Incidences and Predictors of HIV Positivity among Infants who Born from HIV Positive Mother who Have Follow Up at Two Hospitals of Southern Ethiopia, 2014

Abstract

Introduction: Despite a dramatic progress in improvements regarding infant mortality due to HIV/AIDS in the past decades, HIV/AIDS is causing a devastating impact on the world's children. Mother-to-child transmission (MTCT) is by far the largest source of HIV infection in children under the age of 15, with 90% of the cases infected during pregnancy, birth, and major share is after birth.Therefore, this study follows infants after the first test (Deoxyribonucleic acid (DNA) Polymerase Chain Reaction (PCR) testing) is negative, until the occurrences of HIV positivity and predictors associated with it in the two hospital of Southern Ethiopia. Objective: The aim was to assess the incidence, Survival experiences and predictors of HIV positivity among infants born from HIV positive mothers in two hospital of Southern Ethiopia, 2014. Methodology: Institution-Based Retrospective follow up study was conducted at Hawassa Referral and Yirgalem General Hospital from September 2000 to August 2005 E.C. Data was collected by trained BSc nurses from medical registration book of 485 exposed infants. It was entered in to EPI Info 3.5.1 and exported to SPSS version 20 for further analysis. Both Bivariate and Multiple variable Cox regression analysis were conducted to identify predictors. P-value< 0.05 was considered as level of significance. Results: Among 457 participants included under analysis contributed for 4249.4 Person Months of follow up. Cumulative and overall incidence rate of HIV positivity among infants were 19(4.16%) and 4.47/1000 PM (95% CI: 4.02-4.92) respectively.

Mother to Child HIV Transmission and Its Predictors among HIV-Exposed Infants: A Retrospective Follow-Up Study in Southwest Ethiopia

“…We documented that an infant with mixed feeding option was 5.6 times at higher risk of contracting HIV infection than infants on exclusive breast feeding counterparts. This is similar with retrospective follow up studies done in Northern [16] and Southern [5] Ethiopia that reported mixed feeding increase the hazard of HIV infection. The lower risk of HIV infection among infants practicing exclusive breast feeding was also supported in an observational study in South Africa [25], where they found out that exclusive breast feeding during the first three months of life was associated with a lower risk of HIV transmission than mixed feeding.…”

“…The incidence of MTCT in our study was also higher than the reports from studies in Northwest Ethiopia (10%) [16] and Southern Ethiopia (4.2%) [5], but lower than the national MTCT rate that was documented to be 30% [18]. The observed difference between our result and the rates reported by Tadele et al and Koye et al [5,16] of the method they use to estimate the incidence rate. To estimate the transmission rate we have used all infants diagnosed as HIV positive by DNA-PCR test as well as by the rapid antibody test as a numerator and only those infants who have a definitive HIV test result used as a denominator of this rate.…”

“…This may be due to the availability and use of highly active antiretroviral therapy for HIV infected pregnant women, delivery at health center and avoidance of breastfeeding in developed countries [11], where the coverage of such preventive approaches are still limited in resource-limited countries [19]. The incidence of MTCT in our study was also higher than the reports from studies in Northwest Ethiopia (10%) [16] and Southern Ethiopia (4.2%) [5], but lower than the national MTCT rate that was documented to be 30% [18]. The observed difference between our result and the rates reported by Tadele et al and Koye et al [5,16] of the method they use to estimate the incidence rate.…”

“…Several factors have been implicated in mother-to-child transmission (MTCT) of HIV: including high maternal HIV viral load, advanced maternal AIDS-related illness, route of delivery, mixed feeding, breastfeeding and CD4 cell counts during pregnancy [5][6][7][8]. The most effective way to tackle pediatric HIV is to reduce MTCT through early identification of HIV positive pregnant women and putting them on care and treatment [9,10].…”

“…In Ethiopia, the program for prevention of mother-to-child transmission (PMTCT) of HIV was put in place with the main goal of reducing the incidence of new HIV infections among children born to HIV-positive mothers [3]. Previous studies carried out in Northern [16] and Southern [5] Ethiopia reported a high risk of mother to child HIV transmission among exposed infants enrolled under PMTCT program. Despite marked progress to achieve zero MTCT by year 2015 [17], only 24% of people living with HIV received antiretroviral treatment (ART) regimens for preventing MTCT of HIV in 2011.…”