Evaluating the Feasibility of Point of Care Birth Testing in Eswatini

2019 ◽  
Author(s):  
Keyword(s):  
Point Of Care ◽  
Birth Testing

scholarly journals “The right time is just after birth”: acceptability of point-of-care birth testing in Eswatini: qualitative results from infant caregivers, health care workers, and policymakers

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Emma Sacks ◽  
Philisiwe Khumalo ◽  
Bhekisisa Tsabedze ◽  
William Montgomery ◽  
Nobuhle Mthethwa ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Point Of Care ◽  
Care Workers ◽  
Birth Testing ◽  
The Right

scholarly journals “The right time is just after birth”: Acceptability of point-of-care birth testing in Eswatini: qualitative results from infant caregivers, health care workers, and policymakers

2020 ◽  
Author(s):  
Emma Sacks ◽  
Philisiwe Khumalo ◽  
Bhekisisa Tsabedze ◽  
William Montgomery ◽  
Nobuhle Mthethwa ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Point Of Care ◽  
Scale Up ◽  
Testing Machine ◽  
Strong Support ◽  
Return Of Results ◽  
Care Workers ◽  
Birth Testing ◽  
The Right

Abstract Background: Testing for HIV at birth has the potential to identify infants infected in utero , and allows for the possibility of beginning treatment immediately after birth; point of care (POC) testing allows rapid return of results and faster initiation on treatment for positive infants. Eswatini piloted birth testing in three public maternities for over two years. Methods: In order to assess the acceptability of POC birth testing in the pilot sites in Eswatini, interviews were held with caregivers of HIV-exposed infants who were offered birth testing (N=28), health care workers (N=14), and policymakers (N=10). Participants were purposively sampled. Interviews were held in English or SiSwati, and transcribed in English. Transcripts were coded by line, and content analysis and constant comparison were used to identify key themes for each respondent type. Results: Responses were categorized into: knowledge, experience, opinions, barriers and challenges, facilitators, and suggestions to improve POC birth testing. Preliminary findings reveal that point of care birth testing has been very well received but challenges were raised. Most caregivers appreciated testing the newborns at birth and getting results quickly, since it reduced anxiety of waiting for several weeks. However, having a favorable experience with testing was linked to having supportive and informed family members and receiving a negative result. Caregivers did not fully understand the need for blood draws as opposed to tests with saliva, and expressed the fears of seeing their newborns in pain. They were specifically grateful for supportive nursing staff who respected their confidentiality. Health care workers expressed strong support for the program but commented on the high demand for testing, increased workload, difficulty with errors in the testing machine itself, and struggles to implement the program without sufficient staffing, especially on evenings and weekends when phlebotomists were not available. Policymakers noted that there have been challenges within the program of losing mothers to follow up after they leave hospital, and recommended stronger linkages to community groups. Conclusions: There is strong support for scale-up of POC birth testing, but countries should consider ways to optimize staffing and manage demand.

scholarly journals Xpert HIV-1 point-of-care test for neonatal diagnosis of HIV in the birth testing programme of a maternity hospital: a field evaluation study

2017 ◽  
Vol 4 (10) ◽  
pp. e442-e448 ◽  
Author(s):  
Karl-Günter Technau ◽  
Louise Kuhn ◽  
Ashraf Coovadia ◽  
Pamela M Murnane ◽  
Gayle Sherman
Keyword(s):  
Point Of Care ◽  
Field Evaluation ◽  
Evaluation Study ◽  
Maternity Hospital ◽  
Point Of Care Test ◽  
Testing Programme ◽  
Neonatal Diagnosis ◽  
Birth Testing ◽  
Hiv 1

scholarly journals “The right time is just after birth”: Acceptability of point-of-care birth testing in Eswatini: qualitative results from infant caregivers, health care workers, and policymakers

2020 ◽  
Author(s):  
Emma Sacks ◽  
Philisiwe Khumalo ◽  
Bhekisisa Tsabedze ◽  
William Montgomery ◽  
Nobuhle Mthethwa ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Point Of Care ◽  
Scale Up ◽  
Testing Machine ◽  
Strong Support ◽  
Return Of Results ◽  
Care Workers ◽  
Birth Testing ◽  
The Right

Abstract Background: Testing for HIV at birth has the potential to identify infants infected in utero, and allows for the possibility of beginning treatment immediately after birth; point of care (POC) testing allows rapid return of results and faster initiation on treatment for positive infants. Eswatini piloted birth testing in three public maternities for over two years. Methods: In order to assess the acceptability of POC birth testing in the pilot sites in Eswatini, interviews were held with caregivers of HIV-exposed infants who were offered birth testing (N=28), health care workers (N=14), and policymakers (N=10). Participants were purposively sampled. Interviews were held in English or SiSwati, and transcribed in English. Transcripts were coded by line, and content analysis and constant comparison were used to identify key themes for each respondent type. Results: Responses were categorized into: knowledge, experience, opinions, barriers and challenges, facilitators, and suggestions to improve POC birth testing. Preliminary findings reveal that point of care birth testing has been very well received but challenges were raised. Most caregivers appreciated testing the newborns at birth and getting results quickly, since it reduced anxiety of waiting for several weeks. However, having a favorable experience with testing was linked to having supportive and informed family members and receiving a negative result. Caregivers did not fully understand the need for blood draws as opposed to tests with saliva, and expressed the fears of seeing their newborns in pain. They were specifically grateful for supportive nursing staff who respected their confidentiality. Health care workers expressed strong support for the program but commented on the high demand for testing, increased workload, difficulty with errors in the testing machine itself, and struggles to implement the program without sufficient staffing, especially on evenings and weekends when phlebotomists were not available. Policymakers noted that there have been challenges within the program of losing mothers to follow up after they leave hospital, and recommended stronger linkages to community groups. Conclusions: There is strong support for scale-up of POC birth testing, but countries should consider ways to optimize staffing and manage demand.

