ArticleBulletin of the World Health Organization2012
Implementing early infant diagnosis of HIV infection at the primary care level: experiences and challenges in Malawi.
Article in Bulletin of the World Health Organization, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 3 of them syntheses that pooled it.
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Who cites it
46 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- A Systematic Review of HIV Testing Implementation Strategies in Sub-Saharan African Countries.AIDS and behavior · 2022Pooled it
- Diagnostic accuracy of detection and quantification of HBV-DNA and HCV-RNA using dried blood spot (DBS) samples - a systematic review and meta-analysis.BMC infectious diseases · 2017Pooled it
- The magnitude of loss to follow-up of HIV-exposed infants along the prevention of mother-to-child HIV transmission continuum of care: a systematic review and meta-analysis.AIDS (London, England) · 2013Pooled it
- Trial
- High Prevalence of Unconfirmed Positive HIV Polymerase Chain Reaction Test Results Among African Infants With HIV Exposure in the International Epidemiology Databases to Evaluate AIDS Consortium.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Review
- Achieving HIV Epidemic Control and Improving Maternal Healthcare Services with Community-Based HIV Service Delivery in Zambia: Mixed-Methods Assessment of the SMACHT Project.AIDS and behavior · 2023Article
- A dried blood spot test for diagnosis of autoimmune pulmonary alveolar proteinosis.Journal of immunological methods · 2022Article
- Article
- Factors Influencing Loss to Follow-up among Human Immunodeficiency Virus Exposed Infants in the Early Infant Diagnosis Program in Phalombe, Malawi.Global pediatric health · 2021Article
- Strategic site selection for placement of HIV early infant diagnosis point-of-care technology within a national diagnostic network in Lesotho.African journal of laboratory medicine · 2021Article
- HIV diagnostic algorithm requires confirmatory testing for initial indeterminate or positive screens in the first week of life.AIDS (London, England) · 2020Article
- Retention of HIV exposed infants in care at Arua regional referral hospital, Uganda: a retrospective cohort study.BMC public health · 2019Article
- Practices of Care to HIV-Infected Children: Current Situation in Cameroon.Clinical medicine insights. Pediatrics · 2019Article
- p24 revisited: a landscape review of antigen detection for early HIV diagnosis.AIDS (London, England) · 2018Review
- Dried Blood Spots for Global Health Diagnostics and Surveillance: Opportunities and Challenges.The American journal of tropical medicine and hygiene · 2018Review
- Scaling up Pediatric HIV Testing by Incorporating Provider-Initiated HIV Testing Into all Child Health Services in Hurungwe District, Zimbabwe.Journal of acquired immune deficiency syndromes (1999) · 2018Article
- Prevention of Mother-to-Child Transmission and Early Real-Time DNA Polymerase Chain Reaction Results Among HIV-Exposed Infants in Bujumbura, Burundi.The East African health research journal · 2018Article
- Accessibility of Early Infant Diagnostic Services by Under-5 Years and HIV Exposed Children in Muheza District, North-East Tanzania.Frontiers in public health · 2018Article
- A qualitative analysis of the barriers to antiretroviral therapy initiation among children 2 to 18 months of age in Swaziland.African journal of AIDS research : AJAR · 2017Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
problemMalawi's national guidelines recommend that infants exposed to the human immunodeficiency virus (HIV) be tested at 6 weeks of age. Rollout of services for early infant diagnosis has been limited and has resulted in the initiation of antiretroviral therapy (ART) in very few infants. APPROACH: An early infant diagnosis programme was launched. It included education of pregnant women on infant testing, community sensitization, free infant testing at 6 weeks of age, active tracing of HIV-positive infants and referral for treatment and care. LOCAL
settingThe programme was established in two primary care facilities in Blantyre, Malawi. RELEVANT CHANGES: Of 1214 HIV-exposed infants, 71.6% presented for early diagnosis, and 14.5% of those who presented tested positive for HIV. Further testing of 103 of these 126 apparently HIV-positive infants confirmed infection in 88; the other 15 results were false positives. The initial polymerase chain reaction testing of dried blood spots had a positive predictive value (PPV) of 85.4%. Despite active tracing, only 87.3% (110/126) of the mothers of infants who initially tested positive were told their infants' test results. ART was initiated in 58% of the infants with confirmed HIV infection. LESSONS LEARNT: Early infant diagnosis of HIV infection at the primary care level in a resource-poor setting is challenging. Many children in the HIV diagnosis and treatment programme were lost to follow-up at various stages. Diagnostic tools with higher PPV and point-of-care capacity and better infrastructures for administering ART are needed to improve the management of HIV-exposed and HIV-infected infants.
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