Uptake and performance of prevention of mother‐to‐child transmission and early infant diagnosis in pregnant <scp>HIV</scp>‐infected women and their exposed infants at seven health centres in Addis Ababa, Ethiopia

Girma, Marshet; Wendaferash, Rahel; Shibru, Hailu; Berhane, Yemane; Höelscher, Michael; Kroidl, Arne

doi:10.1111/tmi.12881

Cited by 26 publications

(22 citation statements)

References 20 publications

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“…From Burkina Faso, Coulibaly et al reported that only 29.4% of 1,064 HEI received a virologic test within 18 months of life, with 97.8% receiving results by four months post-sample collection [40]. In Ethiopia, 66.2% of 435 HEI had DBS samples collected by 8 weeks of life, and 3.5% had no evidence of sample collection after 12 months of follow-up [41]. Approximately 81% of these HEI received DNA PCR results within 3 months, with 16.1% never receiving results.…”

Section: Discussionmentioning

confidence: 99%

Missed opportunities for early infant diagnosis of HIV in rural North-Central Nigeria: A cascade analysis from the INSPIRE MoMent study

et al. 2019

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Background Early identification of HIV-infected infants for treatment is critical for survival. Efficient uptake of early infant diagnosis (EID) requires timely presentation of HIV-exposed infants, same-day sample collection, and prompt release of results. The MoMent (Mother Mentor) Nigeria study investigated the impact of structured peer support on EID presentation and maternal retention. This cascade analysis highlights missed opportunities for EID and infant treatment initiation during the study. Methods HIV-infected pregnant women and their infants were recruited at 20 rural Primary Healthcare Centers. Routine infant HIV DNA PCR testing was performed at centralized laboratories using dried blood spot (DBS) samples ideally collected by age two months. EID outcomes data were abstracted from study case report forms and facility registers. Descriptive statistics summarized gaps and missed opportunities in the EID cascade. Results Out of 497 women enrolled, delivery data was available for 445 (90.8%), to whom 415 of 455 (91.2%) infants were live-born. Out of 408 live-born infants with available data, 341 (83.6%) presented for DBS sampling at least once. Only 75.4% (257/341) were sampled, with 81.7% (210/257) sampled at first presentation. Only 199/257 (77.4%) sampled infants had results available up to 28 months post-collection. Two (1.0%) of the 199 infants tested HIV-positive; one infant died before treatment initiation and the other was lost to follow-up. Conclusions While nearly 85% of infants presented for sampling, there were multiple missed opportunities, largely due to health system and not necessarily patient-level failures. These included infants presenting without being sampled, presenting multiple times before samples were collected, and getting sampled but results not forthcoming. Finally, neither of the two HIV-positive infants were linked to treatment within the follow-up period, which may have led to the death of one. To facilitate patient compliance and HIV-free infant survival, quality improvement approaches should be optimized for EID commodity availability, consistent DBS sample collection, efficient processing/result release, and prompt infant treatment initiation.

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Section: Discussionmentioning

confidence: 99%

Missed opportunities for early infant diagnosis of HIV in rural North-Central Nigeria: A cascade analysis from the INSPIRE MoMent study

et al. 2019

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“…Após o parto, estas mães optam por obter os antirretrovirais em outros centros de orientação e acompanhamento, em locais mais convenientes a elas. Entretanto, os abandonos do tratamento após o parto são muito freqüentes 13,14 . O fato do HC/ UFPR ser um serviço de referência para gestantes com HIV explica também o porquê de 51% dos pacientes assistidos no referido dispensário serem do sexo feminino, não refletindo, portanto, as estatísticas que confirmam que o sexo masculino se apresenta em maior número entre os pacientes com HIV/Aids 2 .…”

Section: Resultsunclassified

Estimativa de adesão ao medicamento antirretroviral coformulado 3 em 1

et al. 2018

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Introdução: Com o propósito de estimular a adesão aos antirretrovirais e minimizar os riscos de resistência a estes medicamentos, o Ministério da Saúde (MS) passou a disponibilizar o medicamento 3 em 1, uma coformulação de tenofovir (300 mg), lamivudina (300 mg) e efavirenz (600 mg), o qual inova com uso de um único comprimido diário. Objetivo: Estimar a adesão aos medicamentos antirretrovirais da primeira linha de tratamento contra o HIV. Métodos: Verificação da frequência dos retornos mensais de pacientes a um dispensário dos medicamentos antirretrovirais fornecidos pelo MS. Resultados: Os pacientes em tratamento com o medicamento 3 em 1 foram mais assíduos e retornaram com frequência 65% maior ao dispensário. Conclusão: Com a introdução do 3 em 1 confirma-se que a simplificação de esquemas terapêuticos é uma medida que facilita a adesão ao tratamento. Isso gera a expectativa de manter por mais tempo os indivíduos em uso da primeira linha de tratamento, retardando a necessidade de recorrer a outras linhas terapêuticas mais onerosas, com maior número de medicamentos e riscos associados.

