{"title":"Evaluating the implementation of prevention of mother-to-child transmission of HIV in Mwanza district hospital, Malawi.","authors":"John Bester Kalumbi","doi":"10.2989/16085906.2025.2524032","DOIUrl":null,"url":null,"abstract":"<p><p><i>Introduction:</i> 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.<i>Methodology:</i> 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.<i>Results:</i> 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%; <i>χ</i><sup>2</sup> = 9.6521, <i>p</i> = 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.<i>Conclusion:</i> 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.</p>","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":" ","pages":"37-43"},"PeriodicalIF":1.1000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ajar-African Journal of Aids Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2989/16085906.2025.2524032","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/5 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
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.
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.