Mother-to-Child HIV Transmission Rate at Ban Dung Crown Prince Hospital Udon Thani Province from 2007-2019

Abstract

Objectives: The aimed of this study was to observe Mother-to-Child HIV Transmission Rate at Ban Dung Crown Prince Hospital, Udon Thani Province, as well as making in-depth analysis seeking key factors preventing Mother-to-Child HIV transmission. The research was conducted as retrospective descriptive study by gathering data from medical records of all 75 HIV infected pregnant women and all infants born to HIV mother who had engaged medical services at Ban Dung Crown Prince Hospital, Udon Thani Province, from October 1, 2007 to September 30, 2019 as well as analyzing data with descriptive statistics and in-depth analysis.

            Results: The study found that, over a 12-year period, of a total of 11,315 pregnant women, 100% were tested for HIV in the first test, and 99.99% of all pregnant women were tested for HIV in the second test. Found 75 HIV-infected mothers (0.7%), age 21 to 35 years was 65.3%, mothers who had five quality ANC full-term pregnancies, was 26.2%, and the gestational age at full term was 68.0%. Regarding methods of delivery, 96.0% was normal delivery, 37.3 % HIV infected before pregnant, 60% was gestational HIV infection, and 2.7% was unknown, non-antenatal mothers with concealed HIV test results. Eighty-eight percent accessed and received the antiretroviral treatment more than 4 weeks before delivery, 6.6% received less than 4 weeks, 2.7% received less than 12 weeks (since 2017), and 2.7% did not receive the treatment. The most frequent maternal regimen was the combination regimen where 33.33% of the mothers received, followed by AZT3TC+LPN / r, 29.3% of the mothers and 2.7% of the mothers       received no medication. Accessed and received the antiretroviral treatment in antenatal care, 88.0% continued. Of the 75 infants born to HIV-infected mothers, 54.7% were female and 45.3% were male. The infants had an average birth weight of 2768 g. 96.0% consistently received only powdered milk and 4.0% received both powdered milk and breast milk. The infants received the PCR HIV blood test. Two cases (2.7%) of 74 cases (98.7%) from the first test was tested positive. Seventy-one from 74 cases    performed (95.9%) the second test; did not find a positive result. One cases from 8 cases (12.5%) of (88.9%) from the third test (9 cases high risk only) was tested positive. Sixty-six cases (90.4%) infants had tested for antibodies with tested positive for 1.5%. The majority of infant medicine were liquid AZT at 88.0%, 10.7% received AZT+NVP+3TC for 6 weeks, and 1.3% did not receive the treatment. The results of the diagnosis of HIV-infected infants showed that 96% were definitely not infected, 2.7% were likely to be infected, and 1.3% were HIV-positive.

            Summary of the study: The rate of maternal-to-child HIV infection in Ban Dung Crown Prince Hospital. Udon Thani Province 2007-2019 accounted for 4.0%, the mortality rate of infants with HIV from mother to infant was 2.7%. Mothers had delayed access to treatment due to concealment and intermittent    medication intake. This results in the transmission of HIV from mother to baby.