Evidence map›Paper›PMID 34591881›Full record

ArticlePloS one2021

It ain't what you do, it's the way that you do it: The pitfalls of using routine data to measure early infant HIV diagnosis in HIV-exposed infants.

Elizabeth Chappell, Claire Thorne, Intira Jeannie Collins, Kathy Baisley, H Manisha Yapa, Dickman Gareta, Till Bärnighausen, Kobus Herbst, Ali Judd

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact, top 88% 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

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

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 at 6 institutions in 5 countries.

Elizabeth ChappellMRC Clinical Trials Unit at UCL, London, United Kingdom.ORCID 0000-0003-1053-6434
Claire ThorneUCL Great Ormond Street Institute of Child Health, London, United Kingdom.
Intira Jeannie CollinsMRC Clinical Trials Unit at UCL, London, United Kingdom.
Kathy BaisleyMRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, United Kingdom.
H Manisha YapaAfrica Health Research Institute, Mtubatuba, KwaZulu-Natal, South Africa.
Dickman GaretaAfrica Health Research Institute, Mtubatuba, KwaZulu-Natal, South Africa.
Till BärnighausenAfrica Health Research Institute, Mtubatuba, KwaZulu-Natal, South Africa.
Kobus HerbstAfrica Health Research Institute, Mtubatuba, KwaZulu-Natal, South Africa.ORCID 0000-0002-5436-9386
Ali JuddMRC Clinical Trials Unit at UCL, London, United Kingdom.
MRC Clinical Trials Unit at UCL · GBAfrica Health Research Institute · ZAGreat Ormond Street Hospital · GBHeidelberg University · DELondon School of Hygiene & Tropical Medicine · GBUNSW Sydney · AU

Funding

Medical Research Council MC_UU_00004/03Medical Research Council MC_UU_12023Medical Research Council MC_UU_12023/26Medical Research Council MR/K012126/1Medical Research Council MR/R010161/1Wellcome Trust
6 · The paper itself

Abstract

backgroundEarly infant HIV diagnosis (EID) is critical to ensuring timely diagnosis of HIV-exposed infants, and treatment in those found to be infected. However estimates of coverage vary considerably, depending on data sources used. We used 4 methods to estimate coverage among a historical cohort of HIV-exposed infants in rural South Africa, between 2010-2016.

methodsWe estimated the proportion of infants ever tested (methods 1-3) and tested by 7 weeks of age (1-4) as follows: (1) infants born to women identified as HIV-positive in demographic surveillance were linked to those with ≥1 EID result in routine laboratory surveillance; (2) the number of infants with ≥1 EID result in laboratory surveillance divided by the estimated number of HIV-exposed infants, calculated as total live births multiplied by antenatal HIV seroprevalence; (3) the number of infants with ≥1 EID result in routine laboratory surveillance, divided by the number of HIV-exposed infants as estimated by the district health service; (4) from documentation in infants' Road-to-Health-booklets.

resultsThe proportion ever tested was 43%, 88% and 138% for methods 1-3, and by 7 weeks of age was 25%, 49%, 86% and 46% for methods 1-4 respectively.

conclusionsThe four methods, applied to a range of routine data sources, resulted in estimates varying considerably, and the true coverage of EID remains unclear. Our findings highlight the importance of developing unique patient identifiers, improving training of healthcare providers using reporting systems, and ensuring the accuracy of healthcare records, to ensure the best possible health outcomes for HIV-exposed infants.

Indexed as

Delivery of Health CareEarly DiagnosisHIV InfectionsHIV SeroprevalenceHumansInfantInfant, NewbornInfectious Disease Transmission, VerticalPrenatal DiagnosisRural PopulationSouth Africa

Identifiers

PMID34591881
PMCPMC8483382
OpenAlexW3203080364

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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.