Abstract
BackgroundMother-to-child transmission (MTCT) of HIV is one of the commonest avenues through which infants are infected with HIV. To achieve an HIV-free generation, MTCT of HIV should be eliminated. Nigeria began prevention of mother-to-child transmission (PMTCT) services 13 years ago, but it still contributes to over one-third of global MTCT burden. We set out to explore and define the effectiveness of PMTCT in selected sites in North Central Nigeria.MethodsWe conducted a retrospective secondary data analysis at eight service delivery points in two states. One thousand four hundred and fifty-four mother–infant pair data sets from 2012 to 2016 were extracted and analyzed. Maternal/infant antiretroviral (ARV) services, early infant diagnosis (EID), and final outcomes were reviewed to examine the predictors of MTCT of HIV in these centers.ResultsWe retrieved 1,454 mother–infant pair data sets. While 89.5% (1,302) of positive pregnant women (PPW) and 92.2% (1,340) of HIV-exposed infants (HEIs) received ARV prophylaxis/ARV treatment (ART), 88.4% (1,285) infants were breastfed with 32.5% still receiving breast milk at the time of dry blood spot (DBS) collection. EID PCR positivity rate was 3.5% (range, 0.0%–11.1%). Facility of delivery (χ2=24.99, P<0.00), mother on ARV (χ2=48.8, P<0.00), mother having received ARV prophylaxis (χ2=89.59, P<0.00), infant having received ARV prophylaxis (χ2=58.56, P<0.00), and baby having received cotrimoxazole (χ2=55.24, P<0.00) all significantly prevented positive EID results. However, mode of delivery and breastfeeding were not significantly associated with positive EID results.ConclusionThis study supports PMTCT services as it minimizes the transfer of HIV from infected mothers to HEIs. To eliminate HIV and achieve zero new HIV infections, every HIV-positive pregnant woman should receive ARV prophylaxis and should be supported postdelivery to prevent transfer of infection to the newborn. Also, HEIs should receive timely ARV and cotrimoxazole prophylaxis.
Highlights
Mother-to-child transmission (MTCT) of HIV is one of the commonest avenues through which infants are infected with HIV
This study was conducted in sites supported by Excellence and Friends Management Care Center (EFMC), a nongovernmental organization involved in comprehensive HIV health care delivery across a wide range of Nigerian states
The average age of the 1,453 (99.9%) infants whose ages were properly included in the data set at the time of dry blood spot (DBS) collection was 11.2±18.1 weeks with a median and mode of 7 and 6 weeks, respectively
Summary
Mother-to-child transmission (MTCT) of HIV is one of the commonest avenues through which infants are infected with HIV. Nigeria began prevention of mother-to-child transmission (PMTCT) services 13 years ago, but it still contributes to over one-third of global MTCT burden. Conclusion: This study supports PMTCT services as it minimizes the transfer of HIV from infected mothers to HEIs. To eliminate HIV and achieve zero new HIV infections, every HIVpositive pregnant woman should receive ARV prophylaxis and should be supported postdelivery to prevent transfer of infection to the newborn. HIV-positive woman can infect their babies during pregnancy, childbirth, and/or breastfeeding, and this accounts for >90% of new HIV infections among children.[3] For instance, in the absence of any interventions during these stages, infected mothers can transmit the virus to their babies in 15%–45% of cases.[4] In 2015, there were about 1.8 million children (age, 0–14 years) infected with HIV with 490,000 in West and Central Africa and 260,000 in Nigeria alone.[5,6]
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