A5034462800- HIV/AIDS Research and Interventions
- Adolescent Sexual and Reproductive Health
- Mobile Health and mHealth Applications
- Reproductive tract infections research
- Maternal Mental Health During Pregnancy and Postpartum
- Global Maternal and Child Health
- ICT in Developing Communities
- Preterm Birth and Chorioamnionitis
- Reproductive System and Pregnancy
- HIV, Drug Use, Sexual Risk
- Breastfeeding Practices and Influences
- Child and Adolescent Psychosocial and Emotional Development
- Attachment and Relationship Dynamics
- Syphilis Diagnosis and Treatment
- Pregnancy and preeclampsia studies
- HIV-related health complications and treatments
- Pregnancy and Medication Impact
- Cervical Cancer and HPV Research
- Primary Care and Health Outcomes
Kenyatta National Hospital
2016-2025
University of Washington
2020
University of Nairobi
2019-2020
The objective of this study is to determine the risk and cofactors for HIV acquisition during pregnancy postpartum.
There is growing evidence that mobile health (mHealth) approaches including short messaging service (SMS) can improve antiretroviral therapy (ART) adherence, but consensus lacking regarding communication of HIV-related information. Most interventions to date have delivered SMS do not overtly refer HIV or ART in order avoid risk status disclosure. In formative work for an ongoing randomized controlled trial (RCT) evaluating one-way and two-way educational prevention...
Objectives We evaluated the relationship of sexually transmitted infections (STIs) and genital during pregnancy subsequent risk for infant mortality stillbirth. Methods This was a nested longitudinal analysis using data from study peripartum HIV acquisition in Kenya. In parent study, HIV-uninfected women were enrolled followed until 9 months postpartum. For this analysis, who tested positive at any point, had non-singleton or spontaneous abortion <20 weeks excluded. At enrolment,...
Background Pregnant and postpartum women living with HIV (WLWH) need support for maternal child health (MCH) care, which could be provided using short message service (SMS). Methods findings We compared 2-way (interactive) 1-way SMS messaging to no in a 3-arm randomized trial 6 MCH clinics Kenya. Messages were developed the Health Belief Model Social Cognitive Theory; messages integrated into an existing platform. Intervention participants received visit reminders prespecified weekly on...
Objectives Recent studies have identified vaginal bacterial taxa associated with increased HIV risk. A possible mechanism to explain these results is that individual differentially promote cervicovaginal inflammation. This study aimed explore relationships between concentrations of bacteria previously linked acquisition and proinflammatory cytokines chemokines. Methods In this cross-sectional analysis, 17 four (interleukin (IL)-1β, IL-6, IL-10 tumour necrosis factor alpha (TNFα)) two...
Identifying predictors of preterm birth (PTB) in high-burden regions is important as PTB the leading cause global child mortality.This analysis was nested a longitudinal study human immunodeficiency virus (HIV) incidence Kenya. HIV-seronegative women enrolled pregnancy had nucleic acid amplification tests (chlamydia and gonorrhea), rapid plasma reagin (syphilis), wet mount microscopy (Trichomonas yeast), Gram stain (bacterial vaginosis); sexually transmitted infection (STI) treatment...
Perinatal depression is broadly defined as depressive symptoms during pregnancy or within the 12 months following delivery, affecting approximately 20-25% of pregnant and postpartum women in low- middle-income countries. The wide accessibility mobile phones allows health (mHealth) interventions to be considered a solution identify perinatal provide appropriate referrals for treatment. This study, nested larger SMS communication project, examined prevalence correlates depression, determined...
Background Women living with HIV (WLWH) face unique reproductive health (RH) barriers which increase their risks of unmet need for contraception, contraceptive failure, unintended pregnancy, and pregnancy-related morbidity mortality may prevent them from achieving goals. Patient-centered counseling interventions that support care workers (HCWs) in providing high-quality RH counseling, tailored to the needs WLWH, improve outcomes. Methods design We are conducting a non-blinded cluster...
We determined social and behavioral factors associated with virologic non-suppression among pregnant women receiving Option B+ antiretroviral treatment (ART). Baseline data was used from in Mobile WAChX trial 6 public maternal child health (MCH) clinics Kenya. Virologic defined as HIV viral load (VL) ≥1000 copies/ml. Antiretroviral resistance testing performed using oligonucleotide ligation (OLA) assay. ART adherence information, motivation skills were assessed Lifewindows IMB tool,...
We examined longitudinal patterns and cofactors of depressive symptoms among pregnant postpartum women living with HIV (WLWH).This study used data from a randomized trial text messaging intervention. WLWH were serially assessed for pregnancy through 24 months at 6 time points (pregnancy, weeks, 6, 12, 18, postpartum). Depressive using Patient Health Questionnaire-9 group-based trajectory modeling. Moderate-to-severe (MSD) correlates generalized estimating equations.Among 824 enrolled women,...
