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 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 Trends in uptake of early infant diagnosis for HIV: implementation results of the Ugandan military PMTCT program

2021 ◽  
Vol 8 (6) ◽  
pp. 2746
Author(s):  
Paul Lubega ◽  
Stephen Lawoko ◽  
Filbert Akatukunda ◽  
Gloria Seruwagi ◽  
John Bosco Ninsima ◽  
...  
Keyword(s):  
Positive Impact ◽  
Data Extraction ◽  
Statistical Significance ◽  
Hiv Positive ◽  
Early Infant Diagnosis ◽  
Cross Sectional ◽  
Early Infant ◽  
Short Period ◽  
Rapid Tests ◽  
Military Facilities

Background: Early infant diagnosis (EID) is an important strategy of the Prevention of Mother-to-child transmission (PMTCT) and when implemented in combination with other strategies could eliminate HIV MTCT. We implemented a series of strategic interventions intended to improve EID at 9 Military facilities in Uganda and evaluated their impact on uptake of EID.Methods: A retrospective cross-sectional design was adopted, following-up HIV Exposed Infants (HEI) at the study sites over a 2 year period, and using a data extraction tool to capture4 indicators of EID namely; number of HIV-positive mothers, number of HEI enrolled, number of PCR and rapid tests performed on HEI, and number of HIV-positive results of HEI. Scatter plots and simple linear regression were applied to demonstrate trends in EID uptake and estimate intervention impact over time. Statistical significance was assumed at p<0.05.Results: We established incremental trends in numbers of first PCR (f [1,6]=2.8; p=0.15),third PCR (f [1,6]=8.4; p<0.05), rapid tests (f [1,6]=16.1; p<0.05) performed on HEI, and a modest decline in HIV-positivity among HEI over the study period. The intervention improved retention in PMTCT cascade to 80%, when contrasted with the national average of 70%.Conclusions: We have demonstrated that interventions invoking pre-booking HIV-positive pregnant mothers during antenatal care, follow up of mother-baby pairs using telephone and mentor mothers and integrating EID in immunization programs can improve uptake of EID in a relatively short period, and with a positive impact on EID indicators.

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.

Progress toward elimination of perinatal HIV transmission in Kenya: Analysis of early infant diagnosis data

2017 ◽  
Vol 29 (7) ◽  
pp. 632-640 ◽  
Author(s):  
Dunstan Achwoka ◽  
Justin Mandala ◽  
Mutugi Muriithi ◽  
Yanwu Zeng ◽  
Mario Chen ◽  
...  
Keyword(s):  
Scale Up ◽  
Age Groups ◽  
Polymerase Chain Reaction Test ◽  
Hiv Positive ◽  
Early Infant Diagnosis ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Perinatal Hiv ◽  
Early Infant ◽  
Mother To Child

Interrupting vertical transmission of HIV from mothers to infants provides opportunity to transform the HIV/AIDS epidemic by eliminating new infections among children. We estimate mother-to-child transmission rates of infants born to known HIV-positive mothers offered prevention of mother-to-child transmission interventions and provide an indication of Kenya’s progress toward elimination of perinatal transmission. We obtained from the Kenya National Early Infant Diagnosis (EID) database, all 131,451 DNA polymerase chain reaction test results of HIV-exposed infants aged 0–18 months who had dried blood spot samples taken between January 2008 and October 2013. The majority of samples were from infants aged 0–6 months (81.0%). Infants aged 6–12 months comprised 15.5%, while those aged 12–18 months were 3.5%. Overall, 11,439 (8.7%) were HIV-positive. Positivity rates were higher among older age groups: 6.8, 14.6, and 27.5% in age groups 0–6 months, 6–12 months, and 12–18 months old, respectively. In Kenya, scale-up and decentralization to primary health centers of EID services has been remarkable. Both increasing HIV-positivity trends in age groups 12–18 months and differences between provinces require further interrogation. Although significant, declining HIV-positivity trends in age groups 0–6 months and 6–12 months old observed between 2008 and 2013 is insufficient to achieve the elimination agenda.

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 Early infant diagnosis of HIV-I infection using dried blood spots among children born to seropositive mothers in Federal Medical Centre (FMC) Lokoja

2021 ◽  
Vol 8 (2) ◽  
pp. 136-144
Author(s):  
Aminat Omope Yusuf ◽  
Timothy Olugbenga Ogundeko ◽  
MamzhiSeljul Crown Ramyil ◽  
Catherine Nadabo ◽  
Nkiru Philomena Okoye
Keyword(s):  
Transmission Rate ◽  
Dried Blood Spots ◽  
Antiretroviral Drugs ◽  
Medical Centre ◽  
High Rate ◽  
Type I ◽  
Early Infant Diagnosis ◽  
Transmission Rates ◽  
Blood Spots ◽  
Early Infant

