Outcomes of prevention of mother to child transmission of the human immunodeficiency virus-1 in rural Kenya - A cohort study Infectious Disease epidemiologyReport as inadecuate




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Reference: Nduati, EW, Hassan, AS, Knight, MG et al., (2015). Outcomes of prevention of mother to child transmission of the human immunodeficiency virus-1 in rural Kenya - A cohort study Infectious Disease epidemiology. BMC Public Health, 15 (1).Citable link to this page:

 

Outcomes of prevention of mother to child transmission of the human immunodeficiency virus-1 in rural Kenya - A cohort study Infectious Disease epidemiology

Abstract: BackgroundSuccess in prevention of mother-to-child transmission (PMTCT) raises the prospect of eliminating pediatric HIV infection. To achieve global elimination, however, strategies are needed to strengthen PMTCT interventions. This study aimed to determine PMTCT outcomes and identify challenges facing its successful implementation in a rural setting in Kenya.MethodsA retrospective cohort design was used. Routine demographic and clinical data for infants and mothers enrolling for PMTCT care at a rural hospital in Kenya were analysed. Cox and logistic regression were used to determine factors associated with retention and vertical transmission respectively.ResultsBetween 2006 and 2012, 1338 infants were enrolled and followed up for PMTCT care with earlier age of enrollment and improved retention observed over time. Mother to child transmission of HIV declined from 19.4 % in 2006 to 8.9 % in 2012 (non-parametric test for trend p = 0.024). From 2009 to 2012, enrolling for care after 6 months of age, adjusted Odds Ratio [aOR]: 23.3 [95 % confidence interval (CI): 8.3–65.4], presence of malnutrition ([aOR]: 2.3 [95 % CI: 1.1–5.2]) and lack of maternal use of highly active antiretroviral therapy (HAART) (aOR: 6.5 [95 % CI: 1.4–29.4]) was associated with increased risk of HIV infection. Infant’s older age at enrollment, malnutrition and maternal HAART status, were also associated with drop out from care. Infants who were not actively followed up were more likely to drop out from care (adjusted Hazard Ratio: 6.6 [95 % CI: 2.9–14.6]).DiscussionWe report a temporal increase in the proportion of infants enrolling for PMTCT care before 3 months of age, improved retention in PMTCT and a significant reduction in the proportion of infants enrolled who became HIV-infected, emphasizing the benefits of PMTCT.ConclusionA simple set of risk factors at enrollment can identify mother-infant pairs most at risk of infection or drop out for targeted intervention.

Peer Review status:Peer reviewedPublication status:PublishedVersion:Publisher's versionNotes:© 2015 Nduati et al.licensee BioMed Central. Open Access: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License. This is the publisher's version of the article. The final version is available online from BioMed Central at: [10.1186/s12889-015-2355-4].

Bibliographic Details

Publisher: BioMed Central

Publisher Website: http://www.biomedcentral.com/

Journal: BMC Public Healthsee more from them

Publication Website: http://bmcpublichealth.biomedcentral.com/

Issue Date: 2015-10-03Identifiers

Urn: uuid:fa5ea913-db29-40dd-8b07-e5cae2b0fba3

Source identifier: 571512

Eissn: 1471-2458

Doi: https://doi.org/10.1186/s12889-015-2355-4 Item Description

Type: Journal article;

Version: Publisher's versionKeywords: HIV Prevention of mother to child transmission Vertical transmission Retention Tiny URL: pubs:571512

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Author: Nduati, EW - grantNumberWT095068 fundingWellcome Trust - - - Hassan, AS - grantNumberWT089351MA fundingWellcome Trust - - - Knigh

Source: https://ora.ox.ac.uk/objects/uuid:fa5ea913-db29-40dd-8b07-e5cae2b0fba3



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