a. muchedzi, a. chadambuka, b. chikwinya1, a. mahomva, a mushavi abstract number: tupde0204
DESCRIPTION
Evaluating the effect of point-of-care CD4 testing on access to eligibility screening and ART initiation among HIV-positive pregnant women in Zimbabwe: Towards elimination of new pediatric HIV infections by 2015 . A. Muchedzi, A. Chadambuka, B. Chikwinya1, A. Mahomva, A Mushavi - PowerPoint PPT PresentationTRANSCRIPT
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Evaluating the effect of point-of-care CD4 testing on access to eligibility
screening and ART initiation among HIV-positive pregnant women in Zimbabwe:
Towards elimination of new pediatric HIV infections by 2015
A. Muchedzi, A. Chadambuka, B. Chikwinya1, A. Mahomva, A Mushavi
Abstract Number: TUPDE0204
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BACKGROUND
• Treatment-eligible HIV-positive pregnant women have the highest risk of vertical transmission
• In 2010, 11% of 41,042 HIV-positive pregnant women initiated on ART in ANC.
• Low proportion was partially due to limited access to CD4 testing
• CD4 machines in Zimbabwe were mainly laboratory based and highly centralized
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Use of CD4 POC technology in Zimbabwe
• To increase access to ART eligibility:
• In 2009, Pima TM point-of-care evaluated and endorsed in Zimbabwe
• portable, battery poweredproduce a CD4 count in 20mincan be used by non- lab staff
• EGPAF supported bypartners to procure50 POC CD 4 machines
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Background
• Handover of the 50 POC CD4 machines
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Background: TrainingsHealth worker trainings on use of POC CD4 machine and data collection tools
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METHODS
A quasi-experimental before-and-after study was conducted, at 43 high-volume PMTCT sites
Deployment of the POC CD4 machines was the intervention
Data were collected before (Oct 2010 -June 2011) and after (Jul 2011- Mar 2012)
Data were analyzed using SPSS v15.0. Statistical differences were tested
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RESULTS
Before POC CD4 Oct 2010 – Jun 2011
n=4988
After POC CD4Jul 2011 – Mar 2012
n=5156 P Value
HIV+ pregnant women CD4 Testedn(%)
2544 (51%) 4176 (81%) 0. 023
HIV+ pregnant women initiated ART n(%)
449 (9%) 1289 (25%) 0.001
Table 1: CD4 Testing and ART initiation among HIV+ pregnant women before and after deployment of POC CD4 machine
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RESULTS
Table 2: CD4 Testing among clients seen in MCH after deployment of POC CD4 machine at the 43 sites: Jul 2011- March 2012
ANC PNC Male
Total CD 4 tested 4176 1861 723
CD4 <350cells/mm3 2016 (48%) 738 (40%) 311 (43%)
• ART-eligible initiated on ART in ANC – 1289 (64%)
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Conclusion Deployment of POC CD4 analyzers was
associated with significant increases in CD4 testing and ART initiation among HIV-positive pregnant women at the 43 intervention sites.
Based on these early findings, expansion of POC CD4 machines to all high-volume PMTCT sites in Zimbabwe is recommended to increase access to ART for eligible pregnant women towards elimination of new HIV infections in children by 2015.
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AcknowledgementsZimbabwe Ministry of Health and Child Welfare
U.S. President’s Emergency Plan for AIDS Relief through USAID
UK Department for International Development
The Children’s Investment Fund Foundation
EGPAF-FAI partners Kapnek,
OPHID
ZAPP-UZ
10
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THE TIME TO ELIMINATE PEDIATRIC HIV AND AIDS IS NOW- THANK YOU -