Evidence map›Paper›PMID 32520912›Full record

ArticleJournal of acquired immune deficiency syndromes (1999)2020

Effectiveness of Maternal Transmission Risk Stratification in Identification of Infants for HIV Birth Testing: Lessons From Zimbabwe.

Haurovi W Mafaune, Emma Sacks, Addmore Chadambuka, Reuben Musarandega, Emmanuel Tachiwenyika, Francis M Simmonds, Tichaona Nyamundaya, Jennifer Cohn, Agnes Mahomva, Angela Mushavi

Open access · hybridAbstract read
In one paragraph

Article in Journal of acquired immune deficiency syndromes (1999), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
0.1field-weighted citation impact, top 42% of its field
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

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

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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

10 authors at 2 institutions in 2 countries.

Haurovi W MafauneElizabeth Glaser Pediatric AIDS Foundation, Harare, Zimbabwe.
Emma SacksElizabeth Glaser Pediatric AIDS Foundation, Washington, DC.
Addmore ChadambukaElizabeth Glaser Pediatric AIDS Foundation, Harare, Zimbabwe.
Reuben MusarandegaElizabeth Glaser Pediatric AIDS Foundation, Harare, Zimbabwe.
Emmanuel TachiwenyikaElizabeth Glaser Pediatric AIDS Foundation, Harare, Zimbabwe.
Francis M SimmondsElizabeth Glaser Pediatric AIDS Foundation, Harare, Zimbabwe.
Tichaona NyamundayaElizabeth Glaser Pediatric AIDS Foundation, Harare, Zimbabwe.
Jennifer CohnElizabeth Glaser Pediatric AIDS Foundation, Geneva, Switzerland; and.
Agnes MahomvaMinistry of Health and Child Care, Harare, Zimbabwe.
Angela MushaviMinistry of Health and Child Care, Harare, Zimbabwe.
Ministry of Health and Child Welfare · ZWElizabeth Glaser Pediatric AIDS Foundation · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn 2017, Zimbabwe adopted a modified version of the World Health Organization 2016 recommendation on HIV birth testing by offering HIV testing at birth only to infants at "high risk" of HIV transmission. There is limited evidence on the effectiveness of this approach. Our study assessed the sensitivity and specificity of birth testing "high risk" infants only.

methodsWe conducted a cross-sectional study at 10 health facilities from November 2018 to July 2019. A nucleic acid test for HIV was performed on all HIV-exposed infants identified within 48 hours of life, irrespective of risk status. Univariate and bivariate analyses were used to estimate the performance of the risk screening tool.

resultsHIV nucleic acid test was successfully performed on 1970 infants (95%), of whom 266 (13.5%) were classified as high-risk infants. HIV prevalence for all infants tested was 1.5% (95% CI: 1% to 2%), whereas prevalence among high-risk infants and low-risk infants was 6.8% (95% CI: 3.7% to 9.8%) and 0.6% (95% CI: 0.3% to 1%) respectively. Sensitivity and specificity of the maternal risk screening tool was at 62.1% (95% CI: 44.4% to 79.7%) and 87.2% (95% CI: 85.7% to 88.7%), respectively; positive and negative predictive values were 6.8% (95% CI: 3.7% to 9.8%) and 99.4% (95% CI: 99.0% to 99.7%) respectively.

conclusionsDespite high negative predictive value, sensitivity was relatively low, with potential of missing 2 in every 5 HIV infected infants. Given the potential benefits of early ART initiation for all exposed infants, where feasible, universal testing for HIV-exposed infants at birth may be preferred to reduce missing infected infants.

Indexed as

Risk AssessmentCross-Sectional StudiesFemaleHIV InfectionsHIV TestingHumansInfant, NewbornInfant, Newborn, DiseasesInfectious Disease Transmission, VerticalPoint-of-Care TestingPregnancyPregnancy Complications, InfectiousPrevalenceRisk FactorsSensitivity and SpecificityViral Load

Identifiers

PMID32520912
PMCPMC7302327
OpenAlexW3033554563

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

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.