FOLLOW UP-OUTCOMES OF HIV-EXPOSED INFANTS BORN AT HEALTH CENTERS IN AMHARA AND TIGRAY REGIONS OF ETHIOPIA

Abstract

Background: Early diagnosis of HIV infection in exposed infants save lives; without treatment, 35% of HIV-infected infants would die before their first birthday and 50% would die before the age of two. This study assessed the follow-up outcomes of HIV exposed infants born in health centers; and the PMTCT status of their mothers in two regions of Ethiopia.
Methods: A cross-sectional review was conducted on the records of HIV-exposed infants born at health centers in Amhara and Tigray regions from Oct 1st 2011 to Sept 30th, 2013.
Results: Seven hundred eleven (711) HIV-exposed infants born in 23 health centers were in-cluded; 72.7% were from Amhara and 27.3% were from Tigray with 96% of them having active follow-up at the respective health centers at the time of the study. Of the 691 infants whose gender was recorded, 311(45%) were female. Most (82.4%) were enrolled within 45 days of birth. The DNA PCR test was done for 658 (93%) and 630(95.7%) had negative and 9 (1.37%) had positive results, for 8 (1.22%) the result was pending and for 11 (1.67%) the result was not recorded. Six of the DNA PCR positive infants were started on ART at the health centers and 3 were referred to hospital. The records showed that 624 (87.8%) HIV infected mothers have received some form of PMTCT, and most (57.7%) were on HAART before/during pregnancy. The records showed 636 (89.5%) infants received some form of PMTCT, in which 43.5% received NVP for 4-6 weeks. The records of 682 showed that 678 (95.4%) received co-trimoxazole prophylaxis (CPT), and 86.1% began CPT within 45 to 60 days from birth. Most (91.1%) of the HEIs were exclusively breastfed. Out of the 9 HIV-positive infants, 7 were exclusively breastfed and two experienced mixed feeding. Two hundred eleven (211) infants had confirmatory test done at or above 12 months of age, and an additional two infants turned out to be HIV positive and were started on ART treatment.
Conclusion: Enrolling 82.4% of the infants in the first 45 days (6 weeks) after birth has helped 93% to receive DNA PCR tests there by early identification of the 1.37% HIV-positive infants who were started on ART. Most (86.1%) of the infants were started on CPT within 45 to 60 days of birth and most (91.1%) HEIs were exclusively breastfed which all there according towhich 57.7% were on HAART before/during pregnancy, however only 3.7% received option B+. Most (89.5%) of infants have received PMTCT intervention and Option B+ was given to only 44.6% of them; based on the current recommendation option B+ uptake should be improved to maximize protection against HIV. Significant gaps in growth assessment (<70%) and immunization (only 76.2% HEIs were properly vaccinated) were identified which need to improve to minimize the morbid effects of malnutrition and vaccine preventable disease among HIV exposed infants.