BARRIERS TO EARLY INFANT DIAGNOSIS OF HIV IN THE WA MUNICIPAL AND LAWRA DISTRICT OF THE UPPER WEST REGION OF GHANA

ABSTRACT

Introduction

About 90% of HIV new infections among infant and children younger than 14 years are due to mother-to-child transmission. More than half of these children die before their second birthday in the absence of treatment. However, mortality among HIV positive infants can be reduced by over 70% if treatment is initiated within the first three months after birth. Though Ghana has well established Prevention of Mother to Child/Early infant diagnosis (PMTCT/EID) service, over 80 % of HIV Exposed Infants (HEIs) are not tested by DNA PCR at 4 to 6 Weeks as recommended by WHO. The consequence of this is that thousands of HEIs are left undiagnosed and the NACPs (National AIDS control Program) goal of eliminating new infections among infant or reducing HIV related child deaths by 50% by 2015 does not appear to be likely. This study seeks to identify the socio-demographic, health system and psychosocial factors influencing the decision of HIV positive mothers to test their infants for early infant diagnosis by DBS-PCR (Dry Blood Spot DNA polymerase chain reaction)

Methods

A case control study was conducted at ART centers in the Lawra district and Wa Municipal between December 2014 and June 2015 to determine significant barriers to early infant diagnosis of HIV at one ART center in Wa and one in Lawra in the upper west region of Ghana. Early infant diagnosis registers and ANC/PMTCT records were reviewed to obtain a list of HIV positive mothers attending ART. The list of mothers who tested their infants (controls) and those who did not (cases) between January 2011 and December 2014 were then extracted. Data was collected with a checklist and questionnaire, entered into Epi info, cleaned, and exported to Stata 13 for analysis.

Results

One hundred and ninety two HIV positive Mother-infants-pairs including 96 cases and 96 controls were interviewed. Maternal age ranged between 20 -45 years with a median age of 29 years while infant ages ranged from 3 weeks to 205 week. Median age of infant at testing was 10weeks IQR 6-26 weeks and median turn- around-time of DNA-PCR result was 11 weeks IQR 4-27 Weeks. Factors that were significantly associated with follow up for EID were: lack of maternal independent income source with Adjusted Odds Ratio (AOR), 0.4 (95% CI 0.2-0.8) maternal formal education AOR 0.5 (95% CI 0.2-0.9), accessing testing information after delivery (AOR, 18.6 95% CI 1.7-202.5). Mother-to-child-transmission-rate was 2.3 % and 62.4% of infants were not tested due to stock-outs of reagents. Receiving PMTCT intervention reduced the odds of becoming a case. Infants who received only six week AZT were about 14 times more likely to become cases compared to those who received all PMTCT interventions.(AOR=14.6 95% CI 1.1-186.4). Infants of mothers who heard of infant testing after delivery were 18 times likely to become cases compared to infants of mother who heard of testing during pregnancy,(AOR=18.6 ,95% CI 1.7-202.5).

Conclusion

Lack of maternal-independent-income, poor timing of EID information, and stock outs of Laboratory reagents are major barriers to early infant diagnosis. Women who are educated, employed or trading were most likely to test their infants. Efforts towards EID coverage improvement must focus on decentralizing and strengthening laboratory test as well as empowering mothers.

Key Words: Barriers, HIV, early infant diagnosis, DNA-PCR, Ghana.

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APA

NUOH, R (2021). BARRIERS TO EARLY INFANT DIAGNOSIS OF HIV IN THE WA MUNICIPAL AND LAWRA DISTRICT OF THE UPPER WEST REGION OF GHANA. Afribary. Retrieved from https://afribary.com/works/barriers-to-early-infant-diagnosis-of-hiv-in-the-wa-municipal-and-lawra-district-of-the-upper-west-region-of-ghana

MLA 8th

NUOH, ROBERT "BARRIERS TO EARLY INFANT DIAGNOSIS OF HIV IN THE WA MUNICIPAL AND LAWRA DISTRICT OF THE UPPER WEST REGION OF GHANA" Afribary. Afribary, 16 Mar. 2021, https://afribary.com/works/barriers-to-early-infant-diagnosis-of-hiv-in-the-wa-municipal-and-lawra-district-of-the-upper-west-region-of-ghana. Accessed 23 May. 2024.

MLA7

NUOH, ROBERT . "BARRIERS TO EARLY INFANT DIAGNOSIS OF HIV IN THE WA MUNICIPAL AND LAWRA DISTRICT OF THE UPPER WEST REGION OF GHANA". Afribary, Afribary, 16 Mar. 2021. Web. 23 May. 2024. < https://afribary.com/works/barriers-to-early-infant-diagnosis-of-hiv-in-the-wa-municipal-and-lawra-district-of-the-upper-west-region-of-ghana >.

Chicago

NUOH, ROBERT . "BARRIERS TO EARLY INFANT DIAGNOSIS OF HIV IN THE WA MUNICIPAL AND LAWRA DISTRICT OF THE UPPER WEST REGION OF GHANA" Afribary (2021). Accessed May 23, 2024. https://afribary.com/works/barriers-to-early-infant-diagnosis-of-hiv-in-the-wa-municipal-and-lawra-district-of-the-upper-west-region-of-ghana