Mother-to-child transmission of HIV: the pre-rapid advice experience of the university of Nigeria teaching hospital Ituku/Ozalla, Enugu, South-east Nigeria

Ngozi S Ibeziako,Anthony N Ikefuna,Ifeoma J Emodi,Adaeze C Ayuk,Agozie C Ubesie,Kene K Iloh

doi:10.1186/1756-0500-5-305

Abstract

BackgroundMother-to-child transmission of human immune deficiency virus (HIV) is the most common route of HIV transmission in the pediatric age group. A number of risk factors contribute to the rate of this transmission. Such risk factors include advance maternal HIV disease, lack of anti-viral prophylaxis in the mother and child, mixing of maternal and infant blood during delivery and breastfeeding. This study aims to determine the cumulative HIV infection rate by 18 months and the associated risk factors at the University of Nigeria Teaching Hospital, Enugu.ResultsA retrospective study, involving HIV exposed infants seen at the pediatric HIV clinic of UNTH between March 2006 and September 2008. Relevant data were retrieved from their medical records. The overall rate of mother to child transmission of HIV in this study was 3.9% (95% CI 1.1%- 6.7%). However, in children breastfed for 3 months or less, the rate of transmission was 10% (95% CI −2.5%-22.5%), compared to 3.5% (95% CI 0.5%-6.5%) in children that had exclusive replacement feeding.ConclusionsThis retrospective observational study shows a 3.9% cumulative rate of mother-to-child transmission of HIV by 18 months of age in Enugu. Holistic but cost effective preventive interventions help in reducing the rate of mother-to-child transmission of HIV even in economically-developing settings like Nigeria.

Highlights

Mother-to-child transmission of human immune deficiency virus (HIV) is the most common route of HIV transmission in the pediatric age group
A total of 227 HIV exposed babies were enrolled into the HIV Exposed Infant Clinic and complete data retrieved for 178 babies
The details of labor and delivery including known risk factors such as prolonged rupture of membrane, episiotomies and instrumental deliveries were not documented in this review. This retrospective observational study shows a cumulative 3.9% rate of mother-to-child transmission (MTCT) of HIV by 18 months of age in Enugu. This may be attributed to a well-established multi-disciplinary team approach between the Obstetric and Pediatric Departments of University of Nigeria Teaching Hospital (UNTH) Enugu in running the PMTCT program

Summary

Introduction

Mother-to-child transmission of human immune deficiency virus (HIV) is the most common route of HIV transmission in the pediatric age group. Children can be infected with the virus through mother-to-child transmission (MTCT), blood transfusion, unprotected sex and through the use of non-sterile sharp objects [1,2]. The most common route of HIV transmission in children living in economically-developing countries is blood transfusion.[7,8]. This route accounts for about 5 to 20% of pediatric AIDS [3,4]

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