Will an innovative connected AideSmart! app-based multiplex, point-of-care screening strategy for HIV and related coinfections affect timely quality antenatal screening of rural Indian women? Results from a cross-sectional study in India

Autor: Jana Daher, H. R. Prashanth, Rajesh Kannangai, Nitika Pant Pai, Rani Diana Sahni, Rita Isaac, Priya Abraham, Achal Shetty
Rok vydání: 2017
Předmět:
Adult
Rural Population
medicine.medical_specialty
Adolescent
Cross-sectional study
Epidemiology
Health Personnel
Point-of-Care Systems
Sexually Transmitted Diseases
India
Trichomonas Infections
Context (language use)
HIV Infections
Dermatology
03 medical and health sciences
Young Adult
0302 clinical medicine
Pregnancy
Completion rate
Prenatal Diagnosis
medicine
STBBI
antenatal care
cross-sectional study
Humans
030212 general & internal medicine
Syphilis
Pregnancy Complications
Infectious
Functional illiteracy
Point of care
030219 obstetrics & reproductive medicine
Transmission (medicine)
business.industry
Coinfection
Public health
Infant
Prenatal Care
medicine.disease
Mobile Applications
Infectious Disease Transmission
Vertical
3. Good health
multiplex
point-of-care
innovative
HIV
Infectious Diseases
Cross-Sectional Studies
Family medicine
Female
business
Zdroj: Sexually Transmitted Infections
ISSN: 1472-3263
Popis: ObjectivesIn rural pregnant Indian women, multiple missed antenatal screening opportunities due to inadequate public health facility-based screening result in undiagnosed HIV and sexually transmitted bloodborne infections (STBBIs) and conditions (anaemia). Untreated infections complicate pregnancy management, precipitate adverse outcomes and risk mother-to-child transmission. Additionally, a shortage of trained doctors, rural women’s preference for home delivery and health illiteracy affect health service delivery. To address these issues, we developed AideSmart!, an innovative, app-based, cloud-connected, rapid screening strategy that offers multiplex screening for STBBIs and anaemia at the point of care. It offers connectivity, integration, expedited communications and linkages to clinical care throughout pregnancy.MethodsIn a cross-sectional study, we evaluated the AideSmart! strategy for feasibility, acceptability, preference and impact. We trained 15 healthcare professionals (HCPs) to offer the AideSmart! strategy to 510 pregnant women presenting for care to outreach rural service units of Christian Medical College, Vellore, India.ResultsWith the AideSmart! screening strategy, we recorded an acceptability of 100% (510/510), feasibility (completion rate) of 91.6% (466/510) and preference of 73%. We detected 239 infections/conditions (239/510, 46.8%) at the point-of-care, of which 168 (168/239; 70%) were lab confirmed, staged and treated rapidly. Of the 168 confirmed infections/conditions, 127 were anaemia, 11 Trichomonas and 30 hepatitis B virus (HBV) (25 resolved naturally, 5 active infections). Four infants (4/5; 80%) were prophylaxed for HBV and were declared disease-free at 9 months. Recruited participants were young; mean age was 24 years (range: 17–40) and 74% (376/510) were in their second trimester. Furthermore, 95% of the participants were retained throughout their pregnancy.ConclusionThe AideSmart! strategy was deemed feasible to operationalise by HCPs. It was accepted and preferred by participants, resulting in timely screening and treatment of HIV/STIs and anaemia, preventing mother-to-child transmission. The strategy could be reverse-innovated to any context to maximise its health impact.
Databáze: OpenAIRE
Externí odkaz: