Reduction of Vertical Transmission of HIV Through the Use of Mother Buddies in Plateau and Kaduna States of Nigeria
American Journal of Clinical and Experimental Medicine
Volume 3, Issue 5, September 2015, Pages: 200-206
Received: Jul. 19, 2015;
Accepted: Jul. 28, 2015;
Published: Aug. 6, 2015
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Christian Ogoegbunem Isichei, Department of Chemical Pathology, Faculty of Medical Sciences, University of Jos, Jos, Nigeria
David Deakin, Tearfund, London, United Kingdom
Danladi Musa, Tearfund, Jos, Nigeria
Paul Mershak, Tearfund, Jos, Nigeria
Caroline Onwuezobe, Faith Alive Foundation, Jos, Nigeria
Martha Nyam, Faith Alive Foundation, Jos, Nigeria
Jane Nwoke, Faith Alive Foundation, Jos, Nigeria
Background. Nigeria has the second largest number of People Living with HIV/AIDS (PLWHA) in the world. In 2009, of 27,870 Nigerian infants exposed to HIV, only 15,785 were on antiretroviral prophylaxis and 32% of the HIV-positive women received ARVs.It is now possible to reduce the rate of HIV transmission from HIV-infected mothers to their infants to less than 2%. While achievements in Prevention of Parent-To-Child Transmission (PPTCT) of HIV programmes or Prevention of Mother-To-Child Transmission (PMTCT) of HIV programmes are dramatic, these programmes need to be further improved and sustained. Methods. We developed “mother buddies” to improve access to PPTCT services in three underserved local government areas with 15 communities of Plateau and Kaduna States of Northern Nigeria in keeping with Dzama and Deakin’s pilot study in Malawi. Mother buddies are HIV-positive mothers who use Mobile Interactions bringing Hope (Mihope) phones to provide one-to-one life-saving support to vulnerable pregnant women and their families during pregnancy and for 6 months after child birth. The programme was implemented from October 2013 to March 2015.Life-saving support included information on HIV, PPTCT, family planning, Sexually Transmitted Infections, increasing male partners involvement and Antiretroviral(ARVs). Educational topics included the importance of attending antenatal clinic (ANC) before delivery, healthy diet patterns, partner testing for HIV, syphilis testing and malaria prophylaxis. Results. All education and support was accomplished on a one-on-one basis, thereby increasing knowledge, changing attitudes and practice. It also promoted health seeking behavior that improved access and uptake for PMTCT services in these rural areas. Of the 97 HIV--positive women, 64 gave birth safely and the babies received PPTCT/PMTCT Interventions. Forty-seven babies tested negative to two DNA PCR tests at 6 weeks after delivery and 6 weeks after cessation of breast milk feeding, while 17 babies tested negative to first DNA PCR, and were awaiting second DNA PCR after 6 weeks of cessation of breast feeding at the time of this analysis. Conclusions. Despite logistical challenges, security concerns and project design limitations, “Mother buddies” demonstrated the capacity to increase access to PPTCT/PMTCT services in hard to reach and underserved communities with great impact/outcomes.
Christian Ogoegbunem Isichei,
Reduction of Vertical Transmission of HIV Through the Use of Mother Buddies in Plateau and Kaduna States of Nigeria, American Journal of Clinical and Experimental Medicine.
Vol. 3, No. 5,
2015, pp. 200-206.
Isichei Christian, Courtney Snelling Jennifer, Onwuezobe Caroline, Oyebode Tinuade, Mercy Isichei, Njab Jean et al (2015). A Novel Intervention to Increase Male Involvement in Prevention of Parent to Child Transmission of HIV. Science Journal of Clinical Medicine, 4(2):41-51.
Christian O. Isichei, Arthur J.Ammann (2015).The role of Trained Birth Attendants in Delivering PMTCT Services. American Journal of Health Research 3(4):232-238
Christian Isichei, Pamela Brown, Mercy Isichei, Jean Njab, Tinuade Oyebode, Prosper Okonkwo. (2015). HIV prevalence and associated risk factors among rural pregnant women in North Central Nigeria. American Journal of Health Research, 3(1):18-23.
Dzama H, Deakin D Empowering “Mother Buddies” of pregnant mothers: lessons learnt from “grassroot communities” on the use of an android-based mobile phone system in the reduction of HIV and maternal mortality in Malawi-Poster Exhibition WEPE452 AIDS 2014, 20TH International AIDS Conference,Melbourne,Australia(July 20-25th 2014)
WHO (2010) 'Guidelines on HIV and Infant Feeding 2010', Geneva; Friday, 1 January, 2010.
WHO (2010) 'Antiretroviral drugs for treating pregnant women and preventing HIV infection in infants: Towards Universal Access', Geneva; Friday, 1 January, 2010
WHO (1996) 'Maternity waiting homes: a review of experiences'.
