ublic health measures to limit the spread of coronavirus disease 2019 (COVID-19) include requirements not to leave home except for specified purposes, to work from home when practical, to limit proximity to other people, to not visit residential aged care homes, to limit the number of people at social events (weddings, funerals, celebrations), to restrict interstate and international travel, and to accept the enforcement of these restrictions. The mental health consequences of these measures are likely to be unevenly distributed across the community because they also depend on individual social and economic circumstances. A recent position paper 1 summarised international expert opinion on research priorities for mental health during the COVID-19 pandemic. The first recommendation was to gather high quality population level data on its mental health effects. The aim of our study was to assess the mental health of people in Australia during the first month of COVID-19-related restrictions. Our specific objectives were to estimate population prevalence rates of clinically significant symptoms of depression, generalised anxiety, thoughts of being better off dead, increased irritability, and high optimism about the future; to estimate the prevalence of direct experiences of COVID-19, loss of employment caused by COVID-19 restrictions, concern about contracting COVID-19, and major disadvantage because of the restrictions; and to assess associations between these experiences and mental health symptoms. Methods A short, anonymous survey (estimated completion time, 8 minutes) of people living in Australia and aged at least 18 years was available on the Monash University website (https:// www.monash.edu/medic ine/living-with-covid-19-restr ictio nssurvey) from 3 April 2020 (four days after national stage two COVID-19 restrictions were announced by the Prime Minister; phase one restrictions had been gradually introduced during March) until midnight on 2/3 May 2020 (further information: online Supporting Information). Mental health Psychological symptoms experienced during the preceding fortnight were assessed with the Patient Health Questionnaire 9 (PHQ-9) and the Generalised Anxiety Disorder Scale (GAD-7). The PHQ-9 2 is an easily understood scale that asks respondents to rate their experience of nine symptoms from 0 (not experienced) to 3 (experienced nearly every day); a total PHQ-9 score of 10 or more indicates clinically significant (moderate to severe) symptoms, while scores of 5-9 indicate mild symptoms. The GAD-7 3 is an easily understood scale that asks respondents to rate their experience of seven symptoms of anxiety with the same response options as the PHQ-9; a total GAD-7 score of 10 or more indicate clinically significant (moderate to severe) symptoms, while scores of 5-9 indicate mild symptoms. Optimism about the future was assessed with a visual analogue scale (from 0, not at all optimistic, to 10, extremely optimistic).

Among Indian HIV-infected women, we found a high incidence of postpartum TB and associated postpartum maternal and infant death. Active screening and targeted use of isoniazid preventative therapy among HIV-infected women in India should be considered to prevent postpartum maternal TB and associated mother-to-child morbidity and mortality.

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Background: The risk for occupational exposure to HIV has been well characterized in the developed world, but limited information is available about this transmission risk in resource-constrained settings facing the largest burden of HIV infection. In addition, the feasibility and utilization of post-exposure prophylaxis (PEP) programs in these settings are unclear. Therefore, we examined the rate and characteristics of occupational exposure to HIV and the utilization of PEP among health care workers (HCW) in a large, urban government teaching hospital in Pune, India.

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Eighty seven pregnant women belonging to poor socioeconomic groups of population were investigated to find out the effect of calcium supplementation during pregnancy on the bone density of the mother as well as of the neonate. Supplements of 300 and 600 mg of elemental calcium administered daily from the 20th week of gestation onward until term, brought about a significant increase in the bone density of the neonates born of such mothers compared to that of the neonates born to unsupplemented mothers. Although no significant difference was observed between the initial and final values for bone densities among the mothers, there was a tendency for an increase in the bone density of the mothers who received 600 mg of calcium supplements. Individual variation of different neonatal bones in their response to maternal calcium supplements was observed. Bone density of the neonate was not related to the birth weight, crown-heel, or crown-rump lengths.

BackgroundDaily nevirapine (NVP) prophylaxis to HIV-exposed infants significantly reduces breast-milk HIV transmission. We assessed NVP-resistance in Indian infants enrolled in the “six-week extended-dose nevirapine” (SWEN) trial who received single-dose NVP (SD-NVP) or SWEN for prevention of breast-milk HIV transmission but who also acquired subtype C HIV infection during the first year of life.Methods/FindingsStandard population sequencing and cloning for viral subpopulations present at ≥5% frequency were used to determine HIV genotypes from 94% of the 79 infected Indian infants studied. Timing of infection was defined based on when an infant's blood sample first tested positive for HIV DNA. SWEN-exposed infants diagnosed with HIV by six weeks of age had a significantly higher prevalence of NVP-resistance than those who received SD-NVP, by both standard population sequencing (92% of 12 vs. 38% of 29; p = 0.002) and low frequency clonal analysis (92% of 12 vs. 59% of 29; p = 0.06). Likelihood of infection with NVP-resistant HIV through breast-milk among infants infected after age six weeks was substantial, but prevalence of NVP-resistance did not differ among SWEN or SD-NVP exposed infants by standard population sequencing (15% of 13 vs. 15% of 20; p = 1.00) and clonal analysis (31% of 13 vs. 40% of 20; p = 0.72). Types of NVP-resistance mutations and patterns of persistence at one year of age were similar between the two groups. NVP-resistance mutations did differ by timing of HIV infection; the Y181C variant was predominant among infants diagnosed in the first six weeks of life, compared to Y188C/H during late breast-milk transmission.Conclusions/SignificanceUse of SWEN to prevent breast-milk HIV transmission carries a high likelihood of resistance if infection occurs in the first six weeks of life. Moreover, there was a continued risk of transmission of NVP-resistant HIV through breastfeeding during the first year of life, but did not differ between SD-NVP and SWEN groups. As with SD-NVP, the value of preventing HIV infection in a large number of infants should be considered alongside the high risk of resistance associated with extended NVP prophylaxis.Trial RegistrationClinicalTrials.gov NCT00061321

Maternal TB is associated with increased MTCT of HIV. Prevention of TB among HIV-infected mothers should be a high priority for communities with significant HIV/TB burden.