Gaps in the care cascade among human immunodeficiency virus-exposed infants born in 2017 in Mashonaland East Province of Zimbabwe

Autor:	Komtenza Brian, Ajay M. V. Kumar, Mugauri Hamufare Dumisani, Ndaimani Augustine, Zizhou Simukai, Owiti Philip, Mugurungi Owen
Rok vydání:	2021
Předmět:	Nevirapine Human immunodeficiency virus (HIV) human immunodeficiency virus-exposed infants Infectious and parasitic diseases RC109-216 Hiv testing structured operational research and training initiative medicine.disease_cause early infant diagnosis record-based study Hiv test Environmental health Pandemic medicine Hiv transmission business.industry Transmission (medicine) operational research virus diseases vertical human immunodeficiency virus transmission cascade Infectious Diseases Relative risk Original Article Cotrimoxazole prophylaxis business medicine.drug
Zdroj:	Journal of Global Infectious Diseases Journal of Global Infectious Diseases, Vol 13, Iss 2, Pp 72-79 (2021)
ISSN:	0974-777X
DOI:	10.4103/jgid.jgid_171_19
Popis:	Introduction: Prevention of mother-to-child transmission (PMTCT) is a key strategy for ending the human immunodeficiency virus (HIV) pandemic. Most studies have focused on the mothers' side of the PMTCT cascade or the rate of vertical HIV transmission. Information on child-focused cascade is limited. We aimed to evaluate HIV testing, antiretroviral therapy (ART), and cotrimoxazole prophylaxis uptake and associated factors among HIV-exposed infants (HEIs) born in 2017. Methods: This was a record-based descriptive study in Mashonaland East Province, Zimbabwe. We analyzed routinely collected program data abstracted from electronic and paper-based HEI registers. Uptakes were calculated as proportions while associations were measured using adjusted risk ratios (log-binomial regression). Results: Of 1028 HEIs, 1015 (98.7%) were commenced on nevirapine prophylaxis, while 915 (89.0%) were commenced on cotrimoxazole prophylaxis. A total of 880 (85.0%) HEIs were tested for HIV by 6 weeks and 445 (44.4%) by 9 months. Overall, 40 (3.9%) were found to be HIV positive, and of them, 34 (85.0%) commenced on ART. Secondary and tertiary health facilities, being born through nonvaginal delivery, and certain districts were significantly associated with not commencing cotrimoxazole prophylaxis or getting tested for HIV. One district was associated with less risk of not having an HIV test by 9 months. Conclusions: While nevirapine, cotrimoxazole, and ART uptake were high among the HEIs, HIV testing by 9 months was suboptimal. The vertical HIV transmission rate was 3.9%. There is a need to strengthen HIV testing and antiretroviral and cotrimoxazole prophylaxes, especially at high-level facilities and certain districts.
Databáze:	OpenAIRE
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