Evaluating the effectiveness and cost-effectiveness of health facility-based and community-based index-linked HIV testing strategies for children: protocol for the B-GAP study in Zimbabwe

Introduction The number of new paediatric infections per year has declined in sub-Saharan Africa due to prevention-of-mother-to-child HIV transmission programmes; many children and adolescents living with HIV remain undiagnosed. In this protocol paper, we describe the methodology for evaluating an i...

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Main Authors: Helen Anne Weiss, Victoria Simms, Chido Dziva Chikwari, Stefanie Dringus, Katharina Kranzer, Tsitsi Bandason, Arthi Vasantharoopan, Rudo Chikodzore, Edwin Sibanda, Miriam Mutseta, Karen Webb, Barbara Engelsmann, Gertrude Ncube, Hilda Mujuru, Tsitsi Apollo, Rashida Ferrand
Format: Article
Language:English
Published: BMJ Publishing Group 2019-07-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/7/e029428.full
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author Helen Anne Weiss
Victoria Simms
Chido Dziva Chikwari
Stefanie Dringus
Katharina Kranzer
Tsitsi Bandason
Arthi Vasantharoopan
Rudo Chikodzore
Edwin Sibanda
Miriam Mutseta
Karen Webb
Barbara Engelsmann
Gertrude Ncube
Hilda Mujuru
Tsitsi Apollo
Rashida Ferrand
author_facet Helen Anne Weiss
Victoria Simms
Chido Dziva Chikwari
Stefanie Dringus
Katharina Kranzer
Tsitsi Bandason
Arthi Vasantharoopan
Rudo Chikodzore
Edwin Sibanda
Miriam Mutseta
Karen Webb
Barbara Engelsmann
Gertrude Ncube
Hilda Mujuru
Tsitsi Apollo
Rashida Ferrand
author_sort Helen Anne Weiss
collection DOAJ
description Introduction The number of new paediatric infections per year has declined in sub-Saharan Africa due to prevention-of-mother-to-child HIV transmission programmes; many children and adolescents living with HIV remain undiagnosed. In this protocol paper, we describe the methodology for evaluating an index-linked HIV testing approach for children aged 2–18 years in health facility and community settings in Zimbabwe.Methods and analysis Individuals attending for HIV care at selected primary healthcare clinics (PHCs) will be asked if they have any children aged 2–18 years in their households who have not been tested for HIV. Three options for HIV testing for these children will be offered: testing at the PHC; home-based testing performed by community workers; or an oral mucosal HIV test given to the caregiver to test the children at home. All eligible children will be followed-up to ascertain whether HIV testing occurred. For those who did not test, reasons will be determined, and for those who tested, the HIV test result will be recorded. The primary outcome will be uptake of HIV testing. The secondary outcomes will be preferred HIV testing method, HIV yield, prevalence and proportion of those testing positive linking to care and having an undetectable viral load at 12 months. HIV test results will be stratified by sex and age group, and factors associated with uptake of HIV testing and choice of HIV testing method will be investigated.Ethics and dissemination Ethical approval for this study was granted by the Medical Research Council of Zimbabwe, the London School of Hygiene and Tropical Medicine and the Institutional Review Board of the Biomedical Research and Training Institute. Study results will be presented at national policy meetings and national and international research conferences. Results will also be published in international peer-reviewed scientific journals and disseminated to study communities at the end of study.
