2022
The impact of a community health worker intervention on uptake of antenatal care: a cluster-randomized pragmatic trial in Dar es Salaam
Regan M, Cheng C, Mboggo E, Larson E, Lema I, Magesa L, Machumi L, Ulenga N, Sando D, Mwanyika-Sando M, Barnhart D, Hong B, Mungure E, Li N, Siril H, Mujinja P, Naburi H, Kilewo C, Ekström A, Geldsetzer P, Fawzi W, Bärnighausen T, Sudfeld C, Spiegelman D. The impact of a community health worker intervention on uptake of antenatal care: a cluster-randomized pragmatic trial in Dar es Salaam. Health Policy And Planning 2022, 38: 279-288. PMID: 36377764, PMCID: PMC10019560, DOI: 10.1093/heapol/czac100.Peer-Reviewed Original ResearchMeSH KeywordsCommunity Health WorkersFemaleHospitalsHumansInfant, NewbornPregnancyPrenatal CareProgram EvaluationTanzaniaConceptsMore ANC visitsCommunity health worker interventionHealth worker interventionAntenatal careANC visitsPragmatic trialHigh-quality antenatal carePragmatic cluster-randomized trialUptake of ANCDar es SalaamWorker interventionLarge-scale pragmatic trialsCluster-randomized pragmatic trialModest beneficial effectStandard of careRoutine health system dataCluster-randomized trialHealth system dataANC uptakeCare armCHW interventionPrimary outcomeIntervention armFirst trimesterPregnant women
2021
Analysis of Survival Among Adults With Early-Onset Colorectal Cancer in the National Cancer Database
Cheng E, Blackburn HN, Ng K, Spiegelman D, Irwin ML, Ma X, Gross CP, Tabung FK, Giovannucci EL, Kunz PL, Llor X, Billingsley K, Meyerhardt JA, Ahuja N, Fuchs CS. Analysis of Survival Among Adults With Early-Onset Colorectal Cancer in the National Cancer Database. JAMA Network Open 2021, 4: e2112539. PMID: 34132794, PMCID: PMC8209612, DOI: 10.1001/jamanetworkopen.2021.12539.Peer-Reviewed Original ResearchConceptsEarly-onset colorectal cancerOnset colorectal cancerNational Cancer DatabaseColorectal cancerAge 51Overall survivalCancer DatabaseIncidence of CRCCox proportional hazards regressionPrimary colorectal cancerKaplan-Meier analysisProportional hazards regressionAge 50 yearsAge 25 yearsAnalysis of survivalCohort studySurvival benefitHazards regressionUnadjusted analysesCancer incidenceMAIN OUTCOMEAge 35Survival advantageLower riskStage I
2020
Coaching Intensity, Adherence to Essential Birth Practices, and Health Outcomes in the BetterBirth Trial in Utter Pradesh, India
Barnhart DA, Spiegelman D, Zigler CM, Kara N, Delaney MM, Kalita T, Maji P, Hirschhorn LR, Semrau KEA. Coaching Intensity, Adherence to Essential Birth Practices, and Health Outcomes in the BetterBirth Trial in Utter Pradesh, India. Global Health Science And Practice 2020, 8: ghsp-d-19-00317. PMID: 32127359, PMCID: PMC7108945, DOI: 10.9745/ghsp-d-19-00317.Peer-Reviewed Original ResearchConceptsEssential birth practicesSafe Childbirth ChecklistPerinatal health outcomesBirth attendantsHealth outcomesBetterBirth trialWorld Health Organization Safe Childbirth ChecklistBirth practicesQuality of careSustain behavior changeCoaching-based interventionBehavior changeFrequent coachingPerinatal mortalityBirth facilityAdherenceOutcomesGreater improvementAttendantsVisitsTrialsMonthsRegression modelsAssociationUtter Pradesh
2013
