Levels of adherence and factors associated with adherence to option B+ prevention of mother-to-child transmission among pregnant and lactating mothers in selected government health facilities of South Wollo Zone, Amhara Region, northeast Ethiopia, 2016

Tsegaye, Delelegn; Deribe, Leul; Wedajo, Shambel

doi:10.4178/epih.e2016043

Cited by 25 publications

(32 citation statements)

References 11 publications

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“…In Ethiopia, report that immunological treatment failure is associated with old age. 18 Furthermore, in North-West Ethiopia, each unit increase in years is associated with a 3.3% cell/mm 3 decrease in the log of change of CD4 cell count (0.0098, 0.0899); p=0.0264. 13 Patients with lower CD4 cell count at ART initiation and more advanced age (> 40 vs <40 years) demonstrate a decline in CD4 cell count from baseline to 12, 24, and 36 months of follow-up.…”

Section: Discussionmentioning

confidence: 96%

“…On the contrary, it is suggested that immunological treatment failure is associated with lower baseline CD4 count and higher educational status. 18 According to the study conducted in Addis Ababa, it is showed that women with lower CD4 count before ART initiation<200 cells/mm 3 are 0.023 times less likely to achieve good immunological outcome compared to those with CD4 count ≥200 cells/mm 3 (AOR=0.023, 95% CI= (0.003-0.190), p=0.000) among women who start HAART before or during pregnancy in a Hospital in Addis Ababa. 20…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of Antiretroviral Therapy Initiated Among Pregnant Women Under Option B+ by Viral Load and CD4 Count Outcomes in Selected Hospitals of West Shewa Zone, Oromia Region, Ethiopia

Demissie¹,

Bulto²,

Mekuria³

et al. 2020

HIV

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Background: Antiretroviral therapy (ART) is effective for the elimination of mother-to-child transmission (eMTCT) of human immunodeficiency virus (HIV) infection, reducing infant mortality and ensuring maternal virologic suppression, while pregnant women require test and treat under Option B+ programs. Therefore, the study aimed to assess the evaluation of antiretroviral therapy initiated among pregnant women under Option B+ by viral load and CD4 count outcomes in selected hospitals of West Shewa Zone, Oromia Region, Ethiopia. Methods: Hospital-based cross-sectional study design was employed to conduct the study at randomly selected hospitals providing Option B+ services with routine viral load assessment by Oromia Regional Laboratory (ORL) from January 2016 to January 2017. Bivariate and multivariable logistic regression analyses were conducted to determine factors affecting the time to ART initiation following an HIV test and logistic regression was used to determine the correlation between time and treatment outcomes. Results: The viral load suppression (VL <1000 copies/mL) was achieved in 31% and 58.7% of patients who were on ART treatment for ≤37 months and longer than 38 months, respectively. It was identified that the mean viral load and CD4 count were 197.27 and 629.17, respectively, while 85.3% of the clients had their CD4 count increased from the baseline data. The study revealed that level of ART adherence, completion of full doses, compliance on appointments, duration of the ART uptake and baseline CD4 count were independent predictors of viral load suppression for women started on option B+ and continued on lifelong ART. And this study also revealed that gestational age at ART start, maternal age in years and adherence on medication were independently associated with CD4 response among HIV pregnant women initiated for lifelong ART. Conclusion: The study results demonstrated that for 89.7% of study respondents, viral load was suppressed of which 80.3% were undetectable (VL= 0 copies/ml 3 and 85.3% had increased CD4 count). This study determined the factors associated with viral load suppression and CD4 count improvement. Therefore, these factors should be emphatically considered during Option B+ program development and training to ensure CD4 count improvement and viral load suppression achievements.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Evaluation of Antiretroviral Therapy Initiated Among Pregnant Women Under Option B+ by Viral Load and CD4 Count Outcomes in Selected Hospitals of West Shewa Zone, Oromia Region, Ethiopia

Demissie¹,

Bulto²,

Mekuria³

et al. 2020

HIV

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“…The findings of this study were similar with other studies. [28][29][30] In our study findings delivered at home were the main determinant factors for vertical transmission of HIV to their infants. During the follow-up, 73 (35.96%) infants were delivered at home; among those mothers, 16 (21.9%) infants were HIV positive that delivered at health institutions.…”

mentioning

confidence: 44%

Joint and Separate Analysis for Longitudinal and Survival Data on Mother-to-Child Transmission of HIV Among Infected Mothers on Option B+ at Health Centers in North Shewa Zone, Ethiopia, 2017

