A review of the prevalence and rate of utilisation of measures offered to HIV-positive women during delivery in a tertiary hospital in south-south Nigeria

Abstract

Background: Vertical or mother-to-child transmission of HIV which accounts for over 90% of paediatric HIV infection is increasingly becoming a major mode of transmission in  developing countries.

Aim: To determine the prevalence of HIV infection among pregnant women that deliver at the University of Uyo Teaching Hospital and also review the interventions they are offered when they present in labour.

Methods: The case records of all HIV positive patients who delivered between 1st July 2005 and 31st December 2007 were reviewed.

Results: There were 2,851 deliveries out of which 188 patients were HIV positive giving a prevalence of 6.6%. The modal age group of the HIV-positive patients was 26-30 years (40.4%). Most (68.6%) of the patients were multiparous and 89.3% of them had regular antenatal care in the hospital. HIV was diagnosed in the antenatal clinic in 71.8% of the patients.  Most (72.3%) of them had a single dose of nevirapine in labour while 5.8% received highly active anti-retroviral therapy. About 63.8% of the patients had spontaneous vertex delivery while 33.5% were delivered by Caesarean section. All the babies had single doses of nevirapine within 72 hours of birth. Most (84.0%) of the mothers chose to feed their babies exclusively with breast milk substitutes. There were 3 maternal (1.6%) and 16 (8.5%) perinatal deaths.

Conclusion: The prevalence of HIV infection among women who deliver in our hospital (6.6%) is relatively high. The treatment of HIV positive pregnant women in labour with respect to the prevention of mother-to-child transmission fell short of acceptable standards in some of our patients. Efforts should be made to ensure the adoption of anti-retroviral therapy as recommended in the Nigerian national guidelines.

Keywords: HIV prevalence, Delivery, Vertical transmission, Prevention, Uyo