Last data update: Sep 23, 2024. (Total: 47723 publications since 2009)
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Query Trace: Dintwa E [original query] |
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Dolutegravir Use at Conception - Additional Surveillance Data from Botswana
Raesima MM , Ogbuabo CM , Thomas V , Forhan SE , Gokatweng G , Dintwa E , Petlo C , Motswere-Chirwa C , Rabold EM , Tinker SC , Odunsi S , Malima S , Mmunyane O , Modise T , Kefitlhile K , Dare K , Letebele M , Roland ME , Moore CA , Modi S , Williamson DM . N Engl J Med 2019 381 (9) 885-887 In May 2018, an unscheduled analysis from the Botswana-Harvard AIDS Institute Partnership Tsepamo birth-outcomes surveillance study showed a higher prevalence of neural-tube defects among infants born to women who were using dolutegravir-based antiretroviral treatment (ART) regimens at the time of conception relative to infants born to women taking other types of ART.1 In response to this safety signal, the Botswana Ministry of Health and Wellness expanded surveillance for neural-tube defects in selected non-Tsepamo health facilities. |
Barriers and facilitators to linkage to care and ART initiation in the setting of high ART coverage in Botswana
Kebaabetswe P , Manyake K , Kadima E , Auletta-Young C , Chakalisa U , Sekoto T , Dintwa OM , Mmalane M , Makhema J , Lebelonyane R , Bachanas P , Plank R , Gaolathe T , Lockman S , Holme MP . AIDS Care 2019 32 (6) 1-7 We conducted a qualitative study using focus groups and in-depth interviews to explore barriers to and facilitators of linkage-to-care and antiretroviral treatment (ART) initiation in Botswana. Participants were selected from communities receiving interventions through the Ya Tsie Study. Fifteen healthcare providers and 49 HIV-positive individuals participated. HIV-positive participants identified barriers including stigma, discrimination and overcrowded clinics, and negative staff attitudes; personal factors, such as a lack of acceptance of one's HIV status, non-disclosure, and gender differences; along with lack of social/family support, and certain religious beliefs. Healthcare providers cited delayed test results, poverty, and transport difficulties as additional barriers. Major facilitators were support from healthcare providers, including home visits, social support, and knowing the benefits of ART. Participants were highly supportive of universal ART as a personal health measure. Our results highlighted a persistent structural health facility barrier: HIV-positive patients expressed strong discontent with HIV care/treatment being delivered differently than routine healthcare, feeling inconvenienced and stigmatized by separately designated locations and days of service. This barrier was particularly problematic for highly mobile persons. Addressing this structural barrier, which persists even in the context of high ART uptake, could bring gains in willingness to initiate ART and improved adherence in Botswana and elsewhere. |
Quality assurance of prevention of mother-to-child transmission of HIV in Botswana
Matambo S , Machakaire E , Motswere-Chirwa C , Legwaila K , Letsholathebe V , Dintwa E , Lu L , Voetsch AC , Glenshaw M . Afr J Midwifery Womens Health 2014 8 (3) 130-133 The HIV prevalence rate among pregnant women is 37% in Botswana. According to UNICEF (2011), maternal and under-5 mortality rates in Botswana were 160 per 100000 live births and 26 per 1000 live births, respectively. Therefore, this study sought to identify the effects of ongoing clinic audits of the prevention of mother-to-child transmission of HIV (PMTCT) in Francistown, Botswana for the period 2008–2012. | Methods: | Existing data for all women attending antenatal and postnatal clinics were collected and collated manually from monthly from clinic PMTCT registers. | Results: | There were 19 720 new antenatal clinic visits between 2008 and 2012 with an HIV prevalence of 35% among the women. Mother-to-child transmission of HIV decreased from 3% in 2008 to 1% in 2012. The decrease was due, in part, to the introduction of triple antiretroviral prophylaxis/antiretroviral therapy (TAP/ARV) (PMTCT Option B) in 2011. | Conclusions: | Audit results over a 5-year period showed a steady improvement in the cascade of PMTCT interventions. Clinic audits should be implemented nationally to reduce maternal and under-5 mortality. |
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