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

BMC Public Health

Berihun Megabiaw Zeleke¹  Digsu Negese Koye¹ 

[1] Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia

关键词: Ethiopia;    Predictors;    HIV transmission;    HIV-exposed infants;   

Others  :  1162283
DOI  :  10.1186/1471-2458-13-398

 received in 2012-07-10, accepted in 2013-04-22,  发布年份 2013

【 摘 要 】

Background

Mother-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.

Methods

Institution 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.

Results

A 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.

Conclusions

There 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.

【 授权许可】

   
2013 Koye and Zeleke; licensee BioMed Central Ltd.

【 参考文献 】

• [1]UNAIDS: UNAIDS Report on the global AIDS epidemic 2012. Geneva: UNAIDS; 2012.
• [2]FMoH: Guidelines for Prevention of Mother-to-Child Transmission of HIV in Ethiopia. Addis Ababa, Ethiopia: Federal HIV/AIDS Prevention and Control Office; 2007.
• [3]CSA, ICF International: Ethiopia Demographic and Health Survey 2011. Addis Ababa, Ethiopia and Calverton, Maryland, USA: Central Statistical Agency and ICF International; 2012.
• [4]Prevention of Mother to Child Transmission (PMTCT). http://www.unicef.org/supply/index_42855.html webcite
• [5]Mirkuzie AH, Hinderaker SG, Morkve O: Promising outcomes of a national programme for the prevention of mother-to-child HIV transmission in Addis Ababa: a retrospective study. BMC Health Serv Res 2010, 10:267. BioMed Central Full Text
• [6]Thorne C, Patel D, Fiore S, Peckham C, Newell M-L: Mother-to-child transmission of HIV infection in the era of highly active antiretroviral therapy. Clin Infect Dis 2005, 40(3):458-465.
• [7]CDC: Achievements in public health. Reduction in perinatal transmission of HIV infection--United States, 1985–2005. MMWR Morb Mortal Wkly Rep 2006, 55(21):592-597.
• [8]Read JS, Samuel NM, Srijayanth P, Dharmarajan S, Van Hook HM, Jacob M, Junankar V, Bethel J, Yu E, Stoszek SK: Infants of human immunodeficiency virus type 1-infected women in rural south India: feeding patterns and risk of mother-to-child transmission. Pediatr Infect Dis J 2010, 29(1):14-17.
• [9]Hoffman RM, Black V, Technau K, van der Merwe KJ, Currier J, Coovadia A, Chersich M: Effects of highly active antiretroviral therapy duration and regimen on risk for mother-to-child transmission of HIV in Johannesburg, South Africa. J Acquir Immune Defic Syndr 2010, 54(1):35-41.
• [10]Noel F, Mehta S, Zhu Y, Rouzier Pde M, Marcelin A, Shi JR, Nolte C, Severe L, Deschamps MM, Fitzgerald DW: Improving outcomes in infants of HIV-infected women in a developing country setting. PLoS One 2008, 3(11):e3723.
• [11]Shetty AK, Maldonado Y: Preventing mother-to-child transmission of HIV-1: an international perspective. NeoReviews 2001, 2(4):e75-e82.
• [12]Graham WJ, Newell ML: Seizing the opportunity: collaborative initiatives to reduce HIV and maternal mortality. Lancet 1999, 353(9155):836-839.
• [13]Ciaranello AL, Seage GR 3rd, Freedberg KA, Weinstein MC, Lockman S, Walensky RP: Antiretroviral drugs for preventing mother-to-child transmission of HIV in sub-Saharan Africa: balancing efficacy and infant toxicity. AIDS 2008, 22(17):2359-2369.
• [14]Viani RM, Ruiz-Calderon J, Lopez G, Chacón-Cruz E, Spector SA: Mother-to-child HIV transmission in a cohort of pregnant women diagnosed by rapid HIV testing at tijuana general hospital, Baja California, Mexico. J Int Assoc Physicians AIDS Care 2010, 9(2):82-86.
• [15]Mother to child transmission of HIV. http://www.who.int/hiv/mtct/en/index.html webcite
• [16]Dabis F, Bequet L, Ekouevi DK, Viho I, Rouet F, Horo A, Sakarovitch C, Becquet R, Fassinou P, Dequae-Merchadou L: Field efficacy of zidovudine, lamivudine and single-dose nevirapine to prevent peripartum HIV transmission. AIDS 2005, 19(3):309-318.