Early diagnosis of Human immunodeficiency virus (HIV) in infants provides a critical opportunity to strengthen follow-up of HIV- exposed children using dried blood spots and assure early access to antiretroviral treatment for infected children. This study aimed to determine the prevalence of HVI-1 infection in infants born to HIV-seropositive mothers. Early infant diagnosis of HIV sub-type I was carried out using on dried blood spots of 286 babies born to HIV-I seropositive mothers attending the Federal Medical Centre, Lokoja - Kogi State, Nigeria, between the months of July to December, 2013. Data obtained was analyzed using Gene Amp PCR System 9700. The overall rate of HIV-I vertical transmission from infected mothers to their babies was 14.5%. High transmission rates 63.5%was seen in babies whose mothers could not get any form of interventions with the least transmission rates seen in babies whose mothers either took HAART or were one form of ARV or the other (0 – 1.0%). Babies who took nevirapine as prophylaxis after delivery had lower rate (1%) of transmission. From the 30 women that mix-fed their babies, 6.7% transmission rate was recorded.Lack of antiretroviral drugs by HIV-I positive pregnant women was found to be associated with high rate of HIV-I transmission (p<0.05). Early intervention of mother to child transmission of HIV-1 infection using Highly Active Antiretroviral Therapy, exclusive breastfeeding practice as well as constant visit to Tertiary Hospitals for counseling and management of HIV infection reduced the rate of infection among the infants born to seropositive mothers.

scholarly journals PMTCT Service Uptake among Pregnant Women in 3 Internally Displace Persons Camps in Borno State Northeast Nigeria

2020 ◽  
pp. 72-77
Author(s):  
Affiah Nsikan ◽  
Fadoju Sunkanmi ◽  
Dickson Peter ◽  
Jasini Joseph ◽  
Opada Emmanuel ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Hiv Transmission ◽  
Data Extraction ◽  
Healthcare Services ◽  
Hiv Positive ◽  
Pmtct Service ◽  
Early Infant Diagnosis ◽  
North East ◽  
Early Infant ◽  
Hiv Positive Mothers

Background: Humanitarian emergencies upset and wreck existing healthcare services and systems. Pregnant women and infant are incredibly defenseless, as these infants are exposed to the risk of preventable childhood disease which includes HIV that is transmitted from their HIV positive mother. In the absence of any intervention, the risk of HIV transmission increases to about 40% among infant born to HIV positive mothers. Objectives: To examine the prevalence and uptake of HIV services among pregnant women and to assess the level of Early Infant Diagnosis (EID) by PCR uptake for children under 2 months born to HIV positive mothers. Methods: A sentinel case study approach conducted in 3 internally displaced people (IDP) camps in 3 LGAs (Banki, Dikwa and Ngala) of Borno state Nigeria, from January 2018 to May 2019. Data collected using standard tools and DHIS 2.0 used for data extraction and MS Excel used for analysis. Results: Prevalence of HIV among pregnant women (1st ANC Visits) in the 3 IDP camps were 1.22% (Ngala), 0.44% (Banki) and 0.16% (Dikwa) with an average of 0.61% compared to the 2018 National zonal average for the North East of1.1%. Uptake of HIV testing service among pregnant women in the 3 IDP camps were 90.65% (Ngala), 100% (Banki) and 100% (Dikwa), with an average uptake of 96.9%; while EID uptake for HIV exposed children within 2 months of age were: 50.0% (Dikwa), 12.5% (Banki) and 0% (Ngala). Conclusions: The study also shows that none of the 3 IDP camps were able to optimize Early Infant Diagnosis at 2 months of birth. It is hereby recommended that Care-giver Focused Approach should be prioritized in preventing mother-to-child transmission (PMTCT) service delivery.

scholarly journals Early infant diagnosis: gateway to survival for HIV positive infants

2014 ◽  
Vol 14 (S3) ◽  
Author(s):  
Jayanthi Shastri ◽  
Sachee Agrawal ◽  
Sandhya Sawant ◽  
Manish Pathak
Keyword(s):  
Hiv Positive ◽  
Early Infant Diagnosis ◽  
Early Infant

Classification of Infant Vocalizations by Untrained Listeners

2019 ◽  
Vol 62 (9) ◽  
pp. 3265-3275
Author(s):  
Heather L. Ramsdell-Hudock ◽  
Anne S. Warlaumont ◽  
Lindsey E. Foss ◽  
Candice Perry
Keyword(s):  
Formal Education ◽  
Additional Insight ◽  
Listener Responses ◽  
Infant Vocalization ◽  
Early Infant ◽  
Infant Vocalizations ◽  
Audio Recordings ◽  
Speech And Language Development ◽  
Insight Into

Purpose To better enable communication among researchers, clinicians, and caregivers, we aimed to assess how untrained listeners classify early infant vocalization types in comparison to terms currently used by researchers and clinicians. Method Listeners were caregivers with no prior formal education in speech and language development. A 1st group of listeners reported on clinician/researcher-classified vowel, squeal, growl, raspberry, whisper, laugh, and cry vocalizations obtained from archived video/audio recordings of 10 infants from 4 through 12 months of age. A list of commonly used terms was generated based on listener responses and the standard research terminology. A 2nd group of listeners was presented with the same vocalizations and asked to select terms from the list that they thought best described the sounds. Results Classifications of the vocalizations by listeners largely overlapped with published categorical descriptors and yielded additional insight into alternate terms commonly used. The biggest discrepancies were found for the vowel category. Conclusion Prior research has shown that caregivers are accurate in identifying canonical babbling, a major prelinguistic vocalization milestone occurring at about 6–7 months of age. This indicates that caregivers are also well attuned to even earlier emerging vocalization types. This supports the value of continuing basic and clinical research on the vocal types infants produce in the 1st months of life and on their potential diagnostic utility, and may also help improve communication between speech-language pathologists and families.

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