The ＂Mother Complex＂ of Martha Quest

Human experience can best be understood in the framework of collective social relations. Like any other tie, the mother-daughter relationship is forged not in isolation but informed by cultural, historical, and social values, circumstances, and practices. The twentieth century has witnessed the greatest changes in world history. As an outcome of the noticeable shift in gender ideologies in the last half of that century, modern mothers and daughters struggled to experience a union, a bond, an understanding of themselves and the world around them. Clash of tradition and modernity in ideals and mores can be held accountable for the consequential neurotic development of the psyche in twentieth century mothers and daughters. Doris Lessing＇s writings reflect the way in which these complex changes in society affect family relationships. Her first novel of the Children of Violence series, Martha Quest, is an apt study of a mother and her daughter＇s struggle with their newly defined roles in society. This paper will seek to examine the conflicts that are encountered in the wake of such adjustments by contemporary mothers and daughters. In order to do so, the study will focus on an exploration of the kind of issues that Martha Quest and May Quest experience in Lessing＇s Martha Quest through approaches available in works by Carl Jung on his theory of the ＂mother complex＂.

Mother-to-Child Transmission of Human Papillomavirus in Burkina Faso

Introduction: Human papillomavirus (HPV) infection is the most widespread sexually transmitted infection in the world. Today, there is growing evidence that HPV can be transmitted early in life, and one potential route is mother-to-child transmission. Data on this route of HPV transmission are scarce in Africa and particularly in Burkina Faso, where no data on the subject are yet available. The aim of our study was to estimate the rate of mother-to-child transmission of HPV infection and to identify circulating genotypes. Methodology: Cervico-uterine samples were collected from 100 full-term pregnant women and, buccal samples were obtained from their newborns at Hopital Saint Camille de Ouagadougou (HOSCO) by the specialist physician. HPV DNA amplification and genotyping were performed by PCR followed by hybridization using the HPV Direct Flow Chips kit, detecting 36 genotypes including 18 high-risk and 18 low-risk. Results: The prevalence of HPV in newborns was 8% (8/100). Six (6) HPV-positive neonates had HPV-positive mothers, while 2 HPV-positive neonates had HPV-negative mothers. The vertical transmission rate was 26.09% (6/23). Mother-newborn genotypes were concordant. However, the genotype profile of the newborns was more restricted than that of the mothers. Conclusion: HPV DNA was found in 8% of newborns in our study. The genotype profile of the mother-newborn pair was concordant. Asymptomatic HPV infection in a pregnant woman could constitute a risk factor for vertical transmission.

Evolution of Mother-to-Child HIV-1 Transmission Rate in Mali from 2009 to 2018

Despite enormous efforts to achieve the goal of eliminating mother-to-child transmission of HIV-1, it remains a major challenge for many countries in sub-Saharan Africa, particularly Mali. Our objective is to assess changes in the rate of mother-to-child transmission of HIV-1. We conducted a cross-sectional study between January 1, 2009 to December 31, 2018 (10 years) of early diagnosis activity in newborns and children born to HIV-1-positive mothers at the National Institute for Public Health (INSP). The samples came from health and referral centers in mali. All samples were received at the Laboratory of Molecular Biology at the INSP. Proviral DNA extraction was performed from a blood spot sample with a Roche DNA kit, Cobas AmpliPrep/Cobas TaqMan HIV-1 qualitative Test, V2.0 (Roche Molecular System, Inc, USA) following the company procedures. Molecular diagnosis was performed using the same kits using an algorithm of three identical PCRs. The Epi Info version 7 software was used for data analysis with a significance threshold of 5%. A total of 10,714 samples of infants and children born to HIV-positive mothers were analyzed by PCR. Ninety-six percent of mothers were on ARV prophylaxis (AZT 3TC NVP and AZT NVP) and 60% of newborns received the same ARV prophylaxis. Of these children, 956 tested positive with an overall transmission rate of 8.92%, varying between 7.27% in 2009 and 08.01% in 2018. This rate was relatively low among children receiving prophylaxis at 2.04% and remained high for children who received breastfeeding at 5.62%. However, the transmission rate remains low for those who have benefited from mixed and artificial breastfeeding at 1.58% and 1.27% respectively. A significant proportion of children remained infected by their mothers during pregnancy, childbirth or breastfeeding. This study shows the importance of early diagnosis of HIV in children using molecular technology.

