Kurewa E N, Kandawasvika G Q, Mhlanga F, Munjoma M, Mapingure M P, Chandiwana P, Chirenje M Z, Rusakaniko S, Stray-Pedersen B
Letten Foundation Research Center, No.3 Everrett Close, Harare Zimbabwe.
Open AIDS J. 2011;5:51-8. doi: 10.2174/1874613601105010051. Epub 2011 Jun 14.
Complete follow up is an essential component of observational cohorts irrespective of the type of disease.
To describe five years follow up of mother and child pairs on a PMTCT program, highlighting loss to follow up (LTFU) and mortality (attrition).
A cohort of pregnant women was enrolled from the national PMTCT program at 36 weeks gestational age attending three peri urban clinics around Harare offering maternal and child health services. Mother-infant pairs were followed up from birth and twice yearly for five years.
A total of 479 HIV infected and 571 HIV negative pregnant women were enrolled, 445(92.9%) and 495(86.6%) were followed up whereas 14(3.0%) and 3(0.5%) died in the 1st year respectively; RR (95%CI) 5.3(1.5-18.7). At five years 227(56.7%) HIV infected and 239(41.0%) HIV negative mothers turned up, whereas mortality rates were 34 and 7 per 100 person years respectively. Birth information was recorded for 401(83.7%) HIV exposed and 441(77.2%) unexposed infants, 247(51.6%) and 232(40.6) turned up in the first year whilst mortality was 58(12.9%) and 22(4.4%) respectively, RR (95%CI) 3.2(2.0-5.4). At five years 210(57.5%) HIV exposed and 239(44.3%) unexposed infants were seen, whilst mortality rates were 53 per 1000 and 15 per 1 000 person years respectively. Mortality rate for HIV infected children was 112 compared to 21 per 1 000 person years for the exposed but uninfected.
HIV infected mothers and their children succumbed to mortality whereas the HIV negatives were LTFU. Mortality rates and LTFU are high within PMTCT program.
无论疾病类型如何，完整随访都是观察性队列研究的重要组成部分。
描述母婴配对在预防母婴传播（PMTCT）项目中的五年随访情况，重点关注失访（LTFU）和死亡率（损耗）。
从国家PMTCT项目中招募了一组孕周为36周的孕妇，她们在哈拉雷周围的三个城郊诊所接受母婴健康服务。母婴配对从出生开始随访，为期五年，每年随访两次。
共纳入479名感染艾滋病毒的孕妇和571名未感染艾滋病毒的孕妇，445名（92.9%）感染艾滋病毒的孕妇和495名（86.6%）未感染艾滋病毒的孕妇完成随访，而分别有14名（3.0%）和3名（0.5%）在第一年死亡；相对危险度（95%置信区间）为5.3（1.5 - 18.7）。五年时，227名（56.7%）感染艾滋病毒的母亲和239名（41.0%）未感染艾滋病毒的母亲前来随访，而死亡率分别为每100人年34例和7例。记录了401名（83.7%）暴露于艾滋病毒的婴儿和441名（77.2%）未暴露婴儿的出生信息，247名（51.6%）暴露于艾滋病毒的婴儿和232名（40.6%）未暴露婴儿在第一年前来随访，而死亡率分别为58例（12.9%）和22例（4.4%），相对危险度（95%置信区间）为3.2（2.0 - 5.4）。五年时，见到了210名（57.5%）暴露于艾滋病毒的婴儿和239名（44.3%）未暴露婴儿，而死亡率分别为每1000人年53例和15例。感染艾滋病毒儿童的死亡率为每1000人年112例，而暴露但未感染的儿童死亡率为每1000人年21例。
感染艾滋病毒的母亲及其子女死于相关疾病，而未感染艾滋病毒的母亲出现失访情况。在预防母婴传播项目中，死亡率和失访率都很高。
