved in immoral activities. The self righteous attitudes of people have led them to think and believe that HIV & AIDS patients are unrighteous. Due to this judgmental attitude of the church and society, HIV & AIDS affected and infected patients are stigmatized and discriminated by the church and society.

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Gisselquist, David, John J. Potterat, Stuart Brody, and Francois Vachon. "Let it be sexual: how health care transmission of AIDS in Africa was ignored." International Journal of STD & AIDS 14, no. 3 (March 1, 2003): 148–61. http://dx.doi.org/10.1258/095646203762869151.

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The consensus among influential AIDS experts that heterosexual transmission accounts for 90% of HIV infections in African adults emerged no later than 1988. We examine evidence available through 1988, including risk measures associating HIV with sexual behaviour, health care, and socioeconomic variables, HIV in children, and risks for HIV in prostitutes and STD patients. Evidence permits the interpretation that health care exposures caused more HIV than sexual transmission. In general population studies, crude risk measures associate more than half of HIV infections in adults with health care exposures. Early studies did not resolve questions about direction of causation (between injections and HIV) and confound (between injections and STD). Preconceptions about African sexuality and a desire to maintain public trust in health care may have encouraged discounting of evidence. We urge renewed, evidence-based, investigations into the proportion of African HIV from non-sexual exposures.

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Meel, B. L. "HIV/AIDS Post-Exposure Prophylaxis (PEP) for Victims of Sexual Assault in South Africa." Medicine, Science and the Law 45, no. 3 (July 2005): 219–24. http://dx.doi.org/10.1258/rsmmsl.45.3.219.

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An earlier study (Meel, 2003) showed that more than 90% of victims of sexual assault in Transkei region, South Africa, were HIV-seronegative at the time of the incident. This was despite the fact that the community had a high prevalence of HIV. In sexual assault cases post-exposure prophylaxis (PEP) is recommended to prevent HIV transmission. Therefore, therapy with zidovudine (AZT) and lamivudine (3TC) is justified. The purpose of this study is to describe the demographic characteristics of the victims, to assess the outcome of HIV transmission and to evaluate the success of PEP after its implementation in Transkei. There were 594 victims of sexual assault during the study period at Sinawe Centre from 2000-2003. Of these, 346 (58.2%) were children under the age of 15 years. Seventeen children (2.9%) were found to be HIV positive at the first test. Among the adults, 58(9.8%) tested HIV positive. Of the 225 who attended after PEP was introduced, only two were found to be HIV seropositive at the time of the incident. A second test was recommended after four weeks and a third after 12 weeks. The majority of the victims did not report for the second test, but all 35 who did come to be tested were seronegative. Seventeen of those were between 11-15 years of age. Only seven victims came for the third test, and they, too, were negative. Nausea and vomiting were the commonest side effects of PEP treatment in four patients and one developed a generalized rash. Only one victim seroconverted.

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Tshamala, Honoré Kalombayi, Loukia Aketi, Pierre Manianga Tshibassu, Mathilde Bothale Ekila, Eric Musalu Mafuta, Patrick Kalambayi Kayembe, Michel Ntetani Aloni, and Joseph Diayisu Shiku. "The Lipodystrophy Syndrome in HIV-Infected Children under Antiretroviral Therapy: A First Report from the Central Africa." International Journal of Pediatrics 2019 (March 3, 2019): 1–6. http://dx.doi.org/10.1155/2019/7013758.

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Background. Despite the high prevalence of the HIV/AIDS, few studies focused on the prevalence of lipodystrophy in pediatric HIV patients on antiretroviral therapy (ARV) in sub-Saharan African countries. The aim of this study was to assess the prevalence and to identify the risk factors of metabolic disorders related to ARV therapy in this population. Methods. A cross-sectional study was completed in Kinshasa, the Democratic Republic of Congo. HIV-infected children aged between six and 18 years on ARV were consecutively recruited. For each case, two control children (one non-HIV infected child and one HIV-infected antiretroviral therapy-naïve child) were also recruited. Results. 80 HIV-infected on ARV therapy children (group 1), 80 noninfected children (group 2) and 65 HIV-infected antiretroviral therapy-naïve children (group 3) were recruited. The frequency of lipoatrophy was not statistically different between group 1 (16.3%) and group 3 (21.5%). A significantly higher proportion of lipohypertrophy, hypercholesterolemia, and lactic acidosis was noted in children of group 1, compared to the controls (p<0.05). Mixed form was rarely observed in this series. The frequency of hypertriglyceridemia was not different between the 3 groups (p>0.05). Conclusion. Lipohypertrophy, hypercholesterolemia, and lactic acidosis emerge as a frequent metabolic disorders due to ARV therapy.

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5

Aliyu, Zakari Y., Sachdev Vandana, Aisha I. Mamman, Aliyu Babadoko, Peter Akpanpe, Ester Attah, Yusuf Suleiman, et al. "Pulmonary Hypertension in Adults and Children with Sickle Cell Disease in Nigeria: Prevalence, Clinical Characteristics and Role of Endemic Tropical Infections." Blood 110, no. 11 (November 16, 2007): 3793. http://dx.doi.org/10.1182/blood.v110.11.3793.3793.

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Abstract Pulmonary hypertension has a prevalence of 30% in patients with sickle cell disease (SCD) in the United States with mortality rates of 40% at 40 months after diagnosis. The global burden of SCD is highest in sub-Saharan Africa where more than 200,000 children are born with the disease annually. The prevalence of pulmonary hypertension among individuals with SCD in Africa has not been previously reported. We performed Doppler echocardiographic assessments of pulmonary-artery systolic pressure in 206 consecutive hydroxyurea sickle cell patients at steady state in Nigeria, West Africa (101 males and 105 females; age range 10–52, mean [+/−SD] age, 21.5 +/− 7.7 years; 196 homozygous sickle cell and 10 compound heterozygotes SC). A control group consisted of 93 healthy Nigerians. Hemoglobin gentotype was determined by electrophoresis and DNA sequencing. Pulmonary hypertension was defined prospectively as a tricuspid regurgitant jet velocity (TRV) of at least 2.5 m per second. We collected clinical data on the patients and controls, and blood specimens for clinical laboratory measurements. Doppler-defined pulmonary hypertension occurred in 25% of sickle cell patients (21% with TRV 2.5 – 2.9 m/sec, 4% with TRV ≥ 3 m/sec). The presence of pulmonary hypertension was inversly associated with age (p=0.04) and hemoglobin (p=0.0016), and positively associated with reticulocyte count, serum levels of lactose dehydrogenase (p=0.03), creatine kinase, and blood urea nitrogen and systolic (p=0.03) and diastolic blood pressure (p=0.002) in bivariate analyses. In a multivariate linear regression model age, diastolic blood pressure and blood urea nitrogen had significant independent associations with pulmonary hypertension. There were no significant associations of HIV/AIDS, hepatitis B and C co infections and malarial parasitemia rate with pulmonary hypertension. Our findings suggest that pulmonary hypertension is common among sickle cell patients in Africa and it appears to be a complication of chronic hemolysis and vasculopathy. The prevalence of pulmonary hypertension decreases with age in Nigerian SCD patients, in sharp contrast to U.S. SCD patients, who demonstrate increasing prevalence with age. The public health implications of this finding are significant considering the potential number of individuals at risk for this complication. Large prospective cohort studies to determine the outcome of pulmonary hypertension in sickle cell patients in Africa are needed.

