Mekuria Abinet Dagnaw, Sisay Assefa Legesse, Hailegiorgies Kassa Ketsela, Abebe Ayele Mamo
Department of Public Health, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia.
Department of Epidemiology and Bio-Statistics, Jimma University, Jimma, Ethiopia.
J Multidiscip Healthc. 2020 Oct 20;13:1179-1189. doi: 10.2147/JMDH.S269558. eCollection 2020.
Prevention of mother-to-child transmission of HIV (PMTCT) is a frequently used word for programs and intervention methods to decrease the risk of mother-to-child transmission of HIV. The aim of this study was to identify determinants of the reduction of CD4 count through time and the maternal transmission of HIV to their child on the PMTCT program at health centers in North Shewa Zone, Ethiopia.
The cohort study design was conducted by using secondary data collected from the cohort register of PMTCT starting from September 1, 2014 to November 30, 2017. In this study, a longitudinal study was conducted for two types of result; these were longitudinal response measurements of HIV infected women CD4 count and the time to maternal transmission of HIV taken from 203 patients.
The prevalence rate of HIV infection among exposed infants was 5.58%. Baseline CD4 count, visiting times, weight, and interaction between visiting time and baseline CD4 count had a statistically significant effect on the longitudinal biomarker. From the Weibull AFT model, ART start, partner test, clinical stage, educational status, place of delivery, and MUAC were statistically significant. Hence, as a measurement unit decreased in square root CD4 cell count by 1.18 elevates the risk of maternal transmission of HIV.
In this study, the determinant of mother-to-child transmission of HIV including loss of weight, ART start (ANC), place of delivery at home, illiterate and mother with severe malnutrition, had a significant effect. The longitudinal biomarker also had a strong association with baseline CD4 and the risk of maternal transmission of HIV. Health education should be given about balanced diet, weight control, and take medication for HIV positive patients by the responsible bodies.
预防母婴传播艾滋病毒(PMTCT)是用于描述降低艾滋病毒母婴传播风险的项目和干预方法的常用术语。本研究的目的是确定在埃塞俄比亚北谢瓦地区的卫生中心,参与预防母婴传播艾滋病毒项目的妇女随着时间推移CD4细胞计数下降的决定因素以及艾滋病毒的母婴传播情况。
采用队列研究设计,使用从2014年9月1日至2017年11月30日的预防母婴传播艾滋病毒队列登记中收集的二手数据。在本研究中,针对两种类型的结果进行了纵向研究;这些结果是对203名艾滋病毒感染妇女的CD4细胞计数的纵向反应测量以及艾滋病毒母婴传播的时间。
暴露婴儿中的艾滋病毒感染率为5.58%。基线CD4细胞计数、就诊次数、体重以及就诊次数与基线CD4细胞计数之间的相互作用对纵向生物标志物有统计学上的显著影响。从威布尔加速失效时间模型来看,开始抗逆转录病毒治疗、性伴侣检测、临床分期、教育状况、分娩地点和上臂中部周长具有统计学意义。因此,作为测量单位,CD4细胞计数平方根每减少1.18,艾滋病毒母婴传播的风险就会升高。
在本研究中,艾滋病毒母婴传播的决定因素包括体重减轻、开始抗逆转录病毒治疗(产前护理)、在家分娩、文盲以及患有严重营养不良的母亲,这些因素具有显著影响。纵向生物标志物也与基线CD4细胞计数以及艾滋病毒母婴传播风险密切相关。相关责任机构应开展关于均衡饮食、体重控制以及为艾滋病毒阳性患者提供药物治疗的健康教育。