{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T01:15:19Z","timestamp":1789694119323,"version":"4.0.1"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,11,8]],"date-time":"2018-11-08T00:00:00Z","timestamp":1541635200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000016","name":"U.S. Department of Health and Human Services","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000016","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the association between <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> infection and puerperal sepsis among women in Zimbabwe.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A subanalysis was performed using data from a prospective cohort study conducted between September 2, 2014, and July 1, 2015, at two tertiary hospitals in Zimbabwe. Eligible participants were consecutive women who met the <jats:styled-content style=\"fixed-case\">WHO<\/jats:styled-content> criteria for puerperal sepsis. Variables assessed included <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infection status and the use of antiretroviral therapy. Severity of immunosuppression was defined by the number of T cells that expressed cluster of differentiation 4 (<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4). Endocervical swabs and blood samples were collected for microbial culture and susceptibility testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In all, 33 (21.9%) of the 151 women included in the present analysis had <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>. Among women with <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>, severe immunosuppression (<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4\u2010positive T cell count &lt;200\/mm<jats:sup>3<\/jats:sup>) was associated with a mean hospital stay of 19.0\u00a0days versus 10.2\u00a0days for mild\u2010advanced immunosuppression (<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4\u2010positive T cell count 200\u2013500\/mm<jats:sup>3<\/jats:sup>) and insignificant immunosuppression (<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4\u2010positive T cell count &gt;500\/mm<jats:sup>3<\/jats:sup>; <jats:italic>P<\/jats:italic>=0.030). Use of antiretroviral therapy did not independently influence clinical outcomes. Furthermore, infection with <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> did not influence the microorganisms isolated from blood or endocervical samples.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Severe immunosuppression was associated with increased length of hospitalization among women with <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> who had puerperal sepsis.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.12695","type":"journal-article","created":{"date-parts":[[2018,10,21]],"date-time":"2018-10-21T09:44:52Z","timestamp":1540115092000},"page":"67-72","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The association of puerperal sepsis with <scp>HIV<\/scp> infection at two tertiary hospitals in Zimbabwe"],"prefix":"10.1002","volume":"144","author":[{"given":"Rumbidzai","family":"Majangara","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Zimbabwe College of Health Sciences  Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zvavahera M.","family":"Chirenje","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Zimbabwe College of Health Sciences  Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muchabaiwa F.","family":"Gidiri","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Zimbabwe College of Health Sciences  Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,11,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(14)70227-X"},{"key":"e_1_2_8_3_1","unstructured":"MunjanjaSP.Zimbabwe Maternal and Perinatal Mortality Study. 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