Medicine and Health Sciences Commons^™

Interventions For Common Perinatal Mental Disorders In Women In Low- And Middle-Income Countries: A Systematic Review And Meta-Analysis, Atif Rahman, Jane Fisher, Peter Bower, Stanley Luchters, Thach Tran, M. Taghi Yasamy, Shekhar Saxena, Waquas Waheed

Population Health, East Africa

Objective: To assess the effectiveness of interventions to improve the mental health of women in the perinatal period and to evaluate any effect on the health, growth and development of their offspring, in low- and middle-income (LAMI) countries.

Methods: Seven electronic bibliographic databases were systematically searched for papers published up to May 2012 describing controlled trials of interventions designed to improve mental health outcomes in women who were pregnant or had recently given birth. The main outcomes of interest were rates of common perinatal mental disorders (CPMDs), primarily postpartum depression or anxiety; measures of the quality of the mother-infant relationship; …

The Contribution Of Emotional Partners To Sexual Risk Taking And Violence Among Female Sex Workers In Mombasa, Kenya: A Cohort Study, Stanley Luchters, Marlise L. Richter, Wilkister Bosire, Gill Nelson, Nzioki Kingola, Xu-Dong Zhang, Marleen Temmerman, Matthew F. Chersich

Population Health, East Africa

Objectives: To assess sexual risk-taking of female sex workers (FSWs) with emotional partners (boyfriends and husbands), compared to regular and casual clients. Experiences of violence and the degree of relationship control that FSWs have with emotional partners are also described.

Design: Cohort study with quarterly follow-up visit over 12-months.

Methods: Four hundred HIV-uninfected FSWs older than 16 years were recruited from their homes and guesthouses in Mombasa, Kenya. A structured questionnaire assessed participant characteristics and study outcomes at each visit, and women received risk-reduction counselling, male and female condoms, and HIV testing.

Results: Four or more …

Hiv-1 Autologous Antibody Neutralization Associates With Mother To Child Transmission, Elly Baan, Anthony De Ronde, Martijn Stax, Rogier W. Sanders, Stanley Luchters, Joseph Vyankandondera, Joep M. Lange, Georgios Pollakis, William A. Paxton

Population Health, East Africa

The HIV-1 characteristics associated with mother to child transmission (MTCT) are still poorly understood and if known would indicate where intervention strategies should be targeted. In contrast to horizontally infected individuals, exposed infants possess inherited antibodies (Abs) from their mother with the potential to protect against infection. We investigated the HIV-1 gp160 envelope proteins from seven transmitting mothers (TM) whose children were infected either during gestation or soon after delivery and from four non-transmitting mothers (NTM) with similar viral loads and CD4 counts. Using pseudo-typed viruses we tested gp160 envelope glycoproteins for TZM-bl infectivity, CD4 and CCR5 interactions, DC-SIGN capture …

The Case For Investing In Family Planning In The Pacific: Costs And Benefits Of Reducing Unmet Need For Contraception In Vanuatu And The Solomon Islands, Elissa C. Kennedy, Sean Mackesy-Buckley, Sumi Subramaniam, Andreas Demmke, Rufina Latu, Annette Sachs Robertson, Kabwea Tiban, Apisai Tokon, Stanley Luchters

Population Health, East Africa

Background: Unmet need for family planning in the Pacific is among the highest in the world. Better understanding of required investments and associated benefits of increased access to family planning in the Pacific may assist prioritisation and funding.

Methods: We modelled the costs and associated health, demographic and economic impacts of reducing unmet need for family planning between 2010-2025 in Vanuatu and the Solomon Islands. Baseline data were obtained from census reports, Demographic and Health Surveys, and UN agency reports. Using a demographic modelling program we compared a scenario of "no change in unmet need" with two distinct scenarios: 1) …

Family Planning Knowledge, Attitude And Practice Among Married Couples In Jimma Zone, Ethiopia, Tizta Tilahun, Gily Coene, Stanley Luchters, Wondwosen Kassahun, Els Leye, Marleen Temmerman, Olivier Degomme

Population Health, East Africa

Background: Understanding why people do not use family planning is critical to address unmet needs and to increase contraceptive use. According to the Ethiopian Demographic and Health Survey 2011, most women and men had knowledge on some family planning methods but only about 29% of married women were using contraceptives. 20% women had an unmet need for family planning. We examined knowledge, attitudes and contraceptive practice as well as factors related to contraceptive use in Jimma zone, Ethiopia.

Methods: Data were collected from March to May 2010 among 854 married couples using a multi-stage sampling design. Quantitative data based on …

Effectiveness Of A Community-Based Positive Prevention Intervention For People Living With Hiv Who Are Not Receiving Antiretroviral Treatment: A Prospective Cohort Study, Avina Sarna, Stanley Luchters, Eustasius Musenge, Jerry Okal, Matthew Chersich, Waimar Tun, Sabine Mall, Nzioki Kingola, Sam Kalibala

Population Health, East Africa

Background: We report effectiveness of an HIV-prevention intervention delivered by community health workers (CHWs) in Mombasa, Kenya, to PLHIV who have not initiated or who have discontinued ART-an often difficult-to-reach population because they fall outside the ambit of health care and prevention services.

Methods: A 2-arm cohort study assessed a structured risk-reduction intervention involving at least 4 one-to-one counseling sessions and personalized support. The control group received standard prevention services. CHWs recruited treatment-naïve people living with HIV (PLHIV) or those who had previously taken antiretroviral drugs. Data were analyzed using a Propensity Score Matched (PSM)-sample to control for baseline differences …

Priority Interventions To Reduce Hiv Transmission In Sex Work Settings In Sub-Saharan Africa And Delivery Of These Services, Matthew F. Chersich, Stanley Luchters, Innocent Ntaganira, Antonio Gerbase, Ying-Ru Lo, Fiona Scorgie, Richard Steen

Population Health, East Africa

Introduction: Virtually no African country provides HIV prevention services in sex work settings with an adequate scale and intensity. Uncertainty remains about the optimal set of interventions and mode of delivery.

Methods: We systematically reviewed studies reporting interventions for reducing HIV transmission among female sex workers in sub-Saharan Africa between January 2000 and July 2011. Medline (PubMed) and non-indexed journals were searched for studies with quantitative study outcomes.

Results: We located 26 studies, including seven randomized trials. Evidence supports implementation of the following interventions to reduce unprotected sex among female sex workers: peer-mediated condom promotion, risk-reduction counselling and skills-building for …