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 Mortality and Loss to Follow-Up Among HIV-Exposed Infants After Option B+ Guideline Implementation in Amhara Regional State Referral Hospitals, Ethiopia

2021 ◽  
Vol 9 ◽  
Author(s):  
Mesfin Wudu Kassaw ◽  
Ayele Mamo Abebe ◽  
Biruk Beletew Abate ◽  
Mikiyas Amare Getu ◽  
Ayelign Mengesha Kassie
Keyword(s):  
Cumulative Incidence ◽  
Hiv Positive ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Loss To Follow Up ◽  
Regional State ◽  
Hiv Positive Mothers ◽  
Referral Hospitals ◽  
Mother To Child

Background: Prevention of mother-to-child transmission of HIV program (PMTCT) is a comprehensive approach that aimed for the wellbeing of all HIV-infected women, to prevent new HIV infection among infants born to HIV-positive mothers, and providing management for HIV-positive women and infants. Nevertheless, there was considerably high attrition within the prevention of mother-to-child transmission programs that was merely because of loss to follow-up (LTFU) followed by mortality. In resource-limited countries, one-third of infected children die before 1 year, and more than half of them die before 2 years. The aim of this study was to assess the prevalence or incidence of mortality and LTFU among infants born from HIV-positive mothers in the Amhara regional state referral hospitals, Ethiopia.Methods: This study was conducted in five Amhara regional state referral hospitals' prevention of mother-to-child transmission departments. A simple random sampling technique with proportional allocation was used to assess the outcomes of 221 exposed infants. A retrospective cohort design was used in selecting the 221 exposed infants' document from the referral hospitals of the region, Amhara. The exposed infants' profiles were documented between January 1, 2014 and May 30, 2017.Results: This study described attritions (death and loss-to-follow-up) of exposed babies in PMTCT departments of Amhara regional state referral hospitals in Ethiopia. In this study, low LTFU with zero death was reported. Residence, immunization status of babies, and place of delivery were independent factors of LTFU.Conclusions: The cumulative incidence of mortality in this study was zero. This assured that the recommended option is substantial for the elimination of HIV-caused death in 2030 as per WHO plan. However, the cumulative incidence of LTFU was not zero.

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 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

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.

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.

Loss to follow-up of HIV-exposed infants in South London

2003 ◽  
Vol 14 (4) ◽  
pp. 291-292 ◽  
Author(s):  
I-C Sam ◽  
C S Ball ◽  
M J Blott ◽  
J H C Tosswill ◽  
J V Parry ◽  
...  
Keyword(s):  
Loss To Follow Up ◽  
Hiv Exposed Infants ◽  
Hiv Exposed

scholarly journals Receipt of infant HIV DNA PCR test results is associated with a reduction in retention of HIV-exposed infants in integrated HIV care and healthcare services: a quantitative sub-study nested within a cluster randomised trial in rural Malawi

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Elasma Milanzi ◽  
Victor Mwapasa ◽  
Jessica Joseph ◽  
Aurelie Jousset ◽  
Timothy Tchereni ◽  
...  
Keyword(s):  
Randomised Trial ◽  
Hiv Positive ◽  
Healthcare Facilities ◽  
Hiv Exposed Infants ◽  
Hiv Test ◽  
Hiv Exposed ◽  
Infant Study ◽  
Test Result ◽  
Hiv Negative

Abstract Background Retention of HIV-infected mothers in integrated HIV and healthcare facilities is effective at reducing mother-to-child-transmission (MTCT) of HIV. In the context of Option B+, we examined maternal and HIV-exposed infant retention across three study arms to 18 months postpartum: mother-and-infant clinics (MIP), MIP with short-messaging service (MIP + SMS) and standard of care (SOC). In particular, we focused on the impact of mothers receiving an infant’s HIV PCR test result on maternal and infant study retention. Methods A quantitative sub-study nested within a cluster randomised trial undertaken between May 2013 and August 2016 across 30 healthcare facilities in rural Malawi enrolling HIV-infected pregnant mothers and HIV-exposed infants on delivery, was performed. Survival probabilities of maternal and HIV-exposed infant study retention was estimated using Kaplan-Meier curves. Associations between mother’s receiving an infant’s HIV test result and in particular, an infant’s HIV-positive result on maternal and infant study retention were modelled using time-varying multivariate Cox regression. Results Four hundred sixty-one, 493, and 396 HIV-infected women and 386, 399, and 300 HIV-exposed infants were enrolled across study arms; MIP, MIP + SMS and SOC, respectively. A total of 47.5% of mothers received their infant’s HIV test results < 5 months postpartum. Receiving an infant’s HIV result by mothers was associated with a 70% increase in infant non-retention in the study compared with not receiving an infant’s result (HR = 1.70; P-value< 0.001). Receiving a HIV-positive result was associated with 3.12 times reduced infant retention compared with a HIV-negative result (P-value< 0.001). Of the infants with a HIV-negative test result, 87% were breastfed at their final study follow-up. Conclusions Receiving an infant’s HIV test result was a driving factor for reduced infant study retention, especially an infant’s HIV-positive test result. As most HIV-negative infants were still breastfed at their last follow-up, this indicates a large proportion of HIV-exposed infants were potentially at future risk of MTCT of HIV via breastfeeding but were unlikely to undergo follow-up HIV testing after breastfeeding cessation. Future studies to identify and address underlying factors associated with infant HIV testing and reduced infant retention could potentially improve infant retention in HIV/healthcare facilities. Trial registration Pan African Clinical Trial Registry: PACTR201312000678196.

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