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Follow-up and programmatic outcomes of HIV-exposed infants registered in a large HIV centre in Lilongwe, Malawi: 2012 – 2014.

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Ng'ambi WF, Ade S, Harries AD, Midiani D, Owiti P, Takarinda KC, Gugsa S, Phiri S,


Ng'ambi WF, Ade S, Harries AD, Midiani D, Owiti P, Takarinda KC, Gugsa S, Phiri S, (click to view)

Ng'ambi WF, Ade S, Harries AD, Midiani D, Owiti P, Takarinda KC, Gugsa S, Phiri S,

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Tropical medicine & international health : TM & IH 2016 5 20() doi 10.1111/tmi.12727

Abstract
OBJECTIVE
To assess follow-up and programmatic outcomes of HIV-exposed infants at Martin Preuss Centre, Lilongwe, from 2012 to 2014.

METHODS
Retrospective cohort study using routinely collected HIV-exposed infant data. Data were analysed using frequencies and percentages in Stata v.13.

RESULTS
Of 1035 HIV-exposed infants registered 2012-2014, 79% were available to be tested for HIV and 76% were HIV-tested either with DNA PCR or rapid HIV test serology by 24 months of age. 65 infants were found to be HIV-positive and 43% were started on ART at different ages from 6 weeks to 24 months. Overall, 48% of HIV-exposed infants were declared lost-to-follow-up in the database. Of these, 69% were listed for tracing; of these, 78% were confirmed as lost-to-follow-up through patient charts; of these, 51% were traced; and of these, 62% were truly not in care, the remainder being wrongly classified. Commonest reasons for being truly not in care were mother/guardian unavailability to bring infants to MPC, forgetting clinic appointments and transport expenses. Of these 86 patients, 36% were successfully brought back to care and 64% remained lost-to-follow-up.

CONCLUSION
Loss-to-follow-up remains a huge challenge in the care of HIV-exposed infants. Active tracing facilitates the return of some of these infants to care. However, programmatic data documentation must be urgentlyimproved to better follow-up and link HIV-positive children to ART. This article is protected by copyright. All rights reserved.

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