Evidence map›Paper›PMID 32873311›Full record

Trial reportInternational breastfeeding journal2020

Infant feeding knowledge and practice vary by maternal HIV status: a nested cohort study in rural South Africa.

H Manisha Yapa, Róisín Drayne, Nigel Klein, Jan-Walter De Neve, Kathy Petoumenos, Awachana Jiamsakul, Carina Herbst, Deenan Pillay, Frank A Post, Till Bärnighausen

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in International breastfeeding journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02626351 (Optimizing the Delivery of Maternal and Child Health Services to Strengthen the Primary Health Care System in Rural South Africa), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact, top 86% 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.

NCT02626351 nacompletednot on this map

Optimizing the Delivery of Maternal and Child Health Services to Strengthen the Primary Health Care System in Rural South Africa

TypeinterventionalSponsorUniversity of KwaZuluRan2015 to 2017Enrolled3,172ConditionsPregnancy, HIVArmsQuality Improvement, Baseline data collection (active comparator)
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 3 citations in OpenAlex.

  1. Review
  2. Review
  3. Article
  4. 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

10 authors at 6 institutions in 5 countries.

H Manisha YapaThe Kirby Institute, University of New South Wales Sydney, Sydney, Australia. myapa@kirby.unsw.edu.au.ORCID 0000-0002-0100-4754
Róisín DrayneSchool of Population Health & Environmental Sciences, King's College London, London, UK.
Nigel KleinAfrica Health Research Institute (AHRI), KwaZulu-Natal, South Africa.
Jan-Walter De NeveHeidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany.
Kathy PetoumenosThe Kirby Institute, University of New South Wales Sydney, Sydney, Australia.
Awachana JiamsakulThe Kirby Institute, University of New South Wales Sydney, Sydney, Australia.
Carina HerbstAfrica Health Research Institute (AHRI), KwaZulu-Natal, South Africa.
Deenan PillayAfrica Health Research Institute (AHRI), KwaZulu-Natal, South Africa.
Frank A PostKing's College Hospital NHS Foundation Trust, London, UK.
Till BärnighausenAfrica Health Research Institute (AHRI), KwaZulu-Natal, South Africa.
UNSW Sydney · AUAfrica Health Research Institute · ZAHeidelberg University · DEGreat Ormond Street Hospital · GBKing's College Hospital NHS Foundation Trust · GBKing's College London · GB

Funding

Training Tanzanian Researchers for HIV/AIDS Implementation ScienceD43TW009775 · FIC · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI Wafaie W Fawzi, Christopher Sudfeld · 2015 to 2026
$3.0M
New Methods for the design and evaluation of large HIV prevention interventionsR01AI112339 · NIAID · YALE UNIVERSITY · PI SPIEGELMAN, DONNA L · 2014 to 2017
$2.7M
Causal Pathways to population health impact of HIV antiretroviral treatmentR01HD084233 · NICHD · UNIVERSITY OF KWAZULU-NATAL · PI BARNIGHAUSEN, TILL, TANSER, FRANK COURTENEY · 2015 to 2021
$2.3M
FIC NIH HHS D43 TW009775Howard Hughes Medical InstituteNIAID NIH HHS R01 AI112339NICHD NIH HHS R01 HD084233Wellcome Trust 082384/Z/07/Z
6 · The paper itself

Abstract

backgroundWe investigate whether correct infant feeding knowledge and practice differ by maternal HIV status in an era of evolving clinical guidelines in rural South Africa.

methodsThis cohort study was nested within the MONARCH stepped-wedge cluster-randomised controlled trial ( www.clinicaltrials.gov : NCT02626351 ) which tested the impact of continuous quality improvement on antenatal care quality at seven primary care clinics in KwaZulu-Natal, from July 2015 to January 2017. Women aged ≥18 years at delivery were followed up to 6 weeks postpartum. Clinical data were sourced from routine medical records at delivery. Structured interviews at early postnatal visits and the 6-week postnatal immunisation visit provided data on infant feeding knowledge and feeding practices respectively. We measured the relationship between maternal HIV status and (i) correct infant feeding knowledge at the early postnatal visit; and (ii) infant feeding practice at 6 weeks, using Poisson and multinomial regression models, respectively.

resultsWe analysed data from 1693 women with early postnatal and 471 with 6-week postnatal interviews. HIV prevalence was 47% (95% confidence interval [CI] 42, 52%). Women living with HIV were more knowledgeable than women not living with HIV on correct infant feeding recommendations (adjusted risk ratio, aRR, 1.08, p <  0.001). More women living with HIV (33%; 95% CI 26, 41%) were not breastfeeding than women not living with HIV (15%; 95% CI 11, 21%). However, among women who were currently breastfeeding their infants, fewer women living with HIV (5%; 95% CI 2, 9%) mixed fed their babies than women not living with HIV (21%; 95% CI 14, 32%). In adjusted analyses, women living with HIV were more likely to avoid breastfeeding (adjusted relative risk ratio, aRRR, 2.78, p <  0.001) and less likely to mixed feed (aRRR 0.22, p <  0.001) than women not living with HIV.

conclusionsMany mothers in rural South Africa still do not practice exclusive breastfeeding. Women living with HIV were more knowledgeable but had lower overall uptake of breastfeeding, compared with women not living with HIV. Women living with HIV were also more likely to practice exclusive breastfeeding over mixed feeding if currently breastfeeding. Improved approaches are needed to increase awareness of correct infant feeding and exclusive breastfeeding uptake.

Indexed as

Health Knowledge, Attitudes, PracticeAdultBreast FeedingCohort StudiesFemaleHIV InfectionsHumansInfantInfectious Disease Transmission, VerticalMaleMothersPregnancyRural PopulationSouth AfricaYoung AdultClinical guidelinesExclusive breastfeedingHealthcare qualityHIV/AIDSPrimary careResource poor

Identifiers

PMID32873311
PMCPMC7466779
OpenAlexW3082793932

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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.