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Asian Journal of Healthy and Science
p-ISSN: 2980-4302
e-ISSN: 2980-4310
Vol. 2 No. 7 July 2023
ASSESSING THE OUTCOME OF PMTCT OF HIV THERAPY AT
THE EASTERN REGIONAL HOSPITAL, GHANA
Twum Seth, Oscar Opoku Agyemang, Selina Achiaa Owusu, Henry Okudzeto,
Jesse Anak
1,3
Kwame Nkrumah University of Science and Technology, Ghana
2,4,5
University of Cape Coast, Ghana
Email: saintwum@yahoo.com, oscar.opoku@stu.ucc.edu.gh,
Selina.soa@gmail.com, hokudzeto@yahoo.com, jesse.anak001@stu.ucc.edu.gh
Abstract
The study assessed the outcome of the PMTCT of HIV therapy at the Eastern
Regional Hospital. Specifically, the study sought to; determine the percentage of
Retro-exposed babies infected with HIV; assess the health status of the Retro-exposed
babies infected with HIV; determine the infant mortality rate of Retro-exposed babies
infected with HIV; assess the PMTCT treatment options available and used at
Eastern Region Hospital; and assess the demographic characteristics of the mother
that may have influenced the outcomes of Retro-exposed babies infected with HIV.
This is a descriptive study of HIV positive mothers enrolled on the PMTCT
programme at Eastern Regional Hospital. Secondary data on demographic
characteristics of the mothers, the treatment options in use and the outcome of the
PMTCT programme after birth at Eastern Region Hospital were used. Data was
analyzed descriptively using frequencies, percentages, means and standard
deviations whereas relationship and difference were analyzed using t-test, ANOVA,
chi-square techniques. Babies were protected from getting infected with HIV through
PMTCT treatment while only 15 babies were infected with HIV. More females were
infected. Also, aside the 2 babies who died, only few babies have health issues such
as neonatal infection and low birth weight but the remaining were healthier. With
infant mortality rate, out of the 15 babies who were infected with HIV, only 2 (13.3%)
of them died. All the women (165, 100%) on the PMTCT were treated with TDF
300mg +3TC 300mg + EFV 600mg and they all tolerated it. There were differences
between age, educational status of women and Retro exposed babies to infection of
HIV. However, income of the women had nothing to do with the Retro exposed
babies to infection of HIV. PMTCT treatment is key since it is the window through
which babies born to women with HIV can be protected from being infected with
HIV. Again, there were differences between age, educational status of women and
Retro exposed babies to infection of HIV. However, the results of the study indicated
that income of the women had nothing to do with the Retro exposed babies to
infection of HIV.
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Keywords: assessing the outcome; hiv therapy; regional hospital
INTRODUCTION
Globally, about 37.9 million people were living with HIV/AIDS as at 2018.
About 69 percent (approximately 19.4 million) among these people were from sub-
Saharan Africa (SSA), (WHO/GHO, 2019). Progressive anti-retroviral therapy is
administered across the globe, however, close to 74 percent of the 1.5 million AIDS-
related deaths in 2013 was recorded in sub-Saharan Africa (Kharsany & Karim,
2016). According to Ramjee & Daniels, (2013), women have been the most impacted
by HIV/AIDS, and according to UNAIDS, (2012), a young woman is predicted to
contract HIV virtually every minute. In SSA, where females currently make up at
least 56–59% of PLWHAs Kharsany & Karim, 2016; Ramjee & Daniels, 2013; Sia
et al., (2016) the disease has proven particularly devastating. Currently, girls make
about 75% of newly diagnosed cases of SSA among teenagers aged 15 to 19.
Additionally, compared to men in the same age group in the sub-region, women aged
15 to 24 are twice as likely to be living with HIV (Addo et al., 2014). Female
adolescents aged 10 to 19 made up 79% of the HIV incidence in Southern and Eastern
Africa in 2017 (Brown et al., 2018).
In Ghana, women made up 65% of the projected 334,713 PLWHAs in 2018,
while men made up 35% (NACP, 2009). Due to their higher vulnerability than men
due to differences in culture and socioeconomic level, women have a
disproportionately high risk of HIV/AIDS infection (Higgins, Hoffman & Dworkin,
2010; Igulot & Magadi, 2018). In order to prevent or limit the spread of HIV from
women to men or children, especially among pregnant women, suitable steps should
be taken. One of the primary obstacles to any HIV/AIDS program's efforts to stop
the spread of HIV is mother-to-child transmission of the virus (MTCT). The risk of
contracting HIV during pregnancy or at birth ranges from 15 to 30 percent in the
absence of preventive measures, and it rises to 20 to 45 percent when breastfeeding.