Clinical malaria diagnosis in pregnancy in relation to early perinatal mother‐to‐child transmission of HIV: a prospective cohort study
Ezeamama A, Duggan C, Manji K, Spiegelman D, Hertzmark E, Bosch R, Kupka R, Okuma J, Kisenge R, Aboud S, Fawzi W. Clinical malaria diagnosis in pregnancy in relation to early perinatal mother‐to‐child transmission of HIV: a prospective cohort study. HIV Medicine 2013, 15: 276-285. PMID: 24215465, PMCID: PMC4299572, DOI: 10.1111/hiv.12111.Peer-Reviewed Original ResearchConceptsPregnant HIV-positive womenHIV-positive womenRelative riskFever symptomsHIV MTCTHIV infectionPolymerase chain reactionHIV-positive pregnant womenMultivariable logistic regression modelCent of HIVChild's HIV statusHIV MTCT riskInfants of womenPerinatal HIV infectionChild HIV infectionLaboratory-confirmed diagnosisConfidence intervalsPrenatal health careWeeks of lifeLogistic regression modelsHIV motherMaternal malariaMTCT programmeMTCT riskChild transmission
2012
Predictors of stunting, wasting and underweight among Tanzanian children born to HIV-infected women
McDonald CM, Kupka R, Manji KP, Okuma J, Bosch RJ, Aboud S, Kisenge R, Spiegelman D, Fawzi WW, Duggan CP. Predictors of stunting, wasting and underweight among Tanzanian children born to HIV-infected women. European Journal Of Clinical Nutrition 2012, 66: 1265-1276. PMID: 23031850, PMCID: PMC3491141, DOI: 10.1038/ejcn.2012.136.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultBody HeightBody WeightDouble-Blind MethodEducational StatusFemaleGrowth DisordersHIV InfectionsHumansInfantInfant, Low Birth WeightInfant, NewbornInfant, PrematureInfectious Disease Transmission, VerticalMaleMalnutritionPremature BirthPrevalenceProportional Hazards ModelsReference ValuesSex FactorsSocioeconomic FactorsTanzaniaThinnessWasting SyndromeYoung AdultConceptsBirth weightFirst episodeTanzanian childrenMultivariate Cox proportional hazards methodMaternal educationLow infant birth weightCox proportional hazards methodDevelopment of undernutritionInfant birth weightLow Apgar scoreModifiable risk factorsLow birth weightChild HIV infectionHuman immunodeficiency virusPredictors of stuntingRisk of undernutritionProportional hazards methodsLow maternal educationWeeks of ageMorbidity historiesApgar scoreChild transmissionMedian durationPreterm infantsHIV infectionPREDICTORS OF INCIDENT TUBERCULOSIS IN HIV-EXPOSED CHILDREN IN TANZANIA.
Finkelstein J, Manji K, Duggan C, Hertzmark E, Mehta S, Msamanga G, Spiegelman D, Fawzi W. PREDICTORS OF INCIDENT TUBERCULOSIS IN HIV-EXPOSED CHILDREN IN TANZANIA. East African Medical Journal 2012, 89: 183-92. PMID: 26856040, PMCID: PMC10864092.Peer-Reviewed Original ResearchConceptsRisk of tuberculosisChild mid-upper arm circumferenceMid-upper arm circumferenceT-cell countsArm circumferenceReduced riskCD4 T-cell countCD8 T-cell countsLow vitamin E levelsAppropriate infant feedingDuration of breastfeedingLongitudinal cohort studyVitamin E levelsIncident tuberculosisAntenatal clinicCohort studyLymphocyte countHIV infectionTuberculosis infectionChild tuberculosisHIV statusNutritional interventionImmunological statusInfant feedingE levels
2005
Selenium status, pregnancy outcomes, and mother-to-child transmission of HIV-1.
