HIV/AIDSE4ENCT02070900
Does Provision of Point of Care CD4 Technology and Early Knowledge of CD4 Levels Affect Early Initiation and Retention on Anti-retroviral Treatment (ART) in HIV Positive Pregnant Women in the Context of Option B+ for PMTCT?
A study testing POC CD4 and Programmatic Mentoring in people with HIV/AIDS, run by WHO, Department of Maternal, Newborn, Child and Adolescent Health at 32 sites in Zimbabwe.
Trial summary
The study will be conducted at 32 health care facilities in three provinces in Zimbabwe and will compare the impact of the provision Point of Care CD4 technology and early knowledge of CD4 levels on retention at 12 months, with or without POC CD4 and a programmatic mentoring package. Read more about this study
- Who is it for?
- Any age, women onlyHealthy volunteers can take part
- Conditions the study is for
- HIV/AIDS
- What is being tested?
- POC CD4 and Programmatic Mentoring
- Type of treatment
- Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 704 participants
- Where
- 32 sitesZimbabwe
- Study dates
- Jan 2014to Jul 2016
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- Women only
- Healthy volunteers accepted
- Child, Adult, Older adult
Who may be able to join
- Pregnant at the time of booking
- HIV positive diagnosis
- Not on ART at the time of booking
- Present up to 38 weeks into gestation
- Presents more than 48 hours prior to delivery
Who cannot join
- Already on ART at booking
- Presents more than 38 weeks into gestation or less than 48 hours prior to delivery
Trial locations and contacts
32 sites in 1 country.
Alexio Z Mangwiro contact
32 sites in 1 country
Zimbabwe32 sites, 32 recruiting
- Recruiting
Chamnangana
Beitbridge, Matebeleland South
Willard Sibonginkosi, PCN, 0774703830
- Recruiting
Zezani
Beitbridge, Matebeleland South
Gertrude Mbedzi, PCN, 0774704367
- Recruiting
Mdutshane RHC
Bubi, Matebeleland North
0712954518
- Recruiting
Membeswana RHC
Bubi, Matebeleland North
CHN, 0772953292
- Recruiting
Huwana RHC
Bulilima, Matebeleland South
Samkeliso Gonde, PCN, 0777755858
- Recruiting
Madlambudzi
Bulilima, Matebeleland South
Sithandwa Sitole, PCN, 0774566310
- Recruiting
Bromley
Goromonzi, Mashonaland East Province
Adam Muchenje, RGN, 0712960915
- Recruiting
Henry John Rheimer
Goromonzi, Mashonaland East Province
B Deve, RGN, 0772697621
- Recruiting
Kubatsirana
Goromonzi, Mashonaland East Province
Mamboininga, RGN, 0772689582
- Recruiting
Melfort
Goromonzi, Mashonaland East Province
A Maburunje, RGN, 0772515932
- Recruiting
Mwanza RHC
Goromonzi, Mashonaland East Province
Dabion Viano, SCN, 0774432464
- Recruiting
Mzimuni
Gwanda, Matebeleland South
A Moyo, PCN, 0772476328
- Recruiting
West Nicholson Zimcare
Gwanda, Matebeleland South
Mugadziri Shoko, PCN, 0776482393
- Recruiting
Sanale RHC
Insiza, Matebeleland South
Zenele Ncube, PCN, 0712567761
- Recruiting
Zhulube
Insiza, Matebeleland South
P Twala, PCN, 0712947820
- Recruiting
Lupaka
Lupane, Matebeleland North
Musa Gumbo, PCN, 0715327222
- Recruiting
Dingimuzi
Mangwe, Matebeleland South
0773878931
- Recruiting
Border Church RHC
Marondera, Mashonaland East Province
Justice Mulungisi, RGN, 0776424031
- Recruiting
Chipararwe
Marondera, Mashonaland East Province
C Machiridza, RGN, 0772686618
- Recruiting
Lustleigh
Marondera, Mashonaland East Province
Esther Madzande, SCN, 0772319999
- Recruiting
Masikana