In wealthier nations, prevention of MTCT (PMTCT) measures can lower HIV
vertical transmission to less than 1%; nevertheless, despite progress, middle- to low-
income nations experience less success. Mother-to-Child Transmission of HIV
(MTCT) puts pregnant HIV-positive mothers at a high risk of passing the virus to
their unborn children during pregnancy, labour, or delivery, and postpartum through
breastfeeding (Organization, 2010b). MTCT causes over 90% of new HIV infections
in babies, which is a major public health problem, particularly in sub-Saharan African
nations with high fertility rates and a high incidence of HIV infections among women
of childbearing age (UNAIDS, 2012)
A comprehensive approach to addressing a wide range of prevention, care,
treatment, and support services along a continuum of care from pregnancy through
childhood is the prevention of mother-to-child transmission of HIV (PMTCT).
Following the success of short-course Zidovudine and single-dose Nevarapine
clinical trials, this strategy has been at the forefront of international HIV prevention
efforts since 1998 (Organization, 2010a). It has since evolved into a crucial
intervention to lower HIV infection rates in the general population and virtually
eradicate HIV infection in children around the world (Chantry et al., 2012). The
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WHO promotes a four-pronged comprehensive approach to preventing HIV
infection among women of childbearing age, preventing unintended pregnancies
among women living with HIV, preventing HIV transmission from women living
with HIV to their infants, and providing appropriate treatment, care, and support to
mothers living with HIV, their children, and their families.
Since 1995, more than 350,000 children have not contracted HIV thanks to the
use of antiretroviral medications (ARVs) as prophylaxis to moms with HIV.
According to WHO, UNAIDS, and UNICEF (2011), sub-Saharan Africa has the
greatest prevalence of HIV infection among women of reproductive age and is home
to about 86% of the children who may have avoided infection thanks to the benefits
of PMTCT. In 2013, 3 out of 10 pregnant HIV-positive women did not receive ARVs
to prevent MTCT of HIV, and 4 out of 10 HIV-positive pregnant women or their
infants did not receive ARVs during breastfeeding to prevent MTCT of HIV
(UNAIDS/JC2681/1/E, 2014) (Greene, 2007). This is despite the enormous
contribution of PMTCT programmes in the 21 global priority countries.
The median prevalence of HIV among pregnant women attending prenatal
clinics in Ghana has grown from 1.8% in 2015 to 2.4% in 2016, according to the 2016
National Sentinel Survey (NSS) report. All 40 of the prenatal clinic locations around
the nation were able to successfully conduct the survey. In 2016, the prevalence of
HIV among pregnant women varied from 0.4% in the rural area of Nalerigu to 4.2 in
the urban areas of Agormanya and Sunyani. In Ghana, the predominant method of
HIV transmission from mother to child (MTCT) is through young children. An
exceptional opportunity for the start of the PMTCT protocol to prevent HIV infection
in a newborn is presented by an early HIV diagnosis in a pregnant woman (WHO,
2013). By identifying maternal HIV infection during pregnancy and providing
antiretroviral therapy (ART), the risk of mother-to-child HIV transmission can be
decreased or eliminated (Organization, 2014).
The Tema General Hospital reported that from 2012 to 2016, the following
results were obtained from DNA PCR tests conducted to determine the HIV status
of 661 HIV-exposed children, including both those whose mothers participated in the
PMTCT programme and those whose mothers did not. In 2012, 5 out of 83 children
(6.02%) aged between 6 weeks and less than 18 months who had HIV testing were
children. In 2013, 14.6% of the 134 children who were screened for HIV were under
the age of 14 (14/134). Eleven (11) of the 141 children (7.8%) who were screened for
the disease in 2014 also tested positive. In 2015, 14.7% of 150 kids who were screened
for HIV were found to be positive. Twenty-two (22) of the 153 children that were
screened in 2016 (14.4%) were positive (TGH, 2017). Children who tested positive
for HIV climbed from 6.02% in 2012 to 10.4% in 2013. However, there was a 2.6%
decline between 2013 and 2014. However, the rate of HIV-positive patients grew
once more by 1.5% in 2015 and then increased further to 5.1% in 2016. According to
the information above, sixty-six (66) of the six hundred and sixty-one (661) children
(9.98%) born to mothers who were HIV positive during the time period under
consideration were HIV positive. 181 (1.56%) of the 11,589 pregnant women who
underwent ANC testing were found to be retroviral positive.
