Early infant diagnosis of HIV in Myanmar: call for innovative interventions to improve uptake and reduce turnaround time

Thiha, Soe; Shewade, Hemant Deepak; Philip, Sairu; Aung, Thet Ko; Kyaw, Nang Thu Thu; Oo, Myo Minn; Kyaw, Khine Wut Yee; War, May Wint; Oo, Htun Nyunt

doi:10.1080/16549716.2017.1319616

Cited by 11 publications

(16 citation statements)

References 12 publications

(16 reference statements)

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“…The recommendations of our previous studies are similar to those of the current study. Therefore, this study further lends support to the recommendations of our previous study [11].…”

Section: Recommendations For Policy and Practicesupporting

confidence: 89%

“…The limitations were similar to our previous study [11]. Dates for sample receipt and testing at PHL were not routinely recorded.…”

Section: Strengths and Limitationsmentioning

confidence: 72%

“…Under the IHC program in Myanmar, more than two-thirds of HIV-exposed babies whose sample was sent for PCR received their results after seven weeks of sample collection or did not receive the results at all. Among these, only two results were not dispatched from the PCR facility [11]. Prolonged TAT or nonreceipt of results was uniformly high over all subgroups.…”

Section: Discussionmentioning

confidence: 98%

“…The results are given to mother/care giver during the scheduled follow-up visit at the ART center (one month after sample collection). Further details of EID under the IHC program have been reported elsewhere [11].…”

Section: Eid Under Ihc Programmentioning

confidence: 99%

“…Timely uptake of EID decreased if babies' mothers were not on ART before pregnancy, and their ART center was far away from the PCR facility. Among the samples sent for EID from respective ART centers, 33% of the results did not reach the mother [11].…”

mentioning

confidence: 99%

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Factors associated with long turnaround time for early infant diagnosis of HIV in Myanmar

Thiha¹,

Shewade²,

Philip

et al. 2017

Global Health Action

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Background: A previous review of early infant diagnosis (EID) using polymerase chain reaction technology (PCR) under integrated HIV care (IHC) program in Myanmar revealed a low uptake of timely (within 6 to 8 weeks of babies’ age) EID and a long turnaround time (TAT) of receiving results. Objective: This study aimed to determine the proportion and factors associated with the composite outcome of a long TAT (≥7 weeks; from sample collection to receipt of result by mother) or nonreceipt of result among HIV-exposed babies whose blood samples were collected for PCR at <9 months of age under the IHC program, Myanmar (2013–15). Methods: Cohort study involving record review of routinely collected data. A predictive Poisson regression model with robust variance estimates was fitted for risk factors of long TAT or nonreceipt of result. Results: Blood samples of 1 000 babies were collected; among them, long TAT or nonreceipt of results was seen in 690 (69%), and this was more than 50% across all subgroups. Babies with a mother’s CD4 count of 100–350 cells/mm3 at enrollment [adjusted RR (0.95 confidence intervals, CI): 0.8 (0.7, 0.9)] had a 20% lower risk of long TAT or nonreceipt of results when compared with ≥350 cells/mm3. Distance between ART center and PCR facility ≥105 km [adjusted RR (0.95 CI): 1.2 (1.1, 1.4)], when compared with <105 km, was associated with 20% higher risk of long TAT or nonreceipt of results. Conclusions: The proportion of babies with long TAT or nonreceipt of result by the mother was high. Point-of-care testing for EID may reduce TAT/nonreceipt of results by the mother. Health system, laboratory, and logistic factors such as sample transportation, laboratory procedures, and result dispatching associated with long TAT should be further explored.

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“…The recommendations of our previous studies are similar to those of the current study. Therefore, this study further lends support to the recommendations of our previous study [11].…”

Section: Recommendations For Policy and Practicesupporting

confidence: 89%

“…The limitations were similar to our previous study [11]. Dates for sample receipt and testing at PHL were not routinely recorded.…”

Section: Strengths and Limitationsmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 98%

Section: Eid Under Ihc Programmentioning

confidence: 99%

mentioning

confidence: 99%

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Factors associated with long turnaround time for early infant diagnosis of HIV in Myanmar

Thiha¹,

Shewade²,

Philip

et al. 2017

Global Health Action

Self Cite

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Access, timeliness and retention for HIV testing under early infant diagnosis (EID) program, India

Kamble

Gawde

Goel

et al. 2023

Sci Rep

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Early Infant Diagnosis of HIV infection services are crucial for managing the perinatally acquired HIV infection. Assessing the performance of the EID services and its underlying determinants is important for the National AIDS Control Program, India. The objectives of this study were to find out access to HIV testing, the timeliness of the testing cascade, and the proportion of HIV exposed infants who are followed up to 18 months for a definitive diagnosis of HIV. The study design was a mixed method. A total of 11 states accounting for 80% of HIV-positive pregnant women were selected. Program records from a total of 62 Integrated counselling and testing centres (ICTCs) served as the source of information. The qualitative component included interviews of program managers at the state and district level, service providers at the ICTC level, and caregivers of HIV exposed infants. In the sampled 62 ICTCs, 78% of the HIV exposed infants had at least one HIV test. Of the infants who had HIV tests, 50% had at first sample collected by 8 weeks of age. The median turnaround time from sample collection to DNA PCR testing was 36 (IQR 19–70) days and that to next sample collection in case of detection of virus in the first sample was 66 (IQR 55–116) days. At 18 months of age, 544 (62%) HIV exposed infants were retained in the EID testing cascade. A total of 30 infants were diagnosed with HIV at a median age of 421 (IQR 149–650) days. More than three fourth of the HIV exposed infants had access to early infant diagnosis (EID) services. Both demand and supply-side factors contribute to access, timeliness and retention and there is a need to address these factors.

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Accuracy and Operational Characteristics of Xpert Human Immunodeficiency Virus Point-of-Care Testing at Birth and Until Week 6 in Human Immunodeficiency Virus–exposed Neonates in Tanzania

Sabi

Mahiga

Mgaya

et al. 2018

Clinical Infectious Diseases

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Early infant diagnosis of HIV in Myanmar: call for innovative interventions to improve uptake and reduce turnaround time

Cited by 11 publications

References 12 publications

Factors associated with long turnaround time for early infant diagnosis of HIV in Myanmar

Factors associated with long turnaround time for early infant diagnosis of HIV in Myanmar

Access, timeliness and retention for HIV testing under early infant diagnosis (EID) program, India

Accuracy and Operational Characteristics of Xpert Human Immunodeficiency Virus Point-of-Care Testing at Birth and Until Week 6 in Human Immunodeficiency Virus–exposed Neonates in Tanzania

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