Infant HIV diagnosis and turn-around time for testing in Malawi, 2015

Area of Science:

• Pediatrics
• Infectious Diseases
• Public Health

Background:

• Missed opportunities exist in the HIV testing and treatment cascade for HIV-exposed infants in Malawi.
• Early infant diagnosis is crucial for timely HIV intervention and improved outcomes.

Purpose of the Study:

• To assess factors associated with HIV positivity in Malawian infants.
• To evaluate turn-around times for infant HIV testing in Malawi.

Main Methods:

• Analysis of HIV testing data for 106,997 infants aged 0-18 months (2012-2015) from Malawi's HIV laboratory information management system.
• Logistic regression used to identify factors associated with HIV positivity.
• Turn-around time calculated as the duration from sample collection to laboratory results dispatch.

Main Results:

• Overall infant HIV positivity was 4.2%.
• Factors associated with increased HIV positivity included older infant age, female sex, and maternal conditions (alive, not on antiretroviral therapy).
• Infant HIV prophylaxis post-birth was protective (aOR=0.38). Median turn-around time increased from 19 to 34 days between 2012 and 2015.

Conclusions:

• Infant HIV positivity has declined in Malawi, contrasting with an increase in testing turn-around times.
• Key factors influencing infant HIV positivity are infant age, sex, and maternal health status.
• Optimizing the HIV testing cascade and reducing laboratory turn-around times are critical for effective infant HIV management in Malawi.