|dc.contributor.author||Kebaya, Lilian M||
|dc.identifier.citation||Degree Of Masters Of Medicine (mmed) In Paediatrics And Child Health, University Of Nairobi||en_US
HIV is a major contributor to infant mortality. A significant gap remains between the uptake of
infant and maternal ARV regimens and only a minority of HIV-exposed infants receives
prophylaxis and safe infant feeding. Losses to follow-up of HIV-exposed infants are associated
with shortcomings of facility-based PMTCT models with weak community support of linkages.
The rapid expansion of mobile phone coverage in Africa, and in Kenya, presents an opportunity
to strengthen linkages between caregivers and health providers. Mobile phone use offers an
option to improving care and promoting retention for the mother-baby pairs, which is a major
challenge in efforts to achieving an HIV-free generation.
To compare self-reported adherence to infant nevirapine (NVP) prophylaxis and retention in care
over 10 weeks in HIV exposed infants randomized to 2-weekly mobile phone calls (intervention)
versus no phone calls (control).
Open label Randomized controlled trial
One hundred and fifty HIV infected women drawn from 3 health facilities in Western Kenya and
their infants were randomly assigned to receive either phone-based reminders on PMTCT
messages or standard health care messages (no calls) within 24 hours of delivery. The group in
the intervention arm received phone calls fortnightly. At 6 and 10 weeks following
randomization we collected data on infant adherence to nevirapine, mode of infant feeding,
early HIV testing and retention in care in both study arms. All analyses were intention to treat.
Seventy five women were each randomized to the intervention and control arms respectively. At
6 weeks follow-up 68 (90.7%) of participants in the intervention arm reported adherence to
infant NVP prophylaxis, compared with 54 (72%) participants in the control group (p = 0.005).
Participants in the intervention arm were also significantly more likely to be retained in care than
those in the control group. At 6 weeks 59 mother-infant pairs (78.7%) attended scheduled visits
with the visits coinciding with the appointment date versus 44 (58.7%) in the control arm (p =
0.009). At 10 weeks the revisit rates were 69.3% (52) in intervention arm and 37.3% (28) in
control arm for the 150 mother-infant pairs evaluated (p < 0.001).
These results suggest that phone calls can be an important tool to improve adherence to infant
NVP prophylaxis and retention in care for HIV exposed infants||en_US
|dc.publisher||University of Nairobi||en_US
|dc.title||Efficacy of phone use on adherence to nevirapine prophylaxis and retention in care among HIV-exposed infants in prevention of mother to child transmission of HIV: a randomized clinical trial||en_US
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya||