scholarly journals The magnitude of loss to follow-up of HIV-exposed infants along the prevention of mother-to-child HIV transmission continuum of care

AIDS ◽  
2013 ◽  
Vol 27 (17) ◽  
pp. 2787-2797 ◽  
Author(s):  
Euphemia L. Sibanda ◽  
Ian V.D. Weller ◽  
James G. Hakim ◽  
Frances M. Cowan
Keyword(s):  
Hiv Transmission ◽  
Continuum Of Care ◽  
Loss To Follow Up ◽  
Hiv Exposed Infants ◽  
Hiv Exposed ◽  
Mother To Child

scholarly journals Outcomes of HIV Exposed Infants and Predictors of Positivity after Option B+ Guideline Implementation in Amhara Regional State’s Referral Hospitals, Ethiopia

2019 ◽  
Author(s):  
Mesfin Wudu Kassaw ◽  
Ayele Mamo Abebe ◽  
Kenean Getaneh Tilaye ◽  
Gedefaw Diress ◽  
Mikiyas Amare Getu ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Hiv Transmission ◽  
Hiv Positive ◽  
Pmtct Program ◽  
Loss To Follow Up ◽  
Hiv Exposed Infants ◽  
Regional State ◽  
Referral Hospitals ◽  
Hiv Exposed

Abstract Background: Elimination of MTCT of HIV was a global public health priority. In 2013, the World Health Organization recommended antiretroviral therapy administration to all HIV positive pregnant, and breastfeeding women regardless of CD4 cell count or clinical stage, which is called “Option B+”. Ethiopia have had a high rate of MTCT of HIV. The rate of transmission on breastfeeding mothers was 24% in 2012. But the rate had been increased to more than 30% in 2015.Objective: This study aimed to determine outcomes of HIV exposed infants, explore the contributors of mortality and loss to follow up, and identify factors of HIV transmission among infants born from HIV positive mothers in Amhara regional state referral hospitals, Ethiopia, 2018/19. Methods: The study was done in five Amhara regional state referral hospitals’ PMTCT departments. A simple random sampling technique with proportional allocation was used to assess the outcomes of 217 exposed infants. A retrospective quantitative cohort design and qualitative exploratory design were used in all referral hospitals of the Amhara region. The data were collected from each hospital exposed infant medical record, which was documented between January 01/2014 and May 30/2017 . An in-depth interview was also taken place from health professionals working in the PMTCT department, zonal HIV officers, and mothers who are enrolled in the PMTCT department. A cumulative incidence rate was used to present mortality, transmission, and loss to follow- up.Results: The incidence rate of HIV transmission at enrollment to PMTCT program in Amhara regional state referral hospitals was 2.3% (95% CI, 0.5-4.6%), and 3.7 (95% CI, 1.4-6.5) at the time of completing PMTCT program using antibody or DNA-PCR test. Whereas the incidence rate of LTFU in Amhara regional state referral hospitals was 8.8% (95% CI, 5.4-12.4%). But the rate of mortality after enrollment to the program was zero. The interviewees’ opinions on mortality, and loss to follow up were categorized into themes.Conclusions: Irrespective of the WHO guideline expected outcome of option B+, the outcome of the PMTCT program in this study was high, particularly HIV transmission and LTFU.

scholarly journals National-level effectiveness of ART to prevent early mother to child transmission of HIV in Namibia

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0233341
Author(s):  
Andrew Agabu ◽  
Andrew L. Baughman ◽  
Christa Fischer-Walker ◽  
Michael de Klerk ◽  
Nicholus Mutenda ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
National Level ◽  
Prevalence Ratio ◽  
Dried Blood Spots ◽  
Test Results ◽  
Hiv Diagnosis ◽  
Hiv Exposed Infants ◽  
Hiv Test ◽  
Hiv Exposed ◽  
Mother To Child