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Numerous HIV positive mothers struggle with the problem of HIV transmission
from mothers to their offspring. During pregnancy, labour and delivery, or while
nursing, HIV transmission is possible. (GAC, 2010). According to GAC (2010),
vertical transmission from an infected pregnant mother that occurs during pregnancy,
labour, delivery, or nursing is the primary cause of HIV infections in children in
Ghana. In 2009, HIV infection was responsible for 3% of deaths among children
under five in Ghana. (GAC, 2010).
Despite increased global efforts to prevent mother-to-child HIV transmission,
paediatric HIV infections remain high in sub-Saharan Africa, particularly Ghana
(Dako-Gyeke et al., 2016). Despite the fact that there have been numerous studies
conducted on the PMTCT programme on a global scale, examining the difficulties
and ways to improve the programme in order to reduce mother-to-child HIV
transmission by 2030, there is a paucity of empirical data on the effectiveness of the
PMTCT programme implemented in the Eastern Region. This study looked at how
the PMTCT programme at the Eastern Regional Hospital performed.
RESEARCH METHODS
Research design provides the glue that holds the research project together. This
encompasses the stratified stages employed in the data collection procedures and the
steps used in the analysis of the data gathered. Research design is therefore a
summary of how the survey is to be conducted right from collection of data to data
analysis stage (Sullivan, 2001). The research design consisted of a cross sectional and
descriptive retrospective assessment of mothers who received PMTCT and delivered
children who are now less than 5 years old. Leedy and Ormrod (2005) viewed a
descriptive survey as collection of data in order to test hypothesis or answer questions
concerning the current status of a study. It provides opportunities for researchers to
gain valuable insight into the existing state of a phenomenon.
This refers to the total number of respondents involved in a study. For this
study, the targeted population consisted of all pregnant women and nursing mothers
who tested retro-positive and have been coming for services at the Eastern Regional
Hospital.
Patients’ records that included in the study were:
a. All mothers who come for ANC at the facility of Eastern Regional Hospital
b. All mothers who have tested HIV positive, attending ANC and have given birth
at the facility of Eastern Regional Hospital
c. All HIV positive mothers who had their children after birth (children less than 5
years)
d. All pregnant women who have tested retro-positive
Patients records that were excluded in the study were:
a. All mothers who maybe retro-positive but do not attend ANC at the facility of
Eastern Regional Hospital
b. mothers who do not come for PMTCT services at the Eastern Regional Hospital
c. mothers who come for only EID test at the Eastern Regional Hospital
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d. mothers who come to only deliver at the Eastern Regional Hospital without
attending ANC.
With regards to this study, census was used. Census refers to the attempt to
collect information on all eligible elements in a defined population. Therefore, all the
198 women who have been tested positive for HIV and have been coming for services
at the Eastern Regional Hospital were considered for the study.
Table 1: Sample Size For The Study
Frequency
Percent
Targeted population
198
100
Criteria of inclusion
165
83.3
Criteria of exclusion
33
16.7
Table 1 shows that there were 198 women who were tested positive for HIV.
However, out of 198, 165 were attending services as the Eastern Regional Hospital
while the others were not. Therefore, only women (165) who had HIV positive and
have been on the treatment for more than 6 months and receives services from
Eastern Regional Hospital.
Data gathered from the patients register and other records were entered into
Microsoft Excel, edited, cleaned and then export to SPSS for further analysis. Data
analysis were performed using SPSS statistical software. Descriptive statistics such
as means and standard deviation (mean ± SD) were used to describe the quantitative
variables whiles frequencies and percentages n (%) was used to describe categorical
variables and the pattern. Also, Chi-square test was used to establish the association
between women’s demographic characteristics and Retro-exposed babies to HIV
infection. Moreover, independent t-test was used to test the difference between
respondents’ sex and treatment or regiment received
RESULT AND DISCUSSION
Demographic characteristics
On the background information or characteristics of the participants including;
sex, age, mother’s educational level, and average monthly income of mothers or
women. The study found that females dominated among the babies delivered in the
Eastern Regional Hospital. With their ages, babies who were five years were more
while few was a year old. On the mothers, those who were within 20-29 years were
more, followed by those who were within 30-39 years while 28 were more than 40
years old. On educational status of the mothers, majority of them were educated at
least most women had their basic education while 29 women have no form of formal
education. With regards to the average monthly income of the women, only few were
earning high as compared to majority of the women who earned less than Gh 1500.
