Although without any intervention in PMTCT up to 80% of HIV exposed children could not be infected with HIV, PMTCT interventions provide a critical opportunity to prevent vertical transmission of HIV from mother to child during pregnancy, labour and delivery and/or during breastfeeding. The objective of the study therefore was to determine the association between utilization of PMTCT services among HIV positive mothers with children aged 6 to 24 months and HIV status of their exposed children attending post-natal clinics in Mtwara Rural District. The study was carried out between July and August 2012. Analytical cross sectional study using structured questionnaire among 130 HIV positive mothers who had children aged between 6 to 24 months was employed. Random sampling of Health Facilities were done followed by conveniently sampling to select participants, where all HIV positive mothers (who fulfilled the inclusion criteria) who attended the clinic during the time of data collection were consecutively included in the study till the sample size reached. About 10% of children born by mothers who knew their HIV positive status before pregnancy and they were on ARV treatment were infected with HIV compared to 50% of children born by mothers who were not on ART treatment before pregnancy (χ2=4.3, p = 0.038). Transmission rate of HIV from mother to child among mothers whoreceived ARV‘s for PMTCT during pregnancy was 15.5% compared to 58.8% of mothers who do not received ARV‘s for PMTCT during pregnancy. Regardless of intervention, the prevalence of HIV among exposed children who had mixed feeding was 36.1% while for those who were exclusively breastfed/formula fed was 13.8% (χ2= 8.077, p = 0.004). Reduction of MTCT of HIV is possible with effective PMTCT interventions, including access to ARV‘s for PMTCT by mothers during pregnancy, labour, and during lactation period and also for exposed children from birth till when they stopped breastfed or proven to be HIV infected. Appropriate infant feeding practices is also crucial in reduction of MTCT. Strategies to address programmatic challenges of lower ANC attendance, low facility delivery and low post-natal care attendance in rural Tanzania which contribute to low uptake of ARV prophylaxis for PMTCT during pregnancy, labour and after delivery observed in this study are essential

Mohamed, Nassor Salim

English

Background: Although without any intervention in PMTCT up to 80% of HIV exposed children could not be infected with HIV, PMTCT interventions provide a critical opportunity to prevent vertical transmission of HIV from mother to child during pregnancy, labour and delivery and/or during breastfeeding.
Objectives: The objective of the study therefore was to determine the association between utilization of PMTCT services among HIV positive mothers with children aged 6 to 24 months and HIV status of their exposed children attending post-natal clinics in Mtwara Rural District.
Material and Methods: The study was carried out between July and August 2012. Analytical cross sectional study using structured questionnaire among 130 HIV positive mothers who had children aged between 6 to 24 months was employed. Random sampling of Health Facilities were done followed by conveniently sampling to select participants, where all HIV positive mothers (who fulfilled the inclusion criteria) who attended the clinic during the time of data collection were consecutively included in the study till the sample size reached.
Results: About 10% of children born by mothers who knew their HIV positive status before pregnancy and they were on ARV treatment were infected with HIV compared to 50% of children born by mothers who were not on ART treatment before pregnancy (χ2 =4.3, p = 0.038). Transmission rate of HIV from mother to child among mothers who received ARV‘s for PMTCT during pregnancy was 15.5% compared to 58.8% of mothers who do not received ARV‘s for PMTCT during pregnancy. Regardless of intervention, the prevalence of HIV among exposed children who had mixed feeding was 36.1% while for those who were exclusively breastfed/formula fed was 13.8% (χ2 = 8.077, p = 0.004).
Conclusions and Recommendations: Reduction of MTCT of HIV is possible with effective PMTCT interventions, including access to ARV‘s for PMTCT by mothers during pregnancy, labour, and during lactation period and also for exposed children from birth till when they stopped breastfed or proven to be HIV infected. Appropriate infant feeding practices is also crucial in reduction of MTCT. Strategies to address programmatic challenges of lower ANC attendance, low facility delivery and low post-natal care attendance in rural Tanzania which contribute to low uptake of ARV prophylaxis for PMTCT during pregnancy, labour and after delivery observed in this study are essential.Published in 2012.Master of Public Health Dissertation of 
Muhimbili University of Health and Allied Science

Mohamed, N.S.

MUHAS Institutional Repository

Association Between PMTCT Services Utilization Among HIV Positive Mothers and HIV Status of their HIV-Exposed Children in Mtwara District, Tanzania

Digital Library of the Tanzania Health Community

al: Infant Feeding Options, Other Nonchemoprophylactic Factors and Mother-to-Child Transmission of HIV in Zambia.

al: Reducing PMTCT in practice: results from a successful model of a PMTCT programme in a high prevalence HIV urban setting.

ANC visit did you make all together? One Two Three Four

and infant feeding, guidelines for decision makers;

Are infant feeding options that are recommended for mothers with HIV acceptable, feasible, affordable, sustainable and safe? Pregnant women's perspectives. Public health nutrition,

Are there ways in which this transmission can be prevented? Yes No

At what age did you stop breastfed your child?

At what age of gestation did you attend the first ANC visit?

At what pregnancy stage did you take the drug?

At what pregnancy stage were you given the drug?

Attitudes to voluntary counseling and testing prior to the offer of Nevirapine to prevent vertical transmission of HIV in northern Tanzania; AIDS Care: Volume 17,

Barbra A.; et al; Antenatal Couple Counseling Increases Uptake of Interventions to Prevent HIV-1 Transmission.

barriers andoutcomes of HIV serostatus disclosure among women in developing countries:Implications for prevention of mother-to-child transmission programme. Bulletin of the WHO,

Barriers to the implementation of programmes for the prevention of mother-to-child transmission of HIV: A cross-sectional survey in rural andurban uganda. AIDS research and therapy,

Can a mother who is HIV positive and healthy transmit the virus to the baby? (If NO go to question # 17) Yes No

Challenges Faced by Health-Workers

Child mortality and HIV infection in africa: A review.

child tested for HIV at 6 weeks or more after complete cessation of breastfeeding? Yes No

Dabis F: Operational issues in preventing mother-to-child transmission of HIV-1 in Abidjan, Côte d‘Ivoire, 1998-99. Bull World Health Organ

Did you children started ARV prophylaxis?

Did you continue with ARV prophylaxis after delivery?

Did you decide to test HIV during pregnancy? Yes No

Did you given ARV prophylaxis after delivery?

Did you have another child aged less than two years? (If the youngest child is below one year) Yes No Questionnaire No……………………………………………………..

Did you take the HIV test result? Yes No

Did you take the result? Yes No

Disease Control and Prevention (CDC). HIV/AIDS fact sheet mothertochild (perinata) HIV transmission and prevention,

Domestic violence and prevention of mother-to-child transmission of HIV-AIDS (London,

During ANC visit did you heard anything about PMTCT? Yes No

During your pregnancy did you attend Antenatal care?

Ensuring a public health impact of programmes to reduce HIVtransmission from mothers to infants: The place of voluntary counseling and testing.

et al: Early exclusive breastfeeding reduces the risk of postnatal HIV-1 transmission and increases HIV-free survival. AIDS

et al: Effectiveness of a city-wide programme to prevent mother-to-child HIV transmission in

Evaluation of united nations-supported pilot projects for the prevention of mother-to-child transmission of HIV:

Experiences of Prevention of Mother-to-Child Transmission

Extending HIV care in resource-limited settings. Current HIV/AIDS reports,

For how long did your child take ARV prophylaxis?

For how long were you taking ARV prophylaxis after delivery?

For how long were you taking the drugs during pregnancy? Less than a month 1-2 months

for research on women; 1717 Massachusetts Avenue,

gani? Mwalimu Muuguzi Mkulima Mama wa nyumbani Mfanyabiashara Nyingine (Taja)

Hali yako ya ndoa? Sijaolewa Nimeolewa Naishi na mwenza Nimeachika Mjane

Health Service Coverage and its evaluation.

HIV seroprevalence, uptake of interventions to reduce mother-tochild transmission and birth outcomes in greater Kingston, Jamaica; West Indian Medical Journal,

How old are you?

How old is your youngest child? ………………………………………

If yes can the virus pass from mother to the baby, During pregnancy Labour and delivery During breastfeeding

If yes which one? Taking Nevirapine by mother and baby Replacement Feeding Exclusive B/Feeding then abrupt weaning at 6 months Others (specify)………

In which village did you live? …………………………………………

Inam Chitsike and Franc¸ois Dabis; Implementing a rural programme of prevention of mother-to-child transmission of HIV in Zimbabwe: first 18 months of experience.

Je mama mwenye ujauzito ambaye anaishi na VVU anaweza kumuambukiza mtoto aliyetumboni? (kama hapana nenda swali # 17) Ndio Hapana

Je ulikuwa unafahamu hali yako ya maambukizi ya VVU kabla ya ujauzito? (kama HAPANA ruka swali #18) Ndio Hapana

Je ulipata huduma ya kupima VVU wakati wa uchungu/kujifungua? Ndio Hapana

Je ulipata huduma ya ushauri nasaha juu ya kupima VVU wakati wa uchungu/kujifungua? Ndio Hapana

Je ulipatiwa dawa kwa ajili ya kuzuia maambukizi ya VVU kwenda kwa Mtoto? Ndio Hapana SEHEMU 4:

Je ulipima VVU? Ndio Hapana

Je umehudhuria kliniki mara ngapi kwa kipindi chote cha ujauzito? Mmoja Mbili Tatu Nne Zaidi ya Nne

Je una mtoto mwingine mwenye umri chini ya miaka miwili? (kama mtoto mdogo ana umri chini ya mwaka mmoja) Ndio Hapana SEHEMU 2:

Je virusi vinaweza kutoka kwa mama kwenda kwa mtoto. Wakati wa ujauzito Wakati wa kujifungua Wakati wa kunyonyesha

Je wakati wa ujauzito ulihudhuria kliniki? (kama HAPANA nenda swali No. 13) Ndio Hapana

Jobs Periens, Bernhard Schwartz Lander; A public health approach to ARV therapy; overcoming constraints: WHO

Kama ndio ni zipi? Kutumia dawa (Nevirapine) kwa mama na mtoto Lishe mbadala wa maziwa ya mama Maziwa ya mama pekee kwa miezi sita Nyingine (taja)

kwa muda gani umekuwa ukitumia dawa (ARV) baada ya kujifungua?

lini ulianza kutumia dawa (ARV) kwa ajili ya kuzuia maambukizi ya VVU kwenda kwa mtoto? Ndani ya siku 3 baada ya kujifungua Zaidi ya siku 3 baada ya kujifungua

Mandaliya Kishor. Mother-to-child HIV transmission in resource poor settings: How to improve coverage?

matokeo ya kipimo cha VVU kwa mtoto wako yalikuwaje? Aligundulika kuwa na VVU Aligundulika hakuwa na VVU

Medical Information Unit, Centre Hospitalier de Kigali, Rwanda; A cohort study of factors associated with failure to return for HIV post-testcounseling in pregnant women:

Michele Magoni; Luciana Bassani; Pius Okong; Praxedes Kituka Namaganda; Saul Onyango; A theme issue by, for, and about

midwives, and HIV/AIDS in sub-saharan africa.

Monica Glenshaw, Agnes Mahoma, Francois Dasis; PMTCT of HIV: evaluation of a pilot programme in a district hospital in rural Zimbabwe;

Monitoring progress on the implementation of programmes to prevent mother to child transmission of HIV: PMTCT report card,

Mother-to-Child Transmission (MTCT) of HIV (C)

Motivation to seek Voluntary Counseling and Testing services among married or cohabiting clients; Is ‗planning for a child‘ a reason? ANGAZA VCT/PMTCT experience (ORAL PRESENTATION).

mtoto wako alianza kutumia dawa (ARV)? Ndani ya saa 72 baada ya kujifungua Zaidi ya saa 72 baada ya kujifungua

mtoto wako amepimwa VVU akiwa na umri wa miezi sita au zaidi baada ya kuacha kunyonya maziwa ya mama?

mtoto wako anatumia dawa (ARV)?

Mtoto wako mdogo ana umri gani? ……………………………………… Namba ya Dodoso …………………………………………………………..

National road map strategic plan to accelerate reduction of maternal, newborn and child deaths in Tanzania 2008–2015. Dar es Salaam: MoHSW;

Ni katika umri gani wa mimba ulitumia dawa hizo?

Ni katika umri gani wa ujauzito ulipatiwa dawa hizo?

Ni kwa muda gani mtoto wako ametumia dawa (ARV)?

Ni kwa muda gani umetumia dawa hizo wakati wa ujauzito? Chini ya mwezi mmoja Mwezi 1-2 Zaidi ya miezi 2

Ni muda gani ulijua hali yako ya maambukizi baada ya kujifungua? Ndani ya siku 3 baada ya kujifungua Zaidi ya siku 3 baada ya kijifungua

nikatika umri gani ulimuachisha mtoto wako maziwa ya mama?

njia gani ya ulishaji uliichagua kumlisha mtoto wako? Maziwa ya mama pekee Maziwa/Chakula mbadala Mchanganyiko wa maziwa ya mama na maziwa/chakula kingine

njia yoyote ya kuzuia maambukizi ya VVU toka kwa mama kwenda kwa mtoto? Ndio Hapana

note: Department of HIV/AIDS.

Nuru Abseno, Getu Degu, Yared Wondimkun and Solomon Amsalu;knowledge and attitude towards voluntary counseling and testing of HIV: A community based study

Opportunities for Africa‘s newborns,

Ouédraogo; Knowledge of women consulting in primary health care services on

Please state your level of education Primary level Secondary Level College/University level No formal education

Preventing mother-to-child transmission in practice.

Prevention of mother to child transmission of HIV;

Prevention of mother-to-child HIV transmission in resource-poor countries: Translating research into policy and

Prevention of mother-to-child transmission of HIV in Africa: successes and challenges in scalingup a nevirapinebased programme in

Association Between PMTCT Services Utilization Among HIV Positive Mothers and HIV Status of their HIV-Exposed Children in Mtwara District, Tanzania

Abstract

Similar works

Full text

Available Versions

MUHAS Institutional Repository

Digital Library of the Tanzania Health Community