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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>Pour manipuler ce document sous Unix (Dilib)
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