scholarly journals An audit of mother to child HIV transmission rates and neonatal outcomes at a tertiary hospital in South Africa

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Ghad Benali ◽  
Tanusha Ramdin ◽  
Daynia Ballot
Keyword(s):  
South Africa ◽  
Birth Weight ◽  
Hiv Transmission ◽  
Tertiary Hospital ◽  
Academic Hospital ◽  
Child Transmission ◽  
Transmission Rates ◽  
Hiv Exposure ◽  
Hiv Exposed ◽  
Mother To Child

Abstract Objective The aim of this study was to explore the prevalence of congenital HIV infection of neonates at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) between 2015 and 2017, as well as compare the HIV PCR positive and HIV PCR negative neonates. Results A total number of 1443 HIV exposed neonates was examined for the study period out of a total of 5029 admissions (HIV exposure 28.6%) The study found that the rate of HIV transmission at birth was 2.52%. The majority of infants had low birth weight and were also born prematurely. These results show that, despite the introduction of the extended mother to child transmission programme, HIV transmission is high.

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 Growth of HIV-exposed infants from birth to 6 months in the prevention of mother-to-child transmission program

2019 ◽  
Vol 59 (4) ◽  
pp. 183-7
Author(s):  
Maria Priskila ◽  
Ketut Dewi Kumarawati ◽  
Ni Putu Siadi Purniti
Keyword(s):  
Birth Weight ◽  
Hiv Infection ◽  
Distributed Data ◽  
Pmtct Program ◽  
Child Transmission ◽  
Post Hoc Analysis ◽  
Hiv Exposed Infants ◽  
Hiv Exposed ◽  
Post Hoc ◽  
Mother To Child

Background Human immunodeficiency virus (HIV) infection is a global health issue. Most cases of HIV infection in children are acquired through transmission from HIV-infected mothers. Maternal HIV infection affects infant  growth. Objective To evaluate the first six months of growth in HIV-exposed infants born to mothers in the prevention of mother-to-child transmission (PMTCT) program. Methods This prospective cohort study was done in 40 HIV-exposed infants born in Sanglah General Hospital, Bali. Subjects’ underwent weight and length measurements at birth and monthly for 6 months. Data analyses used were repeated ANOVA test with Bonferonni post-hoc analysis for normally distributed data and Friedman test with Wilcoxon post-hoc analysis for abnormally distributed data. Correlations between birth weight and length to weight and length at 6 months of age were analyzed with Spearman’s test. Results Subjects’ mean birth weight was 2,900 (SD 546) grams and median birth length was 48 (range 36-52) cm. Subjects’ body weight and length increased monthly throughout the measurement period (P<0.001). There was a strong negative correlation between birth weight and infant weight gain at 6 months of age (r=-0.678), and a moderate negative correlation between birth length and infant length gain at 6 months of age (r=-0.564). Conclusion HIV-exposed infants born to mothers in the PMTCT program have a significant body weight and body length growth in the first 6 months of life, and followed general WHO weight and length curves for age.

scholarly journals Comparison of the Effects of Quality Improvement Strategies on Prevention of Mother-to-Child HIV Transmission in a Public and a Private Hospital in Lesotho

2019 ◽  
Vol 18 ◽  
pp. 232595821986930
Author(s):  
Kelello L. M. Lerotholi ◽  
Manone Rantekoa ◽  
Khotso G. Mahlalefa ◽  
Lerato Hlehlisi ◽  
Aurora O. Amoah
Keyword(s):  
Quality Improvement ◽  
Private Hospital ◽  
Hiv Transmission ◽  
Hiv Positive ◽  
Child Transmission ◽  
Routine Service ◽  
Hiv Positive Mothers ◽  
Hiv Exposed ◽  
Mother To Child ◽  
Positive Results

We compared quality improvement (QI) interventions for prevention of mother-to-child transmission in a private hospital and a government hospital (GH). From November 2013 to October 2016, data were extracted retrospectively for HIV-positive mothers and HIV-exposed infants. The overall number of mother–baby pairs (MBPs) was significantly ( P < .001) higher at the GH (mean = 294, standard deviation [SD] = 180) than the private hospital (mean = 72, SD = 27). There was a significantly higher number of MBPs receiving care ( P < .001) and routine services ( P < .001) at the GH. The proportion of MBPs retained in care ( P < .001) and receiving the routine service package ( P < .001) was significantly higher at the private hospital. Overtime, indicators at the private hospital peaked significantly in year 2 and reduced moderately in the final year. The trend for the GH showed gradual but nonsignificant improvement in 2 indicators. QI showed positive results in the private hospital. If systematically applied in GHs, QI can support improved services for larger patient volumes.

scholarly journals HIV transmission and retention in care among HIV-exposed children enrolled in Malawi's prevention of mother-to-child transmission programme

2017 ◽  
Vol 20 (1) ◽  
pp. 21947 ◽  
Author(s):  
Andreas D. Haas ◽  
Joep J. van Oosterhout ◽  
Lyson Tenthani ◽  
Andreas Jahn ◽  
Marcel Zwahlen ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Retention In Care ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Hiv Exposed ◽  
Mother To Child

scholarly journals Features of the Neonatal Period in Perinatally HIV-Exposed Children Receiving Combined Сhemoprophylaxis of mother-to-child Transmission of HIV

2021 ◽  
Vol 6 (6-2) ◽  
pp. 92-102
Author(s):  
A. S. Vanyarkina ◽  
A. G. Petrova ◽  
L. V. Rychkova ◽  
E. V. Moskaleva ◽  
E. A. Novikova
Keyword(s):  
High Risk ◽  
Hiv Transmission ◽  
Neonatal Period ◽  
Intrauterine Infection ◽  
Hiv Positive ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Hiv Positive Women ◽  
Hiv Exposed ◽  
Mother To Child

