Utilization and associated factors of early infant diagnosis of Hiv infection in west oromia region, ethiopia

Abstract

Background: Human immunodeficiency virus infection follows a more aggressive course among infants and children than among adults. Early infant HIV infection diagnosis is a virological detection of HIV infection in infants and young children. Objective: To assess utilization and associated factors of early infant diagnosis of HIV infection among HIV exposed infants and young children in Western Oromia Region, Ethiopia. Methods: Institutional based cross-sectional study was conducted at 4 weeks to 18 months age infants and young children born to known women living with HIV / Acquired Immune Deficiency Syndrome (AIDS) from March 01, 2014 to April 30, 2014. Three hundred forty nine 4 weeks to 18 months age HIV exposed infants and young children, and mother pairs enrolled in Anti Retroviral Treatment (ART) and/or Prevention of Mother to Child Transmission (PMTCT) clinics of 27 health facilities in the West Oromia region were recruited. Study health facilities were selected purposively based on their HIV exposed infants enrollment status and all infants and mother pairs with complete records in the aforementioned facilities were included in the study. A developed checklist was used to collect information about mothers and infants from follow-up registers and cards. Analysis for predictors was done using bivariate and multivariate logistic regression where p value of <0.05 was considered as statistically significant. Results: The proportion of HIV testing among HIV-exposed infants and young children was 83.7%, with the median age testing of 6 weeks. Caretaker residence [AOR= 2.92, 95% CI (1.15- 7.40)], number of live children a mother has [AOR= 3.37, 95% CI (1.38-8.22)], mother HIV sero-status disclosure [AOR= 3.29 95% CI (1.05-10.29)], presence of mother support group at health facility [AOR= 6.55, 95% CI (2.88 – 14.90)], and early age enrollment of infant to care [AOR= 4.52, 95% CI (2.00-10.27)] were independent significant predictor for testing of HIVexposed infants and young children. Conclusions and Recommendations: Utilization of early infant diagnosis of HIV infection was relatively high in studied health facilities of Western Oromia Region. The Ministry of Health should strengthen the current health system to ensure uninterrupted supply chain of Dry Blood Spot (DBS) kits, Di ribonucleic Acid/Polymerase Chain Reaction (DNA- PCR) reagents, job aides and proper service documentation. Also, efforts should be directed to the community to raise awareness of early HIV testing during pregnancy, appropriate initiation of PMTCT intervention and earlier age enrollment of HIV-exposed infants to care.