ArticleJournal of acquired immune deficiency syndromes (1999)2013
Routine inpatient provider-initiated HIV testing in Malawi, compared with client-initiated community-based testing, identifies younger children at higher risk of early mortality.
Article in Journal of acquired immune deficiency syndromes (1999), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- 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
- Investigating strategies to enhance access to HIV services among children in Malawi: A multifaceted research approach, study protocol.PloS one · 2026Article
- Mortality by Admission Diagnosis in Children 1-60 Months of Age Admitted to a Tertiary Care Government Hospital in Malawi.The American journal of tropical medicine and hygiene · 2023Article
- A pediatric death audit in a large referral hospital in Malawi.BMC pediatrics · 2018Article
- Integration of Neonatal and Child Health Interventions with Pediatric HIV Interventions in Global Health.International journal of MCH and AIDS · 2018Review
- Article
- Survival of HIV-1 vertically infected children.Current opinion in HIV and AIDS · 2016Article
- Implementation Research for the Prevention of Mother-to-Child HIV Transmission in Sub-Saharan Africa: Existing Evidence, Current Gaps, and New Opportunities.Current HIV/AIDS reports · 2015Review
- Prevalence of hepatitis C virus in mothers and their children in Malawi.Tropical medicine & international health : TM & IH · 2015Article
- High mortality in HIV-infected children diagnosed in hospital underscores need for faster diagnostic turnaround time in prevention of mother-to-child transmission of HIV (PMTCT) programs.BMC pediatrics · 2015Article
- Improved identification and enrolment into care of HIV-exposed and -infected infants and children following a community health worker intervention in Lilongwe, Malawi.Journal of the International AIDS Society · 2015Article
- Reaching the First 90: Improving Inpatient Pediatric Provider-Initiated HIV Testing and Counseling Using a Quality Improvement Collaborative Strategy in Tanzania.The Journal of the Association of Nurses in AIDS Care : JANACArticle
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
objectiveTo determine how routine inpatient provider-initiated HIV testing differs from traditional community-based client-initiated testing with respect to clinical characteristics of children identified and outcomes of outpatient HIV care.
designProspective observational cohort.
methodsRoutine clinical data were collected from children identified as HIV-infected by either testing modality in Lilongwe, Malawi, in 2008. After 1 year of outpatient HIV care at the Baylor College of Medicine Clinical Center of Excellence, outcomes were assessed.
resultsOf 742 newly identified HIV-infected children enrolling into outpatient HIV care, 20.9% were identified by routine inpatient HIV testing. Compared with community-identified children, hospital-identified patients were younger (median 25.0 vs 53.5 months), with more severe disease (22.2% vs 7.8% WHO stage IV). Of 466 children with known outcomes, 15.0% died within the first year of HIV care; median time to death was 15.0 weeks for community-identified children vs 6.0 weeks for hospital-identified children. The strongest predictors of early mortality were severe malnutrition (hazard ratio, 4.3; 95% confidence interval, 2.2-8.3), moderate malnutrition (hazard ratio, 3.2; confidence interval, 1.6-6.6), age < 12 months (hazard ratio, 3.2; 95% confidence interval, 1.4-7.2), age 12 to 24 months (hazard ratio, 2.5; 95% confidence interval, 1.1-5.7), and WHO stage IV (hazard ratio, 2.2; 95% confidence interval, 1.1-4.6). After controlling for other variables, hospital identification did not independently predict mortality.
conclusionsRoutine inpatient HIV testing identifies a subset of younger HIV-infected children with more severe, rapidly progressing disease that traditional community-based testing modalities are currently missing.
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