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

Abstract

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.

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

“…Accordingly infants who were born from mothers who didn't receive HAART or single dose NVP were five times more at risk of developing HIV infection than infants who were born from mother who received PMTCT intervention. This finding is consistent with studies done in North Ethiopia [16]; and other part of the glob [19,23]. This supports that interventions aimed at lowering maternal viral load during pregnancy or breast milk could substantially reduce the risk of mother to child HIV transmission.…”

“…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.…”

“…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.…”

Mother-to-Child Transmisson of HIV: An Eight-Year Experience

“…Güney Afrika'da yapılan bir çalışmada %5.9, Hindistan'da yapılan bir çalışmada ise %6.5 oranında bebeklerde HIV enfeksiyonu geliştiği rapor edilmiştir 14,15 . Etiyopya gibi Afrika ülkelerinde ise HIV ile enfekte anne bebeklerinin neredeyse onda birinde HIV enfeksiyonu görülmektedir 16,17 . Çalışmamızda bulunan %6.2 oranının da, Sağlık Bakanlığı'nın 2013 yılı için açıkladığı %0.7 oranının da ülke genelini yansıtmadığını ve anneden bebeğe perinatal HIV geçişinin ulusal düzeyde kayıt ve takibi konusunda daha ileri düzeyde çalış-malar yapılması gerektiğini düşünmekteyiz.…”