Missed Opportunities for Early Infant Diagnosis in Rural Nigeria: An Analysis from the MoMent Study

: 2.020_INF In Vivo Antibacterial Activity of Dadih and Dadih Ice Cream Toward Salmonella typhimurium Development S. Rezvi, A. Eka Putra, T. Faadhila; Andalas university, Padang, Sumatera barat, Indonesia, Andalas University, Padang, Indonesia Background: Dadih is one of Indonesia’s heritage foods from Minangkabau, West Sumatra. This traditional food contains probiotics. The health benefits of dadih probiotic have been proven. However, in the original form, dadih has sour taste, rendering it less favorable by many people. To overcome the taste problem and increase its acceptance, dadih can be modified into ice cream. Moreover, a study showed that ice cream supports the availability of probiotics. We aimed to prove that dadih processed into ice cream retains its benefit for health by observing the in vivo antibacterial activity toward Salmonella typhimurium. Methods: An experimental study with randomized post-test only control group design was conducted on 20 mice divided equally into five groups. Group K as control; group P1, P2, P3, P4 was given ice cream with dadih concentration 75%, 50%, 25%, 0% respectively, for two weeks. All groups exposed to 200ml 108 CFU/ml of Salmonella typhimurium on day 14 to 16a. Digestive tracts were isolated and microbiology test for colony count was conducted using SS agar. One-way Anova and Tukey tests in SPSS15 were used to analyze the data. A P-value less than 0.05 considered significant. Findings: The result showed that the bacterial count is lower in the treatment groups compared to control (P1:5,60 0,21; P2:6,36 1,40; P3:6,90 1,27; P4:7,37 0,22 vs. K:7,53 0,15; p<0.05). It is indicated that is better for health to consumed ice cream which contain dadih than pure ice cream. And the antibacterial activity of dadih ice cream increased consistently with increasing concentration. Interpretation: This study proves that dadih modified into ice cream retains its ability to keep our body healthy and can act as antibacterial agent. Further study is needed to pave the way for dadih ice cream as a novel functional food. Source of Funding: None. Abstract #: 2.021_INF: 2.021_INF Missed Opportunities for Early Infant Diagnosis in Rural Nigeria: An Analysis from the MoMent Study U.C. Anaba, C. Isah, H. Omari, M. Charurat, N. Sam-Agudu; Instituition, Federal Capital Territory, Abuja, Nigeria, Institute of Human Virology Nigeria, Abuja, Nigeria, University of Maryland, Baltimore, Baltimore, USA Background: Less than 10% of HIV-exposed infants (HEI) in Nigeria receive EID by the recommended age of 2 months. Low EID uptake means delays in time to infant ART initiation, leading to missed opportunities for lifesaving treatment. The MoMent Nigeria study, an interventional PMTCT implementation research study, evaluated EID uptake and cascade losses amongst HEI at Primary Healthcare Centres (PHCs) in rural North-Central Nigeria. Methods: Within this prospective cohort study, HEI were followed up to 62 days of age. HIV status was determined by DNA PCR, and results were collected for pooled analysis. EID uptake was calculated as the number of HEI presenting for DNA PCR test divided by the number of live-born HEIs. To further evaluate missed opportunities, EID uptake was analyzed by 3 domains: HEI who presented for DNA PCR and actually received testing at first presentation; HEI who presented but were not tested at first presentation; and lastly proportion of HEI that got tested and had results available. Findings: There were 403 live HEI births. EID uptake was 301/ 403 (75%). Out of 301 HEI who presented, only 162 (54%) received same-day testing. Lastly, out of 205 EID DNA PCR samples actually collected, only 120 (58%) had available results after at least 3 months post-test. A n n a l s o f G l o b a l H e a l t h , V O L . 8 3 , N O . 1 , 2 0 1 7 Infectious Diseases Old and New e Implications for Global Health J a n u a r y eF e b r u a r y 2 0 1 7 : 1 5 6 – 1 6 9 165 Interpretation: The findings show substantial early losses along the PMTCT cascade. Even where 75% of HEI presented on time, almost half (46%) did not receive same-day testing. Similarly, nearly half of HEI tested (42%) did not have EID results available 3 or more months after receiving the test. These findings may be due to stock-out of DNA PCR test kits and lack of systematic PHC to lab processes for tracking results. The consequence is then delays in testing and result provision, and ART initiation for infected infants. Client confidence is reduced in the efficiency of PMTCT services and thus encourages poor compliance. Innovative, systematic, widely-implemented public health approaches are needed in order to improve rates of same-day EID testing, result receipt, and linkage to care for infected infants. This will have lasting impacts on the health of HIV-exposed infants and the value of EID programs in resource-limited settings. Source of Funding: INSPIRE grant funded by WHO and Global Affairs, Canada. Abstract #: 2.022_INF: 2.022_INF Cutaneous Leishmaniasis Knowledge, Attitudes and Practices (KAP) Survey of an Endemic Rainforest Population

