Combined Effect of Co-trimoxazole Prophylaxis and Safe Water on Diarrhea Amongst HIV-Exposed Infants and People Living With HIV/AIDS: A Systematic Review
Keywords:
Systematic review, safe sanitation, improved water supply, WaSH, co-trimoxazole prophylaxis, HIV-exposed, PLWHA, morbidity, mortality, and diarrhea
Abstract
Irrespective of co-trimoxazole prophylaxis, diarrhea among HIV-exposed infants (HEI) and people living with HIV (PLWHA) remains unacceptably high. We aimed to determine the combined effect of improved water supply interventions and co-trimoxazole prophylaxis on frequency and severity of diarrhea among HEI and PLWHA. Using key search terms of safe sanitation, improved water supply, WaSH, co-trimoxazole prophylaxis, HIV-exposed, PLWHA, morbidity, mortality, diarrhea; we searched for published articles in PubMed, EMBASE, PsycINFO, AMED, CINAHL, DOAJ and Google Scholar databases guided by the acceptance practice developed by PROSPERO and COCHRANE. A PRISMA flow diagram was used to explain on the number of articles retrieved, retained, excluded and justifications for every action. A Mixed Method Appraisal Tool (MMAT) was used to assess the quality of the methodology of the selected studies. Safe water supply interventions and co-trimoxazole prophylaxis together reduced diarrhea episodes by up to 67% (IRR _ 0.33, 95% CI 0.24–0.46, P < 0.0001). The combined interventions resulted in 27% risk reduction in HIV disease progression whilst safe water alone was associated with reductions in the longitudinal prevalence of reported diarrhea of up to 53% among HIV exposed infants aged ≤2 years (LPR = 0.47, 95% CI: 0.30–0.73, P < 0.001). An expanded WaSH response in fighting HIV is critical to prevent diarrhea and rapid disease progression. The protocol was published in the PROSPERO database with registration number CRD42021240512.
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References
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2. Chandna, J., Ntozini, R., Evans, C., Kandawasvika, G., Chasekwa, B., Majo, F.D., Mutasa, K., Tavengwa, N.V., Mutasa, B., Mbuya, M.N. and Moulton, L.H., 2020. Effects of improved complementary feeding and improved water, sanitation and hygiene on early child development among HIV-exposed children: substudy of a cluster randomised trial in rural Zimbabwe. BMJ global health, 5(1), p.e001718.
3. Chavura, E., Singini, W., Chidya, R. and Mbakaya, B.C., 2022. Combined effect of co-trimoxazole preventive therapy and improved water supply interventions on diarrhea amongst HIV-exposed infants and people living with HIV.
4. Chintu, C., Bhat, G.J., Walker, A.S., Mulenga, V., Sinyinza, F., Lishimpi, K., Farrelly, L., Kaganson, N., Zumla, A., Gillespie, S.H. and Nunn, A.J., 2004. Co-trimoxazole as prophylaxis against opportunistic infections in HIV-infected Zambian children (CHAP): a double-blind randomised placebo-controlled trial. The Lancet, 364(9448), pp.1865-1871.
5. Davis, N.L., Wiener, J., Juliano, J.J., Adair, L., Chasela, C.S., Kayira, D., Hudgens, M.G., van der Horst, C., Jamieson, D.J., Kourtis, A.P. and Ahmed, Y., 2017. Co-trimoxazole prophylaxis, asymptomatic malaria parasitemia, and infectious morbidity in human immunodeficiency virus–exposed, uninfected infants in Malawi: the BAN Study. Clinical Infectious Diseases, 65(4), pp.575-580.
6. Ebinger, J., Botwin, G.J., Albert, C.M., Alotaibi, M., Arditi, M., Berg, A.H., Binek, A., Botting, P.G., Fert-Bober, J., Figueiredo, J.C. and Grein, J.D., 2020. SARS-CoV-2 Seroprevalence Across a Diverse Cohort of Healthcare Workers.
7. Flower, B., Brown, J.C., Simmons, B., Moshe, M., Frise, R., Penn, R., Kugathasan, R., Petersen, C., Daunt, A., Ashby, D. and Riley, S., 2020. Clinical and laboratory evaluation of SARS-CoV-2 lateral flow assays for use in a national COVID-19 seroprevalence survey. Thorax, 75(12), pp.1082-1088.
8. Giné Garriga, R. and Pérez Foguet, A., 2013. Unravelling the linkages between water, sanitation, hygiene and rural poverty: the WASH poverty index. Water resources management, 27(5), pp.1501-1515.
9. Hong GN, Pluye P, Fàbregues S, Bartlett G, Boardman F, Cargo M, Dagenais P, Gagnon M, Griffiths F, Nicolau B, O’cathain A, Rousseau M & VI. MIXED METHODS APPRAISAL TOOL (MMAT) VERSION 2018 User guide. Registration of Copyright (#1148552),. Canadian Intellectual Property Office, Industry Canada. 2018.
