Presentation Transcript
HIV: HIV Over 1/3 of hospital
patients positive
HIV: HIV
Subsaharan Africa: 17% on therapy
G-8: universal access by 2010
HIV: HIV test called “super VDRL” or “super”
positive patients “super plus” or “coded”
HIV: HIV In pregnancy:
tested on enrollment for prenatal care
most HIV+ pregnant patients received AZT
HIV+ mothers still encouraged to breastfeed
Nonpregnant patients:
wallet biopsy positive: ART
wallet biopsy negative: no ART or plan
A face to go with the numbers: A face to go with the numbers 19 yo G1P0 at 32 weeks with HIV, TB, malaria admitted with fever, respiratory distress due to TB, hypoglycemia due to malaria
sono IUGR, oligo
hct 19- but BYOBD
Slide6:
no plan for HIV management A face to go with the numbers
Aidsinafrica.net: Aidsinafrica.net
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Aidsinafrica.net: Aidsinafrica.net
Aidsinafrica.net: Aidsinafrica.net
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Aidsinafrica.net: Aidsinafrica.net
Slide16: Malaria in Pregnancy Worldwide
500,000,000 infections each year
2,000,000 deaths
75% of deaths are African children
majority of remainder pregnant women
In the US
1337 cases in the USA in 2002
227 in New York- highest of any state
Malaria in Pregnancy: Malaria in Pregnancy Stable Areas
frequent mosquito bites
acquired immunity
in pregnancy:
low parasitemia
high placental sequestration Unstable Areas
Rare mosquito bites
no acquired immunity
in pregnancy:
heavy parasitemia
low placental sequestration
Slide18: Impaired placental function Placental
Sequestration Low Birth Weight Risk of Newborn Mortality malaria Maternal
Anemia Immune mom Nonimmune
mom Parasitemia
Rationale for the Timing of Chemoprophyllaxis: Conception Birth 20 30 10 Weeks of gestation 16 Rationale for the Timing of Chemoprophyllaxis Fetal growth velocity Quickening Source: WHO 2002. Last
month Rx Rx
Slide20: Malaria and Volunteers Weekly larium or daily doxycycline
light colored clothing
no perfumes
Gin and tonics