The percentage of Retro-exposed babies infected with HIV
This objective sought to estimate the percentage of children that were infected
with HIV after the treatment. This was to examine the efficacy of the treatment and
to examine other factors that might have led to the infection. From Table 2, it came
to bare that, out of the 175 babies, 8.6 percent (15) of them were infected with HIV
while 91.4 percent were negative or non-reactive.
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Table 2: The Retro-exposed babies infected with HIV
Results/sex
Male
Female
Total
HIV positive
6
9
15(8.6)
HIV negative
73
87
160(91.4)
Total
79
96
175(100%)
Treatment for babies PMTCT
Treating babies of PMTCT is crucial. This is due to the fact that such treatment
either protect the babies from future infection of HIV, it can also cure the HIV from
their system within first 18 days after birth as well as protecting them from other
deadly diseases that may be harmful to their system. Therefore, data were gathered
and the result were presented in Table 3.
Table 3: Treatment for babies PMTCT
Status
(ABC+3TC+DTG)
ABC+3TC+NVP
AZT+3TC+EFV
AZT+3TC+NVP
Sex
Male
21
17
19
39
Female
15
21
19
24
Total
36
38
38
63
Age
0
0
9
0
10
1
0
5
7
9
2
9
9
0
17
3
6
7
9
11
4
0
7
9
14
5
8
0
9
20
Total
23
37
34
81
According to Table 3, there are four main types of treatment options available
for babies of PMTCT treatment at the Eastern Regional Hospital in Ghana. These
treatments included; Abacavir + Lamivudine+Dolutegravir (ABC+3TC+DTG),
Tenofovir + Lamivudine + Dolutegravir (ABC+3TC+DTG), Zidovudine +
Lamivudine + Efavirenz(AZT+3TC+EFV), Zidovudine + Lamivudine +
Nevirapine (AZT+3TC+NPV). Table further depicts the number of children, sex of
the children and the age at which each and every treatment is administered to the
children. With sex, there were no difference between the administration of various
treatment and sex. This means that whether male or female, they all received either
Abacavir + Lamivudine+Dolutegravir (ABC+3TC+EFV), Tenofovir + Lamivudine
+ Dolutegravir (ABC+3TC+DTG), Zidovudine + Lamivudine + Efavirenz
(AZT+3TC+EFV), or Zidovudine + Lamivudine + Nevirapine (AZT+3TC+NPV).
The independent t-test conducted shows that there are no statistically significant
different between sex and the various treatment (t=-0.26, p>0.05).
However, with the age of the children, Zidovudine + Lamivudine + Nevirapine
(AZT+3TC+NPV) treatment was normally administered more to children of either
4 or 5 years old. None of the Abacavir + Lamivudine+ Dolutegravir (ABC+3TC+
DTG) was administered to either 0, a year old or 4 years children. This shows that
there were some differences among the various treatment and the years of children.
Despite the differences in the means of the various treatment, the result of One-way
Analysis of Variance shows that there is no statistically significant difference between
the various treatment and age of the children (F-stat = 0.948, p<0.46).
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In all, the Zidovudine + Lamivudine + Nevirapine (AZT+3TC+NPV) was the
treatment that was highly used for PMTCT treatment for children mostly more than
2 years old. It was followed by Tenofovir + Lamivudine + Dolutegravir
(TDF+3TC+DTG) and Zidovudine + Lamivudine + Efavirenz (AZT+3TC+EFV).
Health status of the Retro-exposed babies infected with HIV
After determining the rate and percentage of Retro-exposed babies infected with
HIV, there is the need to examining their health in order. This health status covers
the fitness of the babies after birth, death status, whether the baby is affected with any
neonatal diseases, birth weight issues, congenital issues among others. Data were
gathered on these parameters and presented in Table 4.
