Audit of prevention of mother-to-child transmission programme interventions in HIV-Exposed children at national hospital, Abuja, Nigeria

• Published in: The Nigerian postgraduate medical journal Vol. 25; no. 1; pp. 27 - 31
• Main Authors: Mukhtar-Yola, Mariya, Otuneye, Adekunle, Mairami, Amsa, Wey, Yewande, Nwatah, Vincent, Audu, Lamidi
• Format: Journal Article
• Language: English
• Published: Nigeria Wolters Kluwer India Pvt. Ltd 01.01.2018; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer Medknow Publications
• Subjects: Acquired immune deficiency syndrome; AIDS; Antiretroviral drugs; Antiretroviral Therapy, Highly Active; audit; Breast Feeding; Disease transmission; Female; Guideline Adherence - statistics & numerical data; HIV; HIV Infections - drug therapy; HIV Infections - transmission; Human immunodeficiency virus; human immunodeficiency virus-exposed infants; Humans; Infant; Infant, Newborn; Infectious Disease Transmission, Vertical - prevention & control; Infectious Disease Transmission, Vertical - statistics & numerical data; Nigeria - epidemiology; Post-Exposure Prophylaxis - statistics & numerical data; Pregnancy; Pregnancy Complications, Infectious - drug therapy; Pregnancy Complications, Infectious - epidemiology; prevention of mother-to-child transmission interventions; Retrospective Studies; Trimethoprim, Sulfamethoxazole Drug Combination - administration & dosage; Womens health; Nigeria; Sub-Saharan Africa; Audit; prevention of mother-to-child transmission interventions; human immunodeficiency virus-exposed infants
• ISSN: 1117-1936; 2468-6875
• DOI: 10.4103/npmj.npmj_151_17

Background: Ninety percentage of children acquire human immunodeficiency virus (HIV) infection in the form of Mother-to-child Transmission (MTCT). In the absence of interventions, transmission rates range from 15% to 45%. This can be reduced to below 5% with effective interventions. The last published national guideline (NG) on prevention of MTCT (PMTCT) was in 2010. Clinical audits are essential in improving the quality of care delivered to patients. Objectives: The study objectives were to determine the rate of MTCT of HIV in exposed infants at a follow-up clinic between 2011 and 2014 and to determine the level of adherence to 2010 NG on the use of highly active antiretroviral therapy (HAART), polymerase chain reaction (PCR) testing, feeding options, antiretroviral (ARV) prophylaxis and the use of co-trimoxazole (CTZ). Methods: A retrospective review of data was done over 4 years. The population consisted of babies delivered through PMTCT programme and those referred to the clinic from other centres. Data analysis was done using the Statistical Package for the Social Sciences (SPSS) version 21. Results: Out of 699 babies enrolled, MTCT occurred in 22 babies (3.2%) and PCR testing was done in 445 babies (64.7%), most in the 1-2 months' age group. Breastfeeding was practiced in 402 (58.2%) babies, while about 88.0% of them received post-exposure ARV prophylaxis (PEP). CTZ prophylaxis was offered to only 226 (34.6%) babies. The regression model showed that maternal use of HAART and PEP for babies was independently associated with a reduction in transmission rate. Conclusion: The MTCT rate was 3.2%. There is a need to strengthen service provision to adhere to NG, especially on breastfeeding and CTZ prophylaxis.