Follow-up and programmatic outcomes of HIV-exposed infants registered in a large HIV centre in Lilongwe, Malawi: 2012-2014.

Autor: Ng'ambi WF; The Lighthouse Trust, Kamuzu Central Hospital, Lilongwe, Malawi., Ade S; International Union Against Tuberculosis and Lung Disease, Paris, France.; National Tuberculosis Programme, Cotonou, Benin., Harries AD; International Union Against Tuberculosis and Lung Disease, Paris, France.; London School of Hygiene and Tropical Medicine, London, UK., Midiani D; HIV Department, Ministry of Health, Lilongwe, Malawi., Owiti P; Academic Model Providing Access to Healthcare, Eldoret, Kenya., Takarinda KC; International Union Against Tuberculosis and Lung Disease, Paris, France.; AIDS and TB Department, Ministry of Health and Child Care, Harare, Zimbabwe., Gugsa S; The Lighthouse Trust, Kamuzu Central Hospital, Lilongwe, Malawi.; International Training and Education Center for Health, Seattle, WA, USA., Phiri S; The Lighthouse Trust, Kamuzu Central Hospital, Lilongwe, Malawi.
Jazyk: angličtina
Zdroj: Tropical medicine & international health : TM & IH [Trop Med Int Health] 2016 Aug; Vol. 21 (8), pp. 995-1002. Date of Electronic Publication: 2016 Jun 08.
DOI: 10.1111/tmi.12727
Abstrakt: Objective: To assess follow-up and programmatic outcomes of HIV-exposed infants at Martin Preuss Centre, Lilongwe, from 2012 to 2014.
Methods: Retrospective cohort study using routinely collected HIV-exposed infant data. Data were analysed using frequencies and percentages in Stata v.13.
Results: Of 1035 HIV-exposed infants registered 2012-2014, 79% were available to be tested for HIV and 76% were HIV-tested either with DNA-PCR or rapid HIV test serology by 24 months of age. Sixty-five infants were found to be HIV-positive and 43% were started on antiretroviral therapy (ART) at different ages from 6 weeks to 24 months. Overall, 48% of HIV-exposed infants were declared lost-to-follow-up in the database. Of these, 69% were listed for tracing; of these, 78% were confirmed as lost-to-follow-up through patient charts; of these, 51% were traced; and of these, 62% were truly not in care, the remainder being wrongly classified. Commonest reasons for being truly not in care were mother/guardian unavailability to bring infants to Martin Preuss Centre, forgetting clinic appointments and transport expenses. Of these 86 patients, 36% were successfully brought back to care and 64% remained lost-to-follow-up.
Conclusion: Loss to follow-up remains a huge challenge in the care of HIV-exposed infants. Active tracing facilitates the return of some of these infants to care. However, programmatic data documentation must be urgently improved to better follow-up and link HIV-positive children to ART.
(© 2016 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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