Prophylactic treatment uptake and compliance with recommended follow up among HIV exposed infants: a retrospective study in Addis Ababa, Ethiopia.

Abstract

Children are being infected by HIV/AIDS mainly through mother-to-child transmission. In Ethiopia currently more than 135,000 children are living with HIV/AIDS. The aim of this study was to describe the pattern of ARV uptake after birth, co-trimoxazole prophylaxis and follow up compliance, and to examine which factors are associated with the intervention outcome.
A retrospective quantitative study design was used for data collection through two hospitals. All infants who were delivered by HIV infected mothers between October 2008 and August 2009 were included and information regarding treatment adherence during their first 6 months of age was collected.
118 HIV exposed infant-mother pairs were included in the study. 107 (90.7%) infants received ARV prophylaxis at birth. Sixty six (56%) of the infants were found to be adherent to co-trimoxazole prophylactic treatment. The majority (n = 110(93.2%)) of infants were tested HIV negative with DNA/PCR HIV test at the age of sixth weeks. Infants who took ARV prophylaxis at birth were found to be more likely to adhere with co-trimoxazole treatment: [OR = 9.43(95% CI: 1.22, 72.9)]. Similarly, infants whose mothers had been enrolled for HIV/ART care in the same facility [OR = 14(95% CI: 2.6, 75.4)], and children whose fathers were tested and known to be HIV positive [OR = 3.0(95% CI: 1.0, 9.0)] were more likely to adhere than their counterparts. Infants feeding practice was also significantly associated with adherence χ2 -test, p < 0.01.
The proportion of ARV uptake at birth among HIV exposed infants were found to be high compared to other similar settings. Mother-infant pair enrolment in the same facility and the infant's father being tested and knew their HIV result were major predictors of infants adhering to treatment and follow up. However, large numbers of infants were lost to follow up.

Full text

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SHORT REPORT Open Access
Prophylactic treatment uptake and compliance
with recommended follow up among HIV
exposed infants: a retrospective study in Addis
Ababa, Ethiopia
Mulatu Biru Shargie1*, Frida Eek2and Addisalem Abaychew3
Abstract
Background: Children are being infected by HIV/AIDS mainly through mother-to-child transmission. In Ethiopia
currently more than 135,000 children are living with HIV/AIDS. The aim of this study was to describe the pattern of
ARV uptake after birth, co-trimoxazole prophylaxis and follow up compliance, and to examine which factors are
associated with the intervention outcome.
Methods: A retrospective quantitative study design was used for data collection through two hospitals. All infants
who were delivered by HIV infected mothers between October 2008 and August 2009 were included and
information regarding treatment adherence during their first 6 months of age was collected.
Findings: 118 HIV exposed infant-mother pairs were included in the study. 107 (90.7%) infants received ARV
prophylaxis at birth. Sixty six (56%) of the infants were found to be adherent to co-trimoxazole prophylactic
treatment. The majority (n = 110(93.2%)) of infants were tested HIV negative with DNA/PCR HIV test at the age of
sixth weeks. Infants who took ARV prophylaxis at birth were found to be more likely to adhere with co-trimoxazole
treatment: [OR = 9.43(95% CI: 1.22, 72.9)]. Similarly, infants whose mothers had been enrolled for HIV/ART care in
the same facility [OR = 14(95% CI: 2.6, 75.4)], and children whose fathers were tested and known to be HIV positive
[OR = 3.0(95% CI: 1.0, 9.0)] were more likely to adhere than their counterparts. Infants feeding practice was also
significantly associated with adherence c2-test, p < 0.01.
Conclusion: The proportion of ARV uptake at birth among HIV exposed infants were found to be high compared
to other similar settings. Mother-infant pair enrolment in the same facility and the infant’s father being tested and
knew their HIV result were major predictors of infants adhering to treatment and follow up. However, large
numbers of infants were lost to follow up.
Background
Children under 15 years of age are being infected by
human immunodeficiency virus (HIV) mainly through
mother-to-child transmission (MTCT). According to
World Health Organization (WHO) 2007 report daily
HIV infection among children less than 15 years old is
estimated to be 1,500 [1]. In low income countries,
especially in Africa, all children born by HIV infected
mothers are supposed to receive co-trimoxazole (tri-
methoprim-sulfamethoxazole) prophylaxis to prevent
the occurrence of Pneumocystis jiroveci pneumonia
(PCP) from 6 weeks of age and onwards, until the child
gets tested and determined HIV negative [2]. This pro-
phylaxis is found to be very effective in decreasing high
number of death due to PCP among infants and chil-
dren with HIV, especially in poor countries where direct
viral assessment is expensive and instead antibody-based
HIV test is used. Moreover; in low income countries it
is still difficult to determine the HIV test result among
new born neonates and infants with direct viral assay
* Correspondence: mulatubiru@yahoo.com
1Master’s Programme in Public Health Faculty of Medicine Lund University
Malmö, Sweden
Full list of author information is available at the end of the article
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© 2011 Shargie et al; licensee BioMed Central Ltd This is an Open Access article distributed under the terms of the Creative Commons
Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited.

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test, due to the fact that the majority of infants have no
good alternative to breast milk, which increase the risk
for HIV due to breast feeding from HIV infected
mothers. Therefore, as long as a child is breast fed, co-
trimoxazole is indicated until the infant or child is no
longer at risk to acquire HIV from breast milk [3,4].
Ethiopia is one of the low-income countries in sub-
Saharan Africa that suffer hard from the HIV epidemic.
In Ethiopia, it was estimated that there were 135,000
HIV infected children in 2005 [5]. Despite great number
of children born by HIV infected mothers, only 2% of
HIV infected mothers were found to pass through pre-
vention of mother-to-child HIV transmission (PMTCT)
intervention in 2005. PMTCT guidelines were developed
in Ethiopia only recently, in 2001. However, due to lack
of free access of anti retroviral (ARV) prophylaxis in the
country until 2005, the challenge remained even after
the guideline has developed. In 2005, free ARV was
launched to everybody who was in need [6]. Currently,
the country is implementing the PMTCT program with
the minimum package, which includes the regular provi-
sion of HIV counselling and testing, safe and quality
obstetrical services, provision of HIV care for mothers,
ARV prophylaxis for mother and infant when indicated,
counselling on infant feeding options, family planning
and strengthened referral linkage.
The provision of PMTCT prophylaxis to HIV positive
women is allocated according to set criteria. If a preg-
nant mother is eligible to start antiretroviral therapy
(ART), she is supposed to start the long-term treatment
of a combination of triple highly active antiretroviral
therapy (HAART) after the end of first trimester, which
has a great role in preventing mother-to-child HIV
transmission. For pregnant women who are not eligible
for ART provision, prophylaxis should be started with
zidovudine (AZT 300 mg 2×/day), starting at 28 weeks
of pregnancy or as soon as possible thereafter. During
onset of labour and delivery, triple ARV should be given
and a combination of two ARV should continue for 7
days. The HIV exposed infant should also be given a
single dose of neverapine (NVP) at birth and AZT for 7
days. “The AZT dose for the infant should be extended
for 4 weeks if a mother didn’t receive adequate dose less
than 4 weeks before delivery” [6]. Despite several activ-
ities being implemented in Ethiopia, both ARV uptake
and monthly follow up compliance among infants is
currently not satisfactory. The majority of infants are
lost to follow-up before the final HIV infection status is
determined [7].
The aim of the study
To describe the pattern of ARV prophylactic treatment
uptake after birth as well as the follow up compliance
of taking co-trimoxazole prophylaxis, and to examine
which factors are associated with intervention
outcome.
Methods
Research design and methods
The study was conducted using a retrospective quantita-
tive study design with retrospective data collection,
using the registration books and follow up logs in the
PMTCT and HIV exposed infants’ follow-up units.
Study setting and participants
The study was carried out among infants enrolled to
HIV exposed infants follow up program in Zewuditu
Memorial and Yekatit 12 Hospitals, in Addis Ababa, the
capital of Ethiopia. The total population of Addis Ababa
is 3 million, accounting for 3.7% of the country’s popu-
lation [8]. Zewuditu memorial and Yekatit 12 hospitals
serve patients with referral slips from all over the coun-
try. However, HIV exposed infants mainly come from
Addis Ababa or, to some extent, from the surrounding
districts. The source populations for this particular
study were infants who had been enrolled to HIV
exposed infants follow up in the facility. The study
population included the cohort of HIV exposed infants
who were delivered between October 2008 and August
2009 in the two hospitals, and not suffering from any
other known severe illness. 131 HIV exposed infants
were delivered during the given period of time. Thirteen
infants were found to lack a complete record about
required variables, and were therefore excluded. The
final study sample consisted of 118 HIV exposed infants.