Marondera, Mashonaland East Province
C Bvute, 0774568610
- Recruiting
Kezi
Matopos, Matebeleland South
Lawrence Ndlovu, RGN, 0735613724
- Recruiting
Matopo Hospital
Matopos, Matebeleland South
Cornwell Sibanda, RGN, 0713986064
- Recruiting
Charehwa
Mutoko, Mashonaland East Province
L Muntimwa, PCN, 0773752469
- Recruiting
Kushinga RHC
Mutoko, Mashonaland East Province
M Mauyangwe, RGN, 0772521241
- Recruiting
Nyamazuwe Rural Hospital
Mutoko, Mashonaland East Province
Freddy Chengo, PCN, 0773545616
- Recruiting
Masasa
Seki, Mashonaland East Province
Eveline Mhlanga, PCN, 0775417634
- Recruiting
Madlangombe
Tsholotsho, Matebeleland North
- Recruiting
Makhaza RHC
Tsholotsho, Matebeleland North
- Recruiting
Mbembesi
Umguza Estate, Matebeleland North
Mpilo Moyo, PCN, 0712303818
- Recruiting
Mashambanhaka
UMP, Mashonaland East Province
I Katsande, PCN, 0774000155
- Recruiting
Hlangano
Umzingwane, Matebeleland South
Davison Nkala, RGN, 0772997372
About this study
The study will be conducted at 32 health care facilities in three provinces in Zimbabwe and will compare the impact of the provision Point of Care CD4 technology and early knowledge of CD4 levels on retention at 12 months, with or without POC CD4 and a programmatic mentoring package. Option B+ will be implemented at all sites and 16 intervention sites will receive POC CD4 machines and visits from a team of clinical mentors.
The study also aims to assess rates of ART initiation and time to ART initiation of HIV positive pregnant women in settings implementing option B+ with or without POC CD4 and related counselling/support; rates of retention in care of HIV positive mothers at 6 months post ART initiation in settings implementing option B+ with or without POC CD4 and related counselling/support; rates of ART initiation and retention at 6 and 12 months post ART initiation according to different levels of CD4 count; cost of retaining HIV positive pregnant women until 6 and 12 months; acceptability and feasibility of POC CD4 as an adjunct to good clinical care of HIV positive pregnant women.
- Conditions
- HIV/AIDS
- Being tested
- POC CD4, Programmatic Mentoring
- Keywords
- Prevention of Mother to Child Transmission, PMTCT, Option B+, ART, Retention, Loss to Follow Up, Time to initiation, POC CD4, Clinical mentoring, Costing, HIV, AIDS, Zimbabwe
- Medical subject headings
- Acquired Immunodeficiency Syndrome
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
POC CD4Device
Also called Alere PIMA
Point of Care device for CD4 count testing (to be used as a clinical monitoring tool)
Programmatic MentoringOther
Programmatic Mentoring aimed at messaging around CD4 count to encourage retention on lifelong ART for PMTCT patients, administered by trained clinical mentors
| Study group | Role | What they receive |
|---|---|---|
| Standard of Care | No intervention | Sites implementing Option B+ for pregnant and lactating women according to the standard of care prescribed by the Ministry of health and Child Care national guidelines |
| POC Plus | Experimental | Sites implementing Option B+ according to the standard of care prescribed by the Ministry of Health and Child Care, as well as programmatic mentoring and POC CD4 machines Receives: Device: POC CD4; Other: Programmatic Mentoring |
What is being measured
The primary outcome is the main question the study is designed to answer.
