14 results on '"Chiduo M"'
Search Results
2. Prevalence of sexually transmitted infections among women attending antenatal clinics in northeastern Tanzania: HP 05
- Author
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Chiduo, M.
- Published
- 2012
3. Reducing loss to follow-up in the Comtru Project
- Author
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Chiduo, M.
- Published
- 2010
4. Prevalence of sexually transmitted infections among women attending antenatal clinics in Tanga, north eastern Tanzania
- Author
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Chiduo, M, Theilgaard, Z P, Bakari, V, Mtatifikolo, F, Bygbjerg, I, Flanholc, L, Gerstoft, J, Christiansen, C B, Lemnge, M, Katzenstein, T L, Chiduo, M, Theilgaard, Z P, Bakari, V, Mtatifikolo, F, Bygbjerg, I, Flanholc, L, Gerstoft, J, Christiansen, C B, Lemnge, M, and Katzenstein, T L
- Abstract
This study aimed to determine the prevalence of sexually transmitted infections (STIs) among HIV-infected and uninfected pregnant women in Tanga, Tanzania. Retrospective data on syphilis and HIV status during 2008-2010 were collected from antenatal clinic (ANC) records. Prospective data were collected from HIV-infected (n = 105) and HIV-uninfected pregnant women (n = 100) attending ANCs between April 2009 and August 2010. Syphilis prevalence showed a declining trend (3.1%, 1.4% and 1.3%), while HIV prevalence was stable (6.1%, 6.4% and 5.4%) during 2008-2010. HIV-infected women had significantly higher prevalence of trichomoniasis (18.8% versus 5.0%; P <0.003) and candidiasis (16.5% versus 2.0%; P <0.001) while the higher rate of gonorrhoea (3.5% versus 0%; P = 0.095) was not statistically significant when compared with HIV-uninfected women. There were no statistically significant differences in prevalence of chlamydial infection (0% versus 3.0%; P = 0.156) or syphilis (2.4% versus 3.0%; P = 1) between HIV-infected and uninfected women. Other STIs were common in both HIV-infected and uninfected pregnant women.
- Published
- 2012
5. Prevalence of sexually transmitted infections among women attending antenatal clinics in Tanga, north eastern Tanzania
- Author
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Chiduo, M, primary, Theilgaard, Z P, additional, Bakari, V, additional, Mtatifikolo, F, additional, Bygbjerg, I, additional, Flanholc, L, additional, Gerstoft, J, additional, Christiansen, C B, additional, Lemnge, M, additional, and Katzenstein, T L, additional
- Published
- 2012
- Full Text
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6. Addressing the fear and consequences of stigmatization - a necessary step towards making HAART accessible to women in Tanzania: a qualitative study
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Gerstoft Jan, Bygbjerg Ib C, Pahl Christiane, Chiduo Mercy G, Katzenstein Terese L, Theilgaard Zahra P, Lemnge Martha M, and Tersbøl Britt P
- Subjects
Immunologic diseases. Allergy ,RC581-607 - Abstract
Abstract Background Highly Active Antiretroviral Therapy (HAART) has been available free of charge in Tanga, Tanzania since 2005. However we have found that a high percentage of women referred from prevention of mother-to-child transmission services to the Care and Treatment Clinics (CTC) for HAART never registered at the CTCs. Few studies have focused on the motivating and deterring factors to presenting for HAART particularly in relation to women. This study seeks to remedy this gap in knowledge. Methodology A qualitative approach using in-depth interviews and focus group discussions was chosen to understand these issues as perceived and interpreted by HIV infected women themselves. Results The main deterrent to presenting for treatment appears to be fear of stigmatization including fear of ostracism from the community, divorce and financial distress. Participants indicated that individual counselling and interaction with other people living with HIV encourages women, who are disinclined to present for HAART, to do so, and that placing the entrance to the CTC so as to provide discrete access increases the accessibility of the clinic. Conclusion Combating stigma in the community, although it is essential, will take time. Therefore necessary steps towards encouraging HIV infected women to seek treatment include reducing self-stigma, assisting them to form empowering relationships and to gain financial independence and emphasis by example of the beneficial effect of treatment for themselves and for their children. Furthermore ensuring a discrete location of the CTC can increase its perceived accessibility.
- Published
- 2011
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7. Efficacy of artesunate-amodiaquine for treatment of uncomplicated Plasmodium falciparum malaria in mainland Tanzania.
