Integrating Prevention of Mother-to-Child Transmission of HIV Care into General Maternal Child Health Care in Western Kenya

Berlacher, Michelle; Mercer, Tim; Apondi, Edith; Mwangi, Winfred; Were, Edwin; McHenry, Megan S.

doi:10.21106/ijma.429

Cited by 9 publications

(10 citation statements)

References 13 publications

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“…A mentor mother program was also initiated in 2013 for counselling and peer-support of pregnant women living with HIV 6 . During the trial, beginning in 2015, PMTCT care was integrated with regular ANC care with the aim of decreasing HIV related stigma due to visiting HIV specific clinics 6 , 50 . Another study from Kenya observed improvements in the uptake of EID HIV testing after implementation of a mentor mother and defaulter tracing program to improve PMTCT care 21 .…”

Section: Discussionmentioning

confidence: 99%

The effect of weekly interactive text-messaging on early infant HIV testing in Kenya: a randomised controlled trial (WelTel PMTCT)

Nordberg

Mwangi

Kop

et al. 2021

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Mother-to-child transmission of HIV remains a significant concern in Africa despite earlier progress. Early infant diagnosis (EID) of HIV is crucial to reduce mortality among infected infants through early treatment initiation. However, a large proportion of HIV-exposed infants are still not tested in Kenya. Our objective was to investigate whether weekly interactive text-messages improved prevention of mother-to-child transmission (PMTCT) of HIV care outcomes including EID HIV testing. This multicentre, parallel-group, randomised, open-label trial included six antenatal care clinics across western Kenya. Pregnant women living with HIV, aged 18 years or older, with mobile phone access, were randomised in a 1:1 ratio to weekly text messages that continued until 24 months postpartum, asking “How are you?” (“Mambo?”) to which they were asked to respond within 48 h, or a control group. Healthcare workers contacted participants reporting problems and non-responders by phone. Participants in both groups received routine PMTCT care. The prespecified secondary outcome reported in this paper is EID HIV testing by eight weeks of age (blinded outcome assessment). Final 24-months trial results will be published separately. We estimated risk ratios using Poisson regression with robust standard errors. Between June 2015–July 2016, we screened 735 pregnant women, of whom 600 were enrolled: 299 were allocated to the intervention and 301 to the control group. By eight weeks of age, the uptake of EID HIV testing out of recorded live births was 85.5% in the intervention and 84.7% in the control group (71.2% vs. 71.8% of participants randomised, including miscarriages, stillbirths, etc.). The intention-to-treat risk ratio was 0.99; 95% CI: 0.90–1.10; p = 0.89. The proportion of infants diagnosed with HIV was 0.8% in the intervention and 1.2% in the control group. No adverse events were reported. We found no evidence to support that the WelTel intervention improved EID HIV testing. A higher uptake of EID testing than expected in both groups may be a result of lower barriers to EID testing and improved PMTCT care in western Kenya, including the broader standard use of mobile phone communication between healthcare workers and patients. (ISRCTN No. 98818734. Funded by the European-Developing Countries Clinical Trial Partnership and others).

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Section: Discussionmentioning

confidence: 99%

The effect of weekly interactive text-messaging on early infant HIV testing in Kenya: a randomised controlled trial (WelTel PMTCT)

Nordberg

Mwangi

Kop

et al. 2021

Sci Rep

Self Cite

View full text Add to dashboard Cite

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“…The results show that the average cost per pregnant-infant (PPY) pair in the high HIV city ranges from 6,280 ETB (US$319) to 21,620 ETB (US$1,099), etc. [ 9 ]. There are also researchers who evaluated the effectiveness of the city government-led all-round multilevel cooperation platform model in blocking mother-to-child transmission of AIDS.…”

Section: Introductionsmentioning

confidence: 99%

Analysis of Related Factors of Mother-to-Child Transmission of AIDS and Evaluation of Measures to Prevent Mother-to-Child Transmission

Liu

Zhang

Pang

2022

Computational and Mathematical Methods in Medicine

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AIDS is still a major public health facing the world. With the implementation of AIDS prevention projects and the continuous maturity of technology, more and more HIV-positive women choose to have children. However, the children born to these women are a special group. Exposure to HIV and antiviral drugs during the fetal period can increase the success rate of children’s elimination of the mother, which is worthy of attention and research. This article focuses on the analysis of the related factors of mother-to-child transmission of AIDS and the evaluation of mother-to-child blocking measures, using the method of field research to conduct experiments on AIDS patients in this city who are pregnant and provide them with antidrug treatment and some barrier measures. Then, the mother-to-child transmission rate was recorded, and the experimental results showed that the antidrug treatment plan is related to mother-to-child transmission. After antidrug treatment, the transmission rate of single-drug treatment is reduced by 5%, and the transmission rate of combined drug treatment is reduced by 10%. It can be seen from this that antidrug treatment is an effective measure to block mothers and babies.

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“…AMPATH has enrolled over 200,000 patients and currently provides care for approximately 15,000 children who are HEU and HIV+ in 65 clinics in western Kenya ( 9 , 10 ). The children and their caregivers were recruited from the MTRH and AMPATH pediatric HIV clinics between 12/2017 and 9/2019, where care for prevention of mother-to-child transmission (PMTCT) of HIV has been freely provided since 2003 ( 11 ). Mixed convenience sampling of potential participants occurred within these clinics, with periods of consecutive sampling by study team members positioned within the clinic along with the clinic staff notifying the study team of eligible participants when the team was not physically present.…”

Section: Methodsmentioning

confidence: 99%

Neurodevelopmental Outcomes of Young Children Born to HIV-Infected Mothers: A Pilot Study

et al. 2021

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Introduction: Over 15 million children who were exposed to HIV perinatally but uninfected (HEU) are alive globally, and they are faced with multiple risk factors for poor neurodevelopment. While children who are HIV-infected (HIV+) appear to have worse neurodevelopmental scores compared to children unexposed and uninfected with HIV (HUU), the evidence is mixed in children who are HEU. This small descriptive pilot study aimed to compare neurodevelopmental scores of children who are HIV+, HEU, and HUU in Kenya.Methods: This cross-sectional pilot study included children ages 18–36 months who were HIV+, HEU, or HUU. Neurodevelopment was assessed, along with sociodemographic, lab, and growth data. Statistical analysis included descriptive statistics, one-way ANOVA, chi-squared, and adjusted linear regression models.Results: One hundred seventy two were included (n = 24 HIV+; n = 74 HEU; n = 74 HUU). Mothers of children who were HEU experienced more depressive symptoms (p < 0.001). The only neurodevelopmental differences were found among groups was that children who were HIV+ had higher receptive language scores (p = 0.007). Lower height-for-age z-scores and being left home alone were associated with worse neurodevelopmental scores.Conclusions: Being stunted, left completely alone for at least an hour within the last week, and having higher sociodemographic status were associated with worse neurodevelopmental scores. The higher levels of depressive symptoms within mothers of children who are HEU warrants further investigation.

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Integrating Prevention of Mother-to-Child Transmission of HIV Care into General Maternal Child Health Care in Western Kenya

Cited by 9 publications

References 13 publications

The effect of weekly interactive text-messaging on early infant HIV testing in Kenya: a randomised controlled trial (WelTel PMTCT)

The effect of weekly interactive text-messaging on early infant HIV testing in Kenya: a randomised controlled trial (WelTel PMTCT)

Analysis of Related Factors of Mother-to-Child Transmission of AIDS and Evaluation of Measures to Prevent Mother-to-Child Transmission

Neurodevelopmental Outcomes of Young Children Born to HIV-Infected Mothers: A Pilot Study

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