ArticleJournal of acquired immune deficiency syndromes (1999)2011
Inadequate coordination of maternal and infant HIV services detrimentally affects early infant diagnosis outcomes in Lilongwe, Malawi.
Article in Journal of acquired immune deficiency syndromes (1999), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02682810 (Z 1303 - Point-of-Care Virologic Testing to Improve Outcomes of HIV-Infected Children), which is not on this map. Cited by 67 papers, 4 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Z 1303 - Point-of-Care Virologic Testing to Improve Outcomes of HIV-Infected Children
Who cites it
67 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Interventions to increase early infant diagnosis of HIV infection: A systematic review and meta-analysis.PloS one · 2022Pooled it
- Point-of-care tests detecting HIV nucleic acids for diagnosis of HIV-1 or HIV-2 infection in infants and children aged 18 months or less.The Cochrane database of systematic reviews · 2021Pooled it
- Integrating antiretroviral therapy into antenatal care and maternal and child health settings: a systematic review and meta-analysis.Bulletin of the World Health Organization · 2013Pooled it
- Missed opportunities to prevent mother-to-child-transmission: systematic review and meta-analysis.AIDS (London, England) · 2012Pooled it
- Trial
- Stepped-Wedge Cluster Randomized Controlled Trial to Promote Option B+ Retention in Central Mozambique.Journal of acquired immune deficiency syndromes (1999) · 2017Trial
- Trial
- Point-of-Care Virologic Testing to Improve Outcomes of HIV-Infected Children in Zambia: A Clinical Trial Protocol.Journal of acquired immune deficiency syndromes (1999) · 2016Trial
- Option B+ in Mozambique: Formative Research Findings for the Design of a Facility-Level Clustered Randomized Controlled Trial to Improve ART Retention in Antenatal Care.Journal of acquired immune deficiency syndromes (1999) · 2016Trial
- Improving early infant HIV diagnosis in Kenya: study protocol of a cluster-randomized efficacy trial of the HITSystem.Implementation science : IS · 2015Trial
- Clinical versus rapid molecular HIV diagnosis in hospitalized African infants: a randomized controlled trial simulating point-of-care infant testing.Journal of acquired immune deficiency syndromes (1999) · 2014Trial
- A Qualitative Descriptive Study of the Drivers, Perpetuators, and Impacts of Stigma Among Youth Living with HIV in Lima, Peru.AIDS and behavior · 2026Article
- Impact of a Social Media Campaign on HIV-Related Stigma among Young Adults Living with HIV in Lima, Peru: A Sequential Explanatory Mixed Methods Study.medRxiv : the preprint server for health sciences · 2026Article
- Differentiated community-based point-of-care early infant diagnosis to improve HIV diagnosis and ART initiation among infants and young children in Zambia: a quasi-experimental cohort study.BMJ global health · 2025Observational
- Factors influencing provider deviation from national HIV and nutritional guidelines for HIV-exposed children in western Kenya: a qualitative study.BMC health services research · 2024Article
- Healthcare workers' perceptions on collaborative capacity at a Referral Hospital in Malawi.Health SA = SA Gesondheid · 2021Article
- Barriers to early infant diagnosis of HIV in the Wa Municipality and Lawra District of Upper West Region, Ghana.Ghana medical journal · 2020Article
- Uptake of care and treatment amongst a national cohort of HIV positive infants diagnosed at primary care level, South Africa.BMC infectious diseases · 2019Observational
- Development and Implementation of a Mobile Phone-Based Prevention of Mother-To-Child Transmission of HIV Cascade Analysis Tool: Usability and Feasibility Testing in Kenya and Mozambique.JMIR mHealth and uHealth · 2019Article
- A study using knowledge, attitude and practices on the prevention of HIV-1 vertical transmission with outcomes in early infant HIV-1 diagnosis in Eastern Uganda.Journal of virus eradication · 2019Article
7 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
14 authors.
Funding
Abstract
objectiveTo assess the continuity of care and outcome of pediatric HIV prevention, testing, and treatment services, focusing on early infant diagnosis with DNA polymerase chain reaction (PCR).
designA retrospective observational cohort.
methodsMaternal HIV antibody, infant HIV DNA PCR test results, and outcome data from HIV-infected infants from the prevention of mother-to-child transmission, early infant diagnosis, and pediatric HIV treatment programs operating in Lilongwe, Malawi, between 2004 and 2008 were collected, merged, and analyzed.
resultsOf the 14,669 pregnant women who tested HIV antibody positive, 7875 infants (53.7%) received HIV DNA PCR testing. One thousand eighty-four infants (13.8%) were HIV infected. Three hundred twenty (29.5%) children enrolled into pediatric HIV care, with 202 (63.1%) at the Baylor Center of Excellence. Among these, antiretroviral therapy was initiated on 110 infants (54.5%) whose median age was 9.1 months (interquartile range, 5.4-13.8) and a median of 2.5 months (interquartile range, 1.4-5.2) after HIV clinic registration. Sixty-nine HIV-infected infants (34.2%) died or were lost by December 2008. Initiation of antiretroviral therapy increased the likelihood of survival 7-fold (odds ratio, 7.1; 95% confidence interval, 3.68 to 13.70).
conclusionsSeparate programs for maternal and infant HIV prevention and care services demonstrated high attrition rates of HIV-exposed and HIV-infected infants, elevated levels of mother-to-child transmission, late infant diagnosis, delayed pediatric antiretroviral therapy initiation, and high HIV-infected infant mortality. Antiretroviral therapy increased HIV-infected infant survival, emphasizing the urgent need for improved service coordination and strategies that increase access to infant HIV diagnosis, improve patient retention, and reduce antiretroviral therapy initiation delays.
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