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Ngasala B, Bushukatale S, Chiduo M, Makene T, Mkony L, Mohamed A, Molteni F, Chacky F, Njau RJA, and Mwaiswelo R
- Subjects
- Child, Humans, Infant, Amodiaquine, Artesunate therapeutic use, Tanzania, Plasmodium falciparum, Drug Combinations, Antimalarials, Malaria, Falciparum drug therapy, Artemisinins, Malaria drug therapy
- Abstract
Background: Diversification of artemisinin-based combination therapy (ACT) is suggested as one of the strategies that can be used to contain artemisinin resistance. Artesunate-amodiaquine (ASAQ) is one of the artemisinin-based combinations that can be used in the diversification strategy as an alternative first-line treatment for uncomplicated malaria in mainland Tanzania. There is however limited data on the efficacy of ASAQ in mainland Tanzania. This study assessed the efficacy of ASAQ for treatment of uncomplicated Plasmodium falciparum malaria in selected sentinel sites for therapeutic efficacy studies in mainland Tanzania., Methods: Between December 2018 and March 2020, children aged between 6 months and 10 years, attending at Nagaga, Mkuzi, and Mlimba primary health facilities, and with suspected uncomplicated malaria infection were screened for eligibility to participate in the study. Malaria infection was screened using microscopy. Children with uncomplicated P. falciparum monoinfection and who fulfilled all other inclusion criteria, and had none of the exclusion criteria, according to the World Health Organization (WHO) guidelines, were treated with ASAQ. Follow-up visits were scheduled on days 0, 1, 2, 3, 7, 14, 21, and 28 or on any day of recurrent infection for clinical and laboratory assessment. Polymerase chain reaction (PCR)-corrected cure rate on day 28 was the primary outcome., Results: A total of 264 children, 88 in each of the three study sites (Mlimba, Mkuzi and Nagaga health facilities) were enrolled and treated with ASAQ. The ASAQ PCR-corrected cure rate was 100% at all the three study sites. None of the participants had early treatment failure or late clinical failure. Furthermore, none of the participants had a serious adverse event., Conclusion: ASAQ was highly efficacious for the treatment of uncomplicated P. falciparum malaria in mainland Tanzania, therefore, it can be deployed as an alternative first-line treatment for uncomplicated malaria as part of diversification strategy to contain the spread of partial artemisinin resistance in the country., (© 2024. The Author(s).)
- Published
- 2024
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8. Trends of Plasmodium falciparum molecular markers associated with resistance to artemisinins and reduced susceptibility to lumefantrine in Mainland Tanzania from 2016 to 2021.
- Author
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Bakari C, Mandara CI, Madebe RA, Seth MD, Ngasala B, Kamugisha E, Ahmed M, Francis F, Bushukatale S, Chiduo M, Makene T, Kabanywanyi AM, Mahende MK, Kavishe RA, Muro F, Mkude S, Mandike R, Molteni F, Chacky F, Bishanga DR, Njau RJA, Warsame M, Kabula B, Nyinondi SS, Lucchi NW, Talundzic E, Venkatesan M, Moriarty LF, Serbantez N, Kitojo C, Reaves EJ, Halsey ES, Mohamed A, Udhayakumar V, and Ishengoma DS
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- Humans, Lumefantrine pharmacology, Lumefantrine therapeutic use, Plasmodium falciparum genetics, Tanzania, Artemether therapeutic use, Multidrug Resistance-Associated Proteins genetics, Artemether, Lumefantrine Drug Combination pharmacology, Artemether, Lumefantrine Drug Combination therapeutic use, Biomarkers, Drug Resistance genetics, Protozoan Proteins genetics, Protozoan Proteins therapeutic use, Antimalarials pharmacology, Antimalarials therapeutic use, Artemisinins pharmacology, Artemisinins therapeutic use, Malaria, Falciparum epidemiology, Carubicin analogs & derivatives
- Abstract
Background: Therapeutic efficacy studies (TESs) and detection of molecular markers of drug resistance are recommended by the World Health Organization (WHO) to monitor the efficacy of artemisinin-based combination therapy (ACT). This study assessed the trends of molecular markers of artemisinin resistance and/or reduced susceptibility to lumefantrine using samples collected in TES conducted in Mainland Tanzania from 2016 to 2021., Methods: A total of 2,015 samples were collected during TES of artemether-lumefantrine at eight sentinel sites (in Kigoma, Mbeya, Morogoro, Mtwara, Mwanza, Pwani, Tabora, and Tanga regions) between 2016 and 2021. Photo-induced electron transfer polymerase chain reaction (PET-PCR) was used to confirm presence of malaria parasites before capillary sequencing, which targeted two genes: Plasmodium falciparum kelch 13 propeller domain (k13) and P. falciparum multidrug resistance 1 (pfmdr1)., Results: Sequencing success was ≥ 87.8%, and 1,724/1,769 (97.5%) k13 wild-type samples were detected. Thirty-seven (2.1%) samples had synonymous mutations and only eight (0.4%) had non-synonymous mutations in