scholarly journals Mother-to-Child Transmission of HIV Infection and Its Determinants among Exposed Infants on Care and Follow-Up in Dire Dawa City, Eastern Ethiopia

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Fisseha Wudineh ◽  
Bereket Damtew
Keyword(s):  
Hiv Infection ◽  
Scale Up ◽  
Hiv Positive ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Hiv Exposed Infants ◽  
Dire Dawa ◽  
Hiv Exposed ◽  
Mother To Child

Since the scale-up for prevention of mother-to-child transmission (PMTCT) services, rates of HIV infection among exposed infants have significantly declined. However, current achievements fell short of achieving the target sets. We investigated mother-to-child transmission (MTCT) of HIV infection and its determinants among HIV-exposed infants on care at Dilchora Referral Hospital in Dire Dawa City Administration. A retrospective institutional cohort study was conducted by reviewing follow-up records of HIV-exposed infants who were enrolled into care. Infants’ HIV serostatus was the outcome measure of the study. Bivariate and multivariate logistic regressions were employed to identify significant determinants. Of the 382 HIV-exposed infants enrolled into care, 60 (15.7%) became HIV positive. Rural residence (AOR: 3.29; 95% CI: 1.40, 7.22), home delivery (AOR: 3.35; 95% CI: 1.58, 8.38), infant not receiving ARV prophylaxis at birth (AOR: 5.83; 95% CI: 2.84, 11.94), mixed feeding practices (AOR: 42.21; 95% CI: 8.31, 214.38), and mother-child pairs neither receiving ARV (AOR: 4.42; 95% CI: 2.01, 9.82) were significant independent determinants of MTCT of HIV infection. Our findings suggest additional efforts to intensify scale-up of PMTCT services in rural setting and improve institutional delivery and postnatal care for HIV positive mothers and proper follow-up for HIV-exposed infants.

scholarly journals Maternal Educational Level Determine Mother-to-child Transmission of HIV Among HIV-exposed Infants in Governmental Health Facility of Bahir Dar City, Northwest Ethiopia.

2021 ◽  
Author(s):  
Minyichil Birhanu ◽  
Temesgen Ergetie ◽  
Tiwobista Tenna ◽  
Tsehayinesh Ayana ◽  
Workie Dessie ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Educational Status ◽  
Cd4 Count ◽  
Pmtct Service ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Hiv Exposed Infants ◽  
Hiv Exposed ◽  
Mother To Child

Abstract Background: Globally at the end of 2011, 3.2 million children under the age of 15 were living with HIV, among these children 91% found in Africa. In Ethiopia, one of every three children born to these women is infected with HIV. This study was done to determine mother-to-child transmission of HIV infection and its factors among HIV-exposed infants on PMTCT service. Method: An institutional-based cross-sectional study was conducted among randomly selected 423 HIV exposed infants on PMTCT service in Bahir Dar city public health facility. Data were collected through chart review by using a pre-tested and structured checklist. Data was entered into Epi-data version 3.1 and exported to SPSS version 20 for analysis. The dependent variable association with explanatory variables was determined using logistic regression. Statistical significance was considered at p-value <0.05 with 95% CI. Result: The proportion of mother-to-child transmission of HIV infection among HIV-exposed infants on PMTCT services was 9.9%. Maternal educational status (AOR=3.196; 95% CI: 1.161-8.797), ANC follow-up (AOR=5.414; 95% CI: 1.860-15.761), age of infant at HIV infection confirmed (AOR=0.088; 95% CI: 0.033-0.238), and maternal CD4 count (AOR=3.162; 95% CI: 1.295-7.720) were factors significantly associated with mother-to-child transmission of HIV.Conclusion: The overall proportion of mother-to-child transmission of HIV infection among HIV exposed infants on PMTCT service were significantly high. This was due to low maternal educational status, absence of ANC follow-up, age of the infant at HIV infection confirmed, and low maternal CD4 count. Therefore, promoting women’s education, antenatal care, age of the infant at HIV test, and maintaining maternal CD4 count should be a great concern for health policymakers and health service providers.

