ArticleJournal of acquired immune deficiency syndromes (1999)2015
Implementation and operational research: the impact of option B+ on the antenatal PMTCT cascade in Lilongwe, Malawi.
Article in Journal of acquired immune deficiency syndromes (1999), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 69 papers, 4 of them syntheses that pooled it.
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Who cites it
69 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Interventions to improve early retention of patients in antiretroviral therapy programmes in sub-Saharan Africa: A systematic review.PloS one · 2022Pooled it
- Retention in HIV Care During Pregnancy and the Postpartum Period in the Option B+ Era: Systematic Review and Meta-Analysis of Studies in Africa.Journal of acquired immune deficiency syndromes (1999) · 2018Pooled it
- Pooled it
- A systematic review of interventions to improve prevention of mother-to-child HIV transmission service delivery and promote retention.Journal of the International AIDS Society · 2016Pooled it
- A cluster randomized controlled trial of lay health worker support for prevention of mother to child transmission of HIV (PMTCT) in South Africa.AIDS research and therapy · 2017Trial
- Evaluation of mHealth strategies to optimize adherence and efficacy of Option B+ prevention of mother-to-child HIV transmission: Rationale, design and methods of a 3-armed randomized controlled trial.Contemporary clinical trials · 2017Trial
- Mother Infant Retention for Health (MIR4Health): Study Design, Adaptations, and Challenges With PMTCT Implementation Science Research.Journal of acquired immune deficiency syndromes (1999) · 2016Trial
- Option B+ in Mozambique: Formative Research Findings for the Design of a Facility-Level Clustered Randomized Controlled Trial to Improve ART Retention in Antenatal Care.Journal of acquired immune deficiency syndromes (1999) · 2016Trial
- Implementation and Operational Research: Impact of a Systems Engineering Intervention on PMTCT Service Delivery in Côte d'Ivoire, Kenya, Mozambique: A Cluster Randomized Trial.Journal of acquired immune deficiency syndromes (1999) · 2016Trial
- Why Did I Stop? Barriers and Facilitators to Uptake and Adherence to ART in Option B+ HIV Care in Lilongwe, Malawi.PloS one · 2016Trial
- Uptake and retention in HIV care among pregnant and postpartum women living with HIV under different eras of vertical transmission prevention policies in sub-Saharan Africa: a systematic review and meta-analysis.medRxiv : the preprint server for health sciences · 2026Article
- Observational
- Study design and procedures for a hybrid effectiveness-implementation incomplete stepped-wedge cluster-randomized trial to evaluate a differentiated point-of-care HIV diagnosis and management model for the prevention of vertical transmission of HIV in Malawi: The PAC-Man trial protocol.Implementation science communications · 2025Article
- Acceptability and feasibility of using a blended quality improvement strategy among health workers to monitor women engagement in Option B+ program in Lilongwe Malawi.BMC health services research · 2024Article
- Phone-based psychosocial counseling for people living with HIV: Feasibility, acceptability and impact on uptake of psychosocial counseling services in Malawi.Global mental health (Cambridge, England) · 2024Article
- Incidence and predictors of loss to follow-up among pregnant and lactating women in the Option B+ PMTCT program in Northwestern Ethiopia: a seven-year retrospective cohort study.Frontiers in global women's health · 2023Article
- Predictors of secondary HIV transmission risk in a cohort of adolescents living with HIV in South Africa.AIDS (London, England) · 2022Article
- Article
- Community-facility linkage models and maternal and infant health outcomes in Malawi's PMTCT/ART program: A cohort study.PLoS medicine · 2021Article
- Implementation and experiences of integrated prevention of mother-to-child transmission services in Tanzania, Malawi and South Africa: A mixed methods study.Global public health · 2021Article
9 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
objectiveIn 2011, Malawi implemented Option B+ (B+), lifelong antiretroviral therapy (ART) for pregnant and breastfeeding women. We aimed to describe changes in service uptake and outcomes along the antenatal prevention of mother-to-child transmission (PMTCT) cascade post-B+ implementation.
designPre/post study using routinely collected program data from 2 large Lilongwe-based health centers.
methodsWe compared the testing of HIV-infected pregnant women at antenatal care, enrollment into PMTCT services, receipt of ART, and 6-month ART outcomes pre-B+ (October 2009-March 2011) and post-B+ (October 2011-March 2013).
resultsA total of 13,926 (pre) and 14,532 (post) women presented to antenatal care. Post-B+, a smaller proportion were HIV-tested (99.3% vs. 87.7% post-B+; P < 0.0001). There were 1654 (pre) and 1535 (post) HIV-infected women identified, with a larger proportion already known to be HIV-infected (18.1% vs. 41.2% post-B+; P < 0.0001) and on ART post-B+ (18.7% vs. 30.2% post-B+; P < 0.0001). A significantly greater proportion enrolled into the PMTCT program (68.3% vs. 92.6% post-B+; P < 0.0001) and was retained through delivery post-B+ (51.1% vs. 65% post-B+; P < 0.0001). Among those not on ART at enrollment, there was no change in the proportion newly initiating ART/antiretrovirals (79% vs. 81.9% post-B+; P = 0.11), although median days to initiation of ART decreased [48 days (19, 130) vs. 0 days (0, 15.5) post-B+; P < 0.0001]. Among those newly initiating ART, a smaller proportion was alive on ART 6 months after initiation (89.3% vs. 78.8% post-B+; P = 0.0004).
conclusionsAlthough several improvements in PMTCT program performance were noted with implementation of B+, challenges remain at several critical steps along the cascade requiring innovative solutions to ensure an AIDS-free generation.
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