Mother-to-child transmission of HIV in Kenya: A cross-sectional analysis of the national database over nine years

Matilu, Mwau; Bwana, Priska; Kithinji, Lucy; Ogollah, Francis M; S, Ochieng; Akinyi, Catherine; Adhiambo, Maureen; Ogumbo, Fred; Sirengo, Martin; Boeke, Caroline E.

doi:10.1371/journal.pone.0183860

Cited by 23 publications

(21 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A total of nine countries and 33 studies were included in this systematic review and meta-analysis. Of this, sixteen studies were from Ethiopia (5-11, 21-24, 26-28, 37, 38 ), five studies were from Kenya [ 12 , 15 , 20 ], three studies were from Tanzania [ 13 , 16 ], three studies were from Uganda [ 14 , 18 , 19 , 31 ], two studies were from Zimbabwe [ 33 , 34 ], and the remaining one study was from Eritrea [ 19 ], South Sudan [ 32 ], Malawi [ 35 ], and Rewanda [ 36 ]. In this review, eighteen studies were cross-sectional study designs while fifteen studies were cohorts (Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…A total of ten studies [ 6 , 7 , 9 , 10 , 15 , 21 , 25 , 27 , 38 ] were included in this meta-analysis to show the significance between mixed feeding and MTCT of HIV. The pooled odds ratio showed that mothers practiced mixed feeding for their exposed infants were 6.22 times more likely to acquire HIV infection than exclusively breastfeeding exposed infants (AOR = 6.22 (1.02, 11.41).…”

Section: Resultsmentioning

confidence: 99%

“…The place of delivery [ 6 , 7 , 10 , 14 , 18 , 21 , 24 , 25 , 27 , 38 , 39 ], mixed feeding [ 6 , 9 , 15 , 21 , 25 , 27 , 39 ], mother’s age [ 5 , 24 ], residence [ 7 , 27 ], time to initiate infant prophylaxis [ 7 – 10 , 27 ], mother’s HIV stage [ 9 , 18 ], antenatal care visits [ 8 , 9 , 18 ], prevention of vertical HIV infection [ 6 , 7 , 24 ], and feeding practices [ 7 , 8 , 24 ] were a number of the factors for acquisitions of HIV infection for exposed infants and children. Of these factors, four factors (place of delivery, duration of mother on ART, initiation of ART prophylaxis for newborns, and mixed feeding) were chosen to work out their effect on vertical HIV infection.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prevalence of vertical HIV infection and its risk factors among HIV exposed infants in East Africa: a systematic review and meta-analysis

2020

View full text Add to dashboard Cite

Background Human immunodeficiency virus (HIV) is one of the most important global health problems. More than one and half million of children are living with HIV in the world, and majority of them are found in sub-Saharan Africa. There are primary fragmented study findings, and no review was conducted with regard to vertical HIV infection in East Africa. Therefore, this review aimed to assess the prevalence of vertical HIV infection and its risk factors among HIV-exposed infants in East Africa. Main body Eligible studies were retrieved by relevant search terms in CINHAL, Pub-MED, Google Scholar, EMBASE, Web of Science, SCOPUS, Cochrane, African Journals Online databases, and Ethiopian University research repositories. Data were extracted with Microsoft Excel and analyzed with Stata version 11 software. The random effect model was used to estimate the pooled prevalence of vertical HIV infection in East Africa. The variation between studies was quantified with an I2 statistic test. Furthermore, sub-group and meta-regression analyses were done to identify the sources of heterogeneity between the studies. The publication bias was assessed by Egger test. This systematic review and meta-analysis have included a total of 33 research articles. The overall pooled prevalence of vertical HIV infection in East Africa was 7.68% with a 95% confidence interval [CI]: (6.23, 9.12) with a heterogeneity of I2 = 86.8 with a p value < 0.001. In subgroup analysis, the pooled prevalence of vertical HIV infection in cross-sectional studies was 6.58%, while in cohort studies were 9.37%. Mixed feeding, AOR = 6.22 (1.02, 11.41); home delivery, AOR = 2 (1.01, 3); mothers took ART less than 4 weeks, AOR = 1.92 (1.79, 2.06); and infants who have not received ARV prophylaxis, AOR = 2.02 (1.05, 2.98) were the associated factors for vertical HIV infection for exposed infants. Conclusions The pooled prevalence of the mother to child transmission of HIV is way more than the desired target of the World Health Organization, which is less than 5% in breastfeeding populations. Thus, strengthening the prevention of vertical HIV transmission, promotion of exclusive breastfeeding, timely initiation of ART prophylaxis for HIV exposed infants, encouragement of hospital delivery, and the start of ART at the time of diagnosis of every HIV-positive person may all reduce the transmission of vertical HIV infection.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prevalence of vertical HIV infection and its risk factors among HIV exposed infants in East Africa: a systematic review and meta-analysis

2020

View full text Add to dashboard Cite

show abstract

“…In Kenya, a country with one of the largest HIV epidemics in the world in terms of the number of people living with HIV [13], data from 2018 shows that the overall adult HIV prevalence (~5%) and incidence (36,000 new infections annually) continues to decline, but HIV related deaths continue to plateau [14,15]. Additionally, without treatment and adherence, the risk of mother to child transmission (MTCT) of HIV among HIV positive pregnant women increases [16][17][18][19], with coverage at 74%, down from 86% [20]. While virtual elimination of MTCT is possible [21], this scenario presents the need to not only focus on access to ART and outcomes along the HIV cascade, but also to begin to institute a health systems approach focusing on financing, human resources, service delivery, and information and appropriate technology for comprehensive HIV treatment and prevention [22,23].…”

