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Preliminary assessment of breastfeeding practices in HIV 1-infected mothers (prior to weaning) under the Djoungolo programme on the prevention of mother-to-child transmission of HIV.

Abstract：

BACKGROUND:Human Immunodeficiency virus (HIV) transmission in a breastfeeding population varies from 20% to 45%. OBJECTIVE:To evaluate breastfeeding practices and the early basic HIV transmission rate in HIV-exposed children in the Djoungolo health district (prevention of mother-to-child transmission HIV programme). METHODS:A cross-sectional survey was conducted, targeting breastfeeding mothers recruited from an observational cohort of HIV-positive pregnant women intending to breastfeed. Routine immunological assessment was carried out for all pregnant HIV-positive women coupled with initiation to highly active anti-retroviral therapy (HAART) in those with CD4 cell counts below 350 mm(-3). Early virological diagnosis of HIV infection was done using real-time Polymerase Chain reaction (PCR) RNA for infants aged between 6 weeks and 6 months. Breastfeeding intervention and counselling support were also provided to respondents. RESULTS:Out of 545 women, 287 births were registered of which 64 of the HIV-infected mothers opted for breastfeeding. The mean CD4 cell count was 446 mm(-3); 34.4% of women were taking HAART. The rate of initiation to breastfeeding was observed to be 53% within 1 h following delivery. At 13 weeks, 96.1% were still exclusively breastfeeding on demand with an average of six feedings in the daytime and three feedings during the night. Of the mothers, 18.5% reported at least one episode of breast and/or nipple pain and 4.9% of mothers were practicing mixed feeding. The early rate of HIV transmission among 47 infants assessed was observed to be 4.3% [95% confidence interval 1-10.1]. CONCLUSION:In an HIV context, routine breastfeeding intervention support associated with access to anti-retroviral therapy for women yet requiring treatment for themselves reduces the practice of mixed feeding and slashes the early mother-to-child HIV transmission rate to 4.3% in breastfeeding populations.

journal_name

J Trop Pediatr

journal_title

Journal of tropical pediatrics

authors

Nlend AE,Ekani BB

doi

10.1093/tropej/fmq018

subject

Has Abstract

pub_date

2010-12-01 00:00:00

pages

436-9

issue

eissn

0142-6338

issn

1465-3664

pii

fmq018

journal_volume

pub_type

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Preliminary assessment of breastfeeding practices in HIV 1-infected mothers (prior to weaning) under the Djoungolo programme on the prevention of mother-to-child transmission of HIV.