Significant Patient Impact Observed Upon Implementation of Point-of-Care Early Infant Diagnosis Technologies in an Observational Study in Malawi

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
Reuben MwendaLara Vojnov

Abstract

In Malawi in 2014, <20% of human immunodeficiency virus (HIV)-exposed infants received an early infant diagnosis (EID) test in the first 2 months of life and only 30% of HIV-infected children were on antiretroviral therapy (ART). We sought to understand the potential patient impact of improving timely infant diagnosis and treatment initiation through implementation of point-of-care (POC) EID technologies in Malawi. In this observational study, POC EID technologies were introduced into routine services at 7 health facilities across Malawi in September 2015. The primary outcome was the proportion of HIV-infected infants initiating ART within 60 days of sample collection in the POC arm compared to the baseline arm with conventional laboratory-based EID testing. The time from sample collection to result received by the patient decreased significantly from 56 days (interquartile range [IQR], 30-81 days) in the baseline arm to <1 day in the POC arm (P < .001). Of the HIV-infected infants, the time between sample collection and ART initiation was reduced from 38 days (IQR, 30-54 days) in the baseline arm to <1 day (IQR, 0-1 day) in the POC arm (P = .019). Furthermore, the proportion of HIV-infected infants initiated on ART within 60 d...Continue Reading

References

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Citations

Nov 6, 2018·Current Opinion in HIV and AIDS·Ilesh V Jani, Caroline De Schacht
Feb 14, 2020·Journal of the International Association of Providers of AIDS Care·Collins Otieno OdhiamboJennifer Cohn
Oct 30, 2019·PloS One·Jason T BlackardKenneth E Sherman
May 17, 2019·Clinical Microbiology Reviews·Paul K DrainNigel Garrett
Jun 13, 2019·BMC Public Health·Elizabeth SpoonerAnna Coutsoudis
Aug 2, 2020·Tropical Medicine & International Health : TM & IH·F Terris-PrestholtR W Peeling
Jun 11, 2020·Journal of Acquired Immune Deficiency Syndromes : JAIDS·George AlemnjiSmiljka de Lussigny
Jun 11, 2020·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Flavia BianchiUNKNOWN EGPAF POC EID Study Team
Dec 14, 2018·AIDS and Behavior·Catherine WexlerSarah Finocchario-Kessler
Nov 21, 2020·Journal of the International AIDS Society·Martina Penazzato
Nov 3, 2020·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Prakash GaneshSam Phiri
Jul 12, 2018·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Amy M MedleyStephanie Behel
Jan 20, 2021·The Pediatric Infectious Disease Journal·Catherine WexlerSarah Finocchario-Kessler
May 18, 2021·Tropical Medicine & International Health : TM & IH·Catherine G SutcliffeWilliam J Moss

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