Early infant diagnosis of HIV in three regions in Tanzania; successes and challenges

By the end of 2009 an estimated 2.5 million children worldwide were living with HIV-1, mostly as a consequence of vertical transmission, and more than 90% of these children live in sub-Saharan Africa. In 2008 the World Health Organization (WHO), recommended early initiation of Highly Active Antiretr...

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Bibliographic Details
Published in:BMC public health 2013-10, Vol.13 (1), p.910-910, Article 910
Main Authors: Chiduo, Mercy G, Mmbando, Bruno P, Theilgaard, Zahra P, Bygbjerg, Ib C, Gerstoft, Jan, Lemnge, Martha, Katzenstein, Terese L
Format: Article
Language:English
Subjects:
Analysis
Antiretroviral agents
Antiretroviral Therapy, Highly Active
Babies
CD4 Lymphocyte Count
Children & youth
Clinics
Collaboration
Deoxyribonucleic acid
Diagnosis
Diseases
DNA
Drug therapy
Early Diagnosis
Female
Health aspects
Health facilities
Highly active antiretroviral therapy
HIV
HIV infection
HIV Infections - diagnosis
HIV Infections - drug therapy
HIV Infections - epidemiology
HIV testing
HIV-1
Hospitals
Human immunodeficiency virus
Humans
Infant
Infants
Infants (Newborn)
Infections
Infectious Disease Transmission, Vertical
Laboratories
Lost to Follow-Up
Male
Mass Screening
Medical research
Mothers
Pregnancy
Prevalence
Program Evaluation
Rankings
Risk factors
Tanzania - epidemiology
Womens health
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Summary:By the end of 2009 an estimated 2.5 million children worldwide were living with HIV-1, mostly as a consequence of vertical transmission, and more than 90% of these children live in sub-Saharan Africa. In 2008 the World Health Organization (WHO), recommended early initiation of Highly Active Antiretroviral Therapy (HAART) to all HIV infected infants diagnosed within the first year of life, and since 2010, within the first two years of life, irrespective of CD4 count or WHO clinical stage. The study aims were to describe implementation of EID programs in three Tanzanian regions with differences in HIV prevalences and logistical set-up with regard to HIV DNA testing. Data were obtained by review of the prevention from mother to child transmission of HIV (PMTCT) registers from 2009-2011 at the Reproductive and Child Health Clinics (RCH) and from the databases from the Care and Treatment Clinics (CTC) in all the three regions; Kilimanjaro, Mbeya and Tanga. Statistical tests used were Poisson regression model and rank sum test. During the period of 2009 - 2011 a total of 4,860 exposed infants were registered from the reviewed sites, of whom 4,292 (88.3%) were screened for HIV infection. Overall proportion of tested infants in the three regions increased from 77.2% in 2009 to 97.8% in 2011. A total of 452 (10.5%) were found to be HIV infected (judged by the result of the first test). The prevalence of HIV infection among infants was higher in Mbeya when compared to Kilimanjaro region RR = 1.872 (95%CI = 1.408 - 2.543) p < 0.001. However sample turnaround time was significantly shorter in both Mbeya (2.7 weeks) and Tanga (5.0 weeks) as compared to Kilimanjaro (7.0 weeks), p=
ISSN:1471-2458
1471-2458
DOI:10.1186/1471-2458-13-910