scholarly journals Assessing Very Early Infant Diagnosis Turnaround Times: Findings from a Birth Testing Pilot in Lesotho

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Michelle M. Gill ◽  
Heather J. Hoffman ◽  
Majoalane Mokone ◽  
Vincent J. Tukei ◽  
Matsepeli Nchephe ◽  
...  
Keyword(s):  
Turnaround Time ◽  
Early Infant Diagnosis ◽  
Blood Draw ◽  
Hiv Exposed Infants ◽  
Art Initiation ◽  
Early Infant ◽  
Hiv Test ◽  
Observational Prospective Cohort Study ◽  
Hiv Exposed ◽  
Birth Testing

Very early infant diagnosis (VEID) (testing within two weeks of life), combined with rapid treatment initiation, could reduce early infant mortality. Our study evaluated turnaround time (TAT) to receipt of infants’ HIV test results and ART initiation if HIV-infected, with and without birth testing availability. Data from facility records and national databases were collected for 12 facilities offering VEID, as part of an observational prospective cohort study, and 10 noncohort facilities. HIV-exposed infants born in January–June 2016 and any cohort infant diagnosed as HIV-infected at birth or six weeks were included. The median TAT from blood draw to caregiver result receipt was 76.5 days at birth and 63 and 70 days at six weeks at cohort and noncohort facilities, respectively. HIV-exposed infants tested at birth were approximately one month younger when their caregivers received results versus those tested at six weeks. Infants diagnosed at birth initiated ART about two months earlier (median 6.4 weeks old) than those identified at six weeks (median 14.8 weeks). However, the long TAT for testing at both birth and six weeks illustrates the prolonged process for specimen transport and result return that could compromise the effectiveness of adding VEID to existing overburdened EID systems.

scholarly journals Impact of a Maternal Prevention of Mother-to-child Transmission of HIV (PMTCT) Intervention on HIV-exposed Infants in Uganda

2020 ◽  
Vol 9 (3) ◽  
pp. 320-329
Author(s):  
Anays Murillo ◽  
Mary Bachman DeSilva ◽  
Lora L. Sabin ◽  
Nafisa Halim ◽  
Harriet Chemusto ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Global Health ◽  
Early Infant Diagnosis ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Hiv Exposed Infants ◽  
Early Infant ◽  
Hiv Test ◽  
Hiv Exposed ◽  
Mother To Child

Background: Uganda has successfully reduced pediatric HIV infections through prevention of mother-to-child transmission of HIV (PMTCT) programs, yet little is known about adherence to infant-specific components of interventions. We hypothesized that infants born to mothers receiving the WiseMama (WM) electronic drug monitoring (EDM)-based adherence intervention would have increased uptake of six-week post-natal nevirapine (NVP) infant prophylaxis and better adherence to six-week early infant diagnosis (EID) HIV testing. Methods: At two sites in Uganda, the Wise Infant Study (WIN) prospectively followed an infant cohort. Infants were born to women enrolled in an RCT testing the effect of real-time reminders delivered via EDM on maternal adherence to antiretroviral therapy. We assessed intrapartum and discharge receipt of NVP prophylaxis using pharmacy and infant HIV DNA testing laboratory data. Results: Of 121 women eligible for WIN, 97 (80%) consented and enrolled; 46 had been randomized to control and 51 to intervention. There were no differences in receipt of a six-week NVP supply (control 87%, intervention 82%, p = 0.53). Receipt of any NVP prophylaxis did not vary by delivery location (p = 0.35), and although 12% of infants were delivered at non-study health facilities, they were not less likely to receive NVP at discharge (p = 0.37). Among infants with a completed HIV test, there was no difference in mean time to first test (control 52 days (SD 18), intervention 51 days (SD 15), p = 0.86). Only one infant, in the control group, tested positive for HIV. Conclusion and Global Health Implications: We found no significant differences in adherence to infant PMTCT practices between intervention and control infants with relatively high rates of NVP receipt albeit with suboptimal adherence to six-week EID testing. Further work is needed to ensure improved access, uptake, and follow-up of HIV-exposed infants in the Option B+ era. Key words: • Prevention of maternal to child transmission of HIV • HIV • Nevirapine • Antiretroviral therapy prophylaxis • Early infant diagnosis • HIV-exposed infants   Copyright © 2020 Murillo et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.

