Modifiable factors within the prevention of mother-to-child transmission programme associated with failure to prevent HIV transmission in the Onandjokwe district of Namibia

Figures & data

Table 1: Characteristics of study children and their mothers (n = 59)

Characteristics	n	%
Child gender:
Male	21	35.6
Female	38	64.4
Mode of delivery:
Normal vaginal delivery	54	91.5
Caesarean section	5	8.5
Place of delivery:
Health facility	48	81.4
Home	8	13.6
In transit	3	5.1
Level of education of mothers:
Primary	18	0.5
Secondary	38	64.4
College	1	1.7
None	2	3.4
Time of HIV diagnosis of mothers:
Before pregnancy	29	49.2
During first trimester	3	5.1
During second trimester	5	8.5
During third trimester	5	8.5
During labour and delivery	2	3.4
During postnatal and breastfeeding	15	25.4
Time of ART initiation for mothers:
Before pregnancy	25	42.4
1st trimester	3	5.1
2nd trimester	5	8.5
3rd trimester	3	5.1
Labour and delivery	1	1.7
Postnatal and breastfeeding period	22	37.3

Table 2: PMTCT and feeding options (n = 59)

Variables	n	%
Mother’s PMTCT options:
Allocated to PMTCT Option A	1	1.7
Allocated to PMTCT Option B+	43	72.9
No PMTCT allocation during pregnancy	15	25.4
Children PMTCT options:
Children received nevirapine during delivery only	18	30.8
Children received nevirapine during delivery and breastfeeding	11	18.6
Children never received nevirapine	30	50.8
Mother’s choice of feeding option after delivery:
Breastfeeding	57	96.6
Formula milk feeding	2	3.4
Infant feeding practices:
Exclusive breastfeeding until 6 months	32	54.2
Mixed feeding	26	44.1
Formula milk	1	1.7

Table 3: Mothers’ follow-up care characteristics

Variables	n	%
Mother on ART follow-up ≥ 6 months (n = 59):
Yes	30	50.8
No	29	49.2
Adherence in those on ART follow-up ≥ 6 months (n = 30):
Good	5	16.7
Fair	6	20.0
Poor	19	63.3
Viral load at 6 months post ART initiation (n = 30):
< 40 IU/ml	2	6.7
40–1 000 IU/ml	1	3.3
> 1 000 IU/ml	7	23.3
Viral load not done	20	66.7
Reasons for the viral load not done (n = 20):
Unknown	4	20.0
Missed follow-ups	16	80.0

Table 4: Modifiable factors in mother-to-child transmission (n = 279)

Modifiable factors	n	%
Modifiable factors related to healthcare system:	27	9.7
No system for clinics to identify and follow up postnatal mothers	25	9.0
Nevirapine out of stock	2	0.7
Modifiable factors related to healthcare professionals:	83	29.7
Patient was failing first-line ART regimen with no intervention	36	12.9
Failed to check viral load	4	1.4
Failed to trace the patients who defaulted on ART	14	5.0
Mother attended ANC, but not offered HIV test	10	3.6
Pregnant mother tested HIV-positive, but ART initiated later in pregnancy or only when a child tested positive	10	3.6
The new born was not given NVP until follow up at 6 weeks	8	2.9
Healthcare professionals offered HIV test very late in pregnancy	1	0.4
Modifiable factors related to mother and children:	169	60.6
Mother defaulted on ART during pregnancy and breastfeeding	34	12.2
Mixed feeding started before infant reached 6 months	26	9.3
Mother had high viral load before pregnancy	22	7.9
Mother defaulted on nevirapine treatment in the infant	21	7.5
Mother did not attend appointment for viral load check	16	5.7
Mother seroconverted during pregnancy or breastfeeding	15	5.4
Mother never attended ANC	11	3.9
Mother started ANC very late, HIV test done very late	8	2.9
Mother became pregnant while preparing to start ART	8	2.9
Delivered at home	7	2.5
Mother tested positive, but refused to be initiated on ART	1	0.4