Evaluation of a routine point-of-care intervention for early infant diagnosis of HIV: an observational study in eight African countries

Publication date: Available online 12 April 2019Source: The Lancet HIVAuthor(s): Flavia Bianchi, Jennifer Cohn, Emma Sacks, Rebecca Bailey, Jean-Francois Lemaire, Rhoderick Machekano, Valery Nzima Nzima, Patricia Fassinou Ekouévi, Mafusi Makone, Collins O Odhiambo, Addmore Chadambuka, Thembie E Masuku, Manuel C Sabonete, Angelique R FundiSummaryBackgroundIn 2017, there were 180 000 estimated new HIV infections in children aged 0–14 years. Without early diagnosis and treatment, half of infants with HIV die by age 2 years, with peak mortality around age 8–10 weeks. Conventional early infant diagnosis (EID) systems have not consistently returned results in a timely manner. However, point-of-care (POC) EID devices, which are new to market, could improve outcomes. In December, 2016, POC EID testing was introduced in eight sub-Saharan African countries as part of routine service delivery. We aimed to compare key service delivery and clinical outcomes and costs of POC versus conventional EID.MethodsIn our observational study, we compared service delivery and clinical outcomes in eight countries (Cameroon, Côte d'Ivoire, Kenya, Lesotho, Mozambique, Rwanda, Swaziland, and Zimbabwe), before and after a POC intervention was introduced for EID of HIV. For the baseline, pre-intervention sample, we sampled 30 consecutive tests for HIV-exposed infants who had a documented date of blood collection for EID within Ministry of Health registers in a subset of Elizabeth Glaser Pediatric A...
Source: The Lancet HIV - Category: Infectious Diseases Source Type: research