Retention
Proportion of HIV positive pregnant women that are retained on ART, 12 months after initiation
Measured: 12 months
Secondary outcomes (5)
Time-to-initiation
Median time-to-initiation between HIV positive diagnosis and enrolment onto Option B+ with or without POC CD4 and related counseling/support
Measured: 12 months
Retention at 6 months
Proportion of HIV positive pregnant women that are retained on ART, 6 months after initiation in settings implementing option B+ with or without POC CD4 and related counseling/support
Measured: 6 months
Retention by CD4 count
Proportion of women initiated and retained on ART at 6 and 12 months post ART initiation, according to different levels of CD4 count
Measured: 6 months , 12 months
Cost per pregnant woman retained on ART
Measured: 6 months , 12 months
Initiation within 1 month
Proportion of HIV positive pregnant women initiating ART within 1 month of positive HIV test
Measured: 1 month
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted25 Feb 2014 (estimated)
- Study startJan 2014
- Primary completionJun 2015 (estimated)
- Study completionJul 2016 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for HIV/AIDSStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 704 participants (estimated)
Sponsor and investigators
- Lead sponsor
- WHO, Department of Maternal, Newborn, Child and Adolescent Health
- Sponsor type
- University, hospital or other
- Collaborators
- Canadian International Development Agency, Netherlands: Ministry of Health, Welfare and Sports
- Responsible party
- Sponsor
- Investigators
- Alexio Mangwiro, Principal investigator, Clinton Health Access Initiative, Nigeria
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02070900
- Sponsor's protocol ID
- WHOCHAIZIMBABWE-001
- Acronym
- E4E
- Status last verified
- Feb 2014
- First submitted
- 18 Feb 2014
- Last updated
- 25 Feb 2014
- Results posted
- No
- Data monitoring committee
- Yes
Publications
Erlwanger AS, Joseph J, Gotora T, Muzunze B, Orne-Gliemann J, Mukungunugwa S, Farley T, Mangwiro AZ. Patterns of HIV Care Clinic Attendance and Adherence to Antiretroviral Therapy Among Pregnant and Breastfeeding Women Living With HIV in the Context of Option B+ in Zimbabwe. J Acquir Immune Defic Syndr. 2017 Jun 1;75 Suppl 2:S198-S206. doi: 10.1097/QAI.0000000000001347.
PubMed 28498190Joseph J, Gotora T, Erlwanger AS, Mushavi A, Zizhou S, Masuka N, Boeke CE, Mangwiro AZ. Impact of Point-of-Care CD4 Testing on Retention in Care Among HIV-Positive Pregnant and Breastfeeding Women in the Context of Option B+ in Zimbabwe: A Cluster Randomized Controlled Trial. J Acquir Immune Defic Syndr. 2017 Jun 1;75 Suppl 2:S190-S197. doi: 10.1097/QAI.0000000000001341.
PubMed 28498189Mangwiro AZ, Makomva K, Bhattacharya A, Bhattacharya G, Gotora T, Owen M, Mushavi A, Mangwanya D, Zinyowera S, Rusakaniko S, Mugurungi O, Zizhou S, Busumani W, Masuka N. Does provision of point-of-care CD4 technology and early knowledge of CD4 levels affect early initiation and retention on antiretroviral treatment in HIV-positive pregnant women in the context of Option B+ for PMTCT? J Acquir Immune Defic Syndr. 2014 Nov 1;67 Suppl 2:S139-44. doi: 10.1097/QAI.0000000000000326.
PubMed 25310120
Study at a glance
From the registry record, last updated by the sponsor on 25 Feb 2014. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Does Provision of Point of Care CD4 Technology and Early Knowledge of CD4 Levels Affect Early Initiation and Retention on Anti-retroviral Treatment (ART) in HIV Positive Pregnant Women in the Context of Option B+ for PMTCT?
- ClinicalTrials.gov ID
- NCT02070900
- Acronym / sponsor ID
- E4E / WHOCHAIZIMBABWE-001
- Conditions
- HIV/AIDS
- Keywords
- Prevention of Mother to Child Transmission, PMTCT, Option B+, ART, Retention, Loss to Follow Up, Time to initiation, POC CD4
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 704 participants (estimated)
- Lead sponsor
- WHO, Department of Maternal, Newborn, Child and Adolescent HealthUniversity, hospital or other
- Collaborators
- Canadian International Development Agency, Netherlands: Ministry of Health, Welfare and Sports
- Study start
- Jan 2014
- Primary completion
- Jun 2015 (estimated)
- Study completion
- Jul 2016 (estimated)
- First posted
- 25 Feb 2014 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The study will be conducted at 32 health care facilities in three provinces in Zimbabwe and will compare the impact of the provision Point of Care CD4 technology and early knowledge of CD4 levels on retention at 12 months, with or without POC CD4 and a programmatic mentoring package. Option B+ will be implemented at all sites and 16 intervention sites will receive POC CD4 machines and visits from a team of clinical mentors.
