Reducing Mother-to-Child Transmission of Human Immunodeficiency Virus (HIV): Findings from an early Infant Diagnosis Program in Benue State, North Central Nigeria

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DOI: 10.21522/TIJPH.2013.07.01.Art015

Authors : Plang Jwanle, Ademola Amosu, Franklin Emerenini


Introduction: A critical opportunity to strengthen follow-up of HIV-exposed children and assure early access to ARV treatment for infected children is provided by early infant diagnosis of HIV. This study describes findings from an EID program and the effectiveness of PMTCT intervention in Benue State, Nigeria.

Methods: This was a retrospective study. The study population comprised all perinatally HIV exposed children aged six weeks to 18 months who had Dried Blood Spot (DBS) samples taken for a DNA PCR test between January - December 2017 were enrolled for this study. Details of the ARV regimen received to prevent mother-to-child transmission (MTCT), infant feeding, HIV DNA PCR test results and turnaround time (TAT) for results were analyzed using SPSS version 20.

Results 85.9% of mother-baby pairs received ARVs and 98.4% babies had ever been breastfed. Transmission rates for mother-baby pairs who received ARVs for PMTCT was 1.5% compared to 33% when neither baby nor mother received an intervention. Overall the prevalence of transmission in this study is 3.9% irrespective of intervention. The mean and median turnaround time for test results were 69 days (95% CI: 67.89-70.12) and 56 days respectively

Conclusions. Reduction of MTCT of HIV is possible with effective PMTCT intervention, including improved access to ARVs and appropriate infant feeding practices. The PMTCT programme in Benue State was found to be effective and achieved outcomes comparable to similar setting. Triple combination ARV drugs is feasible and resulted in low MTCT rates under routine clinic conditions in resource-limited setting.

Keywords: mother-to-child transmission of HIV, early infant diagnosis, breastfeeding, vertical transmission.


[1].     Adetokunboh OO, Oluwasanu M. (2016) Eliminating mother-tochild transmission of the human immunodeficiency virus in sub-Saharan Africa: The journey so far and what remains to be done. Journal of Infection and Public Health. 2016; 9(4):396–407.

[2].     Anoje C, Aiyenigba B, Suzuki C, Badru T, Akpoigbe K, Odo M, et al. (2012) Reducing mother-to-child transmission of HIV: findings from an early infant diagnosis program in southsouth region of Nigeria. BMC Public Health. 2012; 12:184.

[3].     FMoH (2015) National HIV Sero-prevalence Sentinel Survey among Pregnant Women Attending Antenatal Clinics in Nigeria.

[4].     Hill A, Dauncey T, Levi J, Heath K, Pérez Casas C. (2015) Higher risks of mother-to-child HIV transmission in countries with lower HIV prevalence: UNAIDS 2013 results for 32 countries with generalised epidemics. Journal of Virus Eradication. 2015; 1(4):257–63. PMid:27482423 PMCid: PMC4946657.

[5].     Ibobo JA, Nwose EU, Chime H. (2017) Reducing the mother-tochild transmission of HIV: findings from an early infant diagnosis program in Delta state Nigeria. Int J Community Med Public Health. 2017; 4(12):4352–7.

[6].     Kahungu MM, Kiwanuka J, Kaharuza F, Wanyenze RK. (2018) Factors associated with HIV positive sero-status among exposed infants attending care at health facilities: a cross sectional study in rural Uganda. BMC Public Health. 2018;

[7].     Kalua T, Barr BA, Oosterhout JJ, Mbori-Ngacha D, Schouten EJ, Gupta S, … Jahn A. (2017) Lessons Learned from Option B+ in the Evolution Toward “Test and Start” From Malawi, Cameroon, and the United Republic of Tanzania (online) (Accessed 5 January,2019).

[8].     Kebede B, Gebeyehu A, Jain S, Sun S, and Haubrich R,(2014) “Delay in Early Infant Diagnosis and High Loss to Follow-Up among Infant Born to HIV-Infected Women in Ethiopia,” World Journal of AIDS, vol. 04, no. 04, pp. 402–412, 2014.(online) (Accessed 2 January 2019).

