Operational feasibility and programmatic impact of Early Infant Diagnosis (EID) HIV testing at birth in Prevention of Mother-to-Child Transmission (PMTCT) Settings: Preliminary findings from Nigeria.
1
Clinton Health Access Initiative, Abuja, Nigeria
2
National HIV/AIDS, Viral Hepatitis and STIs Control Programme - Federal Ministry of Health and Social Welfare, Abuja, Nigeria
Popul. Med. 2026;8(Supplement Supplement 1):A1823
ABSTRACT
INTRODUCTION:
Early Infant Diagnosis (EID) of HIV for infants exposed to HIV is critical for timely treatment initiation and improving child health. However, delayed testing and loss to follow-up continue to limit its effectiveness in PMTCT programs. EID testing at birth has been proposed as a strategy to improve early case identification, linkage to treatment, and retention in care among HIV-exposed infants. An operational research assessed the feasibility and programmatic implications of integrating EID birth testing into routine PMTCT services in Nigeria.
METHODS:
Ethical approval for the study was obtained from the National Health Research Ethics Committee (NHREC/01/01/2007- 22/05/2025). The study comprised HIV-exposed infants aged 0–3 days and their HIV-positive mothers. Twelve facilities were selected based on PMTCT volume and geographical representation from Rivers, Ogun, Kaduna, Benue, Adamawa, and Anambra states. Between July and December 2025, healthcare workers received training on study procedures and Point-of-Care (POC) EID. Written informed consent was obtained from eligible women before enrolment. Quantitative data from national reporting tools were analyzed descriptively to show early implementation outcomes.
RESULTS:
A total of 177 deliveries and 176 live births were recorded. 100% of HIV-exposed infants received EID at birth, demonstrating the operational feasibility and efficiency of integrating EID birth testing within routine PMTCT services. Testing was conducted with minimal or no disruption to standard workflows. At 6-8 weeks, follow-up testing was conducted for 98 of 99 (99%) eligible infants, with 0% positivity. Key challenges, such as staff workload, cartridge supply management, and documentation, highlight areas for improvement during scale-up
CONCLUSIONS:
Integrating EID HIV testing at birth within PMTCT settings is operationally feasible and can improve testing coverage and early case identification within routine health systems. Implementation enhanced coordination and integration across maternity, laboratory, and ART services. These findings provide early implementation evidence to inform scale-up.
Early Infant Diagnosis (EID) of HIV for infants exposed to HIV is critical for timely treatment initiation and improving child health. However, delayed testing and loss to follow-up continue to limit its effectiveness in PMTCT programs. EID testing at birth has been proposed as a strategy to improve early case identification, linkage to treatment, and retention in care among HIV-exposed infants. An operational research assessed the feasibility and programmatic implications of integrating EID birth testing into routine PMTCT services in Nigeria.
METHODS:
Ethical approval for the study was obtained from the National Health Research Ethics Committee (NHREC/01/01/2007- 22/05/2025). The study comprised HIV-exposed infants aged 0–3 days and their HIV-positive mothers. Twelve facilities were selected based on PMTCT volume and geographical representation from Rivers, Ogun, Kaduna, Benue, Adamawa, and Anambra states. Between July and December 2025, healthcare workers received training on study procedures and Point-of-Care (POC) EID. Written informed consent was obtained from eligible women before enrolment. Quantitative data from national reporting tools were analyzed descriptively to show early implementation outcomes.
RESULTS:
A total of 177 deliveries and 176 live births were recorded. 100% of HIV-exposed infants received EID at birth, demonstrating the operational feasibility and efficiency of integrating EID birth testing within routine PMTCT services. Testing was conducted with minimal or no disruption to standard workflows. At 6-8 weeks, follow-up testing was conducted for 98 of 99 (99%) eligible infants, with 0% positivity. Key challenges, such as staff workload, cartridge supply management, and documentation, highlight areas for improvement during scale-up
CONCLUSIONS:
Integrating EID HIV testing at birth within PMTCT settings is operationally feasible and can improve testing coverage and early case identification within routine health systems. Implementation enhanced coordination and integration across maternity, laboratory, and ART services. These findings provide early implementation evidence to inform scale-up.
| eISSN: | 2654-1459 |
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