scholarly journals An analysis of the HIV testing cascade of a group of HIV-exposed infants from birth to 18 months in peri-urban Khayelitsha, South Africa

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262518
Author(s):  
Aurelie Kennedy Nelson ◽  
Tali Cassidy ◽  
Laura Trivino Duran ◽  
Vivian Cox ◽  
Catherine J. Wedderburn ◽  
...  
Keyword(s):  
South Africa ◽  
Hiv Testing ◽  
Transmission Rate ◽  
Point Of Care ◽  
Historical Cohort ◽  
Hiv Positive Mothers ◽  
Hiv Test ◽  
Significant Difference ◽  
Hiv Exposed ◽  
Birth Testing

Background Despite the reduction of HIV mother-to-child transmission, there are concerns regarding transmission rate in the breastfeeding period. We describe the routine uptake of 6 or 10 (6/10) weeks, 9 months and 18 months testing, with and without tracing, in a cohort of infants who received HIV PCR testing at birth (birth PCR) (with and without point of care (POC) testing) in a peri-urban primary health care setting in Khayelitsha, South Africa. Methods In this cohort study conducted between November 2014 and February 2018, HIV-positive mothers and their HIV-exposed babies were recruited at birth and all babies were tested with birth PCR. Results of routine 6/10 weeks PCR, 9 months and 18 months testing were followed up by a patient tracer. We compared testing at 6/10 weeks with a subgroup from historical cohort who was not tested with birth PCR. Results We found that the uptake of 6/10 weeks testing was 77%, compared to 82% with tracing. When including all infants in the cascade and comparing to a historical cohort without birth testing, we found that infants who tested a birth were 22% more likely to have a 6/10 weeks test compared to those not tested at birth. There was no significant difference between the uptake of 6/10 weeks testing after birth PCR POC versus birth PCR testing without POC. Uptake of 9 months and 18 months testing was 39% and 24% respectively. With intense tracing efforts, uptake increased to 45% and 34% respectively. Conclusion Uptake of HIV testing for HIV-exposed uninfected infants in the first 18 months of life shows good completion of the 6/10 weeks PCR but suboptimal uptake of HIV testing at 9 months and 18 months, despite tracing efforts. Birth PCR testing did not negatively affect uptake of the 6/10 weeks HIV test compared to no birth PCR testing.

“Aspirin - resistance”? A few critical considerations on definition, terminology, diagnosis, clinical value, natural course of atherosclerotic disease, and therapeutic consequences

VASA ◽  
2011 ◽  
Vol 40 (6) ◽  
pp. 429-438 ◽  
Author(s):  
Berent ◽  
Sinzinger
Keyword(s):  
Platelet Function ◽  
Point Of Care ◽  
Aspirin Resistance ◽  
Point Of View ◽  
Evidence Based ◽  
Platelet Function Tests ◽  
Clinical Value ◽  
Vascular Events ◽  
Therapeutic Consequences ◽  
Function Tests

Based upon various platelet function tests and the fact that patients experience vascular events despite taking acetylsalicylic acid (ASA or aspirin), it has been suggested that patients may become resistant to the action of this pharmacological compound. However, the term “aspirin resistance” was created almost two decades ago but is still not defined. Platelet function tests are not standardized, providing conflicting information and cut-off values are arbitrarily set. Intertest comparison reveals low agreement. Even point of care tests have been introduced before appropriate validation. Inflammation may activate platelets, co-medication(s) may interfere significantly with aspirin action on platelets. Platelet function and Cox-inhibition are only some of the effects of aspirin on haemostatic regulation. One single test is not reliable to identify an altered response. Therefore, it may be more appropriate to speak about “treatment failure” to aspirin therapy than using the term “aspirin resistance”. There is no evidence based justification from either the laboratory or the clinical point of view for platelet function testing in patients taking aspirin as well as from an economic standpoint. Until evidence based data from controlled studies will be available the term “aspirin resistance” should not be further used. A more robust monitoring of factors resulting in cardiovascular events such as inflammation is recommended.

Cloud-Computing: eHealth aus der Wolke

2018 ◽  
Vol 23 (11) ◽  
pp. 38-41
Author(s):  
Sebastian Krolop ◽  
Florian Benthin ◽  
Constanze Knahl
Keyword(s):  
Cloud Computing ◽  
Point Of Care

Cloud-Computing gewinnt auch in Kliniken zunehmend an Bedeutung. Über das Internet bereitgestellte Lösungen verändern nicht nur Verwaltung und Logistik – im klinischen Bereich geht es zum Beispiel um die Nutzung elektronischer Patientenakten am Point-of-Care.

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