Trends in uptake of early infant diagnosis for HIV: implementation results of the Ugandan military PMTCT program

Paul Lubega, Stephen Lawoko, Filbert Akatukunda, Gloria Seruwagi, John Bosco Ninsima, Lydia Gahurra, Eric Lugada, Juliet Akao, Evelyn Asiimwe, Cassette Wamundu, Robert Ssemmanda, Ben Kikaire, Twaha Rwegyema, Denis Bwayo


Background: Early infant diagnosis (EID) is an important strategy of the Prevention of Mother-to-child transmission (PMTCT) and when implemented in combination with other strategies could eliminate HIV MTCT. We implemented a series of strategic interventions intended to improve EID at 9 Military facilities in Uganda and evaluated their impact on uptake of EID.

Methods: A retrospective cross-sectional design was adopted, following-up HIV Exposed Infants (HEI) at the study sites over a 2 year period, and using a data extraction tool to capture4 indicators of EID namely; number of HIV-positive mothers, number of HEI enrolled, number of PCR and rapid tests performed on HEI, and number of HIV-positive results of HEI. Scatter plots and simple linear regression were applied to demonstrate trends in EID uptake and estimate intervention impact over time. Statistical significance was assumed at p<0.05.

Results: We established incremental trends in numbers of first PCR (f [1,6]=2.8; p=0.15),third PCR (f [1,6]=8.4; p<0.05), rapid tests (f [1,6]=16.1; p<0.05) performed on HEI, and a modest decline in HIV-positivity among HEI over the study period. The intervention improved retention in PMTCT cascade to 80%, when contrasted with the national average of 70%.

Conclusions: We have demonstrated that interventions invoking pre-booking HIV-positive pregnant mothers during antenatal care, follow up of mother-baby pairs using telephone and mentor mothers and integrating EID in immunization programs can improve uptake of EID in a relatively short period, and with a positive impact on EID indicators.


Early infant diagnosis, Intervention, Trends, Impact, Military facilities, Uganda

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