ArticleJournal of the International AIDS Society2017
HIV transmission and retention in care among HIV-exposed children enrolled in Malawi's prevention of mother-to-child transmission programme.
Article in Journal of the International AIDS Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed, 37 citations in OpenAlex.
- Clinical outcomes and survival of HIV exposed children at 18 months in post-conflict region: insight from the Panzi Interdisciplinary PMTCT cohort (Panzi IPC) study.BMC infectious diseases · 2026Article
- Two Decades and Counting Since the Abuja Summit: Where Do We Stand in the Fight Against HIV/AIDS-Related Maternal Mortality?Women's health reports (New Rochelle, N.Y.) · 2025Article
- The progress of mother-to-child transmission of Human Immunodeficiency Virus (HIV) after Dolutegravir (DTG) optimization program: evidence from a multicenter cohort study in Ethiopia.BMC public health · 2024Article
- Effects of the COVID-19 pandemic on early infant diagnosis of HIV in Cape Town, South Africa.Southern African journal of HIV medicine · 2024Article
- Retention in care and viral suppression in the PMTCT continuum at a large referral facility in western Kenya.AIDS and behavior · 2022Article
- The National Evaluation of Malawi's PMTCT Program (NEMAPP) study: 24-month HIV-exposed infant outcomes from a prospective cohort study.HIV medicine · 2022Article
- Probable perinatal depression and social support among women enrolled in Malawi's Option B+ Program: A longitudinal analysis.Journal of affective disorders · 2022Observational
- Article
- Achievements and Challenges in the Prevention of Mother-to-Child Transmission of HIV-A Retrospective Cohort Study from a Rural Hospital in Northern Tanzania.International journal of environmental research and public health · 2021Article
- Article
- Mental health, substance use and viral suppression in adolescents receiving ART at a paediatric HIV clinic in South Africa.Journal of the International AIDS Society · 2020Article
- Article
- Infant and young child feeding learning sessions during savings groups are feasible and acceptable for HIV-positive and HIV-negative women in Malawi.Maternal & child nutrition · 2019Article
- Timing of combination antiretroviral therapy (cART) initiation is not associated with stillbirth among HIV-infected pregnant women in Malawi.Tropical medicine & international health : TM & IH · 2019Article
- Retention of HIV exposed infants in care at Arua regional referral hospital, Uganda: a retrospective cohort study.BMC public health · 2019Article
- "I do all I can but I still fail them": Health system barriers to providing Option B+ to pregnant and lactating women in Malawi.PloS one · 2019Article
- Long-term retention on antiretroviral therapy among infants, children, adolescents and adults in Malawi: A cohort study.PloS one · 2019Article
- Engagement in care among women and their infants lost to follow-up under Option B+ in eSwatini.PloS one · 2019Article
- Progress in the performance of HIV early infant diagnosis services in Zambia using routinely collected data from 2006 to 2016.BMC public health · 2018Article
- Weight gain of HIV-exposed, uninfected children born before and after introduction of the 'Option B+' programme in Malawi.AIDS (London, England) · 2018Article
Corrections and comments
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Authors and funding
13 authors at 6 institutions in 3 countries.
Funding
Abstract
introductionIn Malawi, HIV-infected pregnant and breastfeeding women are offered lifelong antiretroviral therapy (ART) regardless of CD4 count or clinical stage (Option B+). Their HIV-exposed children are enrolled in the national prevention of mother-to-child transmission (PMTCT) programme, but many are lost to follow-up. We estimated the cumulative incidence of vertical HIV transmission, taking loss to follow-up into account.
methodsWe abstracted data from HIV-exposed children enrolled into care between September 2011 and June 2014 from patient records at 21 health facilities in central and southern Malawi. We used competing risk models to estimate the probability of loss to follow-up, death, ART initiation and discharge, and used pooled logistic regression and inverse probability of censoring weighting to estimate the vertical HIV transmission risk.
resultsA total of 11,285 children were included; 9285 (82%) were born to women who initiated ART during pregnancy. At age 30 months, an estimated 57.9% (95% CI 56.6-59.2) of children were lost to follow-up, 0.8% (0.6-1.0) had died, 2.6% (2.3-3.0) initiated ART, 36.5% (35.2-37.9) were discharged HIV-negative and 2.2% (1.5-2.8) continued follow-up. We estimated that 5.3% (95% CI 4.7-5.9) of the children who enrolled were HIV-infected by the age of 30 months, but only about half of these children (2.6%; 95% CI 2.3-2.9) were diagnosed.
conclusionsConfirmed mother-to-child transmission rates were low, but due to poor retention only about half of HIV-infected children were diagnosed. Tracing of children lost to follow-up and HIV testing in outpatient clinics should be scaled up to ensure that all HIV-positive children have access to early ART.
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