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spelling doaj-art-1a1a6d206dd447ca92fd03844fe8a7862025-08-20T02:06:51ZengBMJ Publishing GroupBMJ Open2044-60552019-07-019710.1136/bmjopen-2019-029428Evaluating the effectiveness and cost-effectiveness of health facility-based and community-based index-linked HIV testing strategies for children: protocol for the B-GAP study in ZimbabweHelen Anne Weiss0Victoria Simms1Chido Dziva Chikwari2Stefanie Dringus3Katharina Kranzer4Tsitsi Bandason5Arthi Vasantharoopan6Rudo Chikodzore7Edwin Sibanda8Miriam Mutseta9Karen Webb10Barbara Engelsmann11Gertrude Ncube12Hilda Mujuru13Tsitsi Apollo14Rashida Ferrand15MRC International Statistics & Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK1 Biomedical Research and Training Institute, Harare, Zimbabwe2 Biomedical Research and Training Institute, Harare, Zimbabwe2 Independent global health consultant, London, UKThe Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe1 Biomedical Research and Training Institute, Harare, Zimbabwe4 London School of Hygiene and Tropical Medicine, London, UK5 Matebeleland South, Ministry of Health and Child Care, Bulawayo, Zimbabwe6 City Health Department, Bulawayo City Council, Bulawayo, Zimbabwe7 Population Services International Zimbabwe, Harare, Zimbabwe8 Organization for Public Health Interventions and Development, Harare, Zimbabwe8 Organization for Public Health Interventions and Development, Harare, Zimbabwe9 Ministry of Health and Child Care Zimbabwe, Harare, Zimbabwe7 Department of Paediatrics and Child Health, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe9 Ministry of Health and Child Care Zimbabwe, Harare, ZimbabweDepartment of Clinical Research, London School of Hygiene and Tropical Medicine, London, UKIntroduction The number of new paediatric infections per year has declined in sub-Saharan Africa due to prevention-of-mother-to-child HIV transmission programmes; many children and adolescents living with HIV remain undiagnosed. In this protocol paper, we describe the methodology for evaluating an index-linked HIV testing approach for children aged 2–18 years in health facility and community settings in Zimbabwe.Methods and analysis Individuals attending for HIV care at selected primary healthcare clinics (PHCs) will be asked if they have any children aged 2–18 years in their households who have not been tested for HIV. Three options for HIV testing for these children will be offered: testing at the PHC; home-based testing performed by community workers; or an oral mucosal HIV test given to the caregiver to test the children at home. All eligible children will be followed-up to ascertain whether HIV testing occurred. For those who did not test, reasons will be determined, and for those who tested, the HIV test result will be recorded. The primary outcome will be uptake of HIV testing. The secondary outcomes will be preferred HIV testing method, HIV yield, prevalence and proportion of those testing positive linking to care and having an undetectable viral load at 12 months. HIV test results will be stratified by sex and age group, and factors associated with uptake of HIV testing and choice of HIV testing method will be investigated.Ethics and dissemination Ethical approval for this study was granted by the Medical Research Council of Zimbabwe, the London School of Hygiene and Tropical Medicine and the Institutional Review Board of the Biomedical Research and Training Institute. Study results will be presented at national policy meetings and national and international research conferences. Results will also be published in international peer-reviewed scientific journals and disseminated to study communities at the end of study.https://bmjopen.bmj.com/content/9/7/e029428.full
spellingShingle Helen Anne Weiss
Victoria Simms
Chido Dziva Chikwari
Stefanie Dringus
Katharina Kranzer
Tsitsi Bandason
Arthi Vasantharoopan
Rudo Chikodzore
Edwin Sibanda
Miriam Mutseta
Karen Webb
Barbara Engelsmann
Gertrude Ncube
Hilda Mujuru
Tsitsi Apollo
Rashida Ferrand
Evaluating the effectiveness and cost-effectiveness of health facility-based and community-based index-linked HIV testing strategies for children: protocol for the B-GAP study in Zimbabwe
BMJ Open
title Evaluating the effectiveness and cost-effectiveness of health facility-based and community-based index-linked HIV testing strategies for children: protocol for the B-GAP study in Zimbabwe
title_full Evaluating the effectiveness and cost-effectiveness of health facility-based and community-based index-linked HIV testing strategies for children: protocol for the B-GAP study in Zimbabwe
title_fullStr Evaluating the effectiveness and cost-effectiveness of health facility-based and community-based index-linked HIV testing strategies for children: protocol for the B-GAP study in Zimbabwe
title_full_unstemmed Evaluating the effectiveness and cost-effectiveness of health facility-based and community-based index-linked HIV testing strategies for children: protocol for the B-GAP study in Zimbabwe
title_short Evaluating the effectiveness and cost-effectiveness of health facility-based and community-based index-linked HIV testing strategies for children: protocol for the B-GAP study in Zimbabwe
title_sort evaluating the effectiveness and cost effectiveness of health facility based and community based index linked hiv testing strategies for children protocol for the b gap study in zimbabwe
url https://bmjopen.bmj.com/content/9/7/e029428.full
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