Original Research

Infant HIV diagnosis and turn-around time for testing in Malawi, 2015

Hammad Ali, Peter Minchella, Geoffrey Chipungu, Evelyn Kim, James Kandulu, Dalitso Midiani, Andrea Kim, Mahesh Swaminathan, Steve Gutreuter, John Nkengasong, Daniel Singer
African Journal of Laboratory Medicine | Vol 9, No 1 | a904 | DOI: https://doi.org/10.4102/ajlm.v9i1.904 | © 2020 Hammad Ali, Peter Minchella, Geoffrey Chipungu, Evelyn Kim, James Kandulu, Dalitso Midiani, Andrea Kim, Mahesh Swaminathan, Steve Gutreuter, John Nkengasong, Daniel Singer | This work is licensed under CC Attribution 4.0
Submitted: 30 August 2018 | Published: 26 November 2020

About the author(s)

Hammad Ali, Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
Peter Minchella, Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
Geoffrey Chipungu, Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Lilongwe, Malawi
Evelyn Kim, Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Lilongwe, Malawi
James Kandulu, Ministry of Health, Lilongwe, Malawi
Dalitso Midiani, Ministry of Health, Lilongwe, Malawi
Andrea Kim, Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
Mahesh Swaminathan, Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
Steve Gutreuter, Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
John Nkengasong, Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, Georgia, Malawi
Daniel Singer, Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Lilongwe, Malawi


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Abstract

Background: For HIV-exposed infants in Malawi, there are missed opportunities at each step of the testing and treatment cascade.

Objective: This study assessed factors associated with HIV positivity among infants in Malawi and turn-around times for infant HIV testing.

Methods: HIV testing data for infants aged 0–18 months from 2012 to 2015 were extracted from the Malawi HIV laboratory information management system and analysed using logistic regression. Turn-around time was defined as time between collection of samples to results dispatch from the laboratory.

Results: A total of 106 997 tests were included in the analyses. A subset of 76 006 observations with complete dates were included in the turn-around time analysis. Overall positivity was 4.2%. Factors associated with positivity were increasing age (infants aged 3–6 months: adjusted odds ratio [aOR] = 2.24; infants aged 6–9 months: aOR = 3.42; infants aged > 9 months: aOR = 4.24), female sex (aOR = 1.08) and whether the mother was alive and not on antiretroviral therapy at time of the infant’s test (aOR = 1.57). Provision of HIV prophylaxis to the infant after birth (aOR = 0.38) was found to be protective against HIV positivity. The median turn-around time was 24 days (increased from 19 to 34 days between 2012 and 2015).

Conclusion: Infant HIV positivity has decreased in Malawi, whereas turn-around time has increased. Factors associated with positivity include increasing age, female sex, and whether the mother was alive and not on antiretroviral therapy at the time of the infant’s test.


Keywords

HIV; Malawi; infant HIV testing; turn-around time

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