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Article ; Online: Bayesian analysis of severe acute respiratory syndrome: the 2003 Hong Kong epidemic.

Lekone, Phenyo E

Biometrical journal. Biometrische Zeitschrift

2008 Volume 50, Issue 4, Page(s) 597–607

Abstract: This paper analyzes data arising from a Severe Acute Respiratory Syndrome (SARS) epidemic in Hong Kong in 2003 involving 1755 cases. A discrete time stochastic model that uses a back-projection approach is proposed. Markov Chain Monte Carlo (MCMC) ... ...

Abstract	This paper analyzes data arising from a Severe Acute Respiratory Syndrome (SARS) epidemic in Hong Kong in 2003 involving 1755 cases. A discrete time stochastic model that uses a back-projection approach is proposed. Markov Chain Monte Carlo (MCMC) methods are developed for estimation of model parameters. The algorithm is further extended to integrate numerically over unobserved variables of the model. Applying the method to SARS data from Hong Kong, a value of 3.88 with a posterior standard deviation of 0.09 was estimated for the basic reproduction number. An estimate of the transmission parameter at the beginning of the epidemic was also obtained as 0.149 with a posterior standard deviation of 0.003. A reduction in the transmission parameter during the course of the epidemic forced the effective reproduction number to cross the threshold value of one, seven days after control interventions were introduced. At the end of the epidemic, the effective reproduction number was as low as 0.001 suggesting that the epidemic was brought under control by the intervention measures introduced.
MeSH term(s)	Algorithms ; Basic Reproduction Number ; Bayes Theorem ; Computer Simulation ; Disease Outbreaks ; Hong Kong/epidemiology ; Humans ; Markov Chains ; Models, Biological ; Prevalence ; Severe Acute Respiratory Syndrome/epidemiology ; Severe Acute Respiratory Syndrome/transmission ; Stochastic Processes
Keywords	covid19
Language	English
Publishing date	2008-07-10
Publishing country	Germany
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	131640-0
ISSN	1521-4036 ; 0323-3847 ; 0006-3452
ISSN (online)	1521-4036
ISSN	0323-3847 ; 0006-3452
DOI	10.1002/bimj.200710431
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Article ; Online: Progress towards the UNAIDS 95-95-95 targets in the Fifth Botswana AIDS Impact Survey (BAIS V 2021): a nationally representative survey.

Mine, Madisa / Stafford, Kristen A / Laws, Rebecca L / Marima, Reson / Lekone, Phenyo / Ramaabya, Dinah / Makhaola, Kgomotso / Patel, Hetal K / Mapondera, Prichard / Wray-Gordon, Floris / Agbakwuru, Chinedu / Okui, Lillian / Matroos, Susan / Onyadile, Eden / Ngidi, Julia / Abimiku, Alash'le / Bagapi, Khuteletso / Nkomo, Bornapate / Bodika, Stephane M /

Kim, Kaylee J / Moloney, Mirna / Mitchell, Andrew / Ehoche, Akipu / Ussery, Faith L / Hong, Steven Y / Keipeile, Stella / Matlhaga, Matshelo / Mathumo, Rapetse / Selato, Robert / Charurat, Manhattan E / Voetsch, Andrew C

The lancet. HIV

2024 Volume 11, Issue 4, Page(s) e245–e254

Abstract: Background: In 2014, UNAIDS set a goal to end the AIDS epidemic by achieving targets for the percentage of people living with HIV who were aware of their status, on antiretroviral therapy (ART), and virally suppressed. In 2020, these targets were ... ...

