Do Women Enrolled in PMTCT Understand the Recommendations: A Case Study from Kilimanjaro

Figures & data

Table 1 Socio-Demographic and Clinical Characteristics of Study Participants (N = 521)

	Characteristic	Frequency	%
Mothers age (years)	≤ 24	94	18.0
	≥ 25	427	82.0
Maternal education level	Primary education	345	66.2
	Secondary education/higher	176	33.8
Total number of pregnancies	1–4	451	86.6
	5 or more	70	13.4
Years since diagnosis with HIV	≤ 5 years	370	71.0
	> 5 years	151	30.0
Number of pregnancies while HIV positive	1–2	479	92.0
	> 2	42	8.0
Years on ART	1–2	278	53.4
	> 2	243	46.6
Used ART in previous pregnancy	No	348	66.8
	Yes	173	33.2
Number of ANC visits before delivery	< 4	66	12.7
	4 or more	455	87.3
Gestation trimester at first booking for ANC	1st trimester	233	44.7
	2nd trimester	266	56.1
	3rd trimester	22	4.2
Counselled on breastfeeding	No	71	13.6
	Yes	450	86.4
Counselled on ART	No	41	7.9
	Yes	480	92.1
Childs age category (months)	≤ 6 months	190	36.5
	> 6 months	331	63.5
Level of facility receiving PMTCT care	Dispensary	49	9.4
	Health Centre	249	47.8
	Hospital	223	42.8

Table 2 Mothers Responses to PMTCT Knowledge Questions (N = 521)

PMTCT Knowledge Items	No (%)	Yes (%)
Can mother transmit HIV to child?	52 (10.0)	469 (90.0)
Is it possible to prevent MTCT of HIV?	28 (5.4)	493 (94.6)
Correctly identifies duration of BF for HIV-positive mothers	149 (28.6)	372 (71.4)
Correctly identifies duration of exclusive breastfeeding (EBF)	19 (3.6)	502 (96.4)
Correctly identifies duration of BF for HIV-negative mothers	118 (22.6)	403 (77.4)
Correctly identifies duration or infant ART prophylaxis	281 (53.9)	240 (46.1)
Correctly identifies number of times exposed infant should be tested	241 (46.3)	280 (53.7)
ART for mother can prevent MTCT?	36 (6.9)	485 (93.1)
ART for child can prevent MTCT?	49 (9.4)	472 (90.6)
Can HIV-positive mother safely breastfeed?	13 (2.5)	508 (97.5)
Can ART use during pregnancy prevent MTCT?	321 (61.6)	200 (38.4)
Can ART use during breastfeeding prevent MTCT?	128 (24.6)	393 (75.4)
Can caesarean delivery prevent MTCT?	502 (96.4)	19 (3.6)
Can EBF prevent MTCT?	375 (72.0)	146 (28.0)
Can formula feeding prevent MTCT?	451 (86.6)	70 (13.4)
Can avoidance of mixed feeding prevent MTCT?	494 (94.8)	27 (5.2)
Can MTCT occur during pregnancy?	342 (65.6)	179 (34.4)
Can MTCT occur during labor and delivery?	299 (57.4)	222 (42.6)
Can MTCT occur during breastfeeding?	107 (20.5)	414 (79.5)
Mother has good knowledge (scored above median)	183 (35.1)	338 (64.9)

Abbreviations: MTCT, mother-to-child transmission; ART, antiretroviral therapy; BF, breastfeeding; EBF, exclusive breastfeeding; HIV, human immunodeficiency virus; MTCT, mother-to-child transmission; PMTCT, prevention of mother-to-child transmission.

Table 3 Factors Associated with Mothers’ Good Knowledge of PMTCT

Variable	N	Yes* n (%)	COR (95% CI)	P-value	AOR (95% CI)	P-value
Mothers age category
24 and below	94	53 (56.4)	1		1
Above 24	427	285 (66.7)	1.55 (0.99–2.45)	0.06	1.55 (0.93–2.57)	0.09
Childs age category
≤ 6 Months	190	113 (59.5)	1		1
> 6 months	331	225 (68.0)	1.45 (100–2.09)	0.05	1.25 (0.84–1.85)	0.27
Mothers education category
Primary and below	345	223 (64.6)	1		1
Post-primary	176	115 (65.3)	1.83 (0.70–1.51)	0.87	1.20 (0.79–1.84)	0.39
Number of pregnancies mother has had
1–4	451	291 (64.5)	1		1
5 or more	70	47 (67.1)	1.12 (0.66–1.92)	0.67	1.72 (0.26–11.47)	0.58
Total births woman has had
1–4	446	288 (64.6)	1		1
5 or more	75	50 (66.7)	1.10 (0.65–1.84)	0.73	0.52 (0.08–3.32)	0.49
Years since diagnosis
≤ 5 years	370	236 (63.8)	1		1
> 5 years	151	102 (67.5)	1.18 (0.79–1.77)	0.41	1.12 (0.65–1.94)	0.68
Number of pregnancies while HIV positive
1–2	479	307 (64.1)	1		1
>2	42	42 (73.8)	1.58 (0.77–3.22)	0.21	1.46 (0.64–3.33)	0.36
Years on ART
1–2	278	176 (63.3)	1		1
>2	243	162 (66.7)	1.16 (0.81–1.66)	0.42	0.88 (0.52–1.45)	0.59
Used ART in a previous pregnancy
No	348	216 (62.1)	1		1
Yes	173	122 (70.5)	1.46 (0.99–2.16)	0.06	1.25 (0.75–2.08)	0.39
ANC visits before delivery
Less than 4	66	37 (56.1)	1		1
4 or more	455	301 (66.2)	1.53 (0.91–2.59)	0.11	1.34 (0.68–2.62)	0.40
Booking trimester
1st Trimester	233	158 (67.8)	1		1
2nd Trimester	266	168 (63.2)	0.81 (0.56–1.18)	0.28	0.90 (0.60–1.34)	0.60
3rd Trimester	22	12 (54.5)	0.57 (0.24–1.38)	0.21	0.82 (0.26–2.55)	0.73
Counselled on breastfeeding
No	71	30 (42.3)	1		1
Yes	450	308 (68.4)	2.96 (1.78–4.94)	<0.01	2.38(1.38–4.11)	<0.001
Counselled on ART
No	41	18 (43.9)	1		1
Yes	480	320 (66.7)	2.56 (1.34–4.87)	<0.01	2.17 (1.08–4.36)	0.03
Level of ANC facility
Dispensary	49	31 (63.3)	1		1
Health center	249	166 (66.7)	1.16 (0.61–2.20)	0.65	1.04 (0.53–2.03)	0.92
Hospital	223	141 (63.2)	1.00 (0.53–1.90)	1.00	0.82 (0.41–1.62)	0.57

Note: *Mothers have good knowledge of PMTCT.

Abbreviations: COR, crude odds ratio; AOR, adjusted odds ratio; ANC, antenatal clinic; ART, antiretroviral therapy; CI, confidence interval; HIV, human immunodeficiency virus; PMTCT, prevention of mother-to-child transmission.