Prevention of Mother-to-Child Transmission of HIV in Delta State of Nigeria: Evaluation of the Early Infant Diagnosis Program

Ibobo J A,Chime H,Nwose E U

doi:10.18311/jhsr/2018/20020

Abstract

Background: The global public health issue of Mother-to-Child Transmission (MTCT) of HIV is being addressed with Prevention of MTCT (PMTCT) strategy. A narrative review has recently been published. Objective: The aim of this study was to determine from an early infant diagnosis program in Delta State if there is reduction in MTCT of HIV. Methods: This was a retrospective study. Three health institutions comprising of one from each of the three senatorial district in Delta State were used for the study. The records of 1080 prenatally exposed babies that had DNA PCR tests between 6 weeks to 18 months were evaluated descriptively. Data mining was from the period of August 2009 to December, 2016. Child followup register was reviewed for information that included, age the child had PCR done, commencement of Antiretroviral Therapy (ART) at birth, if mother was on ART, result of PCR and test done at 18 months. Results: 98.0% of HIV positive mothers were on ART during pregnancy, 98.9% of the infants were on ART at birth, and 93.1% were exclusively breast fed. The outcome of the PMTCT program obtained shows that compared to 100% effectiveness among infants who were compulsorily treated on the basis of their mothers being on treatment, there is 89% efficiency among those who either themselves or their mothers received treatment; but only 17% efficiency was achieved where neither mother nor child is receiving treatment. Conclusion: This study shows that with effective PMTCT intervention, reducing MTCT of HIV is being achieved by the public health service.

Highlights

The agenda for Mother-to-Child Transmission (MTCT) of Human Immunodeficiency Virus (HIV) revolves around the vertical infection of HIV from mother to her child[1]
The World Health Organization (WHO) guidelines recommend that pregnant mothers who are HIV-positive should be treated with a regimen of three Antiretroviral drugs (ARV) as soon as possible- and stay on these drugs until their infant is born and breastfeeding concluded[4,5]
Beside the ‘N=1080’; another thirteen infants and their mothers were not on Antiretroviral Therapy (ART) at time of first test, which were included in assessment of Prevention of MTCT (PMTCT) efficiency

Summary

Introduction

The agenda for Mother-to-Child Transmission (MTCT) of Human Immunodeficiency Virus (HIV) revolves around the vertical infection of HIV from mother to her child[1]. The prevalence of MTCT is up to 45%; but it is believed that this rate of infection can be reduced to below 5% with effective interventions[6,7,8], which include prevention of vertical infection during pregnancy and appropriate breastfeeding practices[9]. The global public health issue of Mother-to-Child Transmission (MTCT) of HIV is being addressed with Prevention of MTCT (PMTCT) strategy. Child followup register was reviewed for information that included, age the child had PCR done, commencement of Antiretroviral Therapy (ART) at birth, if mother was on ART, result of PCR and test done at 18 months. Conclusion: This study shows that with effective PMTCT intervention, reducing MTCT of HIV is being achieved by the public health service

Objectives

Methods

Results

Discussion

Conclusion