Abstract
BackgroundThis article assessed maternal and neonatal outcomes amongst users of prevention of mother-to-child transmission (PMTCT) of HIV services in Addis Ababa, Ethiopia.ObjectivesThe study aimed to assess the health outcomes (antiretroviral prophylaxis versus antiretroviral treatment, CD4 counts, World Health Organization (WHO) stages of illness, other illnesses) of women who had used these services, as well as the HIV status of their babies and the infant feeding method adopted.MethodsA quantitative, cross sectional, retrospective cohort design was used. Document reviews were conducted with a sample of 384 mother-infant pairs (out of a population of 796) who had used PMTCT services.ResultsAll respondents were using prophylactic antiretrovirals or antiretroviral therapy, but some were on the wrong treatment based on their CD4 counts. The CD4 counts increased four times more for women on antiretroviral treatment than for those on prophylactic antiretrovirals. The WHO’s stages of HIV illness did not improve but deteriorated in some cases, and 52 other illnesses were recorded. Out of the 384 infants, 6.0% (n = 23) were HIV-positive. Most respondents opted for exclusive breast feeding but some used mixed feeding during the first six months of their infants’ lives, despite having received health education related to infant feeding options.ConclusionThe respondents’ improved CD4 counts were inadequate to improve their World Health Organization stages of HIV illness. Some babies received mixed feeding during the first six months of their lives and 6% of the babies were HIV-positive despite their mothers’ utilisation of PMTCT services.
Highlights
Prevention of mother-to-child transmission (PMTCT) services are available in Ethiopia, but during 2012 only an estimated 50% of pregnant women used these services (Joint United Nations Program on Human Immunodeficiency Virus (HIV)/AIDS [UNAIDS] 2013:38–40), implying that 50% of these pregnant women did not access PMTCT services
The goal of PMTCT programmes is to maximise the health of the HIV-positive woman and decrease the chances of mother-to-child transmission of HIV (MTCT), by decreasing the viral load (VL) and increasing the CD4 count, whilst maintaining the maximum level of health throughout pregnancy (WHO 2011:1–12)
The recorded WHO stages of HIV illness decreased from 100% (n = 384) at the first to 31.3% (n = 120) at the sixth antenatal care (ANC) visit, indicating that the records of the PMTCT programme should be improved in future
Summary
Prevention of mother-to-child transmission (PMTCT) services are available in Ethiopia, but during 2012 only an estimated 50% of pregnant women used these services (Joint United Nations Program on HIV/AIDS [UNAIDS] 2013:38–40), implying that 50% of these pregnant women did not access PMTCT services. The goal of PMTCT programmes is to maximise the health of the HIV-positive woman and decrease the chances of mother-to-child transmission of HIV (MTCT), by decreasing the viral load (VL) and increasing the CD4 count, whilst maintaining the maximum level of health throughout pregnancy (WHO 2011:1–12). Proper implementation of these four prongs of PMTCT services could reduce the incidence of MTCT and improve the quality of these services. Antiretrovirals (ARVs) for PMTCT include the administration of ARVs to HIV-positive mothers and their infants to prevent MTCT. This includes ART http://www.curationis.org.za provision for those pregnant women who were eligible for treatment and temporary ARV prophylaxis for those who were not eligible for ART, based on their CD4 counts
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