Kupka R, Garland M, Msamanga G, Spiegelman D, Hunter D, Fawzi W. Selenium status, pregnancy outcomes, and mother-to-child transmission of HIV-1. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2005, 39: 203-10. PMID: 15905738.Peer-Reviewed Original ResearchConceptsPregnancy outcomesPregnant womenChild transmissionLow selenium statusHIV transmissionMaternal HIV disease progressionHIV-positive pregnant womenSelenium statusDirect epidemiologic evidenceMTCT of HIVLow plasma selenium levelsHIV disease progressionPoor pregnancy outcomesRisk of motherWeeks of gestationMother-child pairsPlasma selenium levelsAdequate selenium statusFetal deathGestational ageEpidemiologic evidenceLow birthweightDisease progressionGenital tractHIV-1Pregnancy Increases BMI in Adolescents of a Population-Based Birth Cohort 1 2
Fawzi W, Msamanga G, Spiegelman D, Hunter DJ. Pregnancy Increases BMI in Adolescents of a Population-Based Birth Cohort 1 2. Journal Of Nutrition 2005, 135: 938-944. PMID: 15795466, DOI: 10.1093/jn/135.4.938.Peer-Reviewed Original ResearchConceptsAntiretroviral therapyMultivitamin supplementsPregnant womenHIV-negative pregnant womenDaily multivitamin supplementEarly childhood infectionsAdverse pregnancy outcomesHIV disease progressionHIV-1 infectionAdequate dietary intakeEfficacy of vitaminAdverse health outcomesFurther studiesLow-cost interventionMo of ageUninfected childrenHIV diseasePregnancy outcomesPregnant HIVHIV infectionChildhood infectionsRandomized trialsNutritional interventionDietary intakeDisease progression
2004
Association Between Low Birth Weight and Infant Mortality in Children Born to Human Immunodeficiency Virus 1-Infected Mothers in Tanzania
Wei R, Msamanga GI, Spiegelman D, Hertzmark E, Baylin A, Manji K, Fawzi WW. Association Between Low Birth Weight and Infant Mortality in Children Born to Human Immunodeficiency Virus 1-Infected Mothers in Tanzania. The Pediatric Infectious Disease Journal 2004, 23: 530-535. PMID: 15194834, DOI: 10.1097/01.inf.0000129691.42964.eb.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAnalysis of VarianceCohort StudiesConfidence IntervalsDeveloping CountriesFemaleHIV InfectionsHIV-1HumansIncidenceInfant MortalityInfant, Low Birth WeightInfant, NewbornInfectious Disease Transmission, VerticalMalePregnancyPregnancy Complications, InfectiousPregnancy OutcomeProportional Hazards ModelsRisk FactorsSex DistributionSurvival AnalysisTanzaniaConceptsLow birth weightBirth weightHIV statusHIV transmissionInfant mortalityCox proportional hazards modelHuman immunodeficiency virus-1Child's HIV statusPediatric HIV infectionHuman immunodeficiency virusRisk of mortalityImmunodeficiency virus-1Proportional hazards modelWeeks of ageAntiretroviral treatmentHIV infectionImmunodeficiency virusNeonatal mortalityPositive infantsPregnant womenPostneonatal mortalityHazards modelMortalityInfantsVirus 1Estimating treatment effects in studies of perinatal transmission of HIV
Bang H, Spiegelman D. Estimating treatment effects in studies of perinatal transmission of HIV. Biostatistics 2004, 5: 31-43. PMID: 14744826, DOI: 10.1093/biostatistics/5.1.31.Peer-Reviewed Original Research
2003
Effect of Providing Vitamin Supplements to Human Immunodeficiency Virus-Infected, Lactating Mothers on the Child's Morbidity and CD4+ Cell Counts
Fawzi WW, Msamanga GI, Wei R, Spiegelman D, Antelman G, Villamor E, Manji K, Hunter D. Effect of Providing Vitamin Supplements to Human Immunodeficiency Virus-Infected, Lactating Mothers on the Child's Morbidity and CD4+ Cell Counts. Clinical Infectious Diseases 2003, 36: 1053-1062. PMID: 12684919, DOI: 10.1086/374223.Peer-Reviewed Original ResearchConceptsMultivitamin armCell countVitamin AHuman immunodeficiency virus type 1Immunodeficiency virus type 1Placebo-controlled trialCells/microLHIV-negative childrenHIV-positive childrenHuman immunodeficiency virusChildren of womenRapid respiratory rateVirus type 1Low-cost interventionEffect of supplementationMaternal receiptMean CD4Immunodeficiency virusMultivitamin supplementsChild morbidityChild healthVitamin supplementsLower riskRespiratory rateType 1
2002
Transmission of HIV-1 Through Breastfeeding Among Women in Dar es Salaam, Tanzania
