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艾滋病病毒暴露婴儿的预防性治疗接受情况及对推荐随访的依从性:埃塞俄比亚亚的斯亚贝巴的一项回顾性研究

Prophylactic treatment uptake and compliance with recommended follow up among HIV exposed infants: a retrospective study in Addis Ababa, Ethiopia.

作者信息

Shargie Mulatu Biru, Eek Frida, Abaychew Addisalem

机构信息

Master's Programme in Public Health Faculty of Medicine Lund University Malmö, Sweden.

出版信息

BMC Res Notes. 2011 Dec 27;4:563. doi: 10.1186/1756-0500-4-563.

Abstract

BACKGROUND

Children are being infected by HIV/AIDS mainly through mother-to-child transmission. In Ethiopia currently more than 135,000 children are living with HIV/AIDS. The aim of this study was to describe the pattern of ARV uptake after birth, co-trimoxazole prophylaxis and follow up compliance, and to examine which factors are associated with the intervention outcome.

METHODS

A retrospective quantitative study design was used for data collection through two hospitals. All infants who were delivered by HIV infected mothers between October 2008 and August 2009 were included and information regarding treatment adherence during their first 6 months of age was collected.

FINDINGS

118 HIV exposed infant-mother pairs were included in the study. 107 (90.7%) infants received ARV prophylaxis at birth. Sixty six (56%) of the infants were found to be adherent to co-trimoxazole prophylactic treatment. The majority (n = 110(93.2%)) of infants were tested HIV negative with DNA/PCR HIV test at the age of sixth weeks. Infants who took ARV prophylaxis at birth were found to be more likely to adhere with co-trimoxazole treatment: [OR = 9.43(95% CI: 1.22, 72.9)]. Similarly, infants whose mothers had been enrolled for HIV/ART care in the same facility [OR = 14(95% CI: 2.6, 75.4)], and children whose fathers were tested and known to be HIV positive [OR = 3.0(95% CI: 1.0, 9.0)] were more likely to adhere than their counterparts. Infants feeding practice was also significantly associated with adherence χ2 -test, p < 0.01.

CONCLUSION

The proportion of ARV uptake at birth among HIV exposed infants were found to be high compared to other similar settings. Mother-infant pair enrolment in the same facility and the infant's father being tested and knew their HIV result were major predictors of infants adhering to treatment and follow up. However, large numbers of infants were lost to follow up.

摘要

背景

儿童感染艾滋病毒/艾滋病主要是通过母婴传播。在埃塞俄比亚,目前有超过13.5万名儿童感染了艾滋病毒/艾滋病。本研究的目的是描述出生后抗逆转录病毒药物的服用模式、复方新诺明预防用药情况及随访依从性,并探讨哪些因素与干预结果相关。

方法

采用回顾性定量研究设计,通过两家医院收集数据。纳入2008年10月至2009年8月期间由感染艾滋病毒的母亲分娩的所有婴儿,并收集其6个月大之前的治疗依从性信息。

结果

118对艾滋病毒暴露的母婴对纳入研究。107名(90.7%)婴儿在出生时接受了抗逆转录病毒药物预防。66名(56%)婴儿被发现坚持复方新诺明预防性治疗。大多数婴儿(n = 110(93.2%))在六周龄时通过DNA/PCR艾滋病毒检测呈阴性。出生时接受抗逆转录病毒药物预防的婴儿被发现更有可能坚持复方新诺明治疗:[比值比 = 9.43(95%置信区间:1.22,72.9)]。同样,母亲在同一机构登记接受艾滋病毒/抗逆转录病毒治疗的婴儿[比值比 = 14(95%置信区间:2.6,75,4)],以及父亲检测呈艾滋病毒阳性且已知结果的儿童[比值比 = 3.0(95%置信区间:1.0,9.0)]比其他儿童更有可能坚持治疗。婴儿的喂养方式也与依从性显著相关(χ²检验,p < 0.01)。

结论

与其他类似情况相比,艾滋病毒暴露婴儿出生时抗逆转录病毒药物的服用比例较高。母婴在同一机构登记以及婴儿父亲接受检测并知晓其艾滋病毒检测结果是婴儿坚持治疗和随访的主要预测因素。然而,大量婴儿失访。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce8e/3260152/8ad7f074b21f/1756-0500-4-563-1.jpg

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