Data collection approach and instrument
The data collection was conducted from February 15 to
March 5, 2010 within the specialized referral hospitals
of Zewuditu memorial and Yekatit 12 Hospitals in
Addis Ababa, Ethiopia. Information regarding treatment
adherence during their first 6 months of age was col-
lected from registration books (see below). At the last
follow up visit, the sixth month of infants’ treatment
adherence and the first 6 months follow up compliance
were observed from the follow up registration books
during the data collection period at both referral hospi-
tals. The main source of information for this particular
study was the registration book for the HIV exposed
infants follow-up. PMTCT pregnant mothers’ registra-
tion log books were also investigated regarding the
infant mother’s socio-demographic data (age, current
marital status, number of children she have, occupation,
educational status, her partner live and HIV status) as
well as her enrolment for care and support within the
hospital.
Some of the infants mothers were interviewed via tele-
phone by hospital nurses to complete some missing
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socio-demographic variables include age, current marital
status, educational status, occupational status and the
number of children she has. A structured template was
prepared to collect the relevant information from the
registration books. Two clinical nurses in each specia-
lized referral hospital supported the principal investiga-
tor in the process of collecting relevant information
about the HIV exposed infant-mother pair from the
registration books.
Data analysis and processing
All data analyses were performed using Statistical Pack-
age for Social Science (SPSS window version 15.0). Fre-
quency distribution of socio-demographic and economic
variables of HIV exposed infants and their mothers’ pair
and some socio-demographic variables of infant’s father
are presented. Cross tabulation and chi-square test was
performed in order to compare and determine the differ-
ences in predictors among treatment adherent and non-
adherent HIV exposed infants. In a first step, we used chi
square/fisher’s test to look for difference in the distribu-
tion between groups. If chi square indicated significant
difference in distribution between the two groups, a
logistic regression were performed to further explore the
relationship between co-trimoxazole treatment adher-
ence and socio-demographic factors. Unadjusted as well
as adjusted models were tested. The adjusted models
included potential confounders such as mothers’ age,
education, occupation, mother’s enrollment for HIV/
ART care and the place where mother’s enrolled for
HIV/ART care. Statistical tests was determined and
interpreted for statistical significance with p-values <
0.05 considered significant. Odds ratios are presented
with corresponding 95% confidence intervals. The sum-
marized results are presented using tables and graphs.
Operational definitions
Adherence for co-trimoxazole prophylaxis
A child is said to be adherent if he/she missed no more
than three doses (took more than 95% of the prescribed
doses correctly) for 1 month prior to the study. Children
who were lost to follow up were also considered as non-
adherent to co-trimoxazole treatment.
Follow-up compliance
HIV exposed infants who were enrolled to follow up
unit at any time of the first 6 months of their age in the
given time duration and followed the remaining visits
regularly were defined as compliant.
Infants’ antiretroviral prophylactic treatment uptake
An infant having single dose NVP at birth and AZT for
7 days.
HIV-concordant couples
Both mother and father of the child having the same
HIV test result, either HIV positive or negative. (In this
particular study it means that both couples should be
HIV positive to fulfil the definition, since all included
mothers were HIV positive).
HIV-discordant couples
Mother and father of the child having different HIV test
results (in this case meaning that the infant’s mother is
HIV positive and father is HIV negative)
Ethical Considerations
Ethical approval was secured from Addis Ababa City
Administration Health Bureau and Zewuditu memorial
and Yekatit 12 specialized hospitals. The study was
strictly followed “the international principles of research
ethics outlined in the world medical association’s
Declaration of Helsinki (2004)”.
Findings
Socio-demographic and economic characteristics
Socio demographic characteristics of the 118 HIV
exposed infants and their parents who were included in
the study presented in Table 1. Figure 1
Distribution of potential predictors among adherent and
non-adherent groups
Differences in distribution of potential predictors
between adherent and non-adherent groups were
explored using chi-square test. Some variables such as
ARV prophylaxis taken by infants at birth, infants’
mothers’ place of enrolment for their HIV/ART care
and infants with their fathers who were tested for HIV
were found to be associated with adherence of recom-
mended treatment for co-trimoxazole prophylaxis
(Table 2).
