Determinants Of Hiv Infection Among Children Born To Mothers On Prevention Of Mother To Child Transmission Program In Public Health Center Of Addis Ketema Sub City , Addis Ababa, Ethiopia: A Case Control Study

Abstract

Background: According to World Health Organization, mother-to-Child transmission of Human immunodeficiency virus occurs when an Human immunodeficiency virus -positive woman transmits the virus to her baby during pregnancy, childbirth or breast-feeding. Despite wide spread use of Antiretroviral Therapy (ART) by pregnant women living with Human Immunodeficiency Virus (HIV), the transmission rate is still higher by 18% after breastfeeding ends. Objective: To identify the determinants of HIV infection among children born to mothers on prevention of mother to child transmission (PMTCT) program in public health center of Addis Ketema sub city Addis Ababa, Ethiopia 2024. Methods: Unmatched case–control study was conducted in Addis Ketema, from April,5 to May,4 2024. Cases: Children born to HIV-positive mothers on the PMTCT program during the study period had confirmed HIV-positive test results at or before 24 months of age.Controls: Children born to HIV-positive mothers on the PMTCT program during the study period had confirmed HIV-negative test results (DNA PCR or antibody) at or before 24 months of age.Sample size of 157 child ( 33 cases and 124 controls with 1:4 case-control) were included in the study. Consequently, all the 33 HIV positive children were considered as cases and for each case four controls with the last six month of birth to the cases were recruited from the same health facilities as the cases .Data were collected using a structured questionnaire and data extraction forms from mothers of exposed infants, medical records of mothers and children .and entered to Epidata version 3.1 and analyzed using SPSS version 22. During bivariable analysis variables with p<0.25 were taken for Multivariable binary logistic regression was fitted to identify determinants of mother-to-child HIV transmission & statistically significant association was declared at p <0.05 with 95% confidence interval. Results: Lack of ANC attend (AOR: 3.5; 95% CI: 1.2, 7.2), unplanned pregnancy (AOR: 3.2; 95% CI: 1.2, 4.2),WHO clinical stage- >II (AOR: 1.3; 95% CI: 1.1, 3.1) poor ART adherence(AOR: 2.5; 95% CI: 1.1, 3.6) , were significantly associated with MTCT of HIV at a p value of <0.05 and 95% CI. Conclusions: Different maternal and obstetric factors determining MTCT of HIV during pregnancy, delivery and postnatal period were identified. Lack of attend ANC, unplanned pregnancy, poor ART adherence level, advanced WHO clinical stage of HIV, are factors determinats with MTCT of HIV