Journal of Family Medicine and Health Care

2020; 6(3): 70-77

http://www.sciencepublishinggroup.com/j/jfmhc
doi: 10.11648/j.jfmhc.20200603.13
ISSN: 2469-8326 (Print); ISSN: 2469-8342 (Online)

HIV Sero Status and Associated Factors Among

HIV-Exposed Infants’ in Selected Health Facilities in
Sidama Zone, Southern Ethiopia
Yirgalem Yosef1, *, Bosena Tebeje2, Jophine Joseph2, Seblework Abeje3
1
Department of Midwifery, College of Health Science, Wolkite University, Wolkite, Ethiopia
2
School of Nursing and Midwifery, Faculty of Health Science, Institute of Health, Jimma University, Jimma, Ethiopia
3
Department of Biochemistry, College of Health Science, Wolkite University, Wolkite, Ethiopia

Email address:

*
Corresponding author

To cite this article:

Yirgalem Yosef, Bosena Tebeje, Jophine Joseph, Seblework Abeje. HIV Sero Status and Associated Factors Among HIV-Exposed Infants’ in
Selected Health Facilities in Sidama Zone, Southern Ethiopia. Journal of Family Medicine and Health Care. Vol. 6, No. 3, 2020, pp. 70-77.
doi: 10.11648/j.jfmhc.20200603.13

Received: January 15, 2020; Accepted: May 27, 2020; Published: June 9, 2020

Abstract: MTC transmission of HIV is a major public health challenge in Ethiopia; however there were a shortage of
evidence on HIV sero status of exposed infants in Sidama zone, Southern Ethiopia. Therefore, this study aimed to assess, the
HIV sero status and associated factors among HIV-exposed infants in selected public health facilities. A cross-sectional study
was conducted in 14 public health facilities at Sidama zone SNNPR state, Ethiopia from May 1- 30/2019Gc. Medical record
cards of HIV-exposed infants and their mothers enrolled from January 2014 to January 2018 was extracted using data
extraction checklist. Magnitude and associated factors of HIV sero status of exposed infants was computed using SPSS version
21.0 software. A total of 203 HIV-exposed infants who had HIV DNA/PCR test results were included in the study. The overall
prevalence of HIV among HIV exposed infants were nearly 9% (95% CI: 4.4, 12.8) Infants born from mothers’ with baseline
CD4+ counts of mother less than 350, (AOR=5.629; 95% CI: 1.454, 21.79), Mothers who had WHO clinical stage I and II,
(AOR=4.975; 95% CI: 1.342, 18.446), and Poor ART adherence (AOR=4.302; 95% CI: 1.100, 16.823) had an increased odds
of HIV infection comparing to their counterparts. Conclusion and recommendation: The prevalence of HIV infection among
infants born to HIV infected mothers was high in the study area. Baseline CD4+ counts, WHO clinical staging, and ART
adherences of mothers are associated with their infants HIV status. Therefore, stakeholders including health care workers
working at PMTCT centers should make create awareness on the effects of poor ART adherence and undertaking further
rigorous longitudinal studies are recommended.
Keywords: HIV Sero Status, HIV Exposed Infants, DNA/PCR Test, OPTION B+ Strategy, Ethiopia

1. Background
MTCT of HIV is transmission of human an projected 3.1 million children were living with HIV
immunodeficiency virus from HIV infected mother to worldwide and there were nearby to 500,000 children
exposed infants during pregnancy, childbirth and post-natal infected with HIV through infected mother to exposed infants
period of the pregnancy [1, 2]. HIV infected infants’ results transmission each year [4]. And also According to USAID
in lifelong chronic health problems, such as premature 2017 report, there were just about 1.4 million pregnant
morbidity and morbidity of the infants [4]. According to the women, and 1.8 million children were livelihood with
United Nations Programmer on HIV/AIDS reported that in HIV/AIDS. It is also projected that 1.8 million individuals
2016 an estimated 160,000 children were newly infected, and turn out to be newly infected, of which 180,000 will be under
71 Yirgalem Yosef et al.: HIV Sero Status and Associated Factors Among HIV-Exposed Infants’ in Selected Health
Facilities in Sidama Zone, Southern Ethiopia

