15 results on '"Alwy Al-Beity, Fadhlun M"'
Search Results
2. Antenatal depression and adverse birth outcomes among pregnant women living with HIV in Dar es Salaam, Tanzania
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Regan, Mathilda, Muhihi, Alfa, Saleh, Arvin, Duggan, Christopher P., Ulenga, Nzovu, Alwy Al-Beity, Fadhlun M., Aboud, Said, Fawzi, Wafaie W., Manji, Karim P., and Sudfeld, Christopher R.
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- 2023
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3. Health workers’ experiences of implementation of Helping Mothers Survive Bleeding after Birth training in Tanzania: a process evaluation using the i-PARIHS framework
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Alwy Al-beity, Fadhlun M, Baker, Ulrika, Kakoko, Deodatus, Hanson, Claudia, and Pembe, Andrea B
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- 2022
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4. “Are all referrals necessary?” Experiences and perceptions of maternity healthcare providers on emergency intrapartum referrals in Dar es Salaam, Tanzania
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Selemani, Shekha, primary, Mwakyusa, Michael O., additional, Bashiri, Selemani, additional, Ezekiel, Mangi J., additional, Mwakawanga, Dorkasi L., additional, Alwy Al-beity, Fadhlun M., additional, and Pembe, Andrea B., additional
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- 2024
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5. Vaccination willingness, vaccine hesitancy, and estimated coverage of SARS‐CoV‐2 vaccine among healthcare workers in Tanzania: A call for action
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Kessy, Suzan Joseph, primary, Wei, Tingting, additional, Zhou, Yiguo, additional, Zhang, Wan‐Xue, additional, Alwy Al‐Beity, Fadhlun M., additional, Zhang, Shan‐Shan, additional, Du, Juan, additional, Cui, Fuqiang, additional, and Lu, Qing‐Bin, additional
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- 2023
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6. COVID-19 vaccine hesitancy among pregnant women attending public antenatal clinics in Dar es Salaam, Tanzania
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Yussuph, Zainab Hassan, primary, Alwy Al-Beity, Fadhlun M., additional, August, Furaha, additional, and Anaeli, Amani, additional
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- 2023
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7. Shared decision making on mode of delivery following a prior cesarean delivery in Dar es Salaam, Tanzania
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Yussuph, Zainab Hassan, primary and Alwy Al-beity, Fadhlun M., additional
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- 2023
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8. Vitamin D.sub.3 supplementation during pregnancy and lactation for women living with HIV in Tanzania: A randomized controlled trial
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Sudfeld, Christopher R., Manji, Karim P., Muhihi, Alfa, Duggan, Christopher P., Aboud, Said, Alwy Al-Beity, Fadhlun M., Wang, Molin, Zhang, Ning, Ulenga, Nzovu, and Fawzi, Wafaie W.
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Maternal-fetal exchange ,Alfacalcidol -- Dosage and administration ,Calcifediol -- Dosage and administration ,Vitamin D -- Dosage and administration ,Highly active antiretroviral therapy -- Dosage and administration ,Lactation -- Health aspects ,Pregnant women -- Care and treatment ,Pediatric research ,HIV infection -- Demographic aspects -- Prevention -- Risk factors ,Biological sciences - Abstract
Background Observational studies suggest that vitamin D deficiency among people living with HIV is associated with a greater risk of disease progression and death. Low levels of vitamin D in pregnancy are also associated with poor fetal and infant growth. Therefore, vitamin D supplementation may improve clinical outcomes for pregnant women living with HIV and improve fetal and postnatal growth for their infants. Methods and findings We conducted a randomized, triple-blind, placebo-controlled trial of vitamin D.sub.3 supplementation among pregnant and lactating women living with HIV in Dar es Salaam, Tanzania (ClinicalTrials.gov NCT02305927). Participants were randomized with 1:1 allocation stratified by study clinic to receive either daily 3,000 IU vitamin D.sub.3 supplements or matching placebo supplements from the second trimester of pregnancy (12-27 weeks) until 1 year postpartum. The primary outcomes were (i) maternal HIV progression or death, (ii) small-for-gestational-age (SGA) live births ( Conclusions The trial findings do not support routine vitamin D supplementation for pregnant and lactating women living with HIV in Tanzania. Trial registration ClinicalTrials.gov Identifier: NCT02305927., Author(s): Christopher R. Sudfeld 1,2,*, Karim P. Manji 3, Alfa Muhihi 4, Christopher P. Duggan 2,5, Said Aboud 6, Fadhlun M. Alwy Al-Beity 7, Molin Wang 8,9,10, Ning Zhang 9, [...]