Development and Evaluation of 3D Delivery Animation Software Designed to Improve the Mother’s and Spouse’s Satisfaction with Delivery

Purpose: To clarify the effectiveness of 3-D delivery animation software for the mother’s and husband’s satisfaction with delivery. Subjects and Method: We independently developed a software application used to display the pelvic region and explain the labor process. The study involved a collaboration with hospital staff who recruited 18 primiparous and 18 multiparous mothers who were hospitalized for delivery at Facility A. The midwife explained the process of delivery using the “Delivery Animation Software”. A self-administered, anonymous questionnaire was distributed and analyzed separately for primiparous and multiparous mothers and their husbands. Results: 1) For both primiparous and multiparous couples, both mothers and their husbands gained a significantly higher level of understanding after delivery than during pregnancy. 2) The Self-Evaluation Scale for Experience of Delivery results were as follows: “I did my best for the baby even if it was painful” was selected more often for “birth coping skills”;“reliable medical staff” was selected more often for “physiological birth process”;“the birth progressed as I expected” was selected frequently by primiparous mothers;and “the birth progressed smoothly” was selected often by multiparous mothers. 3) In terms of husbands’ satisfaction with the delivery, “I was satisfied with the delivery”, “I was given an easy-to-understand explanation”, and “They explained the process to me” was selected of primiparous and multiparous fathers. 4) All primiparous and multiparous mothers positively evaluated whether the delivery animation was helpful in understanding the process of delivery. Conclusion: The delivery animation was effective in improving the understanding and satisfaction of both the mothers and their husbands.

Percutaneous Coronary Intervention in Acute Coronary Syndromes at the Mother-Child University Hospital Luxembourg in Bamako

Introduction: Acute coronary syndromes (ACS) are a diagnostic and therapeutic emergency. Objective: Studying the feasibility, difficulties and results of coronary angioplasty in acute coronary syndromes at the Luxembourg Mother-Child University Hospital in Bamako. Patients and Methods: Cross-sectional, descriptive study with prospective recruitment over 18 months from September 2020 to February 2022. All patients aged at least 18 years old admitted for SCA and having undergone PCI during the study period were included. Result: We collected 249 patients for SCA, of whom 160 underwent angioplasty, either an angioplasty/SCA ratio of 0.64. The average age of the patients was 59.54 ± 11.62 with extremes of 32 and 92 years. The age group of 45 to 65 years was the most representative. The predominance was male, sex ratio of 2.4. The main cardiovascular risk factors were high blood pressure (58.23%) and diabetes (45.78%). Persistent ST-segment elevation on the electrocardiogram was present in 71.48%. The treatment time was more than 12 hours after the first medical contact in 95.5%. The approach was radial in 96.5% of cases. Coronarography was pathological in 91.16% of our patients. The lesions were tri-truncular in 34.13% with the anterior inter ventricular as culprit artery in 72% of cases. The majority of patients (64%) had undergone angioplasty with implantation of an active stent. Angioplasty was performed successfully in 98% and per procedural mortality was 1.87%. Only 6.45% of ACS with ST elevation benefited from primary angioplasty. Conclusion: Percutaneous coronary intervention is performed routinely in our center with satisfactory results. Difficulties exist, related to the diagnostic delay of ACS and the high cost of angioplasty.

Effect of a Nutrition Education Intervention on Food Safety Knowledge, Attitudes and Practices of Mothers of Children under 5 Years in the Peri-Urban Areas of Bobo-Dioulasso: Before and after Study

Background: This study assessed the effect of a nutrition education intervention. This intervention aimed to improve the knowledge, attitudes, and practices of mothers on food safety in the peri-urban areas of Bobo-Dioulasso in Burkina Faso. Methods: A total of 243 mothers of children under 5 years in the peri-urban of Bobo-Dioulasso were administered the FAO questionnaire for food safety knowledge, attitudes, and practices assessment during two cross-sectional surveys, before and after the intervention, in January and October 2017. The intervention included two components consisting of a theoretical phase (counselling and discussion) and cooking demonstrations implemented for ten months. To account for the before-and-after design of the study, the McNemar’s test was used to assess the effect of the intervention on food safety KAP of mothers of children under 5 years. Results: The mean age of mothers was 29 ± 6.2 years and 50.6% of them were between 20 and 29 years old. One for knowledge (cooking thoroughly with, p-value = 0.0001) and another for attitudes (perceived benefits of reheating leftovers before eating them, p-value = 0.0001), significantly increased after the intervention. In terms of food safety practices, all the indicators (cleaning of dirty surfaces, plates and utensils and storage of perishable foods) significantly increased (all p = 0.0001 Conclusion: This study provided some evidence of an effective nutrition education intervention for improving maternal KAP on food safety for their child’s feeding.