Background Namibia introduced the prevention of mother to child HIV transmission (MTCT) program in 2002 and lifelong antiretroviral therapy (ART) for pregnant women (option B-plus) in 2013. We sought to quantify MTCT measured at 4–12 weeks post-delivery. Methods During Aug 2014-Feb 2015, we recruited a nationally representative sample of 1040 pairs of mother and infant aged 4–12 weeks at routine immunizations in 60 public health clinics using two stage sampling approach. Of these, 864 HIV exposed infants had DNA-PCR HIV test results available. We defined an HIV exposed infant if born to an HIV-positive mother with documented status or diagnosed at enrollment using rapid HIV tests. Dried Blood Spots samples from HIV exposed infants were tested for HIV. Interview data and laboratory results were collected on smartphones and uploaded to a central database. We measured MTCT prevalence at 4–12 weeks post-delivery and evaluated associations between infant HIV infection and maternal and infant characteristics including maternal treatment and infant prophylaxis. All statistical analyses accounted for the survey design. Results Based on the 864 HIV exposed infants with test results available, nationally weighted early MTCT measured at 4–12 weeks post-delivery was 1.74% (95% confidence interval (CI): 1.00%-3.01%). Overall, 62% of mothers started ART pre-conception, 33.6% during pregnancy, 1.2% post-delivery and 3.2% never received ART. Mothers who started ART before pregnancy and during pregnancy had low MTCT prevalence, 0.78% (95% CI: 0.31%-1.96%) and 0.98% (95% CI: 0.33%-2.91%), respectively. MTCT rose to 4.13% (95% CI: 0.54%-25.68%) when the mother started ART after delivery and to 11.62% (95% CI: 4.07%-28.96%) when she never received ART. The lowest MTCT of 0.76% (95% CI: 0.36% - 1.61%) was achieved when mother received ART and ARV prophylaxis within 72hrs for infant and highest 22.32% (95%CI: 2.78% -74.25%) when neither mother nor infant received ARVs. After adjusting for mother’s age, maternal ART (Prevalence Ratio (PR) = 0.10, 95% CI: 0.03–0.29) and infant ARV prophylaxis (PR = 0.32, 95% CI: 0.10–0.998) remained strong predictors of HIV transmission. Conclusion As of 2015, Namibia achieved MTCT of 1.74%, measured at 4–12 weeks post-delivery. Women already on ART pre-conception had the lowest prevalence of MTCT emphasizing the importance of early HIV diagnosis and treatment initiation before pregnancy. Studies are needed to measure MTCT and maternal HIV seroconversion during breastfeeding.

scholarly journals Reducing loss to follow-up of HIV exposed infants in Central Mozambique

2016 ◽  
Vol 82 (3) ◽  
pp. 377 ◽  
Author(s):  
M. Napúa ◽  
J.L. Manuel ◽  
L. Costa Vieira ◽  
S. Beste ◽  
C. Michel ◽  
...  
Keyword(s):  
Loss To Follow Up ◽  
Hiv Exposed Infants ◽  
Hiv Exposed

Factors associated with mother to child transmission of HIV despite overall low transmission rates in HIV-exposed infants in rural Kenya

2017 ◽  
Vol 28 (12) ◽  
pp. 1215-1223 ◽  
Author(s):  
Nicollate A Okoko ◽  
Kevin O Owuor ◽  
Jayne L Kulzer ◽  
George O Owino ◽  
Irene A Ogolla ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Hiv Transmission ◽  
Poor Adherence ◽  
Pmtct Service ◽  
Hiv Education ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Hiv Exposed Infants ◽  
Hiv Exposed ◽  
Mother To Child

