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The effects of maternal and child HIV infection on health equity in Tigray Region, Ethiopia, and the implications for the health system: a case-control study.

Authors
  • Abraha, Atakelti1, 2
  • Myléus, Anna3
  • Byass, Peter3, 4, 5
  • Kahsay, Asmelash6
  • Kinsman, John3, 7
  • 1 a Tigray Health Bureau , Tigray , Ethiopia. , (Ethiopia)
  • 2 b Ethiopian Health Insurance Agency , Addis Ababa , Ethiopia. , (Ethiopia)
  • 3 c Department of Epidemiology and Global Health, Umeå University , Umeå , Sweden. , (Sweden)
  • 4 d Institute of Applied Health Sciences, School of Medicine and Dentistry, University of Aberdeen , Aberdeen , UK.
  • 5 e MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa. , (South Africa)
  • 6 f Micronutrient initiative , Tigray , Ethiopia. , (Ethiopia)
  • 7 g Department of Public Health Sciences, Global Health (IHCAR), Karolinska Institutet , Stockholm , Sweden. , (Sweden)
Type
Published Article
Journal
AIDS care
Publication Date
Oct 01, 2019
Volume
31
Issue
10
Pages
1271–1281
Identifiers
DOI: 10.1080/09540121.2019.1601670
PMID: 30957540
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Services that aim to prevent mother-to-child HIV transmission (PMTCT) can simultaneously reduce the overall impact of HIV infection in a population while also improving maternal and child health outcomes. By taking a health equity perspective, this retrospective case control study aimed to compare the health status of under-5 children born to HIV-positive and HIV-negative mothers in Tigray Region, Ethiopia. Two hundred and thirteen HIV-positive women (cases), and 214 HIV-negative women (controls) participated through interviews regarding their oldest children. Of the children born to HIV-positive mothers, 24% had not been tested, and 17% of those who had been tested were HIV-positive themselves. Only 29% of the HIV-positive children were linked to an ART programme. Unexpectedly, exposed HIV-negative children had fewer reports of perceived poor health as compared to unexposed children. Over 90% of all the children, regardless of maternal HIV status, were breastfed and up-to-date with the recommended immunizations. The high rate of HIV infection among the babies of HIV-positive women along with their low rates of antiretroviral treatment raises serious concerns about the quality of outreach to pregnant women in Tigray Region, and of the follow-up for children who have been exposed to HIV via their mothers.

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