Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Introducing a multi-site program for early diagnosis of HIV infection among HIV-exposed infants in Tanzania
BMC Pediatrics, Volume 10, Article 44, Year 2010
Notification
URL copied to clipboard!
Description
Background: In Tanzania, less than a third of HIV infected children estimated to be in need of antiretroviral therapy (ART) are receiving it. In this setting where other infections and malnutrition mimic signs and symptoms of AIDS, early diagnosis of HIV among HIV-exposed infants without specialized virologic testing can be a complex process. We aimed to introduce an Early Infant Diagnosis (EID) pilot program using HIV DNA Polymerase Chain Reaction (PCR) testing with the intent of making EID nationally available based on lessons learned in the first 6 months of implementation.Methods: In September 2006, a molecular biology laboratory at Bugando Medical Center was established in order to perform HIV DNA PCR testing using Dried Blood Spots (DBS). Ninety- six health workers from 4 health facilities were trained in the identification and care of HIV-exposed infants, HIV testing algorithms and collection of DBS samples. Paper-based tracking systems for monitoring the program that fed into a simple electronic database were introduced at the sites and in the laboratory. Time from birth to first HIV DNA PCR testing and to receipt of test results were assessed using Kaplan-Meier curves.Results: From October 2006 to March 2007, 510 HIV-exposed infants were identified from the 4 health facilities. Of these, 441(87%) infants had an HIV DNA PCR test at a median age of 4 months (IQR 1 to 8 months) and 75(17%) were PCR positive. Parents/guardians for a total of 242(55%) HIV-exposed infants returned to receive PCR test results, including 51/75 (68%) of those PCR positive, 187/361 (52%) of the PCR negative, and 4/5 (80%) of those with indeterminate PCR results. The median time between blood draw for PCR testing and receipt of test results by the parent or guardian was 5 weeks (range <1 week to 14 weeks) among children who tested PCR positive and 10 weeks (range <1 week to 21 weeks) for those that tested PCR negative.Conclusions: The EID pilot program successfully introduced systems for identification of HIV-exposed infants. There was a high response as hundreds of HIV-exposed infants were registered and tested in a 6 month period. Challenges included the large proportion of parents not returning for PCR test results. Experience from the pilot phase has informed the national roll-out of the EID program currently underway in Tanzania. © 2010 Nuwagaba-Biribonwoha et al; licensee BioMed Central Ltd.
Authors & Co-Authors
Nuwagaba-Biribonwoha, Harriet
United States, New York
Columbia University
Semo, Bazghina Werq
United States, New York
Columbia University
Botswana
International Training and Education Centre for Health
Abdallah, Aziz
United States, New York
Columbia University
United States, Chevy Chase
University Research Co., Llc
Cunningham, Amy
United States, New York
Columbia University
Tanzania
Mylan Pharmaceuticals Inc.
Gamaliel, John G.
United States, New York
Columbia University
Mtunga, Sevestine
United States, New York
Columbia University
Nankabirwa, Victoria
United States, New York
Columbia University
Malisa, Isaya
Tanzania, Mwanza
Bugando Medical Centre
Gonzalez, Luis F.
United States, New York
Columbia University
Massambu, Charles G.
Tanzania, Dar es Salaam
Ministry of Health and Social Welfare
Nash, Denis B.
United States, New York
Columbia University
Justman, Jessica E.
United States, New York
Columbia University
Abrams, Elaine J.
United States, New York
Columbia University
Statistics
Citations: 91
Authors: 13
Affiliations: 6
Identifiers
Doi:
10.1186/1471-2431-10-44
e-ISSN:
14712431
Research Areas
Food Security
Genetics And Genomics
Infectious Diseases
Maternal And Child Health
Study Locations
Tanzania