1,200 pregnant women (600 HIV+ mothers and 600 HIV-controls) in their third trimester were enrolled from January 2016 to June 2019. Participants are being followed as mother-baby pairs at birth, within 10 days of life 6, 10, 14 24, 48, 72 and 96 weeks of age. At each visit clinical examinations are being used to assess health and the impact of environmental factors. In addition, questionnaires are administered and bio-samples for laboratory tests. The design of the study is non-interventional cohort but participants are being offered advice regarding health and hygiene.

maternal urine, stool, plasma, milk, cord blood, amniotic fluid, placenta, infant serum/plasma, dried blood spots and stool

HIV Infections

Immune Activation

Cormobidities

The University of Zimbabwe College of Health Science (UZ-CHS) BIRTH COHORT Study

HIV Exposure, Disease Acquisition and Progression Among Children: Role of Maternal Immunogenetics, Viral Genetic Diversity, HAART Exposure, Co-morbidities and Psycho-Social Status: (UZ-CHS Birth Cohort)

Comparison of morbidity of HEU vs. HUU infants, defined as impaired growth, immune- and neuro-development and/ or frequent clinically relevant infections

To determine any association of maternal HIV infection, HAART exposure.

To determine any association with maternal HIV and HAART exposure.

To determine any association of HAART exposure in utero and during breast feeding with pregnancy outcome, infant (HUU, HEU, HEI) growth and immune- and neuro-development.

To determine vertical transmission rates for HIV at birth and within the first 2 years of life and assess risk factors for transmission

HIV incidence rate among mother sero-negative at enrollment

To determine the association between maternal baseline and delivery HAART levels in different compartments and the relation of those to infant HIV transmission, mortality and morbidity.

To determine the association between antenatal immune dysregulation and infant death, growth and immune responses to vaccines.

To determine HIV drug resistance profiles in mother and infants unresponsive to HAART

To determine how CMV DNA is influenced by HIV infection, HAART use and as single infection or combined infections in HIV+ and HIV- women and determine the impact on pregnancy outcome and infant cmv vertical transmission

To determine how HBV infection infections in HIV+ and HIV- women and determine the impact on pregnancy outcome, infant vertical transmission

To determine HCV infections proportion in HIV positives and negatives and HIV+ and HIV- women and determine the impact on pregnancy outcome, infant incidence of congenital cmv infection

To determine syphilis infections proportion in HIV positives and negatives and the impact on pregnancy outcome, infant incidence of congenital syphilis infection

To determine the prevalence of helminthes infection using 18s sequencing and correlate with infant development of atopic dermatitis.

To determine the prevalence of maternal under and overnutrition using BMI and MUAC impact on pregnancy outcomes, infant mortality and morbidity.

To assess abnormalities in HIV + and HIV- including lipid profiles, bone, haematological (anemia) and hepatic toxicities associated with exposure to HAART among mothers and infants.

To determine infant non-infectious comorbidities (e.g. anaemia, atopic dermatitis, congenital infections and other conditions) and their impact on mortality and morbidity.

To assess delayed neuro-cognitive development using the Denver II tool in HUU, HEU and HEI infants and correlated with socio economic status and infectious diseases.

To determine humoural immune responses to EPI vaccines including antibody levels against measles, tetanus, diphtheria, pertussis, polio and rotavirus) in HUU, HEU and HEI infants.

To determine immune activation and systemic inflammatory biomarkers in HUU, HEU and HEI infants

To determine biomarkers for endothelial dysfunction including microbial translocation in HUU, HEU and HEI infants and association with household hygiene at delivery, 6, 48 and 96 weeks of age.

To determine antenatal reference ranges for MUAC, haemoglobin from FBC analyses, and biochemistry (kidney function, liver function tests, bone, lipid profiles) in mothers with a favourable outcome of pregnancy

To determine maternal- infant microbiota16S sequencing in pregnancy and relate it to infant immune development and atopy (anti-inflammatory (IL-4, -5, -13) and regulatory cytokines (IL-10, TGF-β) at delivery, 6 weeks 48 and 96 weeks of age.

Bacterial full genome metagenomics shotgun sequencing to identify the microbiota metabolic potential (i.e. bacterial genes present will be done) and mass spectrometry will be performed for analysis of small intestinal content (metabolome).

Wide range of nutritional profiles and HAART levels spectrometry will be performed for analysis of at least 700 metabolites including amino acids and lipids will be performed in plasma, breast milk and stool samples

To characterize pathogen genetic diversity including HIV, HBV, HCV, CMV subtypes, prevalent in our study population at time of infection

To determine host genetic markers for infectious disease susceptibility including human leukocyte antigen (HLA) and killer immunoglobulin like receptor (KIR) gene variants and their association with infection rates of HIV and co-infections in mothers and their infants.

Only anonymous data will be stored at local sites and transferred between sites for collaborative research efforts. All original data will be stored locally at the UZ-CHS for at least 10 years on suitable electronic devices. Data transfer with collaborating partners will be encrypted. using EGAcryptor. With our European partners we will follow the current European General Data Protection Regulation effective May 25, 2018.

