Progress in the performance of HIV early infant diagnosis services in Zambia using routinely collected data from 2006 to 2016
Abstract Background Early diagnosis and treatment initiation of HIV-infected infants can greatly reduce the risk of infant mortality. The WHO recommends testing HIV-exposed infants at 6 weeks of age and immediate initiation of antiretroviral therapy if positive. This study aimed to determine the fea...
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| Format: | Article |
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BMC
2018-11-01
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| Series: | BMC Public Health |
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| Online Access: | http://link.springer.com/article/10.1186/s12889-018-6222-y |
| _version_ | 1831683739117158400 |
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| author | Jasleen Singh Suzanne Filteau Jim Todd Sehlulekile Gumede-Moyo |
| author_facet | Jasleen Singh Suzanne Filteau Jim Todd Sehlulekile Gumede-Moyo |
| author_sort | Jasleen Singh |
| collection | DOAJ |
| description | Abstract Background Early diagnosis and treatment initiation of HIV-infected infants can greatly reduce the risk of infant mortality. The WHO recommends testing HIV-exposed infants at 6 weeks of age and immediate initiation of antiretroviral therapy if positive. This study aimed to determine the feasibility of using an electronic health records system to evaluate the performance of Zambia’s HIV Early Infant Diagnosis services. Methods A retrospective analysis of routinely collected data from the Zambian SmartCare database was performed for the period January 2006 to December 2016. The study population includes all HIV-infected infants (n = 32,593) registered during this period on treatment for HIV. Univariable logistic regression was conducted to identify factors associated with later infant testing and treatment initiation. Results The mean age at infant HIV test decreased from 10.10 months in 2006 to 3.49 months in 2016. Infants born in 2015 were almost 4 times more likely to be tested under 2 months of age compared to infants born in 2006 (OR: 3.72, p-value: < 0.001). The mean time from diagnosis to treatment initiation decreased from 220 days in 2006 to 9 days in 2015. There was substantial regional variability with infants in the provinces of Copperbelt, Luapula and Southern performing best in outcomes and Eastern, Lusaka and Western performing the worst. Conclusions HIV-exposed infants born more recently have significantly better outcomes than infants born a decade ago in Zambia, which could be as a result of increased attention and funding for HIV programmes. |
| first_indexed | 2024-12-20T06:44:19Z |
| format | Article |
| id | doaj.art-83a8e05fe98e4ac0b3e844c7fad12803 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-20T06:44:19Z |
| publishDate | 2018-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-83a8e05fe98e4ac0b3e844c7fad128032022-12-21T19:49:47ZengBMCBMC Public Health1471-24582018-11-011811710.1186/s12889-018-6222-yProgress in the performance of HIV early infant diagnosis services in Zambia using routinely collected data from 2006 to 2016Jasleen Singh0Suzanne Filteau1Jim Todd2Sehlulekile Gumede-Moyo3Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical MedicineDepartment of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical MedicineDepartment of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical MedicineDepartment of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical MedicineAbstract Background Early diagnosis and treatment initiation of HIV-infected infants can greatly reduce the risk of infant mortality. The WHO recommends testing HIV-exposed infants at 6 weeks of age and immediate initiation of antiretroviral therapy if positive. This study aimed to determine the feasibility of using an electronic health records system to evaluate the performance of Zambia’s HIV Early Infant Diagnosis services. Methods A retrospective analysis of routinely collected data from the Zambian SmartCare database was performed for the period January 2006 to December 2016. The study population includes all HIV-infected infants (n = 32,593) registered during this period on treatment for HIV. Univariable logistic regression was conducted to identify factors associated with later infant testing and treatment initiation. Results The mean age at infant HIV test decreased from 10.10 months in 2006 to 3.49 months in 2016. Infants born in 2015 were almost 4 times more likely to be tested under 2 months of age compared to infants born in 2006 (OR: 3.72, p-value: < 0.001). The mean time from diagnosis to treatment initiation decreased from 220 days in 2006 to 9 days in 2015. There was substantial regional variability with infants in the provinces of Copperbelt, Luapula and Southern performing best in outcomes and Eastern, Lusaka and Western performing the worst. Conclusions HIV-exposed infants born more recently have significantly better outcomes than infants born a decade ago in Zambia, which could be as a result of increased attention and funding for HIV programmes.http://link.springer.com/article/10.1186/s12889-018-6222-yEarly infant diagnosisHIVPMTCT |
| spellingShingle | Jasleen Singh Suzanne Filteau Jim Todd Sehlulekile Gumede-Moyo Progress in the performance of HIV early infant diagnosis services in Zambia using routinely collected data from 2006 to 2016 BMC Public Health Early infant diagnosis HIV PMTCT |
| title | Progress in the performance of HIV early infant diagnosis services in Zambia using routinely collected data from 2006 to 2016 |
| title_full | Progress in the performance of HIV early infant diagnosis services in Zambia using routinely collected data from 2006 to 2016 |
| title_fullStr | Progress in the performance of HIV early infant diagnosis services in Zambia using routinely collected data from 2006 to 2016 |
| title_full_unstemmed | Progress in the performance of HIV early infant diagnosis services in Zambia using routinely collected data from 2006 to 2016 |
| title_short | Progress in the performance of HIV early infant diagnosis services in Zambia using routinely collected data from 2006 to 2016 |
| title_sort | progress in the performance of hiv early infant diagnosis services in zambia using routinely collected data from 2006 to 2016 |
| topic | Early infant diagnosis HIV PMTCT |
| url | http://link.springer.com/article/10.1186/s12889-018-6222-y |
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