Implementing early infant diagnosis of HIV infection at the primary care level: experiences and challenges in Malawi

Dube, Queen; Dow, Anna; Chirambo, Chawanangwa; Lebov, Jill F.; Tenthani, Lyson; Moore, Michael J.; Heyderman, Robert S.; Rie, Annelies Van

doi:10.2471/blt.11.100776

Cited by 64 publications

(61 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The median time between blood draw for DBS to result recipient by the respective health facility was 36 days (IQR: 25 -49 days). These findings are consistent with other studies from Kenya and Mozambique [8] [17] [18] but lower than study report from Cameroon and Malawi [9] [19].…”

Section: Discussionsupporting

confidence: 80%

Delay in Early Infant Diagnosis and High Loss to Follow-Up among Infant Born to HIV-Infected Women in Ethiopia

Kebede¹,

Gebeyehu²,

Jain³

et al. 2014

WJA

View full text Add to dashboard Cite

Background: Many HIV-infected infants and children die from HIV related causes without their HIV status being known or receiving HIV care. All HIV exposed infants should be tested by Dried Blood Spots (DBS)-PCR before or at 6 weeks of age. Testing is a crucial step to facilitate early access to antiretroviral treatment (ART). However, studies that assess the level of use and implementation of HIV DNA testing in Ethiopia are lacking. Objective: To investigate the rate of early infant diagnosis (EID), defined as having blood drawn for HIV DNA-PCR testing, and predictive factors of EID among infants born to HIV infected women. Method: A multicentre retrospective cohort study was conducted from April to June 2012 in three public hospitals and three health centers, in Northwest Ethiopia. Mother-infant pairs were followed from delivery until the time of the HIV diagnostic test. Data were captured using standardized forms. The time-to-diagnostic test was estimated using Kaplan-Meier estimators. Factors associated with EID were evaluated using logistic regression. Result: Of the 266 HIV-exposed infants identified from the health facilities, only 109 (41.0%) infants had early HIV DNA-PCR tests. The median age at the time of HIV diagnostic testing was 60 days (95% CI: 47 -73 days), and the median turnaround time between blood draw for DNA-PCR testing to delivery of a test result to the respective health facility was 36 days (95% CI: 33 -40 days). A total of 35 (13.2%) infants were diagnosed with HIV infection. The predictors of EID were the mother having prenatal care, maternal receipt of ART during pregnancy and place of birth. Conclusion: Three out of five HIV-infected women did not bring their infant for HIV testing during the recommended 6 week interval after birth. Special attention is required for infants born to HIV-infected women who did not

show abstract

Section: Discussionsupporting

confidence: 80%

Delay in Early Infant Diagnosis and High Loss to Follow-Up among Infant Born to HIV-Infected Women in Ethiopia

Kebede¹,

Gebeyehu²,

Jain³

et al. 2014

WJA

View full text Add to dashboard Cite

show abstract

“…[3] Studies of antenatal care (ANC), EIDT and paediatric HIV programmes in Blantyre and Lilongwe, Malawi, revealed that there are significant drop-outs at each step of EIDT cascade. [4] Similarly, a Blantyre study identified factors related to failure by women to return for their infant's EID test results.…”

mentioning

confidence: 99%

Barriers, facilitators and recommendations for the early infant diagnosis and treatment (EIDT) cascade: A qualitative study in Malawi

et al. 2016

View full text Add to dashboard Cite

Semistructured interviews were conducted with HCWs who were involved with EIDT activities, and with mothers of HEIs. Convenience sampling was utilised to recruit participants. Ethical approval was received from the Malawi National Health Sciences Research Committee (NHSRC). Settings and participantsThe study was conducted within five purposively selected health facilities within three districts in Malawi that were supported with funding from ViiV-Healthcare to the Elizabeth Glaser Pediatric

show abstract

“…Despite the simplicity of this approach, the scale-up and implementation of Option B+, HIV testing and ART in HIV-exposed infants within EID programmes remain challenging. 5,13 According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), 58 000 HIV-infected women delivered babies in Malawi in 2013; however, only 15% underwent DNA PCR testing for HIV within 2 months of birth. 14 Past studies have indicated particular problems in timely EID uptake and implementation, 5,13,[15][16][17] but few have further explored how testing implementation may impact routine programme outcomes.…”

mentioning

confidence: 99%

“…5,13 According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), 58 000 HIV-infected women delivered babies in Malawi in 2013; however, only 15% underwent DNA PCR testing for HIV within 2 months of birth. 14 Past studies have indicated particular problems in timely EID uptake and implementation, 5,13,[15][16][17] but few have further explored how testing implementation may impact routine programme outcomes. We hypothesised that infants in an EID programme situated in a central hospital that performs DNA PCR testing on site might have better performance and outcomes than those enrolled in an EID programme in an outlying district health facility, where samples have to be sent to a central laboratory for testing.…”

mentioning

confidence: 99%

“…3 However, EID programmes in resource-poor settings-mainly in sub-Saharan Africa-face many challenges, such as difficult transportation of specimens from peripheral health centres to specialised laboratories, long turnaround times for diagnosis and feedback of results, and high losses to follow-up of HIV-exposed infants. [4][5][6][7][8] Overall, only 54% of infants undergo EID between 6 and 8 weeks. 9 Malawi has been running PMTCT programmes for many years.…”

mentioning

confidence: 99%

See 1 more Smart Citation

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

Phiri

Chilenga³

et al. 2017

public health action

View full text Add to dashboard Cite

Implementing early infant diagnosis of HIV infection at the primary care level: experiences and challenges in Malawi

Cited by 64 publications

References 9 publications

Delay in Early Infant Diagnosis and High Loss to Follow-Up among Infant Born to HIV-Infected Women in Ethiopia

Delay in Early Infant Diagnosis and High Loss to Follow-Up among Infant Born to HIV-Infected Women in Ethiopia

Barriers, facilitators and recommendations for the early infant diagnosis and treatment (EIDT) cascade: A qualitative study in Malawi

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

Contact Info

Product

Resources

About