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Andrew Kiboneka. "The evolving burden of asthma and contemporary advances in management: Implications for clinical practice in Southern Africa." World Journal of Advanced Research and Reviews 8, no. 3 (December 30, 2020): 059–70. http://dx.doi.org/10.30574/wjarr.2020.8.3.0315.

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Asthma is a rising significant global public health burden especially in the developing countries. The annual prevalence of severe asthma episodes is estimated from 1% to 21% for adults and over 20% for children aged 6–7 years. The prevalence of asthma varies widely around the world, ranging from 0.2% to 21.0% in adults and from 2.8% to 37.6% in 6- to 7-year-old children. The International Study of Asthma and Allergies in Children (ISAAC) reports a significant increase in the global prevalence of asthmatic episodes among children. t was estimated that more than 339 million people had Asthma globally in 2016. It is a common disease among children. The common disease asthma is probably not a single disease, but rather a complex of multiple, separate syndromes that overlap. Most asthma-related deaths occur in low- and lower-middle income countries. According to the World Health Organization (WHO) estimates, there were 417,918 deaths due to asthma at the global level and 24.8 million DALYS attributable to Asthma in in 2016. The WHO has estimated that the economic costs associated with asthma have exceeded those of TB and HIV/AIDS combined, and the Global Initiative for Asthma Program forecasted the number of asthma patients to grow globally to greater than 400 million by the year 2025. Since its first description by Hippocrates, asthma remains a treatable yet incurable disease. It is now clear that asthma is a complex syndrome with variable severity, natural history and response to treatment In Namibia a prevalence of Asthma of 11.2 % has been reported in adult populations. The increase in asthmatic episodes, morbidity and mortality among populations in Africa, Latin America and parts of Asia is a rising public health concern. The development of novel asthma phenotyping & endo typing plus better classification of patients using machine learning and big data have markedly improved asthma treatment outcomes in both children and Adults. Several research groups have developed cluster analyses of phenotypes in severe asthma. These clusters support the importance of disease heterogeneity in asthma and suggest differences in pathophysiologic mechanisms that define these clusters. Precision medicine is "an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle for each person.

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7

Dayie, Nicholas TKD, Michael Baffuor-Asare, Appiah-Korang Labi, Noah Obeng-Nkrumah, Edeghonghon Olayemi, Margaret Lartey, Hans-Christian Slotved, and Eric S. Donkor. "Epidemiology of Pneumococcal Carriage among HIV-Infected Individuals in the Conjugate Vaccine Era: A Study in Southern Ghana." BioMed Research International 2019 (February 13, 2019): 1–8. http://dx.doi.org/10.1155/2019/3427174.

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Carriage of pneumococcus is considered as the precursor for development of pneumococcal disease. In sub-Saharan Africa, very little research has been done on the pneumococcus in relation to people with HIV infection in the era of pneumococcal conjugate vaccines. This study investigated pneumococcal carriage among HIV/AIDS patients in southern Ghana to determine the prevalence, risk factors, serotypes and antibiotic resistance of the organism. This was a cross sectional study involving 245 HIV/AIDS patients recruited from Korle Bu Teaching Hospital and Princess Marie Louis Hospital in Accra from November 2016 to March 2017. Epidemiological data on demographic, household and clinical features of the study participants were collected. Nasopharyngeal (NP) swabs were also collected from the study participants and cultured for Streptococcus pneumoniae; the isolates were serotyped by latex agglutination and Quellung reaction. Antimicrobial disc susceptibility was performed on the isolates, and antibiotics tested included tetracycline, erythromycin, cotrimoxazole, levofloxacin, oxacillin and ceftriaxone. Prevalence of pneumococcal carriage among the study participants was 11% (95% CI: 7.4 to 15.6); carriage among children and adults was 25% (95% CI: 14% to 38.9%) and 7.3% (95% CI: 4% to 11.9%) respectively. School attendance (p=0.001) and history of pneumococcal disease in the past year (p=0.001) were significantly associated with pneumococcal carriage. The most prevalent pneumococcal serotypes carried by the study participants were 19A (15.4%) and 23F (15.4%). Serotype coverage of the various pneumococcal vaccines were PCV10 (23.1%), PCV13 (42.3%) and PPV23 (50%). The prevalence of pneumococcal multidrug resistance was 18.5%. In conclusion, pneumococcal carriage among HIV-infected children was three-fold higher compared to carriage among HIV-infected adults. Pneumococcal carriage among both HIV-infected children and adults in the study area tends to be characterized by a predominance of non-vaccine serotypes and a considerable level of multidrug resistance.

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Zotor, F. B., and P. Amuna. "The food multimix concept: new innovative approach to meeting nutritional challenges in Sub-Saharan Africa." Proceedings of the Nutrition Society 67, no. 1 (January 30, 2008): 98–104. http://dx.doi.org/10.1017/s0029665108006071.

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Food insecurity, chronic hunger, starvation and malnutrition continue to affect millions of individuals throughout the developing world, especially Sub-Saharan Africa. Various initiatives by African governments and International Agencies such as the UN, the industrial nations, the International Monetary Fund, the World Bank and the World Trade Organisation to boost economic development, have failed to provide the much-needed solution to these challenges. The impact of these economic shifts and the failures of structural adjustment programmes on the nutritional well-being and health of the most vulnerable members of poor communities cannot be over-emphasised. The use of ad hoc measures as an adjunct to community-based rural integrated projects have provided little success and will be unsustainable unless they are linked to harnessing available local resources. The present paper therefore focuses on exploring alternative ways of harnessing the scant agricultural resources by employing a scientific approach to food-related problem-solving. The food multimix (FMM) concept offers a scientific contribution alongside other attempts currently in use by the World Food Programme, WHO and FAO to meet the food insecurity challenges that confront most of the developing world in the twenty-first century. It is an innovative approach that makes better use of traditional food sources as a tool for meeting community nutritional needs. The FMM concept employs a food-based approach using traditional methods of food preparation and locally-available, cheap and affordable staples (fruits, pulses, vegetables and legumes) in the formulation of nutrient-enriched multimixes. Developed recipes can provide ≥40% of the daily nutritional requirements of vulnerable groups, including patients with HIV/AIDS and children undergoing nutrition rehabilitation. The FMM approach can also be used as a medium- to long-term adjunct to community-based rural integration projects aimed at health improvement and economic empowerment in Sub-Saharan Africa.

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Focà, Emanuele, Silvia Odolini, Nigritella Brianese, and Gianpiero Carosi. "MALARIA AND HIV IN ADULTS: When The Parasite runs into The Virus." Mediterranean Journal of Hematology and Infectious Diseases 4, no. 1 (May 7, 2012): e2012032. http://dx.doi.org/10.4084/mjhid.2012.032.

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Malaria and HIV/AIDS are among the principal causes of morbidity and mortality worldwide, particularly in resource-limited settings such as sub-Saharan Africa. Despite the international community’s efforts to reduce incidence and prevalence of these diseases, they remain a global public health problem. Clinical manifestations of malaria may be more severe in HIV infected patients, which have higher risks of severe malaria and malaria related death. Co-infected pregnant women, children and international travelers from non-malaria endemic countries are at higher risk of clinical complications. However, there is a paucity and conflicting data regarding malaria and HIV co-infection, particularly on how HIV infection can modify the response to antimalarial drugs and about drug-interactions between antiretroviral agents and artemisinin-based combined regimens. Moreover, consulting HIV-infected international travelers and physicians specialized in HIV care and travel medicine should prescribe an adequate chemoprophylaxis in patients travelling towards malaria endemic areas and pay attention on interactions between antiretrovirals and antimalarial prophylaxis drugs in order to prevent clinical complications of this co-infection. This review aims to evaluate the available international literature on malaria and HIV co-infection in adults providing a critical comprehensive review of nowadays knowledge.

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Phiri, Sam, Joe Gumulira, Hannock Tweya, Lameck Chinula, Agnes Moses, Bongani Kaimila, Christopher Stanley, et al. "The Malawi Cancer Consortium – Catalyzing Cancer Care and Research in Southern Africa." Journal of Global Oncology 2, no. 3_suppl (June 2016): 3s—4s. http://dx.doi.org/10.1200/jgo.2016.003780.

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Abstract 68 Background: Cancer burden is increasing in Malawi, particularly for HIV-associated malignancies. Methods: With support from the National Cancer Institute, the Malawi Cancer Consortium (MCC) was initiated in September 2014. Partners include the UNC Lineberger Comprehensive Cancer Center, Malawi Ministry of Health, University of Malawi College of Medicine, and Lighthouse Trust. Spanning Malawi’s two major cities, Lilongwe and Blantyre, MCC includes three support cores (administration, analysis, mentoring) and three multi-institution research projects: (1) a national HIV-cancer match study to assess cancer incidence in the ART era; (2) a longitudinal cohort to identify clinical and molecular correlates of KS chemotherapy response; and (3) a longitudinal cohort to elucidate lymphoma biology and develop better treatments for HIV-associated lymphoma. Results: For project 1, 65,500 records from the Malawi National Cancer Registry and Malawi HIV cohorts have been abstracted, and initial data harmonization completed. Record linkage is planned for February 2016, will be updated at regular intervals, and will contribute to regional analyses through the IeDEA- Southern Africa network. For project 2, KS studies through MCC have led to descriptions of KS biologic subtypes defined by viral gene expression profiling, and detailed characterization of multicentric Castleman disease. Malawi has also led enrollment into multinational phase III KS clinical trials implemented by the AIDS Clinical Trials Group and AIDS Malignancy Consortium. For project 3, more than 300 adults and children with lymphoma have been enrolled since June 2014, with approximately 2/3 of adults being HIV-infected. Patients receive standardized treatment and supportive care, and standardized clinical and laboratory evaluations. Specimen-based correlative studies (virologic, genomic, biomarker studies) are ongoing. Finally, the consortium provides a platform for pilot studies in breast and esophageal cancer, and facilitates career development for Malawian cancer investigators. Conclusions: MCC has initiated a national coalition to address cancer in Malawi, and continued progress is anticipated. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: Sam Phiri No relationship to disclose Joe Gumulira No relationship to disclose Hannock Tweya No relationship to disclose Lameck Chinula No relationship to disclose Agnes Moses No relationship to disclose Bongani Kaimila No relationship to disclose Christopher Stanley No relationship to disclose Edwards Kasonkanji No relationship to disclose Steady Chasimpha No relationship to disclose Richard Nyasosela No relationship to disclose Leo Masamba No relationship to disclose Tamiwe Tomoka No relationship to disclose Steve Kamiza No relationship to disclose Mina Hosseinipour No relationship to disclose Nora Rosenberg Research Funding: NIH/NCI Ron Mataya No relationship to disclose Charles Dzamalala No relationship to disclose George Liomba No relationship to disclose Irving Hoffman No relationship to disclose Dirk Dittmer No relationship to disclose Yuri Fedoriw Honoraria: Alexion Pharmaceuticals Blossom Damania No relationship to disclose Satish Gopal No relationship to disclose

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Amona, Fructueux Modeste, David W. Denning, Donatien Moukassa, Michel Develoux, and Christophe Hennequin. "Histoplasmosis in the Republic of Congo dominated by African histoplasmosis, Histoplasma capsulatum var. duboisii." PLOS Neglected Tropical Diseases 15, no. 5 (May 6, 2021): e0009318. http://dx.doi.org/10.1371/journal.pntd.0009318.

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The Republic of Congo (RoC) is one of the African countries with the most histoplasmosis cases reported. This review summarizes the current status regarding epidemiology, diagnostic tools, and treatment of histoplasmosis in the RoC. A computerized search was performed from online databases Medline, PubMed, HINARI, and Google Scholar to collect literature on histoplasmosis in the RoC. We found 57 cases of histoplasmosis diagnosed between 1954 and 2019, corresponding to an incidence rate of 1–3 cases each year without significant impact of the AIDS epidemic in the country. Of the 57 cases, 54 (94.7%) were cases of Histoplasma capsulatum var. duboisii (Hcd) infection, African histoplasmosis. Three cases (5.3%) of Histoplasma capsulatum var. capsulatum infection were recorded, but all were acquired outside in the RoC. The patients’ ages ranged between 13 months to 60 years. An equal number of cases were observed in adults in the third or fourth decades (n = 14; 24.6%) and in children aged ≤15 years. Skin lesions (46.3%), lymph nodes (37%), and bone lesions (26%) were the most frequent clinical presentations. Most diagnoses were based on histopathology and distinctive large yeast forms seen in tissue. Amphotericin B (AmB) was first line therapy in 65% of the cases and itraconazole (25%) for maintenance therapy. The occurrence of African histoplasmosis in apparently normal children raises the possibility that African histoplasmosis is linked to environmental fungal exposure.

