A Review and Analysis of Outcomes from Prevention of Mother-to- Child Transmission of HIV Infant Follow-up Services at a Pediatric Infectious Diseases Unit of a Major Tertiary Hospital in Nigeria: 2007-2020
Background and Objective: Above 90% of childhood HIV infections result from mother-to child transmission (MTCT). This study examined the MTCT rates of HIV-exposed infants enrolled in the infant follow-up arm of the prevention of mother-to-child transmission (PMTCT) program in a teaching hospital in...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Global Health and Education Projects, Inc.
2021-12-01
|
| Series: | International Journal of Maternal and Child Health and AIDS |
| Subjects: | |
| Online Access: | https://mchandaids.org/index.php/IJMA/article/view/510 |
| _version_ | 1818890064735764480 |
|---|---|
| author | EBELECHUKU FRANCESCA UGOCHUKWU CHINYERE UKAMAKA ONUBOGU EMEKA STEPHEN EDOKWE UCHENNA EKWOCHI KENNETH NCHEKWUBE OKEKE ESTHER NGOZI UMEADI STANLEY KENECHI ONAH |
| author_facet | EBELECHUKU FRANCESCA UGOCHUKWU CHINYERE UKAMAKA ONUBOGU EMEKA STEPHEN EDOKWE UCHENNA EKWOCHI KENNETH NCHEKWUBE OKEKE ESTHER NGOZI UMEADI STANLEY KENECHI ONAH |
| author_sort | EBELECHUKU FRANCESCA UGOCHUKWU |
| collection | DOAJ |
| description | Background and Objective: Above 90% of childhood HIV infections result from mother-to child transmission (MTCT). This study examined the MTCT rates of HIV-exposed infants enrolled in the infant follow-up arm of the prevention of mother-to-child transmission (PMTCT) program in a teaching hospital in Southeast Nigeria.
Methods: This was a 14-year review of outcomes of infants enrolled in the infant follow-up arm of the PMTCT program of Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria. The majority of subjects were enrolled within 72 hours of birth and were followed up until 18 months of age according to the National Guidelines on HIV prevention and treatment. At enrollment, relevant data were collected prospectively, and each scheduled follow-up visit was recorded both electronically and in physical copy in the client’s folders. Data were analyzed using SPSS version 20. The major outcome variable was final MTCT status.
Results: Out of 3,784 mother-infant dyads studied 3,049 (80.6%) received both maternal and infant Antiretroviral (ARV) prophylaxis while 447 (11.8%) received none. The MTCT rates were 1.4%, 9.3%, 24.1%, and 52.1% for both mother and infant, mother only, infant only, and none received ARV prophylaxis respectively. There was no gender-based difference in outcomes. The MTCT rate was significantly higher among mixed-fed infants (p<0.001) and among those who did not receive any form of ARVs (p<0.001). Among dyads who received no ARVs, breastfed infants significantly had a higher MTCT rate compared to never breastfed infants (57.9% vs. 34.8%; p<0.001). The MTCT rate was comparable among breastfed (2.5%) and never-breastfed (2.1%) dyads who had received ARVs. After logistic regression, maternal (p<0.001, OR: 7.00) and infant (p<0.001, OR: 4.00) ARV prophylaxis for PMTCT remained significantly associated with being HIV-negative.
Conclusion and Global Health Implications: Appropriate use of ARVs and avoidance of mixed feeding in the first six months of life are vital to the success of PMTCT programs in developing countries. PMTCT promotes exclusive breastfeeding and reduces the burden of pediatric HIV infection, thereby enhancing child survival.
