An assessment of the outcomes of prevention of mother-to-child transmission of HIV services in Addis Ababa, Ethiopia

Abstract

BackgroundThis article assessed maternal and neonatal outcomes amongst users of prevention of mother-to-child transmission (PMTCT) of HIV services in Addis Ababa, Ethiopia.ObjectivesThe study aimed to assess the health outcomes (antiretroviral prophylaxis versus antiretroviral treatment, CD4 counts, World Health Organization (WHO) stages of illness, other illnesses) of women who had used these services, as well as the HIV status of their babies and the infant feeding method adopted.MethodsA quantitative, cross sectional, retrospective cohort design was used. Document reviews were conducted with a sample of 384 mother-infant pairs (out of a population of 796) who had used PMTCT services.ResultsAll respondents were using prophylactic antiretrovirals or antiretroviral therapy, but some were on the wrong treatment based on their CD4 counts. The CD4 counts increased four times more for women on antiretroviral treatment than for those on prophylactic antiretrovirals. The WHO’s stages of HIV illness did not improve but deteriorated in some cases, and 52 other illnesses were recorded. Out of the 384 infants, 6.0% (n = 23) were HIV-positive. Most respondents opted for exclusive breast feeding but some used mixed feeding during the first six months of their infants’ lives, despite having received health education related to infant feeding options.ConclusionThe respondents’ improved CD4 counts were inadequate to improve their World Health Organization stages of HIV illness. Some babies received mixed feeding during the first six months of their lives and 6% of the babies were HIV-positive despite their mothers’ utilisation of PMTCT services.

HIV testing, test results and factors influencing among infants born to HIV positive mothers in public hospitals of Mekelle City, North Ethiopia: a cross-sectional study

“…The odds of overall HIV positivity of low birth-weight infants were 5.64 times higher than the normal birthweight infants. This is consistent with researches done in Arsi and Addis Ababa, Ethiopia [9,26]. The attributed risk difference could be due to the reason that the immature gastrointestinal tract in low birth weight infants might facilitate MTCT of HIV through mother's breast milk.…”

“…The observed risk difference could be due to the reason that ARV prophylaxis for exposed infants decreases vertical transmission of the virus from HIV positive mothers. This finding is in tune with studies conducted in Brazil and Ethiopia [20,25,26,30].…”

“…In the first six weeks the MTCT rate of HIV, as determined by a DNA/PCR test, was 2.3%(95% CI: 1.3, 3.8%). This was one of the lowest MTCT rates of reports compared to a cross-sectional household survey conducted [8,9,[26][27][28]. This could be attributed to the reason that almost all of our study participants gave birth in a health institution, which allowed them good access to the first six weeks of a PMTCT program.…”

“…After reviewing different literatures [8,9,25,26], a checklist developed by the authors was used to collect data regarding socio-demographic and health-related factors. Data were extracted from secondary data sources retrospectively by reviewing patient charts (both paper and electronic medical recording systems), PMTCT, antenatal, delivery, and postnatal care registration books and partographs from January-April, 2018.…”

Prevention of Mother-to-Child Transmission (PMTCT) of HIV in Iran: Situation Analysis of the Pilot Phase

“…After the treatment, the mean level of CD4 was significantly higher than before, and the level of VL was also increased. In Ethiopia [12], the mean CD4 at the time of the initiation of ART was about 302, which reached 404 after the treatment, and in Uganda [6], the median CD4 was 368.…”