Effect of a Mentor Mother Programme on retention of mother-baby pairs in HIV care: A secondary analysis of programme data in Uganda


Autoři: Jude Ofuzinim Igumbor aff001;  Joseph Ouma aff001;  Kennedy Otwombe aff001;  Eustasius Musenge aff001;  Felix Chima Anyanwu aff001;  Tariro Basera aff001;  Marjorie Mbule aff003;  Esca Scheepers aff003;  Kathrin Schmitz aff003
Působiště autorů: School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa aff001;  Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa aff002;  mothers2mothers, Cape Town, South Africa aff003
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0223332

Souhrn

Background

Community healthcare workers (CHWs) play an important role in promoting HIV-care retention. Notwithstanding inconsistencies in the outcomes of CHW programmes, these programmes are known to have a positive effect on retention of mother-baby pairs in HIV-care in sub-Saharan Africa.

Aim

The aim of this analysis was to assess the effect of mothers2mothers (m2m) Ugandan Mentor Mother (MM) programme on the retention of mother-baby pairs in HIV-care.

Methods

We conducted a secondary analysis of data obtained from the m2m Uganda MM programme in nine East Central districts. The primary data was generated through a quasi-experimental study of women attending prevention of mother to child transmission of HIV (PMTCT) clinics in Uganda between January 2011 and March 2014; where those who were enrolled at PMTCT sites with the MM intervention (n = 1161) were compared with those who received standard PMCTCT services without the MM intervention (n = 1143). Frequencies and descriptive statistics were calculated for categorical and continuous measures respectively. Risk factors for retention in care were determined by clustered generalised estimating equations and reported as adjusted odds ratios (AOR) with 95% confidence intervals (95% CI).

Results

Retention in the PMTCT cascade was significantly higher for mother-baby pairs in the intervention arm compared to those in the control arm across all measured time points (96.7% vs 65.8% at 6 weeks after birth, p<0.001; 81.5% vs 42% at 6 weeks after cessation of breastfeeding, p<0.001; and 71.2% vs 20.6% at 18 months after birth, p<0.001). Relative to the control group, women in the intervention group were less likely to be lost to follow up following treatment initiation (AOR 0.05, 95% CI: 0.02, 0.15). There was no difference in the proportion of the retained mother-baby pairs who received prescribed PMTCT interventions at different time points but a significantly higher number of mother-baby pairs in the intervention arm were retained at different time points.

Conclusion

HIV positive mothers and their HIV exposed children in the mothers2mothers Ugandan Mentor Mother programme had higher retention in HIV care at every step along the PMTCT cascade. We therefore recommend adoption of this peer-to-peer model in sub-Saharan Africa to complement retention in care strategies and health system interventions especially among priority and key populations.

Klíčová slova:

Antiretroviral therapy – Breast feeding – HIV – HIV diagnosis and management – HIV prevention – Infants – Pregnancy – Uganda


Zdroje

1. Muhumuza S, Akello E, Kyomugisha-Nuwagaba C, Baryamutuma R, Sebuliba I, Lutalo IM, Kansiime E, Kisaakye LN, Kiragga AN, King R BW. Retention in care among HIV-infected pregnant and breastfeeding women on lifelong antiretroviral therapy in Uganda: A retrospective cohort study. PLoS One. 2017;12(12):e0187605. doi: 10.1371/journal.pone.0187605 29272268

2. Uganda Ministry of Health. All Publications | Ministry of Health Knowledge Management Portal [Internet]. 2017 [cited 2019 Feb 22]. Available from: http://library.health.go.ug/publications/service-delivery-diseases-control-prevention-communicable-diseases/hivaids/uganda-0

3. Unaids. GLOBAL REPORT: UNAIDS REPORT ON THE GLOBAL AIDS EPIDEMIC | 2010 [Internet]. 2010 [cited 2019 Feb 22]. Available from: http://www.unaids.org/globalreport/documents/20101123_GlobalReport_full_en.pdf

4. Bajunirwe F, Tumwebaze F, Akakimpa D, Kityo C MP and AG. Towards 90-90-90 Target: Factors Influencing Availability, Access, and Utilization of HIV Services—A Qualitative Study in 19 Ugandan Districts. Biomed Res Int. 2018;2018.

5. Vrazo AC, Firth J, Amzel A, Sedillo R, Ryan J PB. Interventions to significantly improve service uptake and retention of HIV‐positive pregnant women and HIV‐exposed infants along the prevention of mother‐to‐child transmission continuum of care: systematic review. Int Heal. 23(2):136–48.

6. Obai G, Mubeezi R MF. Rate and associated factors of non-retention of mother-baby pairs in HIV care in the elimination of mother-to-child transmission programme, Gulu-Uganda: a cohort study. BMC Heal Serv Res. 2017;17(1):48.

