Fifteen years of HIV and syphilis outcomes among a prevention of mother‐to‐child transmission program in Haiti: from monotherapy to Option B+

Deschamps, Marie Marcelle; Jannat‐Khah, Deanna; Rouzier, Vanessa; Bonhomme, Jerry; Julma, Pierrot; Lee, Myung Hee; Abrams, Elaine J.; Pape, Jean William; McNairy, Margaret L.

doi:10.1111/tmi.13075

Cited by 3 publications

(4 citation statements)

References 29 publications

(44 reference statements)

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“…Upon entry, women received a physical examination, World Health Organization (WHO) staging, a CD4 count test, tetanus vaccination, and antenatal assessment, including collection of sociodemographics. 24 Follow‐up appointments were scheduled every 4 weeks until 8 months of gestation, and weekly thereafter. During these visits, BP was measured by the auscultation method using a manual sphygmomanometer with a stethoscope, and medication refills were dispensed (ferrous sulphate, folic acid, and ARV medications, if indicated).…”

Section: Methodsmentioning

confidence: 99%

“…Participants were pregnant WLWH in the PMTCT program at the GHESKIO clinic, a nongovernmental organization and the largest provider of HIV and PMTCT services in Haiti. Upon entry, women received a physical examination, World Health Organization (WHO) staging, a CD4 count test, tetanus vaccination, and antenatal assessment, including collection of sociodemographics 24 . Follow‐up appointments were scheduled every 4 weeks until 8 months of gestation, and weekly thereafter.…”

Section: Methodsmentioning

confidence: 99%

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Estimated blood pressure trajectories and hypertension patterns among pregnant women living with HIV, Haiti, 2007–2017

Tymejczyk

Deschamps

Rouzier

et al. 2022

J of Clinical Hypertension

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Hypertension in pregnancy is a key driver of mortality and morbidity among Haitian women. HIV infection and treatment may worsen hypertension and increase cardiovascular disease risk. The authors examined blood pressure and hypertension patterns among 1965 women (2306 pregnancies ending in live births) in a prevention of maternal‐to‐child transmission (PMTCT) program in Port‐au‐Prince, Haiti, between 2007 and 2017. Hypertension was defined as blood pressure ≥140/90 mm Hg on two consecutive visits. Latent class analysis assessed trajectories of mean arterial pressure (MAP) and multinomial ordinal logistic regression examined factors associated with higher trajectories. Between 2007–2009 and 2013–2016, hypertension at PMTCT entry increased from 1.3% to 3.8% (p = .005), while incidence at any time during PMTCT follow‐up increased from 5.0 to 16.1 per 100 person‐years (p < .001). Hypertension detected ≤20 weeks and > 20 weeks of gestation (possible gestational hypertension) increased from 1.1% to 3.5% (p = .003) and from 2.3% to 6.9% (p < .001), respectively. Five MAP trajectories ranged from low‐stable to high‐increasing. In multivariable analysis controlling for history of antiretroviral therapy, age, parity, and weight, program entry in more recent years was associated with greater odds of higher MAP trajectory (adjusted odds ratio for 2013–2016 vs. 2007–2009 = 3.1, 95% confidence interval: 1.7–5.6). The increasing prevalence and incidence of hypertension highlight a need for screening and management prior to PMTCT entry and during follow‐up. In a population with limited access to chronic disease care, and where many deliveries occur outside of a clinical setting, the period of PMTCT follow‐up represents an opportunity to diagnose and initiate management of preexisting and pregnancy‐related hypertension.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Estimated blood pressure trajectories and hypertension patterns among pregnant women living with HIV, Haiti, 2007–2017

