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A. Muchedzi , A. Chadambuka , B. Chikwinya , A. Mahomva , A Mushavi

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. Chikwinya , A. Mahomva , A Mushavi

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A. Muchedzi , A. Chadambuka , B. Chikwinya , A. Mahomva , A Mushavi

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  1. 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. Chikwinya, A. Mahomva, A Mushavi Abstract Number: TUPDE0204

  2. 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

  3. 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

  4. Background • Handover of the 50 POC CD4 machines

  5. Background: Trainings Health worker trainings on use of POC CD4 machine and data collection tools

  6. 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

  7. RESULTS Table 1: CD4 Testing and ART initiation among HIV+ pregnant women before and after deployment of POC CD4 machine

  8. RESULTS Table 2: CD4 Testing among clients seen in MCH after deployment of POC CD4 machine at the 43 sites: Jul 2011- March 2012 • ART-eligible initiated on ART in ANC – 1289 (64%)

  9. 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.

  10. Acknowledgements • Zimbabwe 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

  11. THE TIME TO ELIMINATE PEDIATRIC HIV AND AIDS IS NOW - THANK YOU -

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