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Dawit, Zinabu, Sintayehu Abebe, Samuel Dessu, Molalegn Mesele, Serekebirhan Sahile, and Desalegn Ajema. "Incidence and predictors of mortality among children co-infected with tuberculosis and human immunodeficiency virus at public hospitals in Southern Ethiopia." PLOS ONE 16, no. 6 (June 30, 2021): e0253449. http://dx.doi.org/10.1371/journal.pone.0253449.

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Background Tuberculosis and human immune deficiency virus co-infections remained the most common cause of child mortality for the last ten years. Globally, 1.2 million cases of tuberculosis occurred in patients living with HIV/AIDS, of which 1.0 million cases occurred in children. The public health impact of tuberculosis and human immune deficiency virus co-infection among children is high in developing countries and Sub-Saharan Africa accompanied three fourth of the global burden. However, there are limited studies that assess the incidence and predictors of mortality among tuberculosis and human immune deficiency virus co-infected children in Ethiopia. Methods A facility-based retrospective cohort study was conducted at Public hospitals in Southern Ethiopia with a total of 286 randomly selected records of ART enrolled children from 1st January 2009 to 31stDecember 2018. Data were entered into Epi Data version 3.1 and exported to STATA version 14 for analysis. Bivariate and multivariable Cox proportional hazards model was fitted to identify the predictors of mortality. Variables that had a p-value<0.05 at 95%CI in the multivariable cox proportional hazard model were considered as statistically significant. Results A total of 274 tuberculosis and human immunodeficiency virus co-infected children’s records were reviewed. The incidence of mortality among tuberculosis and human immunodeficiency virus co-infected children was 17.15 per 100 children. The overall incidence density rate of mortality was 2.97(95%CI: 2.2, 3.9) per 100 child year of observation and being anemic (AHR: 2.6; 95%CI: 1.28, 5.21), not initiating isoniazid prophylaxis therapy (AHR: 2.8; 95%CI: 1.44, 5.48), developing extrapulmonary tuberculosis (AHR: 5.7; 95%CI: 2.67, 12.56) and non-adherence (AHR: 5.2; 95%CI: 2.19, 12.39) were independent predictors of mortality. Conclusion Mortality rate was high among TB/HIV co-infected children at the public hospitals in Southern Ethiopia. Extra-pulmonary tuberculosis, anemia, non-adherence, and isoniazid preventive therapy use were statistically significant predictors of mortality among TB/HIV co-infected children. Therefore, extra pulmonary tuberculosis, and anemia should be closely monitored to increase their adherence as well as they should be provided with isoniazid preventive therapy.

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Sitoe, Sonia Paula Benedito Luis, Bernardete Rafael, Luciana Regina Meireles, Heitor Franco de Andrade Jr., and Ricardo Thompson. "Preliminary report of HIV and Toxoplasma gondii occurrence in pregnant women from Mozambique." Revista do Instituto de Medicina Tropical de São Paulo 52, no. 6 (December 2010): 291–95. http://dx.doi.org/10.1590/s0036-46652010000600002.

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Toxoplasmosis, a protozoan disease, causes severe disease in fetuses during pregnancy and deadly encephalitis in HIV patients. There are several studies on its seroprevalence around the world, but studies focusing on African countries are limited in number and mostly anecdotal. We studied two groups of samples from Mozambique by ELISA, using serum samples from 150 pregnant women and six Cerebrospinal fluid (CSF) samples from AIDS patients with encephalitis. HIV status was confirmed, and CD4 blood counts were obtained from HIV-positive pregnant women. IgG seroprevalence of the group as a whole was 18.7% (28/150), with a higher prevalence in HIV-positive individuals compared to those who were HIV-negative (31.3%, [18/58] vs. 10.9%, [10/92]) patients. These data may be biased due to cumulative effects of exposition affecting disease prevalence. If corrected, this data may indicate an interaction of HIV and T. gondii. Prevalence of both diseases increases with age, but this is more clearly seen for toxoplasmosis (p < 0.005) than HIV infection, possibly explained by higher transmission of HIV after childhood. In HIV patients suffering from encephalitis, CSF serology showed that 33% of specific IgG CSF had a high avidity, which was in accordance with the data from the group of pregnant women. Lower prevalence rates of both infections in older groups could be explained by more deaths in the infected groups, resulting in an artificially lower prevalence. Using CD4 counts as a marker of time of HIV infection, and correcting for age, patients with contact with T. gondii had fewer CD4 cells, suggesting prolonged HIV disease or other causes. Toxoplasma IgG prevalence is higher in HIV+ groups, which could be ascribed to HIV- and T. gondii-associated risk factors, such as exposure to higher and more diverse social contacts. The low incidence of Toxoplasma IgG in younger age groups shows that transmission could be related to better access to cyst-containing meat in adulthood, as environmental transmission due to oocysts is usually blamed for higher incidence in children. Taken together, these data support the urgent need of research in toxoplasmosis in Africa, especially in the presence of HIV epidemics.

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Nhampossa, Tacilta, Betuel Sigaúque, Sónia Machevo, Eusebio Macete, Pedro Alonso, Quique Bassat, Clara Menéndez, and Victoria Fumadó. "Severe malnutrition among children under the age of 5 years admitted to a rural district hospital in southern Mozambique." Public Health Nutrition 16, no. 9 (May 2, 2013): 1565–74. http://dx.doi.org/10.1017/s1368980013001080.

