1 Using 3G Mobile Internet Technology to Enhance Early Initiation of Children on ART in Rural Settings of Lesotho O.OYEBANJI, A.TIAM, A.ISAVWA, L. BUHENDWA,
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Slide 1
1 Using 3G Mobile Internet Technology to Enhance Early
Initiation of Children on ART in Rural Settings of Lesotho
O.OYEBANJI, A.TIAM, A.ISAVWA, L. BUHENDWA, A. AHIMBISIBWE, M.
MOKONE, M. PUTSOANE, M. FOSO
Slide 2
Background HIV-related infant mortality is high in sub-Saharan
Africa (260,000 children died from AIDS-related causes in 2009 1
due to delay in diagnosis and timely initiation ART) Infant
mortality is high in Lesotho (91 deaths per 1,000 live births) 2
There is a high under-five mortality rate (117 per 1,000 live
births) 1, especially among children living with HIV Children die
while awaiting DNA PCR results, which can take up to 12 weeks to be
returned to the health facility from the laboratory 2 There is
difficulty not only accessing health care services in some remote
locations, but also transporting laboratory results from facilities
to laboratories and results back to facilities UNAID Report on the
Global AIDS Epidemic, 2010 1 LHDS, 2011 2
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Terrain in Lesotho
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Description EGPAF-Lesotho supported the MOHSW to initiate
innovative approach to promptly distribute DNA PCR results to
health facilities by using 3G mobile internet In Q2 2010, laptops
and 3G mobile internet were provided for EGPAF District Clinical
Coordinators (DCCs), who are trained nurses based in all 10
supported districts All DCCs electronically signed a
confidentiality form Through this approach, the EGPAF Director of
Clinical Services (DCS) receives DNA PCR results from the South
Africa National Institute of Health on a weekly basis and the DCS
immediately sends results to the DCCs The DCCs compile the DNA PCR
results of their districts and take them to the health facilities
Results are printed and patients contacted through the use of
Lesotho Network of AIDS Service Organization (LENASO) focal
persons, mothers2mothers community members (both are EGPAF
sub-grantees), and community volunteers in the districts
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Assessment A two-year data review from January 2010 to December
2011, a total of 787 infants: 345 males (43.8%), 442 females
(56.2%) with a mean age of six weeks had DBS PCR test performed at
Berea Hospital and its feeder clinics, Butha Buthe and Maputsoe
Through the use of 3G technology, average test result turnaround
time was reduced from 12 weeks to 4 weeks The percentage of
HIV-positive children initiated on ART at these facilities and its
feeder clinics increased significantly from 2% (3 out of 127) in
the 2nd quarter of 2010 to 22% (40 out of 181) in the 4th quarter
of 2010, Now 100% (all 137 infants) in1st quarter and all 113
infants in 4 th quarter of 2011 were initiated on ART within.
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ART Initiation of Eligible Children Before and After
Introduction of 3G Technology Mortality: calculated by taking the
of number of deaths among children initiated on ART within 3 months
over the total number of children initiated on ART 3G
Introduced
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ART Initiation of Eligible Children from Jan. to Dec. 2011
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Lessons Learned The use of 3G mobile internet technology is
feasible in Lesotho and has enabled faster and easier transfer of
DNA PCR results to rural health facilities Use of 3G mobile
internet facilitates early initiation of children on ART by
reducing the waiting time for test results This intervention can
have a great impact on infant mortality among HIV-exposed infants
in Lesotho
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Next Steps Further research on the impact of this intervention
on infant mortality among HIV-positive infants in Lesotho is
underway