Ahenkan Ebenezer, Asare-Bediako Anastasia, Damilare Kingsley Adeoye, Antwi-Agyei David, Atawuchugi Paul, Osei-Owusu Frederick, Agyemang Sarah Konadu, Konadu Gifty, Opoku Richard Agyemang, Yeboah Kofi Oduro, Maiga-Ascofare Oumou, Boakye-Gyasi Eric, Osafo Newman
Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana.
Department of Pharmacology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Int J MCH AIDS. 2025 Jul 18;14:e014. doi: 10.25259/IJMA_5_2025. eCollection 2025.
There is a global effort to eliminate new human immunodeficiency virus (HIV) infections among children. However, mother-to-child transmission (MTCT) of HIV, which accounts for nearly all pediatric infections, remains disproportionately high in Africa, including Ghana. This study aims to determine the prevalence and identify the key predictors of MTCT of HIV among HIV-exposed infants in the Ashanti Region of Ghana.
A retrospective cohort analysis of routine follow-up records of HIV-infected mothers and their exposed infants was conducted between August 2023 and June 2024 in four hospitals. A convenient consecutive sampling technique was employed to include exposed infants who were at least 18 months old, had ceased breastfeeding, and had definite HIV test results. A structured form was used to collect sociodemographic, clinical, and treatment data of mother-infant pairs. The data were entered into an Excel sheet and exported to STATA version 17.0 for analysis. Bivariate and multivariate logistic regression models were used to determine key predictors of MTCT.
Out of the 220 records reviewed, 24 infants tested positive for HIV, giving an overall prevalence of 10.9%. The prevalence was 17.5% (21/120) among participants living in rural communities, compared to 0.03% (3/100) in urbanized areas. Maternal viral load ≥1000 copies/mL (adjusted odds ratio [aOR]: 13.13; 95% confidence interval [CI]: 2.75-62.69), no antiretroviral (ARV) prophylaxis in infant (aOR: 11.05; 95% CI: 2.18-55.91), and mixed feeding during the first 6 months of life of the infant (aOR: 5.65; 95% CI: 1.34-23.87) were the main predictors of MTCT of HIV.
The prevalence of MTCT of HIV is high, especially in rural settings. Eliminating MTCT will require effective maternal viral suppression through optimal ART adherence, ensuring prompt ARV prophylaxis for infants at birth and promoting safer feeding practices during the infant's first 6 months of life.
全球都在努力消除儿童中新发的人类免疫缺陷病毒（HIV）感染。然而，在包括加纳在内的非洲，几乎所有儿童感染均由母婴传播（MTCT）导致，其比例仍然过高。本研究旨在确定加纳阿散蒂地区HIV暴露婴儿中MTCT的患病率，并识别其关键预测因素。
2023年8月至2024年6月期间，在四家医院对HIV感染母亲及其暴露婴儿的常规随访记录进行了回顾性队列分析。采用方便连续抽样技术纳入至少18个月大、已停止母乳喂养且有明确HIV检测结果的暴露婴儿。使用结构化表格收集母婴对的社会人口学、临床和治疗数据。数据录入Excel表格并导出到STATA 17.0版本进行分析。使用二元和多元逻辑回归模型确定MTCT的关键预测因素。
在审查的220份记录中，24名婴儿HIV检测呈阳性，总体患病率为10.9%。农村社区参与者中的患病率为17.5%（21/120），而城市化地区为0.03%（3/100）。母亲病毒载量≥1000拷贝/mL（调整优势比[aOR]：13.13；95%置信区间[CI]：2.75 - 62.69）、婴儿未接受抗逆转录病毒（ARV）预防（aOR：11.05；95% CI：2.18 - 55.91）以及婴儿出生后前6个月混合喂养（aOR：5.65；95% CI：1.34 - 23.87）是HIV母婴传播的主要预测因素。
HIV母婴传播的患病率很高，尤其是在农村地区。消除母婴传播需要通过最佳的抗逆转录病毒治疗依从性实现有效的母亲病毒抑制，确保婴儿出生时及时接受ARV预防，并在婴儿出生后的前6个月推广更安全的喂养方式。
