Journal article
Outcomes of prevention of mother to child transmission of the human immunodeficiency virus-1 in rural Kenya - A cohort study Infectious Disease epidemiology
- Abstract:
-
Background
Success 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.
Methods
A 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.
Results
Between 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]).
Discussion
We 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.
Conclusion
A simple set of risk factors at enrollment can identify mother-infant pairs most at risk of infection or drop out for targeted intervention.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
Actions
Access Document
- Files:
-
-
(Preview, Version of record, pdf, 779.0KB, Terms of use)
-
- Publisher copy:
- 10.1186/s12889-015-2355-4
Authors
+ Wellcome Trust
More from this funder
- Funding agency for:
- Urban, B
- Hassan, A
- Nduati, E
- Berkley, J
- Grant:
- WT079082
- WT089351MA
- WT095068
- WT083579MA
- Publisher:
- BioMed Central
- Journal:
- BMC Public Health More from this journal
- Volume:
- 15
- Issue:
- 1
- Publication date:
- 2015-10-03
- Acceptance date:
- 2010-09-25
- DOI:
- EISSN:
-
1471-2458
- Keywords:
- Pubs id:
-
pubs:571512
- UUID:
-
uuid:fa5ea913-db29-40dd-8b07-e5cae2b0fba3
- Local pid:
-
pubs:571512
- Source identifiers:
-
571512
- Deposit date:
-
2016-03-18
- ARK identifier:
Terms of use
- Copyright holder:
- Nduati et al
- Copyright date:
- 2015
- Notes:
- © 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].
- Licence:
- CC Attribution (CC BY)
If you are the owner of this record, you can report an update to it here: Report update to this record