Experiences of Mothers on the Utilization of Elimination of Mother to Child Transmission of HIV Services at Mtendere Clinic, Lusaka

Introduction: Acquired immunodeficiency syndrome is one of the leading causes of mortality among women of reproductive age and Mother to Child Transmission of Human immunodeficiency virus is still a challenge affecting many countries. Globally, an estimation of 180,000 children under 15 years acquire the Human immunodeficiency virus every day, and more than 90% of those infections are due to Mother to Child Transmission. The study sought to explore the experiences of mothers on the Elimination of Mother to Child Transmission-HIV services at Mtendere Clinic, Lusaka. Materials and Methods: Qualitative interpretive phenomenology study design was employed using in-depth interviews to collect data from a sample that was selected using purposive sampling technique. Thirteen participants were recruited, and these were HIV-positive mothers at least between the ages of 15 and 49 years and enrolled in the Elimination of Mother To Child Transmission-HIV program. The in-depth interviews were audiotape recorded and transcribed verbatim. Data was analyzed using thematic method. Findings: Three main themes that emerged are;living with HIV, support system and barriers to utilization of Elimination of Mother To Child Transmission-HIV services. Most of the participants expressed having acquired knowledge from the program, and received counselling and support from spouses, family as well as health personnel at Mtendere health facility which culminated into a positive experience and enhanced their uptake of the Elimination of Mother to Child Transmission-HIV services. However, barriers to service utilization were identified and these included fear of stigma, negative attitudes from health workers, long waiting times, lack of support and lack of transport to the health facility. Conclusion: Interventions such as community awareness campaigns on Elimination of Mother To Child Transmission-HIV, male involvement and implementing mother-to-mother peer support strategies in Elimination of Mother To Child Transmission-HIV service utilization should be prioritized so as to alleviate stigma and enhancing a positive experience for these mothers thus reducing on the Mother to Child HIV Transmission burden and mortality rates.

Acceptability of Kangaroo Mother Care (KMC) by Mothers with Low-Birth-Weight Babies at Arthur Davison Children’s Hospital, in Ndola, Zambia

Background: Kangaroo Mother Care is a simple safe method used to care for low-birth-weight babies. Low-birth-weight is a global public health issue that pose significant challenge to perinatal care systems. Globally, complications due to low-birth-weight are the leading cause of neonatal mortality, resulting in an estimated 1 million deaths annually. Kangaroo Mother Care (KMC) is a low-cost method of care for low-birth-weight infants in areas with inadequate incubators and power outages with positive outcomes. Objectives: To assess factors influencing acceptability of Kangaroo Mother Care (KMC) in NICU at Arthur Davison Children’s Hospital in Ndola, Zambia. Methodology: A cross sectional quantitative analytical study design was used. The study was conducted at Arthur Davison Children’s Hospital (ADCH) in Ndola, Zambia. The purposive sampling method was used to select the study participants and a total of 129 mothers with Low Weight Babies A were selected to participate structured closed ended questionnaire was used to collect data from the participants using an interview. Data was analyzed using a Statistical Package for Social Scientists (SPSS) software version 26. Cross tabulations were done to determine association of variables using a Chi square (x2) test at 95% confidence interval and were assumptions where not met, fishers exact test was used. Multivariate binary logistic regression analysis was used to quantify the relationship between the dependent and independent variables. Results: Most of the respondents had male babies 77%, 69% of the babies weighed 1000 g - 1400 g, majority 79% had normal delivery, 71% of the respondents were multigravida and most of the respondents 79% were married. The study reviewed that 85% of those who attained secondary education accepted KMC, 74% of the respondents without monthly income accepted KMC, 80% of the respondents had positive attitude and accepted KMC. 82% of the respondents who had positive perception accepted KMC. Conclusion: Acceptance of Kangaroo Mother Care (KMC) among 75% of the mothers underscores its widespread favourability as a beneficial method for infant care.

