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Follow‐up and programmatic outcomes of HIV ‐exposed infants registered in a large HIV centre in Lilongwe, Malawi: 2012–2014
Author(s) -
Ng'ambi Wingston F.,
Ade Serge,
Harries Anthony D.,
Midiani Dalitso,
Owiti Philip,
Takarinda Kudakwashe C.,
Gugsa Salem,
Phiri Sam
Publication year - 2016
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12727
Subject(s) - medicine , pediatrics , human immunodeficiency virus (hiv) , antiretroviral therapy , retrospective cohort study , population , cohort , lost to follow up , viral load , family medicine , environmental health
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 .