Publications - Maternal and child health

Timing of maternal isoniazid preventive therapy on tuberculosis infection among infants exposed to HIV in low-income and middle-income settings: a secondary analysis of the TB APPRISE trial

Post Date: 
2023-09-13
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Lancet Child Adolescent Health
Deferral of maternal isoniazid preventive therapy to early postpartum had no effect on infant tuberculosis acquisition in our trial population, regardless of the diagnostic test used.

Pharmacokinetics and Safety of Three Months of Weekly Rifapentine and Isoniazid for Tuberculosis Prevention in Pregnant Women

Post Date: 
2022-03-05
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Clinical Infectious Diseases
Background Pregnancy increases the risk of tuberculosis and its complications. A 3-month regimen of weekly isoniazid and rifapentine (3HP) is safe and effective for tuberculosis prevention in adults and children, including those with HIV, but 3HP has not been evaluated in pregnancy. Methods IMPAACT...

Implementation of the Comprehensive Unit-based Safety Program to Improve Infection Prevention and Control Practices in Four Neonatal Intensive Care Units in Pune, India

Post Date: 
2022-01-06
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Frontiers in Pediatrics
Objective: To implement the Comprehensive Unit-based Safety Program (CUSP) in four neonatal intensive care units (NICUs) in Pune, India, to improve infection prevention and control (IPC) practices. Design: In this quasi-experimental study, we implemented CUSP in four NICUs in Pune, India, to...

Individual and Composite Adverse Pregnancy Outcomes in a Randomized Trial on Isoniazid Preventative Therapy Among Women Living With HIV

Post Date: 
2020-09-30
Publication: 
Clinical Infectious Diseases
Background: IMPAACT P1078, a randomized non-inferiority study designed to compare safety of starting isoniazid preventive therapy (IPT) in women with HIV during pregnancy or after delivery, showed that IPT during pregnancy increased the risk of composite adverse pregnancy outcomes, but not...

A mobile health-facilitated behavioral intervention for community health workers improves exclusive breastfeeding and early infant HIV diagnosis in India: A cluster randomized trial

Post Date: 
2020-07-03
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Journal of the International AIDS Society
When community health workers used a mobile health intervention with HIV+ women to deliver care, there was a higher uptake of exclusive breastfeeding at two months and early infant HIV diagnosis at six weeks

Isoniazid Preventive Therapy and Pregnancy Outcomes in Women Living With Human Immunodeficiency Virus in the Tshepiso Cohort

Post Date: 
2019-10-21
Publication: 
Clinical Infectious Disease
Background Both pregnancy and human immunodeficiency virus (HIV) increase the risk of tuberculosis disease, which results in poor maternal, pregnancy, and infant outcomes. Isoniazid preventive therapy (IPT) reduces mortality among individuals living with HIV in high-burden settings but has recently...

Isoniazid preventive therapy in HIV-infected pregnant and postpartum women

Post Date: 
2019-10-03
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New England Journal of Medicine
New England Journal of Medicine: Dr. Amita Gupta and colleagues found that the current standard of care given to HIV+ pregnant women to prevent TB should wait until 12 weeks after delivery. The study underscores the need to include pregnant women in clinical trials.

Inclusion of key populations in clinical trials of new antituberculosis treatments: Current barriers and recommendations for pregnant and lactating women, children, and HIV-infected persons

Post Date: 
2019-08-15
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PLOS Medicine
PLOS Medicine: Dr. Amita Gupta and colleagues discuss the scientific and ethical basis for including pregnant and lactation women, children, and HIV+ patients in tuberculosis therapeutic clinical trials.

The association of household fine particulate matter and kerosene with tuberculosis in women and children in Pune, India

Post Date: 
2018-09-07
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Occupational and Environmental Medicine
Use of kerosene cooking fuel is positively associated with TB in women and children in our analysis using reported sources of exposure.

Prevention of HIV-1 transmission through breastfeeding:efficacy of safety of maternal antiretroviral therapy versus infant nevirapine prophylaxis for duration of breastfeeding in HIV-1-infected women with high CD4 cell count (IMPAACT PROMISE)

Post Date: 
2018-04-01
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Journal of Acquired Immune Deficiency Syndromes
BACKGROUND: No randomized trial has directly compared the efficacy of prolonged infant antiretroviral prophylaxis versus maternal antiretroviral therapy (mART) for prevention of mother-to-child transmission throughout the breastfeeding period. SETTING: Fourteen...