15 years old children [10]. 2. Methods and Materials

The Plan in the direction of eradicating new HIV
infections among children by 2015 and provide an ultimate 2.1. Study Area and Period
care to their mothers launched in 2011, and set a sequences The study was done in public health facilities found in
of targets for 2015 to reduce new HIV infections among Sidama zone, SNNPR, in the southern part of Ethiopia from
children through 90% in 2015. The successful international May 1 to 30/2019Gc. Sidama Zone, is located in the eastern
pressure groups recommended that all pregnant and part of SNNPR covers about 6,538 km2. It is one of 15 zones
breastfeeding women to be on antiretroviral therapy, found in SNNPR, Ethiopia. In 2017 Total population of
nevertheless of CD4 T-cell count or clinical staging Sidama zone around 4.5 million and there are around 0.75
established the phase for the World Health Organization's million house hold. This zone is located between 3° 14' N
properly named “Treat All” guidelines, eradicated numerous latitude and 33° 48' E and it has 33 districts and two self-
longstanding obstacles to treat HIV/AIDS [11]. administration towns. This zone is bordered on the south by
In Ethiopia there were nearly 90,000 HIV positive the Oromia Region, except for a short stretch in the middle
pregnant women who live with HIV AIDS and a projected where it shares a border with Gedeo zone, on the west by the
14,000 HIV positive births in 2017 [12]. In similar years the Bilate River, which separates it from Wolieta zone, and on
pooled prevalence of mother to child transmission of HIV the north and east by the Oromia Region [24]. Hawassa is the
was 9.93% (3). To eradicate new HIV Infections among capital city of Sidama and SNNPR, and situated 279 km from
children, the Ethiopian MOH adopted PMTCT shift. In Addis Ababa capital city of Ethiopia. Sidama zone is the
“August 2012, the country adopted WHO Prevention of largest most populous and urbanizing zone in the SNNPR
mother to child transmission programmatic shift, option B+ state of Ethiopia. Among adults ages 15-64 years HIV
strategy. The program recommends lifelong antiretroviral prevalence in urban area of SNNPR was 1.8% [2]. Sidama
therapy (ART) for all HIV-positive women who are zone is one of the HIV/AIDS-affected regions in SNNPR
pregnant and breastfeeding, regardless of the CD4 count or state. In this zone there were total 361 HIV exposed infant
clinical staging [13]. The post-2015 HIV priorities were and from total exposed 203 infants had DNA/ PCR test
high impact interventions that radically reduce the annual results from January 2014 to January 2018Gc. This zone has
new infection and save many lives [14]. Studies conducted twelve primary hospitals, one zonal and one general public
in Ethiopia have also shown that the magnitude of HIV- hospital [30].
positive children in Ethiopia is still high [8]. Moreover,
reducing infant death due to infected mother to exposed 2.2. Study Design, Sampling Technique and Procedures
infants’ transmission of HIV has been the matter of concern
for Ethiopian Ministry of health for years. Ethiopia have Institution based cross sectional study design was used to
adopted PMTCT programmatic shift, option B+ strategy investigate HIV sero status and associated factors among
from World Health Organization (WHO) as a HIV-exposed infants using a census sampling technique.
comprehensive approach to reduce the transmission of Participants for this study were HIV-exposed infants medical
HIV/AIDS to infants during pregnancy labour and delivery registration card which had DNA / PCR tested result enrolled
and through breast feeding [13]. But, detailed information from January 2014 to January 2018Gc. Study was conducted
on rate of Mother to child transmission of HIV/AIDS after in selected health facilities which had been providing
end of follow up of exposed infant remains in short in PMTCT service. From the total health facilities found in
Ethiopia, in spite of its harmful effects on child health [15]. Sidama zone, fourteen [14] health facilities had ART clinic
Especially, the HIV sero status and the factors were not and had been providing PMTCT service linked with other
well studied in Ethiopia particularly in Sidama zone. health facilities to address services for the whole catchment
Therefore, this study was conducted to determine the HIV area. In this zone from 2014 to 2018 there were 203 HIV
sero status of infants and associated factors among HIV- positive women and exposed infants pair (mother –infant
exposed infants in selected health facilities in Sidama zone pair) who had PCR test result enrolled in PMTCT of selected
south. health facilities. The data were extracted retrospective from
The study would provide helpful information on HIV sero PMTCT log book and maternal medical registration card by
status and associated factors among exposed infant in Sidama using data extraction checklist.
zone. In addition; it may contribute to reduce infant and 2.3. Study Population and Source Population
maternal morbidity and mortality associated with HIV/AIDS.
It may also provide helpful information to modify and design All HIV-exposed infants’ medical records card having
nursing intervention for HIV exposed infants to eliminating DNA/ PCR test result and enrolled in selected health
new HIV infection among children while keeping children facilities from January 2014 to January 2018Gc used as a
living with HIV alive and well. Additionally, it may give a study population. Medical records of HIV-exposed infants
base line data for interested researchers, policy makers and and their mothers enrolled from January 2014 to January
scientific knowledge. 2018 in the study institutions were considered as a source
population.
Eligibility criteria- All HIV-exposed infants medical
 Journal of Family Medicine and Health Care 2020; 6(3): 70-77 72