the k13 gene; seven of these were not validated by the WHO as molecular markers of resistance. One sample from Morogoro in 2020 had a k13 R622I mutation, which is a validated marker of artemisinin partial resistance. For pfmdr1, all except two samples carried N86 (wild-type), while mutations at Y184F increased from 33.9% in 2016 to about 60.5% in 2021, and only four samples (0.2%) had D1246Y mutations. pfmdr1 haplotypes were reported in 1,711 samples, with 985 (57.6%) NYD, 720 (42.1%) NFD, and six (0.4%) carrying minor haplotypes (three with NYY, 0.2%; YFD in two, 0.1%; and NFY in one sample, 0.1%). Between 2016 and 2021, NYD decreased from 66.1% to 45.2%, while NFD increased from 38.5% to 54.7%., Conclusion: This is the first report of the R622I (k13 validated mutation) in Tanzania. N86 and D1246 were nearly fixed, while increases in Y184F mutations and NFD haplotype were observed between 2016 and 2021. Despite the reports of artemisinin partial resistance in Rwanda and Uganda, this study did not report any other validated mutations in these study sites in Tanzania apart from R622I suggesting that intensified surveillance is urgently needed to monitor trends of drug resistance markers and their impact on the performance of ACT., (© 2024. The Author(s).)
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- 2024
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9. Implementation research of a cluster randomized trial evaluating the implementation and effectiveness of intermittent preventive treatment for malaria using dihydroartemisinin-piperaquine on reducing malaria burden in school-aged children in Tanzania: methodology, challenges, and mitigation.
- Author
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Makenga G, Seth MD, Baraka V, Mmbando BP, Challe DP, Francis F, Mhina A, Minja DTR, Chiduo M, Mandara C, Liheluka E, Gesase S, Segeja M, Mtove G, Kamugisha M, Lusasi A, Chacky F, David A, Thawer S, Mohamed A, Lazaro S, Molteni F, Nkayamba A, Van Geertruyden JP, and Lusingu JPA
- Subjects
- Humans, Child, Tanzania epidemiology, Drug Combinations, Antimalarials therapeutic use, Malaria epidemiology, Malaria prevention & control, Malaria drug therapy, Quinolines therapeutic use
- Abstract
Background: It has been more than 20 years since the malaria epidemiologic shift to school-aged children was noted. In the meantime, school-aged children (5-15 years) have become increasingly more vulnerable with asymptomatic malaria prevalence reaching up to 70%, making them reservoirs for subsequent transmission of malaria in the endemic communities. Intermittent Preventive Treatment of malaria in schoolchildren (IPTsc) has proven to be an effective tool to shrink this reservoir. As of 3
rd June 2022, the World Health Organization recommends IPTsc in moderate and high endemic areas. Even so, for decision-makers, the adoption of scientific research recommendations has been stifled by real-world implementation challenges. This study presents methodology, challenges faced, and mitigations used in the evaluation of the implementation of IPTsc using dihydroartemisinin-piperaquine (DP) in three councils (Handeni District Council (DC), Handeni Town Council (TC) and Kilindi DC) of Tanga Region, Tanzania so as to understand the operational feasibility and effectiveness of IPTsc on malaria parasitaemia and clinical malaria incidence., Methods: The study deployed an effectiveness-implementation hybrid design to assess feasibility and effectiveness of IPTsc using DP, the interventional drug, against standard of care (control). Wards in the three study councils were the randomization unit (clusters). Each ward was randomized to implement IPTsc or not (control). In all wards in the IPTsc arm, DP was given to schoolchildren three times a year in four-month intervals. In each council, 24 randomly selected wards (12 per study arm, one school per ward) were chosen as representatives for intervention impact evaluation. Mixed design methods were used to assess the feasibility and acceptability of implementing IPTsc as part of a more comprehensive health package for schoolchildren. The study reimagined an existing school health programme for Neglected Tropical Diseases (NTD) control include IPTsc implementation., Results: The study shows IPTsc can feasibly be implemented by integrating it into existing school health and education systems, paving the way for sustainable programme adoption in a cost-effective manner., Conclusions: Through this article other interested countries may realise a feasible plan for IPTsc implementation. Mitigation to any challenge can be customized based on local circumstances without jeopardising the gains expected from an IPTsc programme. Trial registration clinicaltrials.gov, NCT04245033. Registered 28 January 2020, https://clinicaltrials.gov/ct2/show/NCT04245033., (© 2023. The Author(s).)- Published
- 2023
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10. Secondary Cutaneous Endometriosis of the Umbilicus in Tanzania: A Case Report.
