ncharpak's blog http://www.mother-child.org/en/blog/3/atom/feed 2008-02-22T13:56:20-05:00 Kangaroo Update http://www.mother-child.org/en/weblogs/2007/jan/06/0911/kangaroo_update 2007-01-06T09:11:04-05:00 2008-02-22T13:55:50-05:00 ncharpak Dear Kangaroo Friends

]]> Dear Kangaroo Friends
In the « What’s new » chapter of the Kangaroo Foundation home page (http://kangaroo.javeriana.edu.co), you can now download the report of the last International meeting on KMC held in Cleveland last October 2006. In the report you will find a link to download a interesting bibliography on KMC wrote and updated and commented by Dr Susan Ludington.
It is a short report we did for those who could not assist to the meeting. The next meeting will be held in Uppsala, Sweden around October-November 2008, keep this date in mind for your agenda. See you soon in Uppsala!!
Nathalie Charpak
Pediatrician
Director
Kangaroo Foundation
Bogota, Colombia

]]> HIV and Breastfeeding http://www.mother-child.org/en/weblogs/2005/sep/26/1808/hiv_and_breastfeeding 2005-09-26T18:08:49-04:00 2008-02-22T13:56:24-05:00 ncharpak Highly Active Antiretroviral Therapy Started during Pregnancy or Postpartum Suppresses HIV-1 RNA, but Not DNA, in Breastmilk

]]> Highly Active Antiretroviral Therapy Started during Pregnancy or Postpartum Suppresses HIV-1 RNA, but Not DNA, in Breastmilk

Roger L. Shapiro,1,4 Thumbi Ndung'u,1 Shahin Lockman,1,3 Laura M. Smeaton,2 Ibou Thior,1 Carolyn Wester,1 Lisa Stevens,1 Gaseene Sebetso,5 Simani Gaseitsiwe,5 Trevor Peter,1 and Max Essex1
1Department of Immunology and Infectious Diseases and 2Center for Biostatistics in AIDS Research, Harvard School of Public Health, 3Infectious Disease Unit, Brigham and Women's Hospital, and 4Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, Massachusetts; 5Botswana Harvard School of Public Health AIDS Initiative Partnership for HIV Research and Education, Bontleng, Gaborone, Botswana
(See the editorial commentary by Bulterys et al. and the article by Shapiro et al)

Background. The ability of highly active antiretroviral therapy (HAART) to reduce human immunodeficiency virus type 1 (HIV-1) RNA and DNA in breast milk has not been described.
Methods. We compared breast-milk HIV-1 RNA and DNA loads of women in Botswana who received HAART (nevirapine, lamivudine, and zidovudine) and women who did not receive HAART.
Results. Women in the HAART group received treatment for a median of 98 days (range, 67 222 days) at the time of breast-milk sampling; 23 (88%) of 26 had whole breast-milk HIV-1 RNA loads <50 copies/mL, compared with 9 (36%) of 25 women who did not receive HAART (P = .0001). This finding remained significant in a multivariate logistic-regression model (P = .0006). The whole-milk HIV-1 DNA load was unaffected by HAART. Of women who received HAART, 13 (50%) of 26 had HIV-1 DNA loads <10 copies/106 cells, compared with 15 (65%) of 23 who did not receive HAART (P = .39).
Conclusions. HAART suppressed cell-free HIV-1 RNA in breast milk and may therefore reduce mother-to-child transmission (MTCT) of HIV-1 via breast-feeding. However, HAART initiated during pregnancy or early after delivery had no apparent effect on cell-associated HIV-1 DNA loads in breast milk. Clinical trials to determine MTCT among breast-feeding women receiving HAART are needed.

Received 14 February 2005; accepted 18 April 2005; electronically published 27 July 2005.
Presented in part: 12th Conference on Retroviruses and Opportunistic Infections, Boston, 22 25 February 2005 (poster 793b).
Potential conflicts of interest: none reported.
Financial support: National Institutes of Childhood Health Development (grants R01-HD37793 and K23-HD01330).
Reprints or correspondence: Dr. Roger L. Shapiro, Div. of Infectious Diseases, Beth Israel Deaconess Medical Center, 110 Francis St, Suite GB, Boston, MA 02215 (rshapiro@bidmc.harvard.edu).

]]> The Kangaroo Mother Care (KMC) Method worldwide http://www.mother-child.org/en/weblogs/2005/aug/18/0952/kangaroo_mother_care_kmc_method_worldwide 2005-08-18T09:52:04-04:00 2008-02-22T13:56:20-05:00 ncharpak Step by step, the KMC method is diffusing in all the neonatal units as a tool for humanizing the high technology or to complement the scarcity of human y/o technological resources in the big health ob

]]> Step by step, the KMC method is diffusing in all the neonatal units as a tool for humanizing the high technology or to complement the scarcity of human y/o technological resources in the big health obstetric facilities of the developing world. Actually KMC can be considered as a unique available tool to decrease the morbimortality and better the nutrition of the low birth weight infants in the developing countries
There is a lack of scientific evaluations on KMC, not anymore on its efficacy or safety but on its impact according to the level of development of the setting where KMC is implemented. We need references data to be able to initiate a massive diffusion of KMC. The Kangaroo Foundation, based in Colombia and known for its research on KMC, designed in collaboration with more than 10 centres in developing countries of different levels of development various projects aim to evaluated this impact.. How to find funds to support these projects? That s the key question.
18 millions of Low Birth Weight born each year, one third will die in the first year and one third in the first month. We must give the access to KMC to all these fragile infants independently of their origin. That s our mission.
Nathalie Charpak
Pediatrician
Director
Kangaroo Foundation
Bogota, Colombia

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