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Current status of medication adherence and infant follow up in the prevention of mother to child HIV transmission programme in Addis Ababa: a cohort study

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dc.contributor.author Mirkuzie, Alemnesh Hailemariam
dc.contributor.author Hinderaker, Sven Gudmund
dc.contributor.author Sisay, Mitike Molla
dc.contributor.author Moland, Karen Marie
dc.contributor.author Mørkve, Odd
dc.date.accessioned 2012-02-06T10:08:56Z
dc.date.available 2012-02-06T10:08:56Z
dc.date.issued 2011-10-21
dc.identifier.citation Journal of the International AIDS Society 14: 50 en
dc.identifier.issn 1758-2652
dc.identifier.uri http://dx.doi.org/10.1186/1758-2652-14-50
dc.identifier.uri http://hdl.handle.net/1956/5547
dc.description.abstract Background: Prevention of mother to child HIV transmission (PMTCT) programmes have great potential to achieve virtual elimination of perinatal HIV transmission provided that PMTCT recommendations are properly followed. This study assessed mothers and infants adherence to medication regimen for PMTCT and the proportions of exposed infants who were followed up in the PMTCT programme. Methods: A prospective cohort study was conducted among 282 HIV-positive mothers attending 15 health facilities in Addis Ababa, Ethiopia. Descriptive statistics, bivariate and mulitivariate logistic regression analyses were done. Results: Of 282 mothers enrolled in the cohort, 232 (82%, 95% CI 77-86%) initiated medication during pregnancy, 154 (64%) initiated combined zidovudine (ZDV) prophylaxis regimen while 78 (33%) were initiated lifelong antiretroviral treatment (ART). In total, 171 (60%, 95% CI 55-66%) mothers ingested medication during labour. Of the 221 live born infants (including two sets of twins), 191 (87%, 95% CI 81-90%) ingested ZDV and single-dose nevirapine (sdNVP) at birth. Of the 219 live births (twin births were counted once), 148 (68%, 95% CI 61-73%) mother-infant pairs ingested their medication at birth. Medication ingested by mother-infant pairs at birth was significantly and independently associated with place of delivery. Mother-infant pairs attended in health facilities at birth were more likely (OR 6.7 95% CI 2.90-21.65) to ingest their medication than those who were attended at home. Overall, 189 (86%, 95% CI 80-90%) infants were brought for first pentavalent vaccine and 115 (52%, 95% CI 45-58%) for early infant diagnosis at six-weeks postpartum. Among the infants brought for early diagnosis, 71 (32%, 95% CI 26-39%) had documented HIV test results and six (8.4%) were HIV positive. Conclusions: We found a progressive decline in medication adherence across the perinatal period. There is a big gap between mediation initiated during pregnancy and actually ingested by the mother-infant pairs at birth. Follow up for HIV-exposed infants seem not to be organized and is inconsistent. In order to maximize effectiveness of the PMTCT programme, the rate of institutional delivery should be increased, the quality of obstetric services should be improved and missed opportunities to exposed infant follow up should be minimized. en
dc.language.iso eng en
dc.publisher BioMed Central en
dc.relation.ispartof <a href="http://hdl.handle.net/1956/5605" target="blank">Successes and challenges of the national programme for the prevention of mother-to-child HIV transmission (PMTCT) in Addis Ababa, Ethiopia. Implementation and impact</a> en
dc.rights Copyright 2011 Mirkuzie et al; licensee BioMed Central Ltd. en
dc.rights.uri http://creativecommons.org/licenses/by/2.0/ en
dc.title Current status of medication adherence and infant follow up in the prevention of mother to child HIV transmission programme in Addis Ababa: a cohort study en
dc.type Peer reviewed en
dc.type Journal article en
dc.subject.nsi VDP::Medical disciplines: 700::Health sciences: 800::Community medicine, Social medicine: 801 en
dc.type.version publishedVersion en


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Copyright 2011 Mirkuzie et al; licensee BioMed Central Ltd. Except where otherwise noted, this item's license is described as Copyright 2011 Mirkuzie et al; licensee BioMed Central Ltd.

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