Different factors associated with loss to follow-up of infants born to HIV-infected or uninfected mothers: observations from the ANRS 12140-PEDIACAM study in Cameroon
Identifieur interne : 001760 ( Main/Exploration ); précédent : 001759; suivant : 001761Different factors associated with loss to follow-up of infants born to HIV-infected or uninfected mothers: observations from the ANRS 12140-PEDIACAM study in Cameroon
Auteurs : Larissa Kamgue Sidze [Cameroun, France] ; Albert Faye [France] ; Suzie Ndiang Tetang [Cameroun] ; Ida Penda [Cameroun] ; Georgette Guemkam [Cameroun] ; Francis Ndongo Ateba [Cameroun] ; Jean Audrey Ndongo [Cameroun] ; Félicité Nguefack [Cameroun] ; Gaëtan Texier [Cameroun, France] ; Patrice Tchendjou [Cameroun, France] ; Anfumbom Kfutwah [Cameroun] ; Josiane Warszawski [France] ; Mathurin Cyrille Tejiokem [Cameroun, France]Source :
- BMC Public Health [ 1471-2458 ] ; 2015.
Abstract
Loss to follow-up (LTFU) is a cause of potential bias in clinical studies. Differing LTFU between study groups may affect internal validity and generalizability of the results. Understanding reasons for LTFU could help improve follow-up in clinical studies and thereby contribute to goals for prevention, treatment, or research being achieved. We explored factors associated with LTFU of mother-child pairs after inclusion in the ANRS 12140-Pediacam study.
From November 2007 to October 2010, 4104 infants including 2053 born to HIV-infected mothers and 2051 born to HIV-uninfected mothers matched individually on gender and study site were enrolled during the first week of life in three referral hospitals in Cameroon and scheduled for visits at 6, 10 and 14 weeks of age. Visits were designated 1, 2 and 3, in chronological order, irrespective of the child’s age at the time of the visit. Mother-child pairs were considered lost to follow-up if they never returned for a clinical visit within the first six months after inclusion. Uni- and multivariable logistic regression were adjusted on matching variables to identify factors associated with LTFU according to maternal HIV status.
LTFU among HIV-unexposed infants was four times higher than among HIV-exposed infants (36.7% vs 9.8%, p < 0.001). Emergency caesarean section (adjusted Odds Ratio (aOR) = 2.46 95% Confidence Interval (CI) [1.47-4.13]), young maternal age (aOR = 2.29, 95% CI [1.18-4.46]), and absence of antiretroviral treatment for prophylaxis (aOR = 3.45, 95% CI [2.30-5.19]) were independently associated with LTFU among HIV-exposed infants. Factors associated with LTFU among HIV-unexposed infants included young maternal age (aOR = 1.96, 95% CI [1.36-2.81]), low maternal education level (aOR = 2.77, 95% CI [1.95-3.95]) and housewife/unemployed mothers (aOR = 1.56, 95% CI [1.16-2.11]).
Failure to return for at least one scheduled clinical visit is a problem especially among HIV-unexposed infants included in studies involving HIV-exposed infants. Factors associated with this type of LTFU included maternal characteristics, socio-economic status, quality of antenatal care and obstetrical context of delivery. Enhanced counselling in antenatal and intrapartum services is required for mothers at high risk of failure to return for follow-up visits.