The study also aims to assess rates of ART initiation and time to ART initiation of HIV positive pregnant women in settings implementing option B+ with or without POC CD4 and related counselling/support; rates of retention in care of HIV positive mothers at 6 months post ART initiation in settings implementing option B+ with or without POC CD4 and related counselling/support; rates of ART initiation and retention at 6 and 12 months post ART initiation according to different levels of CD4 count; cost of retaining HIV positive pregnant women until 6 and 12 months; acceptability and feasibility of POC CD4 as an adjunct to good clinical care of HIV positive pregnant women.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Standard of Care | No intervention | –Sites implementing Option B+ for pregnant and lactating women according to the standard of care prescribed by the Ministry of health and Child Care national guidelines |
| POC Plus | Experimental | Device: POC CD4, Other: Programmatic MentoringSites implementing Option B+ according to the standard of care prescribed by the Ministry of Health and Child Care, as well as programmatic mentoring and POC CD4 machines |
Who may qualify
- Sex
- Female only
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (5 listed)
- Pregnant at the time of booking
- HIV positive diagnosis
- Not on ART at the time of booking
- Present up to 38 weeks into gestation
- Presents more than 48 hours prior to delivery
Key exclusion criteria (2 listed)
- Already on ART at booking
- Presents more than 38 weeks into gestation or less than 48 hours prior to delivery
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| POC CD4Also: Alere PIMAPoint of Care device for CD4 count testing (to be used as a clinical monitoring tool) | Device | POC Plus |
| Programmatic MentoringProgrammatic Mentoring aimed at messaging around CD4 count to encourage retention on lifelong ART for PMTCT patients, administered by trained clinical mentors | Other | POC Plus |
Primary outcome
Retention
Time frame: 12 months
Proportion of HIV positive pregnant women that are retained on ART, 12 months after initiation
5 secondary outcomes
Time-to-initiation
Time frame: 12 months
Retention at 6 months
Time frame: 6 months
Retention by CD4 count
Time frame: 6 months , 12 months
Cost per pregnant woman retained on ART
Time frame: 6 months , 12 months
Initiation within 1 month
Time frame: 1 month
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 25 Feb 2014.
- Derived from this study: PubMed 28498190Erlwanger AS, Joseph J, Gotora T, Muzunze B, Orne-Gliemann J, Mukungunugwa S, Farley T, Mangwiro AZ. Patterns of HIV Care Clinic Attendance and Adherence to Antiretroviral Therapy Among Pregnant and Breastfeeding Women Living With HIV in the Context of Option B+ in Zimbabwe. J Acquir Immune Defic Syndr. 2017 Jun 1;75 Suppl 2:S198-S206. doi: 10.1097/QAI.0000000000001347.
- Derived from this study: PubMed 28498189Joseph J, Gotora T, Erlwanger AS, Mushavi A, Zizhou S, Masuka N, Boeke CE, Mangwiro AZ. Impact of Point-of-Care CD4 Testing on Retention in Care Among HIV-Positive Pregnant and Breastfeeding Women in the Context of Option B+ in Zimbabwe: A Cluster Randomized Controlled Trial. J Acquir Immune Defic Syndr. 2017 Jun 1;75 Suppl 2:S190-S197. doi: 10.1097/QAI.0000000000001341.
- Derived from this study: PubMed 25310120Mangwiro AZ, Makomva K, Bhattacharya A, Bhattacharya G, Gotora T, Owen M, Mushavi A, Mangwanya D, Zinyowera S, Rusakaniko S, Mugurungi O, Zizhou S, Busumani W, Masuka N. Does provision of point-of-care CD4 technology and early knowledge of CD4 levels affect early initiation and retention on antiretroviral treatment in HIV-positive pregnant women in the context of Option B+ for PMTCT? J Acquir Immune Defic Syndr. 2014 Nov 1;67 Suppl 2:S139-44. doi: 10.1097/QAI.0000000000000326.
- CHAI websiteLink provided by the sponsor.
- INSPIRE Initiative pageLink provided by the sponsor.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Alexio Z Mangwiro contact
Alexio Mangwiro principal investigator
Clinton Health Access Initiative, Nigeria
32 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing POC CD4 and Programmatic Mentoring in people with HIV/AIDS, run by WHO, Department of Maternal, Newborn, Child and Adolescent Health at 32 sites in Zimbabwe.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 25 Feb 2014. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 32 sites in Zimbabwe. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Alexio Z Mangwiro (amangwiro@clintonhealthaccess.org), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Retention (time frame: 12 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT02070900, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 25 Feb 2014; AzTrials last refreshed its copy on 7 Nov 2026.