青少年心境障碍患者自杀未遂的影响因素分析

目的探讨青少年心境障碍(mood disorder,MD)患者伴有自杀未遂(suicide attempt,SA)的影响因素。方法采取横断面调查方式,招募2022年8月3日至2023年9月25日在首都医科大学附属北京安定医院儿童青少年病房住院的105例青少年MD患者纳入研究,并根据是否存在SA,分为SA组(n=41)和非SA组(n=64)。收集患者的一般人口学资料,采用抑郁症筛查量表(Patient Health Questionnare 9-item Scale,PHQ-9)、广泛性焦虑问卷(Generalized Anxiety Disorder 7-item Scale,GAD-7)、儿童期创伤问卷(Childhood Trauma Questinnaire,CTQ)、Barratt冲动性量表(Barratt Impulsiveness Scale,BIS-11)中文版进行临床症状评估,并采用χ2/t检验对上述因素进行差异性分析,随后对差异有统计学意义的因素采用多因素Logistic回归对SA的相关因素进行分析。结果SA的发生率为39%(41/105),其中女性为42.5%(37/87),男性为22.2%(4/18)。单因素分析结果显示,女性、母亲受教育程度低更容易出现SA(P均<0.05),SA组患者在PHQ-9总分、GAD-7总分、情感忽视及躯体忽视的比例均高于非SA组(P均<0.05)。Logistic回归分析显示,焦虑(OR=1.246,95%CI:1.048~1.480,P=0.013)、母亲受教育程度低(OR=1.522,95%CI:1.040~2.229,P=0.031)是青少年MD患者伴有SA的危险因素。结论青少年MD患者SA发生率较高,伴有焦虑症状和母亲受教育程度低是发生SA的危险因素。

Umbilical Cord Care Practices and Cord Care Education of Mothers Attending Health Care (Pakistan Prospect)

Neonatal mortality is of global concern, it is the death in the first month of life. According to WHO, 2.4 million children died globally in the first month of life2. Globally the neonatal mortality rate declined slowly from 28/100 live births in 2000 to 17.9/100 live births in 2019. It is a major challenge for the low socioeconomic group of countries. Most neonatal deaths occurred in south Asia and African countries, in 2019 out of 2.4 million death 81% occurred in the Southeast Asia. Objective: To evaluate and improve cord care practices of mothers to reduce the risk of cord related infections. Methodology: The mixed method will be used in this research, questionnaire is used for data collection, total collected sample is 391. Results: 354 (91.0%) of the 394 patients analyzed obtained prenatal care (ANC) in both traditional and nontraditional settings. Among these, 288 (72.3%) got cord care health education, whereas 106 (27.7%) did not. The overall documentation of the instructions for the use of metabolized spirits alone included 116 (48.9%) teaching institutions and 103 (43.5%) private hospitals. the average results show the age of the baby 1 - 7 days, the average age of the mother is 18 - 25 years. The average education of the mothers is primary. Participation of health centers is average. Most of the participants has 1 child. Conclusion: This research concludes the poor umbilical cord practices and knowledge. Those with information used it better. Raise awareness about umbilical cord care and improper behaviors, including using mentholated balms. Before women leave the hospital, they should learn cord care. Mothers must clean wires. Several healthcare organizations don’t provide cord care instruction, and what they provide isn’t research-based.

Mothers’ Level of Schooling, Monitoring of Their Pregnancy and Perinatal Prognosis at the Reference Health Centre of Commune V of the District of Bamako

Introduction: The level of schooling of mothers is a determining factor in the follow-up of pregnancy and consequently the prognosis of childbirth and the quality of the newborn. Objective: The aim was to assess the impact of the level of education on the follow-up of their pregnancy and perinatal prognosis at the Reference Health Centre of Commune V of the District of Bamako. Materials and Methods: This was a prospective, cross-sectional and analytical study aimed descriptive from August 15 to December 15, 2021. We included in this study all pregnant women who had a gestational age of at least 22 weeks of amenorrhea and who gave birth or were received in the immediate postpartum period at the maternity ward of the Reference Health Center of Commune V. Results: Out-of-school parturients accounted for 60% of cases. Among the parturients in school, 18% had a higher level. In our study, 14.3% of women in labour knew the date of the last menstrual period. In our series, 100% of mothers in higher and secondary school had completed an antenatal consultation (CPN) compared to 90.7% in the out-of-school mothers. CPN1 was performed in the first trimester of pregnancy in 21.1% among out-of-school parturients compared to 83.5% among higher-level parturients. The number of NPCs was greater than or equal to 4 in 47.9% of parturients. Conclusion: Women’s schooling has an impact on their socio-economic conditions on the one hand and on the monitoring and prognosis of pregnancies on the other.

