Evidence map›Paper›PMID 32669131›Full record

ArticleBMC pediatrics2020

"The right time is just after birth": acceptability of point-of-care birth testing in Eswatini: qualitative results from infant caregivers, health care workers, and policymakers.

Emma Sacks, Philisiwe Khumalo, Bhekisisa Tsabedze, William Montgomery, Nobuhle Mthethwa, Bonisile Nhlabatsi, Thembie Masuku, Jennifer Cohn, Caspian Chouraya

Open access · goldAbstract read
In one paragraph

Article in BMC pediatrics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.2field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 2 countries.

Emma SacksDepartment of Global Health, George Washington University School of Public Health, 950 New Hampshire Ave, NW, Washington, DC, 20052, USA. esacks@gwu.edu.
Philisiwe KhumaloElizabeth Glaser Pediatric AIDS Foundation, Mbabane, Eswatini.
Bhekisisa TsabedzeElizabeth Glaser Pediatric AIDS Foundation, Mbabane, Eswatini.
William MontgomeryDepartment of Global Health, George Washington University School of Public Health, 950 New Hampshire Ave, NW, Washington, DC, 20052, USA.
Nobuhle MthethwaMinistry of Health, Mbabane, Eswatini.
Bonisile NhlabatsiMinistry of Health, Mbabane, Eswatini.
Thembie MasukuElizabeth Glaser Pediatric AIDS Foundation, Mbabane, Eswatini.
Jennifer CohnElizabeth Glaser Pediatric AIDS Foundation, Geneva, Switzerland.
Caspian ChourayaElizabeth Glaser Pediatric AIDS Foundation, Mbabane, Eswatini.
Elizabeth Glaser Pediatric AIDS Foundation · USGeorge Washington University · USMinistry of Health · SZ

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTesting for HIV at birth has the potential to identify infants infected in utero, and allows for the possibility of beginning treatment immediately after birth; point of care (POC) testing allows rapid return of results and faster initiation on treatment for positive infants. Eswatini piloted birth testing in three public maternities for over 2 years.

methodsIn order to assess the acceptability of POC birth testing in the pilot sites in Eswatini, interviews were held with caregivers of HIV-exposed infants who were offered birth testing (N = 28), health care workers (N = 14), and policymakers (N = 10). Participants were purposively sampled. Interviews were held in English or SiSwati, and transcribed in English. Transcripts were coded by line, and content analysis and constant comparison were used to identify key themes for each respondent type.

resultsResponses were categorized into: knowledge, experience, opinions, barriers and challenges, facilitators, and suggestions to improve POC birth testing. Preliminary findings reveal that point of care birth testing has been very well received but challenges were raised. Most caregivers appreciated testing the newborns at birth and getting results quickly, since it reduced anxiety of waiting for several weeks. However, having a favorable experience with testing was linked to having supportive and informed family members and receiving a negative result. Caregivers did not fully understand the need for blood draws as opposed to tests with saliva, and expressed the fears of seeing their newborns in pain. They were specifically grateful for supportive nursing staff who respected their confidentiality. Health care workers expressed strong support for the program but commented on the high demand for testing, increased workload, difficulty with errors in the testing machine itself, and struggles to implement the program without sufficient staffing, especially on evenings and weekends when phlebotomists were not available. Policymakers noted that there have been challenges within the program of losing mothers to follow up after they leave hospital, and recommended stronger linkages to community groups.

conclusionsThere is strong support for scale-up of POC birth testing, but countries should consider ways to optimize staffing and manage demand.

Indexed as

CaregiversHIV InfectionsEswatiniFemaleHealth PersonnelHumansInfantInfant, NewbornPoint-of-Care SystemsPregnancyBirth testingEswatiniHIV/AIDSInterviewsPoint of carePostnatal careQualitative

Identifiers

PMID32669131
PMCPMC7362515
OpenAlexW3043045124

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.