埃塞俄米亚奥罗米亚地区接受预防母婴传播服务的艾滋病毒阳性母亲不适当的婴儿喂养做法：一项横断面研究
Inappropriate infant feeding practices of HIV-positive mothers attending PMTCT services in Oromia regional state, Ethiopia: a cross-sectional study.
作者信息
Ejara Daba, Mulualem Demelash, Gebremedhin Samson
机构信息
Meda Welabu University, Shashamene Campus, Shashamene, Ethiopia.
2School of Nutrition, Food Science and Technology, Hawassa University, Hawassa, Ethiopia.
出版信息
Int Breastfeed J. 2018 Aug 17;13:37. doi: 10.1186/s13006-018-0181-x. eCollection 2018.
BACKGROUND
Inappropriate infant feeding affects the probability of mother-to-child transmission of HIV and HIV-free survival of infants. However, in Ethiopia limited evidence exists regarding the infant feeding practice of mothers who are HIV-positive. The aim of this study was to determine the prevalence and predictors of inappropriate infant feeding among HIV-positive mothers attending the prevention of mother-to-child transmission (PMTCT) service in Adama and Bushoftu towns, Oromia, central Ethiopia
METHODS
A cross-sectional study was conducted in ten PMTCT service providing health facilities in the towns; 283 mother-infant pairs were enrolled. Appropriate infant feeding practice was defined as exclusive breastfeeding in the first six months of age. Logistic regression was employed to analyze the data and the outputs are presented using adjusted odds ratio (AOR) with 95% confidence intervals (CI).
RESULTS
One hundred thirty of the infants were aged below six months, 103 between 6 and 11 months and 50 were older than 12 months. The prevalence of inappropriate infant feeding was 14.5% (95% CI 10.6, 18.7). About 6.3% and 8.3% practiced exclusive replacement feeding and mixed feeding respectively, in the first six months. Only 1.8% ever expressed their breast milk to feed their baby and none practiced wet nursing. Among 38 mothers who already discontinued breastfeeding 52.6% did so before 12 months of age. Mothers who were HIV-positive and had received antenatal (AOR = 0.05: 0.01, 0.30) and postnatal visits (AOR = 0.18: 0.04, 0.81); received infant feeding counseling (AOR = 0.18: 0.06, 0.55); and disclosed their HIV status to their partners (AOR = 0.28: 0.12, 0.63), showed a reduction of practicing inappropriate infant feeding. Mothers having breast problems (AOR = 4.89: 1.54, 15.60) and infants with mouth ulcers (AOR = 6.41: 2.07, 19.85) were more likely to practice inappropriate feeding.
CONCLUSION
Prompt management of breast complaints in mothers and mouth ulcer in infants; and provision of nutrition counseling to HIV-positive mothers, especially during antenatal and postnatal care, may help to improve the infant feeding practices for HIV exposed infants.
背景
不适当的婴儿喂养会影响母婴传播艾滋病毒的概率以及婴儿无艾滋病毒存活的几率。然而，在埃塞俄比亚，关于艾滋病毒呈阳性母亲的婴儿喂养做法的证据有限。本研究的目的是确定在埃塞俄比亚中部奥罗米亚州阿达马和布舒夫图镇接受预防母婴传播（PMTCT）服务的艾滋病毒呈阳性母亲中，不适当婴儿喂养的患病率及其预测因素。
方法
在这两个镇的10个提供PMTCT服务的卫生设施中进行了一项横断面研究；纳入了283对母婴。适当的婴儿喂养做法被定义为在出生后头六个月进行纯母乳喂养。采用逻辑回归分析数据，并使用调整后的优势比（AOR）及95%置信区间（CI）呈现结果。
结果
130名婴儿年龄在六个月以下，103名在6至11个月之间，50名超过12个月。不适当婴儿喂养的患病率为14.5%（95%CI 10.6，18.7）。在头六个月中，分别约有6.3%和8.3%的母亲采用纯替代喂养和混合喂养。只有1.8%的母亲曾挤出母乳喂哺婴儿，无人采用湿哺。在38名已停止母乳喂养的母亲中，52.6%在12个月前就停止了。艾滋病毒呈阳性且接受过产前检查（AOR = 0.05：0.01，0.30）和产后检查（AOR = 0.18：0.04，0.81）；接受过婴儿喂养咨询（AOR = 0.18：0.06，0.55）；并向伴侣披露自己艾滋病毒感染状况的母亲（AOR = 0.28：0.12，0.63），其不适当婴儿喂养的行为有所减少。有乳房问题的母亲（AOR = 4.89：1.54，15.60）和患有口腔溃疡的婴儿（AOR = 6.41：2.07，19.85）更有可能采用不适当的喂养方式。
结论
及时处理母亲的乳房问题和婴儿的口腔溃疡；并向艾滋病毒呈阳性的母亲提供营养咨询，尤其是在产前和产后护理期间，可能有助于改善艾滋病毒暴露婴儿的喂养做法。
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