Factors Associated with Mother-to-Child Transmission of HIV at the Maternity Unit of the Castors Urban Health Center in Bangui

Introduction: In spite of significant progress towards eliminating mother-to-child transmission (MCT) of HIV by 2025, trends in vertical mother-to-child transmission are still worrying in sub-Saharan African countries. This study aims to take stock of the factors associated with HIV MCT at the level of peripheral health training. Patients and Methods: This was a descriptive and analytical retrospective study, over a five-year period from January 1st, 2017 to December 31st, 2021. The study population was represented by HIV-positive women and their cared infants in the Parent-Child Transmission Prevention Unit (PCTP) of the Castors Urban Health Center (CUHC). Results: 288 medical records were selected out of a total of 347 HIV-positive mothers followed. HIV seroprevalence in the population of women who received PreNatal Consultation (PNC) during the study period was 8.2%. The HIV MCT rate was 3.7%. HIV+ mothers followed were mostly young (average age of 28), not living in a couple (96.9%), poorly educated (58.7%) and not engaged in income-generating activity (58.4%). They had all received triple therapy and the period of initiation of antiretroviral (ARV) therapy was in the majority of cases during the first trimester. Factors associated with MCT were: primiparity (OR = 18.4 [5.55 - 61.05];Khi2 = 32.61;p < 0.001), late discovery of infection during large or after childbirth (OR = 0.03 [0.007 - 0.10];Khi2 = 55.22;p < 0.001), WHO Clinical Stage 2 and 3 (OR = 0.007 [0.001 - 0.03];Khi2 = 108.73;p < 0.001), CD4 count 200/mm3 (OR = 14.12 [4.03 - 57.20];Khi2 = 21.68;p < 0.001), viral load > 1000 copies/mm3 (OR = 8.85 [2.33 - 43.20];Khi2 = 10.46;p = 0.001), prolonged labor (OR = 12.33 [3.45 - 57.25];Khi2 = 18.47;p < 0.001), premature rupture of membranes (OR = 24.03 [6.97 - 96.01];Khi2 = 40.60;p 2 = 5.96;p = 0.014), and artificial or mixed breastfeeding (OR = 0.01 [0.002 - 0.043];Khi2 = 97.65;p Conclusion: Taking into account the risk factors for PCTP is essential if we want to achieve the goal of “Zero New Infections in Children by the year 2025”.

Mother’s Nutritional Knowledge and Practice towards Children under Two Years of Age and Its Impact on Their Health in Abuzaid Albuluk Pediatric Specialized Hospital in 2023

Background: Nutritional knowledge and practise is an important measure to improve dietary habits and food choices. The daily food should contain balanced nutrition as needed to support optimal growth, avoid deficiency diseases and prevent the diseases which might interfere with the children health. Materials & Methods: A descriptive cross-sectional non-interventional hospital-based study was carried out among 122 mothers and 122 children by using a non-probability convenience sampling technique in the period of 15 March to 15 April 2023, and using interviews with structural questionnaires, the data was analyzed using SPSS version 26. Results: We found that most of the children had moderate health, while most of the mothers had moderate nutritional knowledge and practise towards their children, also we found that the relationship between mothers’ knowledge and practise and child health was significant (P Conclusion: Mothers’ knowledge and practise among children was moderate and children had moderate health. Wrong beliefs and cultural taboos play major roles in decreasing knowledge and practise.

