Trend and predictors for early infant diagnosis by PCR among HIV-exposed infants in Dar es Salaam region, Tanzania, 2014-2016

Abstract

BACKGROUND
 Early infant diagnosis (EID) of HIV and timely initiation of antiretroviral therapy reduces morbidity and mortality in HIV-infected infants and children. Although the WHO had a global target for 2018 that 90% of HIV-exposed infants (HEI) should be tested by the age of 8 weeks, by 2015 only half were being tested. This study describes trends and predictors for HIV first testing in HEI in Dar es Salaam, Tanzania, from 2014 to 2016.
 METHODS
 We conducted a cross-sectional study of HEI attending HIV services using secondary data collected at health facilities and collated at the national level. We estimated odds ratios and 95% confidence intervals for factors affecting uptake of HIV testing.
 RESULTS
 Of 12,117 HEI, the proportion tested for HIV by age 8 weeks increased from 53.2% in 2014 to 69.2% in 2016; 2.3% were HIV-positive. Replacement feeding (aOR=2.94, 95% CI 2.31 – 3.74) and receiving nevirapine prophylaxis (aOR=1.55, 95% CI 1.28-1.88) were predictors for EID testing uptake. HEI born to mothers with WHO stage II (aOR=0.53, 95% CI 0.41 – 0.67), stage III (aOR=0.64, 95% CI; 0.52 – 0.79) and stage IV (aOR=0.58, 95% CI 0.34 – 0.99) were less likely to be tested than those born to mothers with WHO stage I disease progression.
 CONCLUSION
 There was an increasing trend in the uptake of HIV testing of infants at age 8 weeks during the study period. However, it is still below the global target. Efforts to promote EID testing are still needed.