Optimization of the vertical transmission prevention program in Guinea: impact of the improvement plan on performance indicators at large-cohort sites.
B + option
Guinea
HIV
PMTCT
Vertical transmission
Journal
AIDS research and therapy
ISSN: 1742-6405
Titre abrégé: AIDS Res Ther
Pays: England
ID NLM: 101237921
Informations de publication
Date de publication:
24 Aug 2024
24 Aug 2024
Historique:
received:
11
06
2024
accepted:
23
07
2024
medline:
26
8
2024
pubmed:
26
8
2024
entrez:
24
8
2024
Statut:
epublish
Résumé
Vertical transmission of HIV remains a major challenge in Guinea, especially, in low-resource rural areas. This paper presents the results of a pilot project designed to enhance the prevention of vertical transmission through a comprehensive improvement plan implemented across 66 large-cohort sites. Data from 66 large-cohort of mother to child transmission prevention (PMTCT) sites from 2019 to 2022 were analysed to compare PMTCT metrics before (2019-2020) and after (2021-2022) the improvement initiative. Key indicators were reviewed, and trends were statistically analysed using Mann‒Whitney tests, with a p value less than 0.05 indicating statistical significance. The implementation of this strategy significantly increased the antiretroviral therapy rate among HIV-positive pregnant women from 66 to 94%, and full antiretroviral prophylaxis coverage was achieved in infants. However, early infant diagnosis via polymerase chain reaction testing falls short of the national target, highlighting deficiencies in laboratory and specimen transport capacities. The study also revealed regional disparities in the use of PMTCT services. The improvement plan effectively enhanced antiretroviral therapy and prophylaxis use, demonstrating the benefits of structured interventions and capacity development. Despite improvements, challenges such as insufficient polymerase chain reaction (PCR) testing and uneven access to services remain. Future initiatives should aim to equip PMTCT sites with essential resources and promote community-driven health-seeking behaviours in underserved areas.
Identifiants
pubmed: 39182113
doi: 10.1186/s12981-024-00639-y
pii: 10.1186/s12981-024-00639-y
doi:
Substances chimiques
Anti-HIV Agents
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
55Informations de copyright
© 2024. The Author(s).
Références
Tiam A, Kassaye SG, Machekano R, Tukei V, Gill MM, Mokone M, Letsie M, Tsietso M, Seipati I, Barasa J, Isavwa A, Tylleskär T, Guay L. Comparison of 6-week PMTCT outcomes for HIV-exposed and HIV-unexposed infants in the era of lifelong ART: results from an observational prospective cohort study. PLoS ONE. 2019;14(12):e0226339. https://doi.org/10.1371/journal.pone.0226339 . PMID: 31877153; PMCID: PMC6932788.
doi: 10.1371/journal.pone.0226339
pubmed: 31877153
pmcid: 6932788
Gumede-Moyo S, Filteau S, Munthali T, Todd J, Musonda P. Implementation effectiveness of revised (post-2010) World Health Organization guidelines on prevention of mother-to-child transmission of HIV using routinely collected data in sub-saharan Africa: a systematic literature review. Med (Baltim). 2017;96(40):e8055. https://doi.org/10.1097/MD.0000000000008055 . PMID: 28984760; PMCID: PMC5737996.
doi: 10.1097/MD.0000000000008055
Larson BA, Tsikhutsu I, Bii M, Halim N, Agaba P, Sugut W, Muli J, Sawe F. The effects of revised peer-counselor support on the PMTCT cascade of care: results from a cluster-randomized trial in Kenya (the EMMA study). BMC Infect Dis. 2023;23:257. https://doi.org/10.1186/s12879-023-08246-4 .
doi: 10.1186/s12879-023-08246-4
pubmed: 37098468
pmcid: 10127503
Alamdo AG, King EJ. Retention in Care and Health outcomes of Infant exposed to HIVin a Prevention of Mother-to-child transmission of HIV (PMTCT) Cohort in Addis Ababa, Ethiopia. HIV AIDS (Auckl). 2021;13:171–9. https://doi.org/10.2147/HIV.S286347 . PMID: 33603493; PMCID: PMC7882432.
