Abstract:
Background: Although without any intervention in PMTCT up to 80% of HIV exposed children could not be infected with HIV, PMTCT interventions provide a critical opportunity to prevent vertical transmission of HIV from mother to child during pregnancy, labour and delivery and/or during breastfeeding.
Objectives: The objective of the study therefore was to determine the association between utilization of PMTCT services among HIV positive mothers with children aged 6 to 24 months and HIV status of their exposed children attending post-natal clinics in Mtwara Rural District.
Material and Methods: The study was carried out between July and August 2012. Analytical cross sectional study using structured questionnaire among 130 HIV positive mothers who had children aged between 6 to 24 months was employed. Random sampling of Health Facilities were done followed by conveniently sampling to select participants, where all HIV positive mothers (who fulfilled the inclusion criteria) who attended the clinic during the time of data collection were consecutively included in the study till the sample size reached.
Results: About 10% of children born by mothers who knew their HIV positive status before pregnancy and they were on ARV treatment were infected with HIV compared to 50% of children born by mothers who were not on ART treatment before pregnancy (χ2 =4.3, p = 0.038). Transmission rate of HIV from mother to child among mothers who received ARV‘s for PMTCT during pregnancy was 15.5% compared to 58.8% of mothers who do not received ARV‘s for PMTCT during pregnancy. Regardless of intervention, the prevalence of HIV among exposed children who had mixed feeding was 36.1% while for those who were exclusively breastfed/formula fed was 13.8% (χ2 = 8.077, p = 0.004).
Conclusions and Recommendations: Reduction of MTCT of HIV is possible with effective PMTCT interventions, including access to ARV‘s for PMTCT by mothers during pregnancy, labour, and during lactation period and also for exposed children from birth till when they stopped breastfed or proven to be HIV infected. Appropriate infant feeding practices is also crucial in reduction of MTCT. Strategies to address programmatic challenges of lower ANC attendance, low facility delivery and low post-natal care attendance in rural Tanzania which contribute to low uptake of ARV prophylaxis for PMTCT during pregnancy, labour and after delivery observed in this study are essential.
