Evidence map›Paper›PMID 37922301›Full record

ArticlePloS one2023

Postnatal clubs: Implementation of a differentiated and integrated model of care for mothers living with HIV and their HIV-exposed uninfected babies in Cape Town, South Africa.

Aurelie Nelson, Keitu Lebelo, Tali Cassidy, Laura Trivino Duran, Nompumelelo Mantangana, Leticia Mdani, Nikiwe Malabi, Suhair Solomon, Kate Buchanan, Damian Hacking and 7 more

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

Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.4field-weighted citation impact, top 39% 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

4 citing papers in PubMed, 2 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

17 authors at 3 institutions in 1 country.

Aurelie NelsonMédecins Sans Frontières, Cape Town, South Africa.ORCID 0000-0001-8681-7377
Keitu LebeloMédecins Sans Frontières, Cape Town, South Africa.
Tali CassidyMédecins Sans Frontières, Cape Town, South Africa.ORCID 0000-0003-1268-3331
Laura Trivino DuranMédecins Sans Frontières, Cape Town, South Africa.
Nompumelelo MantanganaMédecins Sans Frontières, Cape Town, South Africa.
Leticia MdaniMédecins Sans Frontières, Cape Town, South Africa.
Nikiwe MalabiMédecins Sans Frontières, Cape Town, South Africa.
Suhair SolomonMédecins Sans Frontières, Cape Town, South Africa.
Kate BuchananMédecins Sans Frontières, Cape Town, South Africa.
Damian HackingMédecins Sans Frontières, Cape Town, South Africa.
Vinayak BhardwajMédecins Sans Frontières, Cape Town, South Africa.
Virginia de AzevedoCity of Cape Town Health Department, Cape Town, South Africa.
Shariefa Patel-AbrahamsCity of Cape Town Health Department, Cape Town, South Africa.
Beth HarleyCity of Cape Town Health Department, Cape Town, South Africa.
Clare HofmeyrMothers2mothers, Cape Town, South Africa.
Kathrin SchmitzMothers2mothers, Cape Town, South Africa.
Landon MyerDivision of Epidemiology & Biostatistics, School of Public Health, University of Cape Town, Cape Town, South Africa.
Médecins Sans Frontières · ZAUniversity of Cape Town · ZACity of Cape Town · ZA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite the overall reduction in the HIV mother-to-child transmission (MTCT) rate in South Africa, poor adherence and retention in care during breastfeeding contribute to this period being a major driver of MTCT in South Africa. To improve this retention, postnatal clubs were created as an integrated, differentiated model of care providing psychosocial support and comprehensive care for the mother-infant pairs (MIP), including HIV and under-5-child services. We describe the implementation of these facility-based clubs and examine its health outcomes in a peri-urban primary health care setting in Cape Town, South Africa.

methodsIn this prospective cohort study, conducted between June 2016 and December 2019, MIPs were recruited into postnatal clubs between 6 weeks and 6 months of age and followed-up until 18 months of age. Outcomes including maternal Viral Load (VL), and children's HIV testing were compared to a historical control group. Children's immunizations and maternal sexual and reproductive health outcomes are also described.

resultsDuring the implementation of the postnatal club study period, 484 MIP were recruited with 84% overall attendance, 95% overall viral load suppression, and 98% overall uptake of HIV infant testing. Compared to historical controls, the club infant rapid test uptake was 1.6 times higher (95% CI: 1.4-1.9) at 9 months and 2.0 times higher at 18 months (95% CI: 1.6-2.6). Through 12 months and between 12-18 months, maternal VL monitoring was higher in the club group compared to the historical control by 1.5 times (95% CI: 1.3-1.6) and 2.6 times (95% CI: 2.1-3.2), respectively, with similar maternal VL suppression. Of 105 infants attending the 12 months visit, 99% were fully vaccinated by one year.

conclusionMIP in the postnatal clubs showed better PMTCT outcomes than historical controls with high levels of retention in care. Other outcomes such as immunisation results suggest that integration of services, such as in the postnatal club, is feasible and beneficial for MIPs.

Indexed as

Anti-HIV AgentsHIV InfectionsPregnancy Complications, InfectiousFemaleHumansInfantInfectious Disease Transmission, VerticalMothersPregnancyProspective StudiesSouth AfricaAnti-HIV Agents

Identifiers

PMID37922301
PMCPMC10624264
OpenAlexW4388286941

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.