Knowledge, Attitude And Practice Of Ante-Natal Attendees Toward Prevention Of Mother To Child Transmission (PMTCT) Of Hiv Infection In A Tertiary Health Facility, Northeast-Nigeria

摘要

Objective: Knowledge, attitude and practice of pregnant women toward PMTCT have not been evaluated in any tertiary health facility in the Northeast Nigeria. Methods: A structured questionnaire was used to obtain data from 172 women that consecutively attended the antenatal clinic of University of Maiduguri Teaching Hospital to determine their level of knowledge, practice and attitude toward PMTCT. s Results: Knowledge on modes of transmission, risky behaviours and prevention of HIV and other STIs was high among the women. The use of breast milk substitute by HIV positive nursing mothers and condom during sexual intercourse did not receive very encouraging responses from 42 (24.4%) and 58 (33.7%) of the women respectively. Those that discourage BMS indicated spouse dislike as a major reason and the fact that the community places higher premium on breastfeeding. Majority of those that discouraged condom use said the practice was against their religious beliefs while a few believes withdrawal before ejaculation and use of antibiotics after sex can equally prevent HIV infection. Conclusion: The pregnant women accepted PMTCT as a veritable means of preventing infants from HIV infection and a means to determine HIV status. Majority implored greater involvement of male partners and other family members during PMTCT counselling sessions. Staff training, awareness creation and community mobilization were identified as key to success of PMTCT programmes and fight against stigma and discrimination. Introduction The transmission of Human Immunodeficiency Virus (HIV) from mother to child contributes largely to HIV prevalence amongst children. Efforts to reduce this mode of spread include increasing the number of persons who know their HIV status and increasing the number of HIV positive women who when pregnant take instructions and act on them to protect their children from the possibility of infection. The risk of transmission of HIV virus from an infective source such as receptive vagina intercourse and insertive vagina sex is 8 to 20 and 3 to 9 risk/10,000 exposures respectively (1).The rate of perinatal transmisson of HIV in developing countries ranged between 19% to 36% and HIV prevalence in some areas upto 25% (2). In Nigeria, the current prevalence rate of 4.4% is derived from national sentinel surveillance of antenatal attendees aged 15-49 years drawn from rural and urban communities through out the country (3). This report seems to indicate a reduction in HIV prevalence in Nigeria compared to 5.8% and 5.0% obtained in 2001 and 2003 respectively. However, the reality of the situation in many high brow Nigerian cities does not give room for respite considering the dense population and socio-cultural complexity of Nigeria. The 2005 sero-prevalence of 4.4% among ante-natal attendees in Nigeria is 250% increase from 1991 prevalence rate of 1.8% and sexual transmission of HIV is recognized as the dominant mode of transmission making mother to child transmission of HIV an increasing national concern. In the national survey report of 2005, 73,000 HIV-infected infants were born, making it the highest number for any country in the world (3).Currently in Nigeria, several attempts have been made by government and non-governmental organizations to provide cost-effective anti-retroviral regimens to prevent perinatal transmission of HIV. Nevertheless, there is great concern over these regimens in terms of development of resistant strains that could cause limitations in individual patients and on a population basis (1).The current effort to incorporate HIV counseling and testing (HCT) into ante-natal care through prevention of mother to child transmission (PMTCT) programme in all health facilities in Nigeria is a positive one aimed at identifying those pregnant women that are HIV positive and providing adequate steps that will prevent, reduce or eliminate infection of the infants. In it counseling is expected to among other things provide informa