Evaluation Of The PMTCTProgram At Rlruta Health Centre, Nairobi, Kenya,
Karanja, V W
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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.