Prevention of Mother-to-Child HIV Transmission in Nigeria: Six Years Experience from a Tertiary Institution

2021 ◽  
Vol 19 ◽  
Author(s):  
Rabiu Ibrahim Jalo ◽  
Taiwo Amole ◽  
Deepa Dongarwar ◽  
Hadiza Abdullahi ◽  
Fatima I. Tsiga-Ahmed ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Infection Rate ◽  
Hiv Transmission ◽  
Early Infant Diagnosis ◽  
Mixed Feeding ◽  
Hiv Exposed Infants ◽  
Early Infant ◽  
Antiretroviral Prophylaxis ◽  
Hiv Exposed ◽  
Mother To Child

Background: In line with global standards and progress made in Prevention of Mother-to-Child Transmission (PMTCT), an assessment of the outcome of Early Infant Diagnosis in northern Nigeria is necessary to evaluate progress towards a zero Human immunodeficiency Virus (HIV) infection rate among children. Objectives: This study assessed the infection rate and risk factors for mother-to-child HIV transmission among HIV-exposed children in Kano, northwest Nigeria. Method: Using a retrospective cohort design, pregnant HIV-positive women and their exposed infants were recruited over a period of six years (2010 to 2016). Participants were enrolled during pregnancy or at delivery from the PMTCT clinic of a tertiary health facility in Kano, Nigeria. The main observations of the study were Early infant diagnosis positivity for HIV at 6 weeks and the risk factors for positivity. Results: Of the 1,514 infants studied, Early Infant Diagnosis was positive for HIV among 13 infants (0.86%). Infants whose mothers did not have antiretroviral therapy (adjusted Prevalence Ratio aPR = 2.58, 95%CI [1.85- 3.57]); who had mixed feeding (aPR = 12.06, 95%CI [9.86- 14.70]) and those not on antiretroviral prophylaxis (aPR = 20.39, 95%CI [16.04- 25.71]) were more likely to be infected with HIV. HIV-exposed infants on nevirapine and zidovudine prophylaxis accounted for 95% and 74%, respectively, and were less likely to be infected with HIV. Conclusion: HIV infection rate remains high among HIV-exposed infants whose mothers did not receive PMTCT services. Scaling up proven interventions of early commencement of antiretroviral treatment for mothers, adherence to antiretroviral prophylaxis and avoidance of mixed feeding among HIV-exposed infants would protect future generations from HIV infection.

scholarly journals Early infant diagnosis and outcomes in HIV-exposed infants at a central and a district hospital, Northern Malawi

2017 ◽  
Vol 7 (2) ◽  
pp. 83-89 ◽  
Author(s):  
N. A. Phiri ◽  
H-Y Lee ◽  
L. Chilenga ◽  
C. Mtika ◽  
F. Sinyiza ◽  
...  
Keyword(s):  
District Hospital ◽  
Early Infant Diagnosis ◽  
Hiv Exposed Infants ◽  
Early Infant ◽  
Hiv Exposed

Characteristics and outcomes of HIV-exposed infants in Homa Bay County, Kenya, 2015

2020 ◽  
Vol 50 (2) ◽  
pp. 154-156
Author(s):  
Lawrence K Gitonga ◽  
Waqo G Boru ◽  
Lilly Muthoni ◽  
Jacob Odhiambo ◽  
James Ransom
Keyword(s):  
Antenatal Care ◽  
Retrospective Review ◽  
Hiv Positive ◽  
Early Infant Diagnosis ◽  
Western Kenya ◽  
Replacement Feeding ◽  
Hiv Exposed Infants ◽  
Care Services ◽  
Early Infant ◽  
Hiv Exposed

Homa Bay County in south-western Kenya has a low uptake of antenatal care services and the highest prevalence of HIV in the country. We present the findings of a retrospective review of HIV-exposed infants (HEI) who sought early infant diagnosis services in the county throughout 2015. HEI who were breastfed >6 months, had replacement feeding and did not receive prophylaxis were 2–6 times more likely to be HIV-positive.