The online version of this article (doi:10.1186/s12889-015-1555-2) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1186/s12889-015-1555-2
PubMed: 25886161
PubMed Central: 4358721
Affiliations:
- Cameroun, France
- Provence-Alpes-Côte d'Azur, Région du Centre (Cameroun), Île-de-France
- Marseille, Paris, Yaoundé
- Université de Yaoundé I
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Centre Pasteur du Cameroun, Membre du Réseau International des Instituts Pasteur, Yaoundé, Cameroun</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Service d’Epidémiologie et de Santé Publique, Centre Pasteur du Cameroun, Membre du Réseau International des Instituts Pasteur, Yaoundé</wicri:regionArea><wicri:noRegion>Yaoundé</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2">ISPED, Université Victor Segalen, Bordeaux II, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>ISPED, Université Victor Segalen, Bordeaux II</wicri:regionArea><wicri:noRegion>Bordeaux II</wicri:noRegion><wicri:noRegion>Bordeaux II</wicri:noRegion></affiliation></author><author><name sortKey="Faye, Albert" sort="Faye, Albert" uniqKey="Faye A" first="Albert" last="Faye">Albert Faye</name><affiliation wicri:level="3"><nlm:aff id="Aff3">Assistance Publique des Hôpitaux de Paris, Pédiatrie Générale, Hôpital Robert Debré, Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Assistance Publique des Hôpitaux de Paris, Pédiatrie Générale, Hôpital Robert Debré, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="Aff4">Université Paris 7 Denis Diderot, Paris Sorbonne Cité, Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Université Paris 7 Denis Diderot, Paris Sorbonne Cité, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Tetang, Suzie Ndiang" sort="Tetang, Suzie Ndiang" uniqKey="Tetang S" first="Suzie Ndiang" last="Tetang">Suzie Ndiang Tetang</name><affiliation wicri:level="1"><nlm:aff id="Aff5">Service de Pédiatrie, Centre Hospitalier d’Essos, Yaoundé, Cameroun</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Service de Pédiatrie, Centre Hospitalier d’Essos, Yaoundé</wicri:regionArea><wicri:noRegion>Yaoundé</wicri:noRegion></affiliation></author><author><name sortKey="Penda, Ida" sort="Penda, Ida" uniqKey="Penda I" first="Ida" last="Penda">Ida Penda</name><affiliation wicri:level="1"><nlm:aff id="Aff6">Hôpital de Jour, Hôpital Laquintinie, Douala, Cameroun</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Hôpital de Jour, Hôpital Laquintinie, Douala</wicri:regionArea><wicri:noRegion>Douala</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff7">Faculté de Médecine et des Sciences Pharmaceutiques, Université de Douala, Douala, Cameroun</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Faculté de Médecine et des Sciences Pharmaceutiques, Université de Douala, Douala</wicri:regionArea><wicri:noRegion>Douala</wicri:noRegion></affiliation></author><author><name sortKey="Guemkam, Georgette" sort="Guemkam, Georgette" uniqKey="Guemkam G" first="Georgette" last="Guemkam">Georgette Guemkam</name><affiliation wicri:level="1"><nlm:aff id="Aff8">Centre Mère et Enfant de la Fondation Chantal Biya, Yaoundé, Cameroun</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Centre Mère et Enfant de la Fondation Chantal Biya, Yaoundé</wicri:regionArea><wicri:noRegion>Yaoundé</wicri:noRegion></affiliation></author><author><name sortKey="Ateba, Francis Ndongo" sort="Ateba, Francis Ndongo" uniqKey="Ateba F" first="Francis Ndongo" last="Ateba">Francis Ndongo Ateba</name><affiliation wicri:level="1"><nlm:aff id="Aff8">Centre Mère et Enfant de la Fondation Chantal Biya, Yaoundé, Cameroun</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Centre Mère et Enfant de la Fondation Chantal Biya, 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Yaoundé</wicri:regionArea><wicri:noRegion>Yaoundé</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="Aff9">Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé I, Yaoundé, Cameroun</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé I, Yaoundé</wicri:regionArea><orgName type="university">Université de Yaoundé I</orgName><placeName><settlement type="city">Yaoundé</settlement><region type="region" nuts="2">Région du Centre (Cameroun)</region></placeName></affiliation></author><author><name sortKey="Texier, Gaetan" sort="Texier, Gaetan" uniqKey="Texier G" first="Gaëtan" last="Texier">Gaëtan Texier</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Service d’Epidémiologie et de Santé Publique, Centre Pasteur du Cameroun, Membre du Réseau International des Instituts Pasteur, Yaoundé, Cameroun</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Service d’Epidémiologie et de Santé Publique, Centre Pasteur du Cameroun, Membre du Réseau International des Instituts Pasteur, Yaoundé</wicri:regionArea><wicri:noRegion>Yaoundé</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:aff id="Aff10">SESSTIM (UMR 912), Université Aix-Marseille, Marseille, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>SESSTIM (UMR 912), Université Aix-Marseille, Marseille</wicri:regionArea><placeName><region type="region">Provence-Alpes-Côte d'Azur</region><region type="old region">Provence-Alpes-Côte d'Azur</region><settlement type="city">Marseille</settlement></placeName></affiliation></author><author><name sortKey="Tchendjou, Patrice" sort="Tchendjou, Patrice" uniqKey="Tchendjou P" first="Patrice" last="Tchendjou">Patrice Tchendjou</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Service d’Epidémiologie et de Santé Publique, Centre Pasteur du Cameroun, Membre du Réseau International des Instituts Pasteur, Yaoundé, Cameroun</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Service d’Epidémiologie et de Santé Publique, Centre Pasteur du Cameroun, Membre du Réseau International des Instituts Pasteur, Yaoundé</wicri:regionArea><wicri:noRegion>Yaoundé</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2">ISPED, Université Victor Segalen, Bordeaux II, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>ISPED, Université Victor Segalen, Bordeaux II</wicri:regionArea><wicri:noRegion>Bordeaux II</wicri:noRegion><wicri:noRegion>Bordeaux II</wicri:noRegion></affiliation></author><author><name sortKey="Kfutwah, Anfumbom" sort="Kfutwah, Anfumbom" uniqKey="Kfutwah A" first="Anfumbom" last="Kfutwah">Anfumbom Kfutwah</name><affiliation wicri:level="1"><nlm:aff id="Aff11">Service de Virologie, Centre Pasteur du Cameroun, Membre du Réseau International des Instituts Pasteur, Yaoundé, Cameroun</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Service de Virologie, Centre Pasteur du Cameroun, Membre du Réseau International des Instituts Pasteur, Yaoundé</wicri:regionArea><wicri:noRegion>Yaoundé</wicri:noRegion></affiliation></author><author><name sortKey="Warszawski, Josiane" sort="Warszawski, Josiane" uniqKey="Warszawski J" first="Josiane" last="Warszawski">Josiane Warszawski</name><affiliation wicri:level="3"><nlm:aff id="Aff12">Equipe 4 (VIH et IST) - INSERM U1018 (CESP), Le Kremlin Bicêtre, Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Equipe 4 (VIH et IST) - INSERM U1018 (CESP), Le Kremlin Bicêtre, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="Aff13">Assistance Publique des Hôpitaux de Paris, Service d’Epidémiologie et de Santé Publique, Hôpital de Bicêtre, Le Kremlin Bicêtre, Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Assistance Publique des Hôpitaux de Paris, Service d’Epidémiologie et de Santé Publique, Hôpital de Bicêtre, Le Kremlin Bicêtre, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="Aff14">Université de Paris Sud 11, Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Université de Paris Sud 11, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Tejiokem, Mathurin Cyrille" sort="Tejiokem, Mathurin