Predictors of successful early infant diagnosis of HIV in a rural district hospital in Zambézia, Mozambique
Published Date:Apr 2011
Source:J Acquir Immune Defic Syndr. 56(4):e104-e109.
Early Infant Diagnosis
Patient Acceptance Of Health Care
Prevention Of Mother-to-child Transmission
Pubmed Central ID:PMC3073723
Funding:D43 TW001035-13/TW/FIC NIH HHS/United States
U2GPS000631/PHS HHS/United States
D43TW001035/TW/FIC NIH HHS/United States
U2G PS000631/PS/NCHHSTP CDC HHS/United States
D43 TW001035/TW/FIC NIH HHS/United States
A key challenge inhibiting the timely initiation of pediatric antiretroviral treatment is the loss to follow-up of mothers and their infants between the time of mothers' HIV diagnoses in pregnancy and return after delivery for early infant diagnosis (EID) of HIV. We sought to identify barriers to follow-up of HIV-exposed infants in rural Zambézia Province, Mozambique.
We determined follow-up rates for early infant diagnosis and age at first test in a retrospective cohort of 443 HIV-infected mothers and their infants. Multivariable logistic regression models were used to identify factors associated with successful follow-up.
Of the 443 mother-infant pairs, 217 (49%) mothers enrolled in the adult HIV care clinic, and only 110 (25%) infants were brought for early infant diagnosis. The predictors of follow-up for EID were larger household size (OR=1.30; 95% CI, 1.09-1.53), independent maternal source of income (OR=10.8; 95% CI, 3.42-34.0), greater distance from the hospital (OR=2.14; 95% CI, 1.01-4.51) and maternal receipt of ART (OR=3.15; 95% CI, 1.02-9.73). The median age at first test among 105 infants was 5 months (interquartile range 2 to 7); 16% of the tested infants were infected.
Three of four HIV-infected women in rural Mozambique did not bring their children for early infant HIV diagnosis. Maternal receipt of ART has favorable implications for maternal health that will increase the likelihood of early infant diagnosis. We are working with local health authorities to improve the linkage of HIV-infected women to HIV care to maximize early infant diagnosis and care.
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