Knowledge, attitudes and practices of prevention of mother to child transmision of HIV among women in Laroo Division Gulu Municipality, Uganda

This study is exploring the knowledge, attitudes and practices of Prevention of Mother to Child Transmission (PMTCT) of Human Immunodeficiency Virus (HIV) among child bearing women aged between 15- 45 years old in Laroo division in Gulu municipality. The goal of the study was to determine the level of attitude as well as of knowledge and belief about PMTCT and proportion of women practicing it among the child bearing women of Laroo Division. The Cross-sectional and Descriptive study design was applied in multistage sampling method with random selection of a parish followed by random selection of a village within the parish from which a sample of homesteads was randomly selected. From each homesteads, a single respondent was randomly selected and registered in the study. Questionnaires were given to respondents that had consented to take part in the study. A total of 208 respondents were registered and interviewed in a period of February to march 2011. There were 165 (79.3%) of the mothers who had knowledge about various PMTCT methods. Of these 86(52%) heard about PMTCT first from hospital. 50 (30%) knew about exclusive breast feeding, while another 50(30%) use of ART, 45(27%) knew about replacement feedings and only 21(13%) knew of elective caesarean section as method of PMTCT. However the majority of the mothers 159(96.5%) thought that PMTCT was beneficial. Nevertheless some mothers thought that PMTCT causes various counter indications including infertility 17 (10.5%) and abnormalities in children at birth 27 (16.7). Their HIV serostatus also varied. Of the 135(81.7%) screened for HIV 42(31.2%) tested HIV positive and only 27 (64.2%) used contraceptives to prevent pregnancy while they were HIV positive. However of the correspondents who tested positive in their last HIV tests, the majority (83%) had had at least a pregnancy after testing HIV positive of which 6.8% did not practice PMTCT. Our study suggests evidence that Knowledge, attitude and practice of PMTCT among women of reproductive age in Laroo Division in Gulu municipality in Northern Uganda is adequate.Nevertheless with the infection rate of 31.2% among them points out that there is a substantial burden of HIV in the women community

Lack of effectiveness of syndromic management in targeting vaginal infections in pregnancy in Entebbe, Uganda

OBJECTIVES: To measure the prevalence of reproductive tract infections (RTIs) during pregnancy in Entebbe, Uganda, and to evaluate the current syndromic diagnosis and management approach in effectively targeting infections, such as bacterial vaginosis (BV) and trichomoniasis, that are associated with low birth weight and prematurity among newborns. METHODS: We enrolled 250 antenatal clinic attenders. Vaginal swabs and diagnostic tests were performed for BV, Trichomonas vaginalis (TV), candida, Neisseria gonorrhoeae, Chlamydia trachomatis and for HIV-1 and active (TPHA+/RPR+) syphilis infection. Same day treatment was offered for symptoms according to syndromic management guidelines. The treatment actually provided by healthcare workers was documented. Sensitivity, specificity, positive and negative predictive values were used to assess the effectiveness of syndromic management guidelines and practice. RESULTS: The prevalence of infections were: BV 47.7%, TV 17.3%, candida 60.6%, gonorrhoea 4.3%, chlamydia 5.9%, syphilis 1.6%, and HIV 13.1%. In total, 39.7% of women with BV and 30.2% of those with TV were asymptomatic. The sensitivity of syndromic management as applied by health workers in targeting BV and TV was 50.0% and 66.7%, respectively. This would have increased to 60.3% (BV) and 69.8% (TV) had the algorithm been followed exactly. CONCLUSIONS: The prevalence of BV and TV seen in this and other African populations is high. High rates of asymptomatic infection and a tendency of healthcare workers to deviate from management guidelines by following their own personal clinical judgment imply that many vaginal infections remain untreated. Alternative strategies, such as presumptive treatment of BV and TV in pregnancy, should be considered