Knowledge, Attitudes and Practices of HIV Positive Breastfeeding Mothers in Prevention of Mother to Child Transmission of HIV in Ouagadougou (Burkina Faso) and Associated Factors

Abstract

World Health Organization (WHO) places strong emphasis on exclusive breastfeeding of HIV exposed infants during the first 6 months, combined to antiretroviral treatment for mothers and prophylaxis for infants. However, adherence to safe breastfeeding among HIV infected mothers is still a major challenge in Burkina Faso. We conducted a cross sectional study in four hospitals in Ouagadougou, Burkina Faso in order to explore knowledge, attitudes and practices of HIV infected breastfeeding mothers attending selected clinics for Prevention of Mother to Child Transmission of HIV (PMTCT). Two hundred and one HIV infected mothers attended the clinics for their children's routine medical visit, among them 162 (81%) had chosen breastfeeding. The majority of women (95%) were familiar with PMTCT measures required during pregnancy and childbirth, whereas prevention measures required during breastfeeding period were less mentioned: mothers strict adherence to antiretroviral treatment (48.1%), safe sexual practices (1.85%), cessation of breastfeeding in case of breast infection (6.2%), avoiding traditional enema (36.4%) and stopping breastfeeding at the age of 12 months after 6 months of exclusive breastfeeding along with the introduction of other foods and fluids (43.2%). Moreover, 52.2% of women did not practice exclusive breastfeeding during the first six months. Factors associated with poor breastfeeding practices were: infant feeding option decided solely by the mother, living in well serviced areas and having a low score (≤ 3) of knowledge on how to prevent HIV transmission during breastfeeding. There is a need for urgent interventions in support of safe breastfeeding in HIV exposed infants in Ouagadougou.

Determinants of Infant Feeding Practices Among HIV-Infected Mothers in Urban Kano, Nigeria

“…The proportion of participants who indicated awareness of the possibility of mother-to-infant HIV transmission during breastfeeding was similar to the figure reported from Enugu (39.0%; Anoje et al, 2012), but lower than that from Ibadan (86%), both in Nigeria (Balogun & Owoaje, 2015). In sub-Saharan Africa, our figure is comparable with reports from Ethiopia (31.4%; Tesfaye et al, 2015), but much lower than those from Burkina Faso (99.5%; Yonaba et al, 2018), Kenya (85.5%; Wachira et al, 2009), and South Africa (78%; Ladzani et al, 2011). When making these comparisons, there is need for caution due to variations in study populations, design, measurements, and the timing of the studies.…”

“…Compared to mothers in the current study, fewer than half (48.1%) of mothers in the Burkina Faso study considered antiretroviral therapy to be protective (Yonaba et al, 2018). Further, a larger proportion of respondents in the current study indicated awareness of the increased risk of HIV transmission with mastitis compared to their counterparts in Burkina Faso (26%; Yonaba et al, 2018). Further, the proportion of study respondents that mentioned oral ulcers in infants as facilitators of HIV acquisition was much higher than among their contemporaries in Zimbabwe (3.6%; Piwoz et al, 2005).…”

“…The proportion of our study respondents who were aware that HIV-exposed infants should be breastfed exclusively for the initial 6 months after delivery was higher than findings in Ibadan, Nigeria (18.4%; Balogun & Owoaje, 2015). In other parts of Africa, the corresponding figures were lower in Ethiopia (28.1%; Tesfaye et al, 2015), and Burkina Faso (43.2%; Yonaba et al, 2018), but much higher in Lesotho (96%; Olorunfemi & Dudley, 2018). The approximately normal distribution of knowledge scores among participants in this study was unexpected, considering that nearly two third of respondents had at least secondary education.…”

“…These findings concur with reports from previous studies (Ndubuka, Ndubuka, Li, Marshall, & Ehiri, 2013; Piwoz et al, 2005). For instance, previous studies found that maternal knowledge predicted practice (Fadnes et al, 2009; Olorunfemi & Dudley, 2018; Suuk & Veloshnee, 2011; Yonaba et al, 2018). Further, hospital delivery increases the opportunity to counsel potential mothers on appropriate infant feeding (Vikram, Vanneman, & Desai, 2012).…”

“…The questionnaire was a pretested structured interviewer-administered tool adapted from previous studies (Olorunfemi & Dudley, 2018; Yonaba et al, 2018). The questionnaire had five sections with a total of 36 questions.…”