Evidence map›Paper›PMID 24056068›Full record

SynthesisAIDS (London, England)2013

The magnitude of loss to follow-up of HIV-exposed infants along the prevention of mother-to-child HIV transmission continuum of care: a systematic review and meta-analysis.

Euphemia L Sibanda, Ian V D Weller, James G Hakim, Frances M Cowan

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in AIDS (London, England), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 122 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
122citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

122 citing papers in PubMed, 6 syntheses or guidelines pooled it.

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62 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Euphemia L SibandaaCentre for Sexual Health and HIV/AIDS Research (CeSHHAR Zimbabwe), Harare, Zimbabwe bUniversity College London Centre for Sexual Health & HIV Research, London, UK cDepartment of Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
Ian V D Weller
James G Hakim
Frances M Cowan

Funding

Wellcome Trust
6 · The paper itself

Abstract

introductionAlthough prevention of mother-to-child HIV transmission (PMTCT) programs are widely implemented, many children do not benefit from them because of loss to follow-up (LTFU). We conducted a systematic review to determine the magnitude of infant/baby LTFU along the PMTCT cascade.

methodsEligible publications reported infant LTFU outcomes from standard care PMTCT programs (not intervention studies) at any stage of the cascade. Literature searches were conducted in Medline, Embase, Web of Knowledge, CINAHL Plus, and Maternity and Infant Care. Extracted data included setting, methods of follow-up, PMTCT regimens, and proportion and timing of LTFU. For programs in sub-Saharan Africa, random-effects meta-analysis was done using Stata v10. Because of heterogeneity, predictive intervals (PrIs; approximate 95% confidence intervals of a future study based on extent of observed heterogeneity) were computed.

resultsA total of 826 papers were identified; 25 publications were eligible. Studies were published from 2001 to 2012 and were mostly from sub-Saharan Africa (three were from India, one from UK and one from Ireland). There was extensive heterogeneity in findings. Eight studies reported on LTFU of pregnant HIV-positive women between antenatal care (ANC) registration and delivery, which ranged from 10.9 to 68.1%, pooled proportion 49.08% [95% confidence interval (CI) 39.6-60.9%], and PrI 22.0-100%. Fourteen studies reported LTFU of infants within 3 months of delivery, range 4.8-75%, pooled proportion 33.9% (27.6-41.5), and PrI 15.4-74.2. Children were also lost after HIV testing; this was reported in five studies, pooled estimate 45.5% (35.9-57.6), PrI 18.7-100%. Programs that actively tracked defaulters had better retention outcomes.

conclusionThere is unacceptable infant LTFU from PMTCT programs. Countries should incorporate defaulter-tracking as standard to improve retention.

Indexed as

Lost to Follow-UpContinuity of Patient CareFemaleHIV InfectionsHumansInfantInfant, NewbornInfectious Disease Transmission, VerticalPregnancy

Identifiers

PMID24056068
PMCPMC3814628

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.