Prevention of mother-to-child transmission of HIV at Kasangati Health Centre, Uganda

Abstract

1. Abstract Prevention of mother-to-child transmission of HIV at Kasangati Health Centre, Uganda Emina Coric Degree thesis, Programme in Medicine, 2018. Department of Infectious Diseases, the Sahlgrenska Academy at University of Gothenburg. Introduction: More than 90% of children living with HIV acquire the infection via MTCT (mother-to-child transmission) during pregnancy, birth, or breastfeeding. Without treatment, half of them will die before their second birthday. In Uganda, there has been large focus on PMTCT (prevention of mother-to-child transmission), but postnatal follow-up has been insufficient. Only 1/3 of infants received immediate diagnosis of HIV in 2015, and in 2016, only 43% of HIV-positive children had access to treatment in Uganda. Aims: To study the postnatal follow-up of children born by women living with HIV at KHC (Kasangati Health Centre). Methods: A descriptive cross-sectional study was conducted through interviews using a questionnaire based on WHO guidelines. The study population consisted of 103 mothers living with HIV whose youngest child was between six weeks and 18 months old and who were visiting the antenatal or the HIV clinic at KHC. Results: Only one of the children (1%) had acquired HIV. Regarding consistency with guidelines, 80% of the babies had received recommended infant prophylaxis, nevirapine for six to twelve weeks. At six weeks of age, 84% of the babies had been tested for HIV. Only 43% had been tested six weeks after cessation of breastfeeding. At 18 months of age, 57% had been tested. Conclusions: WHO guidelines are being followed to a large extent at KHC, which could possibly explain the low rate of MTCT (1%) that was found, a transmission rate nearly as low as in high-resource countries such as Sweden (0.5%) despite having limited resources and a high prevalence of HIV.