Abstract	Background: In 2014, UNAIDS set a goal to end the AIDS epidemic by achieving targets for the percentage of people living with HIV who were aware of their status, on antiretroviral therapy (ART), and virally suppressed. In 2020, these targets were revised to 95% for each measure (known as 95-95-95), to be reached among people living with HIV by 2025. We used data from the Fifth Botswana AIDS Impact Survey (BAIS V) to measure progress towards these testing and treatment targets in Botswana. Methods: BAIS V used a two-stage cluster design to obtain a nationally representative sample of people aged 15-64 years in Botswana. During March-August, 2021, 14 763 consenting participants were interviewed and tested for HIV in their households by survey teams. HIV-positive specimens were tested for viral load, presence of antiretroviral drugs, and recency of infection using the HIV-1 limiting antigen avidity enzyme immunoassay. Estimates of HIV-positive status and use of ART were based on self-report and the analysis of blood specimens for antiretroviral drugs. Viral load suppression was defined as an HIV RNA concentration of less than 1000 copies per mL. HIV incidence was calculated using the recent infection testing algorithm. Data were weighted to account for the complex survey design. Findings: The national HIV prevalence in Botswana among people aged 15-64 years was 20·8% and the annual incidence of HIV infection was 0·2%. 95·1% (men 93·0%, women 96·4%) of people living with HIV aged 15-64 years were aware of their status, 98·0% (men 97·2%, women 98·4%) of those aware were on ART, and 97·9% (men 96·6%, women 98·6%) of those on ART had viral load suppression. Among young people (aged 15-24 years) living with HIV, 84·5% were aware of their status, 98·5% of those aware were on ART, and 91·6% of those on ART had viral load suppression. The prevalance of viral load suppression among all people living with HIV was 91·8%, and varied by district-ranging from 85·3% in Gaborone to 100·0% in Selibe Phikwe. Interpretation: BAIS V is the first population-based survey worldwide to report the achievement of the UNAIDS 95-95-95 goals, both overall and among women. Strategies to reach undiagnosed men and young people, including young women, are needed. Funding: US President's Emergency Plan for AIDS Relief.
MeSH term(s)	Male ; Humans ; Female ; Adolescent ; Acquired Immunodeficiency Syndrome/drug therapy ; Acquired Immunodeficiency Syndrome/epidemiology ; HIV Infections/drug therapy ; HIV Infections/epidemiology ; Botswana/epidemiology ; Anti-Retroviral Agents/therapeutic use ; Surveys and Questionnaires ; Viral Load ; Prevalence
Chemical Substances	Anti-Retroviral Agents
Language	English
Publishing date	2024-03-08
Publishing country	Netherlands
Document type	Journal Article
ISSN	2352-3018
ISSN (online)	2352-3018
DOI	10.1016/S2352-3018(24)00003-1
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Article ; Online: Outcomes of HIV-positive patients with non-tuberculous mycobacteria positive culture who received anti-tuberculous treatment in Botswana: Implications of using diagnostic algorithms without non-tuberculous mycobacteria.

Agizew, Tefera / Boyd, Rosanna / Mathebula, Unami / Mathoma, Anikie / Basotli, Joyce / Serumola, Christipher / Pals, Sherri / Finlay, Alyssa / Lekone, Phenyo / Rankgoane-Pono, Goabaone / Tlhakanelo, Thato / Chihota, Violet / Auld, Andrew F

PloS one

2020 Volume 15, Issue 6, Page(s) e0234646

Abstract: Background: Patients with non-tuberculous mycobacteria (NTM) or Mycobacterium tuberculosis (MTB) pulmonary disease may have similar clinical presentation. The potential for misdiagnosis and inappropriate treatment exists in settings with limited testing ...

