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We assessed these indicators at community-level in Mozambique, where MTCT is the second highest globally..<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A cross-sectional household survey was conducted within the Manhi\u00e7a Health Demographic Surveillance System in Mozambique (October 2017\u2013April 2018). Live births in the previous 4\u2009years were randomly selected, and mother\/child HIV-status was ascertained through documentation or age-appropriate testing. Estimates on prevalence and transmission were adjusted by multiple imputation chained equation (MICE) for participants with missing HIV-status. Retrospective cumulative mortality rate and risk factors were estimate by Fine-Gray model.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Among 5000 selected mother-child pairs, 3486 consented participate. Community HIV-prevalence estimate in mothers after MICE adjustment was 37.6% (95%CI:35.8\u201339.4%). Estimates doubled in adolescents aged &lt;\u200919\u2009years (from 8.0 to 19.1%) and increased 1.5-times in mothers aged &lt;\u200925\u2009years. Overall adjusted vertical HIV-transmission at the time of the study were 4.4% (95% CI:3.1\u20135.7%) in HIV-exposed children (HEC). Pediatric case rate-infection was estimated at 1654\/100,000 live-births. Testing coverage in HEC was close to 96.0%; however, only 69.1% of them were tested early(&lt;\u20092\u2009months of age). Cumulative child mortality rate was 41.6\/1000 live-births. HIV-positive status and later birth order were significantly associated with death. Neonatal complications, HIV and pneumonia were main pediatric causes of death.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>In Mozambique, SPECTRUM modeling estimated 15% MTCT, higher than our district-level community-based estimates of MTCT among HIV-exposed children. Community-based subnational assessments of progress towards EMTCT are needed to complement clinic-based and modeling estimates.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12889-021-10568-4","type":"journal-article","created":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T09:06:25Z","timestamp":1615971985000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Community-based progress indicators for prevention of mother-to-child transmission and mortality rates in HIV-exposed children in rural Mozambique"],"prefix":"10.1186","volume":"21","author":[{"given":"Laura","family":"Fuente-Soro","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheila","family":"Fern\u00e1ndez-Luis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisa","family":"L\u00f3pez-Varela","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Orvalho","family":"Augusto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tacilta","family":"Nhampossa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ariel","family":"Nhacolo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edson","family":"Bernardo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Blanca","family":"Burgue\u00f1o","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernadette","family":"Ngeno","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aleny","family":"Couto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helga","family":"Guambe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kwalila","family":"Tibana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marilena","family":"Urso","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denise","family":"Naniche","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,3,17]]},"reference":[{"key":"10568_CR1","volume-title":"Global guidance on criteria and processes for validation: elimination of mother-to-child transmission of hiv and syphilis second edition 2017","author":"World Health Organization (WHO)","year":"2017","unstructured":"World Health Organization (WHO). 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AIDS. 2008;22(1):139\u201344. https:\/\/doi.org\/10.1097\/QAD.0b013e3282f2ef43.","journal-title":"AIDS."}],"container-title":["BMC Public Health"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-021-10568-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12889-021-10568-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-021-10568-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T09:07:39Z","timestamp":1615972059000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpublichealth.biomedcentral.com\/articles\/10.1186\/s12889-021-10568-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,17]]},"references-count":43,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["10568"],"URL":"https:\/\/doi.org\/10.1186\/s12889-021-10568-4","relation":{},"ISSN":["1471-2458"],"issn-type":[{"value":"1471-2458","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,17]]},"assertion":[{"value":"16 November 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 March 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 March 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Mozambican National Bioethics Committee, the Institutional Review Boards at the Hospital Clinic of Barcelona (Spain) and the Manhi\u00e7a Health Research Centre. It was also reviewed in accordance with the Centers for Disease Control and Prevention (CDC) human research protection procedures. The purpose of the study was explained to all participants, and written informed consent was obtained from mother\/caregiver. For mothers aged 14\u201316\u2009years, informed consent was provided by the legal representative of the young mother, after the mother assented.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"520"}}