Intestinal barrier dysfunction and microbial translocation in HIV-infected pregnant women is associated with preterm birth

Post Date: 
2018-03-24
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Clinical Infectious Diseases
Our results show select immune markers can identify women at higher risk for PTB in HIV-1-infected populations and suggest modulating gut barrier integrity and microbial translocation may affect PTB.

Secondhand smoke exposure and validity of self-report in low-income women and children in India

Post Date: 
2018-01-10
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Pediatrics
Pediatrics: Dr. Jessica Elf and colleagues evaluated the validity of standard self-reported measures for secondhand smoke (SHS) exposure among women and children in urban India.

Maternal syphilis: An independent risk factor for mother to infant human immunodeficiency virus transmission

Post Date: 
2017-06-15
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Sexually Transmitted Diseases
Abstract Syphilis is associated with increased human immunodeficiency virus acquisition and sexual transmission; we examined impact on human immunodeficiency virus mother-to-child transmission among mother-infant pairs enrolled in the India Six-Week Extended-Dose Nevirapine study...

Efficacy of six-week extended-dose nevirapine varies by infant birth weight with greatest relative efficacy in low birth weight infants

Post Date: 
2016-09-30
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PLOS One
Low birth weight (LBW), defined by the World Health Organization (WHO) as birth weight less than 2500 g, is a significant public health issue in resource-limited settings, particularly in Sub Saharan Africa and South Asia where the estimated annual incidence is 14% and 28–31%, respectively,...

The availability of emergency obstetric care in the context of the JSY cash transfer programme in Madhya Pradesh, India

Post Date: 
2016-05-18
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BMC Pregnancy and Childbirth
Abstract Background: Since 2005, India has implemented a national cash transfer programme, the Janani Suraksha Yojana (JSY), which provides women a cash transfer upon giving birth in an existing public facility. This has resulted in a steep rise in facility births across the...

Assessment of the quality of clinical documentation in India's JSY cash transfer program for facility births in Madhya Pradesh

Post Date: 
2016-02-15
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International Journal of Gynaecology and Obstetrics
Abstract Objective: To gain insight into the quality of care in facilities implementing the Janani Suraksha Yojana (JSY) cash transfer program in Madhya Pradesh, India, by reviewing the level of documentation in the clinical records of women who delivered. ...

Low Vitamin-D levels combined with PKP3-SIGIRR-TMEM16J host variants is strongly associated with tuberculosis and death in HIV-infected and -exposed infants

Post Date: 
2016-02-12
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PLOS One
Background: This study examined the associations of 25-hydroxyvitamin D and specific host genetic variants that affect vitamin D levels or its effects on immune function, with the risk of TB or mortality in children. Methods: A case-cohort sample of 466 South African infants...

Toward earlier inclusion of pregnant and postpartum women in TB drug trials: consensus statements from an International Expert Panel

Post Date: 
2016-01-04
Publication: 
Clinical Infectious Diseases
Tuberculosis is a major cause of morbidity and mortality in women of childbearing age (15–44 years). Despite increased tuberculosis risk during pregnancy, optimal clinical treatment remains unclear: safety, tolerability, and pharmacokinetic data for many tuberculosis drugs are lacking, and...

Knowledge, attitudes, and practices regarding breastfeeding in postpartum mothers at a tertiary care institute during a public health awareness campaign

Post Date: 
2015-10-09
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International Journal of Health Sciences
Background: Breast feeding has several benefits for both the infants and mothers. However, despite strong evidences in support of breast feeding its prevalence has remained low worldwide. The objective of the present study was to examine the knowledge and attitude towards breast feeding and infant...

Soluble CD14: An independent biomarker for risk of HIV mother-to-child transmission in setting of pre- and post-exposure antiretroviral prophylaxis

Post Date: 
2015-10-06
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The Journal of Infectious Diseases
Elevated soluble CD14 (sCD14) concentrations, a marker of monocyte activation, predicts adverse outcomes in human immunodeficiency virus (HIV)-infected adults. To examine the association of sCD14 concentrations with the risk of mother-to-child transmission (MTCT) of HIV, we nested a case-...

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