Prevalence of prenatal depression and associated factors among HIV-positive women in primary care in Mpumalanga province, South Africa.
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ABSTRACT:
SUBMITTER: Peltzer K
PROVIDER: S-EPMC4955403 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:South African protected areas account for 8% of the total landmass according to World Bank indicators. Effective conservation of biodiversity in protected areas requires the development of specific reserve management objectives addressing species and disease management. The primary objective of the current study was to identify predictors of carnivore detection in an effort to inform carnivore species management plans on Andover and Manyeleti nature reserves in South Africa. A limited number of camera traps were placed randomly using a grid system. Species detection data were analysed using mixed-effects logistic regression and Spearman's correlation coefficients. Deterministic inverse distance weighted distribution maps were used to describe the spatial distribution of carnivore species. Camera traps identified similar species as traditional call-up surveys during the study and would be useful as an adjunct census method. Carnivore detection was associated with several variables, including the presence of specific prey species. The measured intra-and interspecies interactions suggested the risk of disease transmission among species, and vaccination for prevalent diseases should be considered to manage this risk.
| S-EPMC8466448 | biostudies-literature
Project description:BACKGROUND:We evaluate the impact a multicomponent, behavioural, prevention of mother to child transmission (PMTCT), cluster randomised controlled trial on HIV stigma reduction among perinatal HIV infected women in rural South Africa. METHODS:In a cluster randomised controlled trial, twelve community health centres (CHCs) in Mpumalanga Province, South Africa, were randomised; pregnant women living with HIV enrolled received either: A Standard Care (SC) condition plus time-equivalent attention-control on disease prevention (SC; 6 CHCs; n =357), or an Enhanced Intervention (EI) condition of SC PMTCT plus the 'Protect Your Family' intervention (EI; 6 CHCs; n =342). HIV-infected pregnant women in the SC attended four antenatal and two postnatal video sessions; those in the EI, four antenatal and two postnatal group PMTCT sessions, including stigma reduction, led by trained lay health workers. Maternal PMTCT, HIV knowledge and HIV related stigma were assessed. The impact of the EI was ascertained on stigma reduction (baseline, 12 months postnatally). A series of logistic regression and latent growth curve models were developed to test the impact of the intervention. RESULTS:In all, 699 women living with HIV were recruited during pregnancy (8-24 weeks), and assessments were completed prenatally at baseline and at 12 months (59.5%) postnatally. Baseline scores of overall HIV related stigma and the four scale factors (personalised stigma, disclosure concerns, negative self-image, and concern public attitudes) decreased at follow-up in the intervention group, while baseline scores of overall stigma and three scale factors (personalised stigma, negative self-image, and concern public attitudes) increased at follow-up in the control group. Using longitudinal analyses, Model 1, which included time-invariant predictors of stigma assessed over the two time periods of baseline and 12 months, increases in stigma from baseline to 12 months were associated with being unemployed, having been diagnosed with HIV before the current pregnancy, and alcohol use. In Model 2, which included time-varying predictors, lower stigma scores were associated with participation in the intervention, greater male partner involvement, and consistent condom use. CONCLUSION:The enhanced PMTCT intervention, including stigma reduction, administered by trained lay health workers had a significant effect on the reduction of HIV related stigma. TRIAL REGISTRATION:clinicaltrials.gov: number NCT02085356.
| S-EPMC6116698 | biostudies-literature
Project description:This study aimed to assess the longitudinal prevalence of prenatal and postnatal depression and associated factors among HIV-infected women in rural South Africa. In a longitudinal, cluster-randomized, prevention of mother to child transmission (PMTCT) intervention trial, 681 HIV-infected prenatal women in 12 community health centres in Mpumalanga province, South Africa, were recruited in 2015 by consecutive sampling at 8-24 weeks pregnancy and followed up at 32 weeks prenatally, and 6 and 12 months postpartum (retention rate = 59.2%). Results indicate that at baseline, 48.7% of the women screened positive for depression (scores of ≥13 on the "Edinburgh Postnatal Depression Scale 10"), while postnatally (at 12 months) the prevalence was 35.6%. Mothers who did not have depression before or after were 205 (50.1%), those who had depression before and after were 58 (14.4%), those who had depression only before were 81 (20.1%), and those who had depression only after were 59 (14.6%). In multinominal logistic regression analyses, less education and physical and psychological intimate partner violence were associated with sustained perinatal depression. Participation in the PMTCT intervention was associated with remitting depression while alcohol use was associated with the onset of postnatal depression. Using generalized linear mixed models in longitudinal analyses, psychological partner violence, lack of male involvement during pregnancy and non-adherence to antiretroviral treatment were associated with depression. In conclusion, a high pre- and postnatal prevalence of depression was found highlighting the utility of interventions to address prevention and treatment of perinatal depression.
