Missed Opportunities along the Prevention of Mother-to-Child Transmission Services Cascade in South Africa: Uptake, Determinants, and Attributable Risk (the SAPMTCTE)
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{"title"=>"Missed opportunities along the prevention of mother-to-child transmission services cascade in South Africa: Uptake, determinants, and attributable risk (the SAPMTCTE)", "type"=>"journal", "authors"=>[{"first_name"=>"Selamawit", "last_name"=>"Woldesenbet", "scopus_author_id"=>"6508203120"}, {"first_name"=>"Debra", "last_name"=>"Jackson", "scopus_author_id"=>"56215236500"}, {"first_name"=>"Carl", "last_name"=>"Lombard", "scopus_author_id"=>"35324919600"}, {"first_name"=>"Thu Ha", "last_name"=>"Dinh", "scopus_author_id"=>"23570640500"}, {"first_name"=>"Adrian", "last_name"=>"Puren", "scopus_author_id"=>"6603367058"}, {"first_name"=>"Gayle", "last_name"=>"Sherman", "scopus_author_id"=>"7102874513"}, {"first_name"=>"Vundli", "last_name"=>"Ramokolo", "scopus_author_id"=>"55973749400"}, {"first_name"=>"Tanya", "last_name"=>"Doherty", "scopus_author_id"=>"8204536000"}, {"first_name"=>"Mary", "last_name"=>"Mogashoa", "scopus_author_id"=>"56530845400"}, {"first_name"=>"Sanjana", "last_name"=>"Bhardwaj", "scopus_author_id"=>"55543537100"}, {"first_name"=>"Mickey", "last_name"=>"Chopra", "scopus_author_id"=>"56579064600"}, {"first_name"=>"Nathan", "last_name"=>"Shaffer", "scopus_author_id"=>"7006659834"}, {"first_name"=>"Yogan", "last_name"=>"Pillay", "scopus_author_id"=>"6701392648"}, {"first_name"=>"Ameena", "last_name"=>"Goga", "scopus_author_id"=>"6701617852"}], "year"=>2015, "source"=>"PLoS ONE", "identifiers"=>{"pui"=>"605749689", "isbn"=>"1932-6203", "issn"=>"19326203", "doi"=>"10.1371/journal.pone.0132425", "scopus"=>"2-s2.0-84940184140", "pmid"=>"26147598", "sgr"=>"84940184140"}, "id"=>"cf780166-ec74-3e06-bf4b-ce071445931d", "abstract"=>"OBJECTIVES: We examined uptake of prevention of mother-to-child HIV transmission (PMTCT) services, predictors of missed opportunities, and infant HIV transmission attributable to missed opportunities along the PMTCT cascade across South Africa. METHODS: A cross-sectional survey was conducted among 4-8 week old infants receiving first immunisations in 580 nationally representative public health facilities in 2010. This included maternal interviews and testing infants' dried blood spots for HIV. A weighted analysis was performed to assess uptake of antenatal and perinatal PMTCT services along the PMTCT cascade (namely: maternal HIV testing, CD4 count test/result, and receiving maternal and infant antiretroviral treatment) and predictors of dropout. The population attributable fraction associated with dropouts at each service point are estimated. RESULTS: Of 9,803 mothers included, 31.7% were HIV-positive as identified by reactive infant antibody tests. Of these 80.4% received some form of maternal and infant antiretroviral treatment. More than a third (34.9%) of mothers dropped out from one or more steps in the PMTCT service cascade. In a multivariable analysis, the following characteristics were associated with increased dropout from the PMTCT cascade: adolescent (<20 years) mothers, low socioeconomic score, low education level, primiparous mothers, delayed first antenatal visit, homebirth, and non-disclosure of HIV status. Adolescent mothers were twice (adjusted odds ratio: 2.2, 95% confidence interval: 1.5-3.3) as likely to be unaware of their HIV-positive status and had a significantly higher rate (85.2%) of unplanned pregnancies compared to adults aged >/=20 years (55.5%, p = 0.0001). A third (33.8%) of infant HIV infections were attributable to dropout in one or more steps in the cascade. CONCLUSION: A third of transmissions attributable to missed opportunities of PMTCT services can be prevented by optimizing the uptake of PMTCT services. Identified risk factors for low PMTCT service uptake should be addressed through health facility and community-level interventions, including raising awareness, promoting women education, adolescent focused interventions, and strengthening linkages/referral-system between communities and health facilities.", "link"=>"http://www.mendeley.com/research/missed-opportunities-along-prevention-mothertochild-transmission-services-cascade-south-africa-uptak", "reader_count"=>120, "reader_count_by_academic_status"=>{"Unspecified"=>8, "Professor > Associate Professor"=>5, "Researcher"=>18, "Student > Doctoral Student"=>6, "Student > Ph. D. Student"=>22, "Student > Postgraduate"=>12, "Student > Master"=>29, "Other"=>7, "Student > Bachelor"=>8, "Lecturer"=>3, "Lecturer > Senior Lecturer"=>2}, "reader_count_by_user_role"=>{"Unspecified"=>8, "Professor > Associate Professor"=>5, "Researcher"=>18, "Student > Doctoral Student"=>6, "Student > Ph. D. Student"=>22, "Student > Postgraduate"=>12, "Student > Master"=>29, "Other"=>7, "Student > Bachelor"=>8, "Lecturer"=>3, "Lecturer > Senior Lecturer"=>2}, "reader_count_by_subject_area"=>{"Unspecified"=>10, "Agricultural and Biological Sciences"=>4, "Arts and Humanities"=>2, "Philosophy"=>1, "Business, Management and Accounting"=>2, "Chemistry"=>1, "Computer Science"=>2, "Nursing and Health Professions"=>20, "Biochemistry, Genetics and Molecular Biology"=>1, "Mathematics"=>1, "Medicine and Dentistry"=>53, "Sports and Recreations"=>1, "Psychology"=>5, "Social Sciences"=>15, "Immunology and Microbiology"=>2}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>53}, "Social Sciences"=>{"Social Sciences"=>15}, "Sports and Recreations"=>{"Sports and Recreations"=>1}, "Psychology"=>{"Psychology"=>5}, "Mathematics"=>{"Mathematics"=>1}, "Unspecified"=>{"Unspecified"=>10}, "Arts and Humanities"=>{"Arts and Humanities"=>2}, "Chemistry"=>{"Chemistry"=>1}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>2}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>4}, "Computer Science"=>{"Computer Science"=>2}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>2}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>20}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>1}, "Philosophy"=>{"Philosophy"=>1}}, "reader_count_by_country"=>{"South Africa"=>1}, "group_count"=>16}