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- 2022
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9. Action leveraging evidence to reduce perinatal mortality and morbidity (ALERT): study protocol for a stepped-wedge cluster-randomised trial in Benin, Malawi, Tanzania and Uganda
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Akuze, Joseph, Annerstedt, Kristi Sidney, Benova, Lenka, Chipeta, Effie, Dossou, Jean-Paul, Gross, Mechthild M., Kidanto, Hussein, Marchal, Bruno, Alvesson, Helle Mölsted, Pembe, Andrea B., van Damme, Wim, Waiswa, Peter, Hanson, Claudia, Namazzi, Gertrude, Babirye, Josephine, Wanduru, Philip, Orsini, Nicola, Unkels, Regine, Pleguezuelo, Virginia Castellano, Snijders, Rian, Delvaux, Therese, Kandeya, Bianca, Mussa, Razak, Meja, Samuel, Stones, William, Nyirenda, Yesaya Z., Laure, Ahossi Angèle Florence, Sognonvi, Antoinette, Vigan, Armelle, Hamed, Banougnin Bolade, Bello, Kéfilath, Metogni, Christelle Boyi, Houngbo, Gisele, Agballa, Gottfried, Hounkpati, Hashim, Agbla, Schadrac, Welsh, Joanne, Abeid, Muzdalifat, Mwansisya, Tumbwene, Alwy Al-Beity, Fadhlun M., Julius, Zamoyoni, Mkoka, Dickson, Mselle, Lilian T., Mwilike, Beatrice, Naburi, Helga, Ayebare, Elizabeth O., Moller, Ann-Beth Nygaard, Ayebare, Elizabeth Ombeva, Hounkpatin, Hashim, Gandaho, Pacos, Kidanto, Hussein L., Mselle, Lilian, Gross, Mechthild, Van Damme, Wim, Hall, Jennifer, Lampa, Erik, Qureshi, Zahida, Gerontology, and Frailty in Ageing
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Malawi ,Malawi/epidemiology ,Respectful maternity care ,Midwifery ,Tanzania ,Health system intervention ,Study Protocol ,Hospital ,03 medical and health sciences ,0302 clinical medicine ,Obstetrics and Gynaecology ,Benin ,Humans ,Uganda ,030212 general & internal medicine ,Sub-Saharan Africa ,030503 health policy & services ,Health Policy ,Infant, Newborn ,Uganda/epidemiology ,Public Health, Environmental and Occupational Health ,Tanzania/epidemiology ,Perinatal health ,3. Good health ,perinatal mortality ,Childbirth ,perinatal death ,Female ,pregnancy ,Maternal health ,Morbidity ,Geriatrics and Gerontology ,Public aspects of medicine ,RA1-1270 ,0305 other medical science ,Intrapartum care - Abstract
Background Insufficient reductions in maternal and neonatal deaths and stillbirths in the past decade are a deterrence to achieving the Sustainable Development Goal 3. The majority of deaths occur during the intrapartum and immediate postnatal period. Overcoming the knowledge-do-gap to ensure implementation of known evidence-based interventions during this period has the potential to avert at least 2.5 million deaths in mothers and their offspring annually. This paper describes a study protocol for implementing and evaluating a multi-faceted health care system intervention to strengthen the implementation of evidence-based interventions and responsive care during this crucial period. Methods This is a cluster randomised stepped-wedge trial with a nested realist process evaluation across 16 hospitals in Benin, Malawi, Tanzania and Uganda. The ALERT intervention will include four main components: i) end-user participation through narratives of women, families and midwifery providers to ensure co-design of the intervention; ii) competency-based training; iii) quality improvement supported by data from a clinical perinatal e-registry and iv) empowerment and leadership mentoring of maternity unit leaders complemented by district based bi-annual coordination and accountability meetings. The trial’s primary outcome is in-facility perinatal (stillbirths and early neonatal) mortality, in which we expect a 25% reduction. A perinatal e-registry will be implemented to monitor the trial. Our nested realist process evaluation will help to understand what works, for whom, and under which conditions. We will apply a gender lens to explore constraints to the provision of evidence-based care by health workers providing maternity services. An economic evaluation will assess the scalability and cost-effectiveness of ALERT intervention. Discussion There is evidence that each of the ALERT intervention components improves health providers’ practices and has modest to moderate effects. We aim to test if the innovative packaging, including addressing specific health systems constraints in these settings, will have a synergistic effect and produce more considerable perinatal mortality reductions. Trial registration Pan African Clinical Trial Registry (www.pactr.org): PACTR202006793783148. Registered on 17th June 2020.