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AbstractObjectiveTo describe the burden, clinical characteristics and prognostic factors of severe malnutrition in children under the age of 5 years.DesignRetrospective study of hospital-based data systematically collected from January 2001 to December 2010.SettingRural Mozambican district hospital.SubjectsAll children aged <5 years admitted with severe malnutrition.ResultsDuring the 10-year long study surveillance, 274 813 children belonging to Manhiça's Demographic Surveillance System were seen at out-patient clinics, almost half of whom (47 %) presented with some indication of malnutrition and 6 % (17 188/274 813) with severe malnutrition. Of these, only 15 % (2522/17 188) were eventually admitted. Case fatality rate of severe malnutrition was 7 % (162/2274). Bacteraemia, hypoglycaemia, oral candidiasis, prostration, oedema, pallor and acute diarrhoea were independently associated with an increased risk of in-hospital mortality, while malaria parasitaemia and breast-feeding were independently associated with a lower risk of a poor outcome. Overall minimum community-based incidence rate was 15 cases per 1000 child-years at risk and children aged 12–23 months had the highest incidence.ConclusionsSevere malnutrition among admitted children in this Mozambican setting was common but frequently went undetected, despite being associated with a high risk of death. Measures to improve its recognition by clinicians responsible for the first evaluation of patients at the out-patient level are urgently needed so as to improve their likelihood of survival. Together with this, the rapid management of complications such as hypoglycaemia and concomitant co-infections such as bacteraemia, acute diarrhoea, oral candidiasis and HIV/AIDS may contribute to reverse the intolerable toll that malnutrition poses in the health of children in rural African settings.

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Aldosari, Mohammed, Sharon Conroy, and Ana Oliveira. "P008 Measuring medicines adherence in children: a systematic review." Archives of Disease in Childhood 104, no. 7 (June 19, 2019): e2.10-e2. http://dx.doi.org/10.1136/archdischild-2019-nppc.18.

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Aim30–70% of children prescribed long-term medicines have poor adherence.1 Knowing the degree of adherence is important to understand the consequences of nonadherence and to develop strategies to improve medication adherence in children. We therefore performed a systematic review to identify measures of medication adherence used in children and the strengths and weaknesses of those measures.MethodsA systematic literature search was performed using PubMed, EMBASE, Medline, CINAHL, IPA and Cochrane library databases covering the period March 2008 to March 2018 in order to focus on the methods recently used to assess adherence. Inclusion criteria were original research studies measuring medication adherence in children (aged 0–18 years) and included all countries and languages. To be included, the assessment tool used to measure adherence in each study needed to be described in detail. Exclusion criteria included: review articles, editorials, conference papers, reports, and studies reporting only adherence outcomes/rates without reporting measurement methods. As a reliability measure, 5% of titles and abstracts were assessed independently by a second researcher.ResultsOf 9,747 papers identified by the search, only 31 articles met the inclusion criteria. Most studies were conducted in the US (14) with four in South Africa, three in Kenya and the remaining ten studies in various countries including one in the UK. Diseases studied included: HIV/AIDS (13), asthma (5), inflammatory bowel disease (3), epilepsy (2), type 1 diabetes (2), others (6). In the commonest disease studied, HIV, self-report, Medication Event Monitoring Systems (MEMS), dose counting, pharmacy refill data and medication plasma levels were used to assess adherence. In patients with diabetes, mobile phone, medication plasma levels and self-report were used. Canister weight and MEMS were used to assess adherence in patients with asthma. Self- reporting was the most commonly used method to assess adherence and was reported to be flexible, inexpensive, and time saving but it was the least accurate and overestimated adherence rates. MEMS was the most accurate method but was also the most expensive. Dose counting was easy to use and inexpensive but adherence was also overestimated with this method. Measuring medication plasma levels was more precise than self-reporting and dose counting but was costly, time consuming and difficult to perform. Pharmacy refill data was more accurate than self-reporting and less accurate than MEMS and medication plasma levels. Mobile phone methods were reported to be very expensive and difficult to perform. Canister weight had the same efficacy as using MEMS and was less expensive, but was only applicable to inhalation devices. ConclusionCurrently, no gold standard method to measure adherence to medicines in children exists as each method has its own advantages and disadvantages. Overall, the MEMS method was the most accurate but most expensive, while self-reporting was the least accurate but least costly.None of these measures were reported to be highly accurate in the assessment of adherence, so it is important to use a combination of multiple measures in order to gain a true picture of adherence.ReferenceChappell F. Medication adherence in children remains a challenge. Prescriber 2015;26(12):31–4.

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Decosas, Josef. "Children and AIDS in Africa." Lancet 356 (December 2000): S33. http://dx.doi.org/10.1016/s0140-6736(00)92019-1.

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Menon, K., C. Bem, D. Gouldesbrough, and D. R. Strachan. "A clinical review of 128 cases of head and neck tuberculosis presenting over a 10-year period in Bradford, UK." Journal of Laryngology & Otology 121, no. 4 (August 21, 2006): 362–68. http://dx.doi.org/10.1017/s0022215106002507.

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Aims: To analyse the epidemiology, presentation and diagnosis of head and neck tuberculosis (TB).Methods: We conducted a 10-year retrospective study of all cases of tuberculosis of the head and neck region occurring in Bradford, UK.Results: Of a total of 1315 cases of TB, 128 presented with head and neck TB (12 per cent of which (15/128) were in children). Cervical lymph nodes were most commonly involved (87 per cent, 111/128), other sites being: salivary glands (five cases); larynx, oral cavity, eyes and ears (two cases each); and skin, thyroid, nasopharynx and retropharyngeal space (one case each). Patients' ethnic origins were Asian (89 per cent, 114/128), Caucasian (10 per cent, 13/128) and African (one case). Only 26 per cent (33/128) had constitutional symptoms, and 20 per cent (25/128) had a coexistent site of TB. Only 39 per cent (40/105) of surgical specimens were sent for culture.Conclusions: Isolated head and neck TB is not uncommon. Atypical presentations render diagnosis challenging, so awareness aids early diagnosis. Mycobacterial cultures should be performed, where possible, for diagnosis.

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&NA;. "Janssen aids patients with AIDS in Africa." Inpharma Weekly &NA;, no. 917 (December 1993): 22. http://dx.doi.org/10.2165/00128413-199309170-00064.

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Kilbride, Philip Leroy. "The Children of Africa Confront AIDS (review)." Africa Today 51, no. 3 (2005): 144–46. http://dx.doi.org/10.1353/at.2005.0024.

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Janse van Rensburg, Bernard. "The South African Society of Psychiatrists (SASOP) and SASOP State Employed Special Interest Group (SESIG) position statements on psychiatric care in the public sector." South African Journal of Psychiatry 18, no. 3 (August 1, 2012): 16. http://dx.doi.org/10.4102/sajpsychiatry.v18i3.374.

