Felicity Gumbo | University of Zimbabwe (original) (raw)

Papers by Felicity Gumbo

Journal of Perinatology, Oct 28, 2010

Pediatric Research, Jul 28, 2020

Respiratory Research

BackgroundAsthma is the commonest chronic respiratory tract disease in children. In low-income co... more BackgroundAsthma is the commonest chronic respiratory tract disease in children. In low-income countries, challenges exist in asthma diagnosis. In surveys done in children, the prevalence of ‘asthma’ defined by symptoms is high compared to ‘doctor diagnosed asthma’. The questions answered by this review are (i) What challenges have been experienced in the diagnosis of asthma in children? (ii) What solutions will address these challenges?MethodsThe Arksey and O’Malley’s framework for scoping reviews was used for the study methodology, while the PRISMA-ScR checklist guided the reporting process. Electronic databases: PubMed Central, EMBASE and Google Scholar were searched. Primary quantitative and qualitative studies and reviews from 2010 to 2021, from Nigeria, South Africa and Uganda written in English or translated to English, which answered the study questions were included. The author, title, country, study type, methods, purpose, findings and references were captured onto a prede...

AIDS

Objective: To determine immune-metabolic dysregulation in children born to women living with HIV.... more Objective: To determine immune-metabolic dysregulation in children born to women living with HIV. Methods: Longitudinal immune-metabolomic analyses of plasma of 32 pregnant women with HIV (WHIV) and 12 uninfected women and their children up to 1.5 years of age were performed. Results: Using liquid chromatography-mass spectrometry and a multiplex bead assay, 280 metabolites (57 amino acids, 116 positive lipids, 107 signalling lipids) and 24 immune mediators (e.g. cytokines) were quantified. combinational antiretroviral therapy (cART) exposure was categorized as cART initiation preconception (long), cART initiation postconception up to 4 weeks before birth (medium) and cART initiation within 3 weeks of birth (short). Plasma metabolite profiles differed between HIV-exposed-uninfected (HEU)-children with long cART exposure compared to HIV-unexposed-children (HUU). Specifically, higher levels of methionine-sulfone, which is associated with oxidative stress, were detected in HEU-children ...

The Central African journal of medicine, Dec 14, 2022

Frontiers in Virology

IntroductionMother-to-child-transmission (MTCT) of human immunodeficiency virus (HIV) can occur i... more IntroductionMother-to-child-transmission (MTCT) of human immunodeficiency virus (HIV) can occur in pregnancy/in utero (IU), during childbirth/intrapartum (IP), or postpartum (PP) through breastfeeding from an infected mother to her infant. Burden of PP-MTCT and associated risk factors remain poorly described, especially in adolescent girls and young women (AGYW) aged 15–24 years. Furthermore, despite concerns on high postnatal seroconversions, there is paucity of data on the burden of subsequent MTCT rates.MethodsPregnant women ≥20 weeks of gestation were enrolled into the University of Zimbabwe Birth Cohort from four primary health centers in Harare, Zimbabwe. Mother–infant dyads were followed up from delivery, week(s) 1, 6, 10, 14, 24, 36, 48, 72, and 96 after birth. Women who were uninfected at baseline were re-tested for HIV on subsequent visits. Plasma HIV RNA was quantified using reverse transcriptase polymerase chain reaction. Exposed babies were tested for HIV using qualitat...

Additional file 2. Table 1: HIV-infected non-transmitting participants. Comparison of characteris... more Additional file 2. Table 1: HIV-infected non-transmitting participants. Comparison of characteristics of HIV-infected non-transmitting participants between the study sample and the control sample. Data are expressed as n (%) or median (IQR); min-max unless stated otherwise. P-values to compare patient groups were calculated using the Mann-Whitney U test or Fisher's exact test where appropriate. Missing data are indicated in the following manner: number of * = number of missing data points. Abbreviations: BMI: body mass index, CMV: cytomegalovirus, HIV: human immunodeficiency virus, WHO: world health organisation, N/A: not applicable. Table 2: HIV-uninfected participants. Comparison of characteristics of HIV-uninfected mothers between the study sample and the control sample. Data are expressed as n (%) or median (IQR); min-max unless stated otherwise. P-values to compare groups were calculated using Mann-Whitney U test or Fisher's exact test where appropriate. Missing data ar...

