scholarly journals Feasibility and acceptability of implementing early infant diagnosis of HIV in Papua New Guinea at the point of care: a qualitative exploration of health worker and key informant perspectives

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e043679
Author(s):  
Yasmin Mohamed ◽  
Martha Kupul ◽  
Janet Gare ◽  
Steven G Badman ◽  
Selina Silim ◽  
...  
Keyword(s):  
Papua New Guinea ◽  
Standard Care ◽  
Health Workers ◽  
Point Of Care ◽  
Hiv Positive ◽  
Early Infant Diagnosis ◽  
Pmtct Programme ◽  
Early Infant ◽  
Qualitative Exploration ◽  
Hiv 1

IntroductionEarly infant diagnosis (EID) of HIV and timely initiation of antiretroviral therapy can significantly reduce morbidity and mortality among HIV-positive infants. Access to EID is limited in many low-income and middle-income settings, particularly those in which standard care involves dried blood spots (DBS) sent to centralised laboratories, such as in Papua New Guinea (PNG). We conducted a qualitative exploration of the feasibility and acceptability of implementing a point-of-care (POC) EID test (Xpert HIV-1 Qualitative assay) among health workers and key stakeholders working within the prevention of mother-to-child transmission of HIV (PMTCT) programme in PNG.MethodsThis qualitative substudy was conducted as part of a pragmatic trial to investigate the effectiveness of the Xpert HIV-1 Qualitative test for EID in PNG and Myanmar. Semistructured interviews were undertaken with 5 health workers and 13 key informants to explore current services, experiences of EID testing, perspectives on the Xpert test and the feasibility of integrating and scaling up POC EID in PNG. Coding was undertaken using inductive and deductive approaches, drawing on existing acceptability and feasibility frameworks.ResultsHealth workers and key informants (N=18) felt EID at POC was feasible to implement and beneficial to HIV-exposed infants and their families, staff and the PMTCT programme more broadly. All study participants highlighted starting HIV-positive infants on treatment immediately as the main advantage of POC EID compared with standard care DBS testing. Health workers identified insufficient resources to follow up infants and caregivers and space constraints in hospitals as barriers to implementation. Participants emphasised the importance of adequate human resources, ongoing training and support, appropriate coordination and a sustainable supply of consumables to ensure effective scale-up of the test throughout PNG.ConclusionsImplementation of POC EID in a low HIV prevalence setting such as PNG is likely to be both feasible and beneficial with careful planning and adequate resources.Trial registration number12616000734460.

scholarly journals Factors influencing the delivery and uptake of early infant diagnosis of HIV services in Greater Accra, Ghana: A qualitative study

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246876
Author(s):  
Antoinette Kailey Ankrah ◽  
Phyllis Dako-Gyeke
Keyword(s):  
Service Delivery ◽  
Health Workers ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Reference Laboratory ◽  
Early Infant Diagnosis ◽  
Timely Initiation ◽  
Hiv Services ◽  
Adequate Knowledge ◽  
Early Infant

Background Early Infant Diagnosis (EID) of HIV and timely initiation of Antiretroviral Therapy (ART) can significantly reduce morbidity and mortality of HIV infected infants. Despite the benefits of early infant testing, the coverage of EID of HIV services is still low in Sub-Saharan Africa, including Ghana. Objectives To ascertain the factors that facilitate or hinder the delivery and uptake of EID of HIV services. Methods The study is a cross-sectional exploratory qualitative research conducted in two health facilities in the Greater Accra Region of Ghana. Respondents (n = 50) comprising health workers (n = 20) and HIV positive mothers (n = 30) were purposively sampled and engaged in in-depth interviews. The Nvivo 11 software and the Braun and Clarke’s stages of thematic analysis were used in coding data and data analysis respectively. Results The study found that health system factors such as inadequate Staff with sample collection skills, unavailability of vehicles to convey samples to the reference laboratory for analysis, the long turnaround time for receipt of Polymerase Chain Reaction (PCR) results, inadequate and frequent breakdown of PCR machine hindered EID service delivery. On the other hand, adequate knowledge of health workers on EID, availability of Dried Blood Spot (DBS) cards and the adoption of task shifting strategies facilitated EID service delivery. Factors such as the denial of HIV status, non-completion of the EID process due to frustrations encountered whiles accessing service and delay in receipt of PCR results served as barriers to mother’s utilisation of EID services for their exposed infants. The study also identified that adequate knowledge of EID, perceived importance of EID, financial stability as well as financial support from others and the positive attitudes of health workers facilitated HIV positive mother’s uptake of EID services for their exposed infants. Conclusion The factors attributing to the low coverage of EID of HIV services must be promptly addressed to improve service delivery and uptake.