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<p><strong>Executive summary.</strong> National mental health policy: SASOP extends its support for the process of formalising a national mental health policy as well as for the principles and content of the current draft policy.</p><p><strong> Psychiatry and mental health:</strong> psychiatrists should play a central role, along with the other mental health disciplines, in the strategic and operational planning of mental health services at local, provincial and national level.</p><p><strong>Infrastructure and human resources:</strong> it is essential that the state takes up its responsibility to provide adequate structures, systems and funds for the specified services and facilities on national, provincial and facility level, as a matter of urgency.</p><p><strong>Standard treatment guidelines (STGs) and essential drug lists (EDLs)</strong>: close collaboration and co-ordination should occur between the processes of establishing SASOP and national treatment guidelines, as well as the related decisions on EDLs for different levels.</p><p><strong>HIV/AIDS in children:</strong> national HIV programmes have to promote awareness of the neurocognitive problems and psychiatric morbidity associated with HIV in children.</p><p><strong>HIV/AIDS in adults:</strong> the need for routine screening of all HIV-positive individuals for mental health and cognitive impairments should also be emphasised as many adult patients have a mental illness, either before or as a consequence of HIV infection, constituting a ‘special needs’ group.</p><p><strong> Substance abuse and addiction:</strong> the adequate diagnosis and management of related substance abuse and addiction problems should fall within the domain of the health sector and, in particular, that of mental health and psychiatry.</p><p><strong>Community psychiatry and referral levels:</strong> the rendering of ambulatory specialist psychiatric services on a community-centred basis should be regarded as a key strategy to make these services more accessible to users closer to where they live.</p><p><strong>Recovery and re-integration:</strong> a recovery framework such that personal recovery outcomes, among others, become the universal goals by which we measure service provision, should be adopted as soon as possible.</p><p><strong> Culture, mental health and psychiatry:</strong> culture, religion and spirituality should be considered in the current approach to the local practice and training of specialist psychiatry, within the professional and ethical scope of the discipline.</p><p><strong> Forensic psychiatry:</strong> an important and significant field within the scope of state-employed psychiatrists, with 3 recognised groups of patients (persons referred for forensic psychiatric observation, state patients, and mentally ill prisoners), each with specific needs, problems and possible solutions.</p><p><strong> Security in psychiatric hospitals and units:</strong> it is necessary to protect public sector mental healthcare practitioners from assault and injury as a result of performing their clinical duties by, among others, ensuring that adequate security procedures are implemented, appropriate for the level of care required, and that appointed security staff members are appropriately trained and equipped.</p>

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Loening-Voysey, H. "HIV/AIDS in South Africa: caring for vulnerable children." African Journal of AIDS Research 1, no. 2 (January 2002): 103–10. http://dx.doi.org/10.2989/16085906.2002.9626550.

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Ryscavage, Patrick, William Still, Vimbai Nyemba, and Kristen Stafford. "Prevalence of Systemic Hypertension Among HIV-Infected and HIV-Uninfected Young Adults." Open Forum Infectious Diseases 4, suppl_1 (2017): S59. http://dx.doi.org/10.1093/ofid/ofx162.138.

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Abstract Background Advances in HIV care and treatment have resulted in perinatally infected children aging into adulthood. These patients may be at higher risk of HIV-associated non-AIDS conditions, including systemic hypertension (HTN). This study examined the association between HIV infection and the prevalence of HTN among young adults receiving care in West Baltimore. Methods We conducted a cross-sectional study of young adults with perinatally-acquired (PA) HIV frequency matched on race and sex to a stratified random sample of young adults with non perinatally-acquired (NPA) HIV and HIV-uninfected young adults (UI). All subjects were aged 18–29 years of age as of September 1, 2014. The outcome of HTN was ascertained through chart review (two systolic blood pressure measurements > = 140 mmHg or diastolic > = 90 mmHg at least three months apart; and/or physician prescription for an antihypertensive mediation). Logistic regression was used to estimate adjusted prevalence odds ratios (aPOR) and 95% confidence intervals (CI) for the association between HIV infection and HTN. All data were collected from clinics within the University of Maryland Medical System. Results Three hundred and twenty-four patients were included in the study, 108 per exposure group. The prevalence of HTN was 23% among PA patients, 10% among NPA patients, and 9% among UI patients. The median age was 24 (IQR 22 - 26), 95% were African American, and 42% were male. PA patients had the highest prevalence of chronic kidney disease (CKD) and dyslipidemia (19% and 13% respectively) compared with NPA (1% and 3%) and UI (0% and 5%). PA patients had 3 (95% CI 1.4 - 6.6) times the base odds (controlling for matching variables) of prevalent HTN compared with UI patients and NPA had 1.1 times the base odds (95% CI 0.5 - 2.7) compared with UI patients. After controlling for race, gender, family history of HTN, and CKD, the prevalence odds ratio for HTN was 2.7 (95% CI 1.06 - 7.0) times higher for PA compared with UI, and 1.3 (95% CI 0.5 - 3.4) times higher for NPA compared with UI. Conclusion Our findings suggest that the prevalence of HTN among young adults with PA HIV is significantly higher than sex and race matched UI patients of similar age. HIV providers should carefully monitor these patients for the development of HTN, particularly as they enter adulthood. Disclosures All authors: No reported disclosures.

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Cluver, Lucie, Frances Gardner, and Don Operario. "Psychological distress amongst AIDS-orphaned children in urban South Africa." Journal of Child Psychology and Psychiatry 48, no. 8 (August 2007): 755–63. http://dx.doi.org/10.1111/j.1469-7610.2007.01757.x.

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Mbugua, N. "The Children of Africa Confront AIDS: From Vulnerability to Possibility." Comparative Studies of South Asia, Africa and the Middle East 25, no. 2 (January 1, 2005): 511–12. http://dx.doi.org/10.1215/1089201x-25-2-511.

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Okaalet, Peter. "Some Religious Responses to HIV/AIDS and Children in Africa." Religion and Theology 14, no. 1 (June 1, 2007): 94–104. http://dx.doi.org/10.1163/157430107x210081.

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26

Breckenridge, Tiffany Ann, Christine Black-Hughes, John Rautenbach, and Michelle McKinley. "HIV/AIDS orphans in South Africa: NGO interventions supporting transitions to alternative care." International Social Work 62, no. 2 (September 21, 2017): 502–17. http://dx.doi.org/10.1177/0020872817732377.

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By 2015, an estimated 2.3–4.8 million children will be orphaned due to AIDS-related illness. Limited information is available on the emotional and behavioral problems that AIDS-orphaned children experience. This qualitative study explores 49 orphaned children who were observed in a non-governmental organization group setting in a small, rural village located in Eastern Cape, South Africa. Of the children in this study, 20 were orphaned due to AIDS. However, 19 children were orphaned due to parental death with an undeclared cause, but the deaths are believed to have resulted from AIDS.

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Sidley, P. "South Africa considers supplying antiretroviral drugs to AIDS patients." BMJ 325, no. 7370 (October 26, 2002): 923a—923. http://dx.doi.org/10.1136/bmj.325.7370.923/a.

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28

Gilborn, L. Z. "The effects of HIV infection and AIDS on children in Africa." Western Journal of Medicine 176, no. 1 (January 1, 2002): 12–14. http://dx.doi.org/10.1136/ewjm.176.1.12.

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Cluver, Lucie D., Mark Orkin, Frances Gardner, and Mark E. Boyes. "Persisting mental health problems among AIDS-orphaned children in South Africa." Journal of Child Psychology and Psychiatry 53, no. 4 (August 30, 2011): 363–70. http://dx.doi.org/10.1111/j.1469-7610.2011.02459.x.

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Young, L., and N. Ansell. "Young AIDS migrants in Southern Africa: policy implications for empowering children." AIDS Care 15, no. 3 (June 2003): 337–45. http://dx.doi.org/10.1080/0954012031000105397.

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31

Sarumi, Rofiah O., and Ann E. Strode. "Using International Law to Protect Children Affected by HIV/AIDS in South Africa – An Audit of HIV/AIDS-Specific International Standards Relevant to Children Affected by HIV/AIDS." African Journal of International and Comparative Law 25, no. 1 (February 2017): 114–26. http://dx.doi.org/10.3366/ajicl.2017.0184.

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The protection of children as members of a vulnerable group in the society is important as they represent the future of the society. With the grave impact of the HIV/AIDS epidemic on global development and stability, the United Nations (UN) has, on several occasions acknowledged the need for member states to take a more progressive role in laying down standards which would ensure that the rights of children living with HIV/AIDS are protected. South Africa as a member of the UN has acknowledged the important role which international law plays in the protection of children generally, and those affected by HIV/AIDS specifically. It is the duty of UN member states to ensure that the standards set out in international instruments are applied in their national legislation and policies. South Africa has ratified a number of the international instruments applicable to the protection of children affected by HIV/AIDS. It is therefore required to adjust its national laws to conform to the standards set out in these instruments. This paper looks at the extent to which international law is applicable to addressing the human rights issues facing children affected by HIV/AIDS. It also suggests ways by which the instruments can be employed for the protection of children affected by HIV/AIDS.

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Colebunders, Robert, Koen Van Den Abbeele, Esther Hauben, Tom Verstraeten, Tom Heremans, Jozef Van Den Ende, and Eric Van Marck. "Histoplasma Capsulatum Infection in Three AIDS Patients Living in Africa." Scandinavian Journal of Infectious Diseases 27, no. 1 (January 1995): 89–91. http://dx.doi.org/10.3109/00365549509018983.

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Lynas, Kathie. "BCPhA recognizes exceptional contribution to HIV/AIDS patients in Africa." Canadian Pharmacists Journal 140, no. 4 (July 2007): 227. http://dx.doi.org/10.3821/1913-701x(2007)140[227a:brecta]2.0.co;2.

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Yuh, Joyceline Ntoh, Karen Ellwanger, Lydia Potts, and Joseph Ssenyonga. "Stigma among HIV/AIDS Patients in Africa: A critical Review." Procedia - Social and Behavioral Sciences 140 (August 2014): 581–85. http://dx.doi.org/10.1016/j.sbspro.2014.04.474.

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Karstaedt, A. S., and S. Grannum. "Pneumocystis carinii pneumonia in patients with AIDS in South Africa." Transactions of the Royal Society of Tropical Medicine and Hygiene 95, no. 1 (January 2001): 40–41. http://dx.doi.org/10.1016/s0035-9203(01)90327-x.

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McLeod, D. T., P. Neill, L. Gwanzura, A. S. Latif, J. C. Emmanuel, N. Nkanza, and S. B. Lucas. "Pneumocystis carinii pneumonia in patients with AIDS in Central Africa." Respiratory Medicine 84, no. 3 (May 1990): 225–28. http://dx.doi.org/10.1016/s0954-6111(08)80039-x.

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Mills, Edward J., and Christine Nabiryo. "Preventing Antiretroviral Treatment Interruptions among HIV/AIDS Patients in Africa." PLoS Medicine 10, no. 1 (January 8, 2013): e1001370. http://dx.doi.org/10.1371/journal.pmed.1001370.

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Ekeng, Bassey E., Kevin Edem, Ikechukwu Amamilo, Zachary Panos, David W. Denning, and Rita O. Oladele. "Histoplasmosis in Children; HIV/AIDS Not a Major Driver." Journal of Fungi 7, no. 7 (June 30, 2021): 530. http://dx.doi.org/10.3390/jof7070530.

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The classification of histoplasmosis as an AIDS-defining illness has largely attributed its occurrence in people to the presence of HIV/AIDS especially in Africa. Prior to the advent of the HIV/AIDS epidemic, many cases of histoplasmosis were documented both in the pediatric and adult population. Our review revealed 1461 reported cases of pediatric histoplasmosis globally in the last eight decades (1939–2021). North America (n = 1231) had the highest number of cases, followed by South America (n = 135), Africa (n = 65), Asia (n = 26) and Europe (n = 4). Histoplasmosis was much more common in the non-HIV pediatric population (n = 1418, 97.1%) compared to the HIV population. The non-HIV factors implicated were, childhood malignancies (n = 207), such as leukemias and lymphomas as well as their treatment, lung diseases (n = 7), environmental exposures and toxins (n = 224), autoimmune diseases (n = 12), organ transplants (n = 12), long-term steroid therapy (n = 3), the use of immunosuppressive drugs such as TNF-alpha inhibitors (n = 7) malnutrition (n = 12), histiocytosis (n = 3), hyperimmunoglobulin M and E syndromes (n = 15, 1.2%), pancytopaenias (n = 26), diabetes mellitus (n = 1) and T-cell deficiency (n = 21). Paediatricians should always consider or rule out a diagnosis of histoplasmosis in children presenting with symptoms suggestive of the above clinical conditions.

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Cluver, Lucie, Mark Boyes, Mark Orkin, and Lorraine Sherr. "Poverty, AIDS and child health: Identifying highest-risk children in South Africa." South African Medical Journal 103, no. 12 (October 11, 2013): 910. http://dx.doi.org/10.7196/samj.7045.

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Strand, Per, Mary Kinney, and Robert Mattes. "Politics and Policy Outcomes on Children Affected by HIV/AIDS in Africa." IDS Bulletin 39, no. 5 (January 26, 2009): 80–87. http://dx.doi.org/10.1111/j.1759-5436.2008.tb00498.x.

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Ansell, Nicola. "Book Review: The children of Africa confront AIDS: from vulnerability to possibility." Progress in Development Studies 5, no. 2 (April 2005): 166–68. http://dx.doi.org/10.1177/146499340500500216.

