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Elimination of mother-to-child transmission of HIV (eMTCT) in Western Nigeria: how far have we gone?

S.O. Usman, G.B. Agboola, A.J. Afe, G.P. Olubayo, T. Akinmurele, O.T Oluwaniyi, O.O Abodunde, O. Adeola, M. Onyema

 

Abstract

Background: HIV pandemic has continued to be a huge challenge in Nigeria, with the problem of stigmatization reducing the chances of early determination of the HIV status of pregnant women, which may increase the chances of transmission to the child from the mother. Hypotheses tested were the influence of maternal antiretroviral therapy (ART) use and infant’s feeding option on baby’s final early infant diagnosis (EID) outcome. The study was aimed at determining the trend as well as diagnosis of HIV infection in exposed infants. It will also determine among infants the factors associated with the transmission of the infection from their mothers.
Methods: This study was a prospective cohort study of HIV-exposed infants conducted in Ekiti State, South Western Nigeria, between June 2015 and June 2017. Dried Blood Spots (DBS) were analyzed using polymerase chain reaction technique. All data were statistically analyzed, using statistical package for the social sciences (SPSS) and statistical test of significance was performed with Chi-Square test.
Results: A total of 200 infants were included in the study, 91 (45.5%) female and 109 (54.5%) male. Three (1.5%) babies were confirmed positive after cessation of all exposures. Maternal antiretroviral therapy (ART) use has significant effect on baby early infant diagnosis (EID) outcome (χ² = 65.40, df = 2, P = 0.001). Infant feeding option has significant effect on baby early infant diagnosis (EID) outcome (χ² = 132.67, df = 2, P = 0.001). Baby’s mode of delivery have higher association with the final EID outcome of the baby (OR: 1.018, 95% CI: 0.998 – 1.038).
Conclusion: ART administration to both HIV-infected mothers and their babies has demonstrated an effective mechanism in the elimination of mother-to-child transmission (eMTCT), as this is evident in the very low positivity outcome. However, the degree to which Cuba, Armenia, Belarus, and Thailand have eliminated HIV transmission from mother-to-baby is achievable in Nigeria through provision of universal access to health care.

Key words: infant, mother, dried blood spot, polymerase chain reaction

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Elimination of mother-to-child transmission of HIV (eMTCT) in Western Nigeria how far have we gone Elimination of mother-to-child transmission of HIV (eMTCT) in Western Nigeria how far have we gone

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Infant immunization coverage in difficult-to-reach area of Lagos metropolis

A Adeiga, SA Omilabu, RA Audu, FA Sanni, GF Lakehinde, O Balogun, O Olagbaju

 

Abstract

A retrospective survey of infant immunization coverage was conducted among 210 children aged 12 to 23 months in difficult-to-reach coastal suburb of Lagos, Nigeria. This was to assess immunization coverage for BCG, DPT, OPV and measles vaccination and to investigate reasons for failure to be immunized and evaluate the drop out rate as well as missed opportunities. An EPI cluster method was used. Questionnaires were administered with WHO cluster form for infant immunization. Recall history and card records of immunization were the tools used. The result showed that 82 (39%) of the 210 children assessed were not immunized, 84 (40%) were partially immunized and only 44 (21%) were fully immunized. At one year of age, only 21 (10%) of the children completed their immunization. Observation of the follow up of vaccination showed that 65.5% of 127 children who started BCG vaccination dropped out as at the time of receiving measles vaccination. Reasons advanced for failure to immunize or complete immunization of the children included obstacles in 47.7%, lack of information 40.7% and lack of motivation in 11.6%. These factors contributed to missed opportunities. Only 9 (11%) of 82 children not vaccinated against measles attributed non vaccination to illnesses. Lack of health facilities and the terrain that is difficult to reach contributed to low coverage. Also, low literacy level, poor maternal health education, poor socioeconomic status and poor advocacy to community leaders and lack of commitment of health workers contributed to low coverage. For immunization coverage to improve in this area, these factors must be addressed.

Keywords: infant, immunization, coverage, antigens, advocacy

African Journal of Clinical and Experimental Microbiology Vol. 6 (3) 2005: 227-231