Early Infant Diagnosis Point of Care Pilot

Evaluation of Point-Of-Care Testing Assays for Early Infant in Mozambique-Cluster Randomised Trial

In Mozambique, early infant HIV diagnosis (EID, i.e. HIV screening of infants under 18 months of age) is conducted using molecular diagnostics at central laboratories in Maputo, Nampula, Beira and Quelimane. However, test volumes are growing and many parts of the country do not have close access to laboratories. Test samples are transported over large distances and this can introduce testing delays, especially for patients in rural and remote areas of the country. There are now new POC EID technologies becoming available that will enable diagnosis of HIV in infants within minutes or a couple of hours on site in the clinic, operated by non technical staff and without laboratory infrastructure. This protocol describes a plan to conduct an evaluation of a Point-Of-Care (POC) Early Infant Diagnosis (EID) testing technologies that are being considered for use in Mozambique, and to pilot those technologies in order to provide more effective diagnostics and clinical care to patients. During this implementation pilot, sites are randomized to use either conventional or POC EID testing only before the inclusion of the patients in the study. No consent will be asked to the parents or guardians. A written permission will be asked to the Direção Provincial de Saúde of both provinces to implement the POC device as routine in those intervention sites. All the information that will be analyzed will be collected from the routine care and it will be analyzed as a group.

Study Overview

• Status: Completed
• Conditions: HIV
• Intervention / Treatment: Device: Alere q

• Study Type: Interventional
• Enrollment (Actual): 179
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Mozambique
  • Maputo, Mozambique
    • Centro de Saude de Machava II
  • Maputo, Mozambique
    • Centro de Saude Matola Gare
  • Maputo, Mozambique
    • Centro de Saúde de Khongolote
  • Maputo
    • Moamba, Maputo, Mozambique
      • Centro de Saude Moamba
  • Sofala
    • Beira, Sofala, Mozambique
      • Centro de Saude de Manga Loforte
    • Beira, Sofala, Mozambique
      • Centro de Saude de Ponta Gea
    • Beira, Sofala, Mozambique
      • Centro de Saude Munhava
    • Beira, Sofala, Mozambique
      • Centro de Saude NHACONJO

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 4 weeks to 1 year (Child)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Born to HIV positive mother
• From 4 weeks to 18 months of age
• Came to CCR consultation for Early Infant Diagnosis

Exclusion Criteria:

• With a valid positive test by other center

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Diagnostic
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Control; Current practice of Early Infant Diagnosis in Mozambique: using conventional system of collecting blood on Dried Blood Spot and sending it to central laboratory for PCR processing and receiving result by SMS printer.
Active Comparator: Intervention; Point Of Care Device (Alere q) is used for Early Infant Diagnosis, with the sample collected and processed in the consultation room with the device	Device: Alere q

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The proportion of HIV-positive infants initiating antiretroviral therapy within 60 days of sample collection		up to 6 months
the proportion of HIV-positive infants who initiated antiretroviral therapy that were retained in care at 90 days of follow-up.	Patients were considered retained in care at 90 days if they had visited the health facility within the previous 30 days.	3 months after treatment initiation

Secondary Outcome Measures

Outcome Measure	Time Frame
The median age at time of results received by patient	Up to 6 months
The median number of days between specimen collection and results received by patient	Up to 6 months
The median age at time of antiretroviral treatment initiation	Up to 6 months
The median number of days between specimen collection and initiation of antiretroviral treatment.	Up to 6 months

Collaborators and Investigators

• Sponsor: Instituto Nacional de Saúde, Mozambique
• Collaborators: UNITAID; Clinton Health Access Initiative Inc.; UNICEF

Publications and helpful links

General Publications

• Jani IV, Meggi B, Loquiha O, Tobaiwa O, Mudenyanga C, Zitha A, Mutsaka D, Mabunda N, Vubil A, Bollinger T, Vojnov L, Peter TF. Effect of point-of-care early infant diagnosis on antiretroviral therapy initiation and retention of patients. AIDS. 2018 Jul 17;32(11):1453-1463. doi: 10.1097/QAD.0000000000001846.

Study record dates

Study Major Dates

• Study Start: September 1, 2015
• Primary Completion (Actual): September 30, 2016
• Study Completion (Actual): September 30, 2016

Study Registration Dates

• First Submitted: December 5, 2015
• First Submitted That Met QC Criteria: December 15, 2015
• First Posted (Estimate): December 18, 2015

Study Record Updates

• Last Update Posted (Actual): July 26, 2017
• Last Update Submitted That Met QC Criteria: July 24, 2017
• Last Verified: July 1, 2017

More Information

Terms related to this study

• Keywords: HIV; children; Diagnostic
• Other Study ID Numbers: POC EID PILOT