Publications

OBJECTIVE: To assess changes in the proportion of CD4 and CD8 T-lymphocyte profiles during pregnancy, at delivery and postpartum, and to determine whether HIV-1 infection affects the normal profile. DESIGN AND METHODS: A total of 416 pregnant HIV-1-infected women and an age and parity-matched HIV-seronegative group of 407 pregnant women were enrolled into a prospective study on the impact of HIV-1 infection on pregnancy. Maternal blood was obtained for lymphocyte subset determination at enrollment, delivery and 6 weeks postpartum.

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PIP: In Kenya, a sexually transmitted disease (STD) program implemented in 10 medical centers in Nairobi allows nurses to diagnose syphilis based on symptoms, have blood tests conducted to confirm syphilis, prescribe treatment, and provide counseling. About 5% of pregnant women in Kenya have syphilis but do not know that they are infected or are afraid to seek sexually transmitted disease treatment in health centers. This program tests all pregnant women for syphilis during the prenatal examination.

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A decentralized syphilis control program in pregnant women was implemented in nine Nairobi City Council antenatal clinics between July 1992 and August 1993, whereby pregnant women were screened for syphilis, treated before leaving the clinic if RPR seroreactive, and counselled on the importance of partner treatment and sexual abstinence during treatment in order to protect their unborn babies from getting congenital syphilis.

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A decentralized syphilis control program in pregnant women was implemented in nine Nairobi City Council antenatal clinics between July 1992 and August 1993, whereby pregnant women were screened for syphilis, treated before leaving the clinic if RPR seroreactive, and counselled on the importance of partner treatment and sexual abstinence during treatment in order to protect their unborn babies from getting congenital syphilis.

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The CuFix (GyneFix), conceived in 1985, was developed to minimize three major problems frequently associated with discontinuation of IUD use: expulsion, bleeding and pain. Since the initial clinical investigations, over 10,000 woman years of experience and up to 8 years of follow-up in international multicenter, non-comparative and comparative clinical trials, including a large proportion of nulligravid/nulliparous women, have been collected.

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SUMMARY: Large numbers of pregnant women in Africa have been invited to participate in studies on HIV infection. Study protocols adhere to guidelines on voluntary participation after pre-test and post-test counseling and informed consent; nevertheless, women may consent because they have been asked to do so without fully understanding the implications of being tested for HIV.

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Sexually transmitted diseases (STDs) are highly prevalent in pregnant women in many developing countries and have been associated with poor obstetric outcomes. Case detection and treatment of STDs in women is problematic and expensive, underscoring the need for other strategies. To explore the potential benefits of routine antimicrobial therapy on pregnancy outcome, we carried out a randomized, double-blind, clinical trial in one of the antenatal clinics in Nairobi, Kenya.

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Sexually transmitted diseases (STDs) are highly prevalent in pregnant women in many developing countries and have been associated with poor obstetric outcomes. Case detection and treatment of STDs in women is problematic and expensive, underscoring the need for other strategies. To explore the potential benefits of routine antimicrobial therapy on pregnancy outcome, we carried out a randomized, double-blind, clinical trial in one of the antenatal clinics in Nairobi, Kenya.

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