Lost to Follow-up and Predictors Among HIV-Exposed Infants in Northwest Ethiopia

Wubneh, Chalachew Adugna; Belay, Getaneh Mulualem; Yehualashet, Fikadu Ambaw; Tebeje, Nigusie Birhan; Mekonnen, Birye Dessalegn; Endalamaw, Aklilu

doi:10.1007/s40121-020-00360-z

Cited by 6 publications

(2 citation statements)

References 31 publications

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“…From a Brazilian public policy perspective, these results indicate the di culty of that primary care services have in identifying, linking, and retaining care for children exposed to HIV, problems also seen in other studies [9,22,25,[34][35][36][37]. In Brazil, primary care services are responsible for monitoring all newborns within their geographic areas of coverage [38].…”

Section: Discussionmentioning

confidence: 70%

Factors Associated with Follow-Up of Children Exposed to Mother-to-Child Transmission of HIV: A Historical Cohort Study Form 2000 to 2017, in Porto Alegre, Brazil.

Calvo

Knauth

Hentges

et al. 2021

Preprint

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Background: There are many inequalities in terms of prevention and treatment for pregnant women with HIV and exposed children in low and middle income countries. The Brazilian protocol for prenatal care includes rapid diagnostic testing for HIV, compulsory notification, and monitoring by the epidemiological surveillance of children exposed to HIV until 18 months after delivery. The case is closed after HIV serology results are obtained. Loss to follow-up is defined as a child who was not located at the end of the case, and, therefore, did not have a laboratory diagnosis. Loss to follow-up is a current problem and has been documented in other countries. This study analyzed the incidence of loss to follow-up of children exposed to HIV and the sociodemographic, behavioral and health variables of associated pregnant women. Methods: This historical cohort study included information on pregnant women living with HIV and the outcome of the child’s exposure to HIV. The association between predictors and the child’s outcome as a loss to follow-up was investigated using the Poisson Regression model. Relative Risk calculations were performed. The significance level of 5% was adopted for variables in the adjusted model. Results: Between 2000 and 2017, of 6,836 children exposed to HIV, 1,763 (25.8%) were classified as loss to follow-up. The factors associated were: maternal age of up to 22 years (aRR 1.25, 95% CI: 1.09-1.43), the mother’s self-declared race/color being black or mixed (aRR 1.13, 95% CI: 1.03-1.25), up to three years of schooling (aRR 1.45, 95% CI: 1.26-1.67), between four and seven years of schooling (aRR 1.14, 95% CI: 1.02-1.28), intravenous drug use (aRR 1.29, 95% CI: 1.12-1.50), and HIV diagnosis during prenatal care or at delivery (aRR 1.37, 95% CI: 1.24-1.52). Conclusion: Variables related to the individual, social and programmatic vulnerability of pregnant women were evidenced.

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Section: Discussionmentioning

confidence: 70%

Factors Associated with Follow-Up of Children Exposed to Mother-to-Child Transmission of HIV: A Historical Cohort Study Form 2000 to 2017, in Porto Alegre, Brazil.

Calvo

Knauth

Hentges

et al. 2021

Preprint

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“…Food supplementation may incentivise caregivers to remain engaged in care. LTFU was more common among CHEU who were orphaned, malnourished, stunted or wasted, from rural residence, or had >3 siblings, in studies in Kenya, Malawi and Ethiopia [ 122 , 123 , 124 ]. Routine neurodevelopmental screenings should coincide with routine paediatric care visits, when children are already receiving immunisations and growth monitoring, to reduce the burden on caregivers and healthcare workers [ 125 ].…”

Section: Discussionmentioning

confidence: 99%

Neurodevelopment among children exposed to HIV and uninfected in sub‐Saharan Africa

Bulterys,

Njuguna,

Mahy

et al. 2023

J Int AIDS Soc.

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IntroductionThe population of 16 million children exposed to HIV and uninfected (CHEU) under 15 years of age continues to expand rapidly, and the estimated prevalence of CHEU exceeds 20% in several countries in sub‐Saharan Africa with high HIV prevalence. Some evidence suggests that CHEU experience suboptimal neurodevelopmental outcomes compared to children born to women without HIV. In this commentary, we discuss the latest research on biologic and socio‐behavioural factors associated with neurodevelopmental outcomes among CHEU.DiscussionSome but not all studies have noted that CHEU are at risk of poorer neurodevelopment across multiple cognitive domains, most notably in language and motor skills, in diverse settings, ages and using varied assessment tools. Foetal HIV exposure can adversely influence infant immune function, structural brain integrity and growth trajectories. Foetal exposure to antiretrovirals may also influence outcomes. Moreover, general, non‐CHEU‐specific risk factors for poor neurodevelopment, such as preterm birth, food insecurity, growth faltering and household violence, are amplified among CHEU; addressing these factors will require multi‐factorial solutions. There is a need for rigorous harmonised approaches to identify children at the highest risk of delay. In high‐burden HIV settings, existing maternal child health programmes serving the general population could adopt structured early child development programmes that educate healthcare workers on CHEU‐specific risk factors and train them to conduct rapid neurodevelopmental screening tests. Community‐based interventions targeting parent knowledge of optimal caregiving practices have shown to be successful in improving neurodevelopmental outcomes in children and should be adapted for CHEU.ConclusionsCHEU in sub‐Saharan Africa have biologic and socio‐behavioural factors that may influence their neurodevelopment, brain maturation, immune system and overall health and wellbeing. Multidisciplinary research is needed to disentangle complex interactions between contributing factors. Common environmental and social risk factors for suboptimal neurodevelopment in the general population are disproportionately magnified within the CHEU population, and it is, therefore, important to draw on existing knowledge when considering the socio‐behavioural pathways through which HIV exposure could impact CHEU neurodevelopment. Approaches to identify children at greatest risk for poor outcomes and multisectoral interventions are needed to ensure optimal outcomes for CHEU in sub‐Saharan Africa.

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Incidence of loss to follow-up and its predictors among HIV-infected under-five children after initiation of antiretroviral therapy in West Amhara Comprehensive Specialized Referral Hospitals, Northwest Ethiopia: a multicenter retrospective follow-up study

Alemu,

Tesfie,

Abuhay

et al. 2024

BMC Pediatr

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Lost to Follow-up and Predictors Among HIV-Exposed Infants in Northwest Ethiopia

Cited by 6 publications

References 31 publications

Factors Associated with Follow-Up of Children Exposed to Mother-to-Child Transmission of HIV: A Historical Cohort Study Form 2000 to 2017, in Porto Alegre, Brazil.

Factors Associated with Follow-Up of Children Exposed to Mother-to-Child Transmission of HIV: A Historical Cohort Study Form 2000 to 2017, in Porto Alegre, Brazil.

Neurodevelopment among children exposed to HIV and uninfected in sub‐Saharan Africa

Incidence of loss to follow-up and its predictors among HIV-infected under-five children after initiation of antiretroviral therapy in West Amhara Comprehensive Specialized Referral Hospitals, Northwest Ethiopia: a multicenter retrospective follow-up study

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