Evaluating the implementation of prevention of mother-to-child transmission of HIV in Mwanza district hospital, Malawi.

IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Ajar-African Journal of Aids Research Pub Date : 2025-09-01 Epub Date: 2025-08-05 DOI:10.2989/16085906.2025.2524032
John Bester Kalumbi
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引用次数: 0

Abstract

Introduction: Globally, mother-to-child transmission (MTCT) of HIV significantly contributes to paediatric HIV infections. Effective prevention of mother-to-child transmission (PMTCT) programs aim to achieve the World Health Organization's target of less than 5% transmission rates. This study evaluated the implementation of PMTCT services in Mwanza district, Malawi, focusing on antiretroviral therapy (ART) adherence and key implementation challenges.Methodology: This was a retrospective study which analysed data from HIV-positive pregnant women and exposed infants enrolled in the PMTCT program (June 2020-June 2022). Logistic regression and bivariate analyses assessed factors influencing MTCT rates. Further, qualitative data from structured interviews with health workers identified implementation barriers.Results: The MTCT rate in Mwanza was 1.7%, below Malawi's national average of 6%. ART defaulting significantly raised MTCT risk (5.56%) versus consistent adherence (0.6%; χ2 = 9.6521, p = 0.002). Logistic regression indicated mothers defaulting ART had nine-fold greater odds of MTCT (OR = 9.134, 95% CI: 1.72-48.43). Key challenges included loss to follow-up, shortage of resources, insufficient healthcare worker training, and other socioeconomic factors affecting adherence.Conclusion: Improving ART adherence and addressing socioeconomic and systemic barriers are crucial to reducing MTCT. Enhanced training, adequate resource allocation, and most importantly, targeted adherence interventions are recommended to strengthen PMTCT program effectiveness in Malawi.

评估马拉维姆万扎地区医院预防艾滋病毒母婴传播的执行情况。
导言:在全球范围内,艾滋病毒的母婴传播(MTCT)在很大程度上导致了儿科艾滋病毒感染。有效预防母婴传播(PMTCT)规划旨在实现世界卫生组织将传播率控制在5%以下的目标。本研究评估了马拉维Mwanza地区预防母婴传播服务的实施情况,重点关注抗逆转录病毒治疗(ART)的依从性和主要实施挑战。方法:这是一项回顾性研究,分析了参加预防母婴传播项目(2020年6月至2022年6月)的艾滋病毒阳性孕妇和暴露婴儿的数据。Logistic回归和双变量分析评估了影响MTCT率的因素。此外,从与卫生工作者的结构化访谈中获得的定性数据确定了实施障碍。结果:姆万扎的MTCT感染率为1.7%,低于马拉维6%的全国平均水平。ART违约显著增加MTCT风险(5.56%),而一贯坚持(0.6%);χ2 = 9.6521, p = 0.002)。Logistic回归显示,母亲拖欠抗逆转录病毒治疗的MTCT几率高出9倍(OR = 9.134, 95% CI: 1.72-48.43)。主要挑战包括随访失败、资源短缺、医护人员培训不足以及影响依从性的其他社会经济因素。结论:提高抗逆转录病毒治疗依从性和解决社会经济和系统障碍对减少MTCT至关重要。建议加强培训,充分分配资源,最重要的是,采取有针对性的坚持干预措施,以加强马拉维预防母婴传播方案的有效性。
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来源期刊
Ajar-African Journal of Aids Research
Ajar-African Journal of Aids Research 医学-公共卫生、环境卫生与职业卫生
CiteScore
1.80
自引率
8.30%
发文量
38
审稿时长
>12 weeks
期刊介绍: African Journal of AIDS Research (AJAR) is a peer-reviewed research journal publishing papers that make an original contribution to the understanding of social dimensions of HIV/AIDS in African contexts. AJAR includes articles from, amongst others, the disciplines of sociology, demography, epidemiology, social geography, economics, psychology, anthropology, philosophy, health communication, media, cultural studies, public health, education, nursing science and social work. Papers relating to impact, care, prevention and social planning, as well as articles covering social theory and the history and politics of HIV/AIDS, will be considered for publication.
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