ABSTRACT
Objective@#To analyze the epidemiological characteristics of HIV-infected pregnant women and exposed infant in Guangdong province and identify the factors associated with infant HIV infection through mother-to-child transmission.@*Methods@#National Information System for Prevention of mother-to-child HIV Transmission and Early Infant Diagnosis Information Management Platform were used to collect the individual information about HIV-infected pregnant women and exposed infants who were delivered in Guangdong from January 1, 2014 to December 31 in 2017. The differences in pregnant women’s demographic data, history of pregnancy and childbirth, the utilization of mother-to-child transmission prevention services and early infant diagnosis between the infected HIV exposed infants and uninfected HIV exposed infants were compared, and univariate and multivariate logistic regression analyses were conducted to identify the factors associated with mother-to-child HIV transmission.@*Results@#Among 349 HIV infected pregnant women, the proportions of the pregnant women whose HIV infection status were confirmed before pregnancy, during pregnancy and at or after childbirth were 30.4% (106/349), 49.6% (173/349) and 20.0% (70/349) respectively. The proportions of those with sexual partners whose HIV infection status were unknown and those receiving no antiviral treatment were 39.5% (138/349) and 13.2% (46/349) respectively. Among the HIV exposed infants, the mother-to-child transmission rate was 4.2%(15/353), the HIV exposed infants had the first or second early diagnosis tests within 44 (P25-P75: 42-50) days and 96 (P25-P75: 92-106) days after birth, respectively. Univariate logistic regression analysis indicated that the risk for mother-to-child HIV transmission increased in those whose HIV infection status were confirmed at or after childbirth compared with before pregnancy (OR=5.72, 95%CI: 1.52-21.61) and in the group that antiviral treatment was given to either mothers or infants compared with the group that antiviral treatment was given to both mothers and infants (OR=33.56, 95%CI: 9.04-124.55), while there was lower mother-to-child HIV transmission risk in artificial feeding group compared with breast feeding group (OR=0.07, 95%CI: 0.01-0.76).@*Conclusion@#The risk of mother-to-child HIV transmission in Guangdong can be effectively reduced by the measures of early diagnosis, antiviral treatment and artificial feeding as well as the improvement of mother-to-child transmission prevention service.
ABSTRACT
Objective There is a high occurrence rate of thalassaemia in Guangdong Province .Major and intermedia thalas-saemia bring severe burden for patients , families, and societies.This study aimed to reveal the economic burden of thalassaemia major and intermedia thalassaemia in Guangdong Province . Methods Eight areas of Guangdong Province were selected as the sampling ar-eas.Patients with major or intermedia thalassaemia were enrolled in the study .The patients′economic burden of this disease , inclu-ding direct economic burden , indirect economic burden and intangible economic burden was calcultated .The direct economic burden was estimated by outpatient fee , hospitalization expense , nutrition and transportation fees , indirect economic burden was evaluated u-sing disability adjusted life years ( DALY) combined with human capital , and intangible economic burden was calculated using method of willingness. Results Per average annual direct economic burden of 45 patients with major or intermedia thalassaemia was 43 058.66 yuan, per average annual indirect economic burden was 20 474.51 yuan, and per person intangible economic burden was 302 466.67 yuan. Conclusion Economic burden of major and intermedia thalassaemia is huge and most patients do not receive standardized treatment .More effective way should be taken to reduce the economic burden of thalassaemia and help the patients to re -ceive standardized treatment .