Division of Virology, ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India.
Division of Bacteriology, ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India.
BMC Pregnancy Childbirth. 2020 Sep 4;20(1):509. doi: 10.1186/s12884-020-03193-3.
In India, preventing mother-to-child transmission (PMTCT) of Human Immunodeficiency Virus (HIV) remains one of the foremost challenge in community health. Countrywide MTCT of HIV is estimated to be > 10,000 annually. Aims of present study are to find out the prevalence of HIV and correlates of HIV transmission among children given birth by HIV infected mother through systematic review along with meta-analysis.
All avaiable articles are retrieved using MEDLINE, Cochrane Library, Science Direct, EMBASE, Google Scholar and PUBMED following guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) are applied to critically reviewing the selected articles. STATA 13.0 is used to preparation of forest plot for Meta-analysis. For assessment of heterogeneity and publication biases I statistics along with Begg and Mazumdar's test and Egger's tests are used. Odds ratio (OR) along with forest plots have been showing with 95% confidence interval (CI).
All together 10 studies including 1537 pairs of mothers and new births are assessed in present meta-analysis. Present analysis revealed the prevalence of HIV due to MTCT in India as 8.76% (95% CI; 5.76, 12.31). Analysis of subgroups exhibit a higher pooled prevalence in eastern region of India, 10.83% (95% CI: 5.9, 17.81) and lower in in Western region in India, 6.37% (95% CI: 4.65, 8.49). Status of MTCT before and after initiation of universal ART are 10.23% (95% CI 6.61, 14.55) and 7.93% (95% CI 4.18, 12.76) respectively. Associated factors with MTCT of HIV include absence of maternal prevention of MTCT intervention, OR = 10.82 (95% CI: 5.28, 22.17), lacking in administration of infant ARV (antiretroviral), OR = 8.21 (95% CI: 4.82, 14.0) and absence of medical facility during childbirth OR = 3.73 (95% CI: 1.67, 8.33).
In India, pooled HIV prevalence of MTCT as high as 8.78% (95% CI; 5.76, 12.31) among babies born to infected mothers warrants urgent need of focused intervention for providing ART (PMTCT intervention), ensuring proper infant ARV prophylaxis, and avoiding delivery without proper medical facility to pregnant women with HIV for reduction of occurrence in HIV transmission from mothers to children.
在印度，预防母婴传播（PMTCT）艾滋病毒（HIV）仍然是社区卫生的首要挑战之一。全国范围内估计每年有超过 10,000 例 HIV 母婴传播。本研究的目的是通过系统评价和荟萃分析，找出在 HIV 感染母亲所生的儿童中 HIV 的流行率及其传播的相关因素。
使用 MEDLINE、Cochrane 图书馆、Science Direct、EMBASE、Google Scholar 和 PUBMED 按照系统评价和荟萃分析的首选报告项目（PRISMA）指南检索所有可用的文章。乔安娜·布里格斯研究所荟萃分析统计评估和审查工具（JBI-MAStARI）用于批判性地审查所选文章。使用 STATA 13.0 准备荟萃分析的森林图。为了评估异质性和发表偏倚，我使用了 I 统计量以及 Begg 和 Mazumdar 的检验和 Egger 的检验。使用优势比（OR）和森林图显示 95%置信区间（CI）。
本荟萃分析共评估了 10 项研究，包括 1537 对母婴和新生儿。本分析显示，印度由于 MTCT 导致的 HIV 流行率为 8.76%（95%CI；5.76, 12.31）。亚组分析显示，印度东部地区的合并患病率较高，为 10.83%（95%CI：5.9, 17.81），而印度西部地区的患病率较低，为 6.37%（95%CI：4.65, 8.49）。在启动普遍 ART 之前和之后，MTCT 的流行率分别为 10.23%（95%CI 6.61, 14.55）和 7.93%（95%CI 4.18, 12.76）。与 HIV 母婴传播相关的因素包括缺乏母婴预防 MTCT 干预、OR=10.82（95%CI：5.28, 22.17）、缺乏婴儿抗逆转录病毒（ARV）治疗、OR=8.21（95%CI：4.82, 14.0）和分娩时缺乏医疗设施、OR=3.73（95%CI：1.67, 8.33）。
在印度，高达 8.78%（95%CI；5.76, 12.31）的感染母亲所生婴儿的 HIV 母婴传播综合流行率表明，迫切需要针对提供抗逆转录病毒治疗（PMTCT 干预）、确保适当的婴儿 ARV 预防以及避免在没有适当医疗设施的情况下为 HIV 孕妇分娩，以减少母婴传播的发生，需要采取有针对性的干预措施。
