Mother-to-child transmission of HIV in Kenya: A cross-sectional analysis of the national database over nine years.
To describe factors associated with mother-to-child HIV transmission (MTCT) in Kenya and identify opportunities to increase testing/care coverage.Cross-sectional analysis of national early infant diagnosis (EID) database.365,841 Kenyan infants were tested for HIV from January 2007-July 2015 and resu...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2017-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC5574578?pdf=render |
| _version_ | 1830220949943746560 |
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| author | Matilu Mwau Priska Bwana Lucy Kithinji Francis Ogollah Samuel Ochieng Catherine Akinyi Maureen Adhiambo Fred Ogumbo Martin Sirengo Caroline Boeke |
| author_facet | Matilu Mwau Priska Bwana Lucy Kithinji Francis Ogollah Samuel Ochieng Catherine Akinyi Maureen Adhiambo Fred Ogumbo Martin Sirengo Caroline Boeke |
| author_sort | Matilu Mwau |
| collection | DOAJ |
| description | To describe factors associated with mother-to-child HIV transmission (MTCT) in Kenya and identify opportunities to increase testing/care coverage.Cross-sectional analysis of national early infant diagnosis (EID) database.365,841 Kenyan infants were tested for HIV from January 2007-July 2015 and results, demographics, and treatment information were entered into a national database. HIV risk factors were assessed using multivariable logistic regression.11.1% of infants tested HIV positive in 2007-2010 and 6.9% in 2014-2015. Greater odds of infection were observed in females (OR: 1.08; 95% CI:1.05-1.11), older children (18-24 months vs. 6 weeks-2 months: 4.26; 95% CI:3.87-4.69), infants whose mothers received no PMTCT intervention (vs. HAART OR: 1.92; 95% CI:1.79-2.06), infants receiving no prophylaxis (vs. nevirapine for 6 weeks OR: 2.76; 95% CI:2.51-3.05), and infants mixed breastfed (vs. exclusive breastfeeding OR: 1.39; 95% CI:1.30-1.49). In 2014-2015, 9.1% of infants had mothers who were not on treatment during pregnancy, 9.8% were not on prophylaxis, and 7.0% were mixed breastfed. Infants exposed to all three risky practices had a seven-fold higher odds of HIV infection compared to those exposed to recommended practices. The highest yield of HIV-positive infants were found through targeted testing of symptomatic infants in pediatric/outpatient departments (>15%); still, most infected infants were identified through PMTCT programs.Despite impressive gains in Kenya's PMTCT program, some HIV-infected infants present late and are not benefitting from PMTCT best practices. Efforts to identify these early and enforce evidence-based practice for PMTCT should be scaled up. Infant testing should be expanded in pediatric/outpatient departments, given high yields in these portals. |
| first_indexed | 2024-12-18T08:17:10Z |
| format | Article |
| id | doaj.art-106303fc1b97473fa5e6dea3b5a422d3 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-18T08:17:10Z |
| publishDate | 2017-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-106303fc1b97473fa5e6dea3b5a422d32022-12-21T21:14:48ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01128e018386010.1371/journal.pone.0183860Mother-to-child transmission of HIV in Kenya: A cross-sectional analysis of the national database over nine years.Matilu MwauPriska BwanaLucy KithinjiFrancis OgollahSamuel OchiengCatherine AkinyiMaureen AdhiamboFred OgumboMartin SirengoCaroline BoekeTo describe factors associated with mother-to-child HIV transmission (MTCT) in Kenya and identify opportunities to increase testing/care coverage.Cross-sectional analysis of national early infant diagnosis (EID) database.365,841 Kenyan infants were tested for HIV from January 2007-July 2015 and results, demographics, and treatment information were entered into a national database. HIV risk factors were assessed using multivariable logistic regression.11.1% of infants tested HIV positive in 2007-2010 and 6.9% in 2014-2015. Greater odds of infection were observed in females (OR: 1.08; 95% CI:1.05-1.11), older children (18-24 months vs. 6 weeks-2 months: 4.26; 95% CI:3.87-4.69), infants whose mothers received no PMTCT intervention (vs. HAART OR: 1.92; 95% CI:1.79-2.06), infants receiving no prophylaxis (vs. nevirapine for 6 weeks OR: 2.76; 95% CI:2.51-3.05), and infants mixed breastfed (vs. exclusive breastfeeding OR: 1.39; 95% CI:1.30-1.49). In 2014-2015, 9.1% of infants had mothers who were not on treatment during pregnancy, 9.8% were not on prophylaxis, and 7.0% were mixed breastfed. Infants exposed to all three risky practices had a seven-fold higher odds of HIV infection compared to those exposed to recommended practices. The highest yield of HIV-positive infants were found through targeted testing of symptomatic infants in pediatric/outpatient departments (>15%); still, most infected infants were identified through PMTCT programs.Despite impressive gains in Kenya's PMTCT program, some HIV-infected infants present late and are not benefitting from PMTCT best practices. Efforts to identify these early and enforce evidence-based practice for PMTCT should be scaled up. Infant testing should be expanded in pediatric/outpatient departments, given high yields in these portals.http://europepmc.org/articles/PMC5574578?pdf=render |
| spellingShingle | Matilu Mwau Priska Bwana Lucy Kithinji Francis Ogollah Samuel Ochieng Catherine Akinyi Maureen Adhiambo Fred Ogumbo Martin Sirengo Caroline Boeke Mother-to-child transmission of HIV in Kenya: A cross-sectional analysis of the national database over nine years. PLoS ONE |
| title | Mother-to-child transmission of HIV in Kenya: A cross-sectional analysis of the national database over nine years. |
| title_full | Mother-to-child transmission of HIV in Kenya: A cross-sectional analysis of the national database over nine years. |
| title_fullStr | Mother-to-child transmission of HIV in Kenya: A cross-sectional analysis of the national database over nine years. |
| title_full_unstemmed | Mother-to-child transmission of HIV in Kenya: A cross-sectional analysis of the national database over nine years. |
| title_short | Mother-to-child transmission of HIV in Kenya: A cross-sectional analysis of the national database over nine years. |
| title_sort | mother to child transmission of hiv in kenya a cross sectional analysis of the national database over nine years |
| url | http://europepmc.org/articles/PMC5574578?pdf=render |
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