Maternal Antiretroviral Therapy Is Associated with Lower Risk of Diarrhea in Early Childhood
Identifieur interne : 000F27 ( Main/Exploration ); précédent : 000F26; suivant : 000F28Maternal Antiretroviral Therapy Is Associated with Lower Risk of Diarrhea in Early Childhood
Auteurs : Kevin A. Sztam [États-Unis] ; Enju Liu [États-Unis] ; Karim P. Manji [Tanzanie] ; Roland Kupka [États-Unis] ; Rodrick Kisenge [Tanzanie] ; Said Aboud [Tanzanie] ; Wafaie W. Fawzi [États-Unis] ; Ronald J. Bosch [États-Unis] ; Christopher P. Duggan [États-Unis]Source :
- The Journal of pediatrics [ 0022-3476 ] ; 2016.
Abstract
To identify risk factors, including maternal antiretroviral therapy (ART), for diarrhea in Tanzanian children exposed to HIV during the first 2 years of life.
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.
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.
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.
ClinicalTrials.gov: NCT00197730.
Url:
DOI: 10.1016/j.jpeds.2016.04.088
PubMed: 27245295
PubMed Central: 4981520
Affiliations:
Links toward previous steps (curation, corpus...)
- to stream Pmc, to step Corpus: 001854
- to stream Pmc, to step Curation: 001853
- to stream Pmc, to step Checkpoint: 000602
- to stream Ncbi, to step Merge: 003809
- to stream Ncbi, to step Curation: 003809
- to stream Ncbi, to step Checkpoint: 003809
- to stream Main, to step Merge: 000F27
- to stream Main, to step Curation: 000F27
Le document en format XML
<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 wicri:level="2"><nlm:aff id="A1">Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston, MA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston</wicri:cityArea></affiliation></author><author><name sortKey="Liu, Enju" sort="Liu, Enju" uniqKey="Liu E" first="Enju" last="Liu">Enju Liu</name><affiliation wicri:level="2"><nlm:aff id="A1">Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston, MA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston</wicri:cityArea></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 wicri:level="1"><nlm:aff id="A2">Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania</nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam</wicri:regionArea><wicri:noRegion>Dar es Salaam</wicri:noRegion></affiliation></author><author><name sortKey="Kupka, Roland" sort="Kupka, Roland" uniqKey="Kupka R" first="Roland" last="Kupka">Roland Kupka</name><affiliation wicri:level="2"><nlm:aff id="A3">Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A4">Nutrition Section, UNICEF Headquarters, New York, NY</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Nutrition Section, UNICEF Headquarters, New York</wicri:cityArea></affiliation></author><author><name sortKey="Kisenge, Rodrick" sort="Kisenge, Rodrick" uniqKey="Kisenge R" first="Rodrick" last="Kisenge">Rodrick Kisenge</name><affiliation wicri:level="1"><nlm:aff id="A2">Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania</nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam</wicri:regionArea><wicri:noRegion>Dar es Salaam</wicri:noRegion></affiliation></author><author><name sortKey="Aboud, Said" sort="Aboud, Said" uniqKey="Aboud S" first="Said" last="Aboud">Said Aboud</name><affiliation wicri:level="1"><nlm:aff id="A5">Department of Microbiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania</nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Department of Microbiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam</wicri:regionArea><wicri:noRegion>Dar es Salaam</wicri:noRegion></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 wicri:level="2"><nlm:aff id="A6">Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston</wicri:cityArea></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 wicri:level="2"><nlm:aff id="A7">Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston</wicri:cityArea></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 wicri:level="2"><nlm:aff id="A1">Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston, MA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A3">Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston</wicri:cityArea></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><idno type="wicri:Area/Pmc/Curation">001853</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">001853</idno><idno type="wicri:Area/Pmc/Checkpoint">000602</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000602</idno><idno type="wicri:Area/Ncbi/Merge">003809</idno><idno type="wicri:Area/Ncbi/Curation">003809</idno><idno type="wicri:Area/Ncbi/Checkpoint">003809</idno><idno type="wicri:doubleKey">0022-3476:2016:Sztam K:maternal:antiretroviral:therapy</idno><idno type="wicri:Area/Main/Merge">000F27</idno><idno type="wicri:Area/Main/Curation">000F27</idno><idno type="wicri:Area/Main/Exploration">000F27</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 wicri:level="2"><nlm:aff