Evaluation Of The PMTCTProgram At Rlruta Health Centre, Nairobi, Kenya,
Abstract
Background: In 2012, approximately 260,000 children were newly infected with HIV
globally, nearly all through mother to child transmission. Majority of these infections
occurred in 10 high-burden countries in Sub-Saharan Africa, of which Kenya lies fourth.
Effective utilization of prevention of mother-to-child transmission (PMTCT) strategies
can reduce transmission rates to less than 2%. However, transmission rates are still high
and it is important to evaluate the effectiveness of the program at level 2 of service
delivery as the first point of contact for many pregnant women.
Objectives: The aim of this study was to evaluate the effectiveness of the PMTCT
program in Riruta Health Centre in providing comprehensive PMTCT services to
pregnant mothers and their infants.
Methodology: This was a cross-sectional survey targeting mother-infant pairs coming for
immunization at 14 weeks post-delivery at Riruta Health Centre. Data was coliected
using a structured questionnaire that assessed socio demographic factors, obstetrical
history and PMTCT services received. Data was analyzed using SPSS 17.0 and tests
conducted using Pearson's Chi-square and Spearman rank correlation tests.
Results: We enrolled 226 mothers of whom 76.5% were identified as HIV infected in the
pregnancy. 94.7% of the mothers received efficacious PMTCT maternal ARV regimens
and 222 (98.2%) infants received ARVs. 79.8% of the women had disclosed their HIV
status to their partners. Sociodemographic and economic factors did not differ between
women who used infant ARVs and those who did not. Age was found to be associated
with the type of maternal ARVs used (p=0.030). Infant HIV DNA testing was performed
in 180 (88.7%) infants, of whom 7 (4.9%) were identified as infected. Postpartum, 175
(77.4%) women reported initiating contraception, most 88 (50.3%) preferring injectables
but only 30.9% on dual contraception.
Conclusion: Most women learned they were HIV infected antenatally, indicating a gap
in pre conception care. Use of infant and maternal ARVs was high as was infant DNA
testing, but the results were not available for all those tested. The rate of MTCT was low
(4.9%), and the postpartum use of contraception was high (77.4%). Provision of
comprehensive PMTCT services even mother-to-child transmission ofHIV.
Citation
Master Of Science In Tropical And Infectious DiseasesPublisher
University of Nairobi