在预防艾滋病毒母婴传播的 Djoungolo 方案下，对感染艾滋病毒 1 型的母亲（在断奶前）的母乳喂养做法进行初步评估。

Preliminary assessment of breastfeeding practices in HIV 1-infected mothers (prior to weaning) under the Djoungolo programme on the prevention of mother-to-child transmission of HIV.

机构信息

National Social Insurance Fund Hospital, Pediatric Unit Yaounde, Cameroon.

出版信息

J Trop Pediatr. 2010 Dec;56(6):436-9. doi: 10.1093/tropej/fmq018. Epub 2010 Mar 23.

DOI:10.1093/tropej/fmq018

PMID:20332220

Abstract

BACKGROUND

Human Immunodeficiency virus (HIV) transmission in a breastfeeding population varies from 20% to 45%.

OBJECTIVE

To evaluate breastfeeding practices and the early basic HIV transmission rate in HIV-exposed children in the Djoungolo health district (prevention of mother-to-child transmission HIV programme).

METHODS

A cross-sectional survey was conducted, targeting breastfeeding mothers recruited from an observational cohort of HIV-positive pregnant women intending to breastfeed. Routine immunological assessment was carried out for all pregnant HIV-positive women coupled with initiation to highly active anti-retroviral therapy (HAART) in those with CD4 cell counts below 350 mm(-3). Early virological diagnosis of HIV infection was done using real-time Polymerase Chain reaction (PCR) RNA for infants aged between 6 weeks and 6 months. Breastfeeding intervention and counselling support were also provided to respondents.

RESULTS

Out of 545 women, 287 births were registered of which 64 of the HIV-infected mothers opted for breastfeeding. The mean CD4 cell count was 446 mm(-3); 34.4% of women were taking HAART. The rate of initiation to breastfeeding was observed to be 53% within 1 h following delivery. At 13 weeks, 96.1% were still exclusively breastfeeding on demand with an average of six feedings in the daytime and three feedings during the night. Of the mothers, 18.5% reported at least one episode of breast and/or nipple pain and 4.9% of mothers were practicing mixed feeding. The early rate of HIV transmission among 47 infants assessed was observed to be 4.3% [95% confidence interval 1-10.1].

CONCLUSION

In an HIV context, routine breastfeeding intervention support associated with access to anti-retroviral therapy for women yet requiring treatment for themselves reduces the practice of mixed feeding and slashes the early mother-to-child HIV transmission rate to 4.3% in breastfeeding populations.

摘要

背景

在母乳喂养人群中，人类免疫缺陷病毒（HIV）的传播率从 20%到 45%不等。

目的

评估 Djoungolo 卫生区（预防母婴传播 HIV 计划）中 HIV 暴露儿童的母乳喂养实践和早期基本 HIV 传播率。

方法

进行了一项横断面调查，针对从打算母乳喂养的 HIV 阳性孕妇观察队列中招募的母乳喂养母亲。对所有 HIV 阳性孕妇进行常规免疫评估，并在 CD4 细胞计数低于 350/mm³时开始进行高效抗逆转录病毒治疗（HAART）。对 6 周至 6 个月大的婴儿使用实时聚合酶链反应（PCR）RNA 进行 HIV 感染的早期病毒学诊断。还向受访者提供母乳喂养干预和咨询支持。

结果

在 545 名妇女中，登记了 287 例分娩，其中 64 名感染 HIV 的母亲选择了母乳喂养。平均 CD4 细胞计数为 446/mm³；34.4%的妇女正在接受 HAART。分娩后 1 小时内开始母乳喂养的比例为 53%。在 13 周时，96.1%的婴儿按需仍在进行纯母乳喂养，白天平均有 6 次喂奶，夜间有 3 次喂奶。在母亲中，18.5%的人报告至少有一次乳房和/或乳头疼痛，4.9%的母亲实行混合喂养。在评估的 47 名婴儿中，早期 HIV 传播率为 4.3%[95%置信区间为 1-10.1]。