The aim. To study the features of the course of the neonatal period in children, perinatally exposed to HIV, who receive an enhanced regimen of chemoprophylaxis of HIV mother-to-child transmission.Patients and methods. A retrospective longitudinal cohort study of mother – child pairs for the period from 2017 to 2019 was carried out. The clinical observation group included HIV-positive women with a high risk of vertical transmission of the immunodeficiency virus (n = 213) and their newborn children (n = 214), who were prescribed an enhanced chemoprophylaxis regimen of HIV transmission from mother to child. Results. According to the results of the study of HIV-positive mothers we revealed a high prevalence of secondary diseases and a high per partum viremia – 1700 (222–18342) copies/ml. 35.9 % of children were born prematurely, 27.5 % – had low birth weight by gestational age. In newborns, diseases of the respiratory (24.3 %) and nervous (17.2 %) systems prevailed. 17.2 % of children developed intrauterine infection; HIV RNA was detected in 3.7 %. Congenital malformations were observed in 7.4 % of children. Symptoms of enteropathy were noted in 24.7 % of newborns. A decrease in red blood counts was found in all children by the 28th day of life (pw < 0.001).Conclusion. The study confirms the need for increased attention and improvement of approaches to medical support of children who were perinatally exposed to high risk of vertical HIV infection.

Antiretroviral Therapy for Children and Newborns

2019 ◽  
pp. 287-296
Author(s):  
Karin Nielsen-Saines
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Hiv Transmission ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Hiv Exposure ◽  
Mother To Child ◽  
Prevention Of Hiv

Upon completion of this chapter, the reader should be able to • Understand the basics regarding pathogenesis of mother to child HIV transmission (MTCT) and be aware of landmark studies targeting prevention of HIV mother to child transmission (PMTCT). • Understand the concept of HIV-exposure versus HIV-infection....

scholarly journals Achievements and Challenges in the Prevention of Mother-to-Child Transmission of HIV—A Retrospective Cohort Study from a Rural Hospital in Northern Tanzania

2021 ◽  
Vol 18 (5) ◽  
pp. 2751
Author(s):  
Sunniva Marie Nydal ◽  
Yuda Munyaw ◽  
Johan N. Bruun ◽  
Arne Broch Brantsæter
Keyword(s):  
Hiv Infections ◽  
Rural Hospital ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Cd4 Cell Count ◽  
Poor Countries ◽  
Northern Tanzania ◽  
Increased Risk ◽  
Hiv Exposed ◽  
Mother To Child

Despite the goal of eliminating new human immunodeficiency virus (HIV) infections in children, mother-to-child transmission is still common in resource-poor countries. The aims of this study were to assess the occurrence of mother-to-child transmission of HIV (MTCT) by age 18 months, risk factors for transmission, and the implementation of the national prevention of MTCT (PMTCT) program in a rural hospital in Tanzania. Data were collated from various medical registers and records. We included 172 children and 167 HIV-infected mothers. Among 88 children (51%) with adequate information, 9 (10.2%) were infected. Increased risk of MTCT was associated with late testing of the child (>2 months) [OR = 9.5 (95% CI: 1.8–49.4)], absence of antiretroviral therapy during pregnancy [OR = 9.7 (95% CI: 2.1–46.1)], and maternal CD4 cell count <200 cells/mm3 [OR = 15.3 (95% CI: 2.1–111)]. We were unable to determine the occurrence of MTCT transmission in 84 children (49%). The results from this study highlight that there is an urgent need for enhanced efforts to improve follow-up of HIV-exposed children, to improve documentation in registries and records, and to facilitate ease of linkage between these.

scholarly journals Reasons for inpatients not to seek clarity at Dr George Mukhari Academic Hospital, Pretoria

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Langalibalele H. Mabuza ◽  
Olufemi B. Omole ◽  
Indiran Govender ◽  
John V. Ndimande
Keyword(s):  
South Africa ◽  
Prior Knowledge ◽  
Effective Communication ◽  
Self Esteem ◽  
Tertiary Hospital ◽  
Bad News ◽  
Academic Hospital ◽  
Management Plans ◽  
Clinical Conditions

Background: Healthcare practitioners should provide patients with information regarding their clinical conditions. Patients should also feel free to seek clarity on information provided. However, not all patients seek this clarity.Objectives: To explore the reasons inpatients gave for not seeking clarity on information that was received but not understood.Methods: This was a qualitative arm of a larger study, titled ‘Are inpatients aware of the admission reasons and management plans of their clinical conditions? A survey at a tertiary hospital in South Africa’, conducted in 2010. Of the 264 inpatients who participated in the larger study, we extracted the unstructured responses from those participants (n = 152) who had indicated in the questionnaire that there was information they had not understood during their encounter with healthcare practitioners, but that they had nonetheless not sought clarity.Data were analysed thematically.Results: Themes that emerged were that inpatients did not ask for clarity as they perceived healthcare practitioners to be ‘too busy’, aloof, non-communicators and sometimes uncertain about patients’ conditions. Some inpatients had unquestioning trust in healthcare practitioners,whilst others had experiences of bad treatment. Inpatients had poor self-esteem, incapacitating clinical conditions, fear of bad news and prior knowledge of their clinical conditions. Some inpatients stated that they had no reason for not seeking clarity.Conclusion: The reasons for not seeking clarity were based on patients’ experiences with the healthcare practitioners and their perceptions of the latter and of themselves. A programme should be developed in order to educate inpatients on effective communication with their healthcare practitioners.

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