HIV STATUS AND FACTORS ASSOCIATED AMONG HIV EXPOSED INFANTS UNDER PMTCT FOLLOW UP IN HEALTH FACILITIES IN, DIRE DAWA TOWN, EASTERN ETHIOPIA.

Abstract

Background: Mother to child transmission of Human Immunodeficiency Virus has resulted in 20% of an estimated 170,000 children which were found to be infected in the year 2014.In the absence of any intervention, among 100 infants born from an HIV infected mother, there is an overall 20 to 45 % risk of transmission from 18 to 24 month. Although, studies have shown the prevalence of human immunodeficiency virus among exposed infants in Ethiopia range from 4% to 17%,there is limited available study that has been done that show the status of exposed infants and therefore this study show the overall status of the exposed infants in Dire Dawa town. Objective: The objective of the study was to assess the Human Immunodeficiency Virus status and factors associated among exposed infants under prevention of mother to child transmission follow up in health facilities in Dire Dawa Town from February 5 -15/2018. Methods: Institution based retrospective cross-sectional study design using quantitative method was conducted. The source population for the study was all Human Immunodeficiency Virus exposed infants on follow from January 1, 2014 to December 31, 2017 and study population were those with complete registration. Sample of 653 complete charts were included in the study based on the criteria of completeness of the charts. Nurses were selected for data collection. Possible associations and statistical significance between variables was measured using crude and adjusted odds ratio, P value <0.05 was used to declare statistical significance. Results: The anti body test result at 18 month show, 56(8.6%), (95% CI (6.4,11.0),infants were positive. Mothers who didn’t start HAART early after diagnosis were 11.7 times more likely to be predisposed to have an infected child. (AOR=11.7:(95% CI,1.7,76.7). Mothers who had CD4 level below 350 were 3.1 times more likely to have an HIV infected infant when compared to those who have greater than 500 (AOR=3.1:95% CI: 1.5, 8.5).Home delivery is related with 10.74 times more likely for the mother to have an infected infant (AOR=10.74:95% CI, 2.2, 52.8).Mixed feeding practice was 12.1 times more likely of having an infected child (AOR=12.1:95% CI, 3.9, 36.4) and Sickness during follow up increases transmission of the HIV virus from the mother to infant by 3.5 times (AOR=3.5:95% CI, 1.5, 8.1)). Conclusion: Even though positivity status has decreased considerably in the study area in comparison to other areas, this result is greater when compared to the national program to totally interrupt vertical transmission of the virus to less than 2%. Recommendation: In order to avert this condition, ante natal care service including PMTCT at pregnancy, labor and delivery and PNC should be strengthened and implemented according to the national protocol. HIV positive mothers should be actively encouraged to take role in PMTCT program through mother support groups in the facilities. Care providers should follow the mothers and infants regarding child care and support. Home delivery should be strictly discouraged in all areas of the country even in the presence of traditional birth attendants. Dire dawa health bureau should play roles in providing necessary human resource, financial and material support for care providers and health institutions as well.