Prevention Of Mother-to-child Transmission Research Articles

Prevalence of hazardous alcohol consumption and associated factors among HIV-positive pregnant women attending public hospitals in Northwest Ethiopia: a multicentred cross-sectional study

BackgroundAlcohol is a major public health problem in pregnant women due to its harmful effects on pregnancy and adverse birth outcomes. Therefore, assessing the prevalence and the factors associated with...

Level of option B+PMTCT drug adherence with male partner involvement and associated factors among breastfeeding women until 18 months in North Gojjam Zone, Amhara region, Northwest Ethiopia, 2022: a multicentre cross-sectional study

BackgroundAdherence to option B+antiretroviral therapy medication is crucial for the effective implementation of the Prevention of Mother-to-Child Transmission (PMTCT) programme. Ethiopia has adopted the WHO’s target of achieving over 95%...

Ocular and Adnexal Diseases in Human Immunodeficiency Virus-Infected Pregnant Women Attending HIV Clinics in Ibadan, Nigeria

Abstract Background: Human immunodeficiency virus (HIV) is a lentivirus. It is transmitted through sexual intercourse, shared intravenous drugs, contaminated needle use, blood transfusion, and mother-to-child transmission. Of the patients with HIV, 50%–75% have ocular manifestations and this may be the primary presentation. This study was carried out in two prevention of mother-to-child transmission (PMTCT)/HIV clinics. The aim was to determine the incidence, patterns of presentation, and determinants of ocular and adnexal diseases in HIV-positive pregnant women attending HIV clinics to develop an eye care protocol for them. Materials and Methods: The study was a cross-sectional study of HIV-positive pregnant women attending the PMTCT/HIV Clinics at University College Hospital and Adeoyo Maternity Teaching Hospital, Ibadan. Patients were interviewed using a structured questionnaire. Blood samples were taken for CD4+ count and viral load. The stage of the disease, type of antiretroviral therapy (ART), and the interval between HIV diagnosis and commencement of ART were recorded. Comprehensive ocular examination, which included visual acuity check unaided and with pinhole, lid, anterior segment examination with slit lamp and posterior segment examination with dilated binocular indirect ophthalmoscopy, was conducted. Statistical Package for Social Sciences version 23 was used to analyse the data. Results: A total of 153 pregnant women aged 23–42 years (mean, 33.5; standard deviation, ±5.6) were recruited. One hundred and fifteen (75.2%) of them were married in a monogamous setting. Multiple sexual partners (48.4%; n = 74—some women married in monogamous settings at the time of recruitment for this study had multiple sexual partners in the past) and the use of unsterilised objects (46.4%; n = 71) were major high-risk behaviours. Ocular and adnexal diseases were found in 81 (53%) participants. HIV-related ocular and adnexal diseases were found in 16 (10%) participants. Of the 16 HIV-related diseases, optic atrophy was found in seven (43.8%), presumed toxoplasmosis in three (18.7%), presumed cytomegalovirus retinitis in three (18.7%) lid warts in two (12.5%), and conjunctival microangiopathy in one (6.3%) participant. The association between HIV- related ocular and adnexal diseases and gestational age, CD4+ count, viral load and type of ART was not statistically significant. Conclusion: The few HIV-related findings in this study could be a result of the improved CD+ count/low viral load of most of the recruited participants. Ensuring that patients attending PMTCT/HIV clinic have at least one ocular examination during pregnancy by collaborating with eyecare professionals could ensure prompt detection and treatment of eye diseases, to improve the quality of life of HIV-positive pregnant women.

Role of mothers in preventing tuberculosis in children: A scoping review

Tuberculosis (TB) remains a significant global health challenge, especially for children. The aim of this scoping review was to investigate the role of mothers in preventing childhood TB transmission and highlight effective strategies and associated barriers. A systematic literature search was conducted using PubMed, Web of Science, and Scopus, covering articles up to January 17, 2024. The search included keywords like “mother,” “parents,” “care,” “prevention,” and “tuberculosis.” Eligibility criteria included peer-reviewed articles on maternal health interventions for TB prevention in children and published in English. The study selection process involved screening titles and abstracts, followed by full-text reviews by Rayyan Artificial Intelligence (AI). Eighteen studies were analyzed, revealing the crucial roles of mothers and healthcare workers in TB prevention. The results indicated that in South Africa, only 47% of eligible pregnant women underwent Mantoux testing, with lower rates in rural areas. The isoniazid preventive therapy (IPT) uptake rate was 79%, with geographical variations. Barriers included insufficient patient information, inadequate screening facilities, and healthcare providers' knowledge gaps. Parental involvement, particularly by mothers, is vital for adherence to TB preventive measures. Challenges in integrating TB case-finding with antenatal care and prevention of mother-to-child transmission (PMTCT) services included inconsistent screening and healthcare worker shortages. Enhancing health services, reducing stigma, and integrating TB prevention into existing programs are essential. In conclusion, this review underscores that effective childhood TB prevention requires a coordinated approach that incorporates the efforts of the mother and healthcare worker. Addressing barriers such as contact tracing gaps and diagnostic delays, alongside enhancing maternal health education and support, is essential for improving TB prevention and management. Targeted interventions and collaborative efforts are needed to reduce transmission and improve health outcomes, particularly in bridging rural-urban disparities.

