Cluster randomised trial of the uptake of a take-home infant dose of nevirapine in Kenya
Reynolds, H.W.; Gachuno, O.; Kayita, J.; Hays, M.A.; Otterness, C.; Rakwar, J.
East African Medical Journal 87(7): 284-293
2010
ISSN/ISBN: 0012-835X PMID: 23451547 Document Number: 572373
To test whether a single take home dose of infant nevirapine increased infant uptake without decreasing institutional deliveries. Cluster randomised post-test only study with control group. Ten hospitals in urban areas of Coast, Rift Valley, and Western provinces, Kenya. Pregnant women with HIV, 18 years and older, and at least 32 weeks gestation recruited during antenatal care and followed up at home approximately one week after delivery. In the intervention group, women were given a single infant's dose of nevirapine to take home prior to delivery. In the control group, no changes were made to the standard of care. Mothers' reports of infant uptake of nevirapine and place of delivery. Uptake of the infant's nevirapine dose was high, 94% in the intervention group and 88% in the control group (p=0.096). Among women who delivered at home, uptake was higher significantly among infants whose mothers got the take home dose compared to women who did not get the dose (93% vs. 53%, p<0.01). The intervention did not influence place of delivery. Providers were positive about the take home dose concept; difficulties were attributed to HIV-related stigma. Making take home infant nevirapine available, either as a single dose administered within 72 hours of birth or as part of a more complex six week postnatal regimen, will increase infant uptake especially among women who deliver at home without affecting place of delivery.