Evidence map›Paper›PMID 24215465›Full record

ArticleHIV medicine2014

Clinical malaria diagnosis in pregnancy in relation to early perinatal mother-to-child transmission of HIV: a prospective cohort study.

A E Ezeamama, C Duggan, K P Manji, D Spiegelman, E Hertzmark, R J Bosch, R Kupka, J O Okuma, R Kisenge, S Aboud and 1 more

Open access · bronzeAbstract read
In one paragraph

Article in HIV medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 3 countries.

A E EzeamamaDepartment of Epidemiology & Biostatistics, University of Georgia, Athens, GA, USA.
C Duggan
K P Manji
D Spiegelman
E Hertzmark
R J Bosch
R Kupka
J O Okuma
R Kisenge
S Aboud
W W Fawzi
Harvard University · USMuhimbili University of Health and Allied Sciences · TZUniversity of Georgia · US

Funding

Trial of Vitamins among Children of HIV-infected MothersR01HD043688 · NICHD · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI FAWZI, WAFAIE W · 2003 to 2007
$2.7M
Patient-oriented Research in Pediatric Diarrheal DiseasesK24HD058795 · NICHD · BOSTON CHILDREN'S HOSPITAL · PI DUGGAN, CHRISTOPHER P · 2010 to 2014
$956k
NICHD NIH HHS K24 HD058795NICHD NIH HHS R01 HD043688NICHD NIH HHS R01HD043688
6 · The paper itself

Abstract

objectivesWe prospectively investigated fever symptoms and maternal diagnosis of malaria in pregnancy (MIP) in relation to child HIV infection among 2368 pregnant HIV-positive women and their infants, followed up from pregnancy until 6 weeks post-delivery in Tanzania.

methodsDoctors clinically diagnosed and treated MIP and fever symptoms during prenatal health care. Child HIV status was determined via DNA polymerase chain reaction (PCR). Multivariable logistic regression models were used to estimate relative risks (RRs) and 95% confidence intervals (CIs) for HIV mother-to-child transmission (MTCT) by the 6th week of life.

resultsMean gestational age at enrolment was 22.2 weeks. During follow-up, 16.6% of mothers had at least one MIP diagnosis, 15.9% reported fever symptoms and 8.7% had both fever and MIP diagnosis. Eleven per cent of HIV-exposed infants were HIV-positive by 6 weeks. The RR of HIV MTCT was statistically similar for infants whose mothers were ever vs. never clinically diagnosed with MIP (RR 1.24; 95% CI 0.94-1.64), were diagnosed with one vs. no clinical MIP episodes (RR 1.07; 95% CI 0.77-1.48) and had ever vs. never reported fever symptoms (RR 1.04; 95% CI 0.78-1.38) in pregnancy. However, the HIV MTCT risk increased by 29% (95% CI 4-58%) per MIP episode. Infants of women with at least two vs. no MIP diagnoses were 2.1 times more likely to be HIV infected by 6 weeks old (95% CI 1.31-3.45).

conclusionsClinical MIP diagnosis, but not fevers, in HIV-positive pregnant women was associated with an elevated risk of early HIV MTCT, suggesting that malaria prevention and treatment in pregnant HIV-positive women may enhance the effectiveness of HIV prevention in MTCT programmes in this setting. Future studies using a laboratory-confirmed diagnosis of malaria are needed to confirm this association.

Indexed as

AdultFemaleHIV InfectionsHumansInfant, NewbornInfectious Disease Transmission, VerticalMalariaMultivariate AnalysisPregnancyPregnancy Complications, InfectiousProspective StudiesRisk FactorsTanzaniaAIDScoinfectionHIV-exposed infantHIV mother-to-child transmissionmalaria

Identifiers

PMID24215465
PMCPMC4299572
OpenAlexW1954081860

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.