Infants of Human Immunodeficiency Virus Type 1-Infected Women in Rural South India

Read, Jennifer S.; Samuel, N; Parameshwari, S; Dharmarajan, Shoba; Hook, Hannah M. Van; Jacob, Mini; Junankar, Viju; Bethel, James; Yu, Eunice; Stoszek, Sonia K.

doi:10.1097/inf.0b013e3181b20ffc

Cited by 10 publications

(9 citation statements)

References 7 publications

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“…Compared to high income countries (<2%) [6,7], and reports from India (6.5%) and South Africa (5.9%) [8,9], in our study risk of MTCT was very high. This may be due to the universal use of highly active antiretroviral therapy for pregnant women, elective caesarean sections and avoidance of breastfeeding in developed countries [10].…”

Section: Discussioncontrasting

confidence: 58%

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

Koye

Zeleke

2013

BMC Public Health

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BackgroundMother-to-child transmission of HIV (MTCT) accounts for more than 90% of pediatric Acquired Immunodeficiency Syndrome (AIDS) cases. Prevention of mother to child transmission (PMTCT) programs are provided for dual benefits i.e. prevention of HIV transmission from mother to child and enrolment of infected pregnant women and their families into antiretroviral treatment (ART). This study assessed risk and predictors of HIV transmission among HIV-exposed infants on follow up at a PMTCT clinic in a referral hospital.MethodsInstitution based retrospective follow up study was carried at Gondar University referral hospital PMTCT clinic. All eligible records of HIV-exposed infants enrolled between September 2005 and July 2011 were included. A midwife nurse collected data using a structured data extraction format. Data were then entered in to EPI INFO Version 3.5.1 statistical software and analyzed by SPSS version 20.0. Both bivariate and multivariate analyses were carried out to identify associations.ResultsA total of 509 infant records were included in the analysis. The median age of infants at enrolment to follow up was 6 weeks (inter quartile range [IQR] = 2 weeks). A total of 51(10%, 95% CI: 7.8% - 13%) infants were infected with HIV. Late enrolment to the exposed infant follow up clinic (Adjusted Odds Ratio [AOR] = 2.89, 95% CI: 1.35, 6.21), rural residence (AOR = 5.05, 95% CI: 2.34, 10.9), home delivery (AOR = 2.82, 95% CI: 1.2, 6.64), absence of maternal PMTCT interventions (AOR = 5.02, 95% CI: 2.43, 10.4) and mixed infant feeding practices (AOR = 4.18, 95% CI: 1.59, 10.99) were significantly and independently associated with maternal to child transmission of HIV in this study.ConclusionsThere is a high risk of MTCT of HIV among exposed infants on follow up at the PMTCT clinic of the University of Gondar referral hospital. The findings of this study will provide valuable information for policy makers to enhance commitment and support for rural settings in the PMTCT scaling-up program.

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Section: Discussioncontrasting

confidence: 58%

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

Koye

Zeleke

2013

BMC Public Health

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“…The result of this study states the overall incidence rate of HIV infection was 4.47 /1000 PM and cumulative HIV positivity at the end of the study was 4.2%(3.97, 4.42). It was higher than study in western country (2%), but lower than the study in India (5.9%) as well study in SouthAfrica (6.9%) (11)(12)(13)(14). This may be due to universal access to PMTCT interventions in developed countries and limited access in resource limited countries as a result of lack of access, lack of awareness, quality of service and others.…”

Section: Discussionmentioning

confidence: 56%

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

Tadele¹

2014

SJPH

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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.

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“…Other studies from Pune [14,59] and Tamil Nadu [58] documented the complexities inherent in the decision making regarding infant feeding and the difficulty of adhering to exclusive breast-feeding. In the study by Read et al (2010), one-third of the mothers initiated breast-feeding and the median duration of breast-feeding was approximately 3 months.…”

Section: Resultsmentioning

confidence: 99%

Systematic review of public health research on prevention of mother-to-child transmission of HIV in India with focus on provision and utilization of cascade of PMTCT services

et al. 2012

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BackgroundIn spite of effective strategies to eliminate mother-to-child-transmission of HIV, the implementation of such strategies remains a major challenge in developing countries. In India, programs for the prevention of mother-to-child transmission (PMTCT) have been scaled up widely since 2005. However, these programs reach only a small percentage of pregnant women, and their overall effectiveness is low. Evidence-based program planning and implementation could significantly improve their effectiveness. This study sought to systematically retrieve, thematically categorize and review published research on PMTCT of HIV in India, focusing on research related to the provision and/or utilization of the cascade of services provided in a PMTCT program, in order to direct further research to enhance program implementation and effectiveness.MethodsA systematic search using MEDLINE, US National Library of Medicine Gateway system (PubMed) and ISI Web of Knowledge resulted in 1,944 abstracts, of which 167 met our inclusion criteria.ResultsA huge share of the empirical literature on PMTCT in India (N = 134) deals with epidemiological studies (N = 60). The 46 papers related to utilization/provision of the cascade of PMTCT services were mostly from the four high HIV prevalence states in southern India and from the public sector. Studies on experiences of implementing a PMTCT program (N = 20) show high rates of drop out of women in the cascade particularly prior to receiving ARV. Studies on individual components of the cascade (N = 26) show that HIV counseling and testing is acceptable and feasible. Literature on other components of the cascade - such as pregnant women’s access to ANC care, HIV infected women’s immunological assessment using CD4 testing, repeat HIV testing among pregnant women, early infant diagnosis and factors related to linking HIV infected women and children to postnatal care – is lacking.ConclusionsWhile the scale of the Indian PMTCT program is large, comprehensive understanding of the context-driven factors affecting its efficiency is lacking. Systematic and more focused public health research output is needed on the issues related to reduction of drop outs of women in the cascade, role of PMTCT programs in improving maternal and child health indicators and role of private sector in delivering PMTCT services.

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Infants of Human Immunodeficiency Virus Type 1-Infected Women in Rural South India

Cited by 10 publications

References 7 publications

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

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

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

Systematic review of public health research on prevention of mother-to-child transmission of HIV in India with focus on provision and utilization of cascade of PMTCT services

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