N A Phiri1,2, H-Y Lee3,4, L Chilenga5, C Mtika1, F Sinyiza1, O Musopole6, R Nyirenda7, J K-L Yu4, A D Harries8,9. 1. Mzuzu Central Hospital, Mzuzu, Malawi. 2. University of Malawi, College of Medicine, Blantyre, Malawi. 3. Luke International, Mzuzu, Malawi. 4. Pingtung Christian Hospital, Pingtung, Taiwan. 5. Chitipa District Hospital, Chitipa, Malawi. 6. Northern Zone Health Office, Ministry of Health, Mzuzu, Malawi. 7. Department of HIV and AIDS, Ministry of Health, Lilongwe, Malawi. 8. International Union Against Tuberculosis and Lung Disease, Paris, France. 9. London School of Hygiene & Tropical Medicine, London, UK.
Abstract
Setting: Mzuzu Central Hospital (MZCH), Mzuzu, and Chitipa District Hospital (CDH), Chitipa, Malawi. Objective: To compare management and outcomes of human immunodeficiency virus (HIV) exposed infants in early infant diagnosis (EID) programmes at MZCH, where DNA polymerase chain reaction (PCR) testing is performed on site, and CDH, where samples are sent to MZCH, between 2013 and 2014. Design: Retrospective cohort study. Results: Of infants enrolled at MZCH (n = 409) and CDH (n = 176), DNA PCR results were communicated to the children's guardians in respectively 56% and 51% of cases. The median time from sample collection to guardians receiving results was 34 days for MZCH and 56 days for CDH. In both hospitals, only half of the dried blood spot (DBS) samples were collected between 6 and 8 weeks. More guardians from MZCH than CDH received test results within 1 month of sample collection (25% vs. 10%). Among the HIV-positive infants, a higher proportion at MZCH (92%) started antiretroviral therapy than at CDH (46%). The relative risk (RR) of death was higher among infants with late DBS collection (RR 1.3, 95%CI 1.0-1.7) or no collection (RR 5.8, 95%CI 4.6-7.2), and when guardians did not receive test results (RR 8.3, 95%CI 5.7-11.9). Conclusion: EID programmes performed equally poorly at both hospitals, and might be helped by point-of-care DNA PCR testing. Better programme implementation and active follow-up might improve infant outcome and retention in care.
Setting: Mzuzu Central Hospital (MZCH), Mzuzu, and Chitipa District Hospital (CDH), Chitipa, Malawi. Objective: To compare management and outcomes of human immunodeficiency virus (HIV) exposed infants in early infant diagnosis (EID) programmes at MZCH, where DNA polymerase chain reaction (PCR) testing is performed on site, and CDH, where samples are sent to MZCH, between 2013 and 2014. Design: Retrospective cohort study. Results: Of infants enrolled at MZCH (n = 409) and CDH (n = 176), DNA PCR results were communicated to the children's guardians in respectively 56% and 51% of cases. The median time from sample collection to guardians receiving results was 34 days for MZCH and 56 days for CDH. In both hospitals, only half of the dried blood spot (DBS) samples were collected between 6 and 8 weeks. More guardians from MZCH than CDH received test results within 1 month of sample collection (25% vs. 10%). Among the HIV-positive infants, a higher proportion at MZCH (92%) started antiretroviral therapy than at CDH (46%). The relative risk (RR) of death was higher among infants with late DBS collection (RR 1.3, 95%CI 1.0-1.7) or no collection (RR 5.8, 95%CI 4.6-7.2), and when guardians did not receive test results (RR 8.3, 95%CI 5.7-11.9). Conclusion: EID programmes performed equally poorly at both hospitals, and might be helped by point-of-care DNA PCR testing. Better programme implementation and active follow-up might improve infant outcome and retention in care.
Authors: G Martínez Pérez; C Metcalf; D Garone; R Coulborn; A D Harries; B Hedt-Gauthier; M Murowa; G S Mwenelupembe; R Van den Bergh; L Triviño Durán Journal: Public Health Action Date: 2014-06-21
Authors: Jordan A Francke; Martina Penazzato; Taige Hou; Elaine J Abrams; Rachel L MacLean; Landon Myer; Rochelle P Walensky; Valériane Leroy; Milton C Weinstein; Robert A Parker; Kenneth A Freedberg; Andrea Ciaranello Journal: J Infect Dis Date: 2016-08-17 Impact factor: 5.226
Authors: David E Bourne; MaryLou Thompson; Linnea L Brody; Mark Cotton; Beverly Draper; Ria Laubscher; M Fareed Abdullah; Jonny E Myers Journal: AIDS Date: 2009-01-02 Impact factor: 4.177
Authors: Avy Violari; Mark F Cotton; Diana M Gibb; Abdel G Babiker; Jan Steyn; Shabir A Madhi; Patrick Jean-Philippe; James A McIntyre Journal: N Engl J Med Date: 2008-11-20 Impact factor: 91.245
Authors: Anirban Chatterjee; Sangeeta Tripathi; Robert Gass; Ndapewa Hamunime; Sok Panha; Charles Kiyaga; Abdoulaye Wade; Matthew Barnhart; Chewe Luo; Rene Ekpini Journal: BMC Public Health Date: 2011-07-13 Impact factor: 3.295
Authors: Catherine G Sutcliffe; Janneke H van Dijk; Francis Hamangaba; Felix Mayani; William J Moss Journal: PLoS One Date: 2014-01-24 Impact factor: 3.240
Authors: Henry Kanyerere; Anthony D Harries; Katie Tayler-Smith; Andreas Jahn; Rony Zachariah; Frank M Chimbwandira; James Mpunga Journal: Trop Med Int Health Date: 2015-11-16 Impact factor: 2.622
Authors: Shaffiq Essajee; Lara Vojnov; Martina Penazzato; Ilesh Jani; George K Siberry; Susan A Fiscus; Jessica Markby Journal: J Int AIDS Soc Date: 2015-12-02 Impact factor: 5.396
Authors: Maryanne Ibrahim; Kenneth Maswabi; Gbolahan Ajibola; Sikhulile Moyo; Michael D Hughes; Oganne Batlang; Maureen Sakoi; Chloe Auletta-Young; Laura Vaughan; Shahin Lockman; Patrick Jean-Philippe; Xu Yu; Matthias Lichterfeld; Daniel R Kuritzkes; Joseph Makhema; Roger L Shapiro Journal: J Int AIDS Soc Date: 2018-05 Impact factor: 6.707
Authors: Udochisom C Anaba; Nadia A Sam-Agudu; Habib O Ramadhani; Nguavese Torbunde; Alash'le Abimiku; Patrick Dakum; Sani H Aliyu; Manhattan Charurat Journal: PLoS One Date: 2019-07-31 Impact factor: 3.240
Authors: Matthew R Sandbulte; Brad J Gautney; May Maloba; Catherine Wexler; Melinda Brown; Natabhona Mabachi; Kathy Goggin; Raphael Lwembe; Niaman Nazir; Thomas A Odeny; Sarah Finocchario-Kessler Journal: Pilot Feasibility Stud Date: 2019-01-25
Authors: Catherine G Sutcliffe; Jane N Mutanga; Nkumbula Moyo; Jessica L Schue; Mutinta Hamahuwa; Philip E Thuma; William J Moss Journal: BMC Infect Dis Date: 2020-03-18 Impact factor: 3.090