scholarly journals Characteristics of HIV/ Malaria co-infected mothers who did not access early infant diagnosis for their HIV-exposed infants in Benin-City, Nigeria

2020 ◽  
Vol 6 (3) ◽  
pp. 306-314
Author(s):  
AE Sadoh ◽  
FE Eki-Udoko
Keyword(s):  
Placental Malaria ◽  
Hiv Infections ◽  
Early Infant Diagnosis ◽  
Infected Woman ◽  
Hiv Exposed Infants ◽  
Benin City ◽  
Early Infant ◽  
And Performance ◽  
Hiv Exposed ◽  
Dna Pcr

Background: Perinatally-acquired HIV infections rapidly lead to death within one to two years of life. Early infant diagnosis (EID) is the key to early identification with the prompt commencement of treatment. This has been shown to reduce morbidity and mortality. In Nigeria, only 21% of HIV-infected infants are on ARTs. Objective: To determine the characteristics of HIV/Malaria co-infected mothers who did not access EID for their HIV- exposed infants. Methods: HIV infected mothers were recruited from three hospitals during the last trimester of pregnancy and were tested for peripheral and placental malaria at delivery. Socio-demographic and some clinical characteristics were obtained using a proforma. Following delivery, the babies were commenced on the Prevention of Mother to Child Transmission (PMTCT) protocol for HIV including prophylactic Nevirapine therapy, infant feeding counselling and performance of DNA PCR at 6-8 weeks of life. Mothers whose infants did not have DNA PCR results were categorized as having not accessed EID services. Results: Of the 162 infants, only 101 (62.4%) had a DNA PCR test done. The mean age of mothers who did not access EID (31.84±4.8 years) was significantly higher than for mothers who accessed EID (30.58±3.09 years) (p<0.0001). Mothers with low levels of education (p = 0.006), cohabiting mothers (p = 0.0067) and HIV serodiscordant couples (p = 0.0029) were more likely not to access EID. Conclusion: Education, marital status and HIV serodiscordance are significant determinants of accessing EID services. Assessment of these factors at first contact with a pregnant HIV-infected woman allows risk categorisation for default from EID.

scholarly journals Early infant diagnosis and associated factors among HIV exposed infants in West Shoa Zone, Ethiopia: A mixed methods study

2020 ◽  
Author(s):  
Gurmesa Tura Debelew ◽  
Bontu Berhanu Fana ◽  
Mahilet Birhanu Habte
Keyword(s):  
Hiv Infection ◽  
Associated Factors ◽  
Qualitative Data ◽  
World Health ◽  
Early Infant Diagnosis ◽  
Hiv Exposed Infants ◽  
Early Infant ◽  
The World ◽  
The Status ◽  
Hiv Exposed

Abstract Background: The World Health Organization recommends testing of all HIV exposed infants at 4–6 weeks of age to optimize detection of intrauterine, intrapartum, and early postnatal HIV transmissions. However, the global coverage of early infant diagnosis remains low. With less than 25% national coverage, the progress of this early diagnosis in Ethiopia is one of the slowest in the World. Furthermore, local studies are limited to determine the status and identify the associated factors in many parts of the country in general and in West Shoa Zone in particular. Thus, this study aimed to fill this gap.Methods: A mixed method study by using retrospective record review of four years facility data of 342 mother-infant pairs supplemented by qualitative method was conducted in West Shoa Zone, Oromia Region, Ethiopia in 2018. The quantitative data related to maternal and HIV exposed infants’ cares were collected by using questionnaire. The qualitative data related to facility related barriers were collected by key-informants interview with selected mothers and service providers. Factors associated with early infant diagnosis of HIV infection were identified by using multivariable logistic regression analysis. The qualitative data were analyzed thematically and triangulated with the quantitative findings. Results: The status of early infant diagnosis was 58.5% (95%CI: 53.3%, 63.7%). Attending secondary education or above (AOR=2.41; 95%CI: 1.54, 3.28), having <4 living children (AOR=4.76, 95%CI: 02.56, 9.09), knowing HIV sero-status during or before pregnancy (AOR=6.24, 95%CI: 2.40, 10.08) and sero-status disclosure (AOR=8.30, 95%CI: 3.30, 20.60) were significantly associated with early infant diagnosis. Attending ANC visit (AOR=5.32; 95%CI: 2.53, 8.11), giving birth in health facility (AOR=62; 95%CI: 3.39, 11.85) and Neverapine provision at enrolment (AOR=6.05; 95%CI: 2.48, 14.73) were also significantly associated with early infant diagnosis of HIV infection.Conclusion: The status of early infant diagnosis in the study area is low to achieve the national target of 95% coverage by 2020. Maternal socio-demography, maternal behavior in knowing sero-status and disclosing and using services during pregnancy and delivery were among the determinants of early infant diagnosis. Promoting ANC and PMTCT cascade through behavioral interventions and fulfilling the essential equipments and supplies are required.