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“…In addition, according to a retrospective quantitative study conducted in Addis Ababa, Ethiopia, only 56% of the infants were found to adhere to cotrimoxazole prophylactic treatment [10]. Moreover, different studies conducted in Ethiopia, India and Tanzania revealed lower adherence level being7%, 63.7%, and 16.7% respectively [19,29,30].…”

Section: Discussionmentioning

confidence: 99%

Cotrimoxazole Prophylaxis Treatment Adherence and Associated Factors Among Human Immunodeficiency Virus (HIV) Exposed Children in Public Hospitals in Ilubabor Zone, Southwest Ethiopia, 2018

Nigatu¹,

Dinegde²,

Sendo³

2019

TOPHJ

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Introduction: Africa is the most affected region by HIV/AIDS in the world with about 26 million people living with HIV, of whom 2.3 million are children under the age of 15 years in 2015. The Human Immunodeficiency Virus (HIV) related estimates and projections for Ethiopia in 2017 revealed that 57,132 under 15 years children were living with HIV with about 1,276 children newly infected. Therefore, this study assessed cotrimoxazole prophylaxis treatment adherence and associated factors among HIV exposed children in public hospitals in Ilubabor zone, Southwest Ethiopia, 2018. Methods: The study design was a facility based, both a retrospective and descriptive study that involves a review of the records of children from PMTCT register books over the past 2 years, and the interview of health care workers and parents/guardian of all children at the follow up clinic. The study included a random sample of children born from HIV infected mothers and enrolled in the PMTCT follow up clinic. The total sample size was 293 and 99 for children (parents/guardian interviewed) and health workers, respectively, and the children’s antiretroviral therapy (ART) registration books in each health facility were reviewed. The collected data was entered into the Epi-data software version 3.1 and then exported to SPSS version 20 for further statistical analysis. Descriptive statistics, bivariate analysis and multivariable logistic regression were used for analysis. Results: Among the total participants, a considerable number (83.3%) of them did not confirm their HIV status, and the majority (88.8%) of participants indicated that they had indeed suffered from one or more opportunistic infections. The common obstacles encountered in accessing care at the health facility were: lack of drugs (33.8%), long procedures in getting drugs (31.4%), unfriendly hospital staff (26.3%), and long distance to the health facility (8.5%). The study showed a significant association between compliance to cotrimoxazole prophylaxis and unfriendly health worker (OR=0.14, CI=0.03-0.78), follow-up (OR= 0.22, CI = 0.06-0.87) and the long procedure of getting drugs (OR= 0.08, CI= 0.01-0.45). Conclusion: The study revealed that a remarkable number of the participants were found to adhered to cotrimoxazole prophylactic treatment. Unfriendly health workers, follow-up and the long procedure of getting drugs were significantly and independently associated with compliance to cotrimoxazole prophylaxis.

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Uptake and performance of prevention of mother‐to‐child transmission and early infant diagnosis in pregnant HIV‐infected women and their exposed infants at seven health centres in Addis Ababa, Ethiopia

Abstract: High retention in PMTCT services, triple maternal ART and high infant nevirapine prophylaxis coverage were associated with low mother-to-child HIV transmission. Declining post-partum ART adherence and challenges of EID linkage require attention.

Cited by 26 publications

References 20 publications

Missed opportunities for early infant diagnosis of HIV in rural North-Central Nigeria: A cascade analysis from the INSPIRE MoMent study

Missed opportunities for early infant diagnosis of HIV in rural North-Central Nigeria: A cascade analysis from the INSPIRE MoMent study

Estimativa de adesão ao medicamento antirretroviral coformulado 3 em 1

Cotrimoxazole Prophylaxis Treatment Adherence and Associated Factors Among Human Immunodeficiency Virus (HIV) Exposed Children in Public Hospitals in Ilubabor Zone, Southwest Ethiopia, 2018

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