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Year : 2013  |  Volume : 1  |  Issue : 2  |  Page : 64-69

Decentralization of prevention-of-mother-to-child transmission services in Nigeria: Aminu Kano teaching hospital's experience

1 Department of Obstetrics and Gynaecology, Aminu Kano Teaching Hospital, Kano, Nigeria
2 Department of Community Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria

Correspondence Address:
Hadiza S Galadanci
Aminu Kano Teaching Hospital, Kano
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2321-9157 .126633

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Introduction: Human Immune deficiency virus infection is a major public health issue in Sub-Saharan Africa with Nigeria having one of the highest burden of human immunodeficiency virus (HIV) disease among pregnant women and children. Since 2003, Aminu Kano Teaching Hospital (AKTH) has been providing prevention-of-mother-to-child transmission (PMTCT) services. This study examined the pattern of HIV counseling and testing (HCT) uptake among antenatal clients at the hospital during a 6-year period. This includes the period when decentralization of PMTCT services occurred in Nigeria. Materials and Methods: This is a hospital-based prospective study that included all pregnant women attending antenatal clinic (ANC) at AKTH, from January 2007 to December 2012. Since October 2003, data are prospectively recorded in registers and later entered into a database. The registers captured information on clients' age, parity, occupation and gestational age at time of registering; they also noted voluntary counseling and testing (VCT)/HCT uptake, HIV sero-status and partner's HIV status. The study obtained data from the hospital registers and subsequently analyzed it using the EPI-Info; version 3.2.2 (released in 2004) statistical software package. Results: The mean maternal age was 27.2 ΁ 5.3 years and the median parity is 1 with a range of 1-14. Of the 23,378 new attendees at ANC, 23,078 (98.7%) accepted testing for HIV. Acceptance of HIV test stayed at 100% from 2007 to 2011 and only dipped slightly to 93.3% in 2012. Overall HIV prevalence was 5.5%. HIV prevalence stabilized at between 8.1% and 8.4% in 2007 and 2008 respectively, before rising to peak at 10.0% in 2009 and started declining to 5.8% in 2010 before reaching its lowest values of 1.7% and 1.1% in 2011 and 2012 respectively. This trend was statistically significant with a P < 0.000. Conclusions: There is a high uptake of VCT among ANC clients and HIV prevalence has decreased significantly in the last 3 years in AKTH, probably as a result of decentralization of PMTCT services.

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