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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Maternal Antiretroviral Therapy Is Associated with Lower Risk of Diarrhea in Early Childhood</title>
<author><name sortKey="Sztam, Kevin A" sort="Sztam, Kevin A" uniqKey="Sztam K" first="Kevin A." last="Sztam">Kevin A. Sztam</name>
<affiliation><nlm:aff id="A1">Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston, MA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Liu, Enju" sort="Liu, Enju" uniqKey="Liu E" first="Enju" last="Liu">Enju Liu</name>
<affiliation><nlm:aff id="A1">Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston, MA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Manji, Karim P" sort="Manji, Karim P" uniqKey="Manji K" first="Karim P." last="Manji">Karim P. Manji</name>
<affiliation><nlm:aff id="A2">Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kupka, Roland" sort="Kupka, Roland" uniqKey="Kupka R" first="Roland" last="Kupka">Roland Kupka</name>
<affiliation><nlm:aff id="A3">Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A4">Nutrition Section, UNICEF Headquarters, New York, NY</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kisenge, Rodrick" sort="Kisenge, Rodrick" uniqKey="Kisenge R" first="Rodrick" last="Kisenge">Rodrick Kisenge</name>
<affiliation><nlm:aff id="A2">Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Aboud, Said" sort="Aboud, Said" uniqKey="Aboud S" first="Said" last="Aboud">Said Aboud</name>
<affiliation><nlm:aff id="A5">Department of Microbiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Fawzi, Wafaie W" sort="Fawzi, Wafaie W" uniqKey="Fawzi W" first="Wafaie W." last="Fawzi">Wafaie W. Fawzi</name>
<affiliation><nlm:aff id="A6">Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Bosch, Ronald J" sort="Bosch, Ronald J" uniqKey="Bosch R" first="Ronald J." last="Bosch">Ronald J. Bosch</name>
<affiliation><nlm:aff id="A7">Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Duggan, Christopher P" sort="Duggan, Christopher P" uniqKey="Duggan C" first="Christopher P." last="Duggan">Christopher P. Duggan</name>
<affiliation><nlm:aff id="A1">Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston, MA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A3">Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">27245295</idno>
<idno type="pmc">4981520</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4981520</idno>
<idno type="RBID">PMC:4981520</idno>
<idno type="doi">10.1016/j.jpeds.2016.04.088</idno>
<date when="2016">2016</date>
<idno type="wicri:Area/Pmc/Corpus">001854</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001854</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Maternal Antiretroviral Therapy Is Associated with Lower Risk of Diarrhea in Early Childhood</title>
<author><name sortKey="Sztam, Kevin A" sort="Sztam, Kevin A" uniqKey="Sztam K" first="Kevin A." last="Sztam">Kevin A. Sztam</name>
<affiliation><nlm:aff id="A1">Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston, MA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Liu, Enju" sort="Liu, Enju" uniqKey="Liu E" first="Enju" last="Liu">Enju Liu</name>
<affiliation><nlm:aff id="A1">Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston, MA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Manji, Karim P" sort="Manji, Karim P" uniqKey="Manji K" first="Karim P." last="Manji">Karim P. Manji</name>
<affiliation><nlm:aff id="A2">Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kupka, Roland" sort="Kupka, Roland" uniqKey="Kupka R" first="Roland" last="Kupka">Roland Kupka</name>
<affiliation><nlm:aff id="A3">Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A4">Nutrition Section, UNICEF Headquarters, New York, NY</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kisenge, Rodrick" sort="Kisenge, Rodrick" uniqKey="Kisenge R" first="Rodrick" last="Kisenge">Rodrick Kisenge</name>
<affiliation><nlm:aff id="A2">Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Aboud, Said" sort="Aboud, Said" uniqKey="Aboud S" first="Said" last="Aboud">Said Aboud</name>
<affiliation><nlm:aff id="A5">Department of Microbiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Fawzi, Wafaie W" sort="Fawzi, Wafaie W" uniqKey="Fawzi W" first="Wafaie W." last="Fawzi">Wafaie W. Fawzi</name>
<affiliation><nlm:aff id="A6">Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Bosch, Ronald J" sort="Bosch, Ronald J" uniqKey="Bosch R" first="Ronald J." last="Bosch">Ronald J. Bosch</name>
<affiliation><nlm:aff id="A7">Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Duggan, Christopher P" sort="Duggan, Christopher P" uniqKey="Duggan C" first="Christopher P." last="Duggan">Christopher P. Duggan</name>
<affiliation><nlm:aff id="A1">Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston, MA</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A3">Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">The Journal of pediatrics</title>
<idno type="ISSN">0022-3476</idno>
<idno type="eISSN">1097-6833</idno>
<imprint><date when="2016">2016</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objectives</title>
<p id="P1">To identify risk factors, including maternal antiretroviral therapy (ART), for diarrhea in Tanzanian children exposed to HIV during the first 2 years of life.</p>
</sec>
<sec id="S2"><title>Study design</title>
<p id="P2">Using generalized estimating equations, we analyzed data from a cohort of 2387 Tanzanian children exposed to HIV from age 6 weeks to 2 years, as well as data from their mothers, to determine risk factors for diarrhea in children. Mothers recorded diarrhea in a diary and reported results at visits scheduled every four weeks.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Body mass index was ≥18.5 in 95.6% of mothers. World Health Organization HIV stage was 1/2 for 1255 (87.8%) mothers. ART was received by 24.3% of mothers, most initiating ART during pregnancy. At baseline (6 weeks of age) 264 (11.3%) children were infected with HIV. In children whose mothers received ART, the relative risk of diarrhea in children was 0.79 (95% CI 0.68–0.92), after we adjusted for multiple factors, including child HIV status and exclusive breastfeeding duration. Exclusive breastfeeding (relative risk 0.67, 95% CI 0.56–0.80) also was protective.</p>
