Dataset Information

Factors associated with non-attendance at scheduled infant follow-up visits in an observational cohort of HIV-exposed infants in South Africa, 2012-2014.

ABSTRACT:

Background

Since 2001 the South African guidelines to improve child health and prevent vertical HIV transmission recommended frequent infant follow-up with HIV testing at 18?months postpartum. We sought to understand non-attendance at scheduled follow-up study visits up to 18?months, and for the 18-month infant HIV test amongst a nationally representative sample of HIV exposed uninfected (HEU) infants from a high HIV-prevalence African setting.

Methods

Secondary analysis of data drawn from a nationally representative observational cohort study (conducted during October 2012 to September 2014) of HEU infants and their primary caregivers was undertaken. Participants were eligible (N?=?2650) if they were 4-8?weeks old and HEU at enrolment. All enrolled infants were followed up every 3?months up to 18?months. Each follow-up visit was scheduled to coincide with each child's routine health visit, where possible. The denominator at each time point comprised HEU infants who were alive and HIV-free at the previous visit. We assessed baseline maternal and early HIV care characteristics associated with the frequency of 'Missed visits' (MV-frequency), using a negative binomial regression model adjusting for the follow-up time in the study, and associated with missed visits at 18?months (18-month MV) using a logistic regression model.

Results

The proportion of eligible infants with MV was lowest at 3?months (32.7%) and 18?months (31.0%) and highest at 12?months (37.6%). HIV-positive mothers not on triple antiretroviral therapy (ART) by 6-weeks postpartum had a significantly increased occurrence rate of 'MV-frequency' (adjusted incidence rate ratio, 1.2 (95% confidence interval (CI), 1.1-1.4), p??24?years had a significantly reduced rate of 'MV-frequency' (p???0.01) and risk of '18-month-MV' (p?ConclusionLate initiation of maternal ART and infant prophylaxis under the Option- A policy and extended travel time to clinics (measured at 6?weeks postpartum), contributed to higher postnatal MV rates. Mothers older than 24?years had lower MV rates. Targeted interventions may be needed during the current PMTCT Option B+ (lifelong ART to pregnant and lactating women at HIV diagnosis) to circumvent these risk factors and reduce missed visits during HIV-care.

SUBMITTER: Ngandu NK

PROVIDER: S-EPMC6745773 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Factors associated with non-attendance at scheduled infant follow-up visits in an observational cohort of HIV-exposed infants in South Africa, 2012-2014.

Ngandu Nobubelo Kwanele NK Jackson Debra D Lombard Carl C Nsibande Duduzile Faith DF Dinh Thu-Ha TH Magasana Vuyolwethu V Mogashoa Mary M Goga Ameena Ebrahim AE

BMC infectious diseases 20190916 Suppl 1

<h4>Background</h4>Since 2001 the South African guidelines to improve child health and prevent vertical HIV transmission recommended frequent infant follow-up with HIV testing at 18 months postpartum. We sought to understand non-attendance at scheduled follow-up study visits up to 18 months, and for the 18-month infant HIV test amongst a nationally representative sample of HIV exposed uninfected (HEU) infants from a high HIV-prevalence African setting.<h4>Methods</h4>Secondary analysis of data d ...[more]

PMID: 31526372

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Dataset Information

Factors associated with non-attendance at scheduled infant follow-up visits in an observational cohort of HIV-exposed infants in South Africa, 2012-2014.

Background

Methods

Results

Publications

Factors associated with non-attendance at scheduled infant follow-up visits in an observational cohort of HIV-exposed infants in South Africa, 2012-2014.

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