registration card which had HIV PCR test result were and exported to SPSS 21 statistical package for analysis.
included while Exposed infants transfer out, lost and stopped Descriptive statistics (frequency and percentage) were used
treatment were excluded from the study. to describe sero status of exposed infants and associated
Study Variables: Dependent variable- HIV sero-status of factors. Then bivariate logistic regression analysis was done
Baby (positive/negative) and the independent variables were to see the crude association between the independent
Socio-demographic factors, Clinical characteristics of the variables and the dependent variables and the strength of
mother, Obstetrics characteristics of the mother, and clinical association were expressed the odds ratio (OR). Eventually,
Characteristics of exposed infants. results from bivariate analysis of p<0.25 were moved to
Operational definitions-Exposed infants HIV status: If the multivariate analysis and done through backward variable
DNA/PCR test result indicated positive or negative for HIV selection logistic regression methods to control the effects of
during the follow-up period of 18 months as indicated by the confounding and to identify predictors of HIV sero status of
infant registration card (15). While, HIV Positive: when the exposed infants. A P value of< 0.05 used to determine the
DNA/PCR test result for exposed infants indicated positive significance of association.
for HIV during the follow-up period of 18 months and HIV
Negative: when the DNA/PCR test result for exposed infants 3. Results
indicated negative for HIV during the follow-up period of 18
months. Magnitude of HIV among exposed infants: The finding of
this study show that among infants who had DNA/PCR test
2.4. Data Collection Instruments and Procedures results, HIV sero status positive infants were 18 (8.9%) CI:
The data were extracted from PMTCT registration log book (4.4, 12.8) and HIV sero status negative were 185 (91.1%)
through using; data extraction format adopted from the during the study period (Figure 1).
national standard HIV exposed infant follow up formats [24].
All HIV-exposed infants and their mothers who started the
Prevention of mother to child transmission service in selected
health facilities during the study period were included in the
study. HIV exposed infants and their mothers with incomplete
data because of transfer out, lost and stopped treatment were
excluded from the study. Some important variables incomplete
in registration logbook during filtration of data were counted
as missing variable. Data was collected by trained and
experienced clinical nurses and diploma midwifes who had at
least 2 years of work experience in ART clinic.

