Menu
Menu
Menu
Menu
Background. The HIV/AIDS epidemic in Kenya is a major public-health problem. Estimating the prevalence of HIV in pregnant women provides essential information for an effective implementation of HIV/AIDS control measures and monitoring of HIV spread within a country. The objective of this study was to determine the prevalence of HIV infection, risk factors for HIV/AIDS and immunologic (lymphocyte profile) characteristics among pregnant women attending antenatal clinics in three district hospitals in North-Rift, Kenya. Methods. Blood samples were collected from pregnant women attending antenatal clinics in three district hospitals (Kitale, Kapsabet and Nandi Hills) after informed consent and pre-test counseling. The samples were tested for HIV antibodies as per the guidelines laid down by Ministry of Health, Kenya. A structured pretested questionnaire was used to obtain demographic data. Lymphocyte subset counts were quantified by standard flow cytometry. Results. Of the 4638 pregnant women tested, 309 (6.7%) were HIV seropositive. The majority (85.1%) of the antenatal attendees did not know their HIV status prior to visiting the clinic for antenatal care. The highest proportion of HIV infected women was in the age group 21-25 years (35.5%). The 31-35 age group had the highest (8.5%) HIV prevalence, while women aged more than 35 years had the lowest (2.5%). Women in a polygamous relationship were significantly more likely to be HIV infected as compared to those in a monogamous relationship (p = 0.000). The highest HIV prevalence (6.3%) was recorded among antenatal attendees who had attended secondary schools followed by those with primary and tertiary level of education (6% and 5% respectively). However, there was no significant relationship between HIV seropositivity and the level of education (p = 0.653 and p = 0.469 for secondary and tertiary respectively). The mean CD4 count was 466 cells/mm3(9-2000 cells/mm3). Those that had less than 200 cells/mm3accounted for 14% and only nine were on antiretroviral therapy. Conclusion. Seroprevalence of HIV was found to be consistent with the reports from the national HIV sentinel surveys. Enumeration of T-lymphocyte (CD4/8) should be carried out routinely in the antenatal clinics for proper timing of initiation of antiretroviral therapy among HIV infected pregnant women.
The study was carried out from April 2005 to September 2006 at Kitale, Kapsabet and Nandi hills district hospitals. All pregnant women attending the antenatal clinic for the first time during the current pregnancy were included. Voluntary counseling and testing (VCT) for HIV among pregnant women has been integrated into maternal child health (MCH) facilities in all the public hospitals as part of prevention of mother to child transmission (PMTCT) of HIV. All the pregnant women attending the antenatal clinics were sensitized with basic knowledge on HIV/AIDS. The importance of knowing their HIV status and the availability of measures to reduce the risk of mother to child transmission were explained in greater detail. The objectives of the study were explained and informed consent was obtained by signature or finger print from ANC attendees. Enrolment and counseling were done in all the three hospitals. This study was approved by the Kenya Medical Research Institute Scientific Steering Committee and Ethical Review Board (Ref. SSC No. 822). The study was conducted according to the national and international regulations governing the use of human subjects in biomedical research. A pre-tested standard structured questionnaire was used for interview. The information sought included basic demographic data. Routine investigations in the antenatal clinic necessitate blood withdrawal for HIV testing. A small amount of this blood was used also for enumeration of T-lymphocytes, which is not done routinely. Five milliliters venous blood sample was collected in a sterile vacutainer tube containing EDTA as anticoagulant from all pregnant women. HIV antibodies were tested by rapid tests as per the guidelines laid down by the Ministry of Health, Kenya. Rapid parallel testing was carried out using Determine™ HIV-1/2 (Abbott Diagnostic Division) and Uni-Gold™ HIV (Trinity Biotech) test kits. In case of discrepancy, Bioline HIV 1/2 3.0 (Standard Diagnostics) was used as a tiebreaker. Lymphocyte subset counts were performed by standard flow cytometry. The details of the procedure were performed in accordance with the manufacturer’s instructions (Tritest; Becton-Dickinson, Franklin Lakes, NJ). Briefly, 50 μl of whole blood with EDTA were incubated with three-color fluorochrome-labeled monoclonal antibodies. After lysis and incubation, flow cytometric analysis was performed on a FACSCalibur cytometer using an automatic acquisition and analysis program (Multiset; Becton-Dickinson). The absolute CD4 T cell counts were recorded and used in this study. Data were entered using Microsoft Access (Microsoft Corporation, Redmond, Washington) and statistical analyses performed using EPI INFO 3.2.2 statistical package. We present odds ratios (OR), and 95% confidence interval (CI) for factors associated with HIV infection.
N/A