Cyrille" uniqKey="Tejiokem M" first="Mathurin Cyrille" last="Tejiokem">Mathurin Cyrille Tejiokem</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Service d’Epidémiologie et de Santé Publique, Centre Pasteur du Cameroun, Membre du Réseau International des Instituts Pasteur, Yaoundé, Cameroun</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Service d’Epidémiologie et de Santé Publique, Centre Pasteur du Cameroun, Membre du Réseau International des Instituts Pasteur, Yaoundé</wicri:regionArea><wicri:noRegion>Yaoundé</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:aff id="Aff12">Equipe 4 (VIH et IST) - INSERM U1018 (CESP), Le Kremlin Bicêtre, Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Equipe 4 (VIH et IST) - INSERM U1018 (CESP), Le Kremlin Bicêtre, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author></analytic><series><title level="j">BMC Public Health</title><idno type="eISSN">1471-2458</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Loss to follow-up (LTFU) is a cause of potential bias in clinical studies. Differing LTFU between study groups may affect internal validity and generalizability of the results. Understanding reasons for LTFU could help improve follow-up in clinical studies and thereby contribute to goals for prevention, treatment, or research being achieved. We explored factors associated with LTFU of mother-child pairs after inclusion in the ANRS 12140-Pediacam study.</p></sec><sec><title>Methods</title><p>From November 2007 to October 2010, 4104 infants including 2053 born to HIV-infected mothers and 2051 born to HIV-uninfected mothers matched individually on gender and study site were enrolled during the first week of life in three referral hospitals in Cameroon and scheduled for visits at 6, 10 and 14 weeks of age. Visits were designated 1, 2 and 3, in chronological order, irrespective of the child’s age at the time of the visit. Mother-child pairs were considered lost to follow-up if they never returned for a clinical visit within the first six months after inclusion. Uni- and multivariable logistic regression were adjusted on matching variables to identify factors associated with LTFU according to maternal HIV status.</p></sec><sec><title>Results</title><p>LTFU among HIV-unexposed infants was four times higher than among HIV-exposed infants (36.7% vs 9.8%, p < 0.001). Emergency caesarean section (adjusted Odds Ratio (aOR) = 2.46 95% Confidence Interval (CI) [1.47-4.13]), young maternal age (aOR = 2.29, 95% CI [1.18-4.46]), and absence of antiretroviral treatment for prophylaxis (aOR = 3.45, 95% CI [2.30-5.19]) were independently associated with LTFU among HIV-exposed infants. Factors associated with LTFU among HIV-unexposed infants included young maternal age (aOR = 1.96, 95% CI [1.36-2.81]), low maternal education level (aOR = 2.77, 95% CI [1.95-3.95]) and housewife/unemployed mothers (aOR = 1.56, 95% CI [1.16-2.11]).</p></sec><sec><title>Conclusion</title><p>Failure to return for at least one scheduled clinical visit is a problem especially among HIV-unexposed infants included in studies involving HIV-exposed infants. Factors associated with this type of LTFU included maternal characteristics, socio-economic status, quality of antenatal care and obstetrical context of delivery. Enhanced counselling in antenatal and intrapartum services is required for mothers at high risk of failure to return for follow-up visits.</p></sec><sec><title>Electronic supplementary material</title><p>The online version of this article (doi:10.1186/s12889-015-1555-2) contains supplementary material, which is available to authorized users.