2.5. Data Quality Management

Figure 1. Magnitude of HIV among exposed infants in Sidama zone SNNPR
Data quality assurance mechanisms was carefully Ethiopia, from 2014 - 2018Gc.
developed and implemented at various stages of the study.
The quality of data may be affected at different points unless 3.1. Characteristics of Study Participants
proper measures were taken throughout the study time. For
The participants of this study were included from the 14
all study areas, three data collectors and two supervisors who
governmental hospitals found in Sidama zone SNNPR
had ability to communicate in Amharic and local language
regional state in Ethiopia. A total of 203 HIV exposed infant
were recruited after one day training about data collection
who had DNA /PCR test results and maternal Medical follow
technique. To ensure data quality, preliminary assessment
up card, were included in this study. More than half of the
was done to include all variables registered in infants
mothers 106 (52.2%) were 25 to 34 years old. One hundred
PMTCT follow up log books and maternal medical
and eighteen (58.1%) mothers resided in urban areas and the
registration card in similar health facility. At the end of the
remaining 85 (41.9%) lived in rural areas. The slightly more
day filled questionnaires were checked for completeness and
than half of HIV infected mothers, 107 (52.7%) were primary
consistency of information by the supervisor and errors were
school and 122 (60.1%) mothers were House wife.
manually edited. Any ambiguity and other problems of data
All mothers of HIV exposed infants were enrolled in
collectors were addressed. Cronbach’s alpha and collinearity
obstetric care and support service during the last pregnancy.
was checked.
Among this 164 (80.8%) women had attended ANC during
2.6. Data Processing and Analysis Procedures Pregnancy, and slightly more than half 108 (53.2%) had not
completed TT5 immunization. Related to labour and delivery
Data cleaning was performed to check for accuracy, care service, 164 (80.8%) of them were gave birth at health
consistencies of the data. The data collection was undertaken facility, majority of women 198 (97.5%) had gave birth
under rigorous daily checking to identify and correct errors. through spontaneous vaginal delivery (SVD), and 161
The investigator entered the data using Epi Data version 3.1 (79.3%) had gave birth at term for last pregnancy.
73 Yirgalem Yosef et al.: HIV Sero Status and Associated Factors Among HIV-Exposed Infants’ in Selected Health
Facilities in Sidama Zone, Southern Ethiopia

All HIV exposed infants who had DNA/PCR test results mother, Baseline CD4 count of mother, ART adherence,
were enrolled in PMTCT of HIV care and support service mother attend ANC during Pregnancy, Place of delivery,
during the follow -up period included in the study. From the infant’s age at diagnosis, infants received Vitamin A, infants
study participants majority 162 (79.8%) of HIV-exposed received NVP at birth, infant feeding practice before six
infants were enrolled into HIV care within six weeks of life. months have shown a significant association with HIV sero
And also, 150 (73.9%) of the infants were given ARV status of baby in the bivariate analysis at P-value <0.25. After
prophylaxis to prevent MTCT of HIV at birth. Most of HIV- adjusting for common confounders, in the multivariate
exposed infants received co-trimoxazole preventive therapy analysis, baseline CD4+ count of mother were less than 350,
(CPT), and 162 (79.8%) of infants started CPT at six weeks maternal WHO clinical stage I and II, Poor ART adherence
of being born. Regarding to infant feeding practice, 163 and infants who didn’t receive Vitamin A had significant
(80.3%) infants were exclusive breastfed before six months. association to HIV sero status of infant at P-value of < 0.05.
Regarding to EPI (expanded programs of immunization) all Mothers whose baseline CD4 count less than 350 were 6
HIV exposed infant were immunized. The majority of this times (AOR=5.629; 95% CI: 1.454, 21.79) more likely to
149 (73.4%) Infants were received Vitamin A. In this study transmit HIV when compared with those with CD4 count
all of HIV exposed infants mothers were enrolled in HIV greater than 350. Regarding to maternal WHO clinical
care and support service during the last pregnancy. Out of staging, mothers who had WHO clinical stage I and II were
these, 203 (100%) of them were taking highly active 80% (AOR=0.201; 95% CI: 0.054, 0.745) less likely transmit
treatment, 146 (71.9%) of were known HIV status before HIV compared with those who had stage III and IV.
PMTCT program Entry, 117 (57.6%) baseline CD4 count According to ART adherence, mothers Poor adherence to
were 350 and above, 134 (66.0%) WHO clinical stages were ART were 4 times (AOR=4.302; 95% CI: 1.100, 16.823)
Stage 3 and four during last pregnancy (Table 1). more likely to HIV compared with those who had good ART
adherence. Infants not receiving Vitamin A at nine months
3.2 Factors Associated with MTCT of HIV Among Exposed were seven times (AOR=7.184; 95% CI: 1.795, 28.759) more
Infants likely to have MTCT of HIV compared with Infants received
HIV disclosure status of mother, HIV Clinical stage of Vitamin A at nine month of life. (Table 2)
Table 1. Socio demographic and clinical characteristics of HIV exposed infants and mothers in Sidama zone, SNNPR state, southern Ethiopia 2014-2018.

