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在埃塞俄比亚西北部的南贡达尔公立医院中,HIV 暴露婴儿的母婴传播发生率及阳性预测因素:竞争风险回归模型。

Incidence of mother-to-child transmission of HIV and predictors of positivity among HIV exposed infants in South Gondar public hospitals, Northwest Ethiopia: competing risk regression model.

机构信息

Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.

Department of comprehensive Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.

出版信息

BMC Pediatr. 2024 Sep 20;24(1):597. doi: 10.1186/s12887-024-05061-x.

DOI:10.1186/s12887-024-05061-x
PMID:39304894
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11414292/
Abstract

BACKGROUND

The principal route of HIV infection in children is vertical transmission. Thus, this study aimed to assess the incidence of mother-to-child transmission of HIV and predictors of positivity among HIV-exposed infants.

METHOD

Institutions-based retrospective follow-up study was conducted in South Gondar Public hospitals, Northwest Ethiopia from December 2019 to November 2021. The data were taken from PMTCT logbooks and patient medical records, with death being the competing event. Data were entered in to Epi info version 7 and exported to STATA version 14 for final analysis. Both bivariable and multiple variable proportional subdistribution hazard analysis were conducted to identify predictors. P-value < 0.05 was level of significance.

RESULT

A total of 469 exposed infant mother pairs records were included. The cumulative incidence rate at the end of the study period was 5.2 per 1000 person months (5.2; 95% CI: 3.4-8.0).Infants' absence of ARV prophylaxis at birth (aSHR = 3.7; 95% CI: 1.33-10.48), Mothers with no PMTCT intervention (aSHR = 5.1; 95% CI: 1.83-14.03), home delivery (aSHR = 4.1; 95%CI: 1.46-11.63) and maternal disclosure of HIV status to partner/families (aSHR = 2.9; 95% CI: 1.06-7.78) were predictors of HIV positivity.

CONCLUSION

The study found that Infants' absence of ARV prophylaxis at birth, mothers without PMTCT intervention, home delivery and mothers who were not disclosing their HIV status to families were predictors of HIV positivity.

摘要

背景

儿童感染 HIV 的主要途径是垂直传播。因此,本研究旨在评估 HIV 暴露婴儿的母婴传播发生率和阳性预测因素。

方法

本研究是在 2019 年 12 月至 2021 年 11 月期间,在埃塞俄比亚西北部南贡德尔公立医院进行的基于机构的回顾性随访研究。数据来自 PMTCT 日志和患者病历,死亡是竞争事件。数据输入 Epi info 版本 7 并导出到 STATA 版本 14 进行最终分析。进行了单变量和多变量比例亚分布风险分析以确定预测因素。P 值<0.05 为显著性水平。

结果

共纳入 469 对 HIV 暴露婴儿母亲的记录。研究期末的累积发病率为 5.2 例/1000 人月(5.2;95%CI:3.4-8.0)。婴儿出生时未接受 ARV 预防(aSHR=3.7;95%CI:1.33-10.48)、母亲未接受 PMTCT 干预(aSHR=5.1;95%CI:1.83-14.03)、在家分娩(aSHR=4.1;95%CI:1.46-11.63)和母亲向伴侣/家属透露 HIV 状况(aSHR=2.9;95%CI:1.06-7.78)是 HIV 阳性的预测因素。

结论

本研究发现,婴儿出生时未接受 ARV 预防、母亲未接受 PMTCT 干预、在家分娩以及母亲未向家属透露 HIV 状况是 HIV 阳性的预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6218/11414292/d4bbe283528c/12887_2024_5061_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6218/11414292/5e39f35ea938/12887_2024_5061_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6218/11414292/d4bbe283528c/12887_2024_5061_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6218/11414292/5e39f35ea938/12887_2024_5061_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6218/11414292/d4bbe283528c/12887_2024_5061_Fig2_HTML.jpg

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