Department of Midwifery, Mekelle University, College of Health Science, Ayder Comprehensive Specialized Hospital, Mekelle, Tigray, Ethiopia.
Ethiopian Public Health Association, Addis Ababa, Ethiopia.
BMC Infect Dis. 2020 Jan 21;20(1):67. doi: 10.1186/s12879-020-4790-9.
Timely infant testing for HIV is critical to ensure optimal treatment outcomes among exposed infants. While world health organization recommends HIV exposed infants to be tested between 4 to 6 weeks of age, in developing countries like Ethiopia, access to timely infant testing is still very limited. The study is intended to assess timely infant testing, testing for HIV at the 18th month, test results and factors influencing HIV positivity among infants born to HIV positive mothers in public hospitals of Mekelle, Ethiopia.
A cross-sectional study design was employed on 558 HIV exposed infants, using consecutive sampling technique. A checklist was used to extract 4 years (January 2014-December 2017) secondary data, collected from January-April 2018. Data were analyzed using SPSS version 20, and binary logistic regression model was used to examine the association of independent variables with the outcome variables.
Timely infant testing for HIV accounted for 346(62.0%). Mothers who attended antenatal care (AOR: 2.77; 95% CI: 1.17, 6.55) and who were counselled on feeding options (AOR: 2.01; 95% CI: 1.11, 3.65) were strongly associated with timely infant testing. Poor maternal adherence status was associated with infants' HIV positivity at the 18th month of antibody test (AOR: 15.93; 95% CI: 2.21, 94.66). Being rural resident (AOR: 4.0; 95% CI: 1.23, 13.04), being low birth weight (AOR: 5.64; 95% CI: 2.00, 16.71) and not receiving ARV prophylaxis (AOR: 4.70; 95% CI: 1.15, 19.11) were positively associated with the overall HIV positivity.
A considerable proportion of exposed infants did not undergo timely testing for HIV. Antenatal care follow-up and counselling on feeding options were associated with timely infant testing. Mother's poor adherence status was associated with infant's HIV positivity at the 18th month of antibody testing. Being rural resident, being low birth weight, and not receiving ARV prophylaxis were the factors that enhance the overall HIV positivity. Timely infant testing, counselling on feeding options and adherence should be intensified, and prevention of mother-to-child transmission program in rural settings need to be strengthened.
及时对 HIV 感染婴儿进行检测对于确保暴露婴儿获得最佳治疗效果至关重要。虽然世界卫生组织建议在 4 至 6 周龄时对 HIV 感染婴儿进行检测，但在埃塞俄比亚等发展中国家，及时对婴儿进行检测的机会仍然非常有限。本研究旨在评估在埃塞俄比亚梅克莱公立医院出生的 HIV 阳性母亲所生婴儿中，及时进行婴儿 HIV 检测、18 月龄时进行 HIV 检测、检测结果以及影响 HIV 阳性率的因素。
采用横断面研究设计，对 558 名 HIV 暴露婴儿进行连续抽样，使用检查表提取 2014 年 1 月至 2017 年 12 月 4 年（2018 年 1 月至 4 月）的二级数据。使用 SPSS 版本 20 对数据进行分析，采用二项逻辑回归模型来检验自变量与因变量之间的关联。
及时进行 HIV 婴儿检测的比例为 346 例（62.0%）。接受产前保健（AOR：2.77；95%CI：1.17，6.55）和接受喂养选择咨询（AOR：2.01；95%CI：1.11，3.65）的母亲与及时进行婴儿检测密切相关。母亲的依从性差与婴儿在 18 月龄时的抗体检测呈 HIV 阳性相关（AOR：15.93；95%CI：2.21，94.66）。农村居民（AOR：4.0；95%CI：1.23，13.04）、低出生体重（AOR：5.64；95%CI：2.00，16.71）和未接受 ARV 预防（AOR：4.70；95%CI：1.15，19.11）与总体 HIV 阳性率呈正相关。
相当一部分暴露婴儿未及时进行 HIV 检测。产前保健随访和喂养选择咨询与及时进行婴儿检测相关。母亲的依从性差与婴儿在 18 月龄时的抗体检测 HIV 阳性相关。农村居民、低出生体重和未接受 ARV 预防是增加总体 HIV 阳性率的因素。应加强及时进行婴儿检测、喂养选择咨询和依从性，并加强农村地区母婴传播预防项目。