10. Kamuhabwa, A.A. and Manyanga, V., 2015. Challenges facing effective implementation of co-trimoxazole prophylaxis in children born to HIV-infected mothers in the public health facilities. Drug, healthcare and patient safety, 7, pp.147-156. Luby, S., 2014. Is Targeting Access to Sanitation Enough?. The Lancet. Global health, 2(11), pp.e620.
11. Lule, J.R., Mermin, J., Ekwaru, J.P., Malamba, S., Downing, R., Ransom, R., Nakanjako, D., Wafula, W.,Hughes, P., Bunnell, R. and Kaharuza, F., 2005. Effect of home-based water chlorination and safe storage on diarrhea among persons with human immunodeficiency virus in Uganda. The American Journal of Tropical Medicine and Hygiene, 73(5):926-933.
12. Makaudze, E.M., 2019. Understanding the Hygiene Needs of People Living with HIV and AIDs in Southern African Developing Community (SADC) Countries. In The Relevance of Hygiene to Health in Developing Countries (p. 39). IntechOpen.
13. Mendeley. Mendeley-Desktop-1.19.4-win32,. 2020; Available from:
https://www.mendeley.com/download-desktop-new/#download.
Booth A, Clarke M, Ghersi D, Moher D, Petticrew M SL. An international registry of systematic-review protocols. Lancet. 2011;377(9760):108.
14. Moher D, Liberati A, Tetzlaff J, Altman DG GP. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7).
15. O Reilly, C.E., Taylor, E.V., Ayres, T., Fanta, R., Abayneh, S.A., Marston, B., Molla, Y.B., Sewnet, T., Abebe, F., Hoekstra, R.M. and Quick, R., 2014. Improving health among people living with HIV/AIDS who received packages of proven preventive health interventions , Amhara, Ethiopia. PLoS One, 9(9), p.e107662.
16. Peletz R, Simunyama M, Sarenje K, Baisley K, Filteau S, et al. (2012) Assessing Water Filtration and Safe Storage in Households with Young Children of HIV-Positive Mothers: A Randomized, Controlled Trial in Zambia. PLoS ONE 7(10): e46548. doi:10.1371/journal.pone.0046548
17. Page, M.J., Shamseer, L. and Tricco, A.C., 2018. Registration of systematic reviews in PROSPERO: 30,000 records and counting. Systematic reviews, 7(1), pp.1-9.
18. Prendergast, A.J., Chasekwa, B., Evans, C., Mutasa, K., Mbuya, M.N., Stoltzfus, R.J., Smith, L.E., Major, F.D., Tavengwa, N.V., Mutasa, B. and Mangwadu, G.T., 2019. Independent and combined effects of improved water, sanitation, and hygiene, and improved complementary feeding, on stunting and anemia among HIV-Exposed children in rural Zimbabwe: a cluster randomized controlled trial. The lancet child and adolescent health, 3(2), pp.77-90.
19. Walson J, Singa B, Sangare´ L, Naulikha J, Piper B, Richardson B, et al. Empiric deworming to delay HIV disease progression in adults with HIV who are ineligible for initiation of antiretroviral treatment (the HEAT study): a multisite, randomised trial. Lancet Infect Dis 2012; 12:925–932.
20. World Health Organization, 2015. Water sanitation & hygiene for accelerating and Sustaining progress on neglected tropical diseases: a global strategy 2015-2020 (No. WHO/FWC/WSH/15.12). World Health Organization.
21. Shrestha, R.K., Marseille, E., Kahn, J.G., Lule, J.R., Pitter, C., Brantford, J.M., Blunnell,R., Coutinho, A., Kizito, F., Quick, R. and Mermin, J., 2006. Cost effectiveness of home-based chlorination and safe water storage in reducing diarrhea among HIV affected households in rural Uganda. The American journal of tropical medicine and hygiene, 74(5), pp.884-890.
22. Xue, J., Mango, Z., Hoffman, I.F., Mofolo, I., Kamanga, E., Campbell, J., All good, G., Cohen, M.S., Martinson, F.E., Miller, W.C., and Hosseinipour, M.C., 2010. Use of nutritional and water hygiene packages for diarrhea prevention among HIV-exposed infants in Lilongwe, Malawi: an evaluation of a pilot prevention of mother to child transmission post natal care service. Tropical medicine and international health, 15(10), pp.1156-1162.
Published
2023-01-11
How to Cite
Chavura, E., Singini, W., Chidya, R., & Mbakaya, B. C. (2023). Combined Effect of Co-trimoxazole Prophylaxis and Safe Water on Diarrhea Amongst HIV-Exposed Infants and People Living With HIV/AIDS: A Systematic Review. European Scientific Journal, ESJ, 13, 83. Retrieved from https://eujournal.org/index.php/esj/article/view/16320
Section
ESI Preprints
Copyright (c) 2023 Elton Chavura, Wales Singini, Russel Chidya, Balwani Chingatichifwe Mbakaya
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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