Point-of-Delivery Prenatal Test Results through mHealth to Improve Birth Outcome

通过移动医疗提供分娩点产前检测结果以改善出生结果

基本信息

批准号：
9020158
负责人：
Echezona Edozie Ezeanolue
金额：
$ 15.67万
依托单位：
UNIVERSITY OF NEVADA LAS VEGAS
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-09-24 至 2017-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9020158
关键词：
AIDS prevention Accounting Adoption Affect African Algorithms Anti-Retroviral Agents Asses B-Lymphocytes Birth Blood Cancer Etiology Caring Case Report Form Cellular Phone Cessation of life Child Chronic Hepatitis B Church Collaborations Communities Community Hospitals Community Networks Country Data Data Analyses Databases Decision Modeling Developing Countries Disease Dose Early Intervention Early identification Effectiveness Electronics Evaluation Evidence based intervention Focus Groups Foundations Genotype Goals HBV Genotype HIV HIV Infections Health Technology Health education Hepatitis B Hepatitis B Prevalence Hepatitis B Surface Antigens Hepatitis B Vaccines Hepatitis B Virus Hour Human immunodeficiency virus test Illinois Immunization Income Infant Infection prevention Information Technology Institution Intervention Interview Laboratories Life Malignant neoplasm of liver Manuals Maps Medical Morbidity - disease rate Mothers Nevada Newborn Infant Nigeria Online Systems Outcome Participant Penicillins Perinatal Phase Prayers Pregnancy Pregnant Women Preparation Prevention Prevention program Program Effectiveness Prophylactic treatment Quality of Care Reading Records Research Infrastructure Resources Risk Secure Services Sickle Cell Sickle Cell Anemia Sickle Cell Trait Site Smart Card Technology Test Result Testing United States National Institutes of Health Universities Virus Diseases Wit Woman antiretroviral therapy base data management disease transmission disorder prevention follow-up improved informant innovation mHealth mortality operation phase III trial prenatal prevent programs public health relevance screening sickling social stigma transmission process uptake usability

项目摘要

DESCRIPTION (provided by applicant): Nigeria is one of the 22 countries identified by the WHO to account for 90% of pregnant women living with HIV. Despite expansions of HIV prevention programs in Nigeria, only 14% of pregnant women were tested for HIV; only 27% of HIV-infected pregnant women received WHO recommended antiretroviral (ARV) therapy; only 11% of HIV-exposed infants received ARV prophylaxis for prevention of mother-to-child HIV transmission (PMTCT) and only 3.9% of exposed infants received appropriate testing within two months and an estimated 51,000 infants became infected with HIV in 2013. Risk of perinatal transmission is increased when a pregnant woman is co-infected with HIV and hepatitis B virus (HBV) infection which remain endemic in Nigeria where liver cancer is now the most common cause of cancer death. Children with sickle cell disease (SCD) are also at increased risk of HIV due to frequent blood transmission and an estimated 50-80% of these children die before their 5th birthday. Despite availability of simple inexpensive interventions such as penicillin prophylaxis, hepatitis B vaccine or antiretroviral prophylaxis, implementation remains inconsistent. In 2013, we demonstrated that the Healthy Beginning Initiative [HBI], a congregation-based intervention that uses prayer session to identify pregnant women early, baby shower to implement an integrated testing (HIV- plus hepatitis B and sickle cell genotype) and baby reception for follow up is acceptable and effective in increasing HIV testing among pregnant women. For this application, we will develop and test the feasibility, acceptability and usability of a web-based database and medical decision model that captures results for HIV, HBV and sickle cell genotype obtained during HBI participants; store data in a secure, web-based database; encrypt data on a "smart card" which is given to participants, and make these data available at the point-of- delivery using a cell-phone application to read the "smart card". Data on the web-based database can also be accessed directly using the cell phone application. Evidence exists that when clinician have maternal records available at the point of delivery, they are more likely to initiate antiretroviral prophylaxis for HIV-exposed infants, administer first dose of hepatitis B vaccine with 24 hours for infants born to women who have positive hepatitis B surface antigen and screen infants born to mothers with sickle cell trait to allow early identification and initiation of penicillin prophylaxis for infants who have sickle cel disease. The ultimate endpoint for the Phase III trial is reduction in mortality among children wit sickle cell disease and prevention of perinatal transmission of HIV and HBV infections. This proposal is collaboration among Sunrise Foundation (local PEPFAR-supported partner in Nigeria); University of Illinois Urbana-Champaign (concept mapping, focus group and key informant interviews); Xavier University (data management and analysis) and University of Nevada, Reno (overall oversight and evaluation of program effectiveness).

描述（由适用提供）：尼日利亚是世界卫生组织确定的22个国家之一，占艾滋病毒孕妇的孕妇的90％。尽管尼日利亚的艾滋病毒预防计划扩大，但只有14％的孕妇接受了艾滋病毒的测试。只有27％的艾滋病毒感染孕妇接受了抗逆转录病毒（ARV）治疗； only 11% of HIV-exposed infants received ARV prophylaxis for prevention of mother-to-child HIV transmission (PMTCT) and only 3.9% of exposed infants received appropriate testing within two months and an estimated 51,000 infants became infected with HIV in 2013. Risk of perinatal transmission is increased when a pregnant woman is co-infected with HIV and hepatitis B virus (HBV) infection which remains endomic in Nigeria where肝癌现在是癌症死亡的最常见原因。镰状细胞疾病（SCD）的儿童由于频繁传播血液的风险也增加了HIV的风险，估计有50-80％的儿童在5岁生日之前死亡。尽管有简单的廉价干预措施，例如青霉素预防，乙型肝炎疫苗或抗逆转录病毒预防，但实施仍然不一致。 2013年，我们证明了一项健康的开始计划[HBI]，这是一种基于会众的干预措施，使用祈祷疗法早期识别孕妇，婴儿淋浴以实施综合测试（HIV-PLUS肝炎B和镰状细胞属型）和婴儿接受接受，可用于随访且可在孕妇增加HIV测试。对于此应用程序，我们将开发和测试基于Web的数据库和医疗决策模型的可行性，可接受性和可用性，该模型捕获了HBI参与者中获得的HIV，HBV和镰状细胞基因型的结果；将数据存储在安全的，基于Web的数据库中；加密给参与者的“智能卡”的数据，并使用手机应用程序在交付点上提供这些数据，以读取“智能卡”。也可以使用手机应用程序直接访问基于Web的数据库的数据。有证据表明，当临床医生在分娩时可获得临床医生记录时，他们更有可能引发抗逆转录病毒预防艾滋病毒暴露的婴儿的抗逆转录病毒预防，对丙型肝炎B疫苗的初次剂量为24小时的丙型肝炎疫苗，对肝炎表面抗原和筛查primiation primatiation for Secyh septiation for Seartiation for Seartiation for Searpiation for Seartiation for Searpiation for Seartiation for Syackle celliation的婴儿允许小心属性的侵害，并允许小心rip依的侵害。镰状病。第三阶段试验的最终终点是镰状细胞病儿童死亡率的降低以及预防HIV和HBV感染的围产期传播。该建议是Sunrise Foundation（尼日利亚当地由PEPFAR支持的合作伙伴）之间的合作；伊利诺伊大学Urbana-Champaign大学（概念映射，焦点小组和主要线人访谈）；泽维尔大学（数据管理与分析）和内华达大学，里诺（总体监督和计划效率评估）。