Table 4: Health status of the Retro-exposed babies infected with HIV
Status
Live birth
173
Death
2
Low birth weight
4
Neonatal infection
4
Congenital microcephaly
0
Table 4 shows that there were 173 live birth out of the 175 babies. This is good
news since majority of the babies were protected from being infected with HIV. Also,
there was a low birth weight case of 4. These were babies that weigh below 2.50kg at
birth. This forms 2.3 percent out of the total babies. However, 2 babies were dead
due to neonatal issues. Moreover, there were four (4) neonatal infection while there
was no congenital infections. The result shows that only 5.71 had issues with their
health while majority of the babies were healthy.
Infant mortality rate of Retro-exposed babies infected with HIV
Infant mortality rate looks at the death of young children under the age of 1.
However, this objective sought to examine the infant mortality rate of Retro-exposed
babies infected with HIV. Thus, the death of these infants due to their infection with
HIV. The results of the data gathered on these variables are presented in Table 5.
Table 5: Infant mortality rate of Retro-exposed babies infected with HIV
Status
Male
Female
Total
HIV Positive
6
7
13(86.7%)
Death
0
2
2(13.3%)
Total
6
9
15(100%)
Table 5 shows that out of the 15 babies who were infected with HIV, 2 of them
who were females died. This represents 13.3 percent of the infected babies. This is
low but still needs attention since 2 out of 15 infected cases as death is not good and
appropriate measures should be taken to help reduce or eliminate such mortality rate.
PMTCT treatment options available and used at Eastern Region Hospital.
This objective sought to identify the various PMTCT treatment options
available and used at the Eastern Regional Hospital. Normally, there are three
different regiment given to women on PMTCT treatment, however, TDF 300mg
+3TC 300mg + EFV 600mg is the first option given to all women for the first time.
Subsequently, if any of the women do not tolerate it, then it is change for the person.
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Data revealed that all the women (165, 100%) on the PMTCT were treated with TDF
300mg +3TC 300mg + EFV 600mg and they all tolerated it.
Differences between demographic characteristics of the mother and Retro
exposed babies infected with HIV
Demographic characteristics of the mother that may have influenced the
outcomes of Retro-exposed babies infected with HIV. Last objective, which is meant
to examine the differences between demographic characteristics of the mother that
may influence the outcome of Retro exposed babies infected with HIV. It is believed
that parents who earn high income and are well educated are highly compliance to
the implementation of administration of drugs or therapy. Therefore, data were
gathered on these characteristics and the outcome of Retro exposed babies infected
with HIV to test these differences. These results were presented in Table 6, 7 and 8.
Table 6: Differences between age of the mothers and Retro exposed babies
infected with HIV
Age
N
Yes
No
χ² statistic
P-value
3.9684
0.023
Less than 20
32
8
26
20-29
57
5
55
30-39
48
2
47
40-49
28
0
28
Total
165
9
156
According to Table 6, there is difference between age of the women and the
Retro-exposed babies infected with HIV. Specifically, women who were less than 20
years were more exposed to Retro exposed babies infected with HIV. However,
women who were within 40-49 years were not susceptible to Retro exposed babies
infected with HIV. Moreover, the Chi-square test was run to examine the significant
of the difference and the result shows that there was statistically significant difference
between age of the women and Retro exposed babies infected with HIV. This means
that the aged were adherence to ART as compared to the young women less than 20
years.
Table 7: Differences between educational status of the mothers and Retro
exposed babies infected with HIV
Education
N
Yes
No
χ² statistic
P-value
None
29
9
23
12.842
0.041
Primary
38
3
36
JHS
45
1
44
Secondary
35
1
35
Tertiary
18
0
18
Total
165
9
156
With regards to educational status of the women and Retro exposed babies
infected with HIV, Table 7 shows that there is difference between educational status
of the women and the Retro-exposed babies infected with HIV. Specifically, women
who were illiterate or have no form of formal education were more exposed to Retro
exposed babies infected with HIV as compared with women who had primary, JHS
education. However, women who have had their secondary and tertiary education
were not susceptible to Retro exposed babies infected with HIV. Moreover, the Chi-
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square test was run to examine the significant of the difference and the result shows
that there was statistically significant difference between educational status of the
women and Retro exposed babies infected with HIV. Thus, women who were
educated were responsive to the demands and the instructions with regards to dosage,
and completion of ART.
