The HIV diagnostic assistant: early findings from a novel HIV testing cadre in Malawi

Autor: Maria H. Kim, Khumbo Namachapa, Elijah Kavuta, Peter N. Kazembe, Robert J. Flick, Rose Nyirenda, Saeed Ahmed, Katherine R Simon, Alan Schooley, Joe Theu, Mina C. Hosseinipour
Rok vydání: 2019
Předmět:
0301 basic medicine
Male
Pediatrics
Malawi
HIV diagnostic tests
Human immunodeficiency virus (HIV)
HIV Infections
medicine.disease_cause
Interrupted Time Series Analysis
0302 clinical medicine
Pregnancy
Syphilis testing
Health care
Outcome Assessment
Health Care
Immunology and Allergy
Mass Screening
030212 general & internal medicine
Pregnancy Complications
Infectious
Child
Pregnancy Outcome
healthcare
Prenatal Care
3. Good health
models/projections
Infectious Diseases
Child
Preschool
Workforce
Female
Adult
medicine.medical_specialty
Adolescent
Epidemiology and Social
Health Personnel
Immunology
Hiv testing
03 medical and health sciences
Young Adult
medicine
Humans
healthcare human resources
Syphilis
business.industry
Diagnostic Tests
Routine
Infant
Newborn
Infant
Patient Acceptance of Health Care
Infectious Disease Transmission
Vertical
030104 developmental biology
Africa
business
Zdroj: AIDS (London, England)
ISSN: 1473-5571
Popis: Objectives: In 2015, Malawi piloted the HIV diagnostic assistant (HDA), a cadre of lay health workers focused primarily on HIV testing services. Our objective is to measure the effect of HDA deployment on country-level HIV testing measures. Design: Interrupted time series analysis of routinely collected data to assess immediate change in absolute numbers and longitudinal changes in trends. Methods: Data from all HDA sites were divided into two periods: predeployment (October 2013 to June 2015) and postdeployment (July 2015 to December 2017). Monthly rates of several key HIV testing measures were evaluated: HIV testing, including all tests done, new positives, and confirmatory testing. Syphilis testing at antenatal clinic (ANC) and early infant diagnosis were also assessed. Findings: The number of patients tested for HIV per month increased after HDA deployment across all sex, age, and testing subgroups. The number of tests immediately increased by 35 588 (P = 0.031), and the postintervention trend was significantly greater than the preintervention slope (+3442 per month, P = 0.001). Of 7.4 million patients tested for HIV in the postdeployment period, 2.6 million (34%) were attributable to the intervention. The proportion of new positives receiving confirmatory tests increased from 28% preintervention to 98% postintervention (P
Databáze: OpenAIRE
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