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Le Coeur, S" uniqKey="Le Coeur S">S Le Coeur</name></author><author><name sortKey="Kanshana, S" uniqKey="Kanshana S">S Kanshana</name></author><author><name sortKey="Jourdain, G" uniqKey="Jourdain G">G Jourdain</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Essomo Megnier Mbo, M" uniqKey="Essomo Megnier Mbo M">M Essomo Megnier-Mbo</name></author><author><name sortKey="Meye, Jf" uniqKey="Meye J">JF Meye</name></author><author><name sortKey="Belembaogo, E" uniqKey="Belembaogo E">E 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Rubel</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Cameroun</li><li>France</li></country><region><li>Provence-Alpes-Côte d'Azur</li><li>Région du Centre (Cameroun)</li><li>Île-de-France</li></region><settlement><li>Marseille</li><li>Paris</li><li>Yaoundé</li></settlement><orgName><li>Université de Yaoundé I</li></orgName></list><tree><country name="Cameroun"><noRegion><name sortKey="Sidze, Larissa Kamgue" sort="Sidze, Larissa Kamgue" uniqKey="Sidze L" first="Larissa Kamgue" last="Sidze">Larissa Kamgue Sidze</name></noRegion><name sortKey="Ateba, Francis Ndongo" sort="Ateba, Francis Ndongo" uniqKey="Ateba F" first="Francis Ndongo" last="Ateba">Francis Ndongo Ateba</name><name sortKey="Guemkam, Georgette" sort="Guemkam, Georgette" uniqKey="Guemkam G" first="Georgette" last="Guemkam">Georgette Guemkam</name><name sortKey="Kfutwah, Anfumbom" sort="Kfutwah, Anfumbom" uniqKey="Kfutwah A" first="Anfumbom" last="Kfutwah">Anfumbom Kfutwah</name><name sortKey="Ndongo, Jean Audrey" sort="Ndongo, Jean Audrey" uniqKey="Ndongo J" first="Jean Audrey" last="Ndongo">Jean Audrey Ndongo</name><name sortKey="Nguefack, Felicite" sort="Nguefack, Felicite" uniqKey="Nguefack F" first="Félicité" last="Nguefack">Félicité Nguefack</name><name sortKey="Nguefack, Felicite" sort="Nguefack, Felicite" uniqKey="Nguefack F" first="Félicité" last="Nguefack">Félicité Nguefack</name><name sortKey="Penda, Ida" sort="Penda, Ida" uniqKey="Penda I" first="Ida" last="Penda">Ida Penda</name><name sortKey="Penda, Ida" sort="Penda, Ida" uniqKey="Penda I" first="Ida" last="Penda">Ida Penda</name><name sortKey="Tchendjou, Patrice" sort="Tchendjou, Patrice" uniqKey="Tchendjou P" first="Patrice" last="Tchendjou">Patrice Tchendjou</name><name sortKey="Tejiokem, Mathurin Cyrille" sort="Tejiokem, Mathurin Cyrille" uniqKey="Tejiokem M" first="Mathurin Cyrille" last="Tejiokem">Mathurin Cyrille Tejiokem</name><name sortKey="Tetang, Suzie Ndiang" sort="Tetang, Suzie Ndiang" uniqKey="Tetang S" first="Suzie Ndiang" last="Tetang">Suzie Ndiang Tetang</name><name sortKey="Texier, Gaetan" sort="Texier, Gaetan" uniqKey="Texier G" first="Gaëtan" last="Texier">Gaëtan Texier</name></country><country name="France"><noRegion><name sortKey="Sidze, Larissa Kamgue" sort="Sidze, Larissa Kamgue" uniqKey="Sidze L" first="Larissa Kamgue" last="Sidze">Larissa Kamgue Sidze</name></noRegion><name sortKey="Faye, Albert" sort="Faye, Albert" uniqKey="Faye A" first="Albert" last="Faye">Albert Faye</name><name sortKey="Faye, Albert" sort="Faye, Albert" uniqKey="Faye A" first="Albert" last="Faye">Albert Faye</name><name sortKey="Tchendjou, Patrice" sort="Tchendjou, Patrice" uniqKey="Tchendjou P" first="Patrice" last="Tchendjou">Patrice Tchendjou</name><name sortKey="Tejiokem, Mathurin Cyrille" sort="Tejiokem, Mathurin Cyrille" uniqKey="Tejiokem M" first="Mathurin Cyrille" last="Tejiokem">Mathurin Cyrille Tejiokem</name><name sortKey="Texier, Gaetan" sort="Texier, Gaetan" uniqKey="Texier G" first="Gaëtan" last="Texier">Gaëtan Texier</name><name sortKey="Warszawski, Josiane" sort="Warszawski, Josiane" uniqKey="Warszawski J" first="Josiane" last="Warszawski">Josiane Warszawski</name><name sortKey="Warszawski, Josiane" sort="Warszawski, Josiane" uniqKey="Warszawski J" first="Josiane" last="Warszawski">Josiane Warszawski</name><name sortKey="Warszawski, Josiane" sort="Warszawski, Josiane" uniqKey="Warszawski J" first="Josiane" last="Warszawski">Josiane Warszawski</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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