Abstract	Background: Patients with non-tuberculous mycobacteria (NTM) or Mycobacterium tuberculosis (MTB) pulmonary disease may have similar clinical presentation. The potential for misdiagnosis and inappropriate treatment exists in settings with limited testing capacity for Xpert® MTB/RIF (Xpert), phenotypic culture and NTM speciation. We describe treatment outcomes among people living with HIV (PLHIV) who received anti-tuberculosis treatment and were found to have NTM or MTB positive sputum cultures. Methods: PLHIV attending one of the 22 participating HIV clinics, who screened positive for ≥1 tuberculosis (TB) symptoms (cough, fever, night sweats, or weight loss) were asked to submit sputa for culture and speciation from August 2012 to November 2014. The national intensified TB case finding algorithms were followed: initially symptomatic patients were evaluated by testing sputum samples using a smear (smear-based TB diagnostic algorithm) and, after GeneXpert instruments were installed, by testing with Xpert (Xpert-based TB diagnostic algorithm). Within the study period, TB diagnostic algorithms used for MTB did not include screening, diagnosis, and management of NTM. Despite MTB negative culture, some symptomatic patients, including those with NTM positive culture, received empirical anti-TB treatment at the discretion of treating clinicians. Per the World Health Organization treatment outcomes classification: died, treatment failure or loss-to-follow-up were classified as unfavorable (unsuccessful) outcome; cured and treatment completed were classified as favorable (successful) outcome. Empiric treatment was defined as initiating treatment without or before receiving a test result indicating MTB. We compare treatment outcomes and characteristics among patients with NTM or MTB positive culture who received anti-TB treatment. Results: Among 314 PLHIV, who were found co-infected with TB, 146 cases had microbiological evidence; and for 131/146 MTB positive cultures were reported. One-hundred fifty-two of the 314 were clinically diagnosed with TB and treated empirically. Among those empirically treated for TB, 36/152 had culture results positive for NTM, and another 43/152 had culture results positive for MTB, reported after patients received empirical anti-TB treatment. Overall, MTB positive culture results were reported for 174 (131 plus 43) patients. Treatment outcomes were available for 32/36 NTM and 139/174 MTB; unfavorable outcomes were 12.5% and 8.7% for NTM and MTB, respectively, p = 0.514, respectively. For 34/36 tested NTM patients, all Xpert results indicated 'no MTB'. Among patients who initially received empiric anti-TB treatment and ultimately were found to have MTB positive culture, the unfavorable outcome was 11.8% (4/34), compared to 12.5% (4/32) of patients with NTM positive culture, Fisher's exact test p = 1.00. Conclusions: While the higher unfavorable outcome was non statistically significant, the impact of inappropriate treatment among NTM patients should not be overlooked. Our findings suggest that Xpert has the potential to rapidly rule-out NTM and avoid sub-optimal treatment; further research is needed to evaluate such potential.
MeSH term(s)	Adult ; Algorithms ; Antitubercular Agents/therapeutic use ; Botswana ; Female ; HIV Infections/diagnosis ; HIV Infections/microbiology ; Humans ; Male ; Nontuberculous Mycobacteria/isolation & purification ; Nontuberculous Mycobacteria/physiology ; Risk Factors ; Species Specificity ; Treatment Outcome ; Tuberculosis/drug therapy
Chemical Substances	Antitubercular Agents
Language	English
Publishing date	2020-06-12
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0234646
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Article ; Online: Improving same-day antiretroviral therapy in Botswana: effects of a multifaceted national intervention.

Montebatsi, Milton / Lavoie, Marie-Claude C / Blanco, Natalia / Marima, Reson / Sebina, Kagiso / Mangope, Justin / Ntwayagae, Ookeditse / Whittington, Anna / Letebele, Mpho / Lekone, Phenyo / Hess, Kristen L / Thomas, Vasavi / Ramaabya, Dinah / Ramotsababa, Mareko / Stafford, Kristen A / Ndwapi, Ndwapi

AIDS (London, England)

2021 Volume 36, Issue 4, Page(s) 533–538

Abstract: Background: In 2019, the Botswana Ministry of Health and Wellness (MOHW) implemented an HIV national Reboot program, which was needed for refocusing and intensifying efforts for achieving epidemic control. The strategies deployed as part of Reboot were ... ...