Section: Introductionmentioning

confidence: 99%

Predictors of Health Insurance Enrollment among HIV Positive Pregnant Women in Kenya: Potential for Adverse Selection and Implications for HIV Treatment and Prevention

Were

Hogan

Galárraga

et al. 2020

IJERPH

View full text Add to dashboard Cite

Background: The global push to achieve the 90-90-90 targets designed to end the HIV epidemic has called for the removing of policy barriers to prevention and treatment, and ensuring financial sustainability of HIV programs. Universal health insurance is one tool that can be used to this end. In sub-Saharan Africa, where HIV prevalence and incidence remain high, the use of health insurance to provide comprehensive HIV care is limited. This study looked at the factors that best predict social health insurance enrollment among HIV positive pregnant women using data from the Academic Model Providing Access to Healthcare (AMPATH) in western Kenya. Methods: Cross-sectional clinical encounter data were extracted from the electronic medical records (EMR) at AMPATH. We used univariate and multivariate logistic regressions to estimate the predictors of health insurance enrollment among HIV positive pregnant women. The analysis was further stratified by HIV disease severity (based on CD4 cell count <350 and 350>) to test the possibility of differential enrollment given HIV disease state. Results: Approximately 7% of HIV infected women delivering at a healthcare facility had health insurance. HIV positive pregnant women who deliver at a health facility had twice the odds of enrolling in insurance [2.46 Adjusted Odds Ratio (AOR), Confidence Interval (CI) 1.24–4.87]. They were 10 times more likely to have insurance if they were lost to follow-up to HIV care during pregnancy [9.90 AOR; CI 3.42–28.67], and three times more likely to enroll if they sought care at an urban clinic [2.50 AOR; 95% CI 1.53–4.12]. Being on HIV treatment was negatively associated with health insurance enrollment [0.22 AOR; CI 0.10–0.49]. Stratifying the analysis by HIV disease severity while statistically significant did not change these results. Conclusions: The findings indicated that health insurance enrollment among HIV positive pregnant women was low mirroring national levels. Additionally, structural factors, such as access to institutional delivery and location of healthcare facilities, increased the likelihood of health insurance enrollment within this population. However, behavioral aspects, such as being lost to follow-up to HIV care during pregnancy and being on HIV treatment, had an ambiguous effect on insurance enrollment. This may potentially be because of adverse selection and information asymmetries. Further understanding of the relationship between insurance and HIV is needed if health insurance is to be utilized for HIV treatment and prevention in limited resource settings.

show abstract

“…Mother-to-child transmission accounts for almost all new infections in children [5]. Without uptake of effective interventions, HIV-infected mothers will continue to infect their children [6,7,8].…”

Section: Introductionmentioning

confidence: 99%

Factors Accounting for Differences of Fertility Desires and Intentions Among HIV-Infected and Uninfected Women of Reproductive Age at Six Hospitals in Two Regions of Kenya

Atieno¹,

Gitonga²,

Ng’ang’a³

et al. 2018

IJHPEBS

View full text Add to dashboard Cite

Previous studies indicate that parenthood is a central life goal in most societies. Child bearing among HIV infected women poses danger of vertical HIV transmission. The study sought to investigate factors accounting for the differences in levels of fertility desires and intentions for HIV-infected and uninfected women of reproductive age from six hospitals in Nyanza and Central regions of Kenya. Intention connotes commitment to a course which usually leads to instrumental behaviors whereas desires are, however, wishes, which may be based more on emotions than on reality. A combination of quantitative and qualitative methods was used. Both HIV-infected and uninfected women desired and intended to have a median of three children. Women from Nyanza were 10.1 times more likely to desire more children than those from Central region (p<0.001). There was significant greater intention to have children among women aged 40-44 years or older with lower levels of education and living in rural areas. Cultural factors were found to influence fertility desires and intentions among women. To eliminate mother-to-child transmission of HIV, reproductive health interventions should take into consideration the special needs of HIV-infected women to avoid unintended pregnancies, and eliminate the risk of vertical transmission. Additional tailored sexual and reproductive care and counselling support should be provided to HIV-infected women; couples and men to assist them make decisions on issues such as number, spacing and timing of pregnancy and use of contraceptives. Fertility and family planning education should be part of each clinic visit for both female and male HIVinfected clients. More effort should be put on educating male HIV infected clients since male partners have greater influence on fertility intentions in the family in Kenyan society.

show abstract

Mother-to-child transmission of HIV in Kenya: A cross-sectional analysis of the national database over nine years

Cited by 23 publications

References 32 publications

Prevalence of vertical HIV infection and its risk factors among HIV exposed infants in East Africa: a systematic review and meta-analysis

Prevalence of vertical HIV infection and its risk factors among HIV exposed infants in East Africa: a systematic review and meta-analysis

Predictors of Health Insurance Enrollment among HIV Positive Pregnant Women in Kenya: Potential for Adverse Selection and Implications for HIV Treatment and Prevention

Factors Accounting for Differences of Fertility Desires and Intentions Among HIV-Infected and Uninfected Women of Reproductive Age at Six Hospitals in Two Regions of Kenya

Contact Info

Product

Resources

About