scholarly journals Assessment of PMTCT Success Rates Based on Antiretroviral Interventions and Feeding Options: A Prospective Cohort Study

2018 ◽  
Vol 7 (2) ◽  
pp. 226-234
Author(s):  
Kolawole A. Fasakin ◽  
Christopher T. Omisakin ◽  
Idowu O. Adebara ◽  
Wasiu A. Ajetunmobi ◽  
Adebayo A. Adeniyi ◽  
...  
Keyword(s):  
Pmtct Service ◽  
Early Infant Diagnosis ◽  
Mother To Child Transmission ◽  
Success Rates ◽  
Child Transmission ◽  
Hiv Exposed Infants ◽  
Early Infant ◽  
Hiv Exposed ◽  
Mother To Child ◽  
Hiv 1

Background: The success of any prevention of mother-to-child transmission (PMTCT) program is assessed by the proportion of HIV-exposed infants that sero-convert at the end of all risk exposures. Although adopting the best feeding option for HIV-exposed infants is one of the factors that impact PMTCT outcomes, there is limited data on the assessment of PMTCT success rates based on antiretroviral interventions and feeding options. This study assesses the success rate of PMTCT service based on antiretroviral interventions and feeding options. Methods: Eighty-five HIV-infected mothers previously in care were enrolled in a prospective cohort study. Folders and structured questionnaires were used to extract data on mother-infant pair and the first CD4, count of infected mothers on enrolment at PMTCT clinic. Dry blood spot samples were obtained from exposed infants for early infant diagnosis. Results were analyzed using the SPSS software. Results: The mean age of enrolled mothers was 31.3 ± 4.4 years, and an average CD4+ T-lymphocyte count of 368.6 ± 216.2 cells/µl. Seven (8.2%) of the HIV-exposed infants were positive for HIV-1 based on early infant diagnosis results. Overall PMTCT success rate (PMTCTSR) was 91.8%. HIV-1 prevalence of 5.0%, 0% and 21.1% was found among infants of patients who opted for breastfeeding, replacement feeding, and mixed feeding respectively thus yielding PMTCT success rates of 95%, 100% and 78.9%. Pediatric antiretroviral interventions success rates in HIV-exposed infants was 95.8%, 80.0% and 66.7% based on age groups ≤ 6 months, > 6 ≤ 12 months, and > 12 ≤ 18 months respectively. Conclusion and Global Health Implications: Quality PMTCT service is vital for successful prevention of mother-to-child transmission of HIV. Implementation of more dynamic approaches such as adherence to option B+ guidelines in PMTCT service in our settings can further reduce mother-to-child transmission of HIV and improve outcomes. Key words: Assessment, Antiretroviral Interventions, PMTCT, Success Rates, Feeding Options, Cohort  Copyright © 2018 Fasakin et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Rates and Predictors of HIV-Exposed Infants Lost to Follow-Up During Early Infant Diagnosis Services in Kenya

2019 ◽  
Vol 33 (8) ◽  
pp. 346-353 ◽  
Author(s):  
Kathy Goggin ◽  
Emily A. Hurley ◽  
Vincent S. Staggs ◽  
Catherine Wexler ◽  
Niaman Nazir ◽  
...  
Keyword(s):  
Early Infant Diagnosis ◽  
Hiv Exposed Infants ◽  
Early Infant ◽  
Hiv Exposed ◽  
Lost To Follow Up
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