Additional file 1. Figure 1: Scatterplot of Maternal baseline HIV-1-RNA load in copies/mL versus ... more Additional file 1. Figure 1: Scatterplot of Maternal baseline HIV-1-RNA load in copies/mL versus CMV-DNA copies/mL in log scale.

A Scoping Review of the Challenges in the diagnosis of asthma in children in Sub Saharan Afirca

Early breastfeeding initiation is one of the cost effective and simple strategies in working towa... more Early breastfeeding initiation is one of the cost effective and simple strategies in working towards reduction of early neonatal illnesses and death. Research has shown that timely initiation of breastfeeding within an hour of birth can reduce about 22 % of neonatal death burden in the developing world.<strong> Materials and Methods:</strong> A descriptive cross sectional study was conducted in Chipinge district after getting ethical approval from the Medical Research Council of Zimbabwe, Manicaland Provincial Medical Director, Chipinge District Medical officer and study participants. Systematic interval sampling was employed to select 550 healthy mother-baby pairs within the first week of giving birth. Analysis of data was done using SPSS version 20 to calculate the frequencies, percentages, mean score, proportion, standard deviation and standard error. Data was presented in tables and figures. Cross tabulation was also employed for demographic characteristics and time ...

The future of any population is children. Resource limited settings with a high prevalence of HIV... more The future of any population is children. Resource limited settings with a high prevalence of HIV infection notably also have an excessive burden of malnutrition. The advances in prevention of mother to child HIV transmission programmes have led to very effective combination antiretro-viral regimens resulting in growing numbers of HIV exposed but uninfected children. The mortal-ity of HIV exposed but uninfected children below 5 years is high in resource limited settings. It is also important to pay particular attention to their longitudinal growth and neurodevelopmental outcomes. In these settings, the contribution of feeding practices, choice of complementary foods and micronutrient deficiencies, to health outcomes of HIV exposed uninfected children are not clearly defined. This review highlights some gaps in research that need to be addressed in areas with increasing numbers of HIV exposed but uninfected children. Interventions to reduce mortal-ity, improve growth and neurodevelop...

Antenatal HIV-1 RNA load and timing of mother to child transmission; a nested case-control study ... more Antenatal HIV-1 RNA load and timing of mother to child transmission; a nested case-control study in a resource poor setting

The Central African journal of medicine, 2017

Objectives: To determine the prevalence of hypernatremia (serum sodium>150mmol/l), associated ... more Objectives: To determine the prevalence of hypernatremia (serum sodium>150mmol/l), associated factors and outcome of children below 2yrs of age admitted with diarrhoea. Design: Cross sectional analytical study. Setting: Harare Children's Hospital, Harare, Zimbabwe. Subjects: Consecutive sampling was used to recruit 127 children between the ages of 1 month and 2 years admitted into the hospital with diarrhoea. Materials and Methods: An interviewer administered questionnaire was used to capture data from the caregivers and each of the participants had anthropometric measurements noted and urea and electrolytes analysed. A univariate logistic regression was performed at 5% significance level to identify factors associated with hypernatremia and odds ratios were calculated. A multivariate logistic regression analysis was then performed on factors with p<0.25. Main Outcome Measures: Hypernatremia, hydration and nutrition. Results: The prevalence of hypernatremia was 27.6% (95% ...

Virology Journal, 2021

Introduction Despite being a leading infectious cause of childhood disability globally, testing f... more Introduction Despite being a leading infectious cause of childhood disability globally, testing for cytomegalovirus (CMV) infections in pregnancy is generally not done in Sub-Sahara Africa (SSA), where breastfeeding practice is almost universal. Whilst CMV and human immunodeficiency virus (HIV) are both endemic in SSA, the relationship between antenatal plasma CMV-DNA, HIV-1-RNA levels and HIV-1-mother to child transmission (MTCT) including pregnancy outcomes remains poorly described. Methods Pregnant women at least 20 weeks’ gestational age at enrolment were recruited from relatively poor high-density suburbs in Harare, Zimbabwe. Mother-infant dyads were followed up until 6 months postpartum. In a case–control study design, we tested antenatal plasma CMV-DNA levels in all 11 HIV-1 transmitting mothers, as well as randomly selected HIV-infected but non-transmitting mothers and HIV-uninfected controls. CMV-DNA was detected and quantified using polymerase chain reaction (PCR) techniqu...