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- 2021
10. Timing of Antiretroviral Therapy: Initiation and Birth Outcomes Among Pregnant Women With Human Immunodeficiency Virus in Tanzania
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Quinn, M K, Williams, Paige L, Muhihi, Alfa, Duggan, Christopher P, Ulenga, Nzovu, Alwy Al-Beity, Fadhlun M, Perumal, Nandita, Aboud, Said, Fawzi, Wafaie W, Manji, Karim P, and Sudfeld, Christopher R
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Pregnancy ,Major Article ,Infant, Newborn ,Pregnancy Outcome ,Humans ,Premature Birth ,Female ,HIV Infections ,Prospective Studies ,Pregnancy Complications, Infectious ,Tanzania - Abstract
BACKGROUND: Combination antiretroviral therapy (cART) initiation during pregnancy reduces the risk of perinatal human immunodeficiency virus (HIV) transmission; however, studies have suggested that there may be unintended adverse consequences on birth outcomes for selected cART regimens. METHODS: We analyzed adverse birth outcomes among a prospective cohort of 1307 pregnant women with HIV in Dar es Salaam who initiated cART during the first or second trimester of a singleton pregnancy. Our primary analysis compared birth outcomes by gestational age at cART initiation among these women initiating cART in pregnancy. RESULTS: Among women who initiated cART in pregnancy, there was no relationship of gestational age at cART initiation with the risk of fetal death or stillbirth. However, women who initiated cART before 20 weeks of gestation compared with after 20 weeks had increased risk of preterm birth (risk ratio [RR], 1.30; 95% confidence interval [CI], 1.03–1.67) but decreased risk of small-for-gestational age birth (RR, 0.71; 95% CI, .55–.93). CONCLUSIONS: With increasing use of cART preconception and early in pregnancy, clinicians should be aware of the benefits and potential risks of cART regimens to optimize birth outcomes.
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- 2022
11. Timing of Antiretroviral Therapy
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Quinn, M K, primary, Williams, Paige L, additional, Muhihi, Alfa, additional, Duggan, Christopher P, additional, Ulenga, Nzovu, additional, Alwy Al-Beity, Fadhlun M, additional, Perumal, Nandita, additional, Aboud, Said, additional, Fawzi, Wafaie W, additional, Manji, Karim P, additional, and Sudfeld, Christopher R, additional
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- 2022
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12. Quality of oxytocin and tranexamic acid for the prevention and treatment of postpartum hemorrhage in Kenya, Nigeria, South Africa, and Tanzania
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Ammerdorffer, Anne, primary, Rushwan, Sara, additional, Timms, Rebecca, additional, Wright, Philip, additional, Beeson, Leanne, additional, Devall, Adam J., additional, Mammoliti, Kristie‐Marie, additional, Alwy Al‐beity, Fadhlun M., additional, Galadanci, Hadiza, additional, Hofmeyr, G. Justus, additional, Singata‐Madliki, Mandisa, additional, Qureshi, Zahida, additional, Lambert, Pete, additional, Gallos, Ioannis D., additional, Coomarasamy, Arri, additional, and Gülmezoglu, A. Metin, additional
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- 2022
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13. Effects of helping mothers survive bleeding after birth in-service training of maternity staff : a cluster-randomized trial and mixed-method evaluation
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Alwy Al-beity, Fadhlun M and Alwy Al-beity, Fadhlun M
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Background: Postpartum Haemorrhage (PPH) causes a significant amount of morbidity and mortality among mothers giving birth in sub-Saharan Africa, Tanzania included. One root cause is the insufficient health worker skills to address postpartum haemorrhage. To combat this in-service training using competency-based simulation is proposed. Aim: To assess the effectiveness of the Helping Mothers Survive Bleeding After Birth (HMS BAB) in-service training of maternity staff on PPH related health outcomes, and health workers’ skills. The thesis also assessed health workers’ perceptions of the training and facility preparedness to support care of women with PPH in Tanzania. Methods: Study I was conceptualised as a cluster-randomized trial. Interrupted time-series