Trained HTC counselors collected DBS samples for EID testing per MoH guidelines [ 26].
We observed an increase in the proportion of HIV-exposed infants receiving DNA PCR testing and earlier uptake of EID testing services over time.
For this denominator, we used ANC HIV prevalence data to estimate the number of HIV-infected pregnant women among those not receiving HTC, and added this to the number of documented HIV-infected women registered in ANC clinic; this approach provided a more conservative estimate of EID testing uptake.
The work of the London School will focus on CD4 counts and two other key diagnostics used in HIV treatments: viral load testing, which tests a patient's response to treatment, and early infant diagnosis (EID), which can test infants before the age of 18 months, when their maternal anti-bodies wear off.
However, Roche/454 sequencing technology has already produced reads >400 bp in production, Illumina gradually increases read length >100 bp, and Pacific Bioscience generates 1000 bp reads in early testing (Eid et al., 2009).
We focused on EIDs by applying screening test evaluation methods to the IHR Annex 2 decision instrument and estimated its sensitivity, specificity, and positive predictive value (PPV).
However, in contrast to routine PMTCT EID programs, in-patient pediatric HIV testing is not systematically implemented due to inadequate staffing, test shortages, and unavailability of rapid infant HIV DNA assays [ 16].
There is a mixed attitude to early infant diagnosis: while some people were willing to carry out EID others lack the courage to test their infants.
There are many drop-off points along the EID "cascade" from timing of first testing to receipt of results and prompt ART initiation [ 4, 5, 23].
To address these issues, renewed focus is required to fill persistent gaps in EID services by ensuring an uninterrupted supply of EID laboratory reagents, moving away from paper-based DNA PCR test result notification systems to SMS and web-based platforms, and enhancing community-facility linkages to improve post-natal mother-infant pair follow-up and retention in care.