Other factors including infants’ sex, age of enrollment,
place where the infant was referred from, age of mother,
educational & occupational status of mother, mothers
HIV/ART care enrollment, number of children a mother
have and mothers who provided PMTCT were not
found to be associated with adherence.
Factors associated with infants’ treatment adherence
Some variables were found to be significantly asso-
ciated with adherence of recommended treatment for
co-trimoxazole prophylaxis after controlling for poten-
tial confounders (Table 3). Significantly increased OR’s
for adherence were found for children who received
ARV prophylaxis at birth, whose mothers were
enrolled for care in the facility, and who had HIV con-
cordant parents, i.e. both mother and father were HIV
positive.
A greater proportion of infants were found to be
adherent with treatment among children whose mothers
had primary or secondary education; 42.4% and 41%
respectively, compared to only 6% among children
whose mother were unable to read and write. However,
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mothers’ education was not found to be significantly
associated with adherence.
Discussion
Studies have shown that ARV treatment uptake at birth
and follow up compliance with recommended treatment
among infants and children, especially in resource lim-
ited countries, are faced with tremendous challenges
[9-11]. In this study, HIV exposed infants ARV prophy-
laxis uptake at birth found to be 91%. This is high com-
pared to similar studies conducted in Zimbabwe and
Uganda, where ARV prophylaxis uptake was found to
be 31% and 84.8% respectively [9,12]. Possible reasons
for better ARV treatment uptake among HIV exposed
infants in our study might be that Ethiopia has an inte-
grated and comprehensive care and follow up program,
as well as an improved service quality in Addis Ababa
health facilities. A further reason could be an increased
awareness about the importance of PMTCT intervention
among infants’ parents.
Even though a great proportion of infants had
received ARV prophylaxis at birth, about 31% of them
were eventually lost to follow up and their co-trimoxa-
zole treatment had been interrupted. One of the reasons
for this could be that the infants’ mothers were being
faced with various difficulties while following a specific
care program laid out for the child, and perhaps a fear
that treatment in the facility would lead to stigmatiza-
tion and discrimination by the community or their part-
ners. Another reason might be that when the infants’
first PCR/DNA HIV test result (at 45 days of age) is
negative, the mother may decide that it is not necessary
to continue follow up further, or may change their
address without informing the facility. A further reason
could be lack of charge free co-trimoxazole drug supply
in the stock of the facility, so treatment cannot be pro-
vided regularly without interruption. A similar study
Table 1 Socio-Demographic characteristics of HIV
exposed infants, their mothers and fathers in Addis
Ababa, Ethiopia (n = 118), March 2010
VariablesFrequency(percentage)
Sex of the Infant
Boy65(55.1)
Girl53(44.9)
Infants age of enrollment
At 6 weeks 99(83.9)
After 6 weeks19(16.1)
Infants Received ARV prophylaxis at birth
Yes 107(90.7)
No11(9.3)
Infants feeding practice
Exclusive Breast feeding 52(44.1)
Replacement feeding61(51.7)
Mixed feeding5(4.2)
Infants PCR/DNA HIV test result
Negative 110(93.2)
Positive5(4.2)
Unknown3(2.5)
Age of the mother (Mean = 28.15)
< 2522(18.6)
25-2832(27.1)
28-3134(28.8)
> = 3130(25.4)
Marital status of the mother
Married73(61.9)
Unmarried29(24.6)
Divorced 10(8.5)
Widowed6(5.1)
Educational status of the mother
Unable to read and write8(6.8)
Primary education 1-850(42.4)
Secondary education 9-12 51(43.2)
Diploma and above9(7.6)
Occupational status of mother
Employed 11(9.3)
Self employed28(23.7)
Unemployed79(66.9)
Number of children a mother have
1-237(31.4)
3-581(68.6)
Mother enrolled in HIV/ART care
Yes 105(89)
No 13(11)
Where the mother enrolled for care
In the facility86(72.9)
Out of the facility11(9.3)
Table 1 Socio-Demographic characteristics of HIV
exposed infants, their mothers and fathers in Addis
Ababa, Ethiopia (n = 118), March 2010 (Continued)
Unknown21(17.8)
Primary Care taker
Biological 115(97.5)
Non-Biological3(2.5)
Father HIV status
Positive62(52.5)
Negative 20(16.9)
Unknown 36(30.5)
Father live status
Alive113(95.8)
Dead5(4.2)
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conducted in Uganda indicated that 53% of mother-
infant pairs were lost-to-follow up (LTFU) [12]. The
major possible reasons discussed in this study were lack
of awareness about the importance of follow up among
the mothers, risk of death and lack of male partner
involvement through the ongoing care and treatment
package being implemented in the facility [12,13].
