Factors associated with untimely uptake of early infant diagnosis (EID) testing among HIV exposed infants (HEI)

Abstract

Background: Highly Exposed Infants (HEI) to HIV through their HIV positive mothers, require to receive timely Early Infant Diagnosis (EID) to enable identification of HIV positive infants, as to facilitate early treatment and follow up, and for negative infants, to reduce risk of infection by planning, counselling on appropriate feeding whilst maintaining adequate nutrition. Objective: To assess the factors associated untimely uptake of Early Infant Diagnosis (EID) among HEIs attending Kiryandongo General Hospital. Methodology: A cross-sectional study design was undertaken among 112 mothers in Kiryandongo Hospital, Kiryandongo District. All HIV positive mothers with HEIs aged 4 weeks to 18 months, enrolled and active in the Mother Baby Care Point (MBCP) in Kiryandongo Hospital were included in this study. Logistic regression was used to assess the factors associated with untimely EID among HEIs’. The data was analyzed by STATA 12 statistical software. Results: Most (70%) of HEIs obtained untimely EID. With all variables accounted for, the statistically independent predictor of untimely EID among HEIs where families where the household head had primary Education were more likely to have untimely EID compared to those where the household head had no formal education (AOR = 4.5986 [95% CI: 1.01-20.95], PV 0.049) Conclusion: Timely EID among HEI remains low in Uganda, Ugandan HEIs continue to be at risk of acquiring HIV infection due to untimely EID. The study recommends reducing untimely EID through proactively identifying and following mothers with identified predisposing factors to untimely EID among HEIs families, as opposed to follow up of HEIs mothers who have already missed timely EID. In addition, this study noted that a number of HEIs receive EID before the recommended timeline which may lead to poor diagnosis especially if the infant contracted HIV at birth. Mothers to HEIs should be given enough information during antenatal and at birth to ensure that they follow the proper recommendations. Most of factors that have been identified in most studies to influence the timeliness of EID did not show any significant association with untimely EID in this study. This calls for an in-depth qualitative study to understand the dynamics in rural settings and how they may influence the timeliness of EID