Abstract	Background: In 2019, the Botswana Ministry of Health and Wellness (MOHW) implemented an HIV national Reboot program, which was needed for refocusing and intensifying efforts for achieving epidemic control. The strategies deployed as part of Reboot were reviewed and evaluated for their effect on same-day and within-seven-days (fast-track initiation) antiretroviral therapy (ART) initiation among adults newly identified with HIV. Methods: We conducted a retrospective cohort analysis of patients aged 18 years or older who were newly diagnosed with HIV from October 2018 to September 2019 across 41 health facilities. We used generalized linear mixed models, adjusting for clustering by facility, to assess the association of the Reboot with same-day or within-seven-days ART initiation (fast-track initiation). Results: From October 2018 to January 2019, 28% (636/2269) of newly diagnosed HIV patients were initiated the same day of diagnosis, and 56% (1260/2269) were initiated within seven days. Following the launch of Reboot (February to September 2019), 59% (2092/3553) were initiated the same day of diagnosis, and 77% (2752/3553) were initiated within seven days. Clients were 2.08 (adjusted risk ratio 95% confidence interval 1.79-2.43) times more likely to be initiated the same day of diagnosis and 1.39 (adjusted risk ratio 95% confidence interval 1.28-1.52) times more likely to be initiated within seven days than before Reboot after adjusting for sex and age. Conclusion: In Botswana, a multifaceted national intervention improved timely ART initiation. Identifying and implementing different client-centered strategies to facilitate ART initiation is critical to preventing AIDS-related complications and prevent ongoing transmission.
MeSH term(s)	Adolescent ; Adult ; Anti-HIV Agents/therapeutic use ; Botswana/epidemiology ; HIV Infections/diagnosis ; HIV Infections/drug therapy ; Health Facilities ; Humans ; Retrospective Studies
Chemical Substances	Anti-HIV Agents
Language	English
Publishing date	2021-12-06
Publishing country	England
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	639076-6
ISSN	1473-5571 ; 0269-9370 ; 1350-2840
ISSN (online)	1473-5571
ISSN	0269-9370 ; 1350-2840
DOI	10.1097/QAD.0000000000003139
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Article: Statistical inference in a stochastic epidemic SEIR model with control intervention: Ebola as a case study.

Lekone, Phenyo E / Finkenstädt, Bärbel F

Biometrics

2006 Volume 62, Issue 4, Page(s) 1170–1177

Abstract: A stochastic discrete-time susceptible-exposed-infectious-recovered (SEIR) model for infectious diseases is developed with the aim of estimating parameters from daily incidence and mortality time series for an outbreak of Ebola in the Democratic Republic ...

Abstract	A stochastic discrete-time susceptible-exposed-infectious-recovered (SEIR) model for infectious diseases is developed with the aim of estimating parameters from daily incidence and mortality time series for an outbreak of Ebola in the Democratic Republic of Congo in 1995. The incidence time series exhibit many low integers as well as zero counts requiring an intrinsically stochastic modeling approach. In order to capture the stochastic nature of the transitions between the compartmental populations in such a model we specify appropriate conditional binomial distributions. In addition, a relatively simple temporally varying transmission rate function is introduced that allows for the effect of control interventions. We develop Markov chain Monte Carlo methods for inference that are used to explore the posterior distribution of the parameters. The algorithm is further extended to integrate numerically over state variables of the model, which are unobserved. This provides a realistic stochastic model that can be used by epidemiologists to study the dynamics of the disease and the effect of control interventions.
MeSH term(s)	Algorithms ; Biometry/methods ; Democratic Republic of the Congo/epidemiology ; Disease Outbreaks/statistics & numerical data ; Hemorrhagic Fever, Ebola/epidemiology ; Hemorrhagic Fever, Ebola/mortality ; Hemorrhagic Fever, Ebola/prevention & control ; Humans ; Likelihood Functions ; Models, Biological ; Models, Statistical ; Stochastic Processes
Language	English
Publishing date	2006-12
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	213543-7
ISSN	0006-341X ; 0099-4987
ISSN	0006-341X ; 0099-4987
DOI	10.1111/j.1541-0420.2006.00609.x
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Article ; Online: Tuberculosis treatment outcomes among people living with HIV diagnosed using Xpert MTB/RIF versus sputum-smear microscopy in Botswana: a stepped-wedge cluster randomised trial.

