Prevalence of vertical HIV infection and its risk factors among HIV exposed infants in East Africa: a systematic review and meta-analysis

Abstract

Background Human immunodeficiency virus (HIV) is one of the most important global health problems. More than one and half million of children are living with HIV in the world, and majority of them are found in sub-Saharan Africa. There are primary fragmented study findings, and no review was conducted with regard to vertical HIV infection in East Africa. Therefore, this review aimed to assess the prevalence of vertical HIV infection and its risk factors among HIV-exposed infants in East Africa. Main body Eligible studies were retrieved by relevant search terms in CINHAL, Pub-MED, Google Scholar, EMBASE, Web of Science, SCOPUS, Cochrane, African Journals Online databases, and Ethiopian University research repositories. Data were extracted with Microsoft Excel and analyzed with Stata version 11 software. The random effect model was used to estimate the pooled prevalence of vertical HIV infection in East Africa. The variation between studies was quantified with an I2 statistic test. Furthermore, sub-group and meta-regression analyses were done to identify the sources of heterogeneity between the studies. The publication bias was assessed by Egger test. This systematic review and meta-analysis have included a total of 33 research articles. The overall pooled prevalence of vertical HIV infection in East Africa was 7.68% with a 95% confidence interval [CI]: (6.23, 9.12) with a heterogeneity of I2 = 86.8 with a p value < 0.001. In subgroup analysis, the pooled prevalence of vertical HIV infection in cross-sectional studies was 6.58%, while in cohort studies were 9.37%. Mixed feeding, AOR = 6.22 (1.02, 11.41); home delivery, AOR = 2 (1.01, 3); mothers took ART less than 4 weeks, AOR = 1.92 (1.79, 2.06); and infants who have not received ARV prophylaxis, AOR = 2.02 (1.05, 2.98) were the associated factors for vertical HIV infection for exposed infants. Conclusions The pooled prevalence of the mother to child transmission of HIV is way more than the desired target of the World Health Organization, which is less than 5% in breastfeeding populations. Thus, strengthening the prevention of vertical HIV transmission, promotion of exclusive breastfeeding, timely initiation of ART prophylaxis for HIV exposed infants, encouragement of hospital delivery, and the start of ART at the time of diagnosis of every HIV-positive person may all reduce the transmission of vertical HIV infection.

Prevalence, trend and associated risk factors of Mother-to-Child Transmission of HIV among HIV-exposed infants

“…In contrast to our nding other studies from different parts of the world as well as Ethiopia obtained high prevalence [11,[22][23][24][25][26][27][28][29]. Furthermore, a study reported from Addis Ababa indicated higher prevalence (4.2%) of HIV infection in HEI [13] than the current study.…”

“…This result was similar with previous studies reported from different settings [10,[13][14]19], 26, 29]. Moreover, in-line with our result, ndings reported by review studies indicated that infants on nevirapine prophylaxes were at lesser risk of HIV infection than those who missed the service [16,25]. These indicate that nevirapine prophylaxis could prevent MTCT of HIV during breastfeeding.…”

Levels of mother-to-child HIV transmission knowledge and associated factors among reproductive-age women in Ethiopia: Analysis of 2016 Ethiopian Demographic and Health Survey Data

“…The rate of transmission of HIV from an HIV-positive mother to her baby ranges from 15 percent to 45 percent in the absence of intervention and can be reduced to below 5 percent with an effective intervention [ 9 ]. Child born from HIV mother is at risk of contracting the disease [ 10 , 11 ]. The MTCT of HIV, which is also known as ‘vertical transmission’, accounts for the majority of infections in children aged 0–14 years [ 8 , 12 ].…”

“…The MTCT of HIV, which is also known as ‘vertical transmission’, accounts for the majority of infections in children aged 0–14 years [ 8 , 12 ]. A systematic review and meta-analysis done using 33 published article depicted that the pooled prevalence of MTCT of HIV in the East Africa is 7.68% [ 11 ].…”

Clinical and Biological Risk Factors Associated with Increased Mother-to-Child Transmission of HIV in Two South-East HIV-AIDS Regional Centers in Romania

“…Important to note, it is relevant nowadays that HIV-positive pregnant woman bet understand the obstetrical risks associated with HIV infection, reinforcing that the sh duration of broken membranes could be associated with less vertical transmission [26] Furthermore, there was no other association between mode of delivery and H infection in our study, although no HIV transmission was registered in 196 patients fro Constanta RC and 119 patients from Craiova RC who underwent elective cesarean sectio We believe that elective cesarean section should be reserved to those patients with higher viral load or those who presented late in delivery without any cART treatment, with poor adherence at cART [27][28][29][30], considering that caesarean scars could lead to oth diseases such asendometriosis [31] in the future, which could causeinfertility, chro pelvic pain, dysmenorrhea, and dyspareunia [32].…”