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A Cluster Randomised Trial on the Impact of Integrating Early Infant HIV Diagnosis with the Expanded Programme on Immunization on Immunization and HIV Testing Rates in Rural Health Facilities in Southern Zambia

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  • Paul C Wang
  • Albert Mwango
  • Sarah Moberley
  • Benjamin J Brockman
  • Alison L Connor
  • Penelope Kalesha-Masumbu
  • Simon Mutembo
  • Maximillian Bweupe
  • Pascalina Chanda-Kapata
  • Godfrey Biemba
  • Davidson H Hamer
  • Benjamin Chibuye
  • Elizabeth McCarthy

Abstract

Background: We assessed the integration of early infant HIV diagnosis with the expanded programme for immunization in a rural Zambian setting with the aim of determining whether infant and postpartum maternal HIV testing rates would increase without harming immunization uptake. Methods: In an unblinded, location stratified, cluster randomised controlled trial, 60 facilities in Zambia’s Southern Province were equally allocated to a control group, Simple Intervention group that received a sensitization meeting and the resupply of HIV testing commodities in the event of a stock-out, and a Comprehensive Intervention group that received the Simple Intervention as well as on-site operational support to facilitate the integration of HIV testing services with EPI. Findings: The average change in number of first dose diphtheria, pertussis, and tetanus vaccine (DPT1) provided per month, per facility was approximately 0.86 doses higher [90% confidence interval (CI) -1.40, 3.12] in Comprehensive Intervention facilities compared to the combined average change in the Simple Intervention and control facilities. The interventions resulted in a 16.6% [90% CI: -7%, 46%, P-value = 0.26] and 10% [90% CI: -10%, 36%, P-value = 0.43] greater change in average monthly infant DBS testing compared to control for the Simple and Comprehensive facilities respectively. We also found 15.76 (90% CI: 7.12, 24.41, P-value

Suggested Citation

  • Paul C Wang & Albert Mwango & Sarah Moberley & Benjamin J Brockman & Alison L Connor & Penelope Kalesha-Masumbu & Simon Mutembo & Maximillian Bweupe & Pascalina Chanda-Kapata & Godfrey Biemba & Davids, 2015. "A Cluster Randomised Trial on the Impact of Integrating Early Infant HIV Diagnosis with the Expanded Programme on Immunization on Immunization and HIV Testing Rates in Rural Health Facilities in South," PLOS ONE, Public Library of Science, vol. 10(10), pages 1-16, October.
    • Handle: RePEc:plo:pone00:0141455
    DOI: 10.1371/journal.pone.0141455
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    References listed on IDEAS

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    1. Guido W. Imbens & Jeffrey M. Wooldridge, 2009. "Recent Developments in the Econometrics of Program Evaluation," Journal of Economic Literature, American Economic Association, vol. 47(1), pages 5-86, March.
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