scholarly journals Field evaluation of near point of care Cepheid GeneXpert HIV-1 Qual for early infant diagnosis

PLoS ONE ◽  
2018 ◽  
Vol 13 (12) ◽  
pp. e0209778 ◽  
Author(s):  
Valarie Sarah Opollo ◽  
Alliance Nikuze ◽  
Jihane Ben-Farhat ◽  
Emily Anyango ◽  
Felix Humwa ◽  
...  
Keyword(s):  
Point Of Care ◽  
Field Evaluation ◽  
Early Infant Diagnosis ◽  
Early Infant ◽  
Hiv 1

scholarly journals Barriers to early infant diagnosis of HIV in the Wa Municipality and Lawra District of Upper West Region, Ghana

2020 ◽  
Vol 54 (2) ◽  
pp. 83-90
Author(s):  
Robert Nuoh ◽  
Kofi Nyarko ◽  
Charles Noora ◽  
Adolphina Addo-Lartey ◽  
Priscillia Nortey ◽  
...  
Keyword(s):  
Formal Education ◽  
Transmission Rate ◽  
Hiv Positive ◽  
Early Infant Diagnosis ◽  
Independent Source ◽  
Positive Mother ◽  
West Region ◽  
Early Infant ◽  
Exposed Infant ◽  
Wa Municipality

Objective: We identified socio-demographic, health system and psycho-social barriers to Early Infant Diagnosis (EID) of HIV in the Upper West Region of Ghana.Design: An unmatched case control study of 96 cases and 96 controls was conducted in the ART centers in Lawra district and Wa Municipality between December 2014 and April 2015.Setting: A public health facilityParticipants: We defined a case as an HIV positive mother with an exposed infant who received EID service between January 2011 and December 2014. A control was defined as HIV Positive Mother with an exposed infant who did not receive EID services between January 2011 and December 2014.Main outcome: EID by dry blood spot Deoxyribonucleic acid Polymerase chain reaction.Results: A total of 192 mother-infant pairs were assessed. The mean age of infants at testing for cases was 17.3±14.9 weeks. Mother-to-child-transmission-rate was 2.3%. Factors associated with EID testing included: mother being formallyemployed (cOR=2.0: 95%CI:1.1-3.8), maternal formal education (cOR=2.0, 95%CI: 1.1-3.6) and maternal independent source of income (cOR 2.2, 95%CI 1.2-4.1). After adjusting for confounders, maternal independent incomebsource was associated with EID testing (aOR 2.2, 95%CI 1.2-4.1). Median turn-around time of EID result was 11 weeks (IQR 4-27weeks).Conclusion: Women need to be empowered to gain an independent source of income. This can help maximize the benefits of e-MTCT and increase EID in the Upper West Region of Ghana.Keywords: Barriers; HIV; early infant diagnosis; DNA-PCR; GhanaFunding: This work was funded by the authors

scholarly journals Task shifting for point-of-care early infant diagnosis: a comparison of the quality of testing between nurses and laboratory personnel in Zimbabwe

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Francis M. Simmonds ◽  
Jennifer E. Cohn ◽  
Haurovi W. Mafaune ◽  
Tichaona H. Nyamundaya ◽  
Agnes Mahomva ◽  
...  
Keyword(s):  
Point Of Care ◽  
Task Shifting ◽  
Early Infant Diagnosis ◽  
Laboratory Personnel ◽  
Early Infant

Evaluation of a routine point-of-care intervention for early infant diagnosis of HIV: an observational study in eight African countries

2019 ◽  
Vol 6 (6) ◽  
pp. e373-e381 ◽  
Author(s):  
Flavia Bianchi ◽  
Jennifer Cohn ◽  
Emma Sacks ◽  
Rebecca Bailey ◽  
Jean-Francois Lemaire ◽  
...  
Keyword(s):  
Observational Study ◽  
Point Of Care ◽  
Early Infant Diagnosis ◽  
African Countries ◽  
Care Intervention ◽  
Early Infant

scholarly journals Successful Use of Near Point-of-Care Early Infant Diagnosis in NAMPHIA to Improve Turnaround Times in a National Household Survey

2021 ◽  
Vol 87 (1) ◽  
pp. S67-S72
Author(s):  
Robert A. Domaoal ◽  
Katrina Sleeman ◽  
Souleymane Sawadogo ◽  
Tafadzwa Dzinamarira ◽  
Ndahafa Frans ◽  
...  
Keyword(s):  
Point Of Care ◽  
Household Survey ◽  
Early Infant Diagnosis ◽  
Early Infant ◽  
National Household Survey
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