Evidence map›Paper›PMID 34234027›Full record

ArticleGlobal health, science and practice2021

Improving Services for HIV-Exposed Infants in Zambia and Cameroon Using a Quality Improvement Collaborative Approach.

Gillian Dougherty, Tihnje Abena, Jean Pierre Abesselo, Jeane Ngala Banda, Tjek Paul Biyaga, Rodrigo Boccanera, Mary Adetinuke Boyd, Mesmey Ebogo, Leoda Hamomba, Suzanne Jed and 12 more

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Global health, science and practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 13% 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

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

  1. Pooled it
  2. Article
  3. 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

22 authors at 6 institutions in 4 countries.

Gillian DoughertyICAP at Columbia University, Columbia University Mailman School of Public Health, New York, NY, USA. gd2410@columbia.edu.
Tihnje AbenaICAP at Columbia University, Yaoundé, Cameroon.
Jean Pierre AbesseloICAP at Columbia University, Yaoundé, Cameroon.
Jeane Ngala BandaMinistry of Health, Lusaka, Zambia.
Tjek Paul BiyagaMinistry of Health, Yaoundé, Cameroon.
Rodrigo BoccaneraHealth Resources and Services Administration, Rockville, MD, USA.
Mary Adetinuke BoydCenters for Disease Control and Prevention, Lusaka, Zambia.
Mesmey EbogoICAP at Columbia University, Yaoundé, Cameroon.
Leoda HamombaCenters for Disease Control and Prevention, Lusaka, Zambia.
Suzanne JedHealth Resources and Services Administration, Rockville, MD, USA.
Zeh Florence KakanouMinistry of Health, Yaoundé, Cameroon.
Prisca KasondeICAP at Columbia University, Lusaka, Zambia.
Siphiwe Chilungu KasonkaICAP at Columbia University, Lusaka, Zambia.
Rachael LungwebunguMinistry of Health, Lusaka, Zambia.
Caitlin Madevu-MatsonICAP at Columbia University, Columbia University Mailman School of Public Health, New York, NY, USA.
Magdalene Mange MayerCenters for Disease Control and Prevention, Yaoundé, Cameroon.
Mukuka MwambaICAP at Columbia University, Lusaka, Zambia.
Milembe PanyaICAP at Columbia University, Dar es Salaam, Tanzania.
Paul SakandaICAP at Columbia University, Lusaka, Zambia.
Fatima TsiourisICAP at Columbia University, Columbia University Mailman School of Public Health, New York, NY, USA.
Lauren WalkerICAP at Columbia University, Columbia University Mailman School of Public Health, New York, NY, USA.
Miriam RabkinICAP at Columbia University, Columbia University Mailman School of Public Health, New York, NY, USA.
ICAP Global HealthColumbia University · USCentre for Infectious Disease Research in Zambia · ZMHealth Resources and Services Administration · USMinistry of Health · ZMMinistry of Public Health · CM

Funding

PEPFAR 1U1NHA285550100
6 · The paper itself

Abstract

introductionEarly infant diagnosis (EID) and rapid antiretroviral therapy (ART) initiation are lifesaving interventions for HIV-infected infants. In Cameroon and Zambia, EID coverage for HIV-exposed infants (HEIs) is suboptimal and the time to ART initiation for infants infected with HIV often exceeds national standards despite numerous policy and training initiatives.

methodsICAP at Columbia University supported the Cameroon and Zambia Ministries of Health (MOHs) and local partners to implement quality improvement collaboratives (QICs) to improve EID coverage and ART initiation at 17 health facilities (HFs) in Cameroon (March 2016 to June 2017) and 15 HFs in Zambia (March 2017 to June 2018). In each country, MOH led project design and site selection. MOH and ICAP provided quality improvement training and monthly supportive supervision, which enabled HF teams to conduct root cause analyses, design and implement contextually appropriate interventions, conduct rapid tests of change, analyze monthly progress, and convene at quarterly learning sessions to compare performance and share best practices.

resultsIn Cameroon, EID testing coverage improved from 57% (113/197 HEIs tested) during the 5-month baseline period to 80% (165/207) in the 5-month endline period. In Zambia, EID testing coverage improved from 77% (4,773/6,197) during the 12-month baseline period to 89% (2,144/2,420) during the 3-month endline period. In a comparison of the same baseline and endline periods, the return of positive test results to caregivers improved from 18% (36/196 caregivers notified) to 86% (182/211) in Cameroon and from 44% (94/214) to 79% (44/56) in Zambia. ART initiation improved from 44% (94/214 HIV-infected infants) to 80% (45/56) in Zambia; the numbers of HIV-infected infants in Cameroon were too small to detect meaningful differences.

conclusionsQICs improved coverage of timely EID and ART initiation in both countries. In addition to building quality improvement capacity and improving outcomes, the QICs resulted in a "change package" of successful initiatives that were disseminated within each country.

Indexed as

HIV InfectionsQuality ImprovementCameroonEarly DiagnosisHumansInfantZambia

Identifiers

PMID34234027
PMCPMC8324201
OpenAlexW3165943599

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.