</sec>
<sec id="S4"><title>Conclusion</title>
<p id="P4">Our results provide additional support to increase ART coverage for all pregnant mothers, to control clinical HIV progression, reduce perinatal HIV infection, but also to reduce the risk of a major cause of death and morbidity in young children worldwide.</p>
</sec>
<sec id="S5"><title>Trial registration</title>
<p id="P5">ClinicalTrials.gov: NCT00197730.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">0375410</journal-id>
<journal-id journal-id-type="pubmed-jr-id">5127</journal-id>
<journal-id journal-id-type="nlm-ta">J Pediatr</journal-id>
<journal-id journal-id-type="iso-abbrev">J. Pediatr.</journal-id>
<journal-title-group><journal-title>The Journal of pediatrics</journal-title>
</journal-title-group>
<issn pub-type="ppub">0022-3476</issn>
<issn pub-type="epub">1097-6833</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">27245295</article-id>
<article-id pub-id-type="pmc">4981520</article-id>
<article-id pub-id-type="doi">10.1016/j.jpeds.2016.04.088</article-id>
<article-id pub-id-type="manuscript">NIHMS791181</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Maternal Antiretroviral Therapy Is Associated with Lower Risk of Diarrhea in Early Childhood</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Sztam</surname>
<given-names>Kevin A.</given-names>
</name>
<degrees>MD, MPH</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Liu</surname>
<given-names>Enju</given-names>
</name>
<degrees>MD, MS, PhD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Manji</surname>
<given-names>Karim P.</given-names>
</name>
<degrees>MBBS, MPH</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kupka</surname>
<given-names>Roland</given-names>
</name>
<degrees>ScD</degrees>
<xref ref-type="aff" rid="A3">3</xref>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kisenge</surname>
<given-names>Rodrick</given-names>
</name>
<degrees>MD, PhD</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Aboud</surname>
<given-names>Said</given-names>
</name>
<degrees>MD, MPhil</degrees>
<xref ref-type="aff" rid="A5">5</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Fawzi</surname>
<given-names>Wafaie W.</given-names>
</name>
<degrees>MBBS, DrPH</degrees>
<xref ref-type="aff" rid="A6">6</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bosch</surname>
<given-names>Ronald J.</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A7">7</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Duggan</surname>
<given-names>Christopher P.</given-names>
</name>
<degrees>MD, MPH</degrees>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston, MA</aff>
<aff id="A2"><label>2</label>
Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania</aff>
<aff id="A3"><label>3</label>
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA</aff>
<aff id="A4"><label>4</label>
Nutrition Section, UNICEF Headquarters, New York, NY</aff>
<aff id="A5"><label>5</label>
Department of Microbiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania</aff>
<aff id="A6"><label>6</label>
Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA</aff>
<aff id="A7"><label>7</label>
Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA</aff>
<author-notes><corresp id="FN1">Reprint requests: Kevin A. Sztam, MD, MPH, Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, 300 Longwood Avenue, Boston, MA 02115. <email>Kevin.Sztam@childrens.harvard.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>10</day>
<month>6</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub"><day>28</day>
<month>5</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="ppub"><month>8</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>01</day>
<month>8</month>
<year>2017</year>
</pub-date>
<volume>175</volume>
<fpage>54</fpage>
<lpage>60</lpage>
<pmc-comment>elocation-id from pubmed: 10.1016/j.jpeds.2016.04.088</pmc-comment>
<abstract><sec id="S1"><title>Objectives</title>
<p id="P1">To identify risk factors, including maternal antiretroviral therapy (ART), for diarrhea in Tanzanian children exposed to HIV during the first 2 years of life.</p>
</sec>
<sec id="S2"><title>Study design</title>
<p id="P2">Using generalized estimating equations, we analyzed data from a cohort of 2387 Tanzanian children exposed to HIV from age 6 weeks to 2 years, as well as data from their mothers, to determine risk factors for diarrhea in children. Mothers recorded diarrhea in a diary and reported results at visits scheduled every four weeks.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Body mass index was ≥18.5 in 95.6% of mothers. World Health Organization HIV stage was 1/2 for 1255 (87.8%) mothers. ART was received by 24.3% of mothers, most initiating ART during pregnancy. At baseline (6 weeks of age) 264 (11.3%) children were infected with HIV. In children whose mothers received ART, the relative risk of diarrhea in children was 0.79 (95% CI 0.68–0.92), after we adjusted for multiple factors, including child HIV status and exclusive breastfeeding duration. Exclusive breastfeeding (relative risk 0.67, 95% CI 0.56–0.80) also was protective.</p>
</sec>
<sec id="S4"><title>Conclusion</title>
<p id="P4">Our results provide additional support to increase ART coverage for all pregnant mothers, to control clinical HIV progression, reduce perinatal HIV infection, but also to reduce the risk of a major cause of death and morbidity in young children worldwide.</p>
</sec>
<sec id="S5"><title>Trial registration</title>
<p id="P5">ClinicalTrials.gov: NCT00197730.</p>
</sec>
</abstract>
</article-meta>
</front>
</pmc>
</record>
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