Professor Atiene Solomon Sagay - University of Jos Institutional ...

Outcome of PMTCT interventions in Nigeria
We have analysed the mother-to-child transmission (MTCT) rates following various
interventions at JUTH and these are shown in green bars in figure 9 above. The transmission
rates at 6 weeks of age are compared with MTCT rates in Botswana, a country that can boast of
some of the best PMTCT programs in Africa.
15%
10%
5%
0%
Figure 9: ARV Interventions and
MTCT [Nigeria vs. Botswana]
BOTSWANA
JOS, NIGERIA
0.7%
0.9%
2.3%
3.3%
2.9%
Pre-preg During 4wks
HAART AZT+sdNVP
4.7%
24
7.0%
5.2%
sdNVP
alone
12.3%
12.6%
No ART
Clearly, outcomes in our programme are comparable indicating that our interventions are
working like elsewhere in the world.
Infant feeding and MTCT between 6wks and 6months
One of the strategies to reduce postnatal mother to child transmission (MTCT) of HIV is the use
of replacement feeding (BMS) which is expected to eliminate transmission through breast milk.
To achieve this goal, BMS must be practiced in a setting where it is culturally acceptable,
feasible, affordable, sustainable and safe (AFASS), otherwise, there is increased risk of infant
morbidity and mortality.
The vast majority of our HIV infected mothers are provided with infant formula (BMS) to
prevent HIV transmission to their babies. Our recent unpublished study compared the risk of
postnatal transmission of HIV at 6 months among infants who are HIV negative at 6 weeks of
age and were exclusively breast fed or given exclusive replacement feeding in the PMTCT
program at JUTH, Jos, Nigeria. The difference in transmission risk between the two feeding
methods was not statistically significant (1.8% vs 2.2%; P value =0.785). This finding showed
that many mothers in the BMS group were practicing mixed feeding. New guidelines endorse
administration of antiretroviral drugs to make breast feeding safer. It is hoped that this strategy
will improve child survival without increasing HIV transmission to the infant.