Low Absolute Neutrophil Counts in African Infants Kourtis, Athena P.; Bramson, Brian; van der Horst, Charles ...
Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002),
07/2005, Volume:
4, Issue:
3
Journal Article
Peer reviewed
Open access
Infants of African origin have a lower normal range of absolute neutrophil counts than white infants; this fact, however, remains under appreciated by clinical researchers in the United States. ...During the initial stages of a clinical trial in Malawi, the authors noted an unexpectedly high number of infants with absolute neutrophil counts that would be classifiable as neutropenic using the National Institutes of Health’s Division of AIDS toxicity tables. The authors argue that the relevant Division of AIDS table does not take into account the available evidence of low absolute neutrophil counts in African infants and that a systematic collection of data from many African settings might help establish the absolute neutrophil count cutpoints to be used for defining neutropenia in African populations.
The increase in health research in sub-Saharan Africa (SSA) has led to a high demand for biostatisticians to develop study designs, contribute and apply statistical methods in data analyses. ...Initiatives exist to address the dearth in statistical capacity and lack of local biostatisticians in SSA health projects. The Sub-Saharan African Consortium for Advanced Biostatistics (SSACAB) led by African institutions was initiated to improve biostatistical capacity according to the needs identified by African institutions, through collaborative masters and doctoral training in biostatistics. SACCAB has created a critical mass of biostatisticians and a network of institutions over the last five years and has strengthened biostatistics resources and capacity for health research studies in SSA. SSACAB comprises 11 universities and four research institutions which are supported by four European universities. In 2015, only four universities had established Masters programmes in biostatistics and SSACAB supported the remaining seven to develop Masters programmes. In 2019 the University of the Witwatersrand became the first African institution to gain Royal Statistical Society accreditation for a Biostatistics Masters programme. A total of 150 fellows have been awarded scholarships to date of which 123 are Masters fellowships (41 female) of whom 58 have already graduated. Graduates have been employed in African academic (19) and research (15) institutions and 10 have enrolled for PhD studies. A total of 27 (10 female) PhD fellowships have been awarded; 4 of them are due to graduate by 2020. To date, SSACAB Masters and PhD students have published 17 and 31 peer-reviewed articles, respectively. SSACAB has also facilitated well-attended conferences, face-to-face and online short courses. Pooling of limited biostatistics resources in SSA combined with co-funding from external partners has shown to be an effective strategy for the development and teaching of advanced biostatistics methods, supervision and mentoring of PhD candidates.
The health of HIV-exposed children after early weaning Parker, Megan E.; Tembo, Martin; Adair, Linda; Chasela, Charles; Piwoz, Ellen G.; Jamieson, Denise J.; Ellington, Sascha; Kayira, Dumbani; Soko, Alice; Mkhomawanthu, Chimwemwe; Martinson, Francis; van der Horst, Charles M.; Bentley, Margaret E
09/2013
Journal Article
IFPRI3; ISI; B Promoting healthy food systems; G Cross-cutting gender theme
Results from the BAN study Parker, Megan E.; Bentley, Margaret E.; Chasela, Charles; Adair, Linda; Piwoz, Ellen G.; Jamieson, Denise J.; Ellington, Sascha; Kayira, Dumbani; Soko, Alice; Mkhomawanthu, Chimwemwe; Tembo, Martin; Martinson, Francis; Van der Horst, Charles M
01/2012
Journal Article
Background: Low dietary selenium (Se) intake coupled with low plasma Se concentrations in HIV infection could result in inadequate breastmilk Se intake by exclusively breastfed infants of ...HIV-infected women. Objective: To test the effect of lipid-based nutrient supplements (LNS) containing 1.3 RDA of sodium selenite and anti-retroviral drugs (ARV) on maternal plasma and breastmilk Se. Design: HIV-infected Malawian mothers in the Breastfeeding, Antiretrovirals, and Nutrition study were randomized at delivery to: LNS, ARV, LNS-ARV, or control. In a sub-sample of 512 mothers and their uninfected infants, we measured plasma and breastmilk Se concentrations at 2 or 6 wk (depending on availability of infant samples) and 24 wk post-partum. Results: Mean maternal (81.1-86.1 ng/mL) and infant (55.6-60.7 ng/mL) plasma Se increased, while breastmilk Se levels declined (14.4-9.8 ng/mL) from 2 or 6 to 24 wk (all p<0.001). The direction of change in Se levels differed by baseline Se tertile. Low (ß=9.1, p<0.001) and mid (ß=20.8, p<0.001) baseline Se tertile were positively associated with change in maternal plasma or breastmilk Se from 2 or 6 to 24 wk. LNS and ARV were not associated with change in Se concentration. Higher maternal plasma and breastmilk Se were associated with higher infant plasma Se at 2 or 6 and 24 wk (p<0.001), regardless of study arm. Conclusions: Similar patterns of change in Se levels in breastmilk and infant plasma have been documented in non-HIV-infected populations and are probably physiological. The lack of Se supplementation effect is likely related to the form of Se used.
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