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Missed opportunities along the prevention of mother-to-child transmission services cascade in South Africa: Uptake, determinants, and attributable risk (the SAPMTCTE)
No full textObjectives: We examined uptake of prevention of mother-to-child HIV transmission (PMTCT) services, predictors of missed opportunities, and infant HIV transmission attributable to missed opportunities along the PMTCT cascade across South Africa. Methods: A cross-sectional survey was conducted among 4-8 week old infants receiving first immunisations in 580 nationally representative public health facilities in 2010. This included maternal interviews and testing infants\u27 dried blood spots for HIV. A weighted analysis was performed to assess uptake of antenatal and perinatal PMTCT services along the PMTCT cascade (namely: maternal HIV testing, CD4 count test/result, and receiving maternal and infant antiretroviral treatment) and predictors of dropout. The population attributable fraction associated with dropouts at each service point are estimated. Results: Of 9,803 mothers included, 31.7% were HIV-positive as identified by reactive infant antibody tests. Of these 80.4% received some form of maternal and infant antiretroviral treatment. More than a third (34.9%) of mothers dropped out from one or more steps in the PMTCT service cascade. In a multivariable analysis, the following characteristics were associated with increased dropout from the PMTCT cascade: adolescent (\u3c20 years) mothers, low socioeconomic score, low education level, primiparous mothers, delayed first antenatal visit, homebirth, and non-disclosure of HIV status. Adolescent mothers were twice (adjusted odds ratio: 2.2, 95% confidence interval: 1.5-3.3) as likely to be unaware of their HIV-positive status and had a significantly higher rate (85.2%) of unplanned pregnancies compared to adults aged ≥20 years (55.5%, p = 0.0001). A third (33.8%) of infant HIV infections were attributable to dropout in one or more steps in the cascade. Conclusion: A third of transmissions attributable to missed opportunities of PMTCT services can be prevented by optimizing the uptake of PMTCT services. Identified risk factors for low PMTCT service uptake should be addressed through health facility and community-level interventions, including raising awareness, promoting women education, adolescent focused interventions, and strengthening linkages/referral-system between communities and health facilities
Panther- February 2015 - Vol. XCV, NO.1
Get PDFhttps://digitalcommons.pvamu.edu/pv-panther-newspapers/1811/thumbnail.jp
Panther - February 2015 - Vol. XCV No. 2
Get PDFhttps://digitalcommons.pvamu.edu/pv-panther-newspapers/1406/thumbnail.jp
Optimal Error Estimate of Upwind Scheme on Adaptive grid for Two Parameter Singular Perturbation Problem
Get PDFA singularly perturbed convection-diffusion problem with two small parameters is considered. The problem is solved by an upwind finite difference operator on an appropriate non-uniform mesh constructed adaptively by equi-distributing a monitor function based on the solution. An error bound in the maximum norm is established theoretically with the error constants shown to be independent of both singular perturbation parameters. The normalized flux obtained via interpolating the polynomial from the numerical solution is also uniformly convergent. A numerical experiment illustrates in practice the result of convergence proved theoretically
Sensitivity Analysis in Correlated Bivariate Continuous and Binary Responses
Get PDFFactorization models for correlated binary and continuous responses are proposed. Full likelihood-based approach that yields maximum likelihood estimates of the model parameters is used. A common way to investigate if perturbations of model components influence key results of the analysis is to compare the results derived from the original and perturbed models using an influence graph. So small perturbation influence of the correlation parameters of the models on likelihood displacement and a general index of sensitivity (ISNI) are also studied. The model is illustrated using data from arthritis and body mass index data. The effect of systolic blood pressure, gender and age on arthritis and body mass index are investigated
The fuzzy over-relaxed proximal point iterative scheme for generalized variational inclusion with fuzzy mappings
Get PDFThis paper deals with the introduction of a fuzzy over-relaxed proximal point iterative scheme based on H(-, -)-cocoercivity framework for solving a generalized variational inclusion problem with fuzzy mappings. The resolvent operator technique is used to approximate the solution of generalized variational inclusion problem with fuzzy mappings and convergence of the iterative sequences generated by the iterative scheme is discussed. Our results can be treated as refinement of many previously-known results
The shifted Jacobi polynomial integral operational matrix for solving Riccati differential equation of fractional order
Get PDFIn this article, we have applied Jacobi polynomial to solve Riccati differential equation of fractional order. To do so, we have presented a general formula for the Jacobi operational matrix of fractional integral operator. Using the Tau method, the solution of this problem reduces to the solution of a system of algebraic equations. The numerical results for the examples presented in this paper demonstrate the efficiency of the present method
Generating Random Vectors Using Transformation with Multiple Roots and its Applications
Get PDFAn approach is proposed to generate random vectors using transformation with multiple roots. This approach generalizes the one-dimensional inverse transformation with multiple roots method to higher dimensions, i.e., to random vectors with or without densities. In this approach, multiple roots of the transformation and probabilities of selecting each of the roots are derived. The strategies for constructing such a transformation are discussed and several examples are presented to motivate this simulation approach
Free Convective Chemically Absorption Fluid Past an Impulsively Accelerated Plate with Thermal Radiation Variable Wall Temperature and Concentrations
Get PDFThe present paper deals with the theoretical study of thermal radiation and chemical reaction on free convective heat and mass transfer flow of a Newtonian viscous incompressible fluid past a suddenly accelerated semi–infinite vertical permeable plate immersed in Darcian absorption media. The fluid media is considered as optically thick and the Rosselend radiative heat flux model is incorporated in the energy equation. The governing equation of motions are first non-dimensionalised and then transformed into a set of ordinary differential equations by employing a suitable periodic transformation. The closed form of the expression for velocity, temperature and concentration fields as well as skin- friction, Nusselt and Sherwood numbers are obtained in terms of various physical parameters present. The effect of parameters like thermal radiation, first order chemical reaction, radiation absorption co-efficient and permeability parameter on the flow variables are obtained numerically and illustrated through graphs and tables. It is observed that, the absorption parameter and radiation parameter increase the temperature as well as the fluid velocity, while the skin–friction is found to be decreasing due to an increase in thermal radiation parameter. It is also observed that, some of the transportation phenomena accelerate due to the presence of chemical reaction parameter
Hyers-Ulam and Hyers-Ulam-Aoki-Rassias Stability for Linear Ordinary Differential Equations
Get PDFHere we prove the Hyers-Ulam stability and Hyers-Ulam-Aoki-Rassias stability of the n-th order ordinary linear differential equation with smooth coefficients on compact and semi-bounded intervals using successive integration by parts. Keywords