Table 8: Differences between income of the mothers and Retro exposed babies
infected with HIV
Income
N
Yes
No
χ² statistic
P-value
Less than 500
42
5
39
6.357
0.135
500-999
55
4
53
Gh 1000-1499
32
4
34
Gh 1500-1999
25
0
25
Gh 2000 and above
11
2
9
Total
165
9
156
Income of women were assessed against Retro exposed babies infected with
HIV due to its significant effect on access to health care services among others. Table
8 shows that there is slightly difference between women who earned less than Gh 500
in a month, women who earned Gh 500-999, women who earned Gh 1000-1499 and
women who earned Gh 2000 and more.
However, the Chi-square analytical technique was used to examine the
significance of the difference and the result shows that there was no statistically
significant difference between average monthly income of the women and Retro
exposed babies infected with HIV. This is due to the fact that the differences between
the income of the women were not that much, therefore, could not cause any
difference in the Retro exposed babies infected with HIV. Thus, whether women
earned lower income or higher income, there was no difference in the Retro exposed
babies infected with HIV.
Percentage of Retro-exposed babies infected with HIV
The study found that out of the 175 babies, 8.6 percent (15) of them were
infected with HIV while 91.4 percent were negative or non-reactive. This shows that
the treatment or regiments administered to the mothers were effective. According to
the WHO, without treatment or intervention, the rate of transmission is between 15
– 45% and with intervention, the rate of infection is reduced to 5% in a breastfeeding
population and less than 2% in a non-breastfeeding population (Achyut et al., 2016).
Comparing the rate of transmission in the study which is 3.6% above the WHO
guideline which is quite remarkable, it can be that some of these mothers did not take
their medications as required. Thus, majority of the children were protected from
getting infected with HIV. Focusing on the sex, it can be deduced that more females
(two-third of males) were infected. This may be due to chance or due to the fact that
females were a little more than male for the total sample size for the study.
Health status of the Retro-exposed babies infected with HIV
After determining the rate and percentage of Retro-exposed babies infected with
HIV, there is the need to examining their health in order. This health status covers
the fitness of the babies after birth, death status, whether the baby is affected with any
neonatal diseases, birth weight issues, congenital issues among others. It came to bear
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that there were 173 live births out of the 175 babies. This is a great result since
majority of the babies were protected from being infected with HIV. Also, there was
4 low birth weight cases. However, 2 babies were dead due to neonatal issues.
Moreover, there were four (4) neonatal infection. The result shows that only 5.71 had
issues with their health while majority of the babies were healthy.
Infant mortality rate of Retro-exposed babies infected with HIV
The results show that out of the 15 babies who were infected with HIV, 2 of
them who were females died. This represents 13.3 percent of the infected babies. This
is low but still needs attention since 2 out of 15 infected cases as death is not good
and appropriate measures should be taken to help reduce or eliminate such mortality
rate.
Treating babies of PMTCT is crucial. This is due to the fact that such treatment
either protect the babies from future infection of HIV, it can also cure the HIV from
their system within first 18 days after birth as well as protecting them from other
deadly diseases that may be harmful to their system. There are four main types of
treatment options available for babies of PMTCT treatment at the Eastern Regional
Hospital in Ghana. These treatments included Abacavir + Lamivudine+
Dolutegravir (ABC+3TC+DTG), Tenofovir + Lamivudine + Dolutegravir
(ABC+3TC+DTG), Zidovudine + Lamivudine + Efavirenz (AZT+3TC+EFV),
Zidovudine + Lamivudine + Nevirapine (AZT+3TC+NPV). With sex, there was no
statistical significant difference between the administration of various treatment and
sex. Thus, whether male or female, they all received either Abacavir + Lamivudine+
Dolutegravir (ABC+3TC+EFV), Tenofovir + Lamivudine + Dolutegravir
(ABC+3TC+DTG), Zidovudine + Lamivudine + Efavirenz (AZT+3TC+EFV), or
Zidovudine + Lamivudine + Nevirapine (AZT+3TC+NPV).
However, with the age of the children, Zidovudine + Lamivudine + Nevirapine
(AZT+3TC+NPV) treatment was normally administered more to children of either
4 or 5 years old. None of the Abacavir + Lamivudine+ Dolutegravir
(ABC+3TC+DTG) was administered to either 0, a year old or 4 years children.
