DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20184482

Determinants of mother to child transmission of HIV among HIV exposed infants managed in Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

Hassan Mairo, Panti A. A., Tunau K. A., Nasir S., Burodo A. T., Adamu N. A., Garba J. A.

Abstract


Background: Mother to child transmission of HIV (MTCT) is globally known to be the major route of spread of HIV to the unborn fetus and neonate. Many factors related to the mother, infant or the type of HIV virus interplay to increase the risk of MTCT of the virus. Antepartum antiretroviral drugs administration reduces the maternal viral load therefore lowering   the risk of transmission. The objective is to determine infection rate and assess determinants of MTCT of HIV exposed infants delivered in UDUTH Sokoto.

Methods: It was a 5-year retrospective study. Records of all HIV positive pregnant women and their babies managed in UDUTH were reviewed from the E health system of the hospital. Patient’s details were recorded from booking to delivery for the period under study. The infant’s records were retrieved and information from delivery to 18 months post-delivery obtained. Structured data collection tool was developed to compile the required information. Data was analyzed using SPSS IBMS 22. Descriptive statistics and comparisons between variables were made statistically using Chi square. P value of   ≤ 0.005 was considered as significant.

Results: Records of all the patients recruited were all available for evaluation because authors use the E-health system of records keeping in our hospital. MTCT rate was 0.92%. Majority 60 (47.2%) were within age group 26-30yrs. The subjects were predominantly house wives 97(71.4%) and multipara 77 (60.6%). Viral load ranged between 112 to 28228 copies/ml. Twenty-two (17.3%) had CD4 count less than 250 cells/µl while 61 (48%) had counts above 500cells/µl. All were in WHO clinical stage 1-3. All were on triple regimen anti-retroviral drugs. Spontaneous rupture of membranes for over 4 hours occurred in 51(32%). Vaginal delivery was recorded in 89.7%. Breast feeding was practiced by 48%.

Conclusions: Breast-feeding still remains a risk factor for MTCT OF HIV Early administration of   maternal antiretroviral drugs significantly reduces the rate of mother to child transmission of HIV.


Keywords


HIV, PMTCT, Risk factors

Full Text:

PDF

References


Dube Q, Dow A, Chirambo C, Lebov J, Tentani L, Moore M, et al. Implementing early infant diagnosis of HIV infection at primary care level. Experiences and challenges in Malawi. Bull World Health Org. 2012; 90(9):699-704.

Federal Ministry of Health. National Guidelines for Prevention of mother to child transmission of HIV (PMTCT). Nigeria 2010.

Cooper ER, Charurat M, Mofenson L, Hanson IC, Pitt J, Diaz C, et al. Combination antiretroviral strategies for the treatment of pregnant HIV-1-infected women and prevention of perinatal HIV-1 transmission. JAIDS-Hagerstown MD. 2002;29(5):484-94.

Al-Husaini AM. Role of placenta in the vertical transmission of human. immunodeficiency virus. J Perinatol. 2009(29);187: 331-6.

Garcia‐Tejedor A, Perales A, Maiques V. Duration of ruptured membranes and extended labor are risk factors for HIV transmission. Int J Gynecol Obstet. 2003;82(1):17-23.

Mofenson LM. Prevention in neglected subpopulations: prevention of mother-to-child transmission of HIV infection. Clin Infect Dis. 2010;50(S3):S130-48.

Bulterys MB, Fowler MG, Hanson IC, Lemay M, Mayaux MJ, Mofenson L, et al. Duration of ruptured membranes and vertical transmission of HIV-1: a meta-analysis from 15 prospective cohort studies. Aids. 2001;15(3):357-68.

De Cock KM, Fowler MG, Mercier E, De Vincenzi I, Saba J, Hoff E, et al. Prevention of mother-to-child HIV transmission in resource-poor countries: translating research into policy and practice. Jama. 2000;283(9):1175-82.

Nduati R, John G, Mbori-Ngacha D, Richardson B, Overbaugh J, Mwatha A, et al. Effect of breastfeeding and formula feeding on transmission of HIV-1: a randomized clinical trial. Jama. 2000;283(9):1167-74.

Coutsoudis A, Pillay K, Kuhn L, Spooner E, Tsai WY, Coovadia HM, South African Vitamin A Study Group. Method of feeding and transmission of HIV-1 from mothers to children by 15 months of age: prospective cohort study from Durban, South Africa. Aids. 2001;15(3):379-87.

Rollins NC, Dedicoat M, Danaviah S, Page T, Bishop K, Kleinschmidt I, et al. Prevalence, incidence, and mother-to-child transmission of HIV-1 in rural South Africa. Lancet. 2002;360:9330-89.

Noubiap JJ, Bongoe A, Demanou SA. Mother-to-child transmission of HIV: findings from an Early Infant Diagnosis program in Bertoua, Eastern Cameroon. Pan Afr Med J. 2013;15(1).

Chukwuemeka IK, Fatima MI, Ovavi ZK, Olukayode O. The impact of a HIV prevention of mother to child transmission program in a nigerian early infant diagnosis centre. Nigerian Med Assoc J. 2014;55(3):204-8.

Marie-Louise N. Prevention of mother-to-child transmission of HIV: challenges for the current decade. Bull World Health Org. 2001;79(12).

Jimmy AV. HIV: Mother-to-child transmission. BMJ Clin Evid. 2008;2008:0909.

Newell ML, Dunn D, Peckham CS, Ades AE, Pardi G, Semprini AE, et al. Risk factors for mother‐to‐child transmission of HIV‐1. Int J Gynecol Obstet. 1992;39(4):357.

Charurat M, Datong P, Matawal B, Ajene A, Blattner W, Abimiku AL. Timing and determinants of mother‐to‐child transmission of HIV in Nigeria. Int J Gynecol Obstet. 2009;106(1):8-13.

Mark S, Murphy KE, Read S, Bitnun A, Yudin MH. HIV mother-to-child transmission, mode of delivery, and duration of rupture of membranes: experience in the current era. Infectious Dis Obstet Gynecol. 2012;2012.

Garcia-Tejedor A, Perales, A, Maiques V. Duration of ruptured membranes and extended labor are risk factors for HIV transmission. Int J Gynecol Obstet. 2003;1(82):17-23.

Peters H, Byrne L, De Ruiter A, Francis K, Harding K, Taylor GP, et al. Duration of ruptured membranes and mother‐to‐child HIV transmission: a prospective population‐based surveillance study. BJOG. 2016;123(6):975-81.

Iloh KK, Iloh ON, Ikefuna AN, Ibeziako NS, Ubesi MPHAC, Emodi IJ. Determinants of mother-to-child transmission of HIV despite PMTCT interventions in Enugu, Nigeria. S Afr J Ch. 2015;9(2):49-52.

Usman A, Dairo D, Fawole O. Exclusive breastfeeding and HIV/AIDS: a crossectional survey of mothers attending prevention of mother-to-child transmission of HIV clinics in southwestern Nigeria. Pan Afr Med J. 2015; 21:309.