Dinis A, Augusto O, Ásbjörnsdóttir KH, Crocker J, Gimbel S, Inguane C, Ramiro I, Coutinho J, Agostinho M, Cruz E, Amaral F, Tavede E, Isidoro X, Sidat Y, Nassiaca R, Murgorgo F, Cuembelo F, Hazim CE, Sherr K. Association between service readiness and PMTCT cascade effectiveness: a 2018 cross-sectional analysis from Manica Province, Mozambique. BMC Health Serv Res. 2022;22:1422. https://doi.org/10.1186/s12913-022-08840-3 .
doi: 10.1186/s12913-022-08840-3
pubmed: 36443742
pmcid: 9703771
van Lettow M, Bedell R, Mayuni I, Mateyu G, Landes M, Chan AK, van Schoor V, Beyene T, Harries AD, Chu S, Mganga A, van Oosterhout JJ. Towards elimination of mother-to-child transmission of HIV: performance of different models of care for initiating lifelong antiretroviral therapy for pregnant women in Malawi (option B
doi: 10.7448/ias.17.1.18994
pubmed: 25079437
pmcid: 4116618
Siegfried N, van der Merwe L, Brocklehurst P, Sint TT. Antiretrovirals for reducing the risk of mother-to-child transmission of HIV infection. Cochrane Database Syst Rev. 2011:CD003510. https://doi.org/10.1002/14651858.CD003510.pub3 .
Ghoma Linguissi LS, Sagna T, Soubeiga ST, Gwom LC, Nkenfou CN, Obiri-Yeboah D, Ouattara AK, Pietra V, Simpore J. Prevention of mother-to-child transmission (PMTCT) of HIV: a review of the achievements and challenges in Burkina-Faso. HIV AIDS (Auckl). 2019;11:165–77. https://doi.org/10.2147/HIV.S204661 . PMID: 31440104; PMCID: PMC6664853.
doi: 10.2147/HIV.S204661
pubmed: 31440104
WHO. Use of antiretroviral drugs for treating pregnant women and preventing HIV infection in infants. Geneva, Switzerland: WHO. 2012:8 Report No.: WHO/HIV/2012.6. http://www.who.int/hiv/pub/mtct/programmatic_update2012/en/ . Accessed November 10, 2018. [Google Scholar].
King R, Matovu JN, Rujumba J, Wavamunno P, Amone A, Gabagaya G, Fowler MG, Homsy J, Seeley J, Musoke P. PMTCT option B + 2012 to 2018 - taking stock: barriers and strategies to improve adherence to option B + in urban and rural Uganda. Afr J AIDS Res. 2020;19:135–46. https://doi.org/10.2989/16085906.2020.1760325 .
doi: 10.2989/16085906.2020.1760325
pubmed: 32780677
Lumbantoruan C, Kermode M, Giyai A, Ang A, Kelaher M. Understanding women’s uptake and adherence in option B + for prevention of mother-to-child HIV transmission in Papua, Indonesia: a qualitative study. PLoS ONE. 2018;13:e0198329. https://doi.org/10.1371/journal.pone.0198329 .
doi: 10.1371/journal.pone.0198329
pubmed: 29912960
pmcid: 6005458
Asefa EY, Dirirsa DE. Level of good adherence on option B + PMTCT and associated factors among HIV positive pregnant and lactating mothers in public health facilities of Ilu Abba Bor and Buno Bedele zones, Oromia Regional State, SouthWestern Ethiopia, 2018. HIV AIDS (Auckl). 2020;12:789–98. https://doi.org/10.2147/hiv.s283184 .
doi: 10.2147/hiv.s283184
Mazanderani AH, Kufa T, Technau KG, Strehlau R, Patel F, Shiau S, Burke M, Kuhn L, Abrams EJ, Sherman GG. Early infant diagnosis HIV-1 PCR cycle-threshold predicts infant viral load at birth. J Clin Virol. 2019;114:21–5. https://doi.org/10.1016/j.jcv.2019.03.009 .
doi: 10.1016/j.jcv.2019.03.009
Olana T, Bacha T, Worku W, Tadesse BT. Early infant diagnosis of HIV infection using DNA-PCR at a referral center: an 8 years retrospective analysis. AIDS Res Ther. 2016;13:29. https://doi.org/10.1186/s12981-016-0112-0 .
doi: 10.1186/s12981-016-0112-0
pubmed: 27617023
pmcid: 5016933
Mazanderani AH, Technau KG, Hsiao NY, Maritz J, Carmona S, Sherman GG. Recommendations for the management of indeterminate HIV PCR results within South Africa’s early infant diagnosis program. South Afr J HIV Med. 2016;17:451. https://doi.org/10.4102/sajhivmed.v17i1.451 .
doi: 10.4102/sajhivmed.v17i1.451
pubmed: 29568610
pmcid: 5843082
Bwirire LD, Fitzgerald M, Zachariah R, Chikafa V, Massaquoi M, Moens M, Kamoto K, Schouten EJ. Reasons for loss to follow-up among mothers registered in a prevention-of-mother-to-child transmission program in rural Malawi. Trans R Soc Trop Med Hyg. 2008;102:1195–200. https://doi.org/10.1016/j.trstmh.2008.04.002 .