Despite a large uncertainty in the estimation, our
study indicated that enrollment of mothers in HIV/ART
care and support in the same facility where HIV
exposed infants attend their regular follow up was asso-
ciated with 14 times higher odds for infants to adhere
with treatment, compared to enrollment in “unknown”
facility (95% CI, 2.6, 75.4). A very recent study con-
ducted in Abidjan Cote d’Ivoire has shown that HIV
exposed infants’ mothers’ enrollment in care through
family-focused model of HIV care in the facility
increased infants’ treatment follow-up compliance. In
addition, this program was found to be successful in
promoting the involvement of male partners and other
family members in HIV care, as the program was
addressing the needs of all individuals in the family [14].
As indicated in our study results, infants whose fathers
were tested for HIV with known result, mainly concor-
dant with mothers’, were found to be 3 times higher
odds for infants to adhere with treatment than those
who didn’t know their HIV status (95% CI, 1.0, 9.0). A
recent similar study conducted in Zimbabwe indicated
that male partners’ involvement in HIV testing is very
low, which may affect the PMTCT and voluntary
Figure 1 HIV Exposed Infants Age of Enrollment versus Follow up Compliance in Addis Ababa, Ethiopia March 2010.
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counseling and testing (VCT) service uptake among HIV
positive pregnant mothers and, subsequently, their HIV
exposed infants [9].
Regarding infants PCR/DNA HIV test outcome at
their age of sixth week, 93% of HIV exposed infants in
our study found to be HIV negative. Hence, among the
cohort of HIV exposed infants only 4% were found to
be HIV positive during their sixth week PCR/DNA test
and the remaining 3% were with unknown HIV test out-
come. The relatively low number of HIV infected infants
in our study could be due to enhanced access to services
among HIV infected mother-infant pair and the effec-
tiveness of PMTCT intervention during pregnancy,
intra-partum and post-natal period with all other com-
prehensive PMTCT intervention packages. In resource-
rich settings, the risk of HIV transmission from HIV
infected pregnant mother-to-infants has already declined
to less than 2%, due to good access of comprehensive
PMTCT package for infants [15-17]. Other studies con-
ducted in various countries of Africa have shown that
HIV test result disclosure and male-partners involve-
ment on HIV/AIDS prevention, care and support pack-
age through community mobilization and behavioral
change communication, promoted both the HIV
exposed infant-mother pairs PMTCT intervention
uptake as well as adherence with prophylactic treatment
[18-20].
In this study, infants’ treatment and follow-up adher-
ence was assessed along with their parents’ socio-demo-
graphic and health care utilization characteristics to
determine the main predictors associated with treatment
Table 2 Differences in co-trimoxazole treatment adherence among HIV exposed infants through various categorical
variables (n = 118), March, 2010
Variables Adherent n(%)Non-adherent n(%)Chi-Square (c2) tests valueDfP-value
Infant Received ARV prophylaxis at birth
Yes63(95.5) 44(84.6) 4.041
f0.04
No 3(4.5)8(15.4)
Infant feeding practice
Exclusive breast feeding37(56.1)15(28.8)10.3 2
L0.006
Replacement feeding28(42.4) 33(63.5)
Mixed feeding 1(1.5) 4(7.7)
Current marital status of the mother
Married37(56.1)36(69.2)2.141 0.14
Unmarried29(43.9) 16(30.8)
Where the mother enrolled for care
In the facility 56(84.8)30(57.7) 14.542 0.001
Out of the facility 6(9.1)5(9.6)
Unknown4(6.1)17(32.7)
Number of children the mother has
1-225(37.9)12(23.1) 2.9610.08
3-5 41(62.1) 40(76.9)
Father HIV status
Positive39(59)23(44) 6.132 0.04
Negative13(20) 7(14)
Unknown 14(21)22(42)
Df = degree of freedom;f= fisher’s exact test;L= Likelihood ratio
Table 3 Independent predictors of adherence to co-
trimoxazole prophylaxis among cohort of HIV exposed
infants Addis Ababa, Ethiopia [n = 118], March, 2010
VariablescORa(95% CI) aORb(95% CI)
Infant Received ARV prophylaxis at birth
Yes3.8(1.0, 15.2) * 9.4(1.2, 72.9)
No11
Where the mother enrolled for care
In the facility 7.9(2.5, 25.7)*14(2.6, 75.4)
Out of the facility 5.10(1.02, 25.54)7.1(0.9, 60)
Unknown11
Father’s HIV status
Positive (concordant)2.5(1.1, 6.2) *3.0(1.0, 9.0)
Negative(discordant) 2.9(0.9, 9.1)3.5(0.8, 14.6)
Unknown11
cORa= Crude Odds Ratio, aORb= Adjusted Odds; CI = Confidence Interval; * P-
value < 0.05
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and follow up adherence, using chi-square test and
unadjusted and adjusted logistic regression analyses.