Tymejczyk

Deschamps

Rouzier

et al. 2022

J of Clinical Hypertension

Self Cite

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“…in either CB or sera and Determine on sera. These results are important because RDTs has been widely implemented in Colombia [34] and other low and middle income countries [13] for the screening of syphilis in pregnant women independently of HIV status and the current Colombian HIV care guidelines recommends their use in the HIV care programs [16]. We also identified several sources of heterogeneity in the sensitivity of RDTs that may explain the highly heterogeneous results of previous field validation studies [10,11] with prediction intervals derived from random effects models for meta-analysis ranging from 57% to 96% [11].…”

Section: Plos Onementioning

confidence: 99%

“…RDTs have been implemented at the point-of-care as part of programs for prevention of mother-to-child transmission of syphilis, and have increased coverage and reduced the time to treatment [9]. These tests, have also been implemented within sexually transmitted disease clinics and as part of HIV care programs [12][13][14][15]. In Colombia, national HIV care guidelines recommend the use of treponemal RDTs for screening of syphilis in PLWH [16], despite a previous systematic review highlighting the insufficient evidence for their use in this population [10].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic performance of two rapid tests for syphilis screening in people living with HIV in Cali, Colombia

Luna¹,

Romero-Rosas²,

Peña³

et al. 2023

PLoS ONE

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Introduction There is insufficient evidence supporting the use of rapid diagnostic tests (RDTs) for syphilis in people living with HIV (PLWH). We evaluated the diagnostic performance of two commercially available RDTs (Bioline and Determine) in PLWH in Cali, Colombia. Methods A cross-sectional field validation study on consecutive adults with confirmed HIV diagnosis attending three outpatient clinics. Both RDTs were performed on capillary blood (CB), obtained by finger prick, and sera, by venipuncture. A combination of treponemal enzyme linked immunosorbent assay (ELISA) and Treponema pallidum haemagglutination assay (TPHA) on serum samples was the reference standard. Rapid plasma reagin (RPR) and clinical criteria were added to define active syphilis. Sensitivity and specificity, predictive values and likelihood ratios (LR) of RDTs were estimated with their corresponding 95% confidence interval (95% CI). Stratified analyses by sample type, patient characteristics, non-treponemal titers, operator and re-training were performed. Results 244 PLWH were enrolled, of whom 112 (46%) had positive treponemal reference tests and 26/234 (11.1%) had active syphilis. The sensitivities of Bioline on CB and sera were similar (96.4% vs 94.6%, p = 0.6). In contrast, Determine had a lower sensitivity on CB than sera (87.5% vs 99.1%, p<0.001). Sensitivities were lower in PLWH not receiving ART (Bioline 87.1% and Determine 64.5%, p<0.001) and for one of the operators (Bioline 85% and Determine 60%, p<0.001). Specificities of the RDTs were > 95% in most analyses. Predictive values were 90% or higher. For active syphilis, the RDTs showed a similar performance pattern but with decreased specificities. Conclusion The studied RDTs have an excellent performance in PLWH to screen for syphilis and potentially for active syphilis, yet Determine performs better on sera than CB. Patient characteristics and potential difficulties operators may face in acquiring enough blood volume from finger pricks should be considered for the implementation and the interpretation of RDTs.

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Sociodemographic characteristics of children born to HIV-infected mothers in Western French Guiana

Ahidan¹,

Buende²,

Osei³

et al. 2023

Journal of Infection and Public Health

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Fifteen years of HIV and syphilis outcomes among a prevention of mother‐to‐child transmission program in Haiti: from monotherapy to Option B+

Abstract: Despite dramatic reductions in MTCT in Haiti, interventions are needed to improve retention to achieve MTCT elimination of HIV and syphilis.

Cited by 3 publications

References 29 publications

Estimated blood pressure trajectories and hypertension patterns among pregnant women living with HIV, Haiti, 2007–2017

Estimated blood pressure trajectories and hypertension patterns among pregnant women living with HIV, Haiti, 2007–2017

Diagnostic performance of two rapid tests for syphilis screening in people living with HIV in Cali, Colombia

Sociodemographic characteristics of children born to HIV-infected mothers in Western French Guiana

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