Barriers to uptake of prevention of mother-to-child transmission of HIV services among mothers of vertically infected HIV-seropositive infants in Makurdi, Nigeria

Emmanuel Ademola Anígilájé,1 Bem Ruben Ageda,2 Nnamdi Okechukwu Nweke1 1Department of Paediatrics, 2Department of Obstetrics and Gynaecology, Federal Medical Centre, Makurdi, Nigeria Background: Perinatal transmission of human immunodeficiency virus (HIV) continues in Nigeria because of the poor use of prevention of mother-to-child transmission of HIV (PMTCT) services. This study reports on the barriers preventing mothers of vertically infected HIV-seropositive infants to use the PMTCT services at the Federal Medical Centre, Makurdi, Nigeria.Methods: This is a descriptive study conducted between January and April, 2014. A quantitative survey was applied to detect barriers along the PMTCT services cascade among 52 mothers of vertically infected HIV-seropositive infants. This includes 22 women who attended antenatal care at the Federal Medical Centre (designated as Group A mothers) and 30 women who did not receive any form of PMTCT service (Group B mothers). The study was supplemented with a focused group discussion involving 12 discussants from the two groups.Results: In the quantitative assessment: among the Group A mothers, falling asleep was the most common reason (n=22, 100%) for missing therapeutic/prophylactic antiretroviral medicine; financial constraint (n=22, 100%) was the most common reason for antenatal care visit defaults; and a lot of the mothers (n=11, 50.0%) did not give nevirapine to their newborns because they delivered at home. Among Group B mothers, unawareness of HIV-seropositive status was the most common reason (n=28, 93.3%) given for not accessing PMTCT services. In the qualitative study: noninvolvement of male partners, stigma and discrimination experienced by HIV-seropositive mothers, financial constraints in couples, involvement of traditional birth attendants in antenatal care and delivery of HIV-infected women, unawareness of HIV-seropositive status by pregnant women, poor health system, and the lack of funding for PMTCT services at private and rural health facilities were the major barriers preventing the use of PMTCT services.Conclusion: In order to reduce the missed opportunities for PMTCT interventions in Makurdi and by extension the Benue State it represents in Nigeria, strong political and financial commitments are needed to overcome the identified barriers. Keywords: obstacles, PMTCT services, Makurdi, Nigeri

A huge polypoid uterine myoma causing severe primary postpartum haemorrhage: A report of one case

Complications from uterine myomas in pregnancy could occur antenally, intrapartum or in the puerperium. One of such was diagnosed in a 36-year old para 2+0 who had successful gestation to term delivery in co-existence with a huge fibroid polyp and had spontaneous vaginal delivery of a life baby. She however developed severe primary postpartum haemorrhage prompting emergency postpartum digital vaginal myomectomy which was very helpful. Nigerian Journal of Surgical Research Vol. 7(1&2) 2005: 220-22