7. Miller K, Muyindike W, Matthews LT, Kanyesigye M SM. Program implementation of option B+ at a President’s emergency plan for AIDS relief-supported HIV clinic improves clinical indicators but not retention in Care in Mbarara, Uganda. AIDS Patient Care STDS. 2017;31(8):335–41. doi: 10.1089/apc.2017.0034 28650703

8. THE UGANDA HIV AND AIDS COUNTRY PROGRESS REPORT [Internet]. 2015 [cited 2019 Feb 22]. Available from: http://www.unaids.org/sites/default/files/country/documents/UGA_2017_countryreport.pdf

9. Nabukeera-Barungi N, Elyanu P, Asire B, Katureebe C, Lukabwe I, Namusoke E, Musinguzi J, Atuyambe L TN. Adherence to antiretroviral therapy and retention in care for adolescents living with HIV from 10 districts in Uganda. BMC Infect Dis. 2015;15(1):520.

10. DiCarlo A, Fayorsey R, Syengo M, Chege D, Sireng M, Reidy W & AE. Lay health worker experiences administering a multi-level combination intervention to improve PMTCT retention. BMC Heal Serv Res. 2018;18(1):17.

11. Asiimwe SB, Kanyesigye M, Bwana B, Okello S MW. Predictors of dropout from care among HIV-infected patients initiating antiretroviral therapy at a public sector HIV treatment clinic in sub-Saharan Africa. BMC Infect Dis. 2015;16(1):43.

12. Geng EH, Odeny TA, Lyamuya R, Nakiwogga-Muwanga A, Diero L, Bwana M, Braitstein P, Somi G, Kambugu A, Bukusi E WM. Retention in care and patient-reported reasons for undocumented transfer or stopping care among HIV-infected patients on antiretroviral therapy in Eastern Africa: application of a sampling-based approach. CLIN INFECT DIS. 2015;62(7):935–44. doi: 10.1093/cid/civ1004 26679625

13. Boeke CE, Nabitaka V, Rowan A, Guerra K, Kabbale A, Asire B, Magongo E, Nawaggi P, Mulema V, Mirembe B B V. Assessing linkage to and retention in care among HIV patients in Uganda and identifying opportunities for health systems strengthening: a descriptive study. BMC Infect Dis. 2018;18(1):138. doi: 10.1186/s12879-018-3042-8 29566666

14. Geldsetzer P, Yapa HMN, Vaikath M, Ogbuoji O, Fox MP ES& BT. A systematic review of interventions to improve postpartum retention of women in PMTCT and ART care. J Int AIDS Soc. 2016;19(1):20679. doi: 10.7448/IAS.19.1.20679 27118443

15. Ambia J & MJ. A systematic review of interventions to improve prevention of mother‐to‐child HIV transmission service delivery and promote retention. J Int AIDS Soc. 2016;19(1):20309. doi: 10.7448/IAS.19.1.20309 27056361

16. Van Lettow M, Bedell R, Mayuni I, Mateyu G, Landes M CA& MA. Towards elimination of mother‐to‐child transmission of HIV: performance of different models of care for initiating lifelong antiretroviral therapy for pregnant women in Malawi (Option B+). J Int AIDS Soc. 2014;17(1):18994.

17. Martineau T, Raven J, Aikins M, Alonso-Garbayo A, Baine S, Huss R MS and WK. Strengthening health district management competencies in Ghana, Tanzania and Uganda: lessons from using action research to improve health workforce performance. BMJ Glob Heal. 2018;3(2):p.e000619.

18. mothers2mothers. m2m.org—We believe in the power of mothers to end paediatric AIDS [Internet]. [cited 2019 Aug 7]. Available from: https://www.m2m.org/

19. Schmitz K, Scheepers E, Okonji E, Kawooya V. Retaining mother-baby-pairs in care and treatment: the mothers2mothers Mentor Mother Model mothers2mothers [Internet]. International AIDS Society (IAS).Vancouver, Canada; 2015 [cited 2019 Aug 7]. Available from: https://www.m2m.org/wp-content/uploads/2015/07/IAS2015_KathrinSchmitzPresentation.pdf

20. Schmitz K, Basera TJ, Egbujie B, Mistri P, Naidoo N MW& IJ. Impact of lay health worker programmes on the health outcomes of mother-child pairs of HIV exposed children in Africa: A scoping review. PLoS One. 2019;14(1):e0211439. doi: 10.1371/journal.pone.0211439 30703152

21. Uganda AIDS Commission. HIV and AIDS Uganda country progress report 2013. Kampala: Uganda AIDS Commission.;

22. Turner AG, Angeles G, Tsui AO, Wilkinson M MR. Sampling manual for facility surveys for population maternal health child health and STD programs in developing countries. 2001.

