Morris Baraka M, Nyamhagata Mukome, Tarimo Edith, Sunguya Bruno
Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania.
Ministry of Health, Dodoma, Tanzania.
PLOS Glob Public Health. 2023 Mar 13;3(3):e0001218. doi: 10.1371/journal.pgph.0001218. eCollection 2023.
Option B+ approach for prevention of mother-to-child transmission (PMTCT) has demonstrated the potential to eliminate pediatric HIV infections. Its success depends on early infant diagnosis (EID) of HIV among the exposed infants within the first 6 weeks, and a subsequent confirmatory HIV test within 18 months. However, most mothers enrolling in option B+ in Tanzania do not come for such confirmatory tests. We examined factors associated with the turning-up of mother-baby pairs on the PMTCT program for a confirmatory HIV testing 18 months post-delivery in Tanzania. This study utilized longitudinal data collected between 2015 and 2017, from 751 mother-baby pairs enrolled in the PMTCT-option B+ approach in 79 health facilities from the 12 regions of Tanzania-mainland. Only 44.2% of 751 mother-baby records observed received the HIV confirmatory test by the 18th month. Mothers aged 25 years or above (adults' mothers) were 1.44 more likely to turn up for confirmatory HIV testing than young mothers; mothers with partners tested for HIV were 1.74 more likely to have confirmatory HIV testing compared with partners not tested for HIV. Newly diagnosed HIV-positive mothers were 28% less likely to bring their babies for a confirmatory HIV-testing compared to known HIV-positive mothers. Mothers with treatment supporters were 1.58 more likely to receive confirmatory HIV-testing compared to mothers without one. Mother-baby pairs who collected DBS-PCR-1 were 3.61 more likely to have confirmatory HIV-testing than those who didn't collect DBS-PCR-1. In conclusion, the confirmatory HIV testing within 18 months among mother-baby pairs enrolled in the Option B+ approach is still low in Tanzania. This is associated with low maternal age, having a male partner not tested for HIV, lack of experience with HIV services, lack of treatment supporters, and failure to take the DBS-PCR-1 HIV test within the first two months post-delivery.
预防母婴传播（PMTCT）的B + 方案已显示出消除儿童期HIV感染的潜力。其成功取决于对暴露婴儿在出生后6周内进行HIV早期婴儿诊断（EID），并在18个月内进行后续的HIV确诊检测。然而，在坦桑尼亚参加B + 方案的大多数母亲并未前来进行此类确诊检测。我们研究了在坦桑尼亚，与母婴对在产后18个月参加PMTCT项目进行HIV确诊检测相关的因素。本研究利用了2015年至2017年期间收集的纵向数据，这些数据来自坦桑尼亚大陆12个地区79个医疗机构中参加PMTCT - B + 方案的751对母婴。在观察到的751份母婴记录中，只有44.2%在第18个月时接受了HIV确诊检测。25岁及以上的母亲（成年母亲）进行HIV确诊检测的可能性比年轻母亲高1.44倍；伴侣接受过HIV检测的母亲进行HIV确诊检测的可能性是伴侣未接受检测的母亲的1.74倍。新诊断出HIV阳性的母亲带孩子进行HIV确诊检测的可能性比已知HIV阳性的母亲低28%。有治疗支持者的母亲进行确诊HIV检测的可能性比没有治疗支持者的母亲高1.58倍。采集干血斑聚合酶链反应1（DBS - PCR - 1）的母婴对进行确诊HIV检测的可能性是未采集DBS - PCR - 1的母婴对的3.61倍。总之，在坦桑尼亚，参加B + 方案的母婴对在18个月内进行HIV确诊检测的比例仍然很低。这与母亲年龄小、男性伴侣未接受HIV检测、缺乏HIV服务经验、缺乏治疗支持者以及在产后两个月内未进行DBS - PCR - 1 HIV检测有关。
