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Missed o.po.tunities fo. Preventio. o. Mo.her-to.Child Transmissio. o. HIV (PMTCT) in Ibadan, So.thwest Nigeria

Wo.ld Jo.rnal o. AIDS 2014年第3期4卷 356-364页

作者： babatunde o. ogunbosi Regina E. o.ado.un o.uto.in Awo.ude Bio.ele J. Bro.n o.ubuko.a A. Adeshina Mo.upe Kuti Babafemi Taiwo.Baiba Berzins Demetrio.s N. Kyriaco. Ellen G. Chadwick Kikelo.o.o.inusi Isaac F. Adewo.e Ro.ert L. Murphy Department o. Paediatrics College of Medicine University of Ibadan Ibadan Nigeria Department o. Paediatrics University College Hospital Ibadan Nigeria Department o. o.stetrics and Gyneco.o.y College of Medicine University of Ibadan Ibadan Nigeria Department o. o.stetrics and Gyneco.o.y University College Hospital Ibadan Nigeria Department o. Chemical Patho.o.y College of Medicine University of Ibadan Ibadan Nigeria Department o. Internal Medicine Feinberg School of Medicine Northwestern University Chicago USA Center fo. Glo.al Health Institute for Public Health and Medicine Feinberg School of Medicine Northwestern University Chicago USA Department o. Emergency Medicine Feinberg School of Medicine Northwestern University Chicago USA Department o. Pediatrics Feinberg School of Medicine Northwestern University Chicago USA

Backgro.nd: Nigeria has the largest paediatric HIV-infected po.ulatio. in the wo.ld. Missed o.po.tunities fo. preventio. o. mo.her-to.child transmissio. o. HIV (PMTCT) co.pro.ise effo.ts at eliminating new pediatric HIV infectio.s. Metho.s: Six hundred children, aged o.the pediatric units o. the University Co.lege Ho.pital (UCH), Ibadan So.thwest Nigeria between June to.December 2007 were studied. The demo.raphics, HIV status and so.io.co.o.ic status o. mo.hers and their children were studied. A 4-step hierarchy was used to.assess the missed o.po.tunities fo. PMTCT. Step 1: utilizatio. o. a health facility fo. antenatal care and delivery;Step 2: maternal HIV status determinatio. during pregnancy;Step 3: pro.isio. o. antiretro.iral medicatio. to.HIV-infected mo.her and baby;and Step 4: avo.dance o. mixed feeding in HIV-expo.ed children. The rates o. missed o.po.tunities fo. PMTCT services at different steps in the PMTCT cascade, perinatal transmissio. rates, and asso.iated facto.s were repo.ted. Results: There were 599 mo.hers and 600 children (o.e set o. twins), 60 (10%) were HIV infected and 56 (93.3%) o. these were adjudged perinatally infected. o. 78 HIV-infected wo.en, 7 (9.0%) accessed all interventio.s in the PMTCT cascade and 71 (91.0%) had missed o.po.tunities fo. PMTCT. Missed o.po.tunities fo. PMTCT o.curred 42.9% in cascade Step 1, 64.2% in Step 2, 52.6% in step 3 and 73.7% in Step 4. All mo.her-baby pairs who.accessed co.plete PMTCT interventio.s received care at a teaching ho.pital. Amo.g infants with perinatal HIV infectio., 53 (94.6%) were bo.n to.mo.hers who.had missed o.po.tunities fo. PMTCT. Mo.t wo.en with missed o.po.tunities attended antenatal care o.tside the teaching ho.pital setting and belo.ged to.lo. so.io.co.o.ic status. Co.clusio.: It is imperative to.expand PMTCT access to.wo.en who.receive antenatal care o.tside the teaching ho.pitals and to.tho.e o. lo. so.io.co.o.ic status.

关键词： HIV Perinatal Preventio. PMTCT Missed o.po.tunities

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