Early Morbidity and Mortality in Neonates of Mothers with Sickle Cell Disease at the Borgou/Alibori Center Departmental Teaching Hospital in Benin

Introduction: Association of sickle cell disease and pregnancy is a risky situation for both the mother and neonate. Objective: To determine the early morbidity and mortality among neonates of mothers with sickle cell disease at Borgou/Alibori Center Departmental Teaching Hospital (CHUD B/A) in Benin. Patients and Methods: This was a descriptive and analytical observational study conducted at CHUD-B/A from January 1, 2015, to August 31, 2019. It included pregnant women with sickle cell disease who gave birth to a liveborn neonate at the term of at least 28 weeks of amenorrhea. Variables studied were sociodemographic, clinical, and evolutionary. Analysis of the factors associated with early death was also carried out with a significance threshold set at p Results: Out of a total of 119 pregnant women, 95 neonates were recorded. Main morbidities were: prematurity and intrauterine growth restriction (49.5%);respiratory distress (40%), bacterial infection (30.5%), and perinatal asphyxia (21.1%). Early mortality rate was 8.4%. In bivariate analysis, the factors associated with early death were: parity (p < 0.001), the severity of maternal anemia (p < 0.008), birth weight under 1500 g (p < 0.002), the birth term under 32 weeks of amenorrhea (p < 0.001), resuscitation for at least 5 minutes (p = 0.001). In multivariate analysis, resuscitation for at least 5 minutes (p = 0.007) was mainly associated with early death. Conclusion: One out of two neonates of mothers with sickle cell disease has a low birth weight. Early mortality is high due to perinatal asphyxia. Hence the multidisciplinary care of these mothers.

Effect of a Nutrition Education Intervention on Mothers’ Infant and Young Child Feeding Knowledge and Practices in the Peri-Urban Areas of Bobo-Dioulasso: Before and after Study

Background: This study assessed the effect of a nutrition education intervention aiming to improve the knowledge and practices of under 5 years children’s mothers on infant and young child feeding in peri urban areas of Bobo-Dioulasso in Burkina Faso. Methods: A total of 243 mothers of children under 5 years in the peri-urban of Bobo-Dioulasso were surveyed before and after the intervention using the FAO questionnaire for infant and young child feeding (IYCF) knowledge and practices assessment in January and October 2017. The intervention included two components consisting of a theoretical phase (counselling and discussion) and cooking demonstrations implemented for ten months. To account for the before-and-after design of the study, the McNemar’s test was used to assess the effect of the intervention on mothers’ infant and young child feeding knowledge and practices. Results: The mean age of mothers was 29 ± 6.2 years and 50.6% of the mothers were between 20 and 29 years old. All indicators used to assess the mothers’ knowledge of breastfeeding and complementary feeding significantly improved after the intervention (all p-values < 0.05). In terms of child feeding practices, half of the indicators (early breastfeeding initiation, age of complementary feeding initiation, and minimum meal frequency) significantly increased (all p = 0.001) while two indicators (minimum dietary diversity, and minimum acceptable diet) did not change (p = 0.06 and 0.67) after the intervention. Finally, continued breastfeeding, significantly declined after the intervention (73.3% vs 86.0% p = 0.001). Conclusion: The intervention improved the mothers’ knowledge on breastfeeding and complementary feeding and some child feeding practices. This study provided some evidence of an effective nutrition education intervention to increase maternal knowledge and practices.

Prevention of Mother-to-Child Transmission of HIV: Experience of a Level 2 Health Center in Senegal

The elimination of vertical transmission of HIV from mother to child is a major global goal. In Senegal, the transmission rate was estimated at 3.2% in 2017. To reduce or even eliminate this transmission, Senegal has implemented various strategies and programs adopted and applied nationally. Thus access to services for the prevention of mother-to-child transmission of HIV has been extended to the level of the health post (the lowest level of the country’s health pyramid) with a delegation of tasks to paramedical staff (nurse, midwife) in the diagnosis and therapeutic management. Objectives: To describe the epidemiological profile of HIV (Human Immunodeficiency Virus)-positive mothers, to assess the care of children born to HIV-positive mothers, to determine the rate of HIV transmission from mother to child. Patients and Method: We carried out a retrospective, cross-sectional and descriptive study of all live newborns of HIV-positive mothers who gave birth at the Gaspard Kamara Health Center (a level 2 health center in Dakar, Senegal) between January 1, 2015 and December 31, 2018. The data were collected from prevention of mother-to-child transmission (PMTCT) prenatal follow-up registers and files, delivery files and registers, and neonatology and pediatric follow-up files, and exploited using the Epi info 7 software. Results: There were 98 children of seropositive mothers. The epidemiological profile of the HIV-positive woman was that of a young woman aged between 16 and 43 with an average of 31.31 years, pauciparous (>65% of cases) from Dakar center (>75% of cases), housewife with a low socio-economic level (63.1% of cases), married in almost all cases, with HIV profile (in almost all cases) and diagnosed before pregnancy (51.02%). The analysis of the children’s data revealed a predominance of girls (52.04%) with a good birth weight (2964g on average) and a pregnancy carried to term in more than 95% of cases. ARV prophylaxis was almost entirely respected with triple therapy (AZT + 3TC + NVP) in a fixed combination as protocol. Protected breastfeeding (80.21%), including 6 months of exclusive protected breastfeeding, was the rule for the mode of feeding. Three children were diagnosed positive with PCR1 as with serology (3.06%). Discussion and Conclusion: the initiatives and strategies put in place in Senegal have enabled a significant reduction in mother-to-child transmission of HIV and deserve to be supported by insisting on primary prevention, programming and good follow-up of pregnancies, and a good support for HIV-positive women.