Assessment of the Knowledge, Attitude and Practice (KAP) of PMTCT among Healthcare Providers at the University of Ghana Legon

One of the leading causes of morbidity and mortality among communicable diseases is acquired immunodeficiency syndrome (AIDS). A vulnerable group in this setting is HIV exposed infants, (born to women living with HIV). The magnitude of the pandemic of HIV infection in developing countries is such that multiple approaches are required to show its spread and alleviate the burden on the health sector and society in general. Every woman of childbearing age needs to be aware of HIV infection, the risks of Mother-to-Child Transmission and the services available to reduce such risks. Considering these, this study assessed the knowledge, attitude and practice of Prevention of mother-to-child transmission (PMTCT) among healthcare providers at the University of Ghana Legon. A descriptive cross-sectional design was used in this study. The minimum sample size for this study was calculated using the single proportion population formula by Fisher (1978): The study area was the University of Ghana Hospital Legon. The collected data was exported into STATA version 16.0 for cleaning and analysis. Descriptive analysis, such as simple frequencies, percentages, means, and standard deviations, were used to summarize the data. Findings were presented in tables and graphs. Generally, the data accumulated from the research on the knowledge, attitude and practice of PMTCT among healthcare workers indicate that there is unsatisfactory knowledge and practice. In this study, no participants had a total good score above 85%. The relationship between gender, ward and knowledge was investigated using a chi-square. The p-value was higher than the alpha-value, indicating acceptance of the null hypothesis (p-value = 0.79 and 0.053, alpha value = 0.05). Sixteen (16) of the respondents, representing 17.6%, said HIV positive pregnant women should be managed like any other pregnant woman in Labour. The majority of the respondents (56) said at the first week of pregnancy, while only (2) said at week 28. However, their attitude was satisfactory. It must be noted that without further training and an increase in staffing levels, the quality and accessibility of PMTCT will be severely affected. It is therefore recommended that there should be continuous and pre-service training on PMTCT. All new medical officers, midwives and nurses should undergo PMTCT training, and those who are already in service should take refresher courses on new and updated guidelines.

Adherence of healthcare providers to Enhanced Adherence Counseling (EAC) intervention protocol in West Amhara Public Health Facilities, Northwest Ethiopia, 2023: mixed method evaluation

BackgroundIn Ethiopia, there were an estimated 670,906 people living with the Human Immune Virus (HIV). Implementing an HIV test and treat strategy and rapid scale-up of anti-retroviral treatment (ART) provided health facilities increased the number of the number of people living with HIV/AIDS. In the same way, the expansion of viral load monitoring in these health facilities and poor adherence to ART increase the number of high-viral load (HVL) patients. To alleviate this problem, the World Health Organization (WHO) recommended EAC intervention for HVL patients. Therefore, the aim of this research was to determine the level of healthcare providers’ adherence to the EAC intervention protocol and explore barriers and facilitators of the intervention in West Amhara, Northwest Ethiopia.MethodDescriptive cross-sectional study design with concurrent mixed-method evaluation was employed. The adherence dimension, with its sub-dimensions of content, coverage, frequency, and duration of the EAC intervention, was used with sixteen indicators. A total of 20 high-case-load public health facilities and 173 HVL patients were included in our study. Quantitative data was entered into Epi Info and exported to SPSS version 25 for analysis. Descriptive statistics are analyzed in terms of frequencies, percentages, variances, and means and presented as narrations, frequency tables, graphs, and charts. Qualitative data were transcribed, translated, coded, and analyzed thematically using Open Code version 4.0 software. The qualitative findings were used to triangulate the quantitative findings.ResultThe average adherence level of health care providers (HCPs) to the EAC intervention protocol was 55.3%, from which content, coverage, frequency, and duration of the intervention contributed 70.3%, 86.3%, 36.9%, and 27.7%, respectively. Most of the intervention contents were delivered during the session, but none of the providers developed a patient adherence plan at the end of the session. All HVL patients were linked and enrolled in the EAC intervention. But only 6% of them were tested for repeat VL.ConclusionThe average adherence level of HCPs to the EAC intervention protocol was very inadequate. The main gap identified was difficulties in completing the EAC intervention sessions based on schedules. Implementing adherence improvement strategies, assigning an adequate number of EAC providers in ART and Prevention of Mother-to-Child Transmission (PMTCT) clinics, and allowing sufficient time during EAC sessions are important.