id="A1">Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston, MA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston</wicri:cityArea></affiliation></author><author><name sortKey="Liu, Enju" sort="Liu, Enju" uniqKey="Liu E" first="Enju" last="Liu">Enju Liu</name><affiliation wicri:level="2"><nlm:aff id="A1">Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston, MA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston</wicri:cityArea></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 wicri:level="1"><nlm:aff id="A2">Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania</nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam</wicri:regionArea><wicri:noRegion>Dar es Salaam</wicri:noRegion></affiliation></author><author><name sortKey="Kupka, Roland" sort="Kupka, Roland" uniqKey="Kupka R" first="Roland" last="Kupka">Roland Kupka</name><affiliation wicri:level="2"><nlm:aff id="A3">Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A4">Nutrition Section, UNICEF Headquarters, New York, NY</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Nutrition Section, UNICEF Headquarters, New York</wicri:cityArea></affiliation></author><author><name sortKey="Kisenge, Rodrick" sort="Kisenge, Rodrick" uniqKey="Kisenge R" first="Rodrick" last="Kisenge">Rodrick Kisenge</name><affiliation wicri:level="1"><nlm:aff id="A2">Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania</nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam</wicri:regionArea><wicri:noRegion>Dar es Salaam</wicri:noRegion></affiliation></author><author><name sortKey="Aboud, Said" sort="Aboud, Said" uniqKey="Aboud S" first="Said" last="Aboud">Said Aboud</name><affiliation wicri:level="1"><nlm:aff id="A5">Department of Microbiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania</nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Department of Microbiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam</wicri:regionArea><wicri:noRegion>Dar es Salaam</wicri:noRegion></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 wicri:level="2"><nlm:aff id="A6">Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston</wicri:cityArea></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 wicri:level="2"><nlm:aff id="A7">Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston</wicri:cityArea></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 wicri:level="2"><nlm:aff id="A1">Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston, MA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A3">Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston</wicri:cityArea></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><affiliations><list><country><li>Tanzanie</li><li>États-Unis</li></country><region><li>Massachusetts</li><li>État de New York</li></region></list><tree><country name="États-Unis"><region name="Massachusetts"><name sortKey="Sztam, Kevin A" sort="Sztam, Kevin A" uniqKey="Sztam K" first="Kevin A." last="Sztam">Kevin A. Sztam</name></region><name sortKey="Bosch, Ronald J" sort="Bosch, Ronald J" uniqKey="Bosch R" first="Ronald J." last="Bosch">Ronald J. Bosch</name><name sortKey="Duggan, Christopher P" sort="Duggan, Christopher P" uniqKey="Duggan C" first="Christopher P." last="Duggan">Christopher P. Duggan</name><name sortKey="Duggan, Christopher P" sort="Duggan, Christopher P" uniqKey="Duggan C" first="Christopher P." last="Duggan">Christopher P. Duggan</name><name sortKey="Fawzi, Wafaie W" sort="Fawzi, Wafaie W" uniqKey="Fawzi W" first="Wafaie W." last="Fawzi">Wafaie W. Fawzi</name><name sortKey="Kupka, Roland" sort="Kupka, Roland" uniqKey="Kupka R" first="Roland" last="Kupka">Roland Kupka</name><name sortKey="Kupka, Roland" sort="Kupka, Roland" uniqKey="Kupka R" first="Roland" last="Kupka">Roland Kupka</name><name sortKey="Liu, Enju" sort="Liu, Enju" uniqKey="Liu E" first="Enju" last="Liu">Enju Liu</name></country><country name="Tanzanie"><noRegion><name sortKey="Manji, Karim P" sort="Manji, Karim P" uniqKey="Manji K" first="Karim P." last="Manji">Karim P. Manji</name></noRegion><name sortKey="Aboud, Said" sort="Aboud, Said" uniqKey="Aboud S" first="Said" last="Aboud">Said Aboud</name><name sortKey="Kisenge, Rodrick" sort="Kisenge, Rodrick" uniqKey="Kisenge R" first="Rodrick" last="Kisenge">Rodrick Kisenge</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/SidaSubSaharaV1/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000F27 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 000F27 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Sante
|area= SidaSubSaharaV1
|flux= Main
|étape= Exploration
|type= RBID
|clé= PMC:4981520
|texte= Maternal Antiretroviral Therapy Is Associated with Lower Risk of Diarrhea in Early Childhood
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Main/Exploration/RBID.i -Sk "pubmed:27245295" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd \
| NlmPubMed2Wicri -a SidaSubSaharaV1
| This area was generated with Dilib version V0.6.32. |  |