Determinants of Breastfeeding Practices among Working Mothers in Solwezi District of Zambia

Background: As one of the strategies to reduce infant morbidity and mortality, the World Health Organization recommends early initiation of exclusive breastfeeding and timely introduction of complementary feeding with continued breastfeeding for up to two years or beyond. Although breastfeeding is a natural process, it is influenced by different socio-cultural factors, habits, standards, and behaviours. Rapid industrialization and changes in lifestyle have seen increasing numbers of women in the labour force, and associated poor Exclusive Breastfeeding practices among working mothers. The aim of this study was to identify the determinants of breastfeeding practices among working mothers in Solwezi District of Zambia. Methods: This was a cross-sectional comparative survey comparing determinants of breastfeeding practices among working mothers aged 15 - 49 years in urban and rural areas of Solwezi District. The study was carried out in the Under-five Clinics at Solwezi, Kimasala and Mushitala Urban Clinics, as well as St. Francis, Kapijimpanga and Kisalala Rural Health Centers. Eighty-seven participants were successfully recruited using convenience sampling. A researcher-assisted questionnaire was used to collect data. Data analysis was done using SPSS version 27.0. Descriptive statistical analysis was done using numerical measures such as measures of central tendency and dispersion. The Pearson Chi Square test, correlation and linear regression analysis were performed to test association between the variables at the 0.05 level of significance. Are you assessing exclusive breastfeeding alone or what? Results: The mean age of respondents was 27.44 years (SD = 6.042 years) and the majority of the respondents were married (71.3%, n = 62). Forty-three percent of the respondents were self-employed while the rest were in formal government or private sector employment. Overall, 97.7% of the respondents had heard of exclusive breastfeeding, with health facilities being the most frequent source of information (64.4%). Attitude towards exclusive breastfeeding was generally positive. Fifty-eight percent of respondents exclusively breastfed while the rest were on mixed feeding. Seventy-one percent of respondents reported that their workplaces did not have breastfeeding facilities at work. Only 11.5% of the respondents reported having cultural beliefs restricting breastfeeding. Statistically significant associations were obtained from cross-tabulation analysis between respondent’s occupation and baby feeding type (p 0.001);workload and feeding type (0.024);as well as knowledge of EBF and feeding type (p 0.001). Conclusion: Majority of the respondents demonstrated good knowledge and positive attitude towards exclusive breastfeeding. This study recommends sensitization campaigns in communities to raise awareness about the importance of breastfeeding, and foster behaviour change that promotes breastfeeding.

Exploring the Lives of Mothers Raising Children with Autism Spectrum Disorder in Japan

Background: Examining the lives that mothers experience and build will allow us to deepen our understanding of children with ASD and their mothers and facilitate developing support methods. The study aimed to examine the lives of mothers raising children with autism spectrum disorder (ASD) and investigate their sources of support. Method: We conducted a qualitative inductive study using semi-structured interviews to identify characteristics of the lives that mothers have created. Results: Semi-structured interviews were conducted with 11 mothers having children with ASD. The analysis comprised three stages of coding and yielded eight categories. The lives of these mothers contained three themes: preoccupation with parenting children with ASD and their siblings;evolving mother;and using social resources. Mothers engaged in “assessing the characteristics, growth, and changes in the child with ASD”, had a “preoccupation with parenting children with ASD”, and were “thinking about the future of the child with ASD”, and “having goals and plans for parenting” while having “consideration toward the child’s siblings”. During this process, mothers experienced “changes in perspective or approach” and created lifestyles while “receiving help from people around them” and engaged in the “use of social resources”. Conclusions: To avoid becoming preoccupied with parenting and being burdened by their lifestyle, mothers require social support to monitor their perceptions. Furthermore, the utilization of social resources requires the supporting individuals to understand the characteristics of children with ASD, provide appropriate information, and assist in decision-making.

