Determinants of Mother to Child Transmission of HIV in Matobo District, Matabeleland South, Zimbabwe

Abstract

Vertical transmission of HIV through mother to child remains a significant public health concern, particularly in regions like Matabeleland South. Vertical transmission of HIV through MTCT ranks the second most common means of HIV transmission. Matobo district, like many other regions in Zimbabwe, continues to grapple with high MTCT rates, recording an average of 3-4 cases of infant infections through MTCT every quarter (DHIS 2 data).Despite the adoption of the B+ option in 2013, MTCT rates in the district have remained stagnant at 10-14%, well above the global target of less than 5% (EMTCT Plan, 2023) Antiretroviral therapy for both the mother and baby, infant feeding method, maternal viral load and mode of delivery have been highlighted as one of the key factors that contribute to mother to child transmission of HIV. MTCT of HIV can occur during pregnancy, delivery, and breastfeeding period. This study aims investigate the determinants of MTCT of HIV contributing to the broader goal of realizing an AIDS-free generation. This was a retrospective analytical cross-sectional study where 185 records of mother baby pairs delivered between January and December 2021 were retrieved from the mother baby pair register and reviewed. A structured data collection proforma created in Microsoft Excel was used to extract data from the MBP registers. Data on mother’s age, gestation age on booking, HIV status, antiretroviral therapy (ART)status, maternal viral load, syphilis results, infants HIV status, ARV prophylaxis status and feeding method were extracted. The study included 185 singletons and one set of twins. Among the mothers, 28.6% were HIV positive, accounting for the six mothers whose infants tested HIV positive. This resulted in an eMTCT transmission rate of 11.3%. The study's findings revealed several significant factors associated with mother-to-child transmission (MTCT) of HIV. Notably, maternal viral load greater than 1000 copies emerged as the primary contributor to MTCT, with (OR=92.0; 95%CI: 6.8-1249.7; p<0.050). Additionally, a positive syphilis result in the mother was strongly associated with MTCT (OR=21.0; 95% CI: 1,7-312.4; p<0.050). The practice of mixed feeding among infants showed a notable association with MTCT with an, (OR=45.0; 95%CI: 4.9 - 410.5; p<0.050). These findings underscore the importance of addressing maternal viral load, syphilis screening, and infant feeding practices to mitigate the risk of HIV transmission from mother to child.