Agizew, Tefera / Chihota, Violet / Nyirenda, Sambayawo / Tedla, Zegabriel / Auld, Andrew F / Mathebula, Unami / Mathoma, Anikie / Boyd, Rosanna / Date, Anand / Pals, Sherri L / Lekone, Phenyo / Finlay, Alyssa

BMC infectious diseases

2019 Volume 19, Issue 1, Page(s) 1058

Abstract: Background: Xpert® MTB/RIF (Xpert) has high sensitivity for diagnosing tuberculosis (TB) compared to sputum-smear microscopy (smear) and can reduce time-to-diagnosis, time-to-treatment and potentially unfavorable patient-level treatment outcome.: ... ...

Abstract	Background: Xpert® MTB/RIF (Xpert) has high sensitivity for diagnosing tuberculosis (TB) compared to sputum-smear microscopy (smear) and can reduce time-to-diagnosis, time-to-treatment and potentially unfavorable patient-level treatment outcome. Methods: People living with HIV (PLHIV) initiating antiretroviral therapy at 22 HIV clinics were enrolled and underwent systematic screening for TB (August 2012-November 2014). GeneXpert instruments were deployed following a stepped-wedge design at 13 centers from October 2012-June 2013. Treatment outcomes classified as an unfavorable outcome (died, treatment failure or loss-to-follow-up) or favorable outcome (cured and treatment completed). To determine outcome, smear was performed at month 5 or 6. Empiric treatment was defined as initiating treatment without/before receiving TB-positive results. Adjusting for intra-facility correlation, we compared patient-level treatment outcomes between patients screened using smear (smear arm)- and Xpert-based algorithms (Xpert arm). Results: Among 6041 patients enrolled (smear arm, 1816; Xpert arm, 4225), 256 (199 per 2985 and 57 per 1582 person-years of follow-up in Xpert and smear arms, respectively; adjusted incidence rate ratio, 9.07; 95% confidence interval [CI]: 4.70-17.48; p < 0.001) received TB diagnosis and were treated. TB treatment outcomes were available for 203 patients (79.3%; Xpert, 157; smear, 46). Unfavorable outcomes were reported for 21.7% (10/46) in the smear and 13.4% (21/157) in Xpert arm (adjusted hazard ratio, 1.40; 95% CI: 0.75-2.26; p = 0.268). Compared to smear, in Xpert arm median days from sputum collection to TB treatment was 6 days (interquartile range [IQR] 2-17 versus 22 days [IQR] 3-51), p = 0.005; patients with available sputum test result had microbiologically confirmed TB in 59.0% (102/173) versus 41.9% (18/43), adjusted Odds Ratio [aOR], 2.00, 95% CI: 1.01-3.96, p = 0.048). In smear arm empiric treatment was 68.4% (39/57) versus 48.7% (97/199), aOR, 2.28, 95% CI: 1.24-4.20, p = 0.011), compared to Xpert arm. Conclusions: TB treatment outcomes were similar between the smear and Xpert arms. However, compared to the smear arm, more patients in the Xpert arm received a TB diagnosis, had a microbiologically confirmed TB, and had a shorter time-to-treatment, and had a lower empiric treatment. Further research is recommended to identify potential gaps in the Botswana health system and similar settings. Trial registration: ClinicalTrials.gov Identifier: NCT02538952. Retrospectively registered on 2 September 2015.
MeSH term(s)	Adult ; Botswana ; Data Accuracy ; Female ; Follow-Up Studies ; HIV Infections/complications ; Humans ; Lost to Follow-Up ; Male ; Mass Screening ; Microscopy/methods ; Mycobacterium tuberculosis/genetics ; Mycobacterium tuberculosis/isolation & purification ; Nucleic Acid Amplification Techniques/methods ; Prospective Studies ; Sensitivity and Specificity ; Sputum/microbiology ; Time-to-Treatment ; Treatment Outcome ; Tuberculosis/complications ; Tuberculosis/diagnosis ; Tuberculosis/drug therapy ; Tuberculosis/microbiology
Language	English
Publishing date	2019-12-16
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Randomized Controlled Trial
ISSN	1471-2334
ISSN (online)	1471-2334
DOI	10.1186/s12879-019-4697-5
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Article ; Online: Prevalence of HIV testing and counseling and associated factors among secondary school students in Botswana.