Factors associated with mother to child transmission of HIV despite overall low transmission rates in HIV-exposed infants in rural Kenya

2017 ◽  
Vol 28 (12) ◽  
pp. 1215-1223 ◽  
Author(s):  
Nicollate A Okoko ◽  
Kevin O Owuor ◽  
Jayne L Kulzer ◽  
George O Owino ◽  
Irene A Ogolla ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Hiv Transmission ◽  
Poor Adherence ◽  
Pmtct Service ◽  
Hiv Education ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Hiv Exposed Infants ◽  
Hiv Exposed ◽  
Mother To Child

Despite the availability of efficacious prevention of mother-to-child transmission (PMTCT) interventions and improved access to preventive services in many developing countries, vertical HIV transmission persists. A matched case–control study of HIV-exposed infants between January and June 2012 was conducted at 20 clinics in Kenya. Cases were HIV-infected infants and controls were exposed, uninfected infants. Conditional logistic regression analysis was conducted to determine characteristics associated with HIV infection. Forty-five cases and 45 controls were compared. Characteristics associated with HIV-infection included poor PMTCT service uptake such as late infant enrollment (odds ratio [OR]: 7.1, 95% confidence interval [CI]: 2.6–16.7) and poor adherence to infant prophylaxis (OR: 8.3, 95%CI: 3.2–21.4). Maternal characteristics associated with MTCT included lack of awareness of HIV status (OR: 5.6, 95%CI: 2.2–14.5), failure to access antiretroviral prophylaxis (OR: 22.2, 95%CI: 5.8–84.6), and poor adherence (OR: 8.1, 95%CI: 3.7–17.8). Lack of clinic-based HIV education (OR: 7.7, 95%CI: 2.0–25.0) and counseling (OR: 8.3, 95%CI: 2.2–33.3) were reported by mothers of cases. Poor uptake of PMTCT services and a reported absence of HIV education and counseling at the clinic were associated with MTCT. More emphasis on high-quality, comprehensive PMTCT service provision are urgently needed to minimize HIV transmission to children.

scholarly journals Mother-to-child transmission of HIV and its predictors among HIV-exposed infants at Bamenda Regional Hospital, Cameroon

2017 ◽  
Vol 6 (1) ◽  
Author(s):  
Victor N. Fondoh ◽  
Njong A. Mom
Keyword(s):  
Pregnant Women ◽  
Feeding Habits ◽  
Regional Hospital ◽  
Hiv Positive ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Public Health Burden ◽  
Hiv Exposed Infants ◽  
Hiv Exposed ◽  
Mother To Child

Background: Mother-to-child transmission (MTCT) of HIV, has been a major global public health burden. Despite the use of antiretroviral prophylaxis by HIV-positive pregnant women and their infants, safe obstetric practice and safe infant feeding habits in the prevention of MTCT of HIV, the prevalence of HIV among HIV-exposed infants is still high in Cameroon.Objective: Our objectives were to determine the prevalence, assess the predictors and determine the effect of combination antiretroviral therapy (cART) on MTCT of HIV at the regional hospital in Bamenda, Cameroon.Methods: This was a retrospective study. Secondary data from 877 HIV-exposed infants aged ≤ 72 weeks were extracted from the records between January 2008 and December 2014. The predictors and effect of cART on MTCT of HIV were analysed using a multivariable logistic regression model and risk analysis, respectively.Results: Out of 877 HIV-exposed infants, 62 were positive for HIV, giving a prevalence of 7.1%. Maternal antiretroviral intervention and infant age group were statistically significant predictors of MTCT of HIV. HIV-positive mothers who were on cART were 2.49 times less likely to transmit HIV than those who were not on cART.Conclusion: In order to reduce the prevalence of HIV among HIV-exposed infants, maternal antiretroviral intervention should be targeted and the use of cART by HIV-positive pregnant women should be encouraged.

scholarly journals Epidemiology of HIV Infection Among HIV-Exposed Infants, Nairobi County, Kenya, 2015

