Gaps in the care cascade among human immunodeficiency virus-exposed infants born in 2017 in Mashonaland East Province of Zimbabwe
Introduction: Prevention of mother-to-child transmission (PMTCT) is a key strategy for ending the human immunodeficiency virus (HIV) pandemic. Most studies have focused on the mothers' side of the PMTCT cascade or the rate of vertical HIV transmission. Information on child-focused cascade is li...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2021-01-01
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| Series: | Journal of Global Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.jgid.org/article.asp?issn=0974-777X;year=2021;volume=13;issue=2;spage=72;epage=79;aulast=Augustine |
| _version_ | 1818872022131802112 |
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| author | Ndaimani Augustine Owiti Philip Ajay M V Kumar Zizhou Simukai Mugurungi Owen Mugauri Hamufare Dumisani Komtenza Brian |
| author_facet | Ndaimani Augustine Owiti Philip Ajay M V Kumar Zizhou Simukai Mugurungi Owen Mugauri Hamufare Dumisani Komtenza Brian |
| author_sort | Ndaimani Augustine |
| collection | DOAJ |
| description | Introduction: Prevention of mother-to-child transmission (PMTCT) is a key strategy for ending the human immunodeficiency virus (HIV) pandemic. Most studies have focused on the mothers' side of the PMTCT cascade or the rate of vertical HIV transmission. Information on child-focused cascade is limited. We aimed to evaluate HIV testing, antiretroviral therapy (ART), and cotrimoxazole prophylaxis uptake and associated factors among HIV-exposed infants (HEIs) born in 2017. Methods: This was a record-based descriptive study in Mashonaland East Province, Zimbabwe. We analyzed routinely collected program data abstracted from electronic and paper-based HEI registers. Uptakes were calculated as proportions while associations were measured using adjusted risk ratios (log-binomial regression). Results: Of 1028 HEIs, 1015 (98.7%) were commenced on nevirapine prophylaxis, while 915 (89.0%) were commenced on cotrimoxazole prophylaxis. A total of 880 (85.0%) HEIs were tested for HIV by 6 weeks and 445 (44.4%) by 9 months. Overall, 40 (3.9%) were found to be HIV positive, and of them, 34 (85.0%) commenced on ART. Secondary and tertiary health facilities, being born through nonvaginal delivery, and certain districts were significantly associated with not commencing cotrimoxazole prophylaxis or getting tested for HIV. One district was associated with less risk of not having an HIV test by 9 months. Conclusions: While nevirapine, cotrimoxazole, and ART uptake were high among the HEIs, HIV testing by 9 months was suboptimal. The vertical HIV transmission rate was 3.9%. There is a need to strengthen HIV testing and antiretroviral and cotrimoxazole prophylaxes, especially at high-level facilities and certain districts. |
| first_indexed | 2024-12-19T12:32:12Z |
| format | Article |
| id | doaj.art-a704277018cd425f8c8fdb70643d6c42 |
| institution | Directory Open Access Journal |
| issn | 0974-777X |
| language | English |
| last_indexed | 2024-12-19T12:32:12Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Global Infectious Diseases |
| spelling | doaj.art-a704277018cd425f8c8fdb70643d6c422022-12-21T20:21:16ZengWolters Kluwer Medknow PublicationsJournal of Global Infectious Diseases0974-777X2021-01-01132727910.4103/jgid.jgid_171_19Gaps in the care cascade among human immunodeficiency virus-exposed infants born in 2017 in Mashonaland East Province of ZimbabweNdaimani AugustineOwiti PhilipAjay M V KumarZizhou SimukaiMugurungi OwenMugauri Hamufare DumisaniKomtenza BrianIntroduction: Prevention of mother-to-child transmission (PMTCT) is a key strategy for ending the human immunodeficiency virus (HIV) pandemic. Most studies have focused on the mothers' side of the PMTCT cascade or the rate of vertical HIV transmission. Information on child-focused cascade is limited. We aimed to evaluate HIV testing, antiretroviral therapy (ART), and cotrimoxazole prophylaxis uptake and associated factors among HIV-exposed infants (HEIs) born in 2017. Methods: This was a record-based descriptive study in Mashonaland East Province, Zimbabwe. We analyzed routinely collected program data abstracted from electronic and paper-based HEI registers. Uptakes were calculated as proportions while associations were measured using adjusted risk ratios (log-binomial regression). Results: Of 1028 HEIs, 1015 (98.7%) were commenced on nevirapine prophylaxis, while 915 (89.0%) were commenced on cotrimoxazole prophylaxis. A total of 880 (85.0%) HEIs were tested for HIV by 6 weeks and 445 (44.4%) by 9 months. Overall, 40 (3.9%) were found to be HIV positive, and of them, 34 (85.0%) commenced on ART. Secondary and tertiary health facilities, being born through nonvaginal delivery, and certain districts were significantly associated with not commencing cotrimoxazole prophylaxis or getting tested for HIV. One district was associated with less risk of not having an HIV test by 9 months. Conclusions: While nevirapine, cotrimoxazole, and ART uptake were high among the HEIs, HIV testing by 9 months was suboptimal. The vertical HIV transmission rate was 3.9%. There is a need to strengthen HIV testing and antiretroviral and cotrimoxazole prophylaxes, especially at high-level facilities and certain districts.http://www.jgid.org/article.asp?issn=0974-777X;year=2021;volume=13;issue=2;spage=72;epage=79;aulast=Augustinecotrimoxazole prophylaxisearly infant diagnosishuman immunodeficiency virus-exposed infantsoperational researchrecord-based studystructured operational research and training initiativevertical human immunodeficiency virus transmission cascade |
| spellingShingle | Ndaimani Augustine Owiti Philip Ajay M V Kumar Zizhou Simukai Mugurungi Owen Mugauri Hamufare Dumisani Komtenza Brian Gaps in the care cascade among human immunodeficiency virus-exposed infants born in 2017 in Mashonaland East Province of Zimbabwe Journal of Global Infectious Diseases cotrimoxazole prophylaxis early infant diagnosis human immunodeficiency virus-exposed infants operational research record-based study structured operational research and training initiative vertical human immunodeficiency virus transmission cascade |
| title | Gaps in the care cascade among human immunodeficiency virus-exposed infants born in 2017 in Mashonaland East Province of Zimbabwe |
| title_full | Gaps in the care cascade among human immunodeficiency virus-exposed infants born in 2017 in Mashonaland East Province of Zimbabwe |
| title_fullStr | Gaps in the care cascade among human immunodeficiency virus-exposed infants born in 2017 in Mashonaland East Province of Zimbabwe |
| title_full_unstemmed | Gaps in the care cascade among human immunodeficiency virus-exposed infants born in 2017 in Mashonaland East Province of Zimbabwe |
| title_short | Gaps in the care cascade among human immunodeficiency virus-exposed infants born in 2017 in Mashonaland East Province of Zimbabwe |
| title_sort | gaps in the care cascade among human immunodeficiency virus exposed infants born in 2017 in mashonaland east province of zimbabwe |
| topic | cotrimoxazole prophylaxis early infant diagnosis human immunodeficiency virus-exposed infants operational research record-based study structured operational research and training initiative vertical human immunodeficiency virus transmission cascade |
| url | http://www.jgid.org/article.asp?issn=0974-777X;year=2021;volume=13;issue=2;spage=72;epage=79;aulast=Augustine |
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