Bodika, Stephane M / Lekone, Phenyo E / Loeto, Peter / Alwano, Mary G / Zulu, Thekiso C / Kim, Evelyn / Machao, Gape / Voetsch, Andrew C

International journal of adolescent medicine and health

2016 Volume 28, Issue 2, Page(s) 149–154

Abstract: Background: The World Health Organization recommends HIV testing and counseling (HTC) for all adolescents living in countries with generalized HIV epidemics. In Botswana, HIV prevalence among adolescents 15-19 years is 3.7% and among pregnant ... ...

Abstract	Background: The World Health Organization recommends HIV testing and counseling (HTC) for all adolescents living in countries with generalized HIV epidemics. In Botswana, HIV prevalence among adolescents 15-19 years is 3.7% and among pregnant adolescents is 10%. We describe the proportion and characteristics of secondary school students who have accessed HTC. Methods: A multistage sample survey was conducted among students in Botswana's public secondary schools in 2010. The survey was self-administered using a personal digital assistant device. The HTC rate was estimated using self-reported history of HIV testing. Results: Of 1,632 participants, 52% were girls, 43% aged below 16 years, and 27% had ever had sexual intercourse. Most (81%) students knew where to get tested for HIV. Overall, 2.2% of students were HIV positive by self-report. The HTC rate was 23% overall, 34% among students who had ever had sexual intercourse, and 45% among students who had sexual intercourse in the past 12 months. Being pregnant or having made someone pregnant and having had sexual intercourse in the past 12 months were associated with having been tested for HIV among students who had ever had sexual intercourse. Discussion: Overall, the HTC rate was low, and the self- reported HIV prevalence was high among secondary students in Botswana. Most sexually active students have never been tested for HIV. Health communications efforts for adolescents that increase demand for HTC, routine opt-out HIV testing in healthcare facilities, and school-based HIV testing are needed as part of a national HIV prevention strategy.
MeSH term(s)	Adolescent ; Adolescent Behavior ; Adult ; Botswana/epidemiology ; Counseling ; Diagnostic Tests, Routine/statistics & numerical data ; Female ; HIV Infections/diagnosis ; HIV Infections/epidemiology ; Health Knowledge, Attitudes, Practice ; Health Surveys ; Humans ; Male ; Pregnancy ; Prevalence ; Risk Factors ; Schools ; Sexual Behavior ; Students ; Young Adult
Language	English
Publishing date	2016-05-01
Publishing country	Germany
Document type	Journal Article
ZDB-ID	639287-8
ISSN	2191-0278 ; 0334-0139
ISSN (online)	2191-0278
ISSN	0334-0139
DOI	10.1515/ijamh-2014-0081
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Article: Statistical Inference in a Stochastic Epidemic SEIR Model with Control Intervention: Ebola as a Case Study

Lekone, Phenyo E / Finkenstädt, Bärbel F

Biometrics. 2006 Dec., v. 62, no. 4

2006

Abstract: A stochastic discrete‐time susceptible‐exposed‐infectious‐recovered (SEIR) model for infectious diseases is developed with the aim of estimating parameters from daily incidence and mortality time series for an outbreak of Ebola in the Democratic Republic ...