2020 ◽  
Vol 13 ◽  
pp. 117863372094886
Author(s):  
Anthony B Kiplagat ◽  
Carol Ngunu ◽  
Elvis Oyugi ◽  
James Ransom
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Turnaround Time ◽  
Hiv Positive ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Public Health Action ◽  
Hiv Exposed Infants ◽  
Hiv Exposed ◽  
Mother To Child

Objective: To characterize human immunodeficiency virus (HIV)-positive infants among HIV-exposed infants (HEIs) in Nairobi County for public health action. Methods: We conducted a retrospective review of records of HEIs’ HIV polymerase chain reaction (PCR) results in Nairobi County in 2015, excluding confirmatory PCR-positive results. HIV-exposed infant registry data were entered into Microsoft Excel and descriptive and associative statistics were calculated with OpenEpi software. Results: A total of 5802 HEI records were analyzed, with a median age of 4.5 (interquartile range, 8.5) months; 342 (5.9%) tested positive, 51% were female, and 4420 (76.2%) were seen at maternal and child health clinics. Standard highly active antiretroviral therapy intervention was given to 184 (60.3%) of the mothers of exposed infants, and 178 (53%) of the HIV-positive infants received active antiretroviral therapy. A total of 3464 (59.7%) HEIs had PCR done within the first 2 months, and 119 (3.4%) tested positive. The average turnaround time for PCR samples was 28 ± 22 days, and a total of 191 (3.3%) HIV-positive HEIs were exclusively breastfed for the first 6 months of life. Conclusion: The recorded mother-to-child transmission (MTCT) rate of 5.9% in Nairobi County is lower than the 2015 national rate, which suggests the Nairobi prevention of mother-to-child transmission efforts are moderately effective. However, results from this study show that Kenya will struggle to meet the MTCT 2020 target rate of <5%.

HIV/AIDS and Children

2021 ◽  
pp. 376-380
Author(s):  
Chandrashekhara Chandrashekhara ◽  
Sandeepkumar O
Keyword(s):  
Sexual Abuse ◽  
Hiv Infection ◽  
Vertical Transmission ◽  
Hiv Positive ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Mother To Child ◽  
Hiv Aids

Children are innocent victims of HIV infection through vertical transmission. Children who are HIV positive, either through mother-to-child transmission or following sexual abuse, are often not told what could happen to them, and they will certainly be frightened when they experience symptoms.

scholarly journals Measuring retention in care for HIV-positive pregnant women in Prevention of Mother-to-Child Transmission of HIV (PMTCT) option B+ programs: the Mozambique experience

2020 ◽  
Author(s):  
Laurence Ahoua ◽  
Shino Arikawa ◽  
Thierry Tiendrebeogo ◽  
Maria Laheurta ◽  
Dario Aly ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Retention In Care ◽  
Retention Rates ◽  
Hiv Positive ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Appointment Adherence ◽  
Art Initiation ◽  
Mother To Child