Kerina Duri

Associate Professor

University of Zimbabwe

University Hospital Inselspital, Berne

University of Hamburg

University of Oxford

Wellcome Trust

University of Yaounde

University of Cape Town

Midlands State University, Zimbabwe

National Institute of Health Research, Zimbabwe

Hypothalamic Obesity

A Personalized Program of Physical Activity and Diet for Hypothalamic Obesity

Individual Nutritional Support at Home for Patients With Hypothalamic Obesity: Efficacy on Eating Behavior, Physical Activity, Physical Abilities, Weight Gain and Quality of Life

PA volume indicator (taking into account the duration and intensity of the APs used) expressed in counts per minute, measured for 1 week objectively by an accelerometer (Actigraph GT3X®).advice and food intake control and a program of adapted physical activities at home in individual support.

In day hospital before and 4 months after supervised program (weight measured during the evaluations) and monthly measurement at home of the patient during 4 months (reported by the patient and his entourage and recorded by the dietician during the monthly telephone interview).

Score of Dyckens questionnaire ( 3 subscores behavior, drive and severity) before and after the 4 months program

lean mass and fat mass in kg and in% (DEXA)

Assistance Publique - Hôpitaux de Paris

55 children who are using
Mega-dose vitamin A supplementation
Food diversification (promotion and education on vitamin A rich food consumption)
Promotion of orange flash sweet potato production and consumption in collaboration with international potato center (CIP) in one of the study area

55 children who are using
Mega-dose vitamin A supplementation
Food diversification (promotion and education on vitamin A rich food consumption)

Vitamin A Deficiency

vitamin A supplementation normally given every six months for under five children in Ethiopia. In addition, there is also dietary intervention like orange flash sweet potato and promotion of other vitamin A rich foods to tackle vitamin A deficiency in Ethiopia.

Mega-dose of vitamin A supplement

Ethiopian Public Health Institute

Using Stable Isotope Techniques to Monitor and Assess the Vitamin A Status of Children Susceptible to Infection

Using Stable Isotope Techniques to Monitor and Assess the Vitamin A Status of Children Susceptible to Infection in Ethiopia

estimate the total body pool size vitamin A in preschool child in Ethiopia using stable isotope technique

Liver Vit A store (µmol/g) cut off <= 0.07

mean intake of beta carotene and dietary diversity score using 24 hour dietary recall

Weight for Height Z-score, Weight for Age Z-score, Height for Age Z-score and middle upper arm circumference

household (HH) family size, marital status of the mother, head of the HH, source of drinking wate, highest level of education the head of HH attend

medical history of the child enrolled in the study such as diarrhea, cough, fever, malaria, rashes, measles, vaccination, vitamin A supplementation, durg for intestinal deworming, iron supplementation.

Tesfaye Hailu

Researcher

International Atomic Energy Agency

Shear Wave sonoelastography (SWE) was performed in patients who were scheduled for a non-focal liver biopsy.

Shear Wave Sonoelastography for Fibrosis Assessment

Sex: Female, Male

Liver elasticity/stiffness was assessed via SE and compared against results of liver biopsy as read by a single pathologist using the Meta-analysis of Histological Data in Viral Hepatitis (METAVIR) 5-point scale (F [Fibrosis]0=no fibrosis, F1=portal fibrosis without septa, F2=portal fibrosis with few septa, F3=numerous septa without cirrhosis, and F4=cirrhosis). Using SE, fibrosis is measured in kilopascals (kPa) with normal values equaling approximately 5.5 kPa (normal liver stiffness ranges between 3.3-7.8 kPa). Significant Fibrosis (F3): = or > 7.6 kPa, Cirrhosis (F4): = or > 9.0- 26 kPa. A higher number corresponds to an increase in stiffness and hepatic fibrosis.

Participants with no fibrosis on liver biopsy evaluation.

Fibrosis 0

Participants with portal fibrosis without septa on liver biopsy evaluation.

Fibrosis 1

Participants with portal fibrosis with few septa on liver biopsy evaluation.

Fibrosis 2

Participants with numerous septa without cirrhosis on liver biopsy evaluation.

Fibrosis 3

Participants with cirrhosis on liver biopsy evaluation.

Fibrosis 4

Liver Elasticity Value Measured Using Sonoelastography (SE)

Overall Study

Anthony E. Samir MD

Chronic Liver Disease

Non-Alcoholic Fatty Liver Disease

Hepatitis C Virus (HCV) Coinfection

Hepatitis B Virus (HBV)

Drug-Induced Liver Injury

Shear Wave sonoelastography (SWE) as an ultrasound technique to measure liver fibrosis was performed on patients scheduled for non-focal liver biopsy. Results were compared with pathological score from liver biopsy.

Shear Wave Sonoelastography

Massachusetts General Hospital

Sonoelastography: Ultrasound Method to Measure Liver Fibrosis

Evaluate the Utility of Shear Wave Sonoelastography as a Tool to Measure Liver Fibrosis Grade

Anthony Samir

Associate Director, Ultrasound Imaging Services Assistant Radiologist, Abdominal Imaging & Intervention Massachusetts General Hospital

Biopsy specimens were assessed via Meta-analysis of Histological Data in Viral Hepatitis (METAVIR) criteria by a pathologist who was blinded to the shear-wave elastography (SWE) values.

tuberculosis/fetma

The University of Zimbabwe College of Health Science (UZ-CHS) BIRTH COHORT Study

A Personalized Program of Physical Activity and Diet for Hypothalamic Obesity

Using Stable Isotope Techniques to Monitor and Assess the Vitamin A Status of Children Susceptible to Infection

Sonoelastography: Ultrasound Method to Measure Liver Fibrosis

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