doi: 10.1016/j.trstmh.2008.04.002
pubmed: 18485431
Kanyuuru L, Kabue M, Ashengo TA, Ruparelia C, Mokaya E, Malonza I. RED for PMTCT: an adaptation of immunization’s reaching every district approach increases coverage, access, and utilization of PMTCT care in Bondo District, Kenya. Int J Gynaecol Obstet. 2015;130(Suppl 2):S68–73. https://doi.org/10.1016/j.ijgo.2015.04.002 .
doi: 10.1016/j.ijgo.2015.04.002
pubmed: 26115861
Woldesenbet S, Cheyip M, Lombard C, Manda S, Ayalew K, Kufa T, Puren A. Progress towards the UNAIDS 95-95-95 targets among pregnant women in South Africa: results from the 2017 and 2019 national antenatal HIV sentinel surveys. PLoS ONE. 2022;17:e0271564. https://doi.org/10.1371/journal.pone.0271564 .
doi: 10.1371/journal.pone.0271564
pubmed: 35862306
pmcid: 9302844
Masereka EM, Ngabirano TD, Osingada CP, Wiltshire CS, Castelnuovo B, Kiragga AN. Increasing retention of HIV positive pregnant and breastfeeding mothers on option-b plus by upgrading and providing full time HIV services at a lower health facility in rural Uganda. BMC Public Health. 2019;19:950. https://doi.org/10.1186/s12889-019-7280-5 .
doi: 10.1186/s12889-019-7280-5
pubmed: 31307455
pmcid: 6631982
Samreth S, Keo V, Tep R, Ke A, Ouk V, Ngauv B, Mam S, Ferradini L, Ly PS, Mean CV, Delvaux T. Access to prevention of mother-to-child transmission of HIV along HIV services cascade through integrated active case management in 15 operational districts in Cambodia. J Int AIDS Soc. 2019;22:e25388. https://doi.org/10.1002/jia2.25388 .
doi: 10.1002/jia2.25388
pubmed: 31631583
pmcid: 6801228
Soubeiga ST, Compaore R, Djigma F, Zagre N, Assengone E, Traore L, Diarra B, Bisseye C, Ouermi D, Sagna T, Karou S, Pietra V, Simpore J. Evaluation of antiretroviral therapy on mother to child transmission HIV in HIV-1 positive pregnant women: case of St. Camillus medical center in Ouagadougou, Burkina Faso. Pan Afr Med J. 2015;20:399. https://doi.org/10.11604/pamj.2015.20.399.5627 .
doi: 10.11604/pamj.2015.20.399.5627
pubmed: 26301003
pmcid: 4524915
Ayanian JZ, Markel H. Donabedian’s lasting framework for health care quality. N Engl J Med. 2016;375:205–7. https://doi.org/10.1056/NEJMp1605101 .
doi: 10.1056/NEJMp1605101
pubmed: 27468057
Granato SA, Gloyd S, Robinson J, Dali SA, Ahoba I, Aka D, Kouyaté S, Billy DA, Kalibala S, Koné A. Results from a rapid national assessment of services for the prevention of mother-to-child transmission of HIV in Côte d’Ivoire. J Int AIDS Soc. 2016;19:20838. https://doi.org/10.7448/ias.19.5.20838 .
doi: 10.7448/ias.19.5.20838
pubmed: 27443269
pmcid: 4956736
Gamell A, Letang E, Jullu B, Mwaigomole G, Nyamtema A, Hatz C, Battegay M, Tanner M. Uptake of guidelines on prevention of mother-to-child transmission of HIV in rural Tanzania: time for change. Swiss Med Wkly. 2013;143:w13775. https://doi.org/10.4414/smw.2013.13775 .
doi: 10.4414/smw.2013.13775
pubmed: 23519621
Bhardwaj S, Barron P, Pillay Y, Treger-Slavin L, Robinson P, Goga A, Sherman G. Elimination of mother-to-child transmission of HIV in South Africa: rapid scale-up using quality improvement. S Afr Med J. 2014;104:239–43. https://doi.org/10.7196/samj.7605 .
doi: 10.7196/samj.7605
pubmed: 24893500
Radebe L, Mazanderani AH, Sherman GG. Indeterminate HIV PCR results within South Africa’s early infant diagnosis program, 2010–2019. Clin Microbiol Infect. 2022;28:e6097–13. https://doi.org/10.1016/j.cmi.2021.08.002 .
doi: 10.1016/j.cmi.2021.08.002
Technau KG, Kuhn L, Coovadia A, Carmona S, Sherman G. Improving early identification of HIV-infected neonates with birth PCR testing in a large urban hospital in Johannesburg, South Africa: successes and challenges. J Int AIDS Soc. 2017;20:21436. https://doi.org/10.7448/ias.20.01/21436 .
