ABSTRACT
Aims: The usefulness of rapid oral fluid HIV antibody tests has rarely been evaluated in exposed babies. Study Design: A diagnostic survey comparing the performance of oral fluid HIV antibody test and the routine rapid blood screening test. Place and Duration of Study: University College Hospital, Ibadan and Nigerian Institute of Medical Research, Lagos, between May 2010 and April 2011. Methodology: The study involved children aged less than 18 months referred for screening in two large HIV care programmes in Nigeria using rapid antibody tests - an oral fluid test (Test A) and the routine blood test (Test B). The testing was blinded and HIV status was confirmed using DNA PCR. Results: A total of 94 children were studied with ages ranging from 0.13 to less than 18months. Out of the 94 parallel tests, when compared with DNA PCR, there were 7 (7.5%) discordant results. Test A gave one false positive, one false negative and no indeterminate result. Test B gave four false positive, one false negative and two indeterminate results. Test A had a sensitivity of 93.3%, specificity of 98.7%, positive predictive value of 93.3% and negative predictive value of 98.7% compared with Test B which had 90.0%, 92.9%, 60.0% and 98.7% respectively. Among the caregivers 88 (93.6%) preferred oral fluid testing to blood as it is painless and easy to perform. Conclusion: Compared with the rapid antibody blood test, the oral fluid test correlates better with DNA PCR in detecting the absence of infection in HIV exposed babies. Given this performance, it may be useful in expanding testing in HIV exposed children in settings where there are challenges with early infant diagnosis.
ABSTRACT
Background : Provision of antenatal care (ANC) is included in the pillars of maternal health care promoted as effective answers to maternal mortality. Early antenatal registration has been linked with optimal utilization and appreciable reduction of perinatal morbidity and mortality. This study aimed to determine the profile and possible predictors of pregnant women who presented early for antenatal registration. Methods : A cross-sectional study was conducted among 796 women presented for antenatal registration at a tertiary hospital. Information was obtained by a self-administered open- and closed-ended questionnaire and analyzed with Statistical Package of Social Science (SPSS) 12.0 software. Results : The mean gestational age at booking was 20 weeks. Univariate analysis showed that first trimester booking was significantly with more educated women; professionals; women of lower parity and those who have had previous stillbirths (P 0.05). Low parity (OR 1.76; 95CI 2.79-1.11) and previous stillbirth (OR 2.97; 95CI 1.61-5.51) were significant predictors of early booking on multivariate analysis. Conclusion : Long-term advocacy and investment in female education will contribute significantly to primary prevention of late or non-attendance of ANC. Pre-conception clinics and community awareness campaigns would be necessary tools to reach these women and encourage them to register early when pregnant