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

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