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Gebremariam ZM, Getahun G, Sahile A, Kejela Y, Getachew Y, Sisay F. Infant feeding practices and associated factors among HIV-positive mothers of infants aged 0-6 months at public health facilities in Addis Ababa, Ethiopia. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:28. [PMID: 38378624 PMCID: PMC10877894 DOI: 10.1186/s41043-024-00496-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 01/05/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND In the era of HIV infection, exclusive breast-feeding highly recommended for infants aged less than 6 months. Avoidance of exclusive breast-feeding by HIV-infected mothers recommended when replacement feeding is acceptable, feasible, affordable, sustainable and safe. The prevalence of exclusive breast-feeding has remained very low worldwide. Despite this fact, there is limited information on infant feeding practices of HIV-positive mothers and factors that affect the practice in the current study area. OBJECTIVE This study assessed the magnitude of infant feeding practice and associated factors among HIV-positive mothers of infants aged 0-6 months at public health facilities in Addis Ababa, Ethiopia. METHODS A multicenter facility-based cross-sectional study design was employed among a total of 397 study participants. The study participants were selected using a simple random sampling technique. The completeness of the data was checked, coded, cleaned and entered into Epi-data version 4.6 software, and exported to SPSS version 24 for analysis. Descriptive statistics and Binary logistic regression model were employed for the analysis with adjusted odds ratio (AOR) with a 95% CI and a P value ≤ 0.05 to determine the strength of association between infant feeding practice and its independent factors. RESULTS The overall magnitude of appropriate infant feeding practice among HIV-positive mothers was 82.6% (95% CI 80.9-88.2). Good knowledge of mother's toward infant feeding (AOR: 1.26, 95%, CI 1.11-3.34), better household monthly income, ≥ 6001 Ethiopian birr (AOR: 1.62, 95% CI 1.33-5.14) and favorable attitude of mother's toward infant feeding (AOR: 1.71, 95% CI 1.01-2.92) were statistically significant associated factors with the recommended way of infant feeding practice. CONCLUSIONS AND RECOMMENDATIONS Hence, the current study area is the capital city of the Ethiopia, where a relatively educated population lived in, there was an opportunity for better income, and appropriate infant feeding practice among HIV-positive mothers was found slightly higher than even the overall national target (70%) that was planned by 2020. Therefore, different stakeholders should develop strategic plan to excel females' education coverage and thereby their knowledge and attitude toward infant feeding to fully eradicate mother-to-child transmission of diseases.
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Affiliation(s)
- Zewdu Minwuyelet Gebremariam
- Menelik II Medical and Health Science College, City Administration of Addis Ababa Health Bureau, Addis Ababa, Ethiopia.
- City Administration of Addis Ababa Health Bureau, Addis Ababa, Ethiopia.
| | - Genanew Getahun
- Menelik II Medical and Health Science College, City Administration of Addis Ababa Health Bureau, Addis Ababa, Ethiopia
| | | | - Yared Kejela
- City Administration of Addis Ababa Health Bureau, Addis Ababa, Ethiopia
| | - Yeworkwuha Getachew
- Menelik II Medical and Health Science College, City Administration of Addis Ababa Health Bureau, Addis Ababa, Ethiopia
| | - Fasil Sisay
- Menelik II Medical and Health Science College, City Administration of Addis Ababa Health Bureau, Addis Ababa, Ethiopia
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Philemon RN, Mmbaga BT, Bartlett J, Renju J, Mtuy TB, Mboya IB, Msuya SE. Adherence to Optimal Breastfeeding Practices Among HIV-Positive Mothers in Kilimanjaro, Tanzania. Patient Prefer Adherence 2022; 16:841-852. [PMID: 35387257 PMCID: PMC8977531 DOI: 10.2147/ppa.s343213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 03/04/2022] [Indexed: 12/04/2022] Open
Abstract
Purpose We sought to assess how HIV-positive mothers enrolled in the PMTCT program adhere to breastfeeding recommendations concerning early initiation of breastfeeding (EIBF), ie, within one hour of birth, pre-lacteal feeds, exclusive breastfeeding until six months (EBF), and continued breastfeeding to one year of age. This study was designed to assess the practices in response to changing recommendations for breastfeeding in HIV, which have differed drastically over the years. Patients and Methods We recruited 524 mother-child pairs from 37 PMTCT clinics across Kilimanjaro, Tanzania. The 5 clinics with the highest patient load in each of the 7 districts of Kilimanjaro were chosen, plus the zonal and municipal referral hospitals. The children were below two years of age and currently in the PMTCT program. We administered a questionnaire to assess the mother's practices in feeding the child. We used multiple logistic regression models to determine factors associated with EIBF, EBF, and continued breastfeeding. Results EIBF was achieved for 73.1% of babies. Cesarean delivery, low birth weight, and partner disclosure of HIV status were significant risk factors for not achieving EIBF. About 19% of children did not breastfeed exclusively. Of the 247 children ≥12 months old, 43.3% had stopped breastfeeding before 12 months. Counseling on ARV, having had >2 pregnancies while HIV-positive and EBF were associated with breastfeeding until 12 months old. Using ART for more than two years decreased the odds of EBF and continued breastfeeding to 12 months of age. Conclusion Adherence to breastfeeding recommendations for HIV-positive women is suboptimal, particularly in aspects of recent changes in recommendations such as continuing breastfeeding for one year. There is a missed opportunity for interventions such as counseling, which has shown to favor adherence. Health education and counseling are needed for providers and mothers to keep them abreast with the frequently changing recommendations.
