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The problem
Intervention: Participation in the African Cohort Study (AFRICOS), an integrated multicountry preventative PMTCT program providing prospective follow-up, linkage to PMTCT services, and monitoring of pregnant women living with HIV and their infants
Who it was tested with: HIV-infected women from 5 African regions (5,591 pregnancies; 228 prospectively followed from enrollment).
The same group is measured before the intervention and again afterwards, with a baseline and an endline and sometimes a midline. Change is visible, but other causes cannot be ruled out.
"HIV infected women from 5 regions of Africa enrolled in the African Cohort Study (AFRICOS) were followed prospectively with assessments performed every 6 months. Sociodemographic factors, pregnancy outcomes, and access of PMTCT resources were reviewed for retrospectively reported pregnancies and those followed prospectively from study enrollment." This design allowed comparison of PMTCT service access and clinical outcomes between cohort participants receiving prospective support versus historical data from the same population.
The study has substantially more retrospectively reported than prospectively followed pregnancies, introducing recall bias. The retrospective design for the majority of cases limits causal inference. Comparison groups differ in study design rather than random assignment, affecting comparability.
Across countries and designs
1 study · 5 countries
