Linkage to Care, Early Infant Diagnosis, and Perinatal Transmission Among Infants Born to HIV-Infected Nigerian Mothers: Evidence From the Healthy Beginning Initiative

Pharr, Jennifer R.; Obiefune, Michael; Ezeanolue, Chinenye O.; Osuji, Alice; Ogidi, Amaka G.; Gbadamosi, Semiu O; Patel, Dina; Iwelunmor, Juliet; Yang, Wei; Ogedegbe, Gbenga; Ehiri, John E.; Sam-Agudu, Nadia A.; Ezeanolue, Echezona E.

doi:10.1097/qai.0000000000001051

Cited by 27 publications

(27 citation statements)

References 22 publications

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“…These findings support studies that have identified the importance of addressing community norms, including involvement of faith-based and lay leaders, to address negative community attitudes and norms regarding critical MNCH behaviours (Campbell et al 2013;Crissman et al 2013;Pell et al 2013;Pharr et al 2016;Skovdal and Campbell 2010;Yargawa and Leonardi-Bee 2015). In particular, in Ghana's Northern region, Moyer et al (2014) concluded that community-based solutions, including working with community leaders, were needed in order to address challenges facing maternal and child health.…”

Section: Comparison Areasupporting

confidence: 60%

Mobilising faith-based and lay leaders to address antenatal care outcomes in northern Ghana

Hembling

McEwan²,

Ali

et al. 2017

Development in Practice

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Despite the benefits of antenatal care, evidence from sub-Saharan Africa suggests that women often initiate these services after the first trimester of pregnancy and do not complete the recommended number of visits. This study examines the impact of mobilising faith-based and lay leaders to address the socio-cultural barriers to antenatal care uptake in northern Ghana in the context of a broader child survival project. A quasi-experimental design was used, and data were analysed using a difference-in-differences approach. The results presented in this article indicate the potential for faith-based and lay leaders to promote uptake of maternal and child health behaviours.Des informations provenant d'Afrique subsaharienne indiquent que malgré les avantages offerts par les soins prénataux, il est fréquent que les femmes n'aient recours à ces services qu'après le premier trimestre de grossesse et n'aillent pas au terme du calendrier de visites recommandé. Cette étude examine l'impact de la mobilisation des leaders confessionnels et laïcs pour faire face aux obstacles socioculturels au recours aux soins prénataux dans le nord du Ghana, au sein d'un plus large projet sur la survie de l'enfant. Le concept de l'étude était quasiment expérimental et les données ont été analysées selon la méthode de l'observation de l'écart dans les différences. Présentés dans cet article, les résultats mettent l'accent sur la possibilité pour les leaders confessionnels et laïcs de promouvoir l'adoption de comportements de santé de la mère et de l'enfant.A pesar de los beneficios comprobados que conlleva el cuidado prenatal, la evidencia disponible correspondiente al África subsahariana sugiere que a menudo las mujeres comienzan a atenderse después del primer trimestre de embarazo y que, además, no realizan la cantidad de visitas sugerida. En el contexto de un proyecto integral destinado a elevar la supervivencia de los niños, el presente estudio examina el impacto logrado por la movilización de líderes religiosos y laicos para hacer frente a los obstáculos socioculturales que impiden una mayor aceptación del cuidado prenatal en el norte de Ghana. Con este fin, se utilizó un diseño cuasiexperimental en el que los datos fueron analizados empleando un enfoque de diferencia en diferencias. Los resultados al respecto, presentados en este artículo, sugieren la posibilidad de que los líderes religiosos y laicos puedan promover una mayor aceptación de aquellas conductas encaminadas a mejorar la salud maternoinfantil. Recently, WHO increased this recommendation to at least eight visits and continued to emphasise the importance of initiation of ANC within the first trimester of pregnancy (WHO 2016). Initiation of ANC in the first trimester allows for early identification of potential underlying conditions that could increase maternal and child morbidity and mortality (e.g. control of anaemia, prevention of malaria complications, and identification and treatment of sexually transmitted infections -see Asundep et al. 2013;Campbell and Graham...

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Section: Comparison Areasupporting

confidence: 60%

Mobilising faith-based and lay leaders to address antenatal care outcomes in northern Ghana

Hembling

McEwan²,

Ali

et al. 2017

Development in Practice

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“…The data on HIV testing during ANC visits were extracted from 8 studies (Table 1 ) conducted in Malawi, [ 7 – 9 ] Nigeria, [ 10 , 11 ] Ghana, [ 12 ] Zimbabwe, [ 13 ] and South Africa. [ 14 ] These studies indicated a high uptake of HIV testing ranging from 75% in Nigeria to over 96% in Zimbabwe and South Africa.…”

Section: Summary Of Resultsmentioning

confidence: 99%

“…In this review, it was reported in 3 studies from DRC, [ 40 ] Zambia, [ 41 ] and Nigeria. [ 11 ] Among HIV-infected infants in DRC, 97% enrolled in 2011 to 2012 were initiated on ART; this was an increase from 61% for infants enrolled in 2007 to 2008. [ 40 ] Lower rates were reported in Zambia where 67% of infants who tested positive started ART by the end of the study [ 41 ] and Nigeria where 75% of HIV-positive infants were initiated on ART.…”

