scholarly journals Associations of Sociodemographic and Clinical Factors with Late Presentation for Early Infant HIV Diagnosis (EID) Services in Kenya

2021 ◽  
Vol 10 (2) ◽  
pp. 210-220
Author(s):  
Agnes Langat ◽  
Tegan Callahan ◽  
Isabella Yonga ◽  
Boniface Ochanda ◽  
Anthony Waruru ◽  
...  
Keyword(s):  
Global Health ◽  
Hiv Testing ◽  
Late Presentation ◽  
Health Facilities ◽  
Inpatient Setting ◽  
Sociodemographic Characteristics ◽  
Early Infant Diagnosis ◽  
Hiv Diagnosis ◽  
Positive Polymerase Chain Reaction ◽  
Early Infant

Background: Understanding the missed opportunities in early infant HIV testing within the PMTCT program is essential to address any gaps. The study set out to describe the clinical and sociodemographic characteristics of the infants presenting late for early infant diagnosis in Kenya. Methods: We abstracted routinely collected clinical and sociodemographic characteristics, in a cross-sectional study, on all HIV-infected infants with a positive polymerase chain reaction (PCR) test from 1,346 President’s Emergency Plan for AIDS Relief (PEPFAR) supported health facilities for the period October 2016 to September 2018. We used multivariate logistic regression to examine the association of sociodemographic and clinical characteristics with late (>2 months after birth) presentation for infant HIV testing. Results: Of the 4,011 HIV-infected infants identified, the median infant age at HIV diagnosis was 3 months [interquartile range (IQR), 1-16 months], and two-thirds [2,669 (66.5%)] presented late for infant HIV testing. Factors that were associated with late presentation for infant testing were: maternal ANC non-attendance, adjusted odds ratio (aOR) 1.41 (95% confidence interval (CI) 1.18 -1.69); new maternal HIV diagnosis, aOR 1.45, (95%CI 1.24 -1.7); and lack of maternal antiretroviral therapy(ART), aOR 1.94, (95% CI 1.64 - 2.30). There was a high likelihood of identifying HIV-infected infants among infants who presented for medical services in the outpatient setting (aOR 18.9; 95% CI 10.2 - 34.9) and inpatient setting (aOR 12.2; 95% CI 6.23-23.9) compared to the infants who presented late in maternity. Conclusion and Global Health Implications: Gaps in early infant HIV testing suggest the need to increase maternal pre-pregnancy HIV diagnosis, timely antenatal care, early infant diagnosis services, early identification of mothers who seroconvert during pregnancy or breastfeeding and improved HIV screening in outpatient and inpatient settings. Early referral from the community and access to health facilities should be strengthened by the implementation of national PMTCT guidelines.   Copyright © 2021 Langat 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.

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.

Consolidating HIV testing in a public health laboratory for efficient and sustainable early infant diagnosis (EID) in Uganda

2015 ◽  
Vol 36 (2) ◽  
pp. 153-169 ◽  
Author(s):  
Charles Kiyaga ◽  
Hakim Sendagire ◽  
Eleanor Joseph ◽  
Jeff Grosz ◽  
Ian McConnell ◽  
...  
Keyword(s):  
Public Health ◽  
Hiv Testing ◽  
Public Health Laboratory ◽  
Early Infant Diagnosis ◽  
Early Infant

scholarly journals Accuracy and Feasibility of Point of Care (POC) Early Infant Diagnosis (EID) in Nigeria: A Field Evaluation

2021 ◽  
Vol 9 (1) ◽  
pp. 95-104
Author(s):  
Busari Olusegun
Keyword(s):  
Point Of Care ◽  
Standard Of Care ◽  
Field Evaluation ◽  
Turnaround Time ◽  
Early Infant Diagnosis ◽  
Hiv Diagnosis ◽  
Healthcare Facilities ◽  
Early Infant ◽  
Hiv Positive Mothers ◽  
First Time

The timely commencement of treatment within the first 12 weeks of life in children reduces the HIV disease progression by 75% and mortality by 76%. For all children infected with HIV to receive essential treatment and care, few things are more important than early and accurate HIV diagnosis. Traditional methods of providing Early Infant Diagnosis (EID) have been bedeviled with several challenges. Point of Care (POC) testing for EID has been recommended as a game-changer. A field evaluation was conducted across 6 healthcare facilities between February 2017 and August 2018 to determine the accuracy and operational feasibility of POC testing for EID in Nigeria. The conceptual framework rides on the WHO SDI ASSURED criteria. Participants were infants aged between 4 weeks and 18 months born to HIV-positive mothers and visiting the clinic for the first time for EID. Results obtained from the POC was compared with the Standard of Care (SOC) to determine accuracy and feasibility. A total of 245 participants took part in the study, with 76% visiting the clinic for EID within 2 months of life. The average turnaround time for EID test using the SOC was 67 days. Analysis of the 10.4% error rate indicate significant correlation by personnel (r= 0.01122, P=0.841706). An average concordance percentage of 99.6%, sensitivity of 91.7% and specificity of 100.0% was observed. Operator’s assessment indicates that the equipment is very good and acceptable. The POC testing for EID is acceptable, rapid, and robust; hence, viable for use in Nigeria.

scholarly journals Late Presentation of HIV Infection: Prevalence, Trends, and the Role of HIV Testing Strategies in Guangzhou, China, 2008–2013

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Weibin Cheng ◽  
Weiming Tang ◽  
Zhigang Han ◽  
Thitikarn May Tangthanasup ◽  
Fei Zhong ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Hiv Testing ◽  
Late Presentation ◽  
Infection Prevalence ◽  
Hiv Disease ◽  
Hiv Diagnosis ◽  
Testing Strategies ◽  
Prevalence Trends ◽  
Advanced Hiv Disease

Background. The prevalence, trends, and the role of different HIV testing strategies in late presentation of HIV infection in China were unknown.Methods. Data of newly reported HIV cases in Guangzhou between 2008 and 2013 was analyzed to examine the prevalence, trends, and characteristics of late presentation of HIV infection by three types of HIV testing strategies.Results. Overall, 53.2% (1412/2653) and 27.3% (724/2653) met the criteria of late presentation and presentation with advanced HIV disease. The overall trend of late presentation of HIV infection within the study period was declining. Late presentation was 62.9% in 2008 and dropped to 43.3% in 2013 (P<0.001); presentation with advanced HIV disease was 40.3% in 2008 and dropped to 15.2% in 2013 (P<0.001). Of the three testing strategies, PITC presented higher odds of both late presentation [AOR (95% CI): PITC versus VCT: 1.37 (1.09, 1.73); PITC versus MHT: 3.09 (2.16, 4.42)] and presentation with advanced HIV disease [AOR (95% CI): PITC versus VCT: 1.65 (1.29, 2.11); PITC versus MHT: 13.14 (8.47, 20.39)].Conclusions. Although the late presentation of HIV infection was declining, it was still high in Guangzhou. The worse situation among PITC cases urges the policy adjustment in medical settings to increase early HIV diagnosis.

scholarly journals Point-of-care HIV testing best practice for early infant diagnosis: an implementation study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Elizabeth Spooner ◽  
Kerusha Govender ◽  
Tarylee Reddy ◽  
Gita Ramjee ◽  
Noxolo Mbadi ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Best Practice ◽  
Point Of Care ◽  
Implementation Study ◽  
Early Infant Diagnosis ◽  
Early Infant
Sign in / Sign up

Export Citation Format

Share Document