V2I12P46

Determinants Of Mother-To-Child Transmission Of HIV: A Quantitative Study At Levy Mwanawasa Hospital, Lusaka, Zambia

Rebotile Shibe Ledwaba¹, Yasmin Sultana-Muchindu^2*

Abstract

The Human Immunodeficiency Virus (HIV) remains a major global public health issue, with millions of people affected worldwide. The African region is the most affected, with 25.7 million people living with the disease, accounting for almost two-thirds of the global total of new HIV infections. One of the critical aspects of HIV transmission is the mother-to-child transmission (MTCT), which occurs during pregnancy, childbirth, or breastfeeding. Globally, an estimated 1.3 million women and girls living with HIV become pregnant each year. In the absence of intervention, the rate of transmission of HIV from a mother living with HIV to her child during pregnancy, labour, delivery, or breastfeeding ranges from 15% to 45%.  The aim of the study was to investigate the determinants of mother-to-child transmission (MTCT) of HIV at Levy Mwanawasa Hospital, Lusaka, Zambia, and inform the development of targeted interventions to reduce MTCT incidence. This was a retrospective case control study that was carried out at levy Mwanawasa teaching hospital. The case were HIV exposed infants who later tested positive during follow up and the controls where HIV exposed infants who remained negative throughout the course of follow-up. The study recruited 96 cases of HIV exposed infants; 24 infants were HIV positive and were designated as cases and 72 infants were HIV negative and were designated as controls in this study. The results showed that age of the mother (p = 0.432), residence of the mother (p = 0.059) marital status (p = 0.145) and level of education (p = 0.684) were not statistically significant in factors in mother to child transmission. For maternal factors, confirmation of HIV status before, during or after pregnancy (p = 0.034), place of birth (p = 0.029), viral load of the mother during pregnancy (p < 0.001), mothers’ adherence to ART during pregnancy (p = 0.037) and mothers’ knowledge about MTCT were statistically significant in mother to child transmission. The only child related factor that was significant for HIV transmission was post-natal ART prophylaxis. Five maternal factors were identified increase the odds of mother to child transmission of HIV transmission. These factors were HIV testing during or after pregnancy, low level viremia or viral load more than 1000 copies/ml and non-adherence to ART services of the mother to ART services significantly increased the risk of vertical transmission. Post-natal adherence to ART prophylaxis was child related factor that was identified as a significant factor in mother to child transmission.

Keywords:

HIV, mother-to-child transmission (MTCT), Levy Mwanawasa Hospital, ART adherence, viral load, HIV testing timing