Traditional Birth Attendants PMTCT Pilot Program (TRAP)

Program Description

The Traditional Birth Attendants PMTCT Pilot Program (TRAP) is a pilot program which seeks to show the feasibility of using trained traditional birth attendants (tTBAs) to provide effective, home-based voluntary HIV counseling and testing using a saliva-based oral HIV test (Ora-Quickã) and two-dose nevirapine prophylaxis during rural home deliveries (the majority of births). TRAP has been operating in Zambia’s Mazabuka and Siavonga Districts. The CGHD is currently working with 20 tTBAs who have undergone PMTCT training and are equipped to perform oral HIV testing of women of unknown (or previously negative) HIV status late in pregnancy as well as administer single-dose nevirapine (a drug regimen used to reduce transmission) to both HIV-positive mothers and their HIV-exposed infants. tTBAs are also encouraging facility-based deliveries as well as ensuring close follow-up for HIV-positive mothers. TRAP tTBAs have so far identified over 250 pregnant women who have agreed to be enrolled in the pilot, have tested 67 women with Ora-Quickã late in pregnancy, and have administered 8 doses of nevirapine to HIV-positive mothers and exposed infants in the home. If successful, we intend to extend this program beyond the two pilot districts and advance it to include the two-ARV prophylactic regimen (NVP/AZT) recently implemented by the government of Zambia. We will also rapidly adapt this program to fit the changes in the PMTCT guidelines for postnatal ART prophylaxis as outlined in the WHO revisions released in March 2010.

This is a sub-project of the Boston University Prevention of Mother to Child Transmission Integration Project.

Project Details

Principal Investigator Donald Thea
Boston University Co-Investigators Godfrey Biemba, Alana Brennan,  Caitlin Goggin, Leoda Hamomba, Arthur Mazimba, Portipher Pilingana, Phil Seidenberg
Collaborators
Country(ies) Zambia
Dates of Research 2008–2010
Donor/Funder