Variables Frequency Percentage

15-24yr 46 22.7%
Age of Mother 25-34 106 52.2%
35-44 51 25.1%
Urban 118 58.1%
Residence of Mother
Rural 85 41.9%
Illiterate 54 26.6%
Primary 107 52.7%
Educational status of the Mother
Secondary 37 18.2%
College and above 5 2.5%
Farmer 12 5.9%
Merchant 59 29.1%
Occupation of Mother
Government worker 10 4.9%
House wife 122 60.1%
Orthodox 63 31.0%
Muslim 84 41.4
Religion of mothers
Protestant 35 17.2
Catholic 21 10.3
Single 16 7.9
Married 178 87.7
Marital status of Mother
Divorced 5 2.5%
Windowed 4 2%

Variables Frequency Percentage

Obstetrics/ Reproductive Health history
Mother attended ANC during Pregnancy
Yes 164 80.8%
No 39 19.2%
Place of delivery
Health facility 146 71.9%
Home delivery 57 28.1%
Mode of delivery
SVD 198 97.5%
C/S 5 2.5%
Give birth at term pregnancy
 Journal of Family Medicine and Health Care 2020; 6(3): 70-77 74

Variables Frequency Percentage

Yes 161 79.3%
No 42 20.7%
TT vaccination
Complete (TT5) 95 46.8%
Not complete 108 53.2%

Variables Frequency Percentage

HIV and ART related History
Variables Category No. %
At 6 weeks 162 79.8%
Infant’s age at diagnosis for HIV
After 6 weeks 41 20.2
Yes 150 73.9%
Infants received NVP at birth
No 53 26.1%
Yes 162 79.8%
Infant received CPT at 6 weeks
No 41 20.2%
EBF 163 80.3%
Feeding practice before six months
Mixed feeding 40 19.7%
Yes 149 73.4%
Infants received Vitamin A
No 46 22.7%
Positive 18 8. 86%
DBS (DNA/PCR) test result
Negative 185 91.13%
Yes 128 63.1%
Mother were on ART during labour
No 75 36.9%
Yes 146 71.9%
HIV disclosure status of mother
No 57 28.1%
During ANC 75 36.9%
Entry to PMTCT During labour 64 31.5%
During PNC 64 31.5%
Less than 350 86 42.4%
Baseline CD4 count of mother
350 and above 117 57.6%
Stage 1 and 2 69 34.0%
Maternal WHO clinical stage
Stage 3 and four 134 66.0%
HAART 203 100%
PMTCT intervention
None
> 4 weeks 46 22.7%
Duration of mother on ART treatment
≤4 weeks 157 77.3%
Good 180 88.7%
ART adherence
Poor 23 11.3%

Table 2. Factors associated with HIV status among infants born to HIV positive mothers, in selected health facility of Sidama zones northern Ethiopia 2014 to
January 2018Gc.