| S-EPMC6150830 | biostudies-literature
Project description:BackgroundSouth Africa has a generalized and explosive HIV/AIDS epidemic with the largest number of people infected with HIV-1 in the world. Molecular investigations of HIV-1 diversity can help enhance interventions to contain and combat the HIV/AIDS epidemic. However, many studies of HIV-1 diversity in South Africa tend to be limited to the major metropolitan centers and their surrounding provinces. Hardly any studies of HIV diversity have been undertaken in Mpumalanga Province, and this study sought to investigate the HIV-1 diversity in this province, as well as establish the occurrence and extent of transmitted antiretroviral drug resistance mutations.MethodsHIV-1 gag p24, pol p10 and p66/p51, pol p31 and env gp41 gene fragments from 43 participants were amplified and sequenced. Quality control on the sequences was carried out using the LANL QC online tool. HIV-1 subtype was preliminary assigned using the REGA 3.0 and jpHMM online tools. Subtype for the pol gene fragment was further designated using the SCUEAL online tool. Phylogenetic analysis was inferred using the Maximum Likelihood methods in MEGA version 6. HIV-1 antiretroviral drug resistance mutations were determined using the Stanford database.ResultsPhylogenetic analysis using Maximum Likelihood methods indicated that all sequences in the study clustered with HIV-1 subtype C. The exception was one putative subtype BC unique recombinant form. Antiretroviral drug resistance mutations K103N and E138A were also detected, indicating possible transmission of anti-retroviral drug resistance mutations.ConclusionsThe phylogenetic analysis of the HIV sequences revealed that, by 2009, patients in the Bushbuckridge, Mpumalanga were predominantly infected with HIV-1 subtype C. However, the generalized, explosive nature of the HIV/AIDS epidemic in South Africa, in the context of extensive mobility by South Africans who inhabit rural areas, renders the continued molecular monitoring and surveillance of the epidemic imperative.
| S-EPMC4340098 | biostudies-literature
Project description:BackgroundPests and diseases are a major contributor to yield losses in sub-Saharan Africa, prompting smallholder farmers to seek cost-effective, accessible and ecologically friendly alternatives for crop protection. This study explored the management of pests and diseases affecting crops across eight selected villages in Ehlanzeni District, Mpumalanga Province, South Africa.MethodsA total of 120 smallholder farmers were purposefully selected utilising the snowball technique. Information on the management of plant pests and diseases was collected through interviews and focus group discussions using semi-structured interview schedules. Ethnobotanical indices, including relative frequency of citation (RFC), use-value (UV) and informant consensus factor (Fic), were used to quantify and rank the plants used for crop protection in the study area.ResultsTwenty-three plant species (16 naturalised exotics and seven indigenous plants) belonging to 16 families were used for managing pests (vertebrates and invertebrates) and diseases (fungal and bacterial related) affecting crops in the study area. The dominant (100%) crops cultivated by the participants were Allium cepa L., Mangifera indica L., Solanum lycopersicum L. and Zea mays L. The RFC value ranged from 0.08 to 0.83 and the three most popular plants for crop protection were Capsium annuum L. (0.83), A. cepa (0.63) and Dichrostachys cinerea (L.) Wight & Arn. (0.43). In terms of the UV, the five most promising plants used as biocontrol were Tulbaghia violacea (0.13), A. cepa (0.12), C. annuum L. (0.09), Solanum campylacanthum Hochst. Ex A.Rich.(0.09) and Pinus pinaster (0.08). Based on the Fic, four categories were established and dominated by fungal diseases (0.64). Furthermore, T. violacea and A. cepa were the most often mentioned plants used against fungal conditions. Other categories cited were bacterial diseases (0.3), invertebrate pests (0.11) and vertebrate pests (0.14), an indication that smallholder farmers had limited agreement or common knowledge about the plants used for their management. The preparation methods included maceration (38%), decoction (38%) and burning (24%). Foliar application (67%) and soil drenching (33%) were used for administering plant extracts during the management of crop pests and diseases.ConclusionThe study highlights the importance of botanicals and associated indigenous knowledge among smallholder farmers in Mpumalanga Province, South Africa. It is pertinent to explore the valorisation of these botanicals by generating empirical data on their biological efficacies and phytochemical profiles.
