scholarly journals Mother-to-child transmission of HIV and its predictors among HIV-exposed infants at a PMTCT clinic in northwest Ethiopia

2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Digsu Negese Koye ◽  
Berihun Megabiaw Zeleke
2017 ◽  
Vol 28 (12) ◽  
pp. 1215-1223 ◽  
Author(s):  
Nicollate A Okoko ◽  
Kevin O Owuor ◽  
Jayne L Kulzer ◽  
George O Owino ◽  
Irene A Ogolla ◽  
...  

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.


2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Fisseha Wudineh ◽  
Bereket Damtew

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.


2020 ◽  
Vol 9 (3) ◽  
pp. 320-329
Author(s):  
Anays Murillo ◽  
Mary Bachman DeSilva ◽  
Lora L. Sabin ◽  
Nafisa Halim ◽  
Harriet Chemusto ◽  
...  

Background: Uganda has successfully reduced pediatric HIV infections through prevention of mother-to-child transmission of HIV (PMTCT) programs, yet little is known about adherence to infant-specific components of interventions. We hypothesized that infants born to mothers receiving the WiseMama (WM) electronic drug monitoring (EDM)-based adherence intervention would have increased uptake of six-week post-natal nevirapine (NVP) infant prophylaxis and better adherence to six-week early infant diagnosis (EID) HIV testing. Methods: At two sites in Uganda, the Wise Infant Study (WIN) prospectively followed an infant cohort. Infants were born to women enrolled in an RCT testing the effect of real-time reminders delivered via EDM on maternal adherence to antiretroviral therapy. We assessed intrapartum and discharge receipt of NVP prophylaxis using pharmacy and infant HIV DNA testing laboratory data. Results: Of 121 women eligible for WIN, 97 (80%) consented and enrolled; 46 had been randomized to control and 51 to intervention. There were no differences in receipt of a six-week NVP supply (control 87%, intervention 82%, p = 0.53). Receipt of any NVP prophylaxis did not vary by delivery location (p = 0.35), and although 12% of infants were delivered at non-study health facilities, they were not less likely to receive NVP at discharge (p = 0.37). Among infants with a completed HIV test, there was no difference in mean time to first test (control 52 days (SD 18), intervention 51 days (SD 15), p = 0.86). Only one infant, in the control group, tested positive for HIV. Conclusion and Global Health Implications: We found no significant differences in adherence to infant PMTCT practices between intervention and control infants with relatively high rates of NVP receipt albeit with suboptimal adherence to six-week EID testing. Further work is needed to ensure improved access, uptake, and follow-up of HIV-exposed infants in the Option B+ era. Key words: • Prevention of maternal to child transmission of HIV • HIV • Nevirapine • Antiretroviral therapy prophylaxis • Early infant diagnosis • HIV-exposed infants   Copyright © 2020 Murillo et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.


Author(s):  
Victor N. Fondoh ◽  
Njong A. Mom

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.


2020 ◽  
Vol 13 ◽  
pp. 117863372094886
Author(s):  
Anthony B Kiplagat ◽  
Carol Ngunu ◽  
Elvis Oyugi ◽  
James Ransom

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%.


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