Nabitaka Linda Kisaakye, Delaney Augustina, Namukanja Phoebe M, Nalugoda Fred, Makumbi Fredrick E, Dirlikov Emilio, Nelson Lisa, Kirungi Wilford, Sendagala Sam, Nakityo Rose B, Kasule Jingo, Ondo Doreen, Mudiope Peter, Ssewanyana Isaac, Opio Joel, Thu-Ha Dinh, Adler Michelle R, Asiimwe Hilda, Birabwa Estella, Ochora Esther Nyamugisa, Serwadda David, Lutalo Tom
Uganda Ministry of Health, AIDS Control Programme, Kampala, Uganda.
Global Health Center, Division of Global HIV and Tuberculosis, US Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA.
Sci Rep. 2025 Jul 8;15(1):24402. doi: 10.1038/s41598-025-09511-z.
Uganda is consistently one of the highest burden countries for mother-to-child transmission of HIV (MTCT). This study assessed Uganda's progress toward elimination of MTCT and factors associated with MTCT. Mother-infant pairs (MIP) were recruited at immunization clinics at randomly sampled public and private health facilities in Uganda during 2017-2019. Using a multistage sampling method, a nationally representative sample of MIP aged 4-12 weeks were recruited and followed longitudinally for 18 months or until the infant acquired HIV. Early MTCT was defined as an infant with confirmed HIV infection at study enrollment and was calculated using logistic regression to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) for associated factors. Poisson regression was used to estimate incidence rate and incidence rate ratio (IRR) for infants acquiring HIV at any time during the study after enrollment (late MTCT) and associated factors. Early MTCT was 2.2% (95% CI: 1.3-3.6) and late MTCT rate was 5.2 per 1000 person-years (95% CI: 2.5-10.9). In the adjusted model, only detectable maternal HIV viral load (≥ 1,000 copies/mL) was significantly associated with early MTCT (aOR: 6.8, 95% CI: 2.3-19.9). Similarly, ever having a detectable viral load (at any visit) was significantly associated with late MTCT (IRR: 6.2, 95% CI: 1.2-31.7). Uganda's program has made large strides to eliminate MTCT. Identifying and addressing elevated maternal HIV viral load, especially during pregnancy and the early breastfeeding period could further reduce the number of new childhood infections in Uganda.
乌干达一直是艾滋病毒母婴传播（MTCT）负担最高的国家之一。本研究评估了乌干达在消除MTCT方面的进展以及与MTCT相关的因素。2017年至2019年期间，在乌干达随机抽取的公立和私立卫生设施的免疫诊所招募母婴对（MIP）。采用多阶段抽样方法，招募了具有全国代表性的4至12周龄MIP样本，并对其进行了18个月的纵向跟踪，或直至婴儿感染艾滋病毒。早期MTCT定义为在研究入组时确诊感染艾滋病毒的婴儿，并使用逻辑回归计算相关因素的调整优势比（aOR）和95%置信区间（95%CI）。采用泊松回归估计入组后研究期间任何时间感染艾滋病毒的婴儿（晚期MTCT）的发病率和发病率比（IRR）以及相关因素。早期MTCT为2.2%（95%CI：1.3 - 3.6），晚期MTCT率为每1000人年5.2例（95%CI：2.5 - 10.9）。在调整模型中，仅可检测到的母亲艾滋病毒病毒载量（≥1000拷贝/mL）与早期MTCT显著相关（aOR：6.8，95%CI：2.3 - 19.9）。同样，曾经有过可检测到的病毒载量（在任何一次就诊时）与晚期MTCT显著相关（IRR：6.2，95%CI：1.2 - 31.7）。乌干达的项目在消除MTCT方面取得了长足进展。识别并解决母亲艾滋病毒病毒载量升高的问题，尤其是在孕期和母乳喂养早期，可能会进一步减少乌干达新的儿童感染病例数。