Protecting maternal health: Strategies against HIV and malaria in pregnancy.

Maternal health remains a global priority, with particular emphasis on combating infectious diseases such as HIV and malaria during pregnancy. Despite significant progress in prevention and treatment efforts, both HIV and malaria continue to pose significant risks to maternal and fetal well-being, particularly in resource-limited settings. The prevention of mother-to-child transmission (PMTCT) programs for HIV and intermittent preventive treatment (IPTp) for malaria represent cornerstone strategies in mitigating the impact of these infections on pregnancy outcomes. PMTCT programs focus on early HIV diagnosis, antiretroviral therapy initiation, and promoting safe infant feeding practices to reduce the risk of mother-to-child transmission. Similarly, IPTp involves the administration of antimalarial medication to pregnant women in malaria-endemic regions to prevent maternal and fetal complications associated with malaria infection. Integration of HIV and malaria prevention and treatment services within existing maternal and child health programs is crucial for maximizing impact and minimizing healthcare system strain. Strengthening health systems, improving access to antenatal care services, and enhancing community engagement are essential components of comprehensive maternal health strategies. Furthermore, promoting awareness, education, and empowerment of pregnant women and communities are vital in fostering health-seeking behaviors and adherence to preventive measures against HIV and malaria. In conclusion, protecting maternal health from the dual threat of HIV and malaria requires a multifaceted approach that encompasses prevention, screening, treatment, and community engagement.

Investigation of Mother-to-Child Transmission of Hepatitis B in Yinchuan, China: Cross-Sectional Survey Study.

Hepatitis B poses a significant global public health challenge, with mother-to-child transmission (MTCT) being the primary method of hepatitis B virus (HBV) transmission. The prevalence of HBV infection in China is the highest in Asia, and it carries the greatest burden globally. This study aims to critically evaluate the existing local strategies for preventing MTCT and the proposed potential enhancements by analyzing the prevalence of hepatitis B among pregnant women and their neonates in Yinchuan. From January 2017 to December 2021, 37,557 prenatal screening records were collected. Among them, 947 pregnant women who tested positive for hepatitis B surface antigen (HBsAg) near delivery and their 960 neonates were included in an HBV-exposed group, while 29 pregnant women who tested negative and their 30 neonates were included in an HBV-nonexposed group. HBV markers in maternal peripheral blood and neonatal cord blood were analyzed using the least absolute shrinkage and selection operator (LASSO) regression, logistic regression, chi-square test, t-test, and U-test. Additionally, to further evaluate the diagnostic value of HBsAg positivity in cord blood, we conducted an additional follow-up study on 103 infants who tested positive for HBsAg in their cord blood. The prevalence of HBV among pregnant women was 2.5% (947/37,557), with a declining trend every year (χ²4=19.7; P=.001). From 2018 to 2020, only 33.0% (35/106) of eligible pregnant women received antiviral medication treatment. Using LASSO regression to screen risk factors correlated with HBsAg positivity in cord blood (when log [λ] reached a minimum value of -5.02), 5 variables with nonzero coefficients were selected, including maternal hepatitis B e-antigen (HBeAg) status, maternal hepatitis B core antibody (HBcAb) status, maternal HBV DNA load, delivery method, and neonatal birth weight. Through univariate and multivariate logistic regression, delivery by cesarean section (adjusted odds ratio [aOR] 0.52, 95% CI 0.31-0.87), maternal HBeAg positivity (aOR 2.05, 95% CI 1.27-3.33), low maternal viral load (aOR 2.69, 95% CI 1.33-5.46), and high maternal viral load (aOR 2.69, 95% CI 1.32-5.51) were found to be strongly associated with cord blood HBsAg positivity. In the additional follow-up study, 61 infants successfully completed the follow-up, and only 2 were found to be infected with HBV. The mothers of both these infants had detectable HBV DNA levels and should have received standard antiviral therapy. The results of the hepatitis B surface antibody (HBsAb) positivity rate and titer test indicated a gradual decline in the immunity of vaccinated infants as the interval after vaccination increased. The clinical relevance of HBV marker detection in cord blood is restricted within the current prevention measures for MTCT. There is an emphasis on the significance of public education regarding hepatitis B and the reinforcement of postnatal follow-up for the prevention of MTCT.

