ArticleBMC pregnancy and childbirth2021
Towards elimination of mother-to-child transmission of HIV in Rwanda: a nested case-control study of risk factors for transmission.
Article in BMC pregnancy and childbirth, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 12 citations in OpenAlex.
- Clinical outcomes and survival of HIV exposed children at 18 months in post-conflict region: insight from the Panzi Interdisciplinary PMTCT cohort (Panzi IPC) study.BMC infectious diseases · 2026Article
- Disclosure and peer support in prevention of mother-to-child transmission of human immunodeficiency virus: Evidence from Rwanda.World journal of virology · 2025Article
- Low birth weight and adverse pregnancy outcomes among women living with HIV and HIV-uninfected in Rwanda.PloS one · 2025Article
- Determinants of comprehensive knowledge on mother-to-child transmission of HIV and its prevention among childbearing women in Rwanda: insights from the 2020 Rwandan Demographic and Health Survey.BMC public health · 2023Article
- Clinical and Biological Risk Factors Associated with Increased Mother-to-Child Transmission of HIV in Two South-East HIV-AIDS Regional Centers in Romania.Medicina (Kaunas, Lithuania) · 2022Article
- Factors associated with the risk of HIV infection among HIV-exposed infants in Malawi: 2013-2020.BMJ paediatrics open · 2022Article
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Authors and funding
13 authors at 8 institutions in 4 countries.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundMother-to-child HIV transmission (MTCT) has substantially declined since the scale-up of prevention programs around the world, including Rwanda. To achieve full elimination of MTCT, it is important to understand the risk factors associated with residual HIV transmission, defined as MTCT at the population-level that still occurs despite universal access to PMTCT.
methodsWe performed a case control study of children born from mothers with HIV with known vital status at 18 months from birth, who were followed in three national cohorts between October and December 2013, 2014, and 2015 in Rwanda. Children with HIV were matched in a ratio of 1:2 with HIV-uninfected children and a conditional logistic regression model was used to investigate risk factors for MTCT.
resultsIn total, 84 children with HIV were identified and matched with 164 non-infected children. The median age of mothers from both groups was 29 years (interquartile range (IQR): 24-33). Of these mothers, 126 (51.4 %) initiated antiretroviral therapy (ART) before their pregnancy on record. In a multivariable regression analysis, initiation of ART in the third trimester (Adjusted Odds Ratio [aOR]: 9.25; 95 % Confidence Interval [95 % CI]: 2.12-40.38) and during labour or post-partum (aOR: 8.87; 95 % CI: 1.92-40.88), compared to initiation of ART before pregnancy, increased the risk of MTCT. Similarly, offspring of single mothers (aOR: 7.15; 95 % CI: 1.15-44.21), and absence of postpartum neonatal ART prophylaxis (aOR: 7.26; 95 % CI: 1.66-31.59) were factors significantly associated with MTCT.
conclusionsLate ART initiation for PMTCT and lack of postpartum infant prophylaxis are still the most important risk factors to explain MTCT in the era of universal access. Improved early attendance at antenatal care, early ART initiation, and enhancing the continuum of care especially for single mothers is crucial for MTCT elimination in Rwanda.
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