In-Home HIV Testing and Nevirapine Dosing by Traditional Birth Attendants in Rural Zambia: A Feasibility Study
| Autor: | Alana T. Brennan, Katherine Semrau, Arthur Mazimba, Leoda Hamomba, Nancy A. Scott, Belinda Botha, Phil Seidenberg, Donald M. Thea, Caitlin Goggin, Portipher Pilingana |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Rural Population
Pediatrics medicine.medical_specialty Nevirapine Anti-HIV Agents Population Zambia HIV Infections Midwifery Article Acquired immunodeficiency syndrome (AIDS) Pregnancy immune system diseases HIV Seropositivity Maternity and Midwifery medicine Humans Mass Screening Dosing Pregnancy Complications Infectious education Mass screening Home Childbirth education.field_of_study Obstetrics business.industry Infant Newborn virus diseases Obstetrics and Gynecology medicine.disease Home Care Services Infectious Disease Transmission Vertical Regimen Feasibility Studies Female Rural area business medicine.drug |
| Zdroj: | Journal of Midwifery & Women's Health. 59:198-204 |
| ISSN: | 1526-9523 |
| DOI: | 10.1111/jmwh.12038 |
| Popis: | INTRODUCTION: Access to lifesaving prevention of mother-to-child transmission (PMTCT) services is problematic in rural Zambia. The simplest intervention used in Zambia has been 2-dose nevirapine (NVP) administration in the peripartum period a regimen of 1 NVP tablet to the mother at the onset of labor and 1 dose in the form of syrup to the newborn within 4 to 72 hours after birth. This 2-dose regimen has been shown to reduce MTCT by nearly 50%. We set out to demonstrate that in-home HIV testing and NVP dosing by traditional birth attendants (TBAs) is feasible and acceptable by women in rural Zambia. METHODS: This was a pilot program using TBAs to perform rapid saliva-based HIV testing and administer single-dose NVP in tablet form to the mother at the onset of labor and syrup to the infant after birth. RESULTS: A total of 280 pregnant women were consented and enrolled into the program of whom 124 (44.3%) gave birth at home with the assistance of a trained TBA. Of those 16 (12.9%) were known to be HIV positive and 101 of the remaining 108 (93.5%) accepted a rapid HIV test. All these women tested HIV negative. In the subset of 16 mothers who were HIV positive 13 (81.3%) took single-dose NVP administered by a TBA between 1 and 24 hours prior to birth and 100% of exposed newborns (16 of 16) received NVP syrup within 72 hours after birth 80% of whom were dosed in the first 24 hours of life. DISCUSSION: With the substantial shortage of human resources in public health care throughout sub-Saharan Africa it is extremely valuable to utilize lay health care workers to help extended services beyond the level of the facility. Given the high uptake of PMTCT services we believe that TBAs with proper training and support can successfully provide country-approved PMTCT. (c) 2013 by the American College of Nurse-Midwives. |
| Databáze: | OpenAIRE |
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