| S-EPMC11293110 | biostudies-literature
Project description:Bacterial vaginosis (BV) is extremely common among the African population and is associated with the transmission and acquisition of human immunodeficiency virus (HIV) infection. The objective of this study was to determine the prevalence and characteristics of BV among HIV-infected and -uninfected women in rural Eastern Cape province of South Africa. A descriptive cross-sectional study was conducted between September 2017 and March 2018 on women aged 18 years and above (n = 100), attending Nelson Mandela Academic Hospital and Ngangelizwe Community Health Centre with signs and symptoms suggestive of vaginal infection. High vaginal swabs were collected, and BV was diagnosed using Nugent's score. The prevalence rate of BV was 70% irrespective of HIV status. Of the 61 HIV-infected patients, 49 (80.3%) and 12 (19.7%) were BV positive and BV negative, respectively; whilst of the 39 HIV-uninfected women, 21 (53.8%) and 18 (46.2%) were BV positive and BV negative, respectively (OR = 3.5; CI: 1.4-8.5; p=0.005). Women aged above 35 years were highly likely to develop BV (p=0.049). The presence of Mobiluncus species (>25 per high microscopic field) was significantly associated with BV among HIV-infected patients (p=0.030). A recent history of antibiotic use (≤3 months) was significantly associated with BV among HIV-negative patients (p=0.044). This study shows that BV is more prevalent among HIV-positive women than their HIV-negative counterparts, and its occurrence is higher among those aged above 35 years. The predominance of Mobiluncus species in the vagina microbiota of HIV-infected women might play a significant role in the development of BV. These findings suggest that the treatment of BV could restore normal flora and reduce susceptibility to and transmission of HIV.
| S-EPMC8321757 | biostudies-literature
Project description:DNA samples from 74 patients with non-malarial acute febrile illness (AFI), 282 rodents, 100 cattle, 56 dogs and 160 Rhipicephalus sanguineus ticks were screened for the presence of Anaplasma phagocytophilum DNA using a quantitative PCR (qPCR) assay targeting the msp2 gene. The test detected both A. phagocytophilum and Anaplasma sp. SA/ZAM dog DNA. Microbiome sequencing confirmed the presence of low levels of A. phagocytophilum DNA in the blood of rodents, dogs and cattle, while high levels of A. platys and Anaplasma sp. SA/ZAM dog were detected in dogs. Directed sequencing of the 16S rRNA and gltA genes in selected samples revealed the presence of A. phagocytophilum DNA in humans, dogs and rodents and highlighted its importance as a possible contributing cause of AFI in South Africa. A number of recently described Anaplasma species and A. platys were also detected in the study. Phylogenetic analyses grouped Anaplasma sp. SA/ZAM dog into a distinct clade, with sufficient divergence from other Anaplasma species to warrant classification as a separate species. Until appropriate type-material can be deposited and the species is formally described, we will refer to this novel organism as Anaplasma sp. SA dog.
| S-EPMC7698776 | biostudies-literature
Project description:We evaluate the impact of a multi-session cognitive behavioral prevention of mother to child transmission (PMTCT) intervention on antiretroviral therapy (ART) adherence. A total of 683 women were enrolled into a randomized control trial conducted at twelve community health centres (CHCs) in Mpumalanga Province. Participants were randomized to Standard Care or Enhanced PMTCT Intervention (EI). EI received three group and three individual intervention sessions. EI impact was ascertained on ART adherence (baseline vs 12 months post-partum). Women in the intervention groups were less likely to remain stable with regards to ART adherence over time compared to the control groups. In predicting if women become adherent over time, the intervention condition had no impact. However, the intervention condition was significantly positively associated with change to non-adherence. The enhanced cognitive-behavioral PMTCT intervention did not show any improvement in relation to maternal ART adherence relative to standard PMTCT care.Trial registration Clinicaltrials.gov: number NCT02085356.