- Author
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Makanda IH, Mushema BN, Chuwa SP, and Chiduo M
- Abstract
Introduction: Endometriosis is characterised by endometrial tissue outside the endometrial cavity. The implantation sites may be pelvic or extrapelvic in nature. Umbilical endometriosis is a rare type of cutaneous endometriosis, accounting for 0.5-1% of extrapelvic endometriosis cases. Current literature on umbilical endometriosis is absent in the Tanzanian population., Case Report: A 30-year-old woman with prior caesarean deliveries presented with a 3-year history of umbilical swelling, cyclical pain, and menses-related bleeding. Examination revealed a firm brown umbilical lesion measuring 5×4 centimetres (cm). Wide excisional biopsy was performed. Histopathological examination confirmed endometriosis and ruled out malignancy. The postoperative follow-up revealed no signs of recurrence., Conclusions: This case report highlights the need for high clinical vigilance and comprehensive differential diagnosis, especially for recurring and cyclical abdominal symptoms. Despite resource limitations, accurate diagnosis and appropriate treatment can result in the successful management of this rare condition. The report emphasises the urgency for clinicians to boost awareness, promote research, and advocate for better resources to ensure optimal patient outcomes., (© The East African Health Research Commission 2023.)
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- 2023
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11. Challenges in Diagnosis and Management of Second Trimester Omental Pregnancy in Limited Resource Settings: Case Report.
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Mushema BN, Nkwama BS, Rweyemamu GA, Makanda IH, and Chiduo M
- Abstract
Background: Abdominal pregnancies are a rare occurrence and are associated with high maternal and perinatal mortality rates compared to intra-uterine and other ectopic pregnancies. Localization of sites of abdominal pregnancies and determining the gestational age at the time of diagnosis play a fundamental role in guiding the treatment approach and minimizing potential complications. However, the vague presentation coupled with low accuracy of ultrasound detection often leads to misdiagnosis of abdominal pregnancy, and hence delaying initiation of appropriate management. We present a case of a second trimester abdominal pregnancy detected following failure of induction for an initial diagnosis of missed abortion, and the ensuing outcome, rarely reported in limited-resource settings., Case Presentation: A 19 year old unbooked woman, gravida 2 para 1 at 17
th week gestation age by ultrasound presented with loss of foetal movement for one week. Based on clinical assessment and referral ultrasound findings, she was initially diagnosed with missed abortion and planned for induction. Failure of induction prompted a repeat ultrasound which revealed a non-viable abdominal pregnancy. Laparotomy was done, localisation of the pregnancy at the omentum was observed and a dead foetus was extracted with the placenta left in-situ. A complication of surgical wound dehiscence with infection developed post-operatively and was managed with secondary sutures. The patient recovered and was discharged in a stable condition., Conclusion: This case demonstrates that the diagnosis of abdominal pregnancy remains a challenge especially in settings where skilled human resources for health are few and equipment and supplies for effective and timely treatment are limited. The case sheds some light on the broader challenges in maternal and perinatal health in developing countries. Accurate pre-operative diagnosis requires a high index of suspicion, especially due to the variability of its presentation. This case emphasises the important of quality antenatal care and the need for clinicians to conduct comprehensive assessments of patients and receive training on obstetric ultrasound skills., (© The East African Health Research Commission 2022.)- Published
- 2022
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12. Factors Influencing Growth of Children Aged 12-24 Months in the Tanga Region, Tanzania.