Tenthani et al (2014) ' Retention in care under universal antiretroviral therapy for HIV-infected pregnant and breastfeeding women (‘Option B+’) in Malawi' in Lippincott Williams & Wilkins.
Temmerman M. et al, "Mother-to-child HIV transmission in resource poor settings: how to improve coverage?", AIDS 17(8), 23 May 2003.
Bulterys M. et al (26 January 2002), " Role of traditional birth attendants in preventing parental transmission of HIV", BMJ 324(7331).
UNICEF (2008, July) ' Guidance on ensuring effective supply chain planning for commodities needed for implementation and scale up of services for the prevention of mother to child transmission PPTCT of HIV infection'
Bassett M.T. (March 2002), ' Ensuring a Public Health Impact of Programs to Reduce HIV Transmission from Mothers to Infants: The Place of Voluntary Counseling and Testing', American Journal of Public Health 92(3)/
Shetty A.K. et al (November 2005), ' The feasibility of voluntary counseling and HIV testing for pregnant women using community volunteers in Zimbabwe', Int J STD AIDS.
Homsy et al (June 2006), ' Routine intrapartum HIV counseling and testing for prevention of mother-to-child transmission of HIV in a rural Ugandan hospital', JAIDS 42(2).
CDC (26 November 2004), ' Introduction of Routine HIV Testing in Prenatal Care --- Botswana, 2004', MMWR 53(46).
Wilfert C. (13 August 2006), ' Site Specific Factors Influencing Access to PPTCT Services, Trends with Time, and Suggestions for Improvement', XVI International AIDS Conference.
Angotti N. et al (2011, July) ‘ An offer you can't refuse? Provider-initiated HIV testing in antenatal clinics in rural Malawi’.
WHO (2011) ' Towards the elimination of mother-to-child transmission of HIV: Report of a WHO technical consultation (9-11 November 2010, Switzerland)'.
Malonza I.M. et al (3 January 2003), " The effect of rapid HIV-1 testing on uptake of perinatal HIV-1 interventions: a randomized clinical trial", AIDS 17(1).
Bulterys M. et al (28 February 2002), " Advances in the prevention of mother-to-child HIV-1 transmission: current issues, future challenges", AIDScience 2(4).
Lu L et al (2009), " HIV incidence in pregnancy and in the first post-partum year and implications for PPTCT programs: Francistown, Botswana", CDC.
UNAIDS (2012) ' Women Out Loud'.
USAID (2 April 2003), " Women's Experiences with HIV Serodisclosure in Africa: Implications for VCT and PPTCT" [PDF].
Mark J.Siedner et al A combination of SMS and transportation reimbursement intervention to improve HIV care following abnormal CD4 test results in rural Uganda, a prospective observational study,BMC Medicine 2015,13:160.
Martin-Herz S.P. et al (December 2006) "Perceived risks and benefits of HIV testing, and predictors of acceptance of HIV counseling and testing among pregnant women in Zimbabwe", International Journal of STD & AIDS 17(12).
USAID (2 April 2003), " Women's Experiences with HIV Serodisclosure in Africa: Implications for VCT and PPTCT " [PDF].
Medley A. et al (April 2004), " Rates, barriers and outcomes of HIV serostatus disclosure among women in developing countries: implications for prevention of mother-to-child transmission programmes", Bulletin of the World Health Organization 82(4).
Semrau K. et al (24 March 2005), " Women in couples antenatal HIV counseling and testing are not more likely to report adverse social events", AIDS 19(6).
Farquhar C. et al (15 December 2004), " Antenatal couple counseling increases uptake of interventions to prevent HIV-1 transmission", JAIDS 37(5).
PlusNews (2012, January 16th) ‘ KENYA: The downside of male involvement in PPTCT ’.
Smart T. and Sheriff L. (14 July 2006), " Getting the most prevention and care out of programmes for the prevention of mother-to-child transmission", HATIP 70. “[PDF].
De Paoli M. M. et al (May 2004), " Factors influencing acceptability of voluntary counseling and HIV-testing among pregnant women in Northern Tanzania", AIDS Care 16(4).
UNAIDS (2011) ' Countdown to Zero: Global Plan Towards the Elimination of New HIV Infections Among Children By 2015 and Keeping Their Mothers Alive 2011-2015'.
Linkages Project (14 April 2004), "A Review of UNICEF Experience with the Distribution of Free Infant Formula for Infants of HIV-Infected Mothers in Africa".
All Africa (2010, 11th March), "Mothers' protest at withdrawal of free formula milk".
Coutsoudis A. et al, " Free formula milk for infants of HIV-infected women: blessing or curse?", Health Policy and Planning 17(2), June 2002.
WHO/UNAIDS/UNICEF (2010) 'Towards Universal Access: Scaling up priority HIV/AIDS interventions in the health sector', Geneva.
UN News Centre (2010, 11th January)'UN seeks to virtually eliminate mother-to-child transmission of HIV/AIDS in Africa'.