Jane N Mutanga1,2,3, Simon Mutembo2,3,4, Amara E Ezeamama5, Robert C Fubisha1, Derrick Sialondwe1, Brenda Simuchembu1, Macwani Mutukwa1, Jelita Chinyonga4, Philip E Thuma6, Christopher C Whalen2,3. 1. Department of Pediatrics and Child Health, Livingstone Central Hospital, Livingstone, Zambia. 2. Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens GA, 30602, USA. 3. Global Health Institute, College of Public Health University of Georgia, Athens GA, 30602, USA. 4. Southern Province Medical Office, Ministry of Health, Choma, 10101, Zambia. 5. Research Division, Department of Psychiatry, Michigan State University, East Lansing, MI, 48824, USA. 6. Macha Research Trust, Choma, 10101, Zambia.
Abstract
BACKGROUND: We carried out analyses of early infant testing results at Livingstone Central Hospital in Zambia to assess time of testing, linkages to care and availability of test results for clinical decision making. METHODS: We abstracted data from registers of HIV-exposed infants who had dried blood spots cards (DBS) collected for DNA-PCR from January 2009 to December 2017. Only those tested from 2014 to 2017 had additional data which were used to estimate risk factors for mother-to-child HIV transmission using logistic regression models. RESULTS: DBS were collected from 2630 children. The proportion of HIV-positive tests decreased from 21% in 2009 to 2% in 2016 and 2017. Median turnaround time for results was 9 weeks (IQR: 5, 15) for HIV-negative, 7 weeks (IQR: 5, 13) for HIV-positive children. Only 2% of infants whose mothers took antiretroviral therapy (ART) were HIV positive, while 18% of infants whose mothers took short course antiretroviral drugs (ARVs) were infected. Infants of mothers who did not take ARVs had 9 times the odds of an HIV positive test (OR = 8.9, 95% CI: 3.6, 22.6). Infants of mothers who received short course ARVs were 40% less likely to get an HIV test within the first 2 months of life (OR = 0.6, 95% CI: 0.4, 0.9) compared to infants of mothers who received ART. Only 52% had a third test at median age 52 weeks (IQR: 50, 54). CONCLUSIONS: Long turnaround time for test results and low retention in care after the initial HIV test were critical challenges to clinical decision making.
BACKGROUND: We carried out analyses of early infant testing results at Livingstone Central Hospital in Zambia to assess time of testing, linkages to care and availability of test results for clinical decision making. METHODS: We abstracted data from registers of HIV-exposed infants who had dried blood spots cards (DBS) collected for DNA-PCR from January 2009 to December 2017. Only those tested from 2014 to 2017 had additional data which were used to estimate risk factors for mother-to-child HIV transmission using logistic regression models. RESULTS:DBS were collected from 2630 children. The proportion of HIV-positive tests decreased from 21% in 2009 to 2% in 2016 and 2017. Median turnaround time for results was 9 weeks (IQR: 5, 15) for HIV-negative, 7 weeks (IQR: 5, 13) for HIV-positive children. Only 2% of infants whose mothers took antiretroviral therapy (ART) were HIV positive, while 18% of infants whose mothers took short course antiretroviral drugs (ARVs) were infected. Infants of mothers who did not take ARVs had 9 times the odds of an HIV positive test (OR = 8.9, 95% CI: 3.6, 22.6). Infants of mothers who received short course ARVs were 40% less likely to get an HIV test within the first 2 months of life (OR = 0.6, 95% CI: 0.4, 0.9) compared to infants of mothers who received ART. Only 52% had a third test at median age 52 weeks (IQR: 50, 54). CONCLUSIONS: Long turnaround time for test results and low retention in care after the initial HIV test were critical challenges to clinical decision making.
Authors: Sydney J Bennett; Catherine Chunda-Liyoka; Lisa K Poppe; Katie Meinders; Chisanga Chileshe; John T West; Charles Wood Journal: AIDS Date: 2020-10-01 Impact factor: 4.632
Authors: Ebelechuku F Ugochukwu; Chinyere U Onubogu; Emeka S Edokwe; Uchenna Ekwochi; Kenneth N Okeke; Esther N Umeadi; Stanley K Onah Journal: Int J MCH AIDS Date: 2021-12-15
Authors: Catherine G Sutcliffe; Jane N Mutanga; Nkumbula Moyo; Jessica L Schue; Mutinta Hamahuwa; Philip E Thuma; William J Moss Journal: BMC Infect Dis Date: 2020-03-18 Impact factor: 3.090