Why is mother to child transmission (MTCT) of HIV a continual threat to new-borns in sub-Saharan Africa (SSA)

Yah, Clarence S.; Tambo, Ernest

doi:10.1016/j.jiph.2018.10.008

Cited by 38 publications

(31 citation statements)

References 61 publications

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“…Similarly, intensifying advocacy interventions that strengthen SRHR, family planning education and PMTCT for AGYW. 80,81 For example, report shows that approximately one third of AGYW below 20 years of age of age attending ANC in South Africa are HIV positive. 34,82 High HIV seroconversion during late pregnancy has been witnessed among women in the general population, enhancing vertical MTCT of HIV.…”

Section: Discussionmentioning

confidence: 99%

The prevalence of pregnancy among adolescent girls and young women across the Southern African development community economic hub: A systematic review and meta-analysis

Yah

Ndlovu

Kutywayo

et al. 2020

Health Promot Perspect

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Background: Despite the high rate of HIV infections, there is still high rate of early unprotected sex, unintended pregnancy, and unsafe abortions especially among unmarried adolescent girls and young women (AGYW) 10-24 years of age in sub Saharan Africa. AGYW face challenges in accessing health care, contraception needs, and power to negotiate safer sex. This study aimed to estimate the rate of pregnancy among AGYW aged 10-24, 10-19 and 15-19 years in the Southern African Development Community (SADC) economic region. Methods: A systematic review and meta-analysis was used to describe the prevalence of pregnancy among AGYW in 15 SADC member countries between January 2007 and December2017. The articles were extracted from PubMed/MEDLINE, African Index Medicus, and other reports. They were screened and reviewed according to PRISMA methodology to fulfil study eligibility criteria. Results: The overall regional weighted pregnancy prevalence among AGYW 10-24 years of age was 25% (95% CI: 21% to 29%). Furthermore, sub-population 10-19 years was 22% (95% CI:19% to 26%) while 15-19 years was 24% (18% to 30%). There was a significant heterogeneity detected between the studies (I=99.78%, P < 0.001), even within individual countries. Conclusion: The findings revealed a high pregnancy rate among AGYW in the SADC region. This prompts the need to explore innovative research and programs expanding and improving sexual and reproductive health communication to reduce risk and exposure of adolescents to early planned, unplanned and unwanted pregnancies, SRHR challenges, access to care, HIV/STIs, as well as other risk strategies.

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Section: Discussionmentioning

confidence: 99%

The prevalence of pregnancy among adolescent girls and young women across the Southern African development community economic hub: A systematic review and meta-analysis

Yah

Ndlovu

Kutywayo

et al. 2020

Health Promot Perspect

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“…Grandmothers are known to be the ‘custodians of infant feeding knowledge and culturally designated advisors’ for infant feeding (Aubel 2012 ; Kerr 2008 ; Negin et al 2016 ). This suggests that exclusive breastfeeding in the context of PMTCT remains a challenging practice for HIV-infected mothers (Yah & Tambo 2019 ).…”

Section: Discussion Of Findingsmentioning

confidence: 99%

“…Mixed infant feeding remains prevalent in some rural South African districts because of adherence to traditional practices or cultural factors (Bland et al 2002 ; Mnyani et al 2017 ). Therefore, feeding HIV-exposed infants continues to be challenging, especially in sub-Saharan Africa, where resources are limited (Yah & Tambo 2019 ) and cultural beliefs and practices prevail. National data on infant feeding indicate that breastfeeding is generally initiated immediately after birth; however, exclusive breastfeeding for the first 6 months does not usually occur regardless of the HIV status (Du Plessis et al 2016 ; Mhlanga 2008 ; National Department of Health South Africa, Statistics South Africa, South African Medical Research Council & ICF 2017; West et al 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Perceptions of grandmothers and HIV-infected mothers on infant feeding practices in a rural South African district

