Background: The fertility rate in Burundi has remained consistently high since the 1980s, while the prevalence of contraceptive use in the country (22%) has been among the lowest in Africa. Reasons for low contraception uptake in Burundi have not been adequately clarified. This study aimed to identify factors associated with contraceptive use among pregnant women who had at least 3 healthy children and sought antenatal care services at an urban tertiary hospital in Burundi. Methods: Data were collected from antenatal clients with 3 or more children at Kamenge University Hospital. Data analysis included univariate and multivariate methods as well as multiple logistic regression analysis using SPSS, version 16.0. Results: We enrolled 255 women with a mean age of 3264.5 years. The majority (n=232, 91.0%) of participants were urban residents with low incomes, and most (n=227, 89.0%) were educated to the primary school level or lower. The mean parity was 4.261.4, and most women had either 3 (n=120, 47.1%), 4 (n=66, 25.9%), or 5 (n=43, 16.9%) children; 26 (10%) participants had at least 6 children. Most (n=166, 65.1%) participants were part of couples who desired to have a final number of 4 to 6 children. About half (n=129, 50.6%) of the participants were able to name 1 or 2 benefits of contraception, and 105 (41.2%) participants mentioned 3 or 4 benefits of contraception. The most commonly reported benefit of contraceptive use was that it allows for improved maternal and child health. Low rates of contraceptive use were reported by participants with partners who worked as farmers, those citing fewer benefits of contraception, and those who relied on neighbours as their main source of information about contraception. Conclusion: Knowledge of the benefits of contraception was among the strongest determinants of contraceptive use in this population. Farmers and traders were less likely to use contraceptives than participants who were engaged in other types of work. Medical personnel were the most relied upon source of information about contraception, and the strongest predictor of contraceptive use was the personal opinion that contraception is acceptable.

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Background: Prevention of mother-to-child transmission (PMTCT) programmes aim to both eliminate vertical transmission of HIV and optimise the health and survival of infants born with HIV. Therefore, early infant diagnosis (EID) of HIV infection via DNA polymerase chain reaction (PCR) testing is a key component of PMTCT programming. We assessed the effectiveness of EID and PMTCT interventions at health-care facilities in Bujumbura, Burundi. Methods: This was a prospective analytical study of infants born to HIV-positive mothers on antiretroviral therapy (ART), who were followed from December 2016 to March 2017 at 3 centres providing PMTCT services in Bujumbura. Babies enrolled in this study received once-daily nevirapine from birth through to 6 weeks of life, after which HIV DNA PCR testing was conducted. Results: Of 122 HIV-exposed infants, 60 were boys and 62 were girls. The mother-to-child transmission rate at 6 weeks of life was 0.9%. Eighty-three (68%) of the women had commenced ART before pregnancy and 39 (32%) during pregnancy. The mean CD4 lymphocyte count was 6536308 cells/ll. Ninety-two (75.4%) of the pregnancies were planned, and 98 (80%) of the births were via spontaneous vaginal delivery. After birth, 111 (91.0%) infants were exclusively breastfed, and 11 (9.0%) infants received exclusive replacement feeding. Conclusion: There was a low rate of transmission of HIV from women taking ART to children who were given nevirapine for the first 6 weeks of life. Infants of HIV-positive women can live healthy lives free from HIV infection if their mothers participate in PMTCT programmes.