doi: 10.7448/ias.20.01/21436
pubmed: 28406596
pmcid: 5515050
Technau KG, Mazanderani AH, Kuhn L, Hans L, Strehlau R, Abrams EJ, Conradie M, Coovadia A, Mbete N, Murnane PM, Patel F, Shiau S, Tiemessen CT, Sherman GG. Prevalence and outcomes of HIV-1 diagnostic challenges during universal birth testing - an urban South African observational cohort. J Int AIDS Soc. 2017;20(Suppl 6):21761. https://doi.org/10.7448/IAS.20.7.21761 . PMID: 28872276; PMCID: PMC6192462.].
doi: 10.7448/IAS.20.7.21761
pubmed: 28872276
pmcid: 6192462
Karugaba G, Simpson J, Mathuba B, Phoi O, Regonamanye T, Mathuba K, Dintwa E, Nkomo B, Ramaabya D, Pule MR, Matshaba M. The barriers and facilitators of HIV-exposed infant testing as perceived by HIV-positive mothers in Botswana: a qualitative study. PLoS ONE. 2022;17(8):e0273777. https://doi.org/10.1371/journal.pone.0273777 . PMID: 36044527; PMCID: PMC9432723.
doi: 10.1371/journal.pone.0273777
pubmed: 36044527
pmcid: 9432723
Chibwesha CJ, Mollan KR, Ford CE, Shibemba A, Saha PT, Lusaka M, Mbewe F, Allmon AG, Lungu R, Spiegel HML, Mweni E, Mwape H, Kankasa C, Chi BH, Stringer JSA. A randomized trial of point-of-care early infant human immunodeficiency virus (HIV) diagnosis in Zambia. Clin Infect Dis. 2022;75:260–8. https://doi.org/10.1093/cid/ciab923 .
doi: 10.1093/cid/ciab923
pubmed: 34718462
Tembo T, Dale H, Muttau N, Itoh M, Williamson D, Mwamba C, Manasyan A, Beard RS, Cox MH, Herce ME. Testing can be done anywhere: a qualitative assessment of targeted community-based point-of-care early infant diagnosis of HIV in Lusaka, Zambia. Glob Health Sci Pract. 2022;10:e2100723. https://doi.org/10.9745/ghsp-d-21-00723 .
doi: 10.9745/ghsp-d-21-00723
pubmed: 36332072
pmcid: 9242615
Ochodo EA, Guleid F, Deeks JJ, Mallett S. Point-of-care tests detecting HIV nucleic acids for diagnosis of HIV-1 or HIV-2 infection in infants and children aged 18 months or less. Cochrane Database Syst Rev. 2021;8:CD013207. https://doi.org/10.1002/14651858.CD013207.pub2 .
doi: 10.1002/14651858.CD013207.pub2
pubmed: 34383961
Ghadrshenas A, Ben Amor Y, Chang J, Dale H, Sherman G, Vojnov L, Young P, Yogev R. Improved access to early infant diagnosis is a critical part of a child-centric prevention of mother-to-child transmission agenda. Aids. 2013;27(Suppl 2):S197–205. https://doi.org/10.1097/qad.0000000000000104 .
doi: 10.1097/qad.0000000000000104
pubmed: 24361629
Phiri NA, Lee HY, Chilenga L, Mtika C, Sinyiza F, Musopole O, Nyirenda R, Yu JK, Harries AD. Early infant diagnosis and outcomes in HIV-exposed infants at a central and a district hospital, Northern Malawi. Public Health Action. 2017;7(2):83–9. https://doi.org/10.5588/pha.16.0119 . PMID: 28695079; PMCID: PMC5493108.
doi: 10.5588/pha.16.0119
pubmed: 28695079
pmcid: 5493108
Cromwell EA, Dow AE, Low D, Chirambo C, Heyderman RS, Dube Q, Van Rie A. Barriers to successful early infant diagnosis of HIV infection at primary care level in Malawi. Pediatr Infect Dis J. 2015;34(3):273-5. https://doi.org/10.1097/INF.0000000000000625 . PMID: 25742076.
Sam-Agudu NA, Isah C, Fan-Osuala C, Erekaha S, Ramadhani HO, Anaba U, Adeyemi OA, Manji-Obadiah G, Lee D, Cornelius LJ, Charurat M. Correlates of facility delivery for rural HIV-positive pregnant women enrolled in the MoMent Nigeria prospective cohort study. BMC Pregnancy Childbirth. 2017;17(1):227. https://doi.org/10.1186/s12884-017-1417-2 . PMID: 28705148; PMCID: PMC5512933.
doi: 10.1186/s12884-017-1417-2
pubmed: 28705148
pmcid: 5512933