The reason for using adjusted analyses was to explore
the effects of various predictors on the outcome, after
controlling for potential confounding factors.
Limitations and strengths
We have faced some limitations while conducting and
analyzing this study. Several subjects were lacking a
complete record of required variables in the data source,
which hampered the size of our study sample and led to
large statistical uncertainty. Another limitation with this
study was that infants’ adherence for treatment through
both hospitals was determined using a record that was
completed by health providers based on the information
provided by infants’ mothers, and by searching the fol-
low up compliance of infants based on their appoint-
ment dates. The information gathered from infants’
mothers may not be perfectly valid, and the prevalence
of adherence might hence have been overestimated. If
the subjects had been directly interviewed and if clinical
markers had been applied, the information about
infants’ treatment adherence may perhaps have been
more accurate.
Despite the limitations identified and explained, this
study has several strengths. As there is no adequate
study about HIV exposed infants follow up and prophy-
lactic treatment compliance, especially in Ethiopia, it
adds some valuable information. The findings of this
study provide additional information about the process
of HIV exposed infants’ service provision and follow up.
Therefore, this study contributes to the HIV exposed
infants follow-up guidelines of the country, since no
such investigations have been performed so far in the
country despite it being an area with many challenges
shared by other sub-Sahara Africa countries [11]. The
study also provides a good opportunity to give feedback
on the experience and trend of the HIV exposed infants’
follow-up in the facility, which is important for further
planning and evidence-based decision making.
Conclusion
The proportion of ARV prophylaxis uptake among the
cohort of HIV exposed infants in Addis Ababa included
in this study was found to be high. However, a great
number of infants were found to be lost to follow up.
ARV prophylaxis at birth, place of mothers’ enrollment
for care, and fathers’ HIV status were significantly asso-
ciated with treatment adherence among children,
although the precision in the estimated OR’s were low.
Finally we recommend a further large-scale study to
explore the challenges related to the follow-up of HIV
exposed infants.
Acknowledgements
We would like to extend our appreciation to Lund University for providing
all technical support through out of the whole process of this study. Our
heartfelt appreciation and thanks also goes to Addis Ababa Regional Health
Bureau for assisting us with necessary information and facilitating condition
so as our study to be performed very smoothly. We are also very grateful
and would like to extend our thanks to data collectors and all facility staffs
who have been assisted during data collection. We express our appreciation
to Michael Nixon, who worked diligently on copyediting of our manuscript.
Author details
1Master’s Programme in Public Health Faculty of Medicine Lund University
Malmö, Sweden.2Division of Laboratory medicine/Occupational and
Environmental Medicine, Lund University, Lund, Sweden.3Department of
Nursing, Bethel Medical College, Addis Ababa, Ethiopia.
Authors’ contributions
MB developed and designed the idea of study, performed the data analysis,
interpretation and wrote the manuscript. FE assisted in all stages of this
study include with the stage of design, critical data analysis, interpretation
and final review of the manuscript. AA assisted during the design of the
study, data analysis and interpretation All authors read and approved the
final manuscript.
Competing interests
The authors declare that they have no competing interests.
Received: 24 February 2011 Accepted: 27 December 2011
Published: 27 December 2011
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doi:10.1186/1756-0500-4-563
Cite this article as: Shargie et al.: Prophylactic treatment uptake and
compliance with recommended follow up among HIV exposed infants:
a retrospective study in Addis Ababa, Ethiopia. BMC Research Notes 2011
4:563.
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