The safety of a dolutegravir (DTG)-based antiretroviral treatment (ART) regimen for pregnancy and birth outcomes in Ethiopia: evidence from multicenter cohort study

BackgroundA dolutegravir (DTG)-based antiretroviral regimen has been rolled out for pregnant women in low- and middle-income countries since 2020. However, available safety data are limited to a few clinical trials and observational studies. Hence, we present real-world pregnancy and birth outcome safety data from a large sample multicenter cohort study in Ethiopia.MethodsA retrospective cohort study was conducted in fourteen hospitals across Ethiopia from 2017 to 2022. HIV-infected pregnant women were followed from the date of prevention of mother-to-child transmission (PMTCT) care enrolment until the infant was 6–8 weeks old. The primary safety outcome was a composite of adverse pregnancy events comprising spontaneous abortion, intrauterine fetal death (IUFD) before onset of labor, preterm birth, and maternal death. Additionally, a composite adverse birth outcome was assessed, comprising intrapartum fetal demise, low birth weight, and neonatal death. Finally, a composite of adverse pregnancy or birth outcome was also investigated. The exposure of interest was the antiretroviral treatment (ART) regimen used during pregnancy for PMTCT of HIV.ResultsDuring the study period, 2643 women were enrolled in routine PMTCT care. However, 2490 (92.2%) participants were eligible for the study. A total of 136/1724 (7.9%, 95% CI: 6.7–9.3%) women experienced adverse pregnancy outcomes. Fewer women in the DTG-based group (5.4%, 95% CI: 3.7–7.5%) had adverse pregnancy outcomes than in the Efavirenz (EFV)-based group (8.3%, 95% CI: 6.6–10.3%), P = 0.004. After controlling for baseline differences, the DTG group had a 43% lower risk of adverse pregnancy outcomes (adjusted odd ratio (AOR), 0.57; 95% CI, 0.32–0.96%) and a 53% lower risk of preterm birth (AOR, 0.47; 95% CI, 0.22–0.98%) compared to the EFV group. A total of 103/1616 (6.4%, 95% CI: 5.2–7.7%) women had adverse birth outcomes. Although the difference was not statistically significant, fewer women in the DTG group (30/548; 5.5%, 95% CI: 3.7–7.7%) than in the EFV group (57/830; 6.9%, 95% CI: 5.2–8.8%) had adverse birth outcomes.ConclusionsIn this study, we observed that DTG-based regimens were associated with better pregnancy and birth outcome safety profiles, reaffirming the WHO recommendation. However, a prospective study is recommended to assess uncaptured maternal and perinatal adverse outcomes, such as congenital abnormalities, and infant growth and neurocognitive development.

Maternal Infant Feeding Knowledge And Dietary Diversity Of Children’s Diet Born Of Hiv-Positive Mothers, In Narok County, Kenya

Despite progress in the prevention of mother-to-child transmission (PMTCT) of HIV, children still acquire HIV infection (Frange et al., 2021), in 2020, the world had 31.6 million HIV positive people and sub-Sahara African countries had 83% pregnant women, 80% infants with HIV, and 78% of teenage women 15-24 years newly infected. Kenya had 1.4 million HIV positive people a prevalence rate of 4.5% and 5% in Narok County. Breastfeeding, especially early and exclusive breastfeeding, is one of the most important ways to improve infant survival (WHO, 2023c). However, the complementary feeding period, from 6 to 23 months of age, is one of the most challenging times to meet children’s nutrient demands. While children’s stomachs can only hold a small amount of food, their nutrient needs reach a lifetime peak leaving them vulnerable to growth faltering (Almasri et al., 2020). The overall objective of the study was to determine maternal infant feeding knowledge and dietary diversity of children’s diet born of HIV-positive mothers, in Narok County, Kenya The research was a cross-sectional analytical study and involved HIV+ mothers and their babies aged 0 – 23 months, purposively selected. A defined questionnaire was utilized for socio demographic indicators (e.g. age, marital status), anthropometry assessment (e.g. weight, Height) and secondary data/ hospital records. Through simple random sampling, mother baby pairs were generated by use of a computer and SPSS version 22.0 was utilized to analyse data. Socio-economic and demographic characteristics were analyzed using descriptive and inferential statistics