Despite the availability of efficacious prevention of mother-to-child transmission (PMTCT) interventions and improved access to preventive services in many developing countries, vertical HIV transmission persists. A matched case–control study of HIV-exposed infants between January and June 2012 was conducted at 20 clinics in Kenya. Cases were HIV-infected infants and controls were exposed, uninfected infants. Conditional logistic regression analysis was conducted to determine characteristics associated with HIV infection. Forty-five cases and 45 controls were compared. Characteristics associated with HIV-infection included poor PMTCT service uptake such as late infant enrollment (odds ratio [OR]: 7.1, 95% confidence interval [CI]: 2.6–16.7) and poor adherence to infant prophylaxis (OR: 8.3, 95%CI: 3.2–21.4). Maternal characteristics associated with MTCT included lack of awareness of HIV status (OR: 5.6, 95%CI: 2.2–14.5), failure to access antiretroviral prophylaxis (OR: 22.2, 95%CI: 5.8–84.6), and poor adherence (OR: 8.1, 95%CI: 3.7–17.8). Lack of clinic-based HIV education (OR: 7.7, 95%CI: 2.0–25.0) and counseling (OR: 8.3, 95%CI: 2.2–33.3) were reported by mothers of cases. Poor uptake of PMTCT services and a reported absence of HIV education and counseling at the clinic were associated with MTCT. More emphasis on high-quality, comprehensive PMTCT service provision are urgently needed to minimize HIV transmission to children.

scholarly journals Loss to follow-up and associated maternal factors among HIV-exposed infants at the Mbarara Regional Referral Hospital, Uganda: A retrospective study

2020 ◽  
Author(s):  
Rogers Ankunda ◽  
Samuel Nambile Cumber ◽  
Catherine Atuhaire ◽  
Kabanda Taseera ◽  
Claude Ngwayu Nkfusai ◽  
...  
Keyword(s):  
Family Planning ◽  
Referral Hospital ◽  
Hiv Care ◽  
Maternal Factors ◽  
Regional Referral Hospital ◽  
Loss To Follow Up ◽  
Hiv Exposed Infants ◽  
Hiv Exposed ◽  
Depth Interviews

Abstract Background Loss to follow-up (LTFU) deprives HIV-exposed infants the lifesaving care required and results in exposing HIV free infants to virus requisition risk. We aimed to determine the rate of LTFU, postnatal mother-to-child HIV-transmission and to identify maternal factors associated with LTFU among HIV-exposed infants enrolled at Mbarara Regional Referral Hospital PMTCT clinic. Methods Study participants were infants born to HIV-positive mothers enrolled in the PMTCT clinic for HIV care at Mbarara Regional Referral Hospital. While access database in the Early Infant Diagnosis (EID) clinic provided data on infants, the open medical record system database at the ISS clinic provided that for mothers. Infants were classified as LTFU if they had not complete their follow-up schedule by 18 months of age. At 18 months, an infant is expected to receive a rapid diagnostic test before being discharged from the PMTCT clinic. Postnatal MTCT of HIV was calculated as a proportion of infants followed and tested from birth to 18 months of age. Logistic regression was used to determine possible associations between mothers’ characteristics and LTFU. In-depth interviews of mothers of LTFU infants and health workers who attend to the HIV-exposed infants were carried out to identify factors not captured in the electronic database. Results Out of 1624 infants enrolled at the clinic, 533 (33%) were dropped for lack of mother’s clinic identification number, 18 (1.1%) were either dead or transferred out. Out of 1073 infants analysed, 515 (48%) were LTFU while out of the 558 who completed their follow-up schedule, 20 (3.6%) tested positive for HIV. Young age of mother, far distance to hospital and non-use of family planning were identified as outstanding factors responsible for LTFU. In addition, in-depth interviews revealed facility-level factors such as “waiting time”. Conclusion This study has revealed a high rate of LTFU among HIV-exposed infants enrolled at Mbarara Regional Referral hospital PMTCT clinic. Young maternal age, long distance to health facility and failure to use family planning were significantly associated with LTFU. Incorporating family planning services in the ART and PMTCT clinics could reduce LTFU of these infants.

