Abstract
BackgroundIn India, preventing mother-to-child transmission (PMTCT) of Human Immunodeficiency Virus (HIV) remains one of the foremost challenge in community health. Countrywide MTCT of HIV is estimated to be > 10,000 annually. Aims of present study are to find out the prevalence of HIV and correlates of HIV transmission among children given birth by HIV infected mother through systematic review along with meta-analysis.MethodsAll avaiable articles are retrieved using MEDLINE, Cochrane Library, Science Direct, EMBASE, Google Scholar and PUBMED following guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) are applied to critically reviewing the selected articles. STATA 13.0 is used to preparation of forest plot for Meta-analysis. For assessment of heterogeneity and publication biases I2 statistics along with Begg and Mazumdar’s test and Egger’s tests are used. Odds ratio (OR) along with forest plots have been showing with 95% confidence interval (CI).ResultsAll together 10 studies including 1537 pairs of mothers and new births are assessed in present meta-analysis. Present analysis revealed the prevalence of HIV due to MTCT in India as 8.76% (95% CI; 5.76, 12.31). Analysis of subgroups exhibit a higher pooled prevalence in eastern region of India, 10.83% (95% CI: 5.9, 17.81) and lower in in Western region in India, 6.37% (95% CI: 4.65, 8.49). Status of MTCT before and after initiation of universal ART are 10.23% (95% CI 6.61, 14.55) and 7.93% (95% CI 4.18, 12.76) respectively. Associated factors with MTCT of HIV include absence of maternal prevention of MTCT intervention, OR = 10.82 (95% CI: 5.28, 22.17), lacking in administration of infant ARV (antiretroviral), OR = 8.21 (95% CI: 4.82, 14.0) and absence of medical facility during childbirth OR = 3.73 (95% CI: 1.67, 8.33).ConclusionsIn India, pooled HIV prevalence of MTCT as high as 8.78% (95% CI; 5.76, 12.31) among babies born to infected mothers warrants urgent need of focused intervention for providing ART (PMTCT intervention), ensuring proper infant ARV prophylaxis, and avoiding delivery without proper medical facility to pregnant women with HIV for reduction of occurrence in HIV transmission from mothers to children.
Highlights
In India, preventing mother-to-child transmission (PMTCT) of Human Immunodeficiency Virus (HIV) remains one of the foremost challenge in community health
New-born babies are solely infected due to transmission from mother, here considering the parental investment by the male partner, who transmit the infection to his partner, in India this phenomenon is aptly termed as parent-to-child transmission (PTCT) [5]
During 2002 PMTCT interventions initiated in India, through free admittance to HIV diagnosis for each enrolled women with pregnancy in nearby antenatal clinics (ANC), administration of a dose of Nevirapine to pregnant women infected with HIV at the time of labour, subsequently for their children instantly during birth
Summary
In India, preventing mother-to-child transmission (PMTCT) of Human Immunodeficiency Virus (HIV) remains one of the foremost challenge in community health. National AIDS Control Organization (NACO) estimated that out of about 30 million annual pregnancies in India, more than 22,000 pregnant women are infected by HIV [11]. During 2002 PMTCT interventions initiated in India, through free admittance to HIV diagnosis for each enrolled women with pregnancy in nearby antenatal clinics (ANC), administration of a dose of Nevirapine to pregnant women infected with HIV at the time of labour, subsequently for their children instantly during birth. From 2016 approximately 21 thousand ICTCs are available to offer free services to pregnant women, across India and most are attached with government aided healthcare facilities [13] Objective of this PPTCT facilities is to prevent the perinatal transmission from a pregnant woman with HIV to her new-born. To gain insight of the Indian scenario the present work of the systematic review and meta-analysis has been initiated on the MTCT of HIV with its correlates in India using accessible published evidence
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