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32. PECA.pdf (2.27 MB)

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2020-05

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Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/202901

Pediatric HIV care cascade in southern mozambique: Missed opportunities for early ART and re-engagement in care

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https://doi.org/10.1097/INF.0000000000002612

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© 2020 Wolters Kluwer Health, Inc. All rights reserved. Background: There are 170,000 children living with HIV in 2017 in Mozambique. Scaling-up HIV care requires effective retention along the cascade. We sought to evaluate the pediatric cascade in HIV care at the Manhiça District Hospital. Methods: A prospective cohort of children <15 years was followed from enrollment in HIV care (January 2013 to December 2015) until December 2016. Loss to follow-up (LTFU) was defined as not attending the HIV hospital visits for ≥90 days following last visit attended. Results: From the 438 children included {median age at enrollment in care of 3,6 [interquartile range (IQR): 1.1-8.6] years}, 335 (76%) were antiretroviral therapy (ART) eligible and among those, 263 (78%) started ART at enrollment in HIV care. A total of 362 children initiated ART during the study period and the incidence rate of LTFU at 12, 24, and 36 months post-ART initiation was 41 [95% confidence interval (CI): 34-50], 34 (95% CI: 29-41), and 31 (95% CI: 27-37) per 100 children-years, respectively. Median time to LTFU was 5.8 (IQR: 1.4-12.7) months. Children 5-9 years of age had a lower risk of LTFU compared with children <1 year [adjusted subhazard ratio 0.36 (95% CI: 0.20-0.61)]. Re-engagement in care (RIC) was observed in 25% of the LTFU children. Conclusions: The high LTFU found in this study highlights the special attention that should be given to younger children during the first 6 months post-ART initiation to prevent LTFU. Once LTFU, only a quarter of those children return to the health unit. Elucidating factors associated with RIC could help to fine tune interventions which promote RIC.

Matèries

Infeccions per VIH, Infants, Moçambic

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HIV infections, Children, Mozambique

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Articles publicats en revistes (ISGlobal)

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FERNÁNDEZ LUIS, Sheila, NHAMPOSSA, Tacilta, FUENTE SORO, Laura, AUGUSTO, Orvalho, CASELLAS, Aina, BERNARDO, Edson, RUPEREZ, María, GONZÁLEZ, Raquel, MACULUVE, Sónia amós, SAURA LÁZARO, Anna, MENÉNDEZ, Clara, NANICHE, Denise, LÓPEZ VARELA, Elisa. Pediatric HIV care cascade in southern mozambique: Missed opportunities for early ART and re-engagement in care. _Pediatric Infectious Disease Journal_. 2020. Vol. 39, núm. 5, pàgs. 429-434. [consulta: 25 de febrer de 2026]. ISSN: 0891-3668. [Disponible a: https://hdl.handle.net/2445/202901]

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