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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.
- Source :
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Sexually transmitted infections [Sex Transm Infect] 2019 Mar; Vol. 95 (2), pp. 133-139. Date of Electronic Publication: 2018 Oct 15. - Publication Year :
- 2019
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Abstract
- Objectives: In 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.<br />Methods: In 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.<br />Results: With 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.<br />Conclusion: The 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.<br />Competing Interests: Competing interests: None declared.<br /> (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.)
- Subjects :
- Adolescent
Adult
Cross-Sectional Studies
Female
HIV Infections diagnosis
Health Personnel
Humans
India
Infant
Infectious Disease Transmission, Vertical prevention & control
Pregnancy
Pregnancy Complications, Infectious prevention & control
Pregnancy Complications, Infectious virology
Prenatal Care methods
Rural Population
Sexually Transmitted Diseases diagnosis
Sexually Transmitted Diseases prevention & control
Syphilis diagnosis
Syphilis prevention & control
Trichomonas Infections diagnosis
Trichomonas Infections prevention & control
Young Adult
Coinfection diagnosis
Coinfection prevention & control
HIV Infections prevention & control
Mobile Applications
Point-of-Care Systems
Prenatal Diagnosis methods
Subjects
Details
- Language :
- English
- ISSN :
- 1472-3263
- Volume :
- 95
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Sexually transmitted infections
- Publication Type :
- Academic Journal
- Accession number :
- 30322858
- Full Text :
- https://doi.org/10.1136/sextrans-2017-053491