TUAC0102 - Oral Abstract Session
Retention in care among women initiated on Option B plus in the Antenatal Clinic (ANC) and labour ward at Mulago National referral hospital Kampala, Uganda
Presented by Emily Namara Lugolobi (Uganda).
E. Namara Lugolobi1, Z. Namukwaya1, P. Musoke1,2, A. Kakande1, J. Matovu1, S. Kamya1, M. Kyarimpa1, J. Byamugisha3, M.G. Fowler1
1MU-JHU Research Collaboration, Prevention of Mother to Child Transmission of HIV, Kampala, Uganda, 2Makerere College of Health Sciences, Department of Pediatrics and Child Health, Kampala, Uganda, 3Makerere College of Health Sciences, Department of Obstetrics and Gynaecology, Kampala, Uganda
Introduction: The World Health Organisation now recommends that all pregnant women are initiated on ART for life irrespective of their CD4 counts (Option B plus). However it's essential that women return to the clinic for CD4 count evaluation, monitoring of adverse reactions and adherence to medications. There is limited data about retention of women initiated on Option B plus. We set out to determine the proportion of women who returned to the clinic after being initiated on ART.
Methods: Mulago National referral Hospital rolled out Option B plus in October 2012. Newly diagnosed HIV infected women in ANC were started on ART the same day and blood drawn to asses CD4 count and renal and liver function tests. They were given two weeks appointment to receive their results. Those diagnosed during labour were given ART and asked to return after two weeks for blood draw for CD4 count and blood chemistry. At this visit they were given another two weeks appointment to receive results.
We reviewed records in ANC and labour ward to determine the number of women who were tested and then started on Option B plus. We also reviewed records at the ART clinic to determine the number of women who returned to receive their results as of 23 January 2013. The attrition rate was determined as the percentage of women who received results divided by the number of women who started ART in the respective units.
Results: From 17th October to 31st December 2012, 190 women tested positive and 92% were initiated on ART in the ANC. Eighty two percent(155/190,CI:75% -87%) have returned to receive their CD4 results. Women who were initiated on ART in labour were 162. Only 20 (12% CI 7.7% -18.4%) of these women have returned to receive their CD4 results.
Conclusion: Women who enrolled on Option B plus in ANC were more likely to return for care compared to those enrolled in labour. There is need to determine the dynamics that affect follow up among women initiated on ART in labour in order to improve retention in care and adherence to ART.
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