A Comparison of Placental Alpha Microglobuliun-1 Rapid Immunoassay and Standard Clinical Method For Diagnosis of Premature Rupture of Membranes

Background/Objective: Premature rupture of membranes (PROM) poses significant risk to the wellbeing of a pregnant woman and her fetus; the risk is more when not appropriately diagnosed and managed. The search for accuracy and increased specificity in diagnosis of PROM is an on-going process. The purpose of this study was to determine the accuracy of placental alpha microglobulin-1 (AmniSure ROM®) based test in detecting presence of amniotic fluid in cervico-vaginal secretions compared with standard clinical assessment in diagnosis of PROM in a rural tertiary hospital in South West, Nigeria. AmniSure ROM is a point of care test which is convenient to both the health care provider and patient; thus its use can shorten the turnaround time and improve patient care. Methodology: This was a cross-sectional study. All pregnant women with symptoms suggestive of PROM premature over a period of six months at the Federal Teaching Hospital, Ido Ekiti, south-west Nigeria, were recruited and evaluated using the standard clinical evaluation and AmniSure ROM®. Results: In all, 64 participants were recruited. Mean maternal age and gestational age at presentation were 29.6 ± 3.4 years and 37.2 ± 2.4 weeks respectively. AmniSure ROM® test was positive in 81.2% of the participants, while standard clinical test was positive in 71.9% of the participants. The two tests were positive in 70.3% of all evaluated participants. The sensitivity of AmniSure ROM in diagnosis of PROM was 97.8% compared to that obtained in standard clinical assessment. The negative predictive value of AmniSure ROM was 91.7%. Conclusion and Global Health Implications: Compared to standard clinical assessment, AmniSure ROM test was a more sensitive, rapid and accurate method for confirming the diagnosis of rupture of membrane. Its adoption in routine practice will reduce complications associated with delay and missed diagnosis following use of routine standard clinical assessment alone. Key words: • Placental • Alpha macroglobulin-1 • Rapid immunoassay • Clinical method • Premature rupture of membranes   Copyright © 2019 Adebara et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

Assessment of PMTCT Success Rates Based on Antiretroviral Interventions and Feeding Options: A Prospective Cohort Study

Background: The success of any prevention of mother-to-child transmission (PMTCT) program is assessed by the proportion of HIV-exposed infants that sero-convert at the end of all risk exposures. Although adopting the best feeding option for HIV-exposed infants is one of the factors that impact PMTCT outcomes, there is limited data on the assessment of PMTCT success rates based on antiretroviral interventions and feeding options. This study assesses the success rate of PMTCT service based on antiretroviral interventions and feeding options. Methods: Eighty-five HIV-infected mothers previously in care were enrolled in a prospective cohort study. Folders and structured questionnaires were used to extract data on mother-infant pair and the first CD4, count of infected mothers on enrolment at PMTCT clinic. Dry blood spot samples were obtained from exposed infants for early infant diagnosis. Results were analyzed using the SPSS software. Results: The mean age of enrolled mothers was 31.3 ± 4.4 years, and an average CD4+ T-lymphocyte count of 368.6 ± 216.2 cells/µl. Seven (8.2%) of the HIV-exposed infants were positive for HIV-1 based on early infant diagnosis results. Overall PMTCT success rate (PMTCTSR) was 91.8%. HIV-1 prevalence of 5.0%, 0% and 21.1% was found among infants of patients who opted for breastfeeding, replacement feeding, and mixed feeding respectively thus yielding PMTCT success rates of 95%, 100% and 78.9%. Pediatric antiretroviral interventions success rates in HIV-exposed infants was 95.8%, 80.0% and 66.7% based on age groups ≤ 6 months, > 6 ≤ 12 months, and > 12 ≤ 18 months respectively. Conclusion and Global Health Implications: Quality PMTCT service is vital for successful prevention of mother-to-child transmission of HIV. Implementation of more dynamic approaches such as adherence to option B+ guidelines in PMTCT service in our settings can further reduce mother-to-child transmission of HIV and improve outcomes. Key words: Assessment, Antiretroviral Interventions, PMTCT, Success Rates, Feeding Options, Cohort  Copyright © 2018 Fasakin et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited