Factors associated with Mother to child transmission of HIV in a Semi-arid County in Kenya, 2014-2017

Introduction: To eliminate mother-to-child-transmission of HIV (eMTCT) a rate of <5% was recommended by the WHO in 2015. The rate was 8.3% for Kenya and 8.8% for Kajiado County in 2016. To identify causes of these higher rates, we described factors associated with HIV transmission among HIV expos...

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Main Authors: Caren Gesare Nyagaka, Elvis Kirui, Maurice Owiny, Alice Njoroge, Elvis Oyugi
Format: Article
Language:English
Published: African Field Epidemiology Network 2022-08-01
Series:Journal of Interventional Epidemiology and Public Health
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Online Access:https://www.afenet-journal.net/content/article/5/18/full/
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author Caren Gesare Nyagaka
Elvis Kirui
Maurice Owiny
Alice Njoroge
Elvis Oyugi
author_facet Caren Gesare Nyagaka
Elvis Kirui
Maurice Owiny
Alice Njoroge
Elvis Oyugi
author_sort Caren Gesare Nyagaka
collection DOAJ
description Introduction: To eliminate mother-to-child-transmission of HIV (eMTCT) a rate of <5% was recommended by the WHO in 2015. The rate was 8.3% for Kenya and 8.8% for Kajiado County in 2016. To identify causes of these higher rates, we described factors associated with HIV transmission among HIV exposed infants (HEI) in Kajiado. Methods: We reviewed HEI 2014-2017 records downloaded from the national early-infant-diagnosis (EID) database. A case was defined as any record of HEI undergoing EID in Kajiado in 2014–2017. Dependent variable was HIV test result and the independent variables were demographic and clinical characteristics. To describe the study population means were calculated for continuous variables and proportions for categorical variables. We performed Multivariate logistic regression to study the factors associated with MTCT while controlling for other factors and we reported the Prevalence OR and their 95% Confidence Intervals. Results: We reviewed 4,195 HEI records. Males were 1,999 (47.7%); median age was 2 months (range of 1.5 – 6months) and 199 (4.7%) tested positive for HIV. Antiretroviral (ARV) prophylaxis was not provided to 308 (7.34%) infants and 291 (6.94%) mothers of the infants. Exclusive-breastfeeding was offered to 2,976 (70.9%) infants and 320 (7.6%) had mixed-feeding. Odds of having a positive HIV result was higher in infants not on ARV prophylaxis compared to those who received ARV prophylaxis (POR: 8.3; 95% CI: 5.9 –11.5); in infants whose mothers received no ARV prophylaxis compared to those whose mothers received ARV prophylaxis (POR: 6.8; 95% CI: 4.9 – 9.6) and in those mixed-fed compared to those who received exclusive breastfeeding (POR: 2.4; 95% CI: 1.3 – 4.3). In infants not on ARV prophylaxis (aOR: 2.86; 95% CI: 1.02 – 6.93); infants whose mothers received no ARV prophylaxis (aOR: 2.45; 95% CI: 1.52 – 3.92) and those mixed-fed (aOR: 2.00; 95% CI: 1.05 – 3.79) were independently associated with a positive HIV result. Conclusion: Transmission was higher where infants missed ARV prophylaxis or had mixed-feeding. Infant prophylaxis and exclusive breastfeeding by HIV positive women should be encouraged.
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spelling doaj-art-56d99d0e0bb7489dae940b8cc1a3ea682025-08-20T03:54:07ZengAfrican Field Epidemiology NetworkJournal of Interventional Epidemiology and Public Health2664-28242022-08-0153https://doi.org/10.37432/jieph.2022.5.3.66Factors associated with Mother to child transmission of HIV in a Semi-arid County in Kenya, 2014-2017Caren Gesare Nyagaka0Elvis Kirui1Maurice Owiny2Alice Njoroge3Elvis Oyugi4County Department of Health, Kajiado County, Kenya; Kenya National HIV and STI Control Program (NASCOP), Kenya; Kenya Field Epidemiology and Laboratory Training Program (FELTP), Nairobi, KenyaKenya National HIV and STI Control Program (NASCOP), KenyaKenya Field Epidemiology and Laboratory Training Program (FELTP), Nairobi, KenyaCounty Department of Health, Kajiado County, KenyaKenya Field Epidemiology and Laboratory Training Program (FELTP), Nairobi, KenyaIntroduction: To eliminate mother-to-child-transmission of HIV (eMTCT) a rate of <5% was recommended by the WHO in 2015. The rate was 8.3% for Kenya and 8.8% for Kajiado County in 2016. To identify causes of these higher rates, we described factors associated with HIV transmission among HIV exposed infants (HEI) in Kajiado. Methods: We reviewed HEI 2014-2017 records downloaded from the national early-infant-diagnosis (EID) database. A case was defined as any record of HEI undergoing EID in Kajiado in 2014–2017. Dependent variable was HIV test result and the independent variables were demographic and clinical characteristics. To describe the study population means were calculated for continuous variables and proportions for categorical variables. We performed Multivariate logistic regression to study the factors associated with MTCT while controlling for other factors and we reported the Prevalence OR and their 95% Confidence Intervals. Results: We reviewed 4,195 HEI records. Males were 1,999 (47.7%); median age was 2 months (range of 1.5 – 6months) and 199 (4.7%) tested positive for HIV. Antiretroviral (ARV) prophylaxis was not provided to 308 (7.34%) infants and 291 (6.94%) mothers of the infants. Exclusive-breastfeeding was offered to 2,976 (70.9%) infants and 320 (7.6%) had mixed-feeding. Odds of having a positive HIV result was higher in infants not on ARV prophylaxis compared to those who received ARV prophylaxis (POR: 8.3; 95% CI: 5.9 –11.5); in infants whose mothers received no ARV prophylaxis compared to those whose mothers received ARV prophylaxis (POR: 6.8; 95% CI: 4.9 – 9.6) and in those mixed-fed compared to those who received exclusive breastfeeding (POR: 2.4; 95% CI: 1.3 – 4.3). In infants not on ARV prophylaxis (aOR: 2.86; 95% CI: 1.02 – 6.93); infants whose mothers received no ARV prophylaxis (aOR: 2.45; 95% CI: 1.52 – 3.92) and those mixed-fed (aOR: 2.00; 95% CI: 1.05 – 3.79) were independently associated with a positive HIV result. Conclusion: Transmission was higher where infants missed ARV prophylaxis or had mixed-feeding. Infant prophylaxis and exclusive breastfeeding by HIV positive women should be encouraged.https://www.afenet-journal.net/content/article/5/18/full/mother-to-child transmissionhivhiv exposed infantskenya
spellingShingle Caren Gesare Nyagaka
Elvis Kirui
Maurice Owiny
Alice Njoroge
Elvis Oyugi
Factors associated with Mother to child transmission of HIV in a Semi-arid County in Kenya, 2014-2017
Journal of Interventional Epidemiology and Public Health
mother-to-child transmission
hiv
hiv exposed infants
kenya
title Factors associated with Mother to child transmission of HIV in a Semi-arid County in Kenya, 2014-2017
title_full Factors associated with Mother to child transmission of HIV in a Semi-arid County in Kenya, 2014-2017
title_fullStr Factors associated with Mother to child transmission of HIV in a Semi-arid County in Kenya, 2014-2017
title_full_unstemmed Factors associated with Mother to child transmission of HIV in a Semi-arid County in Kenya, 2014-2017
title_short Factors associated with Mother to child transmission of HIV in a Semi-arid County in Kenya, 2014-2017
title_sort factors associated with mother to child transmission of hiv in a semi arid county in kenya 2014 2017
topic mother-to-child transmission
hiv
hiv exposed infants
kenya
url https://www.afenet-journal.net/content/article/5/18/full/
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