Interpretation: High burden of HIV stigma exists among women living with HIV in Nepal compared to those from neighboring India and China. HIV stigma was particularly high among those who resided in urban areas and were engaged in sex work. Gender disparity is one of the main predictors of HIV stigma. The findings warrant special programs targeted towards reducing HIV stigma among women, particularly in urban areas and among sex workers. This study reinforces the need to stress on existing disparities among women living with HIV in poor developing countries like Nepal and strengthen HIV response's focus on them through gender-responsive policies, programs and services.
Source of Funding: None.
Abstract #: 2.020_INF In Vivo Antibacterial Activity of Dadih and Dadih Ice Cream Toward Salmonella typhimurium Development S. Rezvi 1 , A. Eka Putra 2 , T. Faadhila 2 ; 1 Andalas university, Padang, Sumatera barat, Indonesia, 2 Andalas University, Padang, Indonesia Background: Dadih is one of Indonesia's heritage foods from Minangkabau, West Sumatra. This traditional food contains probiotics. The health benefits of dadih probiotic have been proven. However, in the original form, dadih has sour taste, rendering it less favorable by many people. To overcome the taste problem and increase its acceptance, dadih can be modified into ice cream. Moreover, a study showed that ice cream supports the availability of probiotics. We aimed to prove that dadih processed into ice cream retains its benefit for health by observing the in vivo antibacterial activity toward Salmonella typhimurium.
Methods: An experimental study with randomized post-test only control group design was conducted on 20 mice divided equally into five groups. Group K as control; group P1, P2, P3, P4 was given ice cream with dadih concentration 75%, 50%, 25%, 0% respectively, for two weeks. All groups exposed to 200ml 108 CFU/ml of Salmonella typhimurium on day 14 to 16a. Digestive tracts were isolated and microbiology test for colony count was conducted using SS agar. One-way Anova and Tukey tests in SPSS15 were used to analyze the data. A P-value less than 0.05 considered significant.
Interpretation: This study proves that dadih modified into ice cream retains its ability to keep our body healthy and can act as antibacterial agent. Further study is needed to pave the way for dadih ice cream as a novel functional food.

Missed Opportunities for Early Infant Diagnosis in Rural
Nigeria: An Analysis from the MoMent Study U.C. Anaba 1 , C. Isah 2 , H. Omari 3 , M. Charurat 3 , N. Sam-Agudu 3 ; 1 Instituition, Federal Capital Territory, Abuja, Nigeria, 2 Institute of Human Virology Nigeria, Abuja, Nigeria, 3 University of Maryland, Baltimore, Baltimore, USA Background: Less than 10% of HIV-exposed infants (HEI) in Nigeria receive EID by the recommended age of 2 months. Low EID uptake means delays in time to infant ART initiation, leading to missed opportunities for lifesaving treatment. The MoMent Nigeria study, an interventional PMTCT implementation research study, evaluated EID uptake and cascade losses amongst HEI at Primary Healthcare Centres (PHCs) in rural North-Central Nigeria.
Methods: Within this prospective cohort study, HEI were followed up to 62 days of age. HIV status was determined by DNA PCR, and results were collected for pooled analysis. EID uptake was calculated as the number of HEI presenting for DNA PCR test divided by the number of live-born HEIs. To further evaluate missed opportunities, EID uptake was analyzed by 3 domains: HEI who presented for DNA PCR and actually received testing at first presentation; HEI who presented but were not tested at first presentation; and lastly proportion of HEI that got tested and had results available.
Interpretation: The findings show substantial early losses along the PMTCT cascade. Even where 75% of HEI presented on time, almost half (46%) did not receive same-day testing. Similarly, nearly half of HEI tested (42%) did not have EID results available 3 or more months after receiving the test. These findings may be due to stock-out of DNA PCR test kits and lack of systematic PHC to lab processes for tracking results. The consequence is then delays in testing and result provision, and ART initiation for infected infants. Client confidence is reduced in the efficiency of PMTCT services and thus encourages poor compliance.
Innovative, systematic, widely-implemented public health approaches are needed in order to improve rates of same-day EID testing, result receipt, and linkage to care for infected infants. This will have lasting impacts on the health of HIV-exposed infants and the value of EID programs in resource-limited settings.