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Affiliation(s)
- Rune Nathaniel Philemon
- Department of Pediatrics and Child Health, Kilimanjaro Christian Medical University College (KCMUCo) & Kilimanjaro Christian Medical Centre (KCMC), Moshi, Kilimanjaro, Tanzania
| | - Blandina T Mmbaga
- Department of Pediatrics and Child Health, Kilimanjaro Christian Medical University College (KCMUCo) & Kilimanjaro Christian Medical Centre (KCMC), Moshi, Kilimanjaro, Tanzania
- Department of Research, Kilimanjaro Clinical Research Institute (KCRI), Moshi, Kilimanjaro, Tanzania
| | - John Bartlett
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Jenny Renju
- Department of Epidemiology & Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Kilimanjaro, Tanzania
- Department of Population Studies, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine (LSHTM), London, UK
| | - Tara B Mtuy
- Department of Epidemiology & Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Kilimanjaro, Tanzania
- Faculty of Public Health and Policy and the Department of Global Health and Development, London School of Hygiene & Tropical Medicine (LSHTM), London, UK
| | - Innocent B Mboya
- Department of Epidemiology & Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Kilimanjaro, Tanzania
- Department of Community Health, Institute of Public Health, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Kilimanjaro, Tanzania
- School of Mathematics, Statistics & Computer Science, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - Sia E Msuya
- Department of Epidemiology & Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Kilimanjaro, Tanzania
- Department of Community Health, Institute of Public Health, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Kilimanjaro, Tanzania
- Department of Community Health, Kilimanjaro Christian Medical Centre (KCMC), Moshi, Kilimanjaro, Tanzania
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Temesgen H, Negesse A, Woyraw W, Getaneh T, Yigizaw M. Prelacteal feeding and associated factors in Ethiopia: systematic review and meta-analysis. Int Breastfeed J 2018; 13:49. [PMID: 30505338 PMCID: PMC6260692 DOI: 10.1186/s13006-018-0193-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 11/19/2018] [Indexed: 11/30/2022] Open
Abstract
Background Prelacteal feeding can be defined as giving any solid or liquid foods other than breast milk during the first three days after birth. It affects timely initiation of breastfeeding and exclusive breastfeeding practices. Even though the issue was investigated in Ethiopia, fragmented and inconsistent findings were reported. Therefore, the main objective of this meta-analysis was to estimate the pooled prevalence of prelacteal feeding and associated factors in Ethiopia. Methods The preferred reporting items for systematic reviews and meta-analyses guideline was followed. Articles were systematically searched through different searching mechanisms. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument adapted for cross-sectional study design was used for quality assessment of each individual study. The total of 28 studies were included and analyzed. The random effect model was used to estimate the pooled prevalence; subgroup analysis and meta-regression were performed to identify the probable source of heterogeneity. Both Egger’s, and Begg’s test were used to check publication bias. The effects between associated factor variables, and prelacteal feeding practices were tested. Results A total of 492 studies were retrieved and 28 studies were included in the meta-analysis. The pooled prevalence of prelacteal feeding practice in Ethiopia was 25.29% (95% Confidence Interval [CI] 17.43, 33.15) with severe heterogeneity (I2 = 99.7, p < 0.001) and no publication bias. Antenatal care (Odds Ratio [OR] 0.25, 95% CI 0.09, 0.69), counselling on infant feeding (OR 0.37, 95% CI 0.22, 0.63), timely initiation of breastfeeding (OR 0.28, 95% CI 0.21, 0.38) and an urban residence (OR 0.47, 95% CI 0.26, 0.86) had lower odds, while home birth had higher odds (OR 3.93, 95% CI 2.17, 7.10) of prelacteal feeding in Ethiopia. Conclusions In Ethiopia, one in four children were given prelacteal foods. Mothers who gave birth at home are more prone to give prelacteal foods. Whereas, antenatal care, timely initiation of breastfeeding, counseling on infant feeding and an urban residence decreases prelacteal feeding practices in Ethiopia. Therefore, the government and health institutions should focus to increase maternal health service utilization and promote infant and young child feeding practices according to the guideline.
