Evidence map›Paper›PMID 33310792›Full record

ArticleBMJ open2020

Loss to follow up of pregnant women with HIV and infant HIV outcomes in the prevention of maternal to child transmission of HIV programme in two high-burden provinces in Papua New Guinea: a retrospective clinical audit.

Angela Kelly-Hanku, Claire Elizabeth Nightingale, Minh Duc Pham, Agnes Mek, Primrose Homiehombo, Mary Bagita, Justine Nankinga, Andrew Vallely, Lisa Vallely, Ghanashyan Sethy and 2 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
0.2field-weighted citation impact, top 36% 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

12 citing papers in PubMed, 15 citations in OpenAlex.

  1. Trial
  2. Review
  3. Review
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. 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

12 authors at 7 institutions in 3 countries.

Angela Kelly-HankuThe Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia a.kelly@unsw.edu.au.
Claire Elizabeth NightingaleSchool of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.ORCID 0000-0002-4103-6240
Minh Duc PhamBurnet Institute, Melbourne, Victoria, Australia.ORCID 0000-0002-5932-3491
Agnes MekPapua New Guinea Institute of Medical Research, Goroka, Eastern Highlands, Papua New Guinea.
Primrose HomiehomboBurnet Institute, Kokopo, East New Britain, Papua New Guinea.
Mary BagitaDepartment of Obstetrics and Gynaecology, Port Moresby General Hospital, Port Moresby, National Capital District, Papua New Guinea.
Justine NankingaFHI360, Port Moresby, National Capital District, Papua New Guinea.
Andrew VallelyThe Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.ORCID 0000-0003-1558-4822
Lisa VallelyThe Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.ORCID 0000-0002-8247-7683
Ghanashyan SethyUNICEF, Port Moresby, National Capital District, Papua New Guinea.
John KaldorThe Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
Stanley LuchtersBurnet Institute, Melbourne, Victoria, Australia.
UNSW Sydney · AUBurnet Institute · AUNational Department of Health · PGPapua New Guinea Institute of Medical Research · PGPapua New Guinea University of Natural Resources and Environment · PGPort Moresby General Hospital · PGThe University of Melbourne · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDespite early adoption of the WHO guidelines to deliver lifelong antiretroviral (ARV) regimen to pregnant women on HIV diagnosis, the HIV prevention of mother to child transmission programme in Papua New Guinea remains suboptimal. An unacceptable number of babies are infected with HIV and mothers not retained in treatment. This study aimed to describe the characteristics of this programme and to investigate the factors associated with programme performance outcomes.

methodsWe conducted a retrospective analysis of clinical records of HIV-positive pregnant women at two hospitals providing prevention of mother to child transmission services. All women enrolled in the prevention of mother to child transmission programme during the study period (June 2012-June 2015) were eligible for inclusion. Using logistic regression, we examined the factors associated with maternal loss to follow-up (LTFU) before birth and before infant registration in a paediatric ARV programme.

results763 of women had records eligible for inclusion. Demographic and clinical differences existed between women at the two sites. Almost half (45.1%) of the women knew their HIV-positive status prior to the current pregnancy. Multivariate analysis showed that women more likely to be LTFU by the time of birth were younger (adjusted OR (AOR)=2.92, 95% CI 1.16 to 7.63), were newly diagnosed with HIV in the current/most recent pregnancy (AOR=3.50, 95% CI 1.62 to 7.59) and were in an HIV serodiscordant relationship (AOR=2.94, 95% CI 1.11 to 7.84). Factors associated with maternal LTFU before infant registration included being primipara at the time of enrolment (AOR=3.13, 95% CI 1.44 to 6.80) and being newly diagnosed in that current/most recent pregnancy (AOR=2.49, 95% CI 1.31 to 4.73). 6.6% (50 of 763) of exposed infants had a positive HIV DNA test.

conclusionsOur study highlighted predictors of LTFU among women. Understanding these correlates at different stages of the programme offers important insights for targets and timing of greater support for retention in care.

Indexed as

HIV InfectionsPregnancy Complications, InfectiousClinical AuditFemaleFollow-Up StudiesHumansInfantInfectious Disease Transmission, VerticalPapua New GuineaPregnancyPregnant PeopleRetrospective Studiesclinical auditHIV & AIDSinternational health servicespaediatric infectious disease & immunisationpublic health

Identifiers

PMID33310792
PMCPMC7735082
OpenAlexW3111073622

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

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.