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Asanbe, Comfort, Anne-Gloria Moleko, Maretha Visser, Angela Thomas, Catherine Makwakwa, Waleska Salgado, and Alexandra Tesnakis. "Parental HIV/AIDS and psychological health of younger children in South Africa." Journal of Child & Adolescent Mental Health 28, no. 2 (July 29, 2016): 175–85. http://dx.doi.org/10.2989/17280583.2016.1216853.

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Kuo, Caroline, Jane Fitzgerald, Don Operario, and Marisa Casale. "SOCIAL SUPPORT DISPARITIES FOR CAREGIVERS OF AIDS-ORPHANED CHILDREN IN SOUTH AFRICA." Journal of Community Psychology 40, no. 6 (July 12, 2012): 631–44. http://dx.doi.org/10.1002/jcop.20521.

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Ford, Kathleen, and Victoria Hosegood. "AIDS Mortality and the Mobility of Children in KwaZulu Natal, South Africa." Demography 42, no. 4 (2005): 757–68. http://dx.doi.org/10.1353/dem.2005.0029.

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Maynard-Tucker, Gisele. "Insecurities Confronting HIV/AIDS Programs in Africa." Practicing Anthropology 30, no. 4 (September 1, 2008): 21–25. http://dx.doi.org/10.17730/praa.30.4.yg1661n621q85715.

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This paper examines the insecurities facing the delivery of HIV/AIDS programs in Nigeria, Guinea and Haiti. These countries depend on international aid and private foundations to fund HIV/AIDS prevention and treatment programs, but funding is limited. Foreign companies exploit local resources and both economic mismanagement and corruption contribute to rising poverty. In addition, there is a highly unequal distribution of wealth in these countries, with more than 70 percent of the population living below the poverty line of $1 a day. Because of the burdens of corruption, lack of commitment and lack of resources, these governments cannot provide and sustain their own HIV/AIDS programs without international aid. Many patients not enrolled in a donor's program cannot afford to pay for treatment, laboratory tests and the cost of opportunistic sicknesses. This paper suggests new strategies that encourage peer-education prevention, consolidation of the health systems and HIV/AIDS programs and sustainable funding through an HIV/AIDS tax imposed on foreign companies.

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Cluver, Lucie, Frances Gardner, and Don Operario. "Poverty and psychological health among AIDS-orphaned children in Cape Town, South Africa." AIDS Care 21, no. 6 (June 2009): 732–41. http://dx.doi.org/10.1080/09540120802511885.

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Mkumbo, Kitila A. K. "Old enough to know: consulting children about sex and AIDS education in Africa." Sex Education 13, no. 4 (July 2013): 478–80. http://dx.doi.org/10.1080/14681811.2012.761897.

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Valleroy, Linda A., Jeffrey R. Harris, and Peter O. Way. "The consequences of HIV/AIDS in Eastern Africa on mothers, children, and orphans." Population and Environment 14, no. 3 (January 1993): 301–5. http://dx.doi.org/10.1007/bf01254377.

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Moosa, M. Y. H., and F. Y. Jeenah. "Treating depression in HIV/AIDS." South African Journal of Psychiatry 13, no. 3 (August 1, 2007): 3. http://dx.doi.org/10.4102/sajpsychiatry.v13i3.20.

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The prevalence of HIV/AIDS has reached alarming proportions in South Africa. Although it is strongly associated with depressive moods, there are very few published studies on its treatment in patients with HIV/AIDS. This article reviews the prevalence, treatment and potential effects of depressive disorders on immunity and adherence to antiretroviral therapy (ART).The studied prevalence of depressive disorders in HIV-positive patients varies widely, ranging from 0% to 47.8%. However, these patients have nearly twice the likelihood of having had a recent episode of major depressive disorder compared with HIV-negative individuals.<p>Currently available antidepressant medications are equally effective in treating HIV/AIDS patients and the general population. Furthermore, intervention studies have shown that psychotherapy reduces depressive symptoms and is well tolerated. Interpersonal psychotherapy is more successful than supportive psychotherapy in lessening depression, and patients experience improved functioning physically and emotionally.</p><p>Untreated depression may be associated with reduced adherence to ART, immunosuppression, and more rapid HIV illness progression. In South Africa, HIV/AIDS patients may be at greater risk for psychiatric disorder given the potentially stressful living conditions including high rates of unemployment and poverty, poor and unstable housing, inadequate social services, and high rates of crime and domestic violence. A lack of data on depression in South Africa underscores the need for further research.</p>

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Mason, John B., Adam Bailes, Karen E. Mason, Olivia Yambi, Urban Jonsson, Claudia Hudspeth, Peter Hailey, Andrea Kendle, Dominique Brunet, and Pierre Martel. "AIDS, drought, and child malnutrition in southern Africa." Public Health Nutrition 8, no. 6 (September 2005): 551–63. http://dx.doi.org/10.1079/phn2005726.

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AbstractObjectiveTo investigate trends in child malnutrition in six countries in southern Africa, in relation to the HIV epidemic and drought in crop years 2001/2 and 2002/3.DesignEpidemiological analysis of sub-national and national surveys with related data.SettingData from Lesotho, Malawi, Mozambique, Swaziland, Zambia and Zimbabwe, compiled and analysed under UNICEF auspices.SubjectsSecondary data: children 0–5 years for weight-for-age; HIV prevalence data from various sources especially antenatal clinic surveillance.ResultsChild nutritional status as measured by prevalence of underweight deteriorated from 2001 onwards in all countries except Lesotho, with very substantial increases in some provinces/districts (e.g. from 5 to 20% in Maputo (Mozambique, 1997–2002), 17 to 32% in Copperbelt (Zambia, 1999–2001/2) and 11 to 26% in Midlands province (Zimbabwe, 1999–2002)). Greater deterioration in underweight occurred in better-off areas. Areas with higher HIV/AIDS prevalences had (so far) lower malnutrition rates (and infant mortality rates), presumably because more modern areas – with greater reliance on trade and wage employment – have more HIV/AIDS. Areas with higher HIV/AIDS showed more deterioration in child nutrition. A significant area-level interaction was found of HIV/AIDS with the drought period, associated with particularly rapid deterioration in nutritional status.ConclusionsFirst, the most vulnerable may be households in more modern areas, nearer towns, to whom resources need to be directed. Second, the causes of this vulnerability need to be investigated. Third, HIV/AIDS amplifies the effect of drought on nutrition, so rapid and effective response will be crucial if drought strikes again. Fourth, expanded nutritional surveillance is now needed to monitor and respond to deteriorating trends. Finally, with or without drought, new means are needed of bringing help, comfort and assistance to the child population.

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