Characteristics Associated with HIV-1 Infection in Pregnant Women in Brazzaville, Congo

Lallemant, Marc; Coeur, Sophie Lallemant-Le; Cheynier, D.; Nzingoula, S.; Jourdain, Gonzague; Sinet, Martine; Dazza, Marie-Christine; Larouz??, Bernard

doi:10.1097/00126334-199203000-00009

Cited by 12 publications

(16 citation statements)

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“…The high prevalence of HIV infection among the pregnant women will inevitably result in an increasing number of children who will be infected with HIV through mother-toinfant transmission. The association of maternal HIV infection with death of the most recent infant among pregnant women has also been observed in other studies 37 and is likely to be in part due to mother-to-infant transmission of HIV either in the peripartum period or through breastfeeding 12,13 . The association of higher infant mortality rates with maternal HIV infection have been reported in studies from Brazzaville (39%) and Kinshasa (21%) 38,39 .…”

Section: Discussionsupporting

confidence: 71%

Risk factors for HIV infection among asymptomatic pregnant women attending an antenatal clinic in western Kenya

et al. 2000

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Our objective was to evaluate HIV prevalence and identify risk factors for HIV infection among women attending the antenatal clinic (ANC) at a large public hospital in Kisumu town, western Kenya. Between June 1996 and November 1997, in the context of a study to determine the effect of placental malaria on mother-to-child transmission of HIV in western Kenya, HIV-1 antibody testing was offered to women with a singleton uncomplicated pregnancy of > or =32 weeks' gestation attending the ANC. Women were interviewed using a structured questionnaire and had a fingerstick blood sample collected for haemoglobin (Hb), malaria smears, and HIV antibody testing. Overall HIV seroprevalence was 26.1% (743/2844) (95% confidence interval (CI): 24.5-27.7) and in bivariate evaluation was significantly associated with anaemia (Hb <11 g/dl) (risk ratio (RR) 1.8), malarial parasitaemia (RR 1.6), fever (axillary temperature > or =37.5 degrees C at screening) (RR 1.6), a history of being treated for either vaginal discharge (RR 1.5) or tuberculosis (RR 1.6), reported alcohol consumption (RR 1.6), being an unmarried multigravida (RR 2.2) or a history of the most recent child having died (RR 2.0). Poisson regression analysis for all women identified 5 significant factors independently associated with HIV seropositivity: anaemia (adjusted RR 1.7; 95% CI 1.3-2.0), malarial parasitaemia (adjusted RR 1.7; 95% CI 1.4-2.0), a history of being treated for vaginal discharge (adjusted RR 1.5; 95% CI 1.1-2.0), fever (adjusted RR 2.0; 95% CI 1.3-3.2) and reported alcohol consumption (adjusted RR 1.6; 95% CI 1.1-2.5). Multigravidae women whose most recent child had died were also more likely to be HIV seropositive (adjusted RR 1.9; 95% CI 1.7-2.8). Only 5.5% (156/2844) of the women had none of these risk factors, of whom 12% (18/156) were HIV(+). Even though the model containing the 5 identified factors fitted the data well (goodness-of-fit chi2=18.41, P=0.10), its collective capacity to predict HIV infection was poor; while 74% of the truly positive women were correctly predicted positive by the model, 52% of the truly negative women were misclassified. Among pregnant women attending the ANC in western Kenya, we were unable to identify a subgroup at risk of HIV infection using non-serological information, indicating that wherever possible universal access to voluntary HIV counselling and testing would be preferable to targeted screening.

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Section: Discussionsupporting

confidence: 71%

Risk factors for HIV infection among asymptomatic pregnant women attending an antenatal clinic in western Kenya

et al. 2000

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“…In Brazzaville, Congo, women living in the central district, closer to the epicentre of the HIV epidemic in that city, not surprisingly had a higher risk of being HIV infected 5 . In one study from Uganda 6 , pain and non-menstrual bleeding during intercourse were associated with a higher risk of HIV infection.…”

Section: Africamentioning

confidence: 97%

“…Because HIV disease can progress more rapidly in children, HIVinfected women may have one or more children who have died from HIV-related illnesses. This probably explains why women with more deceased children were more likely to be HIV infected 5 .…”

Section: Africamentioning

confidence: 99%

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Risk factors for HIV in pregnant women

Smith¹,

Hwang²

1996

Int J STD AIDS

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Worldwide, the number of childbearing women infected with the human immunodeficiency virus (HIV) is rising. Early intervention can improve care for these women and reduce HIV transmission to their children. However, for intervention strategies to be effective, childbearing women at risk must be identified. HIV prevalence and risk factors vary widely from one region to another, and strategies for HIV testing must be tailored to local conditions. In this review, published data on HIV risk factors in pregnant women are presented by region, and implications for regional strategies for HIV testing in pregnant women are discussed.

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“…In Congo, among 1770 women at an antenatal clinic in 1987± 88, 17 of 282 with a history of induced abortions were HIVpositive vs 54 of 1488 without for a crude population attributable fraction (PAF) of HIV associated with induced abortions of 5%; complications from abortions were a common cause of hospitalization, which was also associated with HIV infection 74 . Among 4548 wives of workers in Kinshasha in 1987± 88, 9.2% of 175 HIV-positive women vs 3.9% of 4373 HIV-negative women reported induced abortions for a crude PAF of 10% 69 .…”

Section: Hiv Infections Associated With Induced Abortions and Assistementioning

confidence: 99%

HIV infections in sub-Saharan Africa not explained by sexual or vertical transmission

et al. 2002

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An expanding body of evidence challenges the conventional hypothesis that sexual transmission is responsible for more than 90% of adult HIV infections in Africa. Differences in epidemic trajectories across Africa do not correspond to differences in sexual behaviour. Studies among African couples find low rates of heterosexual transmission, as in developed countries. Many studies report HIV infections in African adults with no sexual exposure to HIV and in children with HIV-negative mothers. Unexplained high rates of HIV incidence have been observed in African women during antenatal and postpartum periods. Many studies show 20%–40% of HIV infections in African adults associated with injections (though direction of causation is unknown). These and other findings that challenge the conventional hypothesis point to the possibility that HIV transmission through unsafe medical care may be an important factor in Africa's HIV epidemic. More research is warranted to clarify risks for HIV transmission through health care.

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Characteristics Associated with HIV-1 Infection in Pregnant Women in Brazzaville, Congo

Cited by 12 publications

References 0 publications

Risk factors for HIV infection among asymptomatic pregnant women attending an antenatal clinic in western Kenya

Risk factors for HIV infection among asymptomatic pregnant women attending an antenatal clinic in western Kenya

Risk factors for HIV in pregnant women

HIV infections in sub-Saharan Africa not explained by sexual or vertical transmission

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