Mekuria¹,

Sisay²,

Hailegiorgies³

et al. 2020

JMDH

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Background: Prevention of mother-to-child transmission of HIV (PMTCT) is a frequently used word for programs and intervention methods to decrease the risk of mother-to-child transmission of HIV. The aim of this study was to identify determinants of the reduction of CD4 count through time and the maternal transmission of HIV to their child on the PMTCT program at health centers in North Shewa Zone, Ethiopia. Methods: The cohort study design was conducted by using secondary data collected from the cohort register of PMTCT starting from September 1, 2014 to November 30, 2017. In this study, a longitudinal study was conducted for two types of result; these were longitudinal response measurements of HIV infected women CD4 count and the time to maternal transmission of HIV taken from 203 patients. Results: The prevalence rate of HIV infection among exposed infants was 5.58%. Baseline CD4 count, visiting times, weight, and interaction between visiting time and baseline CD4 count had a statistically significant effect on the longitudinal biomarker. From the Weibull AFT model, ART start, partner test, clinical stage, educational status, place of delivery, and MUAC were statistically significant. Hence, as a measurement unit decreased in square root CD4 cell count by 1.18 elevates the risk of maternal transmission of HIV. Conclusion: In this study, the determinant of mother-to-child transmission of HIV including loss of weight, ART start (ANC), place of delivery at home, illiterate and mother with severe malnutrition, had a significant effect. The longitudinal biomarker also had a strong association with baseline CD4 and the risk of maternal transmission of HIV. Health education should be given about balanced diet, weight control, and take medication for HIV positive patients by the responsible bodies.

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“…Various PMTCT programmes use different methods for measuring adherence. However, common measures include self and proxy reports, pill counts, pharmacy refills, electronic drug monitoring, virologic markers (CD4 counts, viral loads) and blood draws for drug concentrations.On the other hand report a higher proportion of 87.1% (95% CI 82.6-90.7%) among HIV-positive pregnant women on option B+ with adequate adherence in Tigray, northern Ethiopia reports a similar percentage of 95.9% (306) among women on option B+ with good adherence compared to 12.1% (n=23) with poor adherence in Amhara region, North East Ethiopia (17). A much higher proportion of pregnant and breastfeeding women on option B+ (91.4%) have good adherence to ART (≥95% adherence) (MSPH 2015:10).…”

Section: Discussionmentioning

confidence: 93%

Assessment of Antiretroviral therapy Initiation among pregnant Women under Option B+ Approach; Viral Load and CD4 Count Outcomes in selected Hospitals of West Zone Oromia, Ethiopia: Quantitative Prospective Cohort Study Design

Demissie

et al. 2019

Preprint

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Background: Antiretroviral therapy (ART) is effective for elimination of mother-to-child transmission (eMTCT) of human immunodeficiency virus (HIV) infection, reducing infant mortality and ensuring maternal virologic suppression. While pregnant women require lifelong ART immediately they test HIV positive (“test and treat”) under Option B+ programs, eMTCT programs face challenges and information on the relationship between the time to ART initiation following HIV testing and treatment outcomes is limited in Ethiopia Methods: A quantitative prospective cohort design was employed to conduct the study. Five randomly selected Hospitals providing Option B+ services with routine viral load assessment by Oromia regional Laboratory (ORL) from January 2016 to January 2017 was randomly selected. Bivariate and multivariable analyses were conducted to determine factors affecting the time to ART initiation following an HIV test and logistic regression used to determine the correlation between time and treatment outcomes. Results: The study results produced and evidence of a mean VL (copies/ml) of 197.27 copies/ml. Respondents that were on ART for a shorter period ≤37 months had the least proportion of women 31% were suppressed with VL<1000 copies/ml compared to those on ART for >38 months (58.7%) were suppressed. The median (IQR) CD4 count change or difference among women that had initial and last CD4 was 581 cells/μl and mean of current CD4 count 629.17ceels/ml3 and more than 85.3% had increase CD4 count. Therefore, in this study identified that factors associated with viral load response were poor /fair adherence missing doses in the past month, missing appointments, baseline CD4 and maternal months on ART were statistically significant among HIV positive pregnant women that initiated lifelong ART on option B+ in Ethiopia. Conclusion: The study results demonstrated that HIV positive pregnant women Study results indicate that majority of the respondents 89.7% were suppressed of which 80.3% were undetectable (VL= 0 copies /ml3 and 85.3% had increased CD4 count and 10.3% were not suppressed (VL >1000 copies/ml). Therefore, strategies aimed at improving adherence among women on option B+ are to ensure that these women achieve adequate immunological outcomes. Keywords: ART Initiation Pregnant Women Option B +, Viral Load, CD4 Count

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Levels of adherence and factors associated with adherence to option B+ prevention of mother-to-child transmission among pregnant and lactating mothers in selected government health facilities of South Wollo Zone, Amhara Region, northeast Ethiopia, 2016

Cited by 25 publications

References 11 publications

<p>Evaluation of Antiretroviral Therapy Initiated Among Pregnant Women Under Option B+ by Viral Load and CD4 Count Outcomes in Selected Hospitals of West Shewa Zone, Oromia Region, Ethiopia</p>

<p>Evaluation of Antiretroviral Therapy Initiated Among Pregnant Women Under Option B+ by Viral Load and CD4 Count Outcomes in Selected Hospitals of West Shewa Zone, Oromia Region, Ethiopia</p>

<p>Joint and Separate Analysis for Longitudinal and Survival Data on Mother-to-Child Transmission of HIV Among Infected Mothers on Option B+ at Health Centers in North Shewa Zone, Ethiopia, 2017</p>

Assessment of Antiretroviral therapy Initiation among pregnant Women under Option B+ Approach; Viral Load and CD4 Count Outcomes in selected Hospitals of West Zone Oromia, Ethiopia: Quantitative Prospective Cohort Study Design

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