Early infant diagnosis of HIV in Myanmar: call for innovative interventions to improve uptake and reduce turnaround time
Background: In collaboration with the national AIDS program, early infant diagnosis (EID) is implemented by Integrated HIV Care (IHC) program through its anti-retroviral therapy (ART) centers across 10 cities in five states and regions of Myanmar. Blood samples from the ART centers are sent using pu...
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doaj-24dc383d29814a2882bd599b2027d0a72020-11-24T21:40:16ZengTaylor & Francis GroupGlobal Health Action1654-97161654-98802017-01-0110110.1080/16549716.2017.13196161319616Early infant diagnosis of HIV in Myanmar: call for innovative interventions to improve uptake and reduce turnaround timeSoe Thiha0Hemant Deepak Shewade1Sairu Philip2Thet Ko Aung3Nang Thu Thu Kyaw4Myo Minn Oo5Khine Wut Yee Kyaw6May Wint War7Htun Nyunt Oo8International Union Against Tuberculosis and Lung Disease (The Union)International Union Against Tuberculosis and Lung Disease (The Union)Government T.D. Medical CollegeInternational Union Against Tuberculosis and Lung Disease (The Union)International Union Against Tuberculosis and Lung Disease (The Union)International Union Against Tuberculosis and Lung Disease (The Union)International Union Against Tuberculosis and Lung Disease (The Union)Ministry of Health and SportsMinistry of Health and SportsBackground: In collaboration with the national AIDS program, early infant diagnosis (EID) is implemented by Integrated HIV Care (IHC) program through its anti-retroviral therapy (ART) centers across 10 cities in five states and regions of Myanmar. Blood samples from the ART centers are sent using public transport to a centralized PCR facility. Objectives: Among HIV-exposed babies <9 months at enrolment into IHC program (2013–15), to describe the EID cascade (enrolment, sample collection for PCR, result receipt by mother, HIV diagnosis and ART initiation) and factors associated with delayed (>8 weeks of age) or no blood sample collection for EID. Methods: Retrospective cohort study involving record review. A predictive poisson regression model with robust variance estimates was fitted for risk factors of delayed or no sample collection. Results: Of 1349 babies, 523 (39%) of the babies’ mothers were on ART before pregnancy. Timely uptake of EID (<8 weeks of age) was 47% (633/1349); sample collection was delayed in 27% (367/1349) and not done in 26% (349/1349) babies. Among samples collected (n = 1000), 667 results were received by the mother; 52 (5%) were HIV-infected; among them 42 (81%) were initiated on ART. Median (IQR) turnaround time from sample collection to result receipt by mother and time to initiate ART from result receipt by mother was 7 (4,12) and 8.5 (6,16) weeks, respectively. Mothers not on ART before pregnancy and distance of ART center from PCR facility (more than 128 km) were the risk factors of delayed or no sample collection. Conclusions: Improving provision of ART to mothers (through universal ‘test and treat’) is urgently required, which has the potential to improve the timely uptake of EID as well. Interventions to reduce turnaround times, like point of care EID testing and/or systematic use of mobile technology to communicate results, are needed.http://dx.doi.org/10.1080/16549716.2017.1319616Early diagnosis/utilizationuptake of EIDturnaround timeHIV-exposed babiesSORT IT |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Soe Thiha Hemant Deepak Shewade Sairu Philip Thet Ko Aung Nang Thu Thu Kyaw Myo Minn Oo Khine Wut Yee Kyaw May Wint War Htun Nyunt Oo |
spellingShingle |
Soe Thiha Hemant Deepak Shewade Sairu Philip Thet Ko Aung Nang Thu Thu Kyaw Myo Minn Oo Khine Wut Yee Kyaw May Wint War Htun Nyunt Oo Early infant diagnosis of HIV in Myanmar: call for innovative interventions to improve uptake and reduce turnaround time Global Health Action Early diagnosis/utilization uptake of EID turnaround time HIV-exposed babies SORT IT |
author_facet |
Soe Thiha Hemant Deepak Shewade Sairu Philip Thet Ko Aung Nang Thu Thu Kyaw Myo Minn Oo Khine Wut Yee Kyaw May Wint War Htun Nyunt Oo |
author_sort |
Soe Thiha |
title |
Early infant diagnosis of HIV in Myanmar: call for innovative interventions to improve uptake and reduce turnaround time |
title_short |
Early infant diagnosis of HIV in Myanmar: call for innovative interventions to improve uptake and reduce turnaround time |
title_full |
Early infant diagnosis of HIV in Myanmar: call for innovative interventions to improve uptake and reduce turnaround time |
title_fullStr |
Early infant diagnosis of HIV in Myanmar: call for innovative interventions to improve uptake and reduce turnaround time |
title_full_unstemmed |
Early infant diagnosis of HIV in Myanmar: call for innovative interventions to improve uptake and reduce turnaround time |
title_sort |
early infant diagnosis of hiv in myanmar: call for innovative interventions to improve uptake and reduce turnaround time |
publisher |
Taylor & Francis Group |
series |
Global Health Action |
issn |
1654-9716 1654-9880 |
publishDate |
2017-01-01 |
description |
Background: In collaboration with the national AIDS program, early infant diagnosis (EID) is implemented by Integrated HIV Care (IHC) program through its anti-retroviral therapy (ART) centers across 10 cities in five states and regions of Myanmar. Blood samples from the ART centers are sent using public transport to a centralized PCR facility. Objectives: Among HIV-exposed babies <9 months at enrolment into IHC program (2013–15), to describe the EID cascade (enrolment, sample collection for PCR, result receipt by mother, HIV diagnosis and ART initiation) and factors associated with delayed (>8 weeks of age) or no blood sample collection for EID. Methods: Retrospective cohort study involving record review. A predictive poisson regression model with robust variance estimates was fitted for risk factors of delayed or no sample collection. Results: Of 1349 babies, 523 (39%) of the babies’ mothers were on ART before pregnancy. Timely uptake of EID (<8 weeks of age) was 47% (633/1349); sample collection was delayed in 27% (367/1349) and not done in 26% (349/1349) babies. Among samples collected (n = 1000), 667 results were received by the mother; 52 (5%) were HIV-infected; among them 42 (81%) were initiated on ART. Median (IQR) turnaround time from sample collection to result receipt by mother and time to initiate ART from result receipt by mother was 7 (4,12) and 8.5 (6,16) weeks, respectively. Mothers not on ART before pregnancy and distance of ART center from PCR facility (more than 128 km) were the risk factors of delayed or no sample collection. Conclusions: Improving provision of ART to mothers (through universal ‘test and treat’) is urgently required, which has the potential to improve the timely uptake of EID as well. Interventions to reduce turnaround times, like point of care EID testing and/or systematic use of mobile technology to communicate results, are needed. |
topic |
Early diagnosis/utilization uptake of EID turnaround time HIV-exposed babies SORT IT |
url |
http://dx.doi.org/10.1080/16549716.2017.1319616 |
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