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Year : 2021  |  Volume : 13  |  Issue : 2  |  Page : 72-79

Gaps in the care cascade among human immunodeficiency virus-exposed infants born in 2017 in Mashonaland East Province of Zimbabwe

1 Biomedical Informatics and Biomedical Engineering Department, University of Zimbabwe Faculty of Medicine and Health Sciences, Harare, Zimbabwe
2 Centre for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris, France; National Tuberculosis, Leprosy and Lung Disease Programme, Nairobi, Kenya
3 Centre for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris, France; International Union Against Tuberculosis and Lung Disease, South-East Asia Office, New Delhi; Department of Community Medicine Yenepoya Medical College, Yenepoya (Deemed to be University), Mangalore, Karnataka, India
4 Mashonaland East Provincial Medical Directorate, Ministry of Health and Child Care, Marondera, Zimbabwe
5 AIDS and TB Programme Unit, Ministry of Health and Child Welfare, Harare, Zimbabwe

Correspondence Address:
Dr. Ndaimani Augustine
University of Zimbabwe Faculty of Medicine and Health Sciences, First Floor, New Health Sciences Building, P.O. Box A178, Avondale, Harare
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jgid.jgid_171_19

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Introduction: Prevention of mother-to-child transmission (PMTCT) is a key strategy for ending the human immunodeficiency virus (HIV) pandemic. Most studies have focused on the mothers' side of the PMTCT cascade or the rate of vertical HIV transmission. Information on child-focused cascade is limited. We aimed to evaluate HIV testing, antiretroviral therapy (ART), and cotrimoxazole prophylaxis uptake and associated factors among HIV-exposed infants (HEIs) born in 2017. Methods: This was a record-based descriptive study in Mashonaland East Province, Zimbabwe. We analyzed routinely collected program data abstracted from electronic and paper-based HEI registers. Uptakes were calculated as proportions while associations were measured using adjusted risk ratios (log-binomial regression). Results: Of 1028 HEIs, 1015 (98.7%) were commenced on nevirapine prophylaxis, while 915 (89.0%) were commenced on cotrimoxazole prophylaxis. A total of 880 (85.0%) HEIs were tested for HIV by 6 weeks and 445 (44.4%) by 9 months. Overall, 40 (3.9%) were found to be HIV positive, and of them, 34 (85.0%) commenced on ART. Secondary and tertiary health facilities, being born through nonvaginal delivery, and certain districts were significantly associated with not commencing cotrimoxazole prophylaxis or getting tested for HIV. One district was associated with less risk of not having an HIV test by 9 months. Conclusions: While nevirapine, cotrimoxazole, and ART uptake were high among the HEIs, HIV testing by 9 months was suboptimal. The vertical HIV transmission rate was 3.9%. There is a need to strengthen HIV testing and antiretroviral and cotrimoxazole prophylaxes, especially at high-level facilities and certain districts.

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2008 Journal of Global Infectious Diseases | Published by Wolters Kluwer - Medknow
Online since 10th December, 2008