Section: Summary Of Resultsmentioning

confidence: 99%

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

Gumede-Moyo

Filteau²,

Munthali³

et al. 2017

Medicine

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Background:To synthesize and evaluate the impact of implementing post-2010 World Health Organization (WHO) prevention of mother-to-child transmission (PMTCT) guidelines on attainment of PMTCT targets.Methods:Retrospective and prospective cohort study designs that utilized routinely collected data with a focus on provision and utilization of the cascade of PMTCT services were included. The outcomes included the proportion of pregnant women who were tested during their antenatal clinic (ANC) visits; mother-to-child transmission (MTCT) rate; adherence; retention rate; and loss to follow-up (LTFU).Results:Of the 1210 references screened, 45 met the inclusion criteria. The studies originated from 14 countries in sub-Saharan Africa. The highest number of studies originated from Malawi (10) followed by Nigeria and South Africa with 7 studies each. More than half of the studies were on option A while the majority of option B+ studies were conducted in Malawi. These studies indicated a high uptake of human immunodeficiency virus (HIV) testing ranging from 75% in Nigeria to over 96% in Zimbabwe and South Africa. High proportions of CD4 count testing were reported in studies only from South Africa despite that in most of the countries CD4 testing was a prerequisite to access treatment. MTCT rate ranged from 1.1% to 15.1% and it was higher in studies where data were collected in the early days of the WHO 2010 PMTCT guidelines. During the postpartum period, adherence and retention rate decreased, and LTFU increased for both HIV-positive mothers and exposed infants.Conclusion:Irrespective of which option was followed, uptake of antenatal HIV testing was high but there was a large drop off along later points in the PMTCT cascade. More research is needed on how to improve later components of the PMTCT cascade, especially of option B+ which is now the norm throughout sub-Saharan Africa.

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“…Many studies on HIV testing prevalence in sub-Saharan Africa have been based on samples of adults and pregnant women [ 10 , 19 , 20 ]. Thus, this study extends previous research that focused on populations of adults and/or pregnant women, and attempts to fill the gap in the literature by examining determinants of HIV testing among youths aged 15 to 24.…”

Section: Discussionmentioning

confidence: 99%

Predictors of HIV Testing among Youth in Sub-Saharan Africa: A Cross-Sectional Study

et al. 2016

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IntroductionIn spite of a high prevalence of HIV infection among adolescents and young adults in sub-Saharan Africa, uptake of HIV testing and counseling among youth in the region remains sub-optimal. The objective of this study was to assess factors that influence uptake of HIV testing and counseling among youth aged 15–24 years in sub-Saharan Africa.MethodsThis study used the Demographic and Health Survey (DHS) data from countries that represent four geographic regions of sub-Saharan Africa: Congo (Brazzaville), representing central Africa (DHS 2011–2012); Mozambique, representing southern Africa (DHS 2011); Nigeria, representing western Africa (DHS 2013); and Uganda, representing eastern Africa (DHS 2011). Analyses were restricted to 23,367 male and female respondents aged 15–24 years with complete data on the variables of interest. Chi-square tests and logistic regression models were used to assess predictors of HIV testing. Statistical significance was set at p< 0.01.ResultsThe analysis revealed that a majority of the respondents were female (78.1%) and aged 20-24-years (60.7%). Only a limited proportion of respondents (36.5%) had ever tested for HIV and even fewer (25.7%) demonstrated comprehensive knowledge of HIV/AIDS. There was a significant association between HIV testing and respondents’ gender, age, age at sexual debut, and comprehensive knowledge of HIV in the pooled sample. Older youth (adjusted OR (aOR) = 2.19; 99% CI = 1.99–2.40) and those with comprehensive knowledge of HIV (aOR = 1.98; 1.76–2.22) had significantly higher odds of ever being tested for HIV than younger respondents and those with limited HIV/AIDS knowledge respectively. Furthermore, men had lower odds of HIV testing than women (aOR = 0.32; 0.28–0.37).ConclusionsReaching youth in sub-Saharan Africa for HIV testing continues to be a challenge. Public health programs that seek to increase HIV counseling and testing among youth should pay particular attention to efforts that target high-risk subpopulations of youth. The results further suggest that these initiatives would be strengthened by including strategies to increase HIV comprehensive knowledge.

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Linkage to Care, Early Infant Diagnosis, and Perinatal Transmission Among Infants Born to HIV-Infected Nigerian Mothers: Evidence From the Healthy Beginning Initiative

Cited by 27 publications

References 22 publications

Mobilising faith-based and lay leaders to address antenatal care outcomes in northern Ghana

Mobilising faith-based and lay leaders to address antenatal care outcomes in northern Ghana

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

Predictors of HIV Testing among Youth in Sub-Saharan Africa: A Cross-Sectional Study

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