HIV/AIDS-related knowledge, attitudes and perceptions of urban Ghanaian pregnant women: Results of a qualitative study

IntroductionKnowledge, attitudes, and perceptions (KAPs) regarding HIV/AIDS is one of the cornerstones in the fight against the disease. Mortality and morbidity among HIV-infected pregnant or postpartum women are reported to be eight times higher than their HIV-uninfected counterparts. Preventing mother-to-child transmission (PMTCT) strategies can be more effective if women, particularly pregnant women, have comprehensive knowledge about HIV/AIDS. MethodsThis qualitative study was designed to explore the knowledge, attitudes, and perceptions of HIV/AIDS among 18 pregnant women attending antenatal care in a health facility in Accra, Ghana. Data was collected through individual in-depth interviews, transcribed and thematically analysed using the six steps identified by Braun and Clarke. ResultsThree themes emerged from the analysis: (a) Pregnant women’s knowledge of the causes and transmission of HIV/AIDS, (b) Attitude towards HIV/AIDS and HIV testing, and (c) Perceptions about pregnant women living with HIV. We found the knowledge of the causes and mode of HIV transmission among the pregnant women to be relatively high. However, testing to determine their HIV status was low, owing to factors such as fear of testing positive, the stigma, discrimination, and prejudice associated with HIV/AIDS, and misconceptions some had about how the virus could be contracted (spiritually), which necessitated spiritual assistance before, during, and after testing. ConclusionThe findings underscore the need for health professionals to address myths and superstitions about HIV/AIDS during antenatal care visits to encourage and improve testing uptake among pregnant women.

Use and non-adherence to antiretroviral therapy among Refugee HIV positive pregnant mothers aged 18–49 years in Kyangwali refugee camp, Western Uganda

IntroductionRefugee HIV positive mothers experience significant obstacles in accessing, utilizing and adhering to antiretroviral therapy (ART). Identifying ART non-adherence can help in the development of interventions aimed at improving adherence and subsequently effectiveness of ART among the refugee mothers. We describe the use and the factors associated with non-adherence to ART among Refugee HIV positive pregnant mothers aged 18–49 years in Kyangwali Refugee Camp, Uganda.MethodsWe conducted a cross-sectional study among HIV positive pregnant mothers aged 18–49 years in Kyangwali refugee camp between May and June 2023. Using a structured questionnaire, we collected data on use, and factors associated with non-adherence to ART. We used modified Poisson regression analysis to determine factors associated with non-adherence to ART.ResultsOf the 380 participants enrolled, 192 (50.5%) were married, mean age 32.1 years. Overall, 98.7; 95% Confidence Interval (CI) [97.5–99.8%] were using ART and 27.4; 95% CI [22.9–31.9%] were non-adherent. Non-adherence was associated with: Initiating Prevention of Mother to Child Transmission (PMTCT) care in the third trimester of pregnancy (adjusted Prevalence ration(aPR): 2.06; 95% CI: 1.27–3.35), no need to get permission to seek PMTCT services aPR 1.61; 95% CI [1.07–2.42] and poor attitude of PMTCT providers aPR 1.90; 95% CI [1.20–3.01].Conclusion and recommendationsNon-adherence to ART was generally high; therefore limiting the effectiveness of the PMTCT program in this setting. Refugee context specific education interventional programs aimed at early initiation into HIV care, strong social and psychological support from families, communities and health care providers are vital to improve adherence in this setting.

Brief communication: The rate of switching from first-line to second-line antiretroviral therapy among people living with HIV in Aden City, Yemen

BackgroundEffective management of antiretroviral therapy (ART) is crucial in combating the global HIV pandemic. This study, the first of its kind in Yemen, investigates the rate and determinants of switching from first-line to second-line ART among people living with HIV (PLWH) in Aden City, Yemen.MethodsA retrospective cohort study was conducted using data from PLWH who started first-line ART at Al-Wahda Hospital from 2007 to May 2022. PLWH in prevention of mother-to-child transmission (PMTCT) programs, those already on second-line ART at enrollment, and those with less than 3 months of follow-up were excluded. Cumulative incidence curves and multivariable proportional hazards models were used to identify factors associated with switching, considering death and loss to follow-up as competing risks. Analyses were carried out using IBM SPSS version 26.ResultsOut of 149 PLWH, 18 (12.1%) switched to second-line ART with a cumulative incidence rate of 1.8 per 100 person-years. Significant factors for switching included being older than 33 years (HR: 1.45, 95% CI: 1.12–1.89), having WHO stage 3 disease (HR: 1.58, 95% CI: 1.21–2.06), and being on a TDF-FTC-EFV-based first-line regimen (HR: 1.35, 95% CI: 1.03–1.77). This switching rate is consistent with rates observed in other resource-limited settings, indicating it is neither exceptionally high nor low compared to similar contexts​.ConclusionsThe study highlights key factors associated with switching to second-line ART in Yemen, emphasizing the need for targeted interventions and continuous monitoring to enhance treatment outcomes. These findings are consistent with regional data from other resource-limited settings.

