OBJECTIVE: To assess factors, outcomes and reasons for loss to follow-up (LTFU) among pregnant and breastfeeding women initiated on a lifelong antiretroviral therapy (ART) for PMTCT in a large antenatal clinic in Malawi. METHODS: We identified all pregnant and breastfeeding women who were initiated on ART between September 2011 and September 2013 and had missed their clinic appointment by at least 3 weeks at Bwaila Hospital, the largest antenatal clinic in Malawi. These women were traced by phone or home visits. Their true status and reasons for ART discontinuation were documented during tracing. RESULTS: A total of 2930 women started ART for PMTCT; 2458 (84%) pregnant and 472 (16%) breastfeeding, of which, 577 (20%) missed a scheduled clinic appointment. LTFU was associated with younger age, being pregnant, and earlier year of ART initiation. We successfully traced 229 (40%), of whom, 10 (4%) had died. Of the 219 women found alive, 118 (54%) had stopped taking ARV drugs, 67 (30%) had self-transferred to another ART clinic, 13 (6%) had collected drugs from other sources, 9 (4%) had treatment interruptions and 12 (5%) had other outcomes. Reasons cited for stopping ART were travel (38%), lack of transport money (16%), not understanding the initial ARV education session (10%), being too weak/sick (10%), ARV side effects (10%) and other reasons. CONCLUSION: Approximately half of the women who were traced were taking ARVs. The study emphasises the need for enhanced post-test counselling strategies, ongoing psychosocial support, provision of incentives and further decentralisation efforts of PMTCT services.
OBJECTIVE: To assess factors, outcomes and reasons for loss to follow-up (LTFU) among pregnant and breastfeeding women initiated on a lifelong antiretroviral therapy (ART) for PMTCT in a large antenatal clinic in Malawi. METHODS: We identified all pregnant and breastfeeding women who were initiated on ART between September 2011 and September 2013 and had missed their clinic appointment by at least 3 weeks at Bwaila Hospital, the largest antenatal clinic in Malawi. These women were traced by phone or home visits. Their true status and reasons for ART discontinuation were documented during tracing. RESULTS: A total of 2930 women started ART for PMTCT; 2458 (84%) pregnant and 472 (16%) breastfeeding, of which, 577 (20%) missed a scheduled clinic appointment. LTFU was associated with younger age, being pregnant, and earlier year of ART initiation. We successfully traced 229 (40%), of whom, 10 (4%) had died. Of the 219 women found alive, 118 (54%) had stopped taking ARV drugs, 67 (30%) had self-transferred to another ART clinic, 13 (6%) had collected drugs from other sources, 9 (4%) had treatment interruptions and 12 (5%) had other outcomes. Reasons cited for stopping ART were travel (38%), lack of transport money (16%), not understanding the initial ARV education session (10%), being too weak/sick (10%), ARV side effects (10%) and other reasons. CONCLUSION: Approximately half of the women who were traced were taking ARVs. The study emphasises the need for enhanced post-test counselling strategies, ongoing psychosocial support, provision of incentives and further decentralisation efforts of PMTCT services.
Keywords:
Malawi; Opción B+; Option B+; Prevención de la transmisión madre-hijo; loss to follow-up; perte au suivi; prevention of mother to child transmission; prévention de la transmission mère-enfant; pérdida durante el seguimiento
Authors: Kathy Goggin; Emily A Hurley; Vincent S Staggs; Catherine Wexler; Niaman Nazir; Brad Gautney; Samoel A Khamadi; May Maloba; Raphael Lwembe; Sarah Finocchario-Kessler Journal: AIDS Patient Care STDS Date: 2019-08 Impact factor: 5.078
Authors: Alison L Drake; Jennifer A Unger; Keshet Ronen; Daniel Matemo; Trevor Perrier; Brian DeRenzi; Barbra A Richardson; John Kinuthia; Grace John-Stewart Journal: Contemp Clin Trials Date: 2017-03-14 Impact factor: 2.226
Authors: Bryna J Harrington; Brian W Pence; Madalitso Maliwichi; Allan N Jumbe; Ntchindi A Gondwe; Shaphil D Wallie; Bradley N Gaynes; Joanna Maselko; William C Miller; Mina C Hosseinipour Journal: AIDS Date: 2018-11-28 Impact factor: 4.177
Authors: Angela M Bengtson; Wiza Kumwenda; Mark Lurie; Brandon Klyn; Michael Owino; William C Miller; Vivian Go; Mina C Hosseinipour Journal: AIDS Behav Date: 2020-02
Authors: Blake M Hauser; William C Miller; Hannock Tweya; Colin Speight; Tiwonge Mtande; Sam Phiri; L M Ball; Mina C Hosseinipour; Irving F Hoffman; Nora E Rosenberg Journal: Int J STD AIDS Date: 2017-07-27 Impact factor: 1.359
Authors: Pernille Bejer Nordentoft; Thomas Engell-Sørensen; Sanne Jespersen; Faustino Gomes Correia; Candida Medina; David da Silva Té; Lars Østergaard; Alex Lund Laursen; Christian Wejse; Bo Langhoff Hønge Journal: Infection Date: 2016-10-14 Impact factor: 3.553
Authors: Catherine A Koss; Paul Natureeba; Dalsone Kwarisiima; Mike Ogena; Tamara D Clark; Peter Olwoch; Deborah Cohan; Jaffer Okiring; Edwin D Charlebois; Moses R Kamya; Diane V Havlir Journal: J Acquir Immune Defic Syndr Date: 2017-03-01 Impact factor: 3.731