Status Report on the Elimination of Mother-to-Child Transmission (EMCT) of HIV at the Pikine National Hospital Center (CHNP), Dakar/Senegal

Introduction: For several years, the fight against the human immunodeficiency virus (HIV) has been a major public health issue in Africa. Since 2012, Senegal has adopted WHO option B+, consisting of systematic triple therapy for HIV-positive pregnant women, combined with breastfeeding and antiretroviral (ARV) prophylaxis for exposed newborns. It is in this dynamic that we set ourselves the objectives of evaluating the rate of transmission of HIV from mother to child and taking stock of the monitoring of children born to HIV-positive mothers at the Pediatric Department of the CHN of Pikine located in the Dakar suburbs. Methodology: Thus, we conducted a descriptive and analytical cross-sectional cohort follow-up study from 11/25/2014 to 03/09/2022 including all children born to HIV-positive mothers followed at the Pikine CHN since the start of care. Results: We had collected 51 children exposed to HIV and followed in our structure. They were exposed to HIV1 in 92% of cases. The HIV status of the mothers was known before pregnancy in more than half of the cases. The couples were serodiscordant in 56% of cases. The mothers were in clinical stage 1 of the disease in 69.6% of cases and were already under treatment in 47% of cases. The most used treatment regimen was ATRIPLA with Tenofovir (TDF) + Emtracitabine (FTC) + Efavirenz (EFV) in 59% of cases. Compliance was good in the majority of cases. The CD4 count during pregnancy was low in 10.6% of cases. The pregnancy was well followed in only 36.2% of cases. The mothers had given birth in our structure in 91.4% of cases. The vaginal route was found in 72.5% of cases and delivery was carried out by a midwife in 69.4% of cases. The average birth weight was 2733 ± 564. The majority of newborns had received antiretroviral (ARV) prophylaxis after birth, half of them between 12 and 24 hours. The most used therapeutic protocol was Zidovudine (AZT) + Lamivudine (3TC) + Lopinavir/Ritonavir (LPV/r). Protected breastfeeding was the option chosen in 76.8% of cases. The PCR performed at 6 weeks was negative in more than half of the cases. Retroviral serology was carried out after 14 months in 43% of cases. We noted a single positive case with a negative initial PCR, representing an overall transmission rate of 1.96%. Conclusion: Senegal’s current policy targeting EMTCT of HIV is on good momentum with a fairly low transmission rate thanks to screening of pregnant women and prophylaxis with antiretrovirals (ARV) for HIV-positive mothers during pregnancy and for life. And children exposed from birth and during breastfeeding up to 6 weeks with regular monitoring.

Factor Structure and Measurement Invariance of the Japanese Version of the Mother-to-Infant Bonding Scale

Background: Bonding disorders affect the growth and development of infants. In Japan, the Japanese version of the Mother-to-Infant Bonding Scale (MIBS-J) is widely used for early detection of bonding disorders. Repeated use of a questionnaire has problems of reduced validity. In order to correctly detect bonding disorders at multiple time points, it is necessary to confirm the measurement invariance of the scale. Baba et al. reported that invariance of the MIBS-J factor structure could only be obtained by abridging the scale into three items. Purpose: The aim of this study was to 1) confirm the factor structure and measurement invariance of the MIBS-J between two measurement times and 2) to examine factors that can be used without being affected by measurement time in order to identify item that contribute to measure met invariance. Methods: We analysed the data of 1049 and 878 mothers with a neonate collected in two waves: 5 days (Wave 1) and 1 month postpartum (Wave 2). Exploratory and confirmatory factor analyses were conducted on the data randomly divided into two groups in each wave. Results: The three-item model (MIBS-J items 1, 6, and 8) was most accepted. Measurement invariance and structural invariance were confirmed in the model. This was consistent with Baba et al.’s model. Conclusion: The three MIBS-J items showed measurement invariance and structural invariance in Japanese mothers during 1 month postpartum.