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Figshare

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  • {"files"=>["https://ndownloader.figshare.com/files/2164321"], "description"=>"<p>Percentages are row percentages. The following factors were non-influential in a univariable analysis (for all models) thus were not included in the multivariable model: lack of social Support, inadequate knowledge of mother-to-child transmission modes, unplanned pregnancy, married or living with partner, and race. Disclosure of status was asked only if the mother know her HIV status. All numbers (N, n) are unweighted and all percentages and AORs’ are from weighted analysis. Category frequencies do not add to the total because of missing responses.</p><p>The significance (p.value) of the overall effects for the following multiple category variables were: for first antenatal visit 0.04, 0.049 and 0.005 for models A- C respectively; for number of live children 0.0006, 0.9,0.3 for models A-C respectively and for maternal age 0.0002, 0.04, 0.002 for models A-C respectively.</p><p>TBAs–traditional birth attendant; ANC—antenatal; ARV- antiretroviral</p><p>Factors associated with dropout at the stage of maternal HIV testing (A), CD4 count testing and result (B) and at any of the four steps in the PMTCT cascade(C), 2010 (logistic model).</p>", "links"=>[], "tags"=>["reactive infant antibody tests", "PMTCT service uptake", "infant HIV transmission", "Identified risk factors", "PMTCT cascade", "PMTCT service cascade", "PMTCT services", "infant antiretroviral treatment", "dropout", "SAPMTCTE", "health facilities", "infant HIV infections", "perinatal PMTCT services"], "article_id"=>1475073, "categories"=>["Biological Sciences"], "users"=>["Selamawit Woldesenbet", "Debra Jackson", "Carl Lombard", "Thu-Ha Dinh", "Adrian Puren", "Gayle Sherman", "Vundli Ramokolo", "Tanya Doherty", "Mary Mogashoa", "Sanjana Bhardwaj", "Mickey Chopra", "Nathan Shaffer", "Yogan Pillay", "Ameena Goga"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0132425.t003", "stats"=>{"downloads"=>0, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Factors_associated_with_dropout_at_the_stage_of_maternal_HIV_testing_A_CD4_count_testing_and_result_B_and_at_any_of_the_four_steps_in_the_PMTCT_cascade_C_2010_logistic_model_/1475073", "title"=>"Factors associated with dropout at the stage of maternal HIV testing (A), CD4 count testing and result (B) and at any of the four steps in the PMTCT cascade(C), 2010 (logistic model).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-07-06 04:33:23"}
  • {"files"=>["https://ndownloader.figshare.com/files/2164319"], "description"=>"<p>2010 PMTCT cascade Study Profile.</p>", "links"=>[], "tags"=>["reactive infant antibody tests", "PMTCT service uptake", "infant HIV transmission", "Identified risk factors", "PMTCT cascade", "PMTCT service cascade", "PMTCT services", "infant antiretroviral treatment", "dropout", "SAPMTCTE", "health facilities", "infant HIV infections", "perinatal PMTCT services"], "article_id"=>1475071, "categories"=>["Biological Sciences"], "users"=>["Selamawit Woldesenbet", "Debra Jackson", "Carl Lombard", "Thu-Ha Dinh", "Adrian Puren", "Gayle Sherman", "Vundli Ramokolo", "Tanya Doherty", "Mary Mogashoa", "Sanjana Bhardwaj", "Mickey Chopra", "Nathan Shaffer", "Yogan Pillay", "Ameena Goga"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0132425.g001", "stats"=>{"downloads"=>0, "page_views"=>11, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_2010_PMTCT_cascade_Study_Profile_/1475071", "title"=>"2010 PMTCT cascade Study Profile.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-07-06 04:33:23"}

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Relative Metric

{"start_date"=>"2015-01-01T00:00:00Z", "end_date"=>"2015-12-31T00:00:00Z", "subject_areas"=>[]}
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