Fawzi W, Msamanga G, Spiegelman D, Renjifo B, Bang H, Kapiga S, Coley J, Hertzmark E, Essex M, Hunter D. Transmission of HIV-1 Through Breastfeeding Among Women in Dar es Salaam, Tanzania. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2002, 31: 331-338. PMID: 12439210, DOI: 10.1097/00126334-200211010-00010.Peer-Reviewed Original ResearchConceptsHIV-1High maternal viral loadLow CD4 cell countsMultivariate proportional hazards modelMaternal viral loadCD4 cell countHIV-1 transmissionErythrocyte sedimentation rateAge 6 weeksAge 4 monthsChildren of womenProportional hazards modelDar es SalaamAge 24 monthsAnalysis of correlatesNipple cracksChild transmissionImmune reconstitutionCumulative incidenceViral loadPregnant womenAntiretroviral drugsMean durationMicronutrient supplementsHigh riskRandomized trial of vitamin supplements in relation to transmission of HIV-1 through breastfeeding and early child mortality
Fawzi WW, Msamanga GI, Hunter D, Renjifo B, Antelman G, Bang H, Manji K, Kapiga S, Mwakagile D, Essex M, Spiegelman D. Randomized trial of vitamin supplements in relation to transmission of HIV-1 through breastfeeding and early child mortality. AIDS 2002, 16: 1935-1944. PMID: 12351954, DOI: 10.1097/00002030-200209270-00011.Peer-Reviewed Original ResearchConceptsHIV-1 transmissionInfants of mothersVitamin ALower baseline lymphocyte countsHigh erythrocyte sedimentation rateChild mortalityBaseline lymphocyte countMaternal micronutrient statusHIV-free survivalErythrocyte sedimentation rateLow birthweight babiesEarly child mortalityRisk of transmissionLymphocyte countLower hemoglobinMultivitamin supplementationWeeks' gestationBirthweight babiesPregnant womenHIV-1Vitamin supplementsMultivitaminsNutritional statusMicronutrient statusMortality
2001
Determinants of low birth weight among HIV-infected pregnant women in Tanzania 1 , 2 , 3
Dreyfuss M, Msamanga G, Spiegelman D, Hunter D, Urassa E, Hertzmark E, Fawzi W. Determinants of low birth weight among HIV-infected pregnant women in Tanzania 1 , 2 , 3. American Journal Of Clinical Nutrition 2001, 74: 814-826. PMID: 11722965, DOI: 10.1093/ajcn/74.6.814.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultBirth WeightCohort StudiesDisease ProgressionFemaleHIV InfectionsHumansIncidenceInfant, Low Birth WeightInfant, NewbornInfant, Small for Gestational AgeInfectious Disease Transmission, VerticalLymphocyte CountMalariaMaternal WelfareMiddle AgedOdds RatioParasitic DiseasesPregnancyPregnancy Complications, InfectiousPregnancy OutcomeRandomized Controlled Trials as TopicRisk FactorsTanzaniaConceptsLow birth weightInfant HIV infectionBirth weightHIV infectionMaternal weightRisk factorsIncidence of LBWLow serum vitamin E concentrationsPredictors of LBWCell countAdvanced stage HIV diseaseLower CD8 cell countsMultivariate-adjusted linear regression modelsSerum vitamin E concentrationsInfant risk factorsCD4 cell countCD8 cell countsGestational age statusHIV disease progressionIntestinal parasitic infectionsMean birth weightPlasmodium falciparum malariaHIV-positive womenMidupper arm circumferencePrenatal care clinicsPredictors of intrauterine and intrapartum transmission of HIV-1 among Tanzanian women
Fawzi W, Msamanga G, Renjifo B, Spiegelman D, Urassa E, Hashemi L, Antelman G, Essex M, Hunter D. Predictors of intrauterine and intrapartum transmission of HIV-1 among Tanzanian women. AIDS 2001, 15: 1157-1165. PMID: 11416718, DOI: 10.1097/00002030-200106150-00011.Peer-Reviewed Original ResearchConceptsViral loadHIV-1HIV-1-infected pregnant womenLower genital tract infectionMaternal CD4 cell countVertical transmissionLower genital infectionsMaternal viral loadCD4 cell countGenital tract infectionHIV disease progressionHIV-1 infectionWeeks of gestationPrevention of transmissionIntrapartum transmissionIntrauterine transmissionGenital infectionTract infectionsSustained clearanceClinical stagePregnant womenPrenatal careDisease progressionCopies/Vitamin supplementsHouse Dust Endotoxin and Wheeze in the First Year of Life
PARK J, GOLD D, SPIEGELMAN D, BURGE H, MILTON D. House Dust Endotoxin and Wheeze in the First Year of Life. American Journal Of Respiratory And Critical Care Medicine 2001, 163: 322-328. PMID: 11179100, DOI: 10.1164/ajrccm.163.2.2002088.Peer-Reviewed Original ResearchConceptsElevated endotoxinEndotoxin exposureMultivariate modelLower respiratory illnessMultivariate relative riskHistory of asthmaLow birth weightSignificant univariate associationsFirst yearHouse dust endotoxinRoom dustRace/ethnicityMaternal asthmaPrimary outcomeRespiratory illnessAbove covariatesBirth weightDust endotoxinRelative riskCockroach allergensUnivariate associationsFamilial predispositionBedroom floorWheezeBirth cohortDifferences in perinatal transmission among human immunodeficiency virus type 1 genotypes.
Renjifo B, Fawzi W, Mwakagile D, Hunter D, Msamanga G, Spiegelman D, Garland M, Kagoma C, Kim A, Chaplin B, Hertzmark E, Essex M. Differences in perinatal transmission among human immunodeficiency virus type 1 genotypes. Human Virology 2001, 4: 16-25. PMID: 11213929.Peer-Reviewed Original ResearchMeSH KeywordsBase SequenceCapsidCapsid ProteinsCase-Control StudiesDNA, ViralDouble-Blind MethodFemaleGag Gene Products, Human Immunodeficiency VirusGene Products, envGene Products, gagGenotypeHIV Core Protein p24HIV InfectionsHIV-1HumansInfantInfant, NewbornMolecular Sequence DataRisk FactorsViral ProteinsConceptsHIV-1 genetic subtypesCD4 cell countHIV-1 genotypesCell countGenetic subtypesHIV-1 subtype AHIV-1 subtype CHuman immunodeficiency virus type 1Vertical transmissionHuman immunodeficiency virus type 1 genotypesImmunodeficiency virus type 1Intersubtype recombinant virusesMaternal risk factorsLogistic regression analysisType 1 genotypeVirus type 1HIV-1 GagPerinatal transmissionSubtype CRisk factorsSubtype AHIV-1Intersubtype recombinantsType 1Differential risk
2000
Randomized Trial of Vitamin Supplements in Relation to Vertical Transmission of HIV-1 in Tanzania
Fawzi W, Msamanga G, Hunter D, Urassa E, Renjifo B, Mwakagile D, Hertzmark E, Coley J, Garland M, Kapiga S, Antelman G, Essex M, Spiegelman D. Randomized Trial of Vitamin Supplements in Relation to Vertical Transmission of HIV-1 in Tanzania. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2000, 23: 246-254. DOI: 10.1097/00042560-200003010-00006.Peer-Reviewed Original ResearchConceptsPregnant womenPolymerase chain reactionVitamin APlacebo-controlled trialPoor nutritional statusBackground Observational studiesMultivitamin armHIV infectionHIV statusWeeks postpartumObservational studyHIV-1High riskHIVNutritional statusEffects of supplementsVertical transmissionChain reactionBirthMultivitaminsBabiesWomenSupplementsVitaminArmRandomized trial of vitamin supplements in relation to vertical transmission of HIV-1 in Tanzania.
Fawzi W, Msamanga G, Hunter D, Urassa E, Renjifo B, Mwakagile D, Hertzmark E, Coley J, Garland M, Kapiga S, Antelman G, Essex M, Spiegelman D. Randomized trial of vitamin supplements in relation to vertical transmission of HIV-1 in Tanzania. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2000, 23: 246-54. PMID: 10839660, DOI: 10.1097/00126334-200003010-00006.Peer-Reviewed Original ResearchConceptsPregnant womenPolymerase chain reactionVitamin APlacebo-controlled trialPoor nutritional statusMultivitamin armHIV infectionHIV statusWeeks postpartumObservational studyHIV-1High riskHIVNutritional statusEffects of supplementsVertical transmissionChain reactionBirthMultivitaminsBabiesWomenSupplementsVitaminArmStatus
1999
Rationale and Design of the Tanzania Vitamin and HIV Infection Trial
Fawzi W, Msamanga G, Spiegelman D, Urassa E, Hunter D. Rationale and Design of the Tanzania Vitamin and HIV Infection Trial. Contemporary Clinical Trials 1999, 20: 75-90. PMID: 10027501, DOI: 10.1016/s0197-2456(98)00045-2.Peer-Reviewed Original ResearchConceptsHIV infectionVitamin APregnant womenPolymerase chain reactionVitamin supplementsHIV-positive pregnant womenVertical transmissionHIV Infection TrialInfant immune functionEligible pregnant womenPlacebo-controlled trialClinical staging systemHIV-positive womenGenital tract secretionsUse of supplementsHIV diseaseMost HIVPrevention trialsViral loadMain endpointBreast milkStaging systemCohort retentionPosttest counselingTract secretions