Prevention of diarrhoea in children with HIV infection or exposure to maternal HIV infection

Humphreys, Eliza H; Smith, Nathan; Azman, Hana; McLeod, Deanna; Rutherford, George W

doi:10.1002/14651858.cd008563

Cited by 18 publications

(12 citation statements)

References 65 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This pooling would tend to result in a smaller effect size. Another common therapy used in HIV care is cotrimoxazole, which also can be used to treat diarrhea 16,29 and other infections. 16 Although cotrimoxazole was used as standard of care in mothers with HIV, its use in children was not tracked.…”

Section: Discussionmentioning

confidence: 99%

Maternal Antiretroviral Therapy Is Associated with Lower Risk of Diarrhea in Early Childhood

Sztam

Liu

Manji

et al. 2016

The Journal of Pediatrics

View full text Add to dashboard Cite

Objectives To identify risk factors, including maternal antiretroviral therapy (ART), for diarrhea in Tanzanian children exposed to HIV during the first 2 years of life. Study design 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. Results 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. Conclusion 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. Trial registration ClinicalTrials.gov: NCT00197730.

show abstract

Section: Discussionmentioning

confidence: 99%

Maternal Antiretroviral Therapy Is Associated with Lower Risk of Diarrhea in Early Childhood

Sztam

Liu

Manji

et al. 2016

The Journal of Pediatrics

View full text Add to dashboard Cite

show abstract

“…16,[37][38][39]44 There was a somewhat wider spread in the point estimates for admission, with 8 comparisons (from 7 reviews) lying outside the 0.4 to 2.5 range; 20,22,26,32,33,34,37 for 3 comparisons (from 2 reviews), the 95% CIs did not reach into this region. …”

Section: Effect Sizes For Admissions and Deathmentioning

confidence: 99%

“…Stewart et al 37 Abba et al 20 Okebe et al 31 comparison C Duley et al 48 Kabra et al 27 Humphreys et al 33 comparison A Komossa et al 42 Dodd et al 53 Halliday et al 35 Crowther et al 54 Duley et al 47 Abalos et al 51 comparison A Rumbold et al 56 Cates et al 12 Okebe et al 31 comparison B Buppasiri et al 59 Ducharme et al 11 Martí-Carvajal et al 62 Graves et al 30 Nannini et al 13 Lucero et al 28 Walters et al 21 Peña-Rosas et al 58 Spencer et al 15 Abalos et al 51 comparison B Thomas et al 29 Nannini et al 14 Karner et al 19 Welsh et al 18 King et al 49 Al revic et al 52 Okebe et al 31 comparison D Grimwade et al 24 Rumbold et al 55 Walters et al 9 Halliday et al 36 Soares-Weiser et al 23 Makrides et al 50 Hofmeyr et al 46 Cates et al 16 Cates et al 17 Poole et al 8 Grimwade et al 25 Barr et al 10 Imdad et al 45 Okebe et al …”

Section: Studymentioning

confidence: 99%

Concordance of effects of medical interventions on hospital admission and readmission rates with effects on mortality

Hemkens

Contopoulos‐Ioannidis

Ioannidis

2013

CMAJ

View full text Add to dashboard Cite

Research CMAJ Background:Many clinical trials examine a composite outcome of admission to hospital and death, or infer a relationship between hospital admission and survival benefit. This assumes concordance of the outcomes "hospital admission" and "death." However, whether the effects of a treatment on hospital admissions and readmissions correlate to its effect on serious outcomes such as death is unknown. We aimed to assess the correlation and concordance of effects of medical interventions on admission rates and mortality. Methods:We searched the Cochrane Database of Systematic Reviews from its inception to January 2012 (issue 1, 2012) for systematic reviews of treatment comparisons that included meta-analyses for both admission and mortality outcomes. For each meta-analysis, we synthesized treatment effects on admissions and death, from respective randomized trials reporting those outcomes, using random-effects models. We then measured the concordance of directions of effect sizes and the correlation of summary estimates for the 2 outcomes. Results:We identified 61 meta-analyses including 398 trials reporting mortality and 182 trials reporting admission rates; 125 trials reported both outcomes. In 27.9% of comparisons, the point estimates of treatment effects for the 2 outcomes were in opposite directions; in 8.2% of trials, the 95% confidence intervals did not overlap. We found no significant correlation between effect sizes for admission and death (Pearson r = 0.07, p = 0.6). Our results were similar when we limited our analysis to trials reporting both outcomes. Interpretation:In this metaepidemiological study, admission and mortality outcomes did not correlate, and discordances occurred in about one-third of the treatment comparisons included in our analyses. Both outcomes convey useful information and should be reported separately, but extrapolating the benefits of admission to survival is unreliable and should be avoided. Abstract

show abstract

“…Most of these children acquire the infection by vertical transmission from their HIV-infected mothers during pregnancy, delivery, or through breastfeeding ( World Health Organization, 2017b ). HIV-infected children become progressively immunosuppressed, a situation that increases their risk of acquiring common and life-threatening childhood infections ( Humphreys et al, 2010 ).…”

Section: Introductionmentioning

confidence: 99%

The role of HIV infection in the etiology and epidemiology of diarrheal disease among children aged 0–59 months in Manhiça District, Rural Mozambique

Acácio

Nhampossa

Quintó

et al. 2018

International Journal of Infectious Diseases

View full text Add to dashboard Cite

HighlightsHIV prevalence was higher among cases with moderate-to-severe diarrhea (MSD) than controls.Mortality was higher among HIV-infected children with diarrhea than HIV-uninfected ones.HIV-infected children were more likely to have MSD.Cryptosporidium was the most common pathogen in HIV-infected children with MSD.Escherichia coli producing heat-stable toxin (enterotoxigenic Escherichia coli, any sequence type) was the most common pathogen in HIV-infected children with less severe diarrhea.

show abstract

Prevention of diarrhoea in children with HIV infection or exposure to maternal HIV infection

Cited by 18 publications

References 65 publications

Maternal Antiretroviral Therapy Is Associated with Lower Risk of Diarrhea in Early Childhood

Maternal Antiretroviral Therapy Is Associated with Lower Risk of Diarrhea in Early Childhood

Concordance of effects of medical interventions on hospital admission and readmission rates with effects on mortality

The role of HIV infection in the etiology and epidemiology of diarrheal disease among children aged 0–59 months in Manhiça District, Rural Mozambique

Contact Info

Product

Resources

About