Abstract Background : Failure to retain HIV-positive pregnant women on antiretroviral therapy (ART) leads to increased mortality for the mother and her child. This study evaluated different retention measures for women’s engagement along the continuum of care for prevention of mother-to-child transmission (PMTCT) option B+ services in Mozambique. Methods : We compared ‘point’ retention (patient’s presence in care 12-month post-ART initiation or any time thereafter) with the following definitions: alive and in care 12 month post-ART initiation (Ministry of Health; MOH); attendance at a health facility up to 15-month post-ART initiation (World Health Organization; WHO); alive and in treatment at 1-, 2-, 3-, 6-, 9-, and 12-month post-ART initiation (Inter-Agency Task Team; IATT); and alive and in care 12-month post-ART initiation with ≥75% appointment adherence during follow-up (i.e. ‘appointment adherence’ retention) or with ≥75% of appointments met on time during follow-up (i.e. ‘on-time adherence’ retention). Kaplan-Meier survival curves were produced to assess variability in retention rates. We used ‘on-time adherence’ retention as our reference to estimate sensitivity, specificity, and proportion of misclassified patients. Results : Considering the ‘point’ retention definition, 16,840 HIV-positive pregnant women enrolled in option B+ PMTCT services were identified as ‘retained in care’ 12-month post-ART initiation. Of these, 60.3% (95% CI 59.6–61.1), 84.8% (95% CI 84.2–85.3), and 16.4% (95% CI 15.8–17.0) were classified as ‘retained in care’ using MOH, WHO, and IATT definitions, respectively, and 1.2% (95% CI 1.0–1.4) were classified as ‘retained in care’ using the ‘≥75% on-time adherence’ definition. All definitions provided specificity rates of ≥98%. The sensitivity rates were 3.0% with 78% of patients misclassified according to the WHO definition and 4.3% with 54% of patients misclassified according to the MOH definition. The ‘point’ retention definition misclassified 97.6% of patients. Using IATT and ‘appointment adherence’ retention definitions, sensitivity rates (9.0% and 11.7%, respectively) were also low; however, the proportion of misclassified patients was smaller (15.9% and 18.3%, respectively). Conclusion : More stringent definitions indicated lower retention rates for PMTCT programs. Policy makers and program managers should include attendance at follow-up visits when measuring retention in care to better guide planning, scale-up, and monitoring of interventions.

scholarly journals Measuring retention in care for HIV-positive pregnant women in Prevention of Mother-to-Child Transmission of HIV (PMTCT) option B+ programmes: the Mozambique experience

2019 ◽  
Author(s):  
Laurence Ahoua ◽  
Thierry Tiendrebeogo ◽  
Shino Arikawa ◽  
Maria Laheurta ◽  
Dario Aly ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Retention In Care ◽  
Retention Rates ◽  
Hiv Positive ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Appointment Adherence ◽  
Art Initiation ◽  
Mother To Child

Abstract Background Failure of retention of HIV-positive pregnant women on ART leads to increased mortality for the mother and her child. This study evaluated different retention measures intended to measure women’s engagement along the continuum of care for prevention of mother-to-child transmission (PMTCT) option B+ services in Mozambique. Methods We compared ‘point’ retention (patient’s presence in care at 12-months post-antiretroviral treatment (ART) initiation or any time thereafter) to the following definitions: alive and in care at 12 months post-ART initiation (Ministry of Health); attendance at a health facility up to 15 months post-ART initiation (World Health Organisation); alive and in treatment at 1, 2, 3, 6, 9, and 12 months post-ART initiation (Inter-Agency Task Team); and alive and in care at 12 months post-ART initiation with ≥75% appointment or on-time adherence during follow-up (‘appointment adherence’ and ‘on-time adherence’ retentions). Kaplan-Meier survival curves were produced to assess variability in retention rates. We used ‘on-time adherence’ retention as a gold standard to estimate sensitivity, specificity, and proportion of misclassified patients. Results Considering the ‘point’ retention definition, 16,840 HIV-positive pregnant women enrolled in option B+ PMTCT services were identified as ‘retained in care’ 12 months post-ART initiation. Of these, 60.3% (95% CI 59.6–61.1), 84.8% (95% CI 84.2–85.3), and 16.4% (95% CI 15.8–17.0) were classified as ‘retained in care’ using MOH, WHO, and IATT definitions, respectively, and 1.2% (95% CI 1.0–1.4) were classified as ‘retained in care’ using the ‘ ≥75% on-time adherence’ definition. All definitions provided specificity rates of ≥98%. The sensitivity rates were 3.0% with 78% of patients misclassified according to the WHO definition and 4.3% with 54% of patients misclassified according to the MOH definition. The ‘point’ retention definition misclassified 97.6% of patients. Using IATT and ‘appointment adherence’ retention definitions, sensitivity rates (9.0% and 11.7%, respectively) were also low; however, the proportion of misclassified patients was smaller (15.9% and 18.3%, respectively). Conclusion More stringent definitions indicated lower retention rates for PMTCT programmes. Policy makers and programme managers should include attendance at follow-up visits when measuring retention in care to better guide planning, scaling up, and monitoring of interventions.

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