Reducing the mother-to-child transmission of HIV: findings from an early infant diagnosis program in Delta state Nigeria

Abstract

Background: Mother-to-child transmission (MTCT) of HIV has been a global issue being addressed with prevention of mother to child transmission (PMTCT) strategy. Nigeria is said to be responsible for 30% of the global burden of MTCT of HIV. Hence, Delta state of Nigeria had implemented its own PMTCT in line with the global plan to eliminate MTCT. This paper evaluates the determinants and level of effectives of PMTCT with a view to develop a framework to review the program in Delta state.Methods: This was a narrative literature review which aimed at appraising available reports on PMTCT services and related data. In particular, the ‘Delta state development performance: health sector report 1991–2013’ was appraised. Results: Generally, Delta state has improved on infant survival better than national baseline. Specifically, on PMTCT, more women (average 2.9%) than men (average 2.1%) have tested positive for HIV in the 5 years period of 2008–2012 free screening. Further, the report indicates that the State has achieved 78% of eligible facilities offering PMTCT services in the state, but only 23% coverage of pregnancies. Conclusions: In the context of cost effectiveness as well as improvement in service delivery, there is a need to investigate the success rates of health facilities that are offering PMTCT services. There is also need to investigate the barriers to PMTCT that may be prevailing in Delta state.

Deoxyribonucleic Acid-Polymerase Chain Reaction Status of HIV Exposed Infants in a Sub Regional Prevention of Mother-to-Child Transmission of HIV Programme during the Period 2009-2020

“…This finding is similar to the report by Dakum et al [51]; however, the proportion of DBS sample obtained at 6 -8 weeks in our study is twice as high as reported by Dakum et al [51] and Itiola et al [45] in the country. Reports on fairly large number of HIV-exposed infants in the country by Anoje et al, [28] Olerigbe et al, [41] Ibobo et al, [48] did not report 6 -8 weeks age of DBS sample collection. Higher DBS collection rates at 6 -8 weeks of 67.3%, 50%, and 79% have been reported in Ethiopia, [53] Malawi, [54] and Kenya, [55] respectively.…”

“…[25] Transitioning to more efficacious cART for PMTCT between 2010 and 2012, several studies [26]- [42] in the country reported MTCT rates of between 0% [43] [44] and 9.7% [45]. Most recent reports from Sokoto, [46] FCT/Nasarawa state, [47] Delta, [48] Rivers [49] and Imo state [50] showed MTCT rates of 0.9%, 1%, 4%, 1.1%, and 3.7% respectively. A very large subregional report of EID of HEI by Dakum et al [51] reported a MTCT rate of 5.2% at 12 weeks postpartum.…”

Prevention of Mother-to-Child Transmission of HIV in Delta State of Nigeria: Evaluation of the Early Infant Diagnosis Program

“…In 2009 approximately 370,000 children became infected with HIV globally and most of these infections occurred through MTCT 15 . It is acknowledged that Nigeria accounts for 30% of the burden of MTCT of HIV in the world 14,16 . This justifies why Nigeria is one of the 22 focus countries of the Global Plan to Eliminate MTCT 1,17,18 .…”

“…Thus, this research seeks to examine an EID program in Delta State of Nigeria with a view to determine the level of reduction of MTCT of HIV. A narrative literature review has previously been performed as background to this work 16 . Another study has also examined EID program in two other Southern States of Nigeria 14 .…”

“…Second is the level of negative results (i.e., efficiency).While 4.4% of infants on ART tested positive at first test with indication of reduction at 18 th month (Table 2), up to 83% of the subpopulation of 'mother-and-child' who were suspected to miss early start of PMTCT (i.e., indicated by not being on ART) tested positive at both initial and 18 th month tests. Other studies have previously acknowledged or implied the effectiveness of PMTCT services in Nigeria [33][34][35][36] , and availability of the service in Delta State 16 . What this report adds to the body of literature is evidence of efficiency of the EID program in Delta State.…”