Evidence map›Paper›PMID 37663847›Full record

Trial reportFrontiers in public health2023

Facilitators and barriers to infant post-natal HIV prophylaxis, a qualitative sub-study of the PROMISE-EPI trial in Lusaka, Zambia.

Anaïs Mennecier, Beauty Matoka, Maria Melany Wilfred-Tonga, Catherine Chunda-Liyoka, Mwiya Mwiya, Nicolas Nagot, Jean-Pierre Molès, Philippe Van de Perre, Chipepo Kankasa, Rachel King and 1 more

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Frontiers in public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.6field-weighted citation impact, top 34% 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

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Review
  2. 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

11 authors at 3 institutions in 2 countries.

Anaïs MennecierPathogenesis and Control of Chronic and Emerging Infections, Montpellier University, INSERM, EFS, CHU Montpellier, Montpellier, France.
Beauty MatokaPediatric Centre of Excellence, University Teaching Hospital, Lusaka, Zambia.
Maria Melany Wilfred-TongaPediatric Centre of Excellence, University Teaching Hospital, Lusaka, Zambia.
Catherine Chunda-LiyokaPediatric Centre of Excellence, University Teaching Hospital, Lusaka, Zambia.
Mwiya MwiyaPediatric Centre of Excellence, University Teaching Hospital, Lusaka, Zambia.
Nicolas NagotPathogenesis and Control of Chronic and Emerging Infections, Montpellier University, INSERM, EFS, CHU Montpellier, Montpellier, France.
Jean-Pierre MolèsPathogenesis and Control of Chronic and Emerging Infections, Montpellier University, INSERM, EFS, CHU Montpellier, Montpellier, France.
Philippe Van de PerrePathogenesis and Control of Chronic and Emerging Infections, Montpellier University, INSERM, EFS, CHU Montpellier, Montpellier, France.
Chipepo KankasaPediatric Centre of Excellence, University Teaching Hospital, Lusaka, Zambia.
Rachel KingPathogenesis and Control of Chronic and Emerging Infections, Montpellier University, INSERM, EFS, CHU Montpellier, Montpellier, France.
PROMISE-EPI social science sub-study group
University Teaching Hospital · ZMPathogenesis and Control of Chronic and Emerging InfectionsInserm · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Infant post-natal prophylaxis (PNP) is used to prevent HIV transmission through breastfeeding. The WHO edited recommendations but so far there is no consensus on the duration of prophylaxis and the type of drug used depends on national guidelines. In Zambia, the national recommendations include a three-drug prophylaxis, composed of a dispersible combined tablet of zidovudine (AZT) and lamivudine (3TC) and an oral suspension of nevirapine (NVP) for 12 weeks or until the mother's viral load is <1,000 cp/mL. The PROMISE-EPI study, modified the PNP regimen to lamivudine only, initiated at 6 weeks and continued until 12 months to all HIV exposed uninfected infants of virally unsuppressed mothers. Our aim in this analysis was to identify barriers and facilitators to this extended PNP, the keystone toward an effective prevention. Methods: Individual interviews and focus group discussion (FGD) were conducted with PROMISE-EPI participants who had received prophylaxis for their children from the national program up to 6 weeks and then lamivudine oral solution in PROMISE-EPI study. Health care providers and PROMISE-EPI staff were also interviewed. Sessions were recorded, transcribed verbatim and translated from local languages into English. An initial code-book was designed and then adapted on the basis of the emerging themes, to allow a descriptive thematic analysis. Results: More barriers to PNP adherence were identified with triple drug prophylaxis than with lamivudine. These barriers were related to the formulation and bitter taste of AZT/3TC tablets. The ready to use formulation and sweet taste of lamivudine syrup were appreciated by mothers. Extended PNP proposed in the PROMISE-EPI study was globally well accepted and strategies were found to increase adherence. Adherence to lamivudine appeared to be better than the mothers' adherence to their own antiretroviral therapy. Conclusion: Accompanying mothers living with HIV and giving them the choice of the PNP to prevent transmission

Indexed as

HIV InfectionsInfectious Disease Transmission, VerticalLamivudinePost-Exposure ProphylaxisFemaleFocus GroupsHumansInfantQualitative ResearchZambiaLamivudineadherencebreast-feedingmother to child HIV transmissionpost-natal prophylaxisqualitative analysissub-Saharan Africa

Identifiers

PMID37663847
PMCPMC10469758
OpenAlexW4385904495

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.