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


Ng'ambi, WF; Ade, S; Harries, AD; Midiani, D; Owiti, P; Takarinda, KC; Gugsa, S; Phiri, S; (2016) Follow-up and programmatic outcomes of HIV-exposed infants registered in a large HIV centre in Lilongwe, Malawi: 2012 - 2014. Tropical medicine & international health . ISSN 1360-2276 DOI: 10.1111/tmi.12727

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Abstract

To assess follow-up and programmatic outcomes of HIV-exposed infants at Martin Preuss Centre, Lilongwe, from 2012 to 2014. Retrospective cohort study using routinely collected HIV-exposed infant data. Data were analysed using frequencies and percentages in Stata v.13. 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. 65 infants were found to be HIV-positive and 43% were started on 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 MPC, forgetting clinic appointments and transport expenses. Of these 86 patients, 36% were successfully brought back to care and 64% remained lost-to-follow-up. 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 urgentlyimproved to better follow-up and link HIV-positive children to ART. This article is protected by copyright. All rights reserved.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
PubMed ID: 27197651
URI: http://researchonline.lshtm.ac.uk/id/eprint/2549761

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