Utilization of prevention of mother-to-child transmission of hiv (PMTCT)) at Juba Teaching Hospital-(South Sudan)

Abstract

Mother-to-child transmission (MTCT) of HIV is the most common route of infection in paediatrics HIV acquisition. It contributes to more than 90% of paediatrics HIV infections. Vertical transmission of HIV virus can occur during pregnancy, labour, delivery and even breastfeeding. Without any interventions the risk of a HIV exposed infant acquiring HIV is 20-45% but with interventions the risk can be reduced to less than 2%. Objective: To determine the utilization of PMTCT services by mothers attending postnatal services at Juba Teaching Hospital. Study Design: Cross-sectional study. Study area: The study was conducted at the mother and child health (MCH) clinic at Juba teaching Hospital. Study population: All consenting mothers who attended the clinic at six weeks to nine months after delivery for immunization. Methodology: The data was collected using a structured questionnaire through direct interview of the participants. Results: A total of three hundred (300) women were recruited in the study at the mother and child health (MCH) clinic at Juba Teaching Hospital. All of them had at least one antenatal care visit and 246 (82%) received antenatal counselling for HIV whereby 201(67%) got tested. The HIV prevalence was found to be 7.5%. Of the fifteen (15) mothers who tested positive for HIV, 85.7% delivered in a health facility. None of the HIV positive mothers had a CD4 test result. Only 20% of the mothers were put on single dose Nevirapine, and 13.2% were on more efficacious ARV combination otherwise the rest did receive neither antenatal nor intrapartum ARV intervention. Ten (66.7%) of HIV exposed infants received Nevirapine after delivery. Polymerase chain reaction/Deoxyribonucleic acid (PCR/DNA) was not done to all the HIV exposed babies. Six (40%) of these babies were on exclusive breastfeeding for the first six months with 26.7% and 33.3% on formula and mixed feeding respectively. Six (6[50%]) of the eligible mothers for family planning were not using any mode of family planning, while 16.6% used condoms, IUCD (16.6%) and 16.6% used dates(natural) method. Conclusion: Although majority of the mothers received HIV counselling during the antenatal period yet less than 70% got tested for HIV. CD4 count testing was not routinely done for PMTCT and the use of HAART and other more efficacious ARV combination was very low among HIV positive mothers. DNA/PCR was not routinely done for HIV exposed infants. Safe infant feeding practices were however limited. A great majority of those with HIV positive partners did not practice safe family planning methods.