Evaluation of the Effectiveness of the Prevention of Mother-to-Child Transmission (PMTCT) Interventions in HIV-Exposed Children

ABSTRACT

Background: Mother-to-child transmission of HIV can be reduced by interventions targeted at the mother during pregnancy and at the baby after birth. Aim: To evaluate the effectiveness of the prevention of mother-to-child transmission (PMTCT) interventions in HIV-exposed infants presenting at the University of Port Harcourt Teaching Hospital; and to compare the level of interventions and outcomes at the UPTH-based programme with those elsewhere. Methods: An analytical cross-sectional study of HIV exposed infants aged 6 weeks-18 months presenting at the Paediatric HIV Clinic between November 2007 and June 2008. Information obtained included gender; age; antiretroviral drugs in pregnancy and at birth; place of antenatal care and delivery; method of delivery and feeding option. Infection status was determined by DNA PCR using dried blood spot (DBS) specimen. Results: A total of 294 children (139 males and 155 females; MF ratio of 11.1) were seenwithin the study period; out of which 72 (34 males and 38 females; MF ratio of 11.1) were positive giving an overall infection rate of 24.5. In 92 (31.3) mother-baby pair; there was no intervention and 53 (73.6) of the 72 babies that were infected were from this group whereas 63 (21.4) mother-baby pair received full PMTCT intervention and 1(1.4) was infected. The difference in the number of infected children in those who had no intervention and those who had at least one intervention was highly significant (?2 =41.55; p=0.00000). The transmission rates were 5.6; 7.7; 23.1and 50.4in babies delivered in UPTH; other full PMTCT implementing sites; partial PMTCT implementing sites and non-PMTCT implementing sites respectively.Conclusion: PMTCT interventions are highly effective in preventing HIV infection in exposed infants