Excessive mortality and loss to follow‐up among <scp>HIV</scp>‐infected children in Guinea‐Bissau, West Africa: a retrospective follow‐up study

Steiniche, Ditte; Jespersen, Sanne; Medina, Candida; Sanha, Fatima Corona; Wejse, Christian; Hønge, Bo Langhoff

doi:10.1111/tmi.13136

Cited by 7 publications

(4 citation statements)

References 27 publications

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“…This study found an increase in the number of infants not receiving PMTCT. An increase in the number of HIV-infected children and high rates of HIV infection (9.3%) despite PMTCT have been reported in Guinea-Bissau, suggesting poor treatment retention and challenges to PMTCT coverage and follow-up 15 . While an increase in the number of HIV-infected children may be due to better diagnostics, the late diagnosis of children (median age 3.5 years) suggests a large proportion of children die before being diagnosed with HIV 15 .…”

Section: Discussionmentioning

confidence: 99%

“…High rates of early mortality and loss to follow-up have recently been described among HIV-infected children (< 15 years of age) in Guinea-Bissau. Based on a study of 525 HIV-infected children, 11% died and 39% were lost to follow-up within the first year of follow-up, highlighting continuous challenges with implementing sustainable PMTCT services 15 . Consequently, there remains a paucity of research exploring the delivery of PMTCT services with the overall aim of improving treatment and care for HIV-infected mothers and their children in Guinea Bissau.…”

Section: Introductionmentioning

confidence: 99%

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HIV-1 and HIV-2 prevalence, risk factors and birth outcomes among pregnant women in Bissau, Guinea-Bissau: a retrospective cross-sectional hospital study

Rasmussen

Vieira²,

Hønge

et al. 2020

Sci Rep

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The human immunodeficiency virus (HIV) remains a leading cause of maternal morbidity and mortality in Sub-Saharan Africa. Prevention of mother-to-child transmission (PMTCT) has proven an effective strategy to end paediatric infections and ensure HIV-infected mothers access treatment. Based on cross-sectional data collected from June 2008 to May 2013, we assessed changes in HIV prevalence, risk factors for HIV, provision of PMTCT antiretroviral treatment (ART), and the association between HIV infection, birth outcomes and maternal characteristics at the Simão Mendes National Hospital, Guinea-Bissau's largest maternity ward. Among 24,107 women, the HIV prevalence was 3.3% for HIV-1, 0.8% for HIV-2 and 0.9% for HIV-1/2. A significant decline in HIV-1, HIV-2, and HIV-1/2 prevalence was observed over time. HIV infection was associated with age and ethnicity. A total of 85% of HIVinfected women received ART as part of PMTCT, yet overall treatment coverage during labour and delivery declined significantly for both mothers and infants. Twenty-two percent of infants did not receive treatment, and 67% of HIV-2-infected mothers and 77% of their infants received ineffective non-nucleoside reverse transcriptase inhibitors for PMTCT. Maternal HIV was associated with low birth weight but not stillbirth. Inadequate continuity of care and ART coverage present challenges to optimal PMTCT in Guinea-Bissau. Despite remarkable progress over the past decade, Sub-Saharan Africa (SSA) continues to have the highest global prevalence of HIV. Women remain disproportionately at risk of acquiring HIV, with an estimated 59% of all new infections occurring amongst females 1. Furthermore, HIV remains one of the leading causes of mortality among women of reproductive age in the region 2. In 2017, an estimated 1.3 million pregnant women were living with HIV, and 130,000 infants were infected with HIV in SSA 3 .

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

HIV-1 and HIV-2 prevalence, risk factors and birth outcomes among pregnant women in Bissau, Guinea-Bissau: a retrospective cross-sectional hospital study

Rasmussen

Vieira²,

Hønge

et al. 2020

Sci Rep

Self Cite

View full text Add to dashboard Cite

show abstract

“…The mortality rate in our cohort is comparable to multiyear mortality results in other low resource settings with similar HIV disease burden. A recent national study in Togo found mortality rate of 4.5 per 100 person-years for children ages 0-15 at 8 years (Mouhari-Touré et al, 2018) while a 10-year study of children in Guinea-Bissau found 10.4 per 100 personyears (Steiniche et al, 2018). A longitudinal analysis of 8 years in 2017 found 10.1 per 100 person-years in Bali, Indonesia (Utami et al, 2017).…”