Abstract	A stochastic discrete‐time susceptible‐exposed‐infectious‐recovered (SEIR) model for infectious diseases is developed with the aim of estimating parameters from daily incidence and mortality time series for an outbreak of Ebola in the Democratic Republic of Congo in 1995. The incidence time series exhibit many low integers as well as zero counts requiring an intrinsically stochastic modeling approach. In order to capture the stochastic nature of the transitions between the compartmental populations in such a model we specify appropriate conditional binomial distributions. In addition, a relatively simple temporally varying transmission rate function is introduced that allows for the effect of control interventions. We develop Markov chain Monte Carlo methods for inference that are used to explore the posterior distribution of the parameters. The algorithm is further extended to integrate numerically over state variables of the model, which are unobserved. This provides a realistic stochastic model that can be used by epidemiologists to study the dynamics of the disease and the effect of control interventions.
Keywords	Markov chain ; Monte Carlo method ; algorithms ; biometry ; case studies ; infectious diseases ; models ; mortality ; time series analysis ; Democratic Republic of the Congo
Language	English
Dates of publication	2006-12
Size	p. 1170-1177.
Publishing place	Blackwell Publishing Inc
Document type	Article
ZDB-ID	213543-7
ISSN	0099-4987 ; 0006-341X
ISSN	0099-4987 ; 0006-341X
DOI	10.1111/j.1541-0420.2006.00609.x
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Article ; Online: Voluntary Medical Male Circumcisions for HIV Prevention - 13 Countries in Eastern and Southern Africa, 2017-2021.

Peck, Megan E / Ong, Katherine S / Lucas, Todd / Harvey, Pauline / Lekone, Phenyo / Letebele, Mpho / Thomas, Vasavi T / Maziya, Vusi / Mkhontfo, Mandzisi / Gultie, Teruwork / Mulatu, Dejene / Shimelis, Mesfin / Zegeye, Tiruneh / Juma, Ambrose W / Odoyo-June, Elijah / Musingila, Paul K / Njenga, John / Auld, Andrew / Kapito, Martin /

Maida, Alice / Msungama, Wezi / Canda, Marcos / Come, Jotamo / Malimane, Inacio / Aupokolo, Mekondjo / Zemburuka, Brigitte / Kankindi, Ida / Malamba, Samuel / Remera, Eric / Tubane, Emmanuel / Machava, Richard / Maphothi, Nandi / Vranken, Peter / Amuri, Mbaraka / Kazaura, Kokuhumbya J / Simbeye, Daimon / Alamo, Stella / Kabuye, Geoffrey / Chituwo, Omega / Kamboyi, Royd / Masiye, Joseph / Mandisarisa, John / Xaba, Sinokuthemba / Toledo, Carlos

MMWR. Morbidity and mortality weekly report

2023 Volume 72, Issue 10, Page(s) 256–260

Abstract: In 2007, voluntary medical male circumcision (VMMC) was endorsed by the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS after it was found to be associated with approximately a 60% reduction in the risk for female-to- ... ...

