TY - JOUR
T1 - The impact of structured mentor mother programs on presentation for early infant diagnosis testing in rural north-central Nigeria
T2 - A prospective paired cohort study
AU - Sam-Agudu, Nadia A.
AU - Ramadhani, Habib O.
AU - Isah, Christopher
AU - Erekaha, Salome
AU - Fan-Osuala, Chinenye
AU - Anaba, Udochisom
AU - Adejuyigbe, Ebunoluwa A.
AU - Charurat, Manhattan
N1 - Publisher Copyright:
© Copyright 2017 Wolters Kluwer Health, Inc.
PY - 2017/6/1
Y1 - 2017/6/1
N2 - Background: Early infant diagnosis (EID) by 2 months of age is an important prevention of mother-to-child cascade step that serves as an early postpartum indicator of program success. Uptake and timely presentation for infant HIV diagnosis are significant challenges in resource-limited settings. Few studies on maternal peer support (PS) have demonstrated impact on EID. The MoMent study evaluated the impact of structured PS on timely presentation for EID testing in rural North-Central Nigeria. Methods: A total of 497 HIV-positive pregnant women were consecutively recruited at 10 primary health care centers with structured, closely supervised Mentor Mother (MM) support, and 10 pair-matched primary health care centers with routine but ad hoc PS. EID was assessed among HIV-exposed infants delivered to recruited women, and was defined by presentation for DNA polymerase chain reaction testing between 35 and 62 days of life. A logistic regression model with generalized estimating equation to account for clustering was used to assess the effect of MMs on EID presentation. Results: Data from 408 live-born infants were available for analysis. Exposure to MM support was associated with higher odds of timely EID presentation among infants, compared with routine PS (adjusted odds ratios = 3.7, 95% confidence interval: 2.8 to 5.0). Conclusions: Closely supervised, organized MM support significantly improved presentation for EID among HIV-exposed infants in a rural Nigerian setting. Structured PS can improve rates of timely EID presentation and potentially the uptake of EID testing in resource-limited settings.
AB - Background: Early infant diagnosis (EID) by 2 months of age is an important prevention of mother-to-child cascade step that serves as an early postpartum indicator of program success. Uptake and timely presentation for infant HIV diagnosis are significant challenges in resource-limited settings. Few studies on maternal peer support (PS) have demonstrated impact on EID. The MoMent study evaluated the impact of structured PS on timely presentation for EID testing in rural North-Central Nigeria. Methods: A total of 497 HIV-positive pregnant women were consecutively recruited at 10 primary health care centers with structured, closely supervised Mentor Mother (MM) support, and 10 pair-matched primary health care centers with routine but ad hoc PS. EID was assessed among HIV-exposed infants delivered to recruited women, and was defined by presentation for DNA polymerase chain reaction testing between 35 and 62 days of life. A logistic regression model with generalized estimating equation to account for clustering was used to assess the effect of MMs on EID presentation. Results: Data from 408 live-born infants were available for analysis. Exposure to MM support was associated with higher odds of timely EID presentation among infants, compared with routine PS (adjusted odds ratios = 3.7, 95% confidence interval: 2.8 to 5.0). Conclusions: Closely supervised, organized MM support significantly improved presentation for EID among HIV-exposed infants in a rural Nigerian setting. Structured PS can improve rates of timely EID presentation and potentially the uptake of EID testing in resource-limited settings.
KW - Early infant diagnosis
KW - Implementation science
KW - Mentor mothers
KW - Nigeria
KW - PMTCT
UR - http://www.scopus.com/inward/record.url?scp=85020400070&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85020400070&partnerID=8YFLogxK
U2 - 10.1097/QAI.0000000000001345
DO - 10.1097/QAI.0000000000001345
M3 - Article
C2 - 28498188
AN - SCOPUS:85020400070
SN - 1525-4135
VL - 75
SP - S182-S189
JO - Journal of Acquired Immune Deficiency Syndromes
JF - Journal of Acquired Immune Deficiency Syndromes
ER -