Copyright © 2021 Ugochukwu et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0. |
| first_indexed | 2024-12-19T17:18:59Z |
| format | Article |
| id | doaj.art-52d679434e124d7dade676cc339339e3 |
| institution | Directory Open Access Journal |
| issn | 2161-8674 2161-864X |
| language | English |
| last_indexed | 2024-12-19T17:18:59Z |
| publishDate | 2021-12-01 |
| publisher | Global Health and Education Projects, Inc. |
| record_format | Article |
| series | International Journal of Maternal and Child Health and AIDS |
| spelling | doaj.art-52d679434e124d7dade676cc339339e32022-12-21T20:12:44ZengGlobal Health and Education Projects, Inc.International Journal of Maternal and Child Health and AIDS2161-86742161-864X2021-12-01102A Review and Analysis of Outcomes from Prevention of Mother-to- Child Transmission of HIV Infant Follow-up Services at a Pediatric Infectious Diseases Unit of a Major Tertiary Hospital in Nigeria: 2007-2020EBELECHUKU FRANCESCA UGOCHUKWU0CHINYERE UKAMAKA ONUBOGU1EMEKA STEPHEN EDOKWE2UCHENNA EKWOCHI3KENNETH NCHEKWUBE OKEKE4ESTHER NGOZI UMEADI5STANLEY KENECHI ONAH6Department of Pediatrics, Faculty of Medicine, Nnamdi Azikiwe University, Awka, NigeriaDepartment of Pediatrics, Faculty of Medicine, Nnamdi Azikiwe University, Awka, NigeriaDepartment of Pediatrics, Faculty of Medicine, Nnamdi Azikiwe University, Awka, NigeriaDepartment of Pediatrics, College of Medicine, Enugu State University of Science and Technology, Enugu, NigeriaDepartment of Pediatrics, Faculty of Medicine, Nnamdi Azikiwe University, Awka, NigeriaDepartment of Pediatrics, Faculty of Medicine, Nnamdi Azikiwe University, Awka, NigeriaDepartment of Pediatrics, Faculty of Medicine, Nnamdi Azikiwe University, Awka, NigeriaBackground and Objective: Above 90% of childhood HIV infections result from mother-to child transmission (MTCT). This study examined the MTCT rates of HIV-exposed infants enrolled in the infant follow-up arm of the prevention of mother-to-child transmission (PMTCT) program in a teaching hospital in Southeast Nigeria. Methods: This was a 14-year review of outcomes of infants enrolled in the infant follow-up arm of the PMTCT program of Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria. The majority of subjects were enrolled within 72 hours of birth and were followed up until 18 months of age according to the National Guidelines on HIV prevention and treatment. At enrollment, relevant data were collected prospectively, and each scheduled follow-up visit was recorded both electronically and in physical copy in the client’s folders. Data were analyzed using SPSS version 20. The major outcome variable was final MTCT status. Results: Out of 3,784 mother-infant dyads studied 3,049 (80.6%) received both maternal and infant Antiretroviral (ARV) prophylaxis while 447 (11.8%) received none. The MTCT rates were 1.4%, 9.3%, 24.1%, and 52.1% for both mother and infant, mother only, infant only, and none received ARV prophylaxis respectively. There was no gender-based difference in outcomes. The MTCT rate was significantly higher among mixed-fed infants (p<0.001) and among those who did not receive any form of ARVs (p<0.001). Among dyads who received no ARVs, breastfed infants significantly had a higher MTCT rate compared to never breastfed infants (57.9% vs. 34.8%; p<0.001). The MTCT rate was comparable among breastfed (2.5%) and never-breastfed (2.1%) dyads who had received ARVs. After logistic regression, maternal (p<0.001, OR: 7.00) and infant (p<0.001, OR: 4.00) ARV prophylaxis for PMTCT remained significantly associated with being HIV-negative. Conclusion and Global Health Implications: Appropriate use of ARVs and avoidance of mixed feeding in the first six months of life are vital to the success of PMTCT programs in developing countries. PMTCT promotes exclusive breastfeeding and reduces the burden of pediatric HIV infection, thereby enhancing child survival. Copyright © 2021 Ugochukwu et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.https://mchandaids.org/index.php/IJMA/article/view/510HIV-Exposed Infants Antiretroviral Prophylaxis Mixed Feeding PMTCT Outcome Exclusive Breastfeeding Early Infant Diagnosis |
| spellingShingle | EBELECHUKU FRANCESCA UGOCHUKWU CHINYERE UKAMAKA ONUBOGU EMEKA STEPHEN EDOKWE UCHENNA EKWOCHI KENNETH NCHEKWUBE OKEKE ESTHER NGOZI UMEADI STANLEY KENECHI ONAH A Review and Analysis of Outcomes from Prevention of Mother-to- Child Transmission of HIV Infant Follow-up Services at a Pediatric Infectious Diseases Unit of a Major Tertiary Hospital in Nigeria: 2007-2020 International Journal of Maternal and Child Health and AIDS HIV-Exposed Infants Antiretroviral Prophylaxis Mixed Feeding PMTCT Outcome Exclusive Breastfeeding Early Infant Diagnosis |
