Determinants of HIV infection among children born to HIV positive mothers on prevention of mother to child transmission program at referral hospitals in west Amhara, Ethiopia; case control study

Abstract

Background Human Immune Deficiency Virus infection among children has continued to be a global concern with an estimated 160,000 new infections in 2018. Over 90% acquire HIV from their mother. Currently, 92% of pregnant women are on antiretroviral therapy (ART). Despite, greater achievements in coverage of PMTCT and ARV drug in Ethiopia as well as in west Amhara, child HIV infections are yet an important public health problem with a high transmission rate. There are limited studies done in Ethiopia on identifying determinants of child HIV infection. Objective This study was aimed at identifying determinants of HIV infection among children born to HIV positive mothers on the PMTCT program at referral hospitals in the west Amhara, Ethiopia, 2021. Methods An unmatched case–control study was conducted at referral hospitals in the west Amhara region, Ethiopia. Data were collected through document review, which has been registered from July 1, 2016 to July 1, 2020. A two-stage sampling technique was applied. Consecutive sampling technique for cases and simple random sampling technique for controls was done to include a total of 320 samples (66 cases and 254 controls). Epi data 4.6 for data entry and SPSS 23 for analysis were used. Variables with p- value ≤0.2 in bivariate regression were run in the multivariable logistic regression and AOR with 95% CI and a p-value ≤0.05 was used to declare determinants. Result Home delivery (AOR = 4.3; 95%CI: 2.0, 11.6), mixed feeding (AOR = 10; 95%CI: 3.2, 17.9), poor maternal ARV drug adherence (AOR = 4.3; 95% CI: 1.4, 13.4), advanced WHO clinical stage (AOR = 11.4; 95% CI: 4.1,19.1), poor nevirapine adherence (AOR = 10; 95% CI: 3.2, 22.4) and late enrollment of the infant (AOR = 15; 95% CI: 3.0, 3.0,20.5) were determinants. Conclusion Minister of Health and NGOs should work on mobilization of the community and awareness creation on the important of exclusive breast feeding, drugs adherence, on benefit of health institutional delivery as well as the risk of homedelivery.

Effect of Dolutegravir-Based First-Line Antiretroviral Therapy on Mother-to-Child Transmission of HIV Among HIV-Exposed Infants in Ethiopia: a Before-and-After Study

“…In this regard, the risk of acquiring the virus from mothers was 3.61 times higher among infants born at home than among those born at a health facility. This finding is consistent with a study conducted in the Amhara region, 13,18,22,24 Addis Ababa, 15 Dire Dawa, 17 and Southern Ethiopia. 21 This might be because mothers who gave birth at home could not receive PMTCT services available at health facilities, such as active management of labor with partographs, infection prevention practices, safe delivery practices, and lack of ARV prophylaxis for their infants.…”

“…7,11 Previous studies have focused on the incidence and risk factors of MTCT of HIV among infants exposed to EFVbased regimens. [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] Despite its preference due to rapid viral suppression, the high genetic barrier to resistance, and availability at a low cost, 4,28 the effectiveness of DTG-based therapy in reducing MTCT of HIV over the previously used EFV-based therapy is not known. Therefore, this study aimed to compare the effect of DTG-based first-line antiretroviral therapy versus EFV-based regimens on the MTCT of HIV among HIV-exposed infants in Ethiopia.…”

Maternal and neonatal risk factors associated with increased mother-to-child transmission of HIV-1 in Mexico: Results of a case–control study

“…In studies in Ethiopia, HIV-exposed children who had been mixed breastfed were 10 times more likely to get acquire HIV than those who had been exclusive breastfed or replacement fed. 27,28…”

“…In studies in Ethiopia, HIV-exposed children who had been mixed breastfed were 10 times more likely to get acquire HIV than those who had been exclusive breastfed or replacement fed. 27,28 In Kenya, breastfeeding is recommended, because of high malnutrition rates; but breastfeeding by mothers who are seropositive for HIV is not recommended in Mexico; 29 however, accumulating evidence has shown that giving antiretroviral drugs to the mother or the infant can significantly reduce the risk of HIV transmission through breastfeeding. Here, we found that a high proportion of mothers in the MTCT group breastfed.…”

Advances for pediatricians in 2022: allergy, anesthesiology, cardiology, dermatology, endocrinology, gastroenterology, genetics, global health, infectious diseases, metabolism, neonatology, neurology, oncology, pulmonology

“…In West Amhara, Ethiopia an unmatched case-control study from 2016 to 2020, aimed to identify determinants of HIV infection among children born to HIV positive mothers on the prevention of the mother -child transmission program at referral hospitals [132]. The region is characterized by an important HIV public health problem with a high transmission rate.…”