analysis was used to compare the following PPH related health outcomes i) PPH near miss and ii) PPH case fatality between 10 intervention and 10 comparison clusters. Study II was a before-after study of health workers (n=636), and assessed skills change immediately and ten months after the training, as well as the association between health workers’ characteristics and skill change. Study III was a qualitative study using seven Focus Group Discussions (FGD) of health workers to explore their perceptions of the training implementation. A deductive theory-driven analysis informed by integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework was used. Study IV explored health workers (FGDs, n=7) and health managers (In-depth interviews, n=12) perceptions of health facility preparedness to support care given to women with PPH. The data was analysed using thematic analysis. Results: There was a significant decline of severe PPH cases in intervention clusters compared to the comparison clusters observed immediately after the intervention. This was sustained in the post-intervention period (Study I). A small reduction in PPH case fatality was observed in intervention clusters during the
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- 2020
14. Vitamin D3 supplementation during pregnancy and lactation for women living with HIV in Tanzania: A randomized controlled trial.
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Sudfeld, Christopher R., Manji, Karim P., Muhihi, Alfa, Duggan, Christopher P., Aboud, Said, Alwy Al-Beity, Fadhlun M., Wang, Molin, Zhang, Ning, Ulenga, Nzovu, and Fawzi, Wafaie W.
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HIV-positive women ,DIETARY supplements ,STUNTED growth ,RANDOMIZED controlled trials ,LACTATION ,SECOND trimester of pregnancy - Abstract
Background: Observational studies suggest that vitamin D deficiency among people living with HIV is associated with a greater risk of disease progression and death. Low levels of vitamin D in pregnancy are also associated with poor fetal and infant growth. Therefore, vitamin D supplementation may improve clinical outcomes for pregnant women living with HIV and improve fetal and postnatal growth for their infants. Methods and findings: We conducted a randomized, triple-blind, placebo-controlled trial of vitamin D
3 supplementation among pregnant and lactating women living with HIV in Dar es Salaam, Tanzania (ClinicalTrials.gov NCT02305927). Participants were randomized with 1:1 allocation stratified by study clinic to receive either daily 3,000 IU vitamin D3 supplements or matching placebo supplements from the second trimester of pregnancy (12–27 weeks) until 1 year postpartum. The primary outcomes were (i) maternal HIV progression or death, (ii) small-for-gestational-age (SGA) live births (<10th percentile), and (iii) infant stunting at 1 year of age (length-for-age z-score < −2). We also examined the effect of vitamin D3 supplementation on secondary maternal and infant health outcomes, maternal and infant serum 25-hydroxyvitamin D (25[OH]D) concentrations, and maternal hypercalcemia. An intent-to-treat analysis was used as the primary analytic approach. We enrolled 2,300 pregnant women between June 15, 2015, and April 17, 2018, and follow-up of mothers and infants was completed on October 20, 2019. There were 1,148 pregnant women randomly assigned to the vitamin D3 group, and 1,152 to the placebo group. The proportion of mothers lost to follow-up at 1 year postpartum was 6.6% in the vitamin D3 group (83 of 1,148) and 6.6% in the placebo group (76 of 1,152). The proportion of children lost to follow-up at 1 year of age was 5.5% in the vitamin D3 group (59 of 1,074 live births) and 5.2% in the placebo group (57 of 1,093 live births). There was no difference in the risk of maternal HIV progression or death, with 166 events during 1,461 person-years of follow-up in the vitamin D3 group and 141 events during 1,469 person-years of follow-up in the placebo group (hazard ratio 1.21, 95% CI 0.97 to 1.52, p = 0.09). There was no difference in the risk of SGA birth between the vitamin D3 (229 SGA births among 1,070 live births) and placebo groups (236 SGA births among 1,091 live births) (relative risk 1.03, 95% CI 0.87 to 1.22, p = 0.70). There was also no difference in the risk of infant stunting at 1 year of age between the vitamin D3 (407 events among 867 infants) and