Prevention of Mother-to-Child HIV Transmission in Nigeria: Six Years Experience from a Tertiary Institution

2021 ◽  
Vol 19 ◽  
Author(s):  
Rabiu Ibrahim Jalo ◽  
Taiwo Amole ◽  
Deepa Dongarwar ◽  
Hadiza Abdullahi ◽  
Fatima I. Tsiga-Ahmed ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Infection Rate ◽  
Hiv Transmission ◽  
Early Infant Diagnosis ◽  
Mixed Feeding ◽  
Hiv Exposed Infants ◽  
Early Infant ◽  
Antiretroviral Prophylaxis ◽  
Hiv Exposed ◽  
Mother To Child

Background: In line with global standards and progress made in Prevention of Mother-to-Child Transmission (PMTCT), an assessment of the outcome of Early Infant Diagnosis in northern Nigeria is necessary to evaluate progress towards a zero Human immunodeficiency Virus (HIV) infection rate among children. Objectives: This study assessed the infection rate and risk factors for mother-to-child HIV transmission among HIV-exposed children in Kano, northwest Nigeria. Method: Using a retrospective cohort design, pregnant HIV-positive women and their exposed infants were recruited over a period of six years (2010 to 2016). Participants were enrolled during pregnancy or at delivery from the PMTCT clinic of a tertiary health facility in Kano, Nigeria. The main observations of the study were Early infant diagnosis positivity for HIV at 6 weeks and the risk factors for positivity. Results: Of the 1,514 infants studied, Early Infant Diagnosis was positive for HIV among 13 infants (0.86%). Infants whose mothers did not have antiretroviral therapy (adjusted Prevalence Ratio aPR = 2.58, 95%CI [1.85- 3.57]); who had mixed feeding (aPR = 12.06, 95%CI [9.86- 14.70]) and those not on antiretroviral prophylaxis (aPR = 20.39, 95%CI [16.04- 25.71]) were more likely to be infected with HIV. HIV-exposed infants on nevirapine and zidovudine prophylaxis accounted for 95% and 74%, respectively, and were less likely to be infected with HIV. Conclusion: HIV infection rate remains high among HIV-exposed infants whose mothers did not receive PMTCT services. Scaling up proven interventions of early commencement of antiretroviral treatment for mothers, adherence to antiretroviral prophylaxis and avoidance of mixed feeding among HIV-exposed infants would protect future generations from HIV infection.

scholarly journals Mother-to-Child Transmission of HIV Infection and Its Determinants among Exposed Infants on Care and Follow-Up in Dire Dawa City, Eastern Ethiopia

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Fisseha Wudineh ◽  
Bereket Damtew
Keyword(s):  
Hiv Infection ◽  
Scale Up ◽  
Hiv Positive ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Hiv Exposed Infants ◽  
Dire Dawa ◽  
Hiv Exposed ◽  
Mother To Child

Since the scale-up for prevention of mother-to-child transmission (PMTCT) services, rates of HIV infection among exposed infants have significantly declined. However, current achievements fell short of achieving the target sets. We investigated mother-to-child transmission (MTCT) of HIV infection and its determinants among HIV-exposed infants on care at Dilchora Referral Hospital in Dire Dawa City Administration. A retrospective institutional cohort study was conducted by reviewing follow-up records of HIV-exposed infants who were enrolled into care. Infants’ HIV serostatus was the outcome measure of the study. Bivariate and multivariate logistic regressions were employed to identify significant determinants. Of the 382 HIV-exposed infants enrolled into care, 60 (15.7%) became HIV positive. Rural residence (AOR: 3.29; 95% CI: 1.40, 7.22), home delivery (AOR: 3.35; 95% CI: 1.58, 8.38), infant not receiving ARV prophylaxis at birth (AOR: 5.83; 95% CI: 2.84, 11.94), mixed feeding practices (AOR: 42.21; 95% CI: 8.31, 214.38), and mother-child pairs neither receiving ARV (AOR: 4.42; 95% CI: 2.01, 9.82) were significant independent determinants of MTCT of HIV infection. Our findings suggest additional efforts to intensify scale-up of PMTCT services in rural setting and improve institutional delivery and postnatal care for HIV positive mothers and proper follow-up for HIV-exposed infants.

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