Nevertheless, there was no statistically significant difference between age and the
treatment given to the babies. In all, the Zidovudine + Lamivudine + Nevirapine
(AZT+3TC+NPV) was the treatment that was highly used for PMTCT treatment for
children mostly more than 2 years old with small attention to the use of Tenofovir +
Lamivudine + Dolutegravir (ABC+3TC+DTG) and Zidovudine + Lamivudine +
Efavirenz (AZT+3TC+EFV) as treatment for the babies.
PMTCT treatment options available and used at Eastern Region Hospital
The result shows that TDF 300mg +3TC 300mg + EFV 600mg was the first
option given to all women for the first time. All the women (165, 100%) on the
PMTCT were treated with TDF 300mg +3TC 300mg + EFV 600mg and they all
tolerated it. It can be deduced that women who were treated with TDF 300mg +3TC
300mg + EFV 600mg had no complications or whatsoever. This drug was also
effective since it was able to prevent majority of the babies from being infected with
HIV.
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Demographic characteristics of the mother that may have influenced the
outcomes of Retro-exposed babies infected with HIV
Demographic characteristics of the mother that may have influenced the
outcomes of Retro-exposed babies infected with HIV. It was revealed that there was
statistically significant difference between age of the women and the Retro-exposed
babies infected with HIV. Specifically, women who were less than 20 years were
more exposed to Retro exposed babies infected with HIV. However, women who
were within 40-49 years were not susceptible to Retro exposed babies infected with
HIV. This means that the aged were adherence to ART as compared to the young
women less than 20 years. This was similar to the findings of (Gourley et al., 2013)
that, younger maternal age influence adherence to the uptake of ART. In addition,
Whelan et al., (2015) examined early initiation of ARVs during pregnancy to move
towards virtual elimination of mother-to-child transmission of HIV-1 in Yunnan in
China and found that the likelihood of pregnant women between the ages of 20-30
years to start ARVs early is higher as compared to those beyond 35 years.
Remarkably, 8 (more than half) out of 15 babies who were infected with HIV were
born to women who were of the ages of 20-29 years.
There was statistically significant difference between educational status of the
women and the Retro-exposed babies infected with HIV. Specifically, women who
were illiterate or have no form of formal education were more exposed to Retro
exposed babies infected with HIV as compared with women who had primary, JHS
education. However, women who have had their secondary and tertiary education
were not susceptible to Retro exposed babies infected with HIV. Gourley et al. (2013)
concluded that inadequate knowledge of HIV coupled with lower educational level
may lead to poor uptake of ART. Therefore, it is not surprise to found that the result
of this study shows that 9 out of the 15 babies infected with HIV were born to women
who have no form of formal education or illiterate. Comparatively, those women
who were educated were less likely to born babies infected with HIV due to their
strictly adherence to the dictates and instructions concerning ART.
Income of women were assessed against Retro exposed babies infected with
HIV due to its significant effect on access to health care services among others. There
was slightly difference between women who earned less than Gh 500 in a month,
women who earned Gh 500-999, women who earned Gh 1000-1499 and women who
earned Gh 2000 and more. However, this difference was not statistically significant.
CONCLUSION
After conducting the study, based on the findings, it can therefore, be concluded
that PMTCT treatment is crucial since it is the window through which babies born
to women with HIV can be protected from being infected with HIV. Babies were
protected from getting infected with HIV while only 15 babies were infected with
HIV. Focusing on the sex, more females were infected. Also, aside the 2 babies who
died, only few babies have health issues such as neonatal infection and low birth
weight but the remaining were healthier. With infant mortality rate, out of the 15
babies who were infected with HIV, only 2 (13.3%) of them died. All the women
(165, 100%) on the PMTCT were treated with TDF 300mg +3TC 300mg + EFV
600mg and they all tolerated it. There were differences between age, educational
status of women and Retro exposed babies to infection of HIV. However, income of
the women had nothing to do with the Retro exposed babies to infection of HIV
https://ajhsjournal.ph/index.php/gp 337
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https://ajhsjournal.ph/index.php/gp 338
Copyright holders:
Twum Seth, Oscar Opoku Agyemang, Selina Achiaa Owusu, Henry Okudzeto,
Jesse Anak (2023)
First publication right:
AJHS - Asian Journal of Healthy and Science
This article is licensed under a Creative Commons Attribution-ShareAlike 4.0
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