Objective: The aim of this study was to understand predictors adverse pregnancy outcomes (APOs) among women on antiretroviral treatment (ART). Design: A longitudinal cohort Methods: Participants from the Mobile WAChX trial were evaluated for APOs, including stillbirth (fetal death at ≥20 weeks’ gestation), preterm birth (PTB, livebirth <37 gestation,) and neonatal (NND, ≤28 days after live birth). Predictors determined by univariable multivariable Cox proportional hazards log-binomial...
Depression among pregnant women living with HIV (WLWH) in sub-Saharan Africa leads to poor pregnancy and outcomes. This cross-sectional analysis utilized enrollment data from a randomized trial (Mobile WAChX, NCT02400671) six Kenyan public maternal child health clinics. Depressive symptoms were assessed the Patient Health Questionnaire-9 (PHQ-9), stigma Stigma Scale for Chronic Illness, intimate partner violence (IPV) Abuse Assessment Screen. Correlates of moderate-to-severe depressive...
Globally, 2.5 million neonates die and 2 more are stillborn each year; the vast majority occur where access to life-saving care is limited. High quality, feasible interventions needed reach, educate empower pregnant women new mothers improve care-seeking behaviors. Mobile WACh (Mobile solutions for Women's Children's health) NEO a human-computer hybrid mobile health (mHealth) system that allows two-way short message service (SMS) communication between healthcare workers during peripartum...
Introduction Globally, approximately half of the estimated 6.3 million under-5 deaths occur in neonatal period (within first 28 days life). Kenya ranks among countries with highest number deaths, at 20 per 1000 live births. Improved identification and management neonates potentially life-threatening illness is critical to meet WHO’s target ≤12 births by 2035. We developed an interactive (two-way) short messaging service (SMS) communication intervention, Mobile Solutions for Neonatal Health...
Objective: To evaluate the relationship between cervical cytokine/chemokine concentrations and HIV-1 acquisition in peripartum Kenyan women. Design: Nested case–control study. Methods: Women participating a prospective study of HIV Kenya (the Mama Salama Study ), were tested for at 1–3 month intervals during pregnancy through 9 months postpartum. Cases positive RNA follow-up ( N = 14), matched 3 : 1 with HIV-negative controls 42) based on age, marital status, partner transactional sex,...
Prevention of mother-to-child transmission programs serve women continuing and initiating antiretroviral therapy (ART) in pregnancy, follow-up schedules align to delivery rather than ART initiation, making conventional HIV retention measures (assessed from initiation) challenging apply. We evaluated 3 peripartum nonretention Kenyan living with pregnancy 2 years postpartum. This longitudinal analysis used programmatic data the Mobile WAChX trial (NCT02400671). Outcomes included loss (LTFU)...
Specific causes of preterm birth remain unclear. Several recent studies have suggested that immune changes during pregnancy are associated with the timing delivery, yet few been performed in low-income country settings where rates highest. We conducted a retrospective nested case-control evaluation within longitudinal study among HIV-uninfected pregnant Kenyan women. To characterize function these women, we evaluated unstimulated and stimulated peripheral blood mononuclear cells vitro...
Abstract Background : Globally, approximately half of the estimated 6.3 million under-5 deaths occur in neonatal period (within first 28 days life) and 75% week life. Kenya ranks among countries with highest number deaths, a mortality rate 20 per 1000 live births. Novel strategies are needed to meet WHO’s Every Newborn Action Plan target 10 or fewer births by 2035. Improved identification management neonates potentially life-threatening illness is critical. We developed an interactive...
Welcome to Annals of Global Health,Annals Health is a peer-reviewed, fully open access, online journal dedicated publishing high quality articles all aspects global health. The journal's mission advance health, promote research, and foster the prevention treatment disease worldwide. Its goals are improve health well-being people, equity, wise stewardship earth's environment. latest impact factor 3.64.Annals supported by Program for Public Common Good at Boston College. It was founded in 1934...
Differentiated service delivery (DSD) approaches decrease frequency of clinic visits for individuals who are stable on antiretroviral therapy. It is unclear how to optimize DSD models postpartum women living with HIV (PWLH). We evaluated longitudinal viral load (VL) and cofactors, modelled eligibility virologic failure (VF) among PWLH in prevention mother-to-child transmission programs. This analysis used programmatic data from participants the Mobile WAChX trial (NCT02400671). Women were...
Jiang, Wenwen MPH; Osborn, Lusi BS; Drake, Alison L. PhD, Unger, Jennifer A. MD, Matemo, Daniel Kinuthia, John MBChB, MMed, John-Stewart, Grace Ronen, Keshet MPH Author Information
Abstract Background Perinatal depression is broadly defined as depressive symptoms during pregnancy or within the 12 months following delivery, affecting approximately 20-25% of pregnant and postpartum women in low- middle-income countries. The wide accessibility mobile phones allows health (mHealth) interventions to be considered a solution identify perinatal provide appropriate referrals for treatment. This study, nested larger SMS communication project, examined prevalence correlates...