{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,9,15]],"date-time":"2024-09-15T12:35:25Z","timestamp":1726403725976},"reference-count":40,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,11,11]],"date-time":"2013-11-11T00:00:00Z","timestamp":1384128000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2014,5]]},"abstract":"Objectives<\/jats:title>We prospectively investigated fever symptoms and maternal diagnosis of malaria in pregnancy (MIP<\/jats:styled-content>) in relation to child HIV<\/jats:styled-content> infection among 2368 pregnant HIV<\/jats:styled-content>\u2010positive women and their infants, followed up from pregnancy until 6 weeks post\u2010delivery in T<\/jats:styled-content>anzania.<\/jats:p><\/jats:sec>Methods<\/jats:title>Doctors clinically diagnosed and treated MIP<\/jats:styled-content> and fever symptoms during prenatal health care. Child HIV<\/jats:styled-content> status was determined via DNA<\/jats:styled-content> polymerase chain reaction (PCR<\/jats:styled-content>). Multivariable logistic regression models were used to estimate relative risks (RRs<\/jats:styled-content>) and 95% confidence intervals (CIs<\/jats:styled-content>) for HIV<\/jats:styled-content> mother\u2010to\u2010child transmission (MTCT<\/jats:styled-content>) by the 6th week of life.<\/jats:p><\/jats:sec>Results<\/jats:title>Mean gestational age at enrolment was 22.2 weeks. During follow\u2010up, 16.6% of mothers had at least one MIP<\/jats:styled-content> diagnosis, 15.9% reported fever symptoms and 8.7% had both fever and MIP<\/jats:styled-content> diagnosis. Eleven per cent of HIV<\/jats:styled-content>\u2010exposed infants were HIV<\/jats:styled-content>\u2010positive by 6 weeks. The RR<\/jats:styled-content> of HIV MTCT<\/jats:styled-content> was statistically similar for infants whose mothers were ever vs.<\/jats:italic> never clinically diagnosed with MIP<\/jats:styled-content> (RR<\/jats:styled-content> 1.24; 95% CI<\/jats:styled-content> 0.94\u20131.64), were diagnosed with one vs.<\/jats:italic> no clinical MIP<\/jats:styled-content> episodes (RR<\/jats:styled-content> 1.07; 95% CI<\/jats:styled-content> 0.77\u20131.48) and had ever vs.<\/jats:italic> never reported fever symptoms (RR<\/jats:styled-content> 1.04; 95% CI<\/jats:styled-content> 0.78\u20131.38) in pregnancy. However, the HIV MTCT<\/jats:styled-content> risk increased by 29% (95% CI<\/jats:styled-content> 4\u201358%) per MIP<\/jats:styled-content> episode. Infants of women with at least two vs.<\/jats:italic> no MIP<\/jats:styled-content> diagnoses were 2.1 times more likely to be HIV<\/jats:styled-content> infected by 6 weeks old (95% CI<\/jats:styled-content> 1.31\u20133.45).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Clinical MIP<\/jats:styled-content> diagnosis, but not fevers, in HIV<\/jats:styled-content>\u2010positive pregnant women was associated with an elevated risk of early HIV MTCT<\/jats:styled-content>, suggesting that malaria prevention and treatment in pregnant HIV<\/jats:styled-content>\u2010positive women may enhance the effectiveness of HIV<\/jats:styled-content> prevention in MTCT<\/jats:styled-content> programmes in this setting. Future studies using a laboratory\u2010confirmed diagnosis of malaria are needed to confirm this association.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.12111","type":"journal-article","created":{"date-parts":[[2013,11,12]],"date-time":"2013-11-12T03:15:28Z","timestamp":1384226128000},"page":"276-285","source":"Crossref","is-referenced-by-count":6,"title":["Clinical malaria diagnosis in pregnancy in relation to early perinatal mother\u2010to\u2010child transmission of HIV<\/scp>: a prospective cohort study"],"prefix":"10.1111","volume":"15","author":[{"given":"AE","family":"Ezeamama","sequence":"first","affiliation":[{"name":"Department of Epidemiology & Biostatistics University of Georgia Athens GA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C","family":"Duggan","sequence":"additional","affiliation":[{"name":"Department of Nutrition Harvard School of Public Health Boston MA USA"},{"name":"Division of Gastroenterology and Nutrition Children's Hospital Boston MA 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