Section: Comparability To Previous Studiesmentioning

confidence: 99%

Implementing an integrated community based health systems strengthening approach to improve HIV survival in Northern Togo

et al. 2019

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To disseminate lessons learned from the implementation experience of a public-private sector partnership, we describe a comprehensive HIV/AIDS program including 5-year survival outcomes for individuals who initiated antiretroviral therapy (ART) treatment in Togo from 2010 to 2015. A retrospective case study analysis was conducted from a cohort of patients receiving ART at an HIV/AIDS care clinic in Kara Region, Togo. Kaplan-Meier curves with Log rank tests were used to compare estimated survival curves by demographic and clinical characteristics. Associations were described between survival probability and age, gender, World Health Organization (WHO) disease stage, and timing of ART initiation. Cox proportional hazard model was used to determine predictors of mortality. After approximately five-years since ART initiation (1780 days), there were 114 deaths, with a survival probability of 75.3% (95% CI: 70.3-80.6%). Participants with advanced WHO disease stage were more likely at risk of death relative to patients categorized as WHO Stage 1, with Stage 4 approximately 9 times more likely (aHR 9.22, 95% CI 4.29-19.84). Our study suggests that delivering comprehensive HIV care through a private-public partnership may serve as a model to expand and improve HIV/AIDS care as well as high quality primary care.

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“…One of the fundamental reasons for the high LTFU rate is that we still lack a suitable predictive model for LTFU [11]. Hence, we cannot take effective measures before the occurrence of LTFU to prevent it [5,[7][8][9][10][11][13][14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Predicting the loss to follow‐up (LTFU) of HIV/AIDS patients in China using a recency‐frequency (RF) model

Wang

2022

HIV Medicine

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Background We constructed a recency‐frequency (RF) model for predicting the loss to follow‐up (LTFU) in HIV/AIDS patients in China. Methods Data on HIV/AIDS outpatients in the research unit from 1 August 2009 to 30 September 2020 and from 1 October to 31 December 2020 were exported as the observation and prediction datasets, respectively. The classic recency‐frequency‐monetary (RFM) model was expanded into RFm, RF, RFL and RFmL models. In the observation dataset, the best predictive model was obtained using k‐means clustering and C5.0 verification. Then, two rounds of k‐means modelling were performed on the best model: data with R ≤ 6 months were retained, randomly divided into a training set (70%) and a testing set (30%) and used to perform the second round of modelling to subdivide the churn and non‐churn patients. Next, an ANN algorithm was used to predict LTFU, and the confusion matrix with prediction datasets was constructed. Results The observation and prediction datasets included 16 949 and 10 748 samples, respectively. The RF model with three clusters and a quality of 0.82 was the best predictive model. From the observation set, 13 799 samples were retained, and the model accuracy was 100% on the training and testing sets. These 13 799 samples were subdivided into 1563 samples of churn patients and 12 216 samples of non‐churn patients. The accuracy of ANN prediction was 99.89%. The accuracy and precision of the confusion matrix were 85.41% and 99.76%, respectively. Conclusion The RF model is effective in predicting the LTFU of HIV/AIDS patients in China and preventing its occurrence.

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Excessive mortality and loss to follow‐up among HIV‐infected children in Guinea‐Bissau, West Africa: a retrospective follow‐up study

Abstract: This study reveals a high rate of early mortality and loss to follow-up among HIV-infected children in Guinea-Bissau. Initiatives to improve patient retention are urgently needed.

Cited by 7 publications

References 27 publications

HIV-1 and HIV-2 prevalence, risk factors and birth outcomes among pregnant women in Bissau, Guinea-Bissau: a retrospective cross-sectional hospital study

HIV-1 and HIV-2 prevalence, risk factors and birth outcomes among pregnant women in Bissau, Guinea-Bissau: a retrospective cross-sectional hospital study

Implementing an integrated community based health systems strengthening approach to improve HIV survival in Northern Togo

Predicting the loss to follow‐up (LTFU) of HIV/AIDS patients in China using a recency‐frequency (RF) model

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