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埃塞俄比亚阿姆哈拉地区各健康中心和医院中暴露于HIV的婴儿的结局及其与慢性病护理的关联:对预防HIV母婴传播项目的启示:一项横断面研究

Outcomes and linkage to chronic care of HIV exposed infants among health centers and hospitals in Amhara Region, Ethiopia: implications to prevention of mother-to-child transmission of HIV program: a cross sectional study.

作者信息

Kebede Zemene Tigabu, Taye Belaynew Wasie

机构信息

Department of Pediatrics and Child Health, University of Gondar, Ethiopia.

Departments of Epidemiology and Biostatistics, Bahir Dar University, Ethiopia.

出版信息

Pan Afr Med J. 2016 May 13;24:61. doi: 10.11604/pamj.2016.24.61.7305. eCollection 2016.

Abstract

INTRODUCTION

Numerous challenges exist in provision of prevention of mother-to-child transmission of HIV (PMTCT) such as linking HIV exposed infants (HEI) and their mothers to chronic cares services, and tackling loss to follow up. Limited evidence exists in Ethiopian setting that explains the persisting high HIV infection rate among HEIs and extent of linkage to chronic care. The study assessed the proportion of HIV infection; children linked to chronic care and determinants of HIV infection among HEI in Northern Ethiopia.

METHODS

This institution-based cross-sectional study was conducted in health centers and hospitals of Amhara Region. A total of 484 HEI-mother pairs selected by multistage random sampling were included in the study. Data were collected from PMTCT and anti-retroviral therapy (ART) clinics using pre-tested and structured questionnaires. Quantitative data were entered in Epi Info version 7.0 and exported to SPSS 20.0 for analysis.

RESULTS

A total of 484 mother-infant pairs with a response rate of 92.4% were included in the analysis. About 94.2% of infants and women were linked to chronic care follow-up sometime after the diagnosis. The proportion of HIV infection was 12.4%. Antenatal care attendance had a significant association with HIV infection among HEI (p < 0.0001). Delivering in health institution (p < 0.005), mode of delivery (p < 0.032), and provision of both infant (p < 0.0001) and maternal (p < 0.0001) prophylaxis showed a highly significant association with HIV infection among HIV exposed infants.

CONCLUSION

Health facilities shall encourage antenatal care that increased institutional delivery, leads to timely initiation and high uptake of PMTCT to reduce the vertical transmission of HIV infection and meet national targets.

摘要

引言

在提供预防母婴传播艾滋病毒(PMTCT)服务方面存在诸多挑战,例如将艾滋病毒暴露婴儿(HEI)及其母亲与慢性病护理服务联系起来,以及解决失访问题。在埃塞俄比亚的背景下,关于解释HEI中持续高艾滋病毒感染率以及与慢性病护理联系程度的证据有限。该研究评估了埃塞俄比亚北部HEI中的艾滋病毒感染比例、与慢性病护理有联系的儿童以及艾滋病毒感染的决定因素。

方法

这项基于机构的横断面研究在阿姆哈拉地区的卫生中心和医院进行。通过多阶段随机抽样选择的总共484对HEI-母亲对被纳入研究。使用预先测试和结构化的问卷从PMTCT和抗逆转录病毒疗法(ART)诊所收集数据。定量数据输入到Epi Info 7.0版本中,并导出到SPSS 20.0进行分析。

结果

总共484对母婴对,应答率为92.4%,被纳入分析。约94.2%的婴儿和妇女在诊断后的某个时间与慢性病护理随访有联系。艾滋病毒感染比例为12.4%。产前护理就诊与HEI中的艾滋病毒感染有显著关联(p < 0.0001)。在医疗机构分娩(p < 0.005)、分娩方式(p < 0.032)以及提供婴儿(p < 0.0001)和母亲(p < 0.0001)预防措施与艾滋病毒暴露婴儿中的艾滋病毒感染有高度显著关联。

结论

卫生设施应鼓励增加机构分娩的产前护理,及时启动并提高PMTCT的接受率,以减少艾滋病毒感染的垂直传播并实现国家目标。

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本文引用的文献

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Analysis of HIV early infant diagnosis data to estimate rates of perinatal HIV transmission in Zambia.
PLoS One. 2012;7(8):e42859. doi: 10.1371/journal.pone.0042859. Epub 2012 Aug 17.
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