Journal of Health Care and Research [ISSN: 2582-8967]
Article Type: Original Article
J Health Care and Research. 2023 Aug 04;4(2):71-80
Corresponding Author: Mazaher Hassan Jaffer ORCID iD
Address: Associate professor, Department of clinical medicine, Mount Kenya University, P.O. Box 31117-00600, Nairobi, Kenya.
Received date: 10 July 2023; Accepted date: 28 July 2023; Published date: 04 August 2023
Citation: Jaffer MH, Kingwara L. A Case Control Study to Assess Factors Associated with HIV Mother to Child Transmission in Kenya. J Health Care and Research. 2023 Aug 04;4(2):71-80.
Copyright © 2023 Jaffer MH, Kingwara L. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium provided the original work is properly cited.
Keywords: HIV, Highly Active Antiretroviral Treatment, Mother-to-Child Transmission, HIV Exposed Infant, Prevention of mother-to-child transmission, Viral Discordance
Abbreviations: HAART: Highly Active Antiretroviral Treatment; MTCT: Mother-to-Child Transmission; EMTCT: Elimination of MTCT; HEI: HIV Exposed Infant; PMTCT: Prevention of Mother-to-Child Transmission
Background: With the proposal that people with undetectable serum viral loads of HIV cannot transmit, there is a large gap, either due to viral discordance or transcytosis, that would be explaining the persistent 4 to 7 percent vertical transmission of HIV to infants by Kenyan mothers.
Therefore, we looked for factors that predispose mothers with HIV to transmit the disease to their children so that policy can be generated for their screening to be conducted if they fit the specified criteria that identifies them as a high-risk group.
Methods: Through access to the National Database providing HIV treatment services country wide, we looked for the presence of the available factors from MTCT cases and assessed their association with increased risk of vertical transmission. The factors assessed were mother’s blood plasma viral load (BPVL), geographic location of the mother and child (associated with specific higher and lower socioeconomic status), gender of the baby being born, time age after birth with confirmation of Mother to Child Transmission (MTCT), method of feeding chosen by mothers, age of the mothers, and the regimen of Highly Active Anti Retro Viral treatment (HAART) that the mother and child had been given.
Results: Mixed breast feeding posed a much higher risk, mothers of a younger age posed a higher risk, residents of some areas were at higher risks, of note the town of Lamu in Kenya. The at birth stat administration of Niverapin with Zidovudin (NVP+AZT) to the baby was very effective against the transmission, in comparison to any of the other interventions, and having an UD BPVL led to a six-fold reduction the risk of MTCT.
Conclusion: There are factors that are associated with a higher risk of vertical transmission from pregnant and lactating UD BPVL mothers which warrant implementation of more stringent policy in their case to achieve Elimination of MTCT(EMTCT) in Kenya. Other factors that were not in the available records and the ones found to have an impact need to be investigated with more accuracy through a prospective study.