Level of option B plus drug adherence for preventing mother-to-child transmission of HIV and associated factors among HIV-positive women in the awi zone, amhara region, northwest Ethiopia,2020

IntroductionAdherence to Option B+ antiretroviral medication (ART) is essential for the successful implementation of the Prevention of Mother-to-Child Transmission (PMTCT) program. However, poor adherence to Option B + PMTCT drugs among women results in increased viral load and mother-to-child transmission and reduces immunological and clinical outcomes. ObjectiveThe objective of the study was to assess the level of Option B plus drug adherence for preventing mother-to-child transmission of HIV and associated factors among HIV positive women in selected government health facilities of Awi zone, Amhara region, Northwest Ethiopia,2020. MethodsThis institutional-based cross-sectional study was conducted from March 1 to April 30 among 358 HIV-positive women (pregnant and lactating mothers). A multistage sampling procedure was used to select the study participants. Data were collected using a structured questionnaire through interviews. The collected data were entered into EPI Data 3.1 statistical software for data management and analyzed using SPSS version 25 statistical package. The associations between variables were analyzed using bivariate and multivariable logistic regression models. A p-value ≤0.05 at the 95 % confidence interval was considered statistically significant. ResultsOut of the 358 participants, adherence to Option B + PMTCT was 83.24 %. The study revealed that counselling [AOR = 4.4, 95 % CI: 1.60–12.29], partner support involvement [AOR = 3.0, 95 % CI: 1.17–7.92], and time taken to reach from home to the facility [AOR = 3.1, 95 % CI: 1.51–6.52] were significantly associated with the level of adherence to Option B + PMTCT. ConclusionThis study showed that the level of Option B + PMTCT drug adherence was lower than the nationally recommended adherence level. Good counselling, partner support, and reduced travel time from home to the facility were associated with adherence to Option B + PMTCT drugs. Therefore, counselling is crucial for increasing adherence to Option B + PMTCT drugs. Accessible health facilities reduce travel burdens, encourage regular clinic visits, and enhance adherence to PMTCT drugs. Partners can provide reminders, attend appointments, offer emotional support, and explore alternatives such as mobile clinics or medication delivery services.

Assessment of Health Care Workers' Attitude towards PMTCT of HIV at Primary Health Care Center in Minna Metropolis, Niger State

Human immunodeficiency virus is grouped into the genus Lentivirus within the family of retroviridean, a subfamily of retrovirinae. Since its emergence, it has remained a global public health crisis with approximately 39.0 million (33.1 – 45.7 mil) people living with HIV globally in 2022, with some countries reporting increased trends in new infections and it is incurable. There has been documented success in decreasing new cases and mortality resulting from HIV/AIDS globally; however, in sub-Saharan Africa, the rate of new infections has increased disproportionately among young women. Thus, the region accounts for about 9 – 10 women and children living with HIV. Mother-to-child transmission (MTCT) of HIV occurs when HIV is transmitted from the mother to the child during pregnancy, childbirth, or breastfeeding, although the rate of MTCT of HIV in high-income countries has significantly reduced to less than 1% in some low-income countries, MTCT of HIV remains high at 8.9%, and about 90% of HIV infection in children occurs through MTCT of HIV. Prevention of Mother-to-child transmission (PMTCT) of HIV is recommended to curb the menace of MTCT of HIV (Falnes et al., 2010). It involves a series of events, services, or interventions, which, when fully implemented, result in a reduction in the risk of mother-to-child transmission (MTCT) of HIV (Centers for Disease Control and Prevention, 2016) that involves the use of drugs and non-drug-related services. Health care workers play an important role in the provision of services and interventions aimed at reducing HIV transmission. Therefore, this study intends to Asses Health Care Workers' Attitude Towards PMTCT of HIV At Primary Health Care Center. The study is an institutional-based cross-sectional descriptive survey study. The sample size was calculated using the formula of Yamane (1967), a multistage sampling was used to select sampling unit. A self-administered closed-ended questionnaire was used as the instrument for data collection, all responses to the completed questionnaire were coded and entered into SPSS v25.0, edited, and checked accordingly. Descriptive statistics were used to describe the frequency distribution and measures of central tendency, whereas inferential statistics were used to determine the relationship between the study variables. The study finding reveals that the general attitude score of the respondents on PMTCT of HIV was Positive (3.1) and there is a statistically significant level of association between years of work and attitude (p<0.024). In this study, it can be concluded that the level of health care workers attitude towards PMTCT of HIV was positive and there is a statistically significant level of association between years of work and attitude. This shows that health care workers with more year of working experience have a better attitude, this could be related to the fact that they have more contact time and training on PMTCT and HIV in general, it is recommended that further studies be conducted to the explore the reason behind the statistical association above.

