Determinants of Mother to Child HIV Transmission (HIV MTCT); A Case Control Study in Assela, Adama and Bishoftu Hospitals, Oromia Regional State,Ethiopia

Abstract

Background: HIV Mother-to-child transmission is the second most common mode of HIV transmission in sub-Saharan Africa which includes Ethiopia. However; there is little study on determinants of mother-to-child HIV transmission in the country. Objective: To assess determinants of Mother-To-Child HIV Transmission. Methods: A case-control study on infants who were born to HIV positive mothers was conducted in Assela, Adama and Bishoftu Hospitals. One hundred and six HIV infected (cases) and 318 not infected infants (controls) were selected by stratified random sampling method. Results: Mothers who knew their HIV sero-positivity during pregnancy and after delivery were found significantly more likely to transmit HIV to their babies compared with those who knew before getting pregnant (AOR [95% CI] = 4.71 [ 1.39-15.93 ] and 4.46 [1.40-16.22]), respectively. Similarly, mothers who took Zidovudine prophylaxis for < 4 weeks and no Zidovudine prophylaxis at all during pregnancy were found significantly more likely to transmit (AOR [95% CI] = 13.29 [2.34-75.33] and 15.63 [3.29-74.26]), respectively. Likewise, Mothers with CD4 cell count < 200 and 201-500 cells/μl during lactation were found significantly more likely to transmit (AOR [95% CI] = 7.65 [3.20-18.31] and 4. 07 [1.90-8.71]), respectively. Mother who had cracked nipple/mastitis while lactating and who were practicing mixed feeding were also found significantly more likely to transmit (AOR [95% CI] = 13.05 [1.23-138.21] and 3.55 [1.62-7.78]), in that order. On the other hand, infants who were given Zidovudine for 28 days or 7 days after birth were found significantly less likely to contract HIV than single done Nevirapine given ones (AOR [95% CI] = 0.19 [0.07-0.48]. Conclusions: Knowing HIV sero-positivity before getting pregnant, longer duration of Zidovudine prophylaxis during pregnancy, extended prophylaxis to infant with Zidovudine, higher maternal CD4 cell count and healthy maternal breast while lactating and exclusive breastfeeding were found significantly protective of HIV mother-to-child transmission.