Impact of maternal ART on mother-to-child transmission (MTCT) of HIV at six weeks postpartum in Rwanda

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dc.contributor.authorMugwaneza, Placidie
dc.contributor.authorLyambabaje, Alexandre
dc.contributor.authorUmubyeyi, Aline
dc.contributor.authorHumuza, James
dc.contributor.authorTsague, Landry
dc.contributor.authorMwanyumba, Fabian
dc.contributor.authorMutabazi, Vincent
dc.contributor.authorNsanzimana, Sabin
dc.contributor.authorRibakare, Muhayimpundu
dc.contributor.authorIrakoze, Ange
dc.contributor.authorMutaganzwa, Emmanuel
dc.contributor.authorLombard, Carl
dc.contributor.authorJackson, Debra
dc.date.accessioned2018-11-22T06:47:11Z
dc.date.available2018-11-22T06:47:11Z
dc.date.issued2018
dc.description.abstractBACKGROUND: In 2010, Rwanda adopted ART for prevention of mother to child transmission of HIV from pregnant women living with HIV during pregnancy and breasfeeding period. This study examines rates of mother-to-childtransmission of HIV at 6–10 weeks postpartum and risk factors for mother-to-child transmission of HIV (MTCT) among HIV infected women on ART during pregnancy and breastfeeding. METHODS: A cross-sectional survey study was conducted between July 2011–June 2012 among HIV-exposed infants aged 6–10 weeks and their mothers/caregivers. Stratified multi-stage, probability proportional to size and systematic sampling to select a national representative sample of clients. Consenting mothers/caregivers were interviewed on demographic and program interventions. Dry blood spots from HIV-exposed infants were collected for HIV testing using DNA PCR technique. Results are weighted for sample realization. Univariable analysis of socio-demographic and programmatic determinants of early mother-to-child transmission of HIV was conducted. Variables were retained for final multivariable models if they were either at least of marginal significance (p-value < 0.10) or played a confounding role (the variable had a noticeable impact > 10% change on the effect estimate). RESULTS: The study sample was 1639 infants with HIV test results. Twenty-six infants were diagnosed HIV-positive translating to a weighted MTCT estimate of 1.58% (95% CI 1.05–2.37%). Coverage of most elimination of MTCT (EMTCT) program interventions, was above 80, and 90.4% of mother-infant pairs received antiretroviral treatment or prophylaxis. Maternal ART and infant antiretroviral prophylaxis (OR 0.01; 95%CI 0.001–0.17) and maternal age older than 25 years were significantly protective (OR 0.33; 95%CI 0.14–0.78). No disclosure of HIV status, not testing for syphilis during pregnancy and preterm birth were significant risk factors for MTCT. Factors suggesting higher sociodemographic status (flush toilet, mother self-employed) were borderline risk factors for MTCT. CONCLUSION: ART for all women during pregnancy and breastfeeding was associated with the estimated low MTCT rate of 1.58%. Mothers who did not receive a full package of anti-retroviral therapy according to the Rwanda EMTCT protocol, and young and single mothers were at higher risk of MTCT and should be targeted for support in preventing HIV infection.en_US
dc.identifier.citationMugwaneza, P. et al. (2018). Impact of maternal ART on mother-to-child transmission (MTCT) of HIV at six weeks postpartum in Rwanda. BMC Public Health, 18: 1248en_US
dc.identifier.issn1471-2458
dc.identifier.urihttps://doi.org/10.1186/s12889-018-6154-6
dc.identifier.urihttp://hdl.handle.net/10566/4220
dc.language.isoenen_US
dc.privacy.showsubmitterFALSE
dc.publisherBMCen_US
dc.rights© The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
dc.status.ispeerreviewedTRUE
dc.subjectEMTCTen_US
dc.subjectHIVen_US
dc.subjectOperational effectivenessen_US
dc.subjectSentinel surveyen_US
dc.subjectRwandaen_US
dc.subjectMTCTen_US
dc.subjectEMTCT surveillanceen_US
dc.subjectMaternal ARTen_US
dc.titleImpact of maternal ART on mother-to-child transmission (MTCT) of HIV at six weeks postpartum in Rwandaen_US
dc.typeArticleen_US

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