Evidence map›Paper›PMID 32183779›Full record

Trial reportBMC health services research2020

HIV-exposed infant follow-up in Mozambique: formative research findings for the design of a cluster randomized controlled trial to improve testing and ART initiation.

Lúcia Vieira, Arlete Miloque Mahumane, Manuel Napua, Falume Chale, João Luís Manuel, Jessica Greenberg Cowan, Kenneth Sherr, Rachel R Chapman, James T Pfeiffer

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Article
  2. Article
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

9 authors.

Lúcia VieiraMinistry of Health, Centro de Investigação Operacional da Beira, Institute Nacional de Saúde, 1323 Correia de Brito Street, Ponta-gêa Health Center Building, Beira, Sofala, Mozambique. luciadacostavieira@gmail.com.ORCID http://orcid.org/0000-0002-6410-9262
Arlete Miloque MahumaneMinistry of Health, Centro de Investigação Operacional da Beira, Institute Nacional de Saúde, 1323 Correia de Brito Street, Ponta-gêa Health Center Building, Beira, Sofala, Mozambique.
Manuel NapuaMinistry of Health, Centro de Investigação Operacional da Beira, Institute Nacional de Saúde, 1323 Correia de Brito Street, Ponta-gêa Health Center Building, Beira, Sofala, Mozambique.
Falume ChaleMinistry of Health, Centro de Investigação Operacional da Beira, Institute Nacional de Saúde, 1323 Correia de Brito Street, Ponta-gêa Health Center Building, Beira, Sofala, Mozambique.
João Luís ManuelMinistry of Health, Centro de Investigação Operacional da Beira, Institute Nacional de Saúde, 1323 Correia de Brito Street, Ponta-gêa Health Center Building, Beira, Sofala, Mozambique.
Jessica Greenberg CowanSchool of Nursing, University of Washington, Seattle, USA.
Kenneth SherrSchool of Nursing, University of Washington, Seattle, USA.
Rachel R ChapmanDepartment of Anthropology, University of Washington, Seattle, USA.
James T PfeifferSchool of Nursing, University of Washington, Seattle, USA.

Funding

National Academy of Sciences of USA (NAS) 200003598
6 · The paper itself

Abstract

backgroundEarly infant diagnosis (EID) of HIV-exposed and initiation of HIV-positive infants on anti-retroviral therapy (ART) requires a well-coordinated cascade of care. Loss-to-follow-up (LTFU) can occur at multiple steps and effective EID is impeded by human resource constraints, difficulty with patient tracking, and long waiting periods. The objective of this research was to conduct formative research to guide the development of an intervention to improve the pediatric HIV care cascade in central Mozambique. The study was conducted in Manica and Sofala Provinces where the adult HIV burden is higher than the national average. The research focused on 3 large clinics in each province, along the highly populated Beira corridor.

methodsThe research was conducted in 2014 over 3 months at six facilities and consisted of 1) patient flow mapping and collection of health systems data from postpartum, child-at-risk, and ART service registries, 2) measurement of clinic waiting times, and 3) patient and health worker focus groups.

resultsHIV testing and ART initiation coverage for mothers tends to be high, but EID and pediatric ART initiation are hampered by lack of patient tracking, long waiting times, and inadequate counseling to navigate the care cascade. About 76% of HIV-positive infants were LTFU and did not initiate ART.

conclusionsEffective interventions to reduce LTFU in EID and improve pediatric ART initiation should focus on patient tracking, active follow-up of defaulting patients, reduction in EID turn-around times for PCR results, and initiation of ART by nurses in child-at-risk services.

trial registrationRetrospectively registered, ISRCTN67747315, July 24, 2019.

Indexed as

Infectious Disease Transmission, VerticalAdultAnti-Retroviral AgentsEarly DiagnosisFemaleFollow-Up StudiesHealth Services ResearchHIV InfectionsHumansInfant, NewbornLost to Follow-UpMaleMass ScreeningMozambiquePregnancyPregnancy Complications, InfectiousAnti-Retroviral AgentsEIDFormative researchImplementation scienceLTFUMozambiquePediatric HIV

Identifiers

PMID32183779
PMCPMC7079378

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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.