{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T11:06:13Z","timestamp":1790766373473,"version":"4.1.0"},"reference-count":32,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T00:00:00Z","timestamp":1632960000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MC_UU_12023"],"award-info":[{"award-number":["MC_UU_12023"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011264","name":"FP7 People: Marie-Curie Actions","doi-asserted-by":"publisher","award":["612216"],"award-info":[{"award-number":["612216"]}],"id":[{"id":"10.13039\/100011264","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/K012126\/1"],"award-info":[{"award-number":["MR\/K012126\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000278","name":"Department for International Development","doi-asserted-by":"publisher","award":["MR\/K012126\/1"],"award-info":[{"award-number":["MR\/K012126\/1"]}],"id":[{"id":"10.13039\/501100000278","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100019256","name":"NIHR GOSH BRC","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100019256","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Early infant HIV diagnosis (EID) is critical to ensuring timely diagnosis of HIV-exposed infants, and treatment in those found to be infected. However estimates of coverage vary considerably, depending on data sources used. We used 4 methods to estimate coverage among a historical cohort of HIV-exposed infants in rural South Africa, between 2010\u20132016.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We estimated the proportion of infants ever tested (methods 1\u20133) and tested by 7 weeks of age (1\u20134) as follows: (1) infants born to women identified as HIV-positive in demographic surveillance were linked to those with \u22651 EID result in routine laboratory surveillance; (2) the number of infants with \u22651 EID result in laboratory surveillance divided by the estimated number of HIV-exposed infants, calculated as total live births multiplied by antenatal HIV seroprevalence; (3) the number of infants with \u22651 EID result in routine laboratory surveillance, divided by the number of HIV-exposed infants as estimated by the district health service; (4) from documentation in infants\u2019 Road-to-Health-booklets.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The proportion ever tested was 43%, 88% and 138% for methods 1\u20133, and by 7 weeks of age was 25%, 49%, 86% and 46% for methods 1\u20134 respectively.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The four methods, applied to a range of routine data sources, resulted in estimates varying considerably, and the true coverage of EID remains unclear. Our findings highlight the importance of developing unique patient identifiers, improving training of healthcare providers using reporting systems, and ensuring the accuracy of healthcare records, to ensure the best possible health outcomes for HIV-exposed infants.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0257496","type":"journal-article","created":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T18:06:53Z","timestamp":1633025213000},"page":"e0257496","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["It ain\u2019t what you do, it\u2019s the way that you do it: The pitfalls of using routine data to measure early infant HIV diagnosis in HIV-exposed infants"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1053-6434","authenticated-orcid":true,"given":"Elizabeth","family":"Chappell","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Thorne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Intira Jeannie","family":"Collins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy","family":"Baisley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. Manisha","family":"Yapa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dickman","family":"Gareta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Till","family":"B\u00e4rnighausen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5436-9386","authenticated-orcid":true,"given":"Kobus","family":"Herbst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Judd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,9,30]]},"reference":[{"issue":"1","key":"pone.0257496.ref001","first-page":"694","article-title":"Progress towards the 2020 targets for HIV diagnosis and antiretroviral treatment in South Africa","volume":"18","author":"L.F. 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Newell","year":"2004","journal-title":"Lancet"},{"key":"pone.0257496.ref004","volume-title":"National Consolidated Guidelines For The Prevention Of Mother-To-Child Transmission Of HIV (PMTCT) And The Management Of HIV In Children, Adolescents And Adults","author":"National Department of Health of South Africa","year":"2015"},{"issue":"3","key":"pone.0257496.ref005","doi-asserted-by":"crossref","first-page":"235","DOI":"10.7196\/SAMJ.7598","article-title":"Laboratory information system data demonstrate successful implementation of the prevention of mother-to-child transmission programme in South Africa","volume":"104","author":"G.G. Sherman","year":"2014","journal-title":"South African Medical Journal"},{"issue":"1","key":"pone.0257496.ref006","doi-asserted-by":"crossref","first-page":"010701","DOI":"10.7189\/jogh.07.010701","article-title":"Toward elimination of mother-to-child transmission of HIV in South Africa: how best to monitor early infant infections within the Prevention of Mother-to-Child Transmission Program","volume":"7","author":"G.G. Sherman","year":"2017","journal-title":"Journal of Global Health"},{"issue":"11","key":"pone.0257496.ref007","doi-asserted-by":"crossref","first-page":"e25212","DOI":"10.1002\/jia2.25212","article-title":"Neonatal and infant diagnostic HIV-PCR uptake and associations during three sequential policy periods in Cape Town, South Africa: a longitudinal analysis","volume":"21","author":"E. 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Wolmarans","year":"2014","journal-title":"South African Health Review"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0257496","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T18:07:30Z","timestamp":1633025250000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0257496"}},"subtitle":[],"editor":[{"given":"Emma K.","family":"Kalk","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,9,30]]},"references-count":32,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021,9,30]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0257496","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,30]]}}}