Assessment of the effectiveness of PMTCT program in eight service delivery points in North Central Nigeria
Received 21 November 2017
Accepted for publication 11 August 2018
Published 20 November 2018 Volume 2018:10 Pages 253—259
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Andrew Yee
Peer reviewer comments 4
Editor who approved publication: Professor Bassel Sawaya
Obinna Ositadimma Oleribe,1 Ede Enenche,1 Deborah Udofia,1 Ekei Ekom,1 Princess Ifunanya Osita-Oleribe,1 Jin Un Kim,2 Simon David Taylor-Robinson2
1Excellence and Friends Management Care Centre (EFMC), Abuja, Nigeria; 2Hepatology Unit, Imperial College London, London, UK
Background: Mother-to-child transmission (MTCT) of HIV is one of the commonest avenues through which infants are infected with HIV. To achieve an HIV-free generation, MTCT of HIV should be eliminated. Nigeria began prevention of mother-to-child transmission (PMTCT) services 13 years ago, but it still contributes to over one-third of global MTCT burden. We set out to explore and define the effectiveness of PMTCT in selected sites in North Central Nigeria.
Methods: We conducted a retrospective secondary data analysis at eight service delivery points in two states. One thousand four hundred and fifty-four mother–infant pair data sets from 2012 to 2016 were extracted and analyzed. Maternal/infant antiretroviral (ARV) services, early infant diagnosis (EID), and final outcomes were reviewed to examine the predictors of MTCT of HIV in these centers.
Results: We retrieved 1,454 mother–infant pair data sets. While 89.5% (1,302) of positive pregnant women (PPW) and 92.2% (1,340) of HIV-exposed infants (HEIs) received ARV prophylaxis/ARV treatment (ART), 88.4% (1,285) infants were breastfed with 32.5% still receiving breast milk at the time of dry blood spot (DBS) collection. EID PCR positivity rate was 3.5% (range, 0.0%–11.1%). Facility of delivery (X2=24.99, P<0.00), mother on ARV (X2=48.8, P<0.00), mother having received ARV prophylaxis (X2=89.59, P<0.00), infant having received ARV prophylaxis (X2=58.56, P<0.00), and baby having received cotrimoxazole (X2=55.24, P<0.00) all significantly prevented positive EID results. However, mode of delivery and breastfeeding were not significantly associated with positive EID results.
Conclusion: This study supports PMTCT services as it minimizes the transfer of HIV from infected mothers to HEIs. To eliminate HIV and achieve zero new HIV infections, every HIV-positive pregnant woman should receive ARV prophylaxis and should be supported postdelivery to prevent transfer of infection to the newborn. Also, HEIs should receive timely ARV and cotrimoxazole prophylaxis.
Keywords: antiretroviral therapy, infectious diseases, prevention of mother-to-child transmission, women, Africa
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