Faculty of Medicine, Gulu University, Gulu, Uganda.
Department of Paediatrics and Child Health, Faculty of Health Sciences, Lira University, Lira, Uganda.
Pan Afr Med J. 2020 Dec 2;37:297. doi: 10.11604/pamj.2020.37.297.22928. eCollection 2020.
the HIV-free survival rate is the gold-standard measure of the effectiveness of interventions towards prevention of mother-to-child transmission of HIV in any setting. However, data on HIV-free survival among the HIV-exposed infants followed up in most low-resource settings are lacking. We determined the HIV-free survival among breastfed infants in two tertiary facilities in a resource-poor setting in northern Uganda.
we conducted a retrospective cohort study in May 2019 and retrospectively reviewed records of HIV-exposed infants registered in 2014 through 2016 at two tertiary facilities in northern Uganda. We analyzed data using SPSS v16 software package. The chi-square and Student t-tests were used to compare factors among infant groups. Multivariate logistic regression analysis was used to determine factors independently associated with HIV-free survival. P-value <0.05 was considered for statistical significance.
majority of the infants were males 55.6% (203/365) and 98.6% (360/365) received nevirapine prophylaxis. A total of 345 (94.5%) infants were exclusively breastfed, only 100/345 (29.0%) of whom were exclusively breastfed for at least 6 months, while the breastfeeding status of 44/345 (12.8 %) infants could not be ascertained. The overall HIV-free survival rate was 93.7% (342/365), while 2.7% (10/365) were HIV-infected and 3.6% (13/365) died. Infants´ age at enrolment in care (aOR 5.20, p=0.008) and treatment facility (aOR 3.76, p=0.027) were the independent determinants of HIV-free survival.
the HIV-free survival rate among the breastfed infants in the study setting marginally falls short of the recommended standard, thus calling for more efforts to improve survival.
HIV 无存活期是评估母婴传播 HIV 预防干预措施有效性的金标准。然而，在大多数资源匮乏的环境中，缺乏对接受 HIV 暴露的婴儿进行随访的 HIV 无存活期数据。我们在乌干达北部的两个三级机构中确定了母乳喂养婴儿的 HIV 无存活期。
我们于 2019 年 5 月进行了一项回顾性队列研究，回顾性分析了 2014 年至 2016 年在乌干达北部的两个三级机构登记的 HIV 暴露婴儿的记录。我们使用 SPSS v16 软件包分析数据。采用卡方检验和 Student t 检验比较婴儿组间的因素。采用多变量逻辑回归分析确定与 HIV 无存活期独立相关的因素。P 值<0.05 为有统计学意义。
大多数婴儿为男性（55.6%，203/365），98.6%（360/365）接受了奈韦拉平预防。共有 345 名（94.5%）婴儿接受纯母乳喂养，其中仅 100/345 名（29.0%）至少纯母乳喂养 6 个月，而 44/345 名（12.8%）婴儿的母乳喂养情况无法确定。总的 HIV 无存活期为 93.7%（342/365），2.7%（10/365）感染 HIV，3.6%（13/365）死亡。婴儿入组时的年龄（OR 5.20，p=0.008）和治疗机构（OR 3.76，p=0.027）是 HIV 无存活期的独立决定因素。
研究环境中母乳喂养婴儿的 HIV 无存活期略低于推荐标准，因此需要做出更多努力以提高生存率。
