ABSTRACT
Pregnant women constitute a promising sentinel group for continuous monitoring of malaria transmission. To identify antibody signatures of recent Plasmodium falciparum exposure during pregnancy, we dissected IgG responses against VAR2CSA, the parasite antigen that mediates placental sequestration. We used a multiplex peptide-based suspension array in 2,354 samples from pregnant women from Mozambique, Benin, Kenya, Gabon, Tanzania, and Spain....
Subject(s)
Humans , Female , Pregnancy , Plasmodium , Pregnancy , Malaria , Parasites , Serology , Benin , Immunity , Kenya , MozambiqueABSTRACT
We assessed the effect of maternal human immunodeficiency virus (HIV) infection on birth outcomes and infant survival in rural Mozambique. Pregnant women attending the antenatal clinic were recruited. These women and their infants were followed-up for one year. Birth outcomes were assessed at delivery and infant HIV status was determined at 1 and 12 months of age. Women positive for HIV were more likely to have anemia at delivery than women negative for HIV (51.3% versus 35.4%; P < 0.001). Infants born to HIV-positive mothers had a significantly higher post-neonatal mortality rate than infants born to HIV-negative mothers (7.8% versus 1.9%; P < 0.001). The rate of transmission of HIV by breastfeeding during the first year of life was 15.1% (95% confidence interval = CI 7.6-22.4). Assessment of the impact of HIV infection on birth outcomes in rural Africa is essential for tailoring public health measures to reduce mother-to-child transmission of HIV and excess infant mortality....
Subject(s)
Humans , Female , Infant, Newborn , Adult , Pregnancy , HIV-1 , Infectious Disease Transmission, Vertical , Viral Load , Rural Population , Infant Mortality , Adolescent , Adult , Young Adult , Infant , Mozambique/epidemiologyABSTRACT
Introduction: Anaemia is the most frequent haematological disorder in childhood. The notion that defines naemia does not change throughout life, although parameters used for its evaluation show significant variations during childhood. Haematocrit (Hct) (%) is usually defined as three times the value of haemoglobin (Hgb) (g/dl), while the clinical definition of anaemia is related to either an abnormal Hct or Hgb value. Objective: To evaluate the agreement between Hgb and Hct values in the definition of anaemia, the relationship between these two parameters and their age-dependence. Methods: The Hct and Hgb paired values from children aged 2-18 months from Ifakara (Tanzania) and children aged 1-4 years from Manhiça (Mozambique) were analysed. Haematological determinations of the Manhiça samples were done using a KX-21N cell counter (Kobe, Japan) and Ifakara samples were analysed in a semiautomatic cell counter (Sysmex F800 microcell counter, TOA Medical Electronics, Kobe, Japan). The kappa-statistic was used to calculate the agreement between anaemia definitions in each group. Crude and multivariate relationship between Hct and Hgb levels were analysed by linear regression model estimation. The age-dependence of the crude ratio (Hct/Hgb) was analysed using linear regression models and fractional polynomials. Results: The prevalences of mild and moderate anaemia as defined by Hgb levels in the Manhiça group were 61% and 6%, respectively, and 41% and 2% by Hct. In the Ifakara group these were 74% and 10%, respectively, by Hgb and 42% and 3% by Hct, respectively. Agreement between mild and moderate anaemia definitions made up from Hgb or from Hct levels were from fair to moderate. Hct levels decreased with age for high Hgb levels, whereas they increased for low Hgb levels. The classification of cases is improved when higher age-related cut-off values for Hct are used. The crude relationship between Hct and Hgb levels was significantly different from 3, and this was modified by age. The evaluation of the age-dependence ratio (Hct/Hgb) showed a non-linear relationship with an asymptotic trend to 3...
