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Correlates and determinants of Early Infant Diagnosis outcomes in North-Central Nigeria
BACKGROUND: A negative status following confirmatory Early Infant Diagnosis (EID) is the desired pediatric outcome of prevention of Mother to Child Transmission (PMTCT) programs. EID impacts epidemic control by confirming non-infected HIV-exposed infants (HEIs) and prompting timely initiation of ART...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6744629/ https://www.ncbi.nlm.nih.gov/pubmed/31521170 http://dx.doi.org/10.1186/s12981-019-0245-z |
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author | Dakum, Patrick Tola, Monday Iboro, Nta Okolo, Chukwuemeka A. Anuforom, Olachi Chime, Christopher Peters, Sam Jumare, Jibreel Ogbanufe, Obinna Ahmad, Aliyu Ndembi, Nicaise |
author_facet | Dakum, Patrick Tola, Monday Iboro, Nta Okolo, Chukwuemeka A. Anuforom, Olachi Chime, Christopher Peters, Sam Jumare, Jibreel Ogbanufe, Obinna Ahmad, Aliyu Ndembi, Nicaise |
author_sort | Dakum, Patrick |
collection | PubMed |
description | BACKGROUND: A negative status following confirmatory Early Infant Diagnosis (EID) is the desired pediatric outcome of prevention of Mother to Child Transmission (PMTCT) programs. EID impacts epidemic control by confirming non-infected HIV-exposed infants (HEIs) and prompting timely initiation of ART in HIV-infected babies which improves treatment outcomes. OBJECTIVES: We explored factors associated with EID outcomes among HEI in North-Central Nigeria. METHOD: This is a cross-sectional study using EID data of PMTCT-enrollees matched with results of HEI’s dried blood samples (DBS), processed for DNA-PCR from January 2015 through July 2017. Statistical analyses were done using SPSS version 20.0 to generate frequencies and examine associations, including binomial logistic regression with p < 0.05 being statistically significant. RESULTS: Of 14,448 HEI in this analysis, 51.8% were female and 95% (n = 12,801) were breastfed. The median age of the infants at sample collection was 8 weeks (IQR 6–20), compared to HEI tested after 20 weeks of age, those tested earlier had significantly greater odds of a negative HIV result (≤ 6 weeks: OR = 3.8; 6–8 weeks: OR = 2.1; 8–20 weeks: OR = 1.5) with evidence of a significant linear trend (p < 0.001). Similarly, HEI whose mothers received combination antiretroviral therapy (cART) before (OR = 11.8) or during the index pregnancy (OR = 8.4) had significantly higher odds as compared to those whose mothers did not receive cART. In addition, HEI not breastfed had greater odds of negative HIV result as compared to those breastfed (OR = 1.9). CONCLUSIONS: cART prior to and during pregnancy, earlier age of HEI at EID testing and alternative feeding other than breastfeeding were associated with an increased likelihood of being HIV-negative on EID. Therefore, strategies to scale-up PMTCT services are needed to mitigate the burden of HIV among children. |
format | Online Article Text |
id | pubmed-6744629 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-67446292019-09-18 Correlates and determinants of Early Infant Diagnosis outcomes in North-Central Nigeria Dakum, Patrick Tola, Monday Iboro, Nta Okolo, Chukwuemeka A. Anuforom, Olachi Chime, Christopher Peters, Sam Jumare, Jibreel Ogbanufe, Obinna Ahmad, Aliyu Ndembi, Nicaise AIDS Res Ther Research BACKGROUND: A negative status following confirmatory Early Infant Diagnosis (EID) is the desired pediatric outcome of prevention of Mother to Child Transmission (PMTCT) programs. EID impacts epidemic control by confirming non-infected HIV-exposed infants (HEIs) and prompting timely initiation of ART in HIV-infected babies which improves treatment outcomes. OBJECTIVES: We explored factors associated with EID outcomes among HEI in North-Central Nigeria. METHOD: This is a cross-sectional study using EID data of PMTCT-enrollees matched with results of HEI’s dried blood samples (DBS), processed for DNA-PCR from January 2015 through July 2017. Statistical analyses were done using SPSS version 20.0 to generate frequencies and examine associations, including binomial logistic regression with p < 0.05 being statistically significant. RESULTS: Of 14,448 HEI in this analysis, 51.8% were female and 95% (n = 12,801) were breastfed. The median age of the infants at sample collection was 8 weeks (IQR 6–20), compared to HEI tested after 20 weeks of age, those tested earlier had significantly greater odds of a negative HIV result (≤ 6 weeks: OR = 3.8; 6–8 weeks: OR = 2.1; 8–20 weeks: OR = 1.5) with evidence of a significant linear trend (p < 0.001). Similarly, HEI whose mothers received combination antiretroviral therapy (cART) before (OR = 11.8) or during the index pregnancy (OR = 8.4) had significantly higher odds as compared to those whose mothers did not receive cART. In addition, HEI not breastfed had greater odds of negative HIV result as compared to those breastfed (OR = 1.9). CONCLUSIONS: cART prior to and during pregnancy, earlier age of HEI at EID testing and alternative feeding other than breastfeeding were associated with an increased likelihood of being HIV-negative on EID. Therefore, strategies to scale-up PMTCT services are needed to mitigate the burden of HIV among children. BioMed Central 2019-09-14 /pmc/articles/PMC6744629/ /pubmed/31521170 http://dx.doi.org/10.1186/s12981-019-0245-z Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Dakum, Patrick Tola, Monday Iboro, Nta Okolo, Chukwuemeka A. Anuforom, Olachi Chime, Christopher Peters, Sam Jumare, Jibreel Ogbanufe, Obinna Ahmad, Aliyu Ndembi, Nicaise Correlates and determinants of Early Infant Diagnosis outcomes in North-Central Nigeria |
title | Correlates and determinants of Early Infant Diagnosis outcomes in North-Central Nigeria |
title_full | Correlates and determinants of Early Infant Diagnosis outcomes in North-Central Nigeria |
title_fullStr | Correlates and determinants of Early Infant Diagnosis outcomes in North-Central Nigeria |
title_full_unstemmed | Correlates and determinants of Early Infant Diagnosis outcomes in North-Central Nigeria |
title_short | Correlates and determinants of Early Infant Diagnosis outcomes in North-Central Nigeria |
title_sort | correlates and determinants of early infant diagnosis outcomes in north-central nigeria |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6744629/ https://www.ncbi.nlm.nih.gov/pubmed/31521170 http://dx.doi.org/10.1186/s12981-019-0245-z |
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