Abstract
Introduction. Successful prevention of mother-to-child transmission (PMTCT) of the human immunodeficiency virus (HIV) requires early diagnosis, consistent access to antiretroviral therapy (ART), and regular health care during and after pregnancy. This study assessed the determinants of early HIV diagnosis by children born to HIV-positive (HIV+) mothers in the Kongo Central Province, Democratic Republic of the Congo (DRC). Methodology. Data from 230 HIV+ mothers screened under the PMTCT program between July 2015 and December 2017 were extracted from the databases of 31 Health Zones (HZ) of Kongo Central province. Data detailing laboratory and anthropometric findings, morbidity, and mortality were collected from each exposed child. The determinants of inaccessibility to early diagnosis were identified using logistic regression. Results. The mothers' mean age was 32.4 years, and 90.9% were on ART; 68.8% of children were older than 12 months at diagnosis. Diagnosis during the first 6 months of the child’s life was critical. Malnutrition was found in almost 90% of the children. Determinants of non-access to an early diagnosis were mothers who attained a primary education level and did not disclose their HIV status. Conclusion. All possible interventions should be considered to prevent mother-to-child HIV transmission. To ensure a child’s survival to their first birthday, early diagnosis should be performed soon after birth to an HIV+ mother and ART should be initiated.
Highlights
Successful prevention of mother-to-child transmission (PMTCT) of the human immunodeficiency virus (HIV) requires early diagnosis, consistent access to antiretroviral therapy (ART), and regular health care during and after pregnancy
The number of people living with HIV (PLWHIV) under antiretroviral therapy (ART) has increased by approximately one third, from 15 million in 2015 to 17 million, an increase of 2 million compared to the target set by the United Nations General Assembly in 2011 [1]
The largest percentage of women had achieved a primary level of education (53.5%) and were under ARV treatment (90.9%), with most receiving combined treatment of 4.2 zidovudine (AZT) plus lamivudine (3TC) plus Nevirapine (NVP) (41.7%); 35.7% had started ARV before pregnancy and 55.2% during pregnancy
Summary
Successful prevention of mother-to-child transmission (PMTCT) of the human immunodeficiency virus (HIV) requires early diagnosis, consistent access to antiretroviral therapy (ART), and regular health care during and after pregnancy. The goal of conquering the HIV epidemic has become more attainable in the last 15 years, making it possible to achieve the United Nations (UN) General Assembly’s 2016 ambition to eliminate HIV/AIDS by 2030; UN member countries endorsed this goal as part of the Sustainable Development Goals endorsed by the Joint United Nations Program on HIV and AIDS (UNAIDS) and the World Health Organization (WHO). This call to mobilize nations and implement WHO recommendations will help countries with limited resources to reach the 2030 goal. Despite significant progress toward this goal over the past decade, most of the 220,000 new pediatric HIV infections in 2014 were attributed to vertical transmission [1]
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