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在埃塞俄比亚提格雷北部,通过干血斑实时 PCR 检测评估 HIV 阳性母亲所生婴儿的 HIV 流行率和危险因素。

HIV prevalence and risk factors in infants born to HIV positive mothers, measured by dried blood spot real-time PCR assay in Tigray, Northern Ethiopia.

机构信息

Department of Medical Microbiology and Immunology, Division of Biomedical Science, School of Medicine, College of Health Science, Mekelle University, 1871, Mekelle, Ethiopia.

Tigray Health Research Institute (THRI), 1871, Mekelle, Ethiopia.

出版信息

BMC Pediatr. 2019 Jul 26;19(1):257. doi: 10.1186/s12887-019-1636-y.

Abstract

BACKGROUND

Infants infected during pregnancy or while breastfeeding requires early HIV diagnosis at 6 weeks after birth to identify HIV infection and timely treatment. The objective of this work was to determine the prevalence and associated risk factors of HIV among HIV exposed infants in the Tigray regional state, Northern Ethiopia.

METHODS

A cross-sectional study was conducted on 350 exposed infants born to HIV seropositive mothers from September 01 to December 30, 2016. Convenient consecutive sampling technique was employed to enroll HIV exposed infants from age 6 weeks to 18 months attending prevention of mother to child transmission (PMCT) clinic at Anti Retroviral Therapy (ART) site facility in Tigray, Ethiopia. Sociodemographic data and associated risk factors were collected using a structured questionnaire. Dried Blood Spot (DBS) samples were collected from each infant and transported by post to Tigray Health Research Institute to detect HIV infection using real-time Polymerase Chain Reaction (PCR). Data were entered into EPI Info version 7, exported and analyzed using Statistical Package for Social Sciences (SPSS) version 22. p-value less than 0.05 was deemed to be statistically significant by Fisher's exact test.

RESULTS

Three hundred forty infants (175 males, 165 females) met the criteria for selection during the completion of the study and the overall HIV prevalence was found to be 2.1% (n = 7). The majority of infants were from urban areas (n = 246, 72.4%). 45.5% (5/11, p = 0.001) infants were without ARV prophylaxis, 60% (3/5, p = 0.001) infants born to mothers who did not take maternal PMTCT intervention, 43% (3/7, p = 0.001) infants born to mothers who were not enrolled to ART care, and 6.1% (4/66, p = 0.029) infants of unmarried mothers showed statistically significant difference.

CONCLUSIONS

The overall prevalence of HIV among exposed infants was high but lower than the Millennium Development Goal targets. In order to eliminate the mother to child HIV transmission (MTCT) ARV prophylaxis in infants must be strengthened, and enrollment of HIV positive pregnant women to PMTCT and ART care and treatment is needed.

摘要

背景

在怀孕期间或哺乳期感染的婴儿需要在出生后 6 周内进行早期 HIV 诊断,以确定 HIV 感染并及时进行治疗。本研究的目的是确定在埃塞俄比亚提格雷地区,HIV 暴露婴儿中 HIV 的流行率和相关危险因素。

方法

2016 年 9 月 1 日至 12 月 30 日,对 350 名来自 HIV 阳性母亲的 HIV 暴露婴儿进行了横断面研究。采用方便连续抽样技术,从年龄 6 周至 18 个月的婴儿中招募参加预防母婴传播(PMTCT)诊所的 HIV 暴露婴儿,地点为提格雷的抗逆转录病毒治疗(ART)点。使用结构化问卷收集社会人口统计学数据和相关危险因素。从每个婴儿采集干血斑(DBS)样本,并通过邮寄运至提格雷健康研究所,使用实时聚合酶链反应(PCR)检测 HIV 感染。数据输入 EPI Info 版本 7,使用统计软件包(SPSS)版本 22 导出和分析。Fisher 精确检验认为 p 值小于 0.05 具有统计学意义。

结果

在完成研究期间,有 340 名婴儿(175 名男性,165 名女性)符合入选标准,总体 HIV 流行率为 2.1%(n=7)。大多数婴儿来自城市地区(n=246,72.4%)。45.5%(n=5,p=0.001)的婴儿未接受 ARV 预防,60%(n=3,p=0.001)的婴儿母亲未接受母婴 PMTCT 干预,43%(n=3,p=0.001)的婴儿母亲未纳入 ART 护理,6.1%(n=4,p=0.029)的婴儿母亲未婚,这些差异均具有统计学意义。

结论

暴露婴儿的总体 HIV 流行率较高,但低于千年发展目标的目标。为了消除母婴 HIV 传播(MTCT),必须加强婴儿的 ARV 预防,并需要将 HIV 阳性孕妇纳入 PMTCT 和 ART 护理和治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/448b/6659294/9d9c7c0cd2c9/12887_2019_1636_Fig1_HTML.jpg

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