Source of Funding: INSPIRE grant funded by WHO and Global Affairs, Canada.
Abstract #: 2.022_INF

Cutaneous Leishmaniasis Knowledge, Attitudes and Practices (KAP) Survey of an Endemic Rainforest Population in Northern Ecuador
T. Sorocco 1 , M. Weigel 1 , R. Armijos 1 , W. Cevallos 2 , X. Sanchez 2 , E. Puebla 2 ; 1 Indiana University, Bloomington, Indiana, USA, 2 Universidad Central del Ecuador, Quito, Ecuador Background: Cutaneous leishmaniasis (CL) is endemic throughout the Pacific coastal rainforest region of Ecuador. We conducted a survey in the same endemic region to examine CLrelated KAP. We also compared these findings with those from prior studies we conducted two decades ago. We did so because extensive primary rainforest destruction and intensive economic development activities have changed the region's ecology and disease distribution patterns. In addition, many subsistence farmers who originally settled have been replaced by migrants from non-endemic areas of Ecuador. We hypothesized that these changes would decrease community familiarity with CL, its vector, disease transmission, and disease prevention and control methods. Tropical disease education and control program acceptability and effectiveness can be enhanced through better understanding of community KAP.

Methods:
The survey was conducted during a 24-month period (2013)(2014)(2015). Grid sampling was used to randomly select 10% of households in 21 rural hamlets. A subsample of 351 adults (> 18 years) from each site participated in face-to-face interviews which collected closed-and open-ended data on household and community characteristics, clinical and laboratory indicators of past or current CL, and CL-related KAP. The study received institutional review board approval and participants provided their informed consent.
Findings: One-third of participants had a positive CL history, 75% reported familiarity with CL and 82% with the sandfly vector. Nearly 80% said they knew how CL is transmitted. The most frequent CL transmission theory identified was infection (bacterial, viral, infected snake venom) transmitted by mosquito or sandflies. Of participants familiar with CL, most reported knowing about (85%) or personally practicing (81%) at least one prevention method. Bednets and insect repellants were most frequently reported. Nearly 60% said an effective vaccine was needed when asked to give suggestions for community-based CL prevention programs.
Interpretation: Although familiarity with CL, its vector, and some CL-related KAP has either stayed the same or decreased since the 1990s, knowledge about/use of bednets and insect repellants was increased suggesting that governmental mass media campaigns against dengue, malaria, and other mosquito-borne diseases appear to have produced a beneficial spill-over effect for CL, another vectorborne disease. Background: Social media can be utilized for health-related advocacy. Twitter users post "tweets" which are limited to 140 characters. Within a Tweet, users can use hashtags which can later be searchable and utilized to advocate for issues like Tuberculosis. World TB Day which happens annually on March 24 was started in 1882. This day was started to build awareness and advocate for those living with Tuberculosis. This year the #worldTBday was added to the Symplur database. When conducting a social media campaign, businesses often identify when to post to maximize reach. This principle can also be utilized in health related advocacy. This study aimed to look at a 24 hour period to see when the greatest number of posts occurred.
Methods: Utilizing Symplur, a website that collects information on healthcare based hashtags, we viewed the trend of #worldtbday over the period of 03/23/16 (17:00 PT) e 03/24/16( 17:00 PT). For this hashtag, we searched the number of tweets per hour and converted it into Central Standard Time given our location. We then analyzed the data by using frequencies and created graphs using Excel.
Findings: From March 23-March 24, 2016, we found that there were a total of 22,795 tweets posted with the #worldtbday. This translated into a total of 11,484 twitter users that posted during this time period. The highest Tweet frequency occurred at 5:00AM CST on 3/24 with 1,852 tweets. This translated into 10:00 AM in London and 3:30 PM in India.
Interpretation: This graph shows that from 00:00-16:00 CST would the ideal time to post on Twitter to get the maximum audience. If a targetted audience is needed like in time zones in India, and east Asia then tweets can be created and pre-scheduled to post using applications like Hootsuite. While this report presents one data point, it is important to study the trends of post timing in order to maximize reach and engage the desired audience.