Pediatric Research, 2020

Background Fewer children than adults have been affected by the COVID-19 pandemic, and the clinic... more Background Fewer children than adults have been affected by the COVID-19 pandemic, and the clinical manifestations are distinct from those of adults. Some children particularly those with acute or chronic co-morbidities are likely to develop critical illness. Recently, a multisystem inflammatory syndrome (MIS-C) has been described in children with some of these patients requiring care in the pediatric ICU. Methods An international collaboration was formed to review the available evidence and develop evidence-based guidelines for the care of critically ill children with SARS-CoV-2 infection. Where the evidence was lacking, those gaps were replaced with consensus-based guidelines. Results This process has generated 44 recommendations related to pediatric COVID-19 patients presenting with respiratory distress or failure, sepsis or septic shock, cardiopulmonary arrest, MIS-C, those requiring adjuvant therapies, or ECMO. Evidence to explain the milder disease patterns in children and the...

International Journal of Contemporary Pediatrics, 2017

Background: Neonatal sepsis is one of the leading causes of neonatal morbidity and mortality duri... more Background: Neonatal sepsis is one of the leading causes of neonatal morbidity and mortality during the neonatal period especially in the first week of life. The objectives of this study were to determine early breastfeeding initiation (EBFI) and the incidence of neonatal sepsis in in the first week of life in Chipinge District, Zimbabwe.Methods: After obtaining approval from the ethical institutional review board and Medical research council of Zimbabwe, a total of 200 healthy term neonates were recruited into a prospective cohort study within 24 hours of birth after the mothers had given an informed consent. Mother and baby pair was followed up at day 3 and day 7 to assess presence of infection using clinical checklist and physical examination.Results: The Pearson correlation was significant at 0.01 level (2 tailed) at day 3 and day 7. The findings revealed a significant association between EBFI and neonatal sepsis in the first week of life.Conclusions: Neonatal sepsis is one of ...

African journal of reproductive health, 2018

This study aimed at investigating the maternal characteristics that in turn influence the immunol... more This study aimed at investigating the maternal characteristics that in turn influence the immunological status of infants in asymptomatic enteric pathogen carriers in mother baby pairs (MBPs) in a high HIV burdened population in Harare, Zimbabwe. BIOPLEX immunoassay was used to analyse serum samples from 39 MBPs for 27 cytokines and 6 immunoglobulins. The MBP were purposively selected based on HIV infection and Entamoeba histolytica carriage. Logistic regression was used to identify any link between maternal demographic and clinical data with infant cytokine and immunoglobulin levels. Maternal E. histolytica carriers were more likely to have infants with low levels of IL-12p70, FGF-basic, GM-CSF and TNF-α cytokines (OR: 0.14; 95% CI: 0.03-0.79) and high levels of IgA immunoglobulin (OR: 8.1; 95% CI: 1.45-45.06). HIV infected mothers were more likely to have infants with low levels of IgG2 (OR: 0.24; 95% CI: 0.06-1.00) and IgA (OR: 0.22; 95% CI: 0.05-0.90) immunoglobulins. Notably, i...

World Journal of AIDS, 2013

Background: Pediatric HIV is a leading cause of morbidity and mortality worldwide. The substantia... more Background: Pediatric HIV is a leading cause of morbidity and mortality worldwide. The substantial expansion in PMTCT has generated information on rates of transmission and associated factors, but there are limited studies on disease progression and mortality in vertically infected children, especially from resource poor settings. Methods: A birth cohort study was initiated in 2002 to focus on the role of a single dose of nevirapine in HIV transmission before Highly Active Antiretroviral Therapy (HAART) was readily available. The enrolment of women and subsequent follow up of the children occurred at 3 peri urban clinics around Harare. Findings: 479 women were HIV infected. From these, 93 (19%) children became HIV infected, 182 (38.0%) uninfected and 204 (43%) lost to follow up before HIV diagnosis. Of the HIV infected children, 40 (43%) died before the fifth birthday, 26 (28%) were lost to follow up and 27 (29%) were alive five years after maternal enrolment prior to availability of cART. Conclusion: In this setting, there was unacceptable high mortality from HIV infected children and loss to follow up prior to availability of HAART. A small proportion of HIV vertically infected children is surviving in resource poor settings without antiretroviral therapy.