Gambaran Tingkat Pengetahuan Ibu Hamil Tentang Pencegahan Penularan HIV pada Anak (PPIA) di Puskesmas Putat Jaya Kota Surabaya

The proportion of HIV-positive pregnant women in Indonesia rises annually. Pregnant women’s HIV test results in Indonesia fall a little short of the target for 2022. Knowledge is one of the most important aspects of the prevention of mother-to-child transmission of HIV (PMTCT). The aim of this research is to determine the knowledge among pregnant women in Putat Jaya Community Health Care in Surabaya regarding the transmission of HIV from mothers to their children. Cross-sectional analysis is used in this descriptive study. There are 35 pregnant women who have responded. Mothers enrolled in trimesters 1, 2, and 3 who are getting antenatal care at Putat Jaya Community Health Care in Surabaya meet the inclusion criteria for this study. However, a mother with special needs is the sole requirement for this study. In September 2023, this study was carried out at Putat Jaya Community Health Care in Surabaya. The method for gathering samples is called purposive sampling. According to the findings, 77.1% were sufficiently aware of how to prevent HIV transmission from mother to child, followed by 14.3% who had high knowledge and 8.6% who had a lack of knowledge about the prevention of mother-to-child transmission (PMTCT) of HIV.

Attrition from care and its predictors among women exposed to dolutegravir- and efavirenz-based first-line antiretroviral therapy in Ethiopia: a before-and-after study.

The effect of dolutegravir (DTG)-based regimens on reducing attrition from care among women enrolled in the prevention of mother-to-child transmission (PMTCT) care program is unknown. Therefore, this study aimed to compare the incidence of attrition among women exposed to DTG-based with those exposed to efavirenz (EFV)-based first-line antiretroviral therapy (ART) in Ethiopia. An uncontrolled before-and-after study was conducted involving 932 women (with 466 on EFV-based and 466 on DTG-based regimens) who were enrolled in the PMTCT care program from September 2015 to February 2023. The outcome variable was attrition (i.e., maternal death or loss to follow-up before their infants' final HIV status was determined). A Kaplan-Meier estimator was employed to estimate the probability of attrition. The Cox proportional hazards regression model was fitted to identify predictor variables. The adjusted hazard ratio (aHR) with the corresponding 95% confidence interval (CI) was calculated to examine the risk difference in the comparison groups. The cumulative incidence of attrition among women was 5.2% (3.0% for those placed in the DTG-based regimen arm and 7.3% for those placed in the EFV-based regimen arm). Women on DTG-based regimens had a 57% (aHR: 0.43; 95% CI: 0.23-0.80) lower risk of attrition from care compared to those on EFV-based regimens. Women who delivered their infants at home (aHR: 2.35; 95% CI: 1.14-4.85), had poor/fair adherence (aHR: 3.23; 95% CI: 1.62-6.45), had unsuppressed/unknown viral load status (aHR: 2.61; 95% CI: 1.42-4.79), and did not disclose their status to partners (aHR: 2.56; 95% CI: 1.34-4.92) had a higher risk of attrition from PMTCT care compared to their counterparts. The cumulative incidence of attrition among women receiving PMTCT care is optimal. In addition, the risk of attrition among women receiving DTG-based regimens is lower than that among women receiving EFV-based regimens. Thus, DTG-based first-line ART regimen supplementation should be sustained to achieve a national retention target of 95% and above.

