Document Detail

Predictors of successful early infant diagnosis of HIV in a rural district hospital in Zambézia, Mozambique.
MedLine Citation:
PMID:  21266912     Owner:  NLM     Status:  MEDLINE    
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.
Rebecca E Cook; Philip J Ciampa; Mohsin Sidat; Meridith Blevins; Janeen Burlison; Mario A Davidson; Jorge A Arroz; Alfredo E Vergara; Sten H Vermund; Troy D Moon
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of acquired immune deficiency syndromes (1999)     Volume:  56     ISSN:  1944-7884     ISO Abbreviation:  J. Acquir. Immune Defic. Syndr.     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-01     Completed Date:  2011-04-12     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  100892005     Medline TA:  J Acquir Immune Defic Syndr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e104-9     Citation Subset:  IM; X    
Vanderbilt University Institute for Global Health, Nashville, TN 37203, USA.
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MeSH Terms
Early Diagnosis
HIV Infections / diagnosis*
Hospitals, District
Infant, Newborn
Patient Acceptance of Health Care / statistics & numerical data*
Retrospective Studies
Rural Population
Grant Support
D43 TW001035/TW/FIC NIH HHS; D43 TW001035-13/TW/FIC NIH HHS; D43TW001035/TW/FIC NIH HHS; U2GPS000631//PHS HHS

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