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埃塞俄比亚东部德雷达瓦市接受护理及随访的暴露婴儿中HIV感染的母婴传播及其决定因素

Mother-to-Child Transmission of HIV Infection and Its Determinants among Exposed Infants on Care and Follow-Up in Dire Dawa City, Eastern Ethiopia.

作者信息

Wudineh Fisseha, Damtew Bereket

机构信息

Pediatric ART Clinic, ART Department, Dil Chora Referral Hospital, Dire Dawa, Ethiopia.

Department of Epidemiology and Biostatistics, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.

出版信息

AIDS Res Treat. 2016;2016:3262746. doi: 10.1155/2016/3262746. Epub 2016 Feb 16.

Abstract

Since the scale-up for prevention of mother-to-child transmission (PMTCT) services, rates of HIV infection among exposed infants have significantly declined. However, current achievements fell short of achieving the target sets. We investigated mother-to-child transmission (MTCT) of HIV infection and its determinants among HIV-exposed infants on care at Dilchora Referral Hospital in Dire Dawa City Administration. A retrospective institutional cohort study was conducted by reviewing follow-up records of HIV-exposed infants who were enrolled into care. Infants' HIV serostatus was the outcome measure of the study. Bivariate and multivariate logistic regressions were employed to identify significant determinants. Of the 382 HIV-exposed infants enrolled into care, 60 (15.7%) became HIV positive. Rural residence (AOR: 3.29; 95% CI: 1.40, 7.22), home delivery (AOR: 3.35; 95% CI: 1.58, 8.38), infant not receiving ARV prophylaxis at birth (AOR: 5.83; 95% CI: 2.84, 11.94), mixed feeding practices (AOR: 42.21; 95% CI: 8.31, 214.38), and mother-child pairs neither receiving ARV (AOR: 4.42; 95% CI: 2.01, 9.82) were significant independent determinants of MTCT of HIV infection. Our findings suggest additional efforts to intensify scale-up of PMTCT services in rural setting and improve institutional delivery and postnatal care for HIV positive mothers and proper follow-up for HIV-exposed infants.

摘要

自从扩大预防母婴传播(PMTCT)服务以来,暴露婴儿中的艾滋病毒感染率已显著下降。然而,目前的成就未达到既定目标。我们调查了迪雷达瓦市行政区迪尔乔拉转诊医院接受护理的艾滋病毒暴露婴儿中艾滋病毒母婴传播(MTCT)情况及其决定因素。通过审查纳入护理的艾滋病毒暴露婴儿的随访记录进行了一项回顾性机构队列研究。婴儿的艾滋病毒血清学状态是该研究的结果指标。采用双变量和多变量逻辑回归来确定重要的决定因素。在纳入护理的382名艾滋病毒暴露婴儿中,60名(15.7%)艾滋病毒呈阳性。农村居住(调整后比值比:3.29;95%置信区间:1.40,7.22)、在家分娩(调整后比值比:3.35;95%置信区间:1.58,8.38)、婴儿出生时未接受抗逆转录病毒药物预防(调整后比值比:5.83;95%置信区间:2.84,11.94)、混合喂养方式(调整后比值比:42.21;95%置信区间:8.31,214.38)以及母婴均未接受抗逆转录病毒药物治疗(调整后比值比:4.42;95%置信区间:2.01,9.82)是艾滋病毒感染母婴传播的重要独立决定因素。我们的研究结果表明,需要做出更多努力,在农村地区加强扩大预防母婴传播服务,改善艾滋病毒阳性母亲的机构分娩和产后护理,以及对艾滋病毒暴露婴儿进行适当的随访。

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