RESEARCH ARTICLE


Realities and Challenges of a Five Year Follow Up of Mother and Child Pairs on a PMTCT Program in Zimbabwe



E.N Kurewa*, 1, G.Q Kandawasvika2, F Mhlanga3, M Munjoma3, M.P Mapingure4, P Chandiwana1, M.Z Chirenje3, S Rusakaniko4, B Stray-Pedersen5
1 Letten Foundation Research Center, No.3 Everrett Close, Harare Zimbabwe.
2 Department of Paediatrics, College of Health Sciences University of Zimbabwe Medical School, Box A178, Harare, Zimbabwe
3 Department of obstetrics and gynaecology, College of Health Sciences University of Zimbabwe Medical School, Box A178, Harare, Zimbabwe
4 Department of Community Medicine, College of Health Sciences University of Zimbabwe Medical School, Box A178, Harare, Zimbabwe
5 Department of Obs and Gynae, Division of women’s health, Rikshospitalet, University of Oslo, Norway


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© Kurewa et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Letten Foundation Research Center, No.3 Everrett Close, Harare Zimbabwe; Tel: 00 47 21383634; E-mail: enkurewa@hotmail.com


Abstract

Background:

Complete follow up is an essential component of observational cohorts irrespective of the type of disease.

Objectives:

To describe five years follow up of mother and child pairs on a PMTCT program, highlighting loss to follow up (LTFU) and mortality (attrition).

Study Design:

A cohort of pregnant women was enrolled from the national PMTCT program at 36 weeks gestational age attending three peri urban clinics around Harare offering maternal and child health services. Mother-infant pairs were followed up from birth and twice yearly for five years.

Results:

A total of 479 HIV infected and 571 HIV negative pregnant women were enrolled, 445(92.9%) and 495(86.6%) were followed up whereas 14(3.0%) and 3(0.5%) died in the 1st year respectively; RR (95%CI) 5.3(1.5-18.7). At five years 227(56.7%) HIV infected and 239(41.0%) HIV negative mothers turned up, whereas mortality rates were 34 and 7 per 100 person years respectively. Birth information was recorded for 401(83.7%) HIV exposed and 441(77.2%) unexposed infants, 247(51.6%) and 232(40.6) turned up in the first year whilst mortality was 58(12.9%) and 22(4.4%) respectively, RR (95%CI) 3.2(2.0-5.4). At five years 210(57.5%) HIV exposed and 239(44.3%) unexposed infants were seen, whilst mortality rates were 53 per 1000 and 15 per 1 000 person years respectively. Mortality rate for HIV infected children was 112 compared to 21 per 1 000 person years for the exposed but uninfected.

Conclusion:

HIV infected mothers and their children succumbed to mortality whereas the HIV negatives were LTFU. Mortality rates and LTFU are high within PMTCT program.

Keywords: HIV, Follow up, Mortality, PMTCT..