| title | A Review and Analysis of Outcomes from Prevention of Mother-to- Child Transmission of HIV Infant Follow-up Services at a Pediatric Infectious Diseases Unit of a Major Tertiary Hospital in Nigeria: 2007-2020 |
| title_full | A Review and Analysis of Outcomes from Prevention of Mother-to- Child Transmission of HIV Infant Follow-up Services at a Pediatric Infectious Diseases Unit of a Major Tertiary Hospital in Nigeria: 2007-2020 |
| title_fullStr | A Review and Analysis of Outcomes from Prevention of Mother-to- Child Transmission of HIV Infant Follow-up Services at a Pediatric Infectious Diseases Unit of a Major Tertiary Hospital in Nigeria: 2007-2020 |
| title_full_unstemmed | A Review and Analysis of Outcomes from Prevention of Mother-to- Child Transmission of HIV Infant Follow-up Services at a Pediatric Infectious Diseases Unit of a Major Tertiary Hospital in Nigeria: 2007-2020 |
| title_short | A Review and Analysis of Outcomes from Prevention of Mother-to- Child Transmission of HIV Infant Follow-up Services at a Pediatric Infectious Diseases Unit of a Major Tertiary Hospital in Nigeria: 2007-2020 |
| title_sort | review and analysis of outcomes from prevention of mother to child transmission of hiv infant follow up services at a pediatric infectious diseases unit of a major tertiary hospital in nigeria 2007 2020 |
| topic | HIV-Exposed Infants Antiretroviral Prophylaxis Mixed Feeding PMTCT Outcome Exclusive Breastfeeding Early Infant Diagnosis |
| url | https://mchandaids.org/index.php/IJMA/article/view/510 |
| work_keys_str_mv | AT ebelechukufrancescaugochukwu areviewandanalysisofoutcomesfrompreventionofmothertochildtransmissionofhivinfantfollowupservicesatapediatricinfectiousdiseasesunitofamajortertiaryhospitalinnigeria20072020 AT chinyereukamakaonubogu areviewandanalysisofoutcomesfrompreventionofmothertochildtransmissionofhivinfantfollowupservicesatapediatricinfectiousdiseasesunitofamajortertiaryhospitalinnigeria20072020 AT emekastephenedokwe areviewandanalysisofoutcomesfrompreventionofmothertochildtransmissionofhivinfantfollowupservicesatapediatricinfectiousdiseasesunitofamajortertiaryhospitalinnigeria20072020 AT uchennaekwochi areviewandanalysisofoutcomesfrompreventionofmothertochildtransmissionofhivinfantfollowupservicesatapediatricinfectiousdiseasesunitofamajortertiaryhospitalinnigeria20072020 AT kennethnchekwubeokeke areviewandanalysisofoutcomesfrompreventionofmothertochildtransmissionofhivinfantfollowupservicesatapediatricinfectiousdiseasesunitofamajortertiaryhospitalinnigeria20072020 AT estherngoziumeadi areviewandanalysisofoutcomesfrompreventionofmothertochildtransmissionofhivinfantfollowupservicesatapediatricinfectiousdiseasesunitofamajortertiaryhospitalinnigeria20072020 AT stanleykenechionah areviewandanalysisofoutcomesfrompreventionofmothertochildtransmissionofhivinfantfollowupservicesatapediatricinfectiousdiseasesunitofamajortertiaryhospitalinnigeria20072020 AT ebelechukufrancescaugochukwu reviewandanalysisofoutcomesfrompreventionofmothertochildtransmissionofhivinfantfollowupservicesatapediatricinfectiousdiseasesunitofamajortertiaryhospitalinnigeria20072020 AT chinyereukamakaonubogu reviewandanalysisofoutcomesfrompreventionofmothertochildtransmissionofhivinfantfollowupservicesatapediatricinfectiousdiseasesunitofamajortertiaryhospitalinnigeria20072020 AT emekastephenedokwe reviewandanalysisofoutcomesfrompreventionofmothertochildtransmissionofhivinfantfollowupservicesatapediatricinfectiousdiseasesunitofamajortertiaryhospitalinnigeria20072020 AT uchennaekwochi reviewandanalysisofoutcomesfrompreventionofmothertochildtransmissionofhivinfantfollowupservicesatapediatricinfectiousdiseasesunitofamajortertiaryhospitalinnigeria20072020 AT kennethnchekwubeokeke reviewandanalysisofoutcomesfrompreventionofmothertochildtransmissionofhivinfantfollowupservicesatapediatricinfectiousdiseasesunitofamajortertiaryhospitalinnigeria20072020 AT estherngoziumeadi reviewandanalysisofoutcomesfrompreventionofmothertochildtransmissionofhivinfantfollowupservicesatapediatricinfectiousdiseasesunitofamajortertiaryhospitalinnigeria20072020 AT stanleykenechionah reviewandanalysisofoutcomesfrompreventionofmothertochildtransmissionofhivinfantfollowupservicesatapediatricinfectiousdiseasesunitofamajortertiaryhospitalinnigeria20072020 |