DBS PCR/DNA Result

Variables COR (95% CI) P-Value AOR (95% CI) P-Value
Negative Positive
HIV disclosure status of mother
Yes (Ref) 137 (93.8%) 9 (6.2%)
No 48 (84.2%) 9 (15.8%) 2.85 (1.07, 7.61) 0.036
HIV Clinical stage of mother
WHO stage I and II (Ref) 59 (85.5%) 10 (14.5%) 0.37 (.141, 0.998) 0.050 0.2 (0.054, 0.75) 0.016*
WHO stage III and IV 126 (94.0%) 8 (6.0%)
Baseline CD4 count of mother
Less than 350 74 (86.0%) 12 (14.0%) 3.0 (1.07, 8.346) 0.035 5.63 (1.45, 21.79) 0.012*
350 and above (Ref) 111 (94.9%) 6 (5.1%)
ART adherence
Good (Ref) 168 (93.3%) 12 (6.7%)
Poor 17 (73.9%) 6 (26.1%) 4.94 (1.65, 14.84) 0.004 4.3 (1.10, 16.82) 0.036*
Mother attend ANC during Pregnancy
Yes (Ref) 153 (93.3%) 11 (6.7%)
No 32 (82.1%) 7 (17.9%) 3.043 (1.1, 8.45) 0.033
Place of delivery
Health facility (Ref) 153 (93.3%) 11 (6.7%)
Home delivery 32 (82.1%) 7 (17.9%) 3.04 (1.1, 8.45) 0.033
Infant’s age at diagnosis
At 6 weeks 43 (81.1%) 10 (18.9%) 4.128 (1.5, 11.1) 0.005
After 6 weeks (Ref) 142 (94.7%) 8 (5.3%)
Infants received Vitamin A
Yes (Ref) 140 (94.0%) 9 (6.0%)
75 Yirgalem Yosef et al.: HIV Sero Status and Associated Factors Among HIV-Exposed Infants’ in Selected Health
Facilities in Sidama Zone, Southern Ethiopia

DBS PCR/DNA Result

Variables COR (95% CI) P-Value AOR (95% CI) P-Value
Negative Positive
No 38 (82.6%) 8 (17.4%) 3.28 (1.18, 9.06) 0.022 7.18 (1.79, 28.8) 0.005**
Infants received NVP at birth
Yes (Ref) 151 (93.2%) 11 (6.8%)
No 34 (82.9%) 7 (17.1%) 2.83 (1.02, 7.8) 0.045 3.43 (0.96, 12.26) 0.058
Infant feeding practice before six months
EBF (Ref) 152 (93.3%) 11 (6.7%)
Mixed feeding 33 (82.5%) 7 (17.5%) 2.93 (1.057, 8.13) 0.039 3.3 (0.85, 12.8) 0.083

