Gaps in preventing mother to child transmission (PMTCT) and human immune deficiency virus (HIV) exposure among infants in a Nigerian City: Implications for health systems strengthening

Abstract

In many countries, paediatric human immune deficiency virus (HIV) has been virtually eliminated. Nigeria however still records an unacceptably high number of HIV positive births. This study aims to identify HIV exposure rates among infants and to quantify gaps in preventing mother to child transmission (PMTCT) services in a major Nigerian city. A cross-sectional design was used to assess the prevalence of HIV sero-positivity in infants and use of PMTCT services among mothers in routine immunization clinics across the city. A total of 2,125 mother-infant pairs from 53 Primary Health Care Facilities were studied. More mothers who had received Ante natal care (ANC) services from orthodox health facilities were screened for HIV; 77.5% compared to 42.5% of those who used non-orthodox care providers (p < 0.001). In all, 0.6% of mothers were people living with HIV/AIDS (PLWHA). Overall, 0.9% of infants tested positive for HIV, only one infant was confirmed by DNA polymerase chain reaction (PCR) to be HIV infected. Only one of the 18 mothers of the HIV exposed infants had been previously diagnosed as having HIV infection. Among the newly diagnosed HIV positive mothers, 58.8% had received antenatal care from an orthodox health facility and 35.3% had been screened for HIV in pregnancy. Most mothers had practiced mixed feeding of their babies. The low HIV exposure rates among infants indicate progress in limiting mother-to-child transmission of HIV infections in Nigeria. However, the achievement of National PMTCT targets will need joint action of all stakeholders to reach those women without access to orthodox health facilities. Key words: Human immune deficiency virus (HIV), polymerase chain reaction, preventing mother to child transmission.