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Elverud IS, Størdal K, Chiduo M, and Klingenberg C
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- Adult, Child, Preschool, Cross-Sectional Studies, Female, Humans, Infant, Male, Maternal Age, Protein-Energy Malnutrition, Socioeconomic Factors, Breast Feeding, Child Development physiology, Infant Nutritional Physiological Phenomena physiology, Mothers education, Nutritional Status physiology
- Abstract
Background: The first 1000 days of life, from conception to the second birthday, offer a unique window of opportunity for optimal growth, critical for future health. The primary aim of this study was to analyze growth of children between 12 and 24 months age in Tanzanian children, and to explore possible predictors for growth., Methods: Observational, cross-sectional study performed between March and April 2017. Eligible children, and their mothers, attended routine follow-up at two health clinics in Tanga, Tanzania. At the study day, the child's weight and height were recorded. The mothers answered a structured interview regarding breastfeeding, immunization and socioeconomic conditions., Results: We recruited 300 mother-child pairs. Median [interquartile range (IQR)] age at study visit was 16 (14-20) months. Mothers reported that 170 (57%) of their children were exclusively breastfed for a minimum of 6 months; median (IQR) 6 (4-6) months. Using the World Health Organization (WHO) standard growth curves, mean weight-for-age Z-score was -0.30 and mean length-for-age Z-score was -0.47. Children whose mothers had higher education had higher Z-scores for weight and length compared to children of mothers with lower education. Education remained the most important predictor for growth also after adjusting for other variables. Overall, 48/300 (16%) were moderate-severe stunted and 25/300 (8.4%) had moderate-severe underweight., Conclusion: Children aged 12-24 months in this region of Tanzania had weight and height below the WHO standard. Higher educated mothers had children with better growth parameters. Duration of exclusive breastfeeding was long, but did not predict growth parameters., (© The Author(s) [2019]. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2020
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13. Hepatitis E virus epidemiology among HIV-infected women in an urban area in Tanzania.
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Harritshøj LH, Theilgaard ZP, Mannheimer E, Midgley SE, Chiduo M, Ullum H, and Katzenstein TL
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- Adult, Coinfection, Female, Hepatitis Antibodies blood, Humans, Pregnancy, Retrospective Studies, Seroepidemiologic Studies, Tanzania epidemiology, HIV Infections virology, Hepatitis E epidemiology, Pregnancy Complications, Infectious epidemiology
- Abstract
Objectives: This study was performed to determine the seroprevalence and incidence of hepatitis E virus (HEV) infection among HIV-infected women during pregnancy and after delivery in a cohort of 200 Tanzanian women., Methods: HIV-infected women participating in a study on antiretroviral therapy for the prevention of mother-to-child HIV transmission between 2006 and 2011, were tested retrospectively for anti-HEV immunoglobulin G (IgG) in plasma samples at 9 months post-partum. Anti-HEV IgG-positive patients were tested for anti-HEV IgG and immunoglobulin M (IgM) in samples from enrolment, and seroconverting women were tested for HEV RNA., Results: A total of 16 women were anti-HEV IgG-positive, two of whom had seroconverted between enrolment and 9 months post-partum, with no detection of anti-HEV IgM or HEV RNA, yielding an HEV seroprevalence of 8.0% (confidence interval 5.0-12.6%) and an annual incidence rate of 1.0% (confidence interval 0.2-3.4%). CD4 cell counts were relatively high (median 403×10
6 /l), with no significant difference between women with and without serological signs of HEV., Conclusions: An annual HEV infection incidence rate of 1% strongly indicates ongoing transmission of HEV in Tanzania and should be kept in mind for pregnant women presenting with signs of acute hepatitis., (Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.)- Published
- 2018
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14. Good performance of an immunoassay based method for nevirapine measurements in human breast milk.
- Author
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Salado-Rasmussen K, Theilgaard ZP, Chiduo M, Pedersen C, Gerstoft J, and Katzenstein TL
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- Calibration, Female, Humans, Immunoassay standards, Limit of Detection, Quality Control, Reproducibility of Results, Immunoassay methods, Milk, Human chemistry, Nevirapine analysis
- Abstract
Background: Understanding the distribution of antiretro-virals in breastfeeding HIV-positive mothers is essential, both for prevention of mother-to-child HIV transmission and for research on the development of drug resistance. The ARK nevirapine (NVP)-test is an immunoassay method for nevirapine measurements, developed and validated for plasma use. In this study, the ARK NVP-test was evaluated for measurement of nevirapine concentrations in breast milk. High performance liquid chromatography (HPLC) is the method currently used to determine nevirapine in breast milk. This method, however, requires complicated extraction techniques. The ARK method employs an immunoassay technology and requires a small sample volume (40 μL) and no pre-treatment of the samples., Methods: Commercial enzyme and antibody were used and calibration standards and quality controls were prepared from pooled breast milk from HIV-uninfected women. Clinical samples from HIV-infected women receiving a single-dose of nevirapine were analyzed., Results: Precision and accuracy were evaluated with two concentrations of quality control materials analyzed in three replicates on four different days and was <4%, and between 96.5% and 104.6%, respectively. Clinical samples were analyzed and CVs ranged from 0.0% to 11.1%. The median nevirapine concentration in breast milk 1 week post-partum was 0.29 μg/mL (range 0.11-0.90 μg/mL) in women treated with a single-dose of nevirapine., Conclusions: The ease of use and small sample volume makes the ARK assay an attractive alternative to HPLC analyses for determinations of nevirapine concentrations in breast milk.
- Published
- 2011
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