Feeding modalities, HIV transmission and its predictors among HIV-exposed infants visited Gamo and Gofa zones public health facilities, Southern Ethiopia: a retrospective follow up study

BackgroundDespite the highest (88%) Prevention of Mother-To-Child Transmission (PMTCT) of HIV coverage in Eastern Africa, 50% of new HIV infections in children aged 0–14 years occur in the region.ObjectiveThe aim of this study was to assess the feeding modalities, the rate of HIV transmission and its predictors among HIV exposed infants (HIV-EIs) visited Gamo and Gofa Zones public health facilities, Southern Ethiopia from January 2013 to February 2019.Method and materialsInstitution-based retrospective follow up study was employed among 450 HIV-EIs having DNA/PCR test results. All infant-mother pair records in selected health facilities were reviewed using a standard data extraction tool from March to July 2019. HIV transmission probabilities were assessed by Kaplan–Meier time-to-event analysis method and log-rank tests were used to compare the risk among different groups. The Cox-proportional hazards model, adjusted on infant feeding modalities and other co-variants was used to identify predictors of HIV transmission, and statistical significance was declared at a p-value of < 0.05.ResultsIn total, 383 complete records were analyzed. In the study, 85.6% (95%CI: 81.6%, 89.1%) of HIV-EIs were exclusively breastfed in the first six months. The 18 months probability of infant HIV transmission was 64 (16.7%) (95%CI: 13.1%–20.8%). The risk of HIV-transmission was higher among infants who were delivered at the hospital than health centers/health posts (AHR = 3.07; 95%CI: 1.19, 7.95); discontinued Cotrimoxazole prophylaxis in at least one visit (AHR = 6.32; 95%CI: 3.35, 11.94); did not exclusively breastfeed (AHR = 3.07; 95%CI: 1.72, 5.47) and came from urban areas (AHR = 5.90; 95%CI: 1.40, 24.85).ConclusionsThe study showed that HIV-EIs had a greater rate of 18 months HIV transmission than the national pooled prevalence. The risk of transmission is higher among infants who do not breastfeed exclusively for the first 6 months, and the risk increases with the number of months spent by breastfeeding. Therefore, strengthening counselling on safer feeding options and Cotrimoxazole prophylaxis use; provision of quality PMTCT service with special focus in hospitals and urban residents were recommended.

Knowledge of pregnant women regarding prevention of mother-to-child transmission of HIV infection in Gert Sibande District, Mpumalanga Province, South Africa: A qualitative study.

Prevention of mother-to-child transmission (PMTCT) of HIV helps in closing the gaps for new HIV infections, thereby contributing to achieving the global targets of an AIDS-free generation. To explore knowledge regarding PMTCT among pregnant women in Gert Sibande District, Mpumalanga Province, South Africa (SA). The study was performed in two clinics in Chief Albert Luthuli Municipality, Gert Sibande District. It was a qualitative and descriptive exploratory study involving in-depth, one-on-one interviews with pregnant women regarding their PMTCT knowledge and perspectives. The study findings showed that pregnant women from the two clinics have a good knowledge of PMTCT. However, they were not aware that caesarean section can minimise mother-to-child transmission (MTCT) of HIV infection. PMTCT is important in establishing an HIV-free generation. The study revealed that women had a good understanding of MTCT; nevertheless, additional education is necessary, particularly regarding birthing procedures that minimise the risk of MTCT.

HIV in pregnant woman and children: Mother-to-child transmission of HIV in the Brazilian land border from 2010 to 2021.

The aim of the present study was to analyze the profile and trends of HIV mother-to-child transmission (MTCT) in the Brazilian land border strip (LBS). This was a quantitative, ecological, and cross-sectional study using secondary data available in the information systems of the Brazilian Ministry of Health. All cases reported in the Notifiable Diseases Information System between 2010 and 2021 were studied. Between 2010 and 2021, 275 children were born infected through MTCT, and 6076 pregnant women were living with HIV in the Brazilian LBS. HIV detection rates in pregnant women increased in all border arcs. The northern arc experienced the highest increase (19.6%), followed by the central arc (11.4%), and the southern arc (6.1%). Despite historically high detection rates, the southern arc exhibited the smallest increase. While MTCT rate decreased by 37.7% in the border area, the central arc showed no statistically significant reduction. In 2021, the average age of pregnant women was 26.2 years, 25.7% had up to 8 years of schooling, and 55.8% identified as non-white. The majority (92.8%) received antenatal care, and 59.7% were diagnosed with HIV before prenatal care. The use of prophylactic antiretroviral therapy during prenatal care occurred in 69.6% of pregnant women, and infant prophylaxis was provided within first 24 h to 43.6% of live births. The results indicate progress in reducing MTCT cases in Brazilian LBS. Disparities in HIV detection rates may be influenced by differences in testing uptake, despite mandatory testing for all babies. It is crucial to continue implementing strategies to reach these women and ensure equitable access to healthcare services for MTCT prevention.