23. Ndaimani A, Chitsike I HC& S-PB. Missed Prevention of Mother-to-Child Transmission of HIV (PMTCT) Visits and Associated Programmatic Predictors: A Pilot Study. Adv Infect Dis. 2017;7(4):107.

24. Chang LW, Kagaayi J, Nakigozi G, Ssempijja V, Packer AH, Serwadda D, Quinn TC, Gray RH, Bollinger RC RS. Effect of peer health workers on AIDS care in Rakai, Uganda: a cluster-randomized trial. PLoS One. 2010;5(6):e10923. doi: 10.1371/journal.pone.0010923 20532194

25. Igumbor JO, Scheepers E, Ebrahim R, Jason A GA. An evaluation of the impact of a community-based adherence support programme on ART outcomes in selected government HIV treatment sites in South Africa. AIDS Care. 2011;23(2):231–6. doi: 10.1080/09540121.2010.498909 21259136

26. Sam-Agudu NA, Ramadhani HO, Isah C, Anaba U, Erekaha S, Fan-Osuala C, Galadanci H CM. The impact of structured Mentor Mother programs on 6-month postpartum retention and viral suppression among HIV-positive women in rural Nigeria: a prospective paired cohort study. J Acquir Immune Defic Syndr. 2017;75:S173–81. doi: 10.1097/QAI.0000000000001346 28498187

27. Phiri S, Tweya H, van Lettow M, Rosenberg NE, Trapence C, Kapito-Tembo A, Kaunda-Khangamwa B, Kasende F, Kayoyo V, Cataldo F SC. Impact of facility-and community-based peer support models on maternal uptake and retention in Malawi’s option B+ HIV prevention of mother-to-child transmission program: a 3-arm cluster randomized controlled trial (PURE Malawi). J Acquir Immune Defic Syndr. 2017;75:75:S140–8. doi: 10.1097/QAI.0000000000001357 28498183

28. Vogt F, Ferreyra C, Bernasconi A, Ncube L, Taziwa F, Marange W, Wachi D BH. Tracing defaulters in HIV prevention of mother‐to‐child transmission programmes through community health workers: results from a rural setting in Zimbabwe. J Int AIDS Soc. 2015;18(1):20022.

29. Ahoua L, Ayikoru H, Gnauck K, Odaru G, Odar E, Ondoa–Onama C, Pinoges L, Balkan S, Olson D P-RM. Evaluation of a 5-year programme to prevent mother-to-child transmission of HIV infection in Northern Uganda. J Trop Pediatr. 2009;56(1):43–52. doi: 10.1093/tropej/fmp054 19602489

30. Unaids. Start Free Stay Free AIDS Free—2017 progress report [Internet]. 2017 [cited 2019 Feb 22]. Available from: http://www.unaids.org/sites/default/files/media_asset/JC2923_SFSFAF_2017progressreport_en.pdf

31. Izudi J, Akot A, Kisitu GP AP& KA. Quality improvement interventions for early hiv infant diagnosis in Northeastern Uganda. Biomed Res Int. 2016;2016.

32. Sam-Agudu NA, Ramadhani HO, Isah C, Erekaha S, Fan-Osuala C, Anaba U, Adejuyigbe EA CM. The impact of structured Mentor Mother programs on presentation for early infant diagnosis testing in rural North-Central Nigeria: a prospective paired cohort study. J Acquir Immune Defic Syndr. 2017;75:S182–9. doi: 10.1097/QAI.0000000000001345 28498188

33. ENHAT-CS. The Role of Mother Mentors in Supporting HIV-Positive Mothers The Ethiopia Network for HIV/AIDS Treatment, Care and Support Program, Feburary 2014 [Internet]. [cited 2019 Feb 22]. Available from: https://www.msh.org/sites/msh.org/files/or_march_2014.pdf

34. Kim MH, Ahmed S, Buck WC, Preidis GA, Hosseinipour MC, Bhalakia A, Nanthuru D, Kazembe PN, Chimbwandira F, Giordano TP CE. The Tingathe programme: a pilot intervention using community health workers to create a continuum of care in the prevention of mother to child transmission of HIV (PMTCT) cascade of services in Malawi. J Int AIDS Soc. 2012;15:17389. doi: 10.7448/IAS.15.4.17389 22789644

35. Celletti F, Sherman G MA. Early infant diagnosis of HIV: review of current and innovative practices. Curr Opin HIV AIDS. 2017;12(2):112–6. doi: 10.1097/COH.0000000000000343 27941493


Článek vyšel v časopise

PLOS One


2019 Číslo 10