Abstract	In 2007, voluntary medical male circumcision (VMMC) was endorsed by the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS after it was found to be associated with approximately a 60% reduction in the risk for female-to-male transmission of HIV (1). As a result of this endorsement, the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), through partnerships with U.S. government agencies, including CDC, the U.S. Department of Defense, and the U.S. Agency for International Development, started supporting VMMCs performed in prioritized countries in southern and eastern Africa. During 2010-2016, CDC supported 5,880,372 VMMCs in 12 countries (2,3). During 2017-2021, CDC supported 8,497,297 VMMCs performed in 13 countries. In 2020, the number of VMMCs performed declined 31.8% compared with the number in 2019, primarily because of COVID-19-related disruptions to VMMC service delivery. PEPFAR 2017-2021 Monitoring, Evaluation, and Reporting data were used to provide an update and describe CDC's contribution to the scale-up of the VMMC program, which is important to meeting the 2025 Joint United Nations Programme on HIV/AIDS (UNAIDS) target of 90% of males aged 15-59 years having access to VMMC services in prioritized countries to help end the AIDS epidemic by 2030 (4).
MeSH term(s)	Humans ; Male ; Female ; Acquired Immunodeficiency Syndrome ; HIV Infections/epidemiology ; HIV Infections/prevention & control ; Circumcision, Male ; COVID-19 ; Africa, Southern/epidemiology ; Africa, Eastern/epidemiology ; Voluntary Programs ; HIV-1
Language	English
Publishing date	2023-03-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	412775-4
ISSN	1545-861X ; 0149-2195
ISSN (online)	1545-861X
ISSN	0149-2195
DOI	10.15585/mmwr.mm7210a2
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Article ; Online: Follow-up of infants diagnosed with HIV - Early Infant Diagnosis Program, Francistown, Botswana, 2005-2012.

Motswere-Chirwa, Catherine / Voetsch, Andrew / Lu, Lydia / Letsholathebe, Victor / Lekone, Phenyo / Machakaire, Esther / Legwaila, Keitumetse / Matambo, Stembile / Maruping, Maruping / Kolobe, Thatayotlhe / Petlo, Chipo / Lebelonyane, Refeletswe / Glenshaw, Mary / Dale, Helen / Davis, Margarett / El Halabi, Shenaaz / Pelletier, Andrew

MMWR. Morbidity and mortality weekly report

2014 Volume 63, Issue 7, Page(s) 158–160

Abstract: The 2011 prevalence of human immunodeficiency virus (HIV) among pregnant women in Botswana was 30.4%. High coverage rates of HIV testing and antiretroviral prophylaxis have reduced the rate of mother-to-child transmission of HIV in Botswana from as high ... ...

Abstract	The 2011 prevalence of human immunodeficiency virus (HIV) among pregnant women in Botswana was 30.4%. High coverage rates of HIV testing and antiretroviral prophylaxis have reduced the rate of mother-to-child transmission of HIV in Botswana from as high as 40% with no prophylaxis to <4% in 2011. In June 2005, the national Early Infant Diagnosis (EID) Program began testing HIV-exposed infants (i.e., those born to HIV-infected mothers) for HIV using polymerase chain reaction (PCR) at 6 weeks postpartum. During 2005-2012, follow-up of all HIV-infected infants diagnosed in all 13 postnatal care facilities in Francistown, Botswana, was conducted to ascertain patient outcomes. A total of 202 infants were diagnosed with HIV. As of September 2013, 82 (41%) children were alive and on antiretroviral therapy (ART), 79 (39%) had died, and 41 (20%) were either lost to follow-up, had transferred, or their mothers declined ART. Despite success in preventing mother-to-child transmission in Botswana, results of the EID program highlight the need for early diagnosis of HIV-infected infants, prompt initiation of ART, and retention in care.
MeSH term(s)	Anti-HIV Agents/therapeutic use ; Botswana ; Counseling/statistics & numerical data ; Female ; Follow-Up Studies ; HIV Infections/diagnosis ; HIV Infections/drug therapy ; HIV Infections/mortality ; HIV Infections/transmission ; Humans ; Infant ; Infectious Disease Transmission, Vertical/prevention & control ; Male ; Polymerase Chain Reaction ; Pregnancy ; Pregnancy Complications, Infectious/prevention & control ; Program Evaluation ; Survival Rate ; Treatment Outcome
Chemical Substances	Anti-HIV Agents
Language	English
Publishing date	2014-02-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	412775-4
ISSN	1545-861X ; 0149-2195
ISSN (online)	1545-861X
ISSN	0149-2195
Database	MEDical Literature Analysis and Retrieval System OnLINE

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