| S-EPMC6766468 | biostudies-literature
Project description:There is progressive concern about the evolving burden of morbidity and mortality caused by coinfection with HIV-1 and hepatitis B virus (HBV) in sub-Saharan Africa, but the epidemiology and impact of this problem are not well defined. We therefore set out to assimilate more information about the nature of HBV/HIV coinfection in this region by undertaking a retrospective observational study of southern African adult women. We used samples from previously recruited HIV-1 positive women attending antenatal clinics in three settings in South Africa and Botswana (n = 950) and added a small cohort of HIV-negative antenatal South African women for comparison (n = 72). We tested for HBsAg and followed up HBsAg-positive samples by testing for HBeAg, HBV DNA, HBV genotype, presence of drug-resistance associated mutations (RAMs) and HDV. We identified HBsAg in 72 individuals (7% of the whole cohort), of whom 27% were HBeAg-positive, and the majority HBV genotypes A1 and A2. We did not detect any HDV coinfection. HBV prevalence was significantly different between geographically distinct cohorts, but did not differ according to HIV status. Among adults from South Africa, HBV/HIV coinfected patients had lower CD4+ T cell counts compared to those with HIV-monoinfection (p = 0.02), but this finding was not replicated in the cohort from Botswana. Overall, these data provide a snapshot of the coinfection problem at the heart of the HIV/HBV co-epidemic, and are important to inform public health policy, resource allocation, education, surveillance and clinical care.
| S-EPMC4517770 | biostudies-literature
Project description:BackgroundPersistent high-risk (hr) human papillomavirus (HPV) infection is a necessary cause of cervical cancer. Cervical cancer is a major public health problem in Sub-Saharan Africa including South Africa. This study investigated the prevalence of and factors associated with hr-HPV infection among women attending a tertiary hospital in Gauteng Province, South Africa.MethodsCervical samples were collected from 526 participants aged ≥ 18 years using a Cervex Brush® Combi and tested for hr-HPV types on the Abbott m2000 analyzer using the Abbott RealTime HR HPV assay. Samples that tested hr-HPV deoxyribonucleic acid (DNA)-positive were further tested for hr-HPV E6/E7 messenger ribonucleic acid (mRNA) using the APTIMA® HPV assay on the Panther system (Hologic, Inc.). Sociodemographic data were collected using a self-administered questionnaire. Binomial regression analysis was used to assess factors associated with hr-HPV infection.ResultsOverall hr-HPV DNA prevalence was 48.1% (95%CI: 43.8-52.4%). Of the hr-HPV DNA-positives, 24.5% (95%CI: 19.3-30.1) had HPV-16; 12.3% (95%CI: 8.5-16.9) had HPV-18 and 87.4% (95%CI: 82.6-91.2) had other 12 h-HPVs. Of the samples positive for hr-HPV DNA, 84.2% (95%CI: 79.1-88.5) (213/253) were positive for hr-HPV E6/E7 mRNA. Advanced age was an important factor linked to hr-HPV E6/E7 mRNA positivity. Based on multivariate binomial regression analysis, unemployment (PR: 1.50; 95%CI: 1.23-1.83) and being married (PR: 0.61; 95%CI: 0.47-0.81) were identified as statistically significant (p < 0.0001) predictive and protective factors, respectively, for hr-HPV infection.ConclusionsThe prevalence of hr-HPV infection was high. Furthermore, hr-HPV DNA-positive samples had a high hr-HPV E6/E7 mRNA prevalence. The presence of hr-HPV E6/E7mRNA indicates active infection and thus a greater risk of developing the cervical disease. Therefore, HPV mRNA testing could be a better test to monitor women who are positive with Pap smear before colposcopy is performed to reduce the burden of referrals.
| S-EPMC9354293 | biostudies-literature