Mlambo

Peltzer

2020

Health SA Gesondheid

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Background: Despite enormous interventions aimed at preventing mother-to-child transmission (MTCT) of HIV, cultural practices on mixed infant feeding remain prevalent. Complementary food provision to infants seems to be the most common and acceptable form of infant feeding highly endorsed by grandmothers.Aim: This study aimed to explore the perceptions of grandmothers and HIV-infected mothers on infant feeding practices in the context of prevention of mother-to-child transmission.Setting: This study was undertaken in two primary healthcare facilities in the Mpumalanga province, South Africa.Methods: A qualitative exploratory narrative design was used to conduct four focus group discussions with 32 purposefully selected grandmothers and 21 in-depth interviews with postnatal HIV-infected women in the two identified health facilities. Data were analysed using an interthematic inductive analysis approach, resulting in major themes and subthemes supported by participants’ excerpts.Results: Four themes emerged showing (1) high mixed feeding endorsement because of the need to adhere to conventional practices, strengthen the umbilicus and have fuller, fat and calmer babies; (2) infant feeding fallacies and stigma reflected by exclusive breastfeeding period confusion, breastfeeding scepticism and infant feeding stigma; (3) breastfeeding endorsement for other disease prevention and family support for breastfeeding and (4) conflict between traditional and western infant feeding approaches.Conclusion: Total elimination of MTCT of HIV in a rural context calls for targeted education for grandmothers addressing their perceptions and practices of infant feeding. The knowledge of the identified factors encouraging mixed infant feeding can assist in designing programmes to change community beliefs on infant feeding. Cultural, social and psychosocial factors should be addressed when making recommendations for exclusive breastfeeding for HIV-positive mothers.

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“…10 12 STIs have also been shown to increase the risk of HIV acquisition and transmission. [13][14][15] Sub-Saharan Africa bears a heavy HIV burden, accounting for approximately 61% of all people living with HIV in 2018. 16 South Africa has the largest number of people living with HIV globally, with 7.9 million people living with HIV in 2018.…”

Section: Introductionmentioning

confidence: 99%

Prevalence, incidence and associated risk factors of STIs during pregnancy in South Africa

et al. 2020

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ObjectiveSTIs during pregnancy increase adverse pregnancy and birth outcomes and may increase HIV risk. STI syndromic management is standard of care in South Africa. Our study evaluated the prevalence and incidence of STIs in pregnant women and the associated risk factors.MethodsWe combined data from two prospective observational studies of pregnant women enrolled while attending their first antenatal clinic (ANC) visit in Tshwane District and Cape Town. Women ≥18 years were tested at first ANC visit and at their first postpartum visit for Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis using Xpert assays (Cepheid, USA). We evaluated the prevalence and incidence of STI and the associated risk factors using multivariable regression models.ResultsWe enrolled 669 pregnant women, 64% (n=427) from Tshwane District and 36% (n=242) from Cape Town; 80% (n=534) were women living with HIV (WLHIV) and 20% (n=135) without HIV. At enrolment, 37% (n=250) were diagnosed with at least one STI, of which 76% (n=190) were asymptomatic. STI prevalence was 40% (n=213) in WLHIV and 27% (n=37) in women without HIV (p=0.01). Baseline STI infection was associated with younger age (OR=0.95 per year, 95% CI 0.92 to 0.98), higher gestational age (adjusted OR (aOR)=1.03 per week, 95% CI 1.00 to 1.05), single relationship status (aOR=1.53, 95% CI 1.09 to 2.15) and HIV status (aOR=1.86, 95% CI 1.17 to 2.95). Of 419 participants with no STI at baseline, 21 had an incident STI during follow-up, with a mean follow-up time of 140 days. The incidence rate of STI during pregnancy and early post partum was 15 infections per 100 women-years (95% CI 9 to 23). Younger age was associated with STI incidence.ConclusionOur study shows high prevalence and incidence of STIs in pregnancy, especially in WLHIV, demonstrating the need for STI screening in ANC to prevent adverse pregnancy and birth outcomes. Most STI cases were asymptomatic and would have gone untreated with syndromic management. Aetiological STI screening is urgently needed to reduce the burden of STIs in pregnancy.

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Why is mother to child transmission (MTCT) of HIV a continual threat to new-borns in sub-Saharan Africa (SSA)

Cited by 38 publications

References 61 publications

The prevalence of pregnancy among adolescent girls and young women across the Southern African development community economic hub: A systematic review and meta-analysis

The prevalence of pregnancy among adolescent girls and young women across the Southern African development community economic hub: A systematic review and meta-analysis

Perceptions of grandmothers and HIV-infected mothers on infant feeding practices in a rural South African district

Prevalence, incidence and associated risk factors of STIs during pregnancy in South Africa

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