International Journal of Epidemiology, Vol 28, 769-775, Copyright © 1999 by International Epidemiological Association
JP Ioannidis, TE Taha, N Kumwenda, R Broadhead, L Mtimavalye, P Miotti, F Yellin, DG Contopoulos-Ioannidis and RJ Biggar
BACKGROUND: Large simple trials which aim to study therapeutic
interventions and epidemiological associations of human immunodeficiency
virus (HIV) infection, including perinatal transmission, in Africa may have
substantial rates of loss to follow- up. A better understanding of the
characteristics and the impact of women and children lost to follow-up is
needed. METHODS: We studied predictors and the impact of losses to
follow-up of infants born in a large cohort of delivering women in urban
Malawi. The cohort was established as part of a trial of vaginal cleansing
with chlorhexidine during delivery to prevent mother-to-infant transmission
of HIV. RESULTS: The HIV infection status could not be determined for 797
(36.9%) of 2156 infants born to HIV-infected mothers; 144 (6.7%) with
missing status because of various sample problems and 653 (30.3%) because
they never returned to the clinic. Notably, the observed rates of perinatal
transmission were significantly lower in infants who returned later for
determination of their infection status (odds ratio = 0.94 per month, P =
0.03), even though these infants must have had an additional risk of
infection from breastfeeding. In multivariate models, infants of lower
birthweight (P = 0.003) and, marginally, singletons (P = 0.09) were less
likely to return for follow-up. The parents of infants lost to follow-up
tended to be less educated (P < 0.001) and more likely to be in farming
occupations, although one educated group, teachers and students, were also
significantly less likely to return. Of these variables, infant
birthweight, twins versus singletons, and maternal education were also
associated with significant variation in the observed risk of perinatal
transmission among infants of known HIV status. CONCLUSIONS: Several
predictors of loss to follow-up were identified in this large HIV perinatal
cohort. Losses to follow-up can impact the observed transmission rate and
the risk associations in different studies.
ARTICLES
Predictors and impact of losses to follow-up in an HIV-1 perinatal transmission cohort in Malawi
HIV Research Branch, Division of AIDS, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, USA. jioannid@otenet.gr
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  P. L. Williams, R. Van Dyke, M. Eagle, D. Smith, C. Vincent, G. Ciupak, J. Oleske, G. R. Seage III, and for the PACTG 219C Team Association of Site-specific and Participant-specific Factors with Retention of Children in a Long-term Pediatric HIV Cohort Study Am. J. Epidemiol., June 1, 2008; 167(11): 1375 - 1386. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Varga and H. Brookes Preventing Mother-to-Child HIV Transmission Among South African Adolescents Journal of Adolescent Research, March 1, 2008; 23(2): 172 - 205. [Abstract] [PDF]
|
|
|
|
 |
|
 T. E. Taha, S. M. Graham, N. I. Kumwenda, R. L. Broadhead, D. R. Hoover, D. Markakis, L. van der Hoeven, G. N. Liomba, J. D. Chiphangwi, and P. G. Miotti Morbidity Among Human Immunodeficiency Virus-1-Infected and -Uninfected African Children Pediatrics, December 1, 2000; 106(6): 77e - 77. [Abstract] [Full Text]
|
|
|
|
 |
|
 K. Castetbon, R. Spira, V. Leroy, F. Dabis, P. G. Miotti, T. E. T. Taha, N. I. Kumwenda, L. Van der Hoeven, R. Broadhead, L. A. R. Mtimavalye, et al. Risk of HIV Transmission Through Breastfeeding JAMA, February 23, 2000; 283(8): 999 - 1000. [Full Text] [PDF]
|
|