Zimbabwe which showed that maternal CD4 count less than

4. Discussion 200 were more likely affect MTCT of HIV than counterpart
(AOR=7.1; 95% CI: 2.6-17) [19]. Our study also illustrated
Prevention of Mother to child transmission of HIV needs that mothers who had WHO clinical stages I and II were 80%
early HIV diagnosis and timely preventive management. (AOR=0.201; 95% CI: 0.054, 0.745) less likely to be MTCT
Polymerase chain reaction (PCR)-based HIV DNA and HIV of HIV compared with clinical stages III and IV. This reflects
RNA assays have become the most widely used, even in that mother having clinical stages I and II have minimum
resource-limited settings, for both diagnostic and monitoring chance of MTCT of HIV. In the same line, a study conducted
purposes [31]. This study was conducted to find out the at northwest Ethiopia showed those in clinical stages I and II
magnitude of HIV status and associated factors among HIV- were four (AOR=4.4 (CI: 1.5, 12) times more likely to
Exposed Infants’ in Sidama zone, SNNPR state, southern prevent mother to child transmission of HIV compared with
Ethiopia. clinical stages III and IV [33]. Our study also demonstrated
In this study, the prevalence of HIV infections among that poor ART adherence during last pregnancy four
exposed infants was 18 (8.9%) 95% CI: [4.4-12.8]. This (AOR=4.302; 95% CI: 1.100, 16.823) times more likely
reflects that the morbidity and mortality of the children is high affect MTCT of HIV compared to good ART adherence. This
due to this diseases condition. If appropriate preventive may indicate that there were significant numbers of women
measures are not taking place, the risk of HIV among exposed who might loss four and more doses within 60 days which
infants might be ranked as tope five of infants’ mortality. This could lead to poor ART adherence. This was incomparable
finding was slightly higher than compared to the global target with the study conducted in other area [23, 26]. The
in 2015, which was 5% among breastfeeding women [7] and inconsistency might be due to the difference in the study
also to be study conducted in East and West Gojjam Zones, area, study design, and health seeking behavior of the
Northwest Ethiopia shows that the prevalence of MTCT of mothers. Numerous risk factors examined are strength of this
HIV was 5.9% (3.9–7.9), [32] and the study conducted in study. Since the data was secondary, the information gathered
Oromia Regional State 7.70% [23]. The possible explanation was not complete in some infant’s logbook and mother’s
for this difference might be the difference in study design medical registration card are limitations.
which most of them used cohort study design, sample size and
study area. In addition to this, the gap might be due to the 5. Conclusion
difference in the health care seeking behavior of infected
mothers which in turn increases the recognition and prevention The prevalence of mother to child transmission of HIV
of MTCT. Despite the fact that the current health policy of was 18 (8.9%). ART poor adherence, clinical stages I and II
Ethiopia focused on the implementation of option B+ and free and low maternal CD4+ counts were factors associated with
PMTCT service for infected mother and exposed infants; the MTCT of HIV among exposed infants. Therefore, relevant
prevalence of MTCT of HIV in our study is higher than the stakeholders should make efforts to reduce the magnitude of
2015 global target but lower than the systematic review and MTCT of HIV through strengthening the prevention of
meta-analysis study conducted in Ethiopia (9.93%; 95% CI, mother-to-child transmission (PMTCT) of HIV, and health
7.29, 12.56) [3]. This gap might be due to the differences in education for infected mother on the importance of ART
the study period, sample size, geographical difference of the adherence and undertaking further study are recommended.
study areas and health seeking behavior of the HIV infected
mothers. List of Abbreviation / Acronym
This study also revealed that factors associated with
MTCT of HIV are: baseline CD4 count, WHO clinical stage AIDS: Acquired immune deficiency virus
of mother, ART adherence, and received Vitamin A. Mothers ART: Ant retro viral therapy
baseline CD4+ count less than 350 were six (AOR=5.629; CD4+: Cluster of differentiation four plus
95% CI: 1.454, 21.79) times more likely to have an increased HIV: Human immunodeficiency virus
MTCT of HIV compared to those of Baseline CD4+ count IRV: Institutional review board
greater than or equal to 350. This reflects that having CD4+ JU: Jimma University
count less than 350 increases the likelihood of MTCT of MTCT: Mother to child transmission o
HIV. This finding was in line with the study conducted at PMTCT: Prevention mother to child transmission
 Journal of Family Medicine and Health Care 2020; 6(3): 70-77 76

PCR: Polymerase chain reaction 2030: 5 Strategies to Ensure Continued Progress.

SVD: Spontaneous vaginal delivery [12] Deressa W, Seme A, Asefa A, Teshome G, Enqusellassie F.
UNSAID: Unitized state aid for international development Utilization of PMTCT services and associated factors
WHO: World health organization among pregnant women attending antenatal clinics in
SNNPR: South nation nationality and people region Addis Ababa, Ethiopia. BMC Pregnancy Childbirth. 2014;
14 (14): 328.
[13] FMOH. National aids and sti’s control programme federal
Ethics Approval and Consent to ministry of health 2016.
Participate
[14] EDHS. Demographic and Health Survey HIV Prevalence
Ethical clearance for the study was obtained from the Jimma Report. 2016.
university, institutional review board (IRB) of Jimma University [15] FDRE. Federal Democratic Republic of Ethiopia | Ministry of
Ethical Review Board (Nu85/8050/2018Gc). The permission Health for comprehensive hiv prevention, care and treatment
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YY, BT, JJ and SA, contributed to the planning and
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C, et al. Mother-to-child transmission of HIV in Kenya: A
data collection. YY, BT, JJ and SA were involved in the data cross-sectional analysis of the national database over nine
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manuscript with significant contributions from all authors.
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