[9].     Martin F, Palladino C. (2017) Early infant diagnosis of HIV-1 infection in Luanda, Angola, using a new DNA PCR assay and dried blood spots. 2017; 12(7): e0181352.

[10]. Mateus R, Bolzan A, Gomes P, Brito J, Carvalho AP, Cardoso Y, et al. (2014) Cost-effectiveness of early infant HIV diagnosis of HIV-exposed infants and immediate antiretroviral therapy in HIV-infected children under 24 months in Thailand.PLoS One. 2014; 9(3): e91004.

[11]. Motswere-Chirwa C, Voetsch A, Lu L, Letsholathebe V, Lekone P, Machakaire E, et al. (2014) Follow-up of infants diagnosed with HIV- Early Infant Diagnosis Program, Francistown, Botswana, 2005-2012. MMWR Morbidity and Mortality Weekly Report. 2014; 63(7):158–60. Mid:24553200 PMCid: PMC4584761.

[12]. Noubiap JJ, Bongoe A, Demanou SA. (2013 Mother-to-child transmission of HIV: Findings from an early infant diagnosis program in Bertoua, Eastern Cameroon. The Pan African Medical Journal. 2013; 15:65.

[13]. Pharr JR, Obiefune MC, Ezeanolue CO, Osuji A, Ogidi, AG. Gbadamosi S… Ezeanolue EE (2016) Linkage to Care, Early Infant Diagnosis, and Perinatal Transmission among Infants Born to HIV-Infected Nigerian Mothers: Evidence from the Healthy Beginning Initiative. August 1, 2016 - Volume 72 - Issue > Linkage to Care, Early Infant Diagnosis, and Perinatal Trans...

[14]. Piot P, Bartos M, Larson H, Zewdie D, Mane P. (2008) Coming to terms with complexity: A call to action for HIV prevention. The Lancet. 2008; 372(9641):845–59.

[15]. Rupali P, Condon R, Roberts S, Wilkinson L, Voss L, Thomas M. (2007) Prevention of mother to child transmission of HIV infection in Pacific countries. Internal Med J. 2007; 37(4):216–23.

[16]. Stringer JS, Sinkala M, Maclean CC, Levy J, Kankasa C, Degroot A, et al. (2005) Effectiveness of a city-wide program to prevent mother-to-child HIV transmission in Lusaka, Zambia. AIDS. 2005; 19(12):1309–15.

[17]. Stringer, J. (2009) PMTCT Effectiveness in Africa: Research and Linkages to Care and Treatment (online)

[18]. Stringer EM, Ekouevi DK, Coetzee D, Tih PM, Greek TL, Stinson K… Stringer JS (2010) Coverage of Nevirapine-Based Services to Prevent Mother-to-Child HIV Transmission in 4 African Countries JAMA. 2010; 304(3):293-302. doi:10.1001/jama.2010.990. (online) (Accessed 4 January, 2018).

[19]. Torpey K, Kasonde P, Kabaso M, Weaver MA, Bryan-Mofya G, Mukonka V, … Colebunders R (2010) “Reducing pediatric HIV infection: Estimating mother-to-child transmission rates in a program setting in Zambia.” Journal of Acquired Immune Deficiency Syndromes.54 (4):415-422.

[20]. UNAIDS (2011). Countdown to zero - global plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive; 2011.

[21]. UNAIDS (2018). Miles to go: Global AIDS update. UNAIDS;2018.

[22]. Wettstein C, Mugglin C, Egger M, Blaser N, Salazar L, Estill J, … Keiser O (2012) Missed Opportunities to Prevent Mother-to-Child-Transmission in sub-Saharan Africa: Systematic Review and Meta-Analysis. AIDS. 2012 Nov 28; 26(18): 2361–2373. (online) (Accessed 2 January 2019).

[23]. WHO, UNICEF, UNAIDS, UNFPA. (2004) HIV transmission through breastfeeding: a review of available evidence. 2004. Geneva: World Health Organization; 2004.

[24]. WHO (2016). Mother-to-child transmission of HIV.

[25]. WHO (2016b). Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach: 2nd Edition.