Leonard Kabongo

Protection of Mother To Child Transmission of HIV: Towards Virtual Elimination of Paediatric HIV in Rural western Zambia Leonard Kabongo

Master's Thesis from the year 2011 in the subject Medicine - Public Health, grade: B, Atlantic International University (Social and Human studies), course: Master of Public Health, language: English, abstract: Limited information exists currently on factors associated with ''virtual elimination of paediatric HIV'' in resource constrained settings since the publication of new PMTCT guidelines by the WHO in 2010. In this study, we aimed to assess predictors of unfavourable infant clinical outcomes (Mortality and HIV infection) at 2 years follow-up in PMTCT program. Using data collected from registers (PMTCT and ANC) at Sichili Mission Hospital, 151 women were enrolled in the program from 2008 to 2010 and 80 of them fulfilled the inclusion criteria. An in-depth interview with HIV positive women was conducted using structured questionnaires. Factors associated with ''virtual elimination of paediatric HIV'' were determined by multivariable regression analysis models. At 2 years follow-up, 8 (10%) children died 47(87%) were HIV negative and 7(13%) were HIV positive on HAART. Socio-demographic factors age and education level were correlated with poor infant outcomes in PMTCT program (Pearson coefficient correlation<0). Home delivery and unskilled conducted deliveries were significantly associated with unfavourable infant clinical outcomes (p<0.0001). Only 28(35%) pregnant women had received Sd NVP and this was weakly correlated with high HIV transmission rate (Pearson=0.076). The majority of respondents (96%) had exclusively breastfed up to 6 months and this variable was associated with low early mortality and high survival rate (Pearson>1). Socio-demographic factors, PMTCT specific indicators and infant's variables are potential determinants to successful attainment of ''Virtual elimination of paediatric HIV by 2015''. KEY WORDS: PMTCT, Virtual Elimination of Paediatric HIV, Sichili Mission Hospital, Socio-demographic variables, infant outcomes, Zambia.