placebo groups (413 events among 873 infants) (relative risk 1.00, 95% CI 0.92 to 1.10, p = 0.95). In terms of adverse events, no cases of maternal hypercalcemia were identified. One hypersensitivity reaction to the trial supplements occurred for a pregnant woman in the placebo group. A limitation of our study is that our findings may not be generalizable to HIV-negative pregnant women or contexts where severe vitamin D deficiency is prevalent. Conclusions: The trial findings do not support routine vitamin D supplementation for pregnant and lactating women living with HIV in Tanzania. Trial registration: ClinicalTrials.gov Identifier: NCT02305927. Christopher R. Sudfeld and colleagues, investigate the impact of vitamin D supplementation on clinical outcomes for pregnant women living with HIV, and growth outcomes for their infants. Author summary: Why was this study done?: Observational studies have found that vitamin D deficiency among people living with HIV is associated with an increased risk of HIV disease progression and death. Low levels of vitamin D in pregnancy are also associated with adverse birth outcomes and poor infant growth. What did the researchers do and find?: We conducted a randomized controlled trial of maternal vitamin D3 supplementation during pregnancy and lactation and found no effect on the primary trial outcomes of maternal HIV progression or death, small-for-gestational-age (SGA) live births, and infant stunting (length-for-age z-score < −2) at 1 year of age. There was no effect on most secondary outcomes; however, we found that vitamin D supplementation decreased the risk of death for mothers and increased the risk of preterm birth. Maternal vitamin D supplementation increased maternal serum 25-hydroxyvitamin D (25[OH]D) concentrations throughout follow-up and increased infant 25(OH)D at 6 weeks and 6 months of age, but not at 12 months of age. What do these findings mean?: The trial findings are not in support of routine vitamin D supplementation for pregnant and lactating women living with HIV. The mixed findings on the secondary outcomes of maternal death and preterm birth should be interpreted with caution and require replication in other randomized trials. [ABSTRACT FROM AUTHOR]- Published
- 2022
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15. Fetal, neonatal, and infant death among offspring of pregnant women living with HIV in Tanzania.
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Manji KP, Muhihi A, Duggan CP, Alwy Al-Beity FM, Perumal N, Ulenga N, Fawzi WW, and Sudfeld CR
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Objective: Assess the risk of death for offspring of pregnant women living with HIV (PWLHIV) and the association with sociodemographic, pregnancy, HIV-related, and birth factors., Design: We conducted a prospective cohort study of PWLHIV on antiretroviral therapy (ART) and their offspring in urban Tanzania who were enrolled in a vitamin D trial conducted from June 2015 to October 2019., Methods: We described rates of fetal, neonatal, and infant death and assessed risk factors for these outcomes with generalized estimating equations. We also estimated population-attributable risk percentages for the contribution of prematurity and small-for-gestational age (SGA) to neonatal and infant mortality., Results: Among 2,299 PWLHIV, there were a total of 136 fetal deaths (5.6%) and the stillbirth rate was 42.0 per 1,000 total births. Among 2,167 livebirths, there were 57 neonatal deaths (26.3 per 1,000 livebirths) and 114 infant deaths (52.6 per 1,000 livebirths). Twin birth was associated with neonatal death, while maternal CD4 T-cell count <350 cells/μL in pregnancy was associated with infant death (p-values < 0.05). As compared to term-appropriate-for-gestational age (AGA) births, the relative risks for neonatal mortality for term-SGA, preterm-AGA, and preterm-SGA infants were 2.07 (95% CI: 1.00-4.28), 2.87 (95% CI 1.54-5.35) and 7.15 (95% CI: 2.11-24.30), respectively. We estimated that 42.7% of neonatal and 29.4% of infant deaths were attributable to prematurity and SGA in the cohort., Conclusions: The risk of death is high for offspring of PWLHIV in Tanzania and the combination of prematurity and fetal growth restriction may account for nearly half of neonatal deaths., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2024
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