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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Predictors of successful early infant diagnosis of HIV in a rural district hospital in zambézia, mozambique
Journal of Acquired Immune Deficiency Syndromes, Volume 56, No. 4, Year 2011
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Description
Background: A key challenge inhibiting the timely initiation of pediatric antiretroviral treatment is the loss to follow-up of mothers and their infants between the time of mothers' HIV diagnoses in pregnancy and return after delivery for early infant diagnosis of HIV. We sought to identify barriers to follow-up of HIV-exposed infants in rural Zambézia Province, Mozambique. Methods: We determined follow-up rates for early infant diagnosis and age at first test in a retrospective cohort of 443 HIV-infected mothers and their infants. Multivariable logistic regression models were used to identify factors associated with successful follow-up. Results: Of the 443 mother-infant pairs, 217 (49%) mothers enrolled in the adult HIV care clinic, and only 110 (25%) infants were brought for early infant diagnosis. The predictors of follow-up for early infant diagnosis were larger household size (odds ratio [OR], 1.29; 95% confidence interval [CI], 1.09-1.53), independent maternal source of income (OR, 10.8; 95% CI, 3.42-34.0), greater distance from the hospital (OR, 2.14; 95% CI, 1.01-4.51), and maternal receipt of antiretroviral therapy (OR, 3.15; 95% CI, 1.02-9.73). The median age at first test among 105 infants was 5 months (interquartile range, 2-7); 16% of the tested infants were infected. Conclusions: Three of four HIV-infected women in rural Mozambique did not bring their children for early infant HIV diagnosis. Maternal receipt of antiretroviral therapy has favorable implications for maternal health that will increase the likelihood of early infant diagnosis. We are working with local health authorities to improve the linkage of HIV-infected women to HIV care to maximize early infant diagnosis and care. © 2011 Lippincott Williams & Wilkins.
Authors & Co-Authors
Cook, Rebecca E.
United States, Nashville
Vanderbilt University
Ciampa, Philip J.
United States, Nashville
Vanderbilt University
Mozambique, Maputo
Friends in Global Health
Sidat, Mohsin M.
Mozambique, Maputo
Universidade Eduardo Mondlane
Blevins, Meridith L.
United States, Nashville
Vanderbilt University
Burlison, J. R.
United States, Nashville
Vanderbilt University
Mozambique, Maputo
Friends in Global Health
Davidson, Mario A.
Unknown Affiliation
Arroz, Jorge Alexandre Harrison
United States, Nashville
Vanderbilt University School of Medicine
Vergara, Alfredo E.
United States, Nashville
Vanderbilt University
Mozambique, Maputo
Friends in Global Health
Mozambique
Zambézia Provincial Department of Health
Vermund, Sten Havlor
United States, Nashville
Vanderbilt University
Mozambique, Maputo
Friends in Global Health
Moon, Troyd D.
United States, Nashville
Vanderbilt University
Mozambique, Maputo
Friends in Global Health
Statistics
Citations: 114
Authors: 10
Affiliations: 5
Identifiers
Doi:
10.1097/QAI.0b013e318207a535
ISSN:
15254135
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Cohort Study
Case-Control Study
Study Locations
Mozambique
Participants Gender
Female