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Affiliation(s)
- Habtamu Temesgen
- 1Department of Human Nutrition and Food Sciences, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Ayenew Negesse
- 1Department of Human Nutrition and Food Sciences, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Wubetu Woyraw
- 1Department of Human Nutrition and Food Sciences, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Temesgen Getaneh
- 2Department of Midwifery, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Molla Yigizaw
- 3Department of Public Health, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
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Role of HIV exposure and infection in relation to neonatal GBS disease and rectovaginal GBS carriage: a systematic review and meta-analysis. Sci Rep 2017; 7:13820. [PMID: 29062060 PMCID: PMC5653843 DOI: 10.1038/s41598-017-13218-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 09/20/2017] [Indexed: 12/31/2022] Open
Abstract
Streptococcus agalactiae (GBS) is the leading cause worldwide of neonatal sepsis. We sought to assess to which extent HIV exposure of neonates is associated with GBS neonatal disease. Furthermore, we assessed to which extent HIV infection in women is associated with maternal rectovaginal GBS carriage, the single most important risk factor for GBS neonatal disease. We searched Pubmed, Embase, and Web of Science for studies assessing the association between neonatal GBS disease and HIV-status of the mother and studies that assessed the association between rectovaginal GBS colonization and HIV status in women. HIV-exposed uninfected neonates were more than twice as likely to have neonatal GBS disease compared to unexposed neonates. HIV-exposed neonates were not at increased risk for early-onset neonatal disease, but were 4.43 times more likely to have late-onset neonatal GBS disease. There was no significant association between HIV infection status and rectovaginal GBS carriage. Public health interventions preventing neonatal GBS disease are urgently needed for the increasing group of HIV-exposed neonates. A framework integrating and explaining our findings highlights opportunities for the clinical practice and global health policy to prevent disease. Well-designed studies should clarify the relation between HIV-status and GBS carriage.
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Infant feeding counseling and knowledge are the key determinants of prelacteal feeding among HIV exposed infants attending public hospitals in Ethiopia. ACTA ACUST UNITED AC 2017; 75:23. [PMID: 28536653 PMCID: PMC5439130 DOI: 10.1186/s13690-017-0191-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 03/27/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Despite the fact that breastfeeding promotes optimal health and growth for infants and young children, inappropriate feeding practice, such as prelacteal feeding increases the risk of neonatal death and illness and remains a public health problem in Ethiopia. Therefore, this study assessed the prevalence of prelacteal feeding and associated factors among HIV positive mothers with children aged 7-20 months attending government hospitals in North Gondar zone, northwest Ethiopia. METHODS An institution based cross-sectional study was conducted from February to March, 2016, at public hospitals of North Gondar Zone. Three hundred sixty-seven HIV positive mothers attending PMTCT clinics in government hospitals during the study period were included in the study. A multivariate logistic regression analysis was used to investigate factors associated with prelacteal feeding. The Adjusted Odds Ratio (AOR) with the corresponding 95% Confidence Interval (CI) was used to show the strength of association, and variables with a P-value of <0.05 were considered statistically significant. RESULTS In this study, the overall prevalence of prelacteal feeding was 19.1% (95% CI: 15-23). According to the multivariate analysis, prelacteal feeding was associated with fathers with no formal education (AOR = 5.85; 95% CI: 2.02, 16.92), lack of infant feeding counseling (AOR = 3.36; 95% CI: 1.27, 8.85), discarding the colostrum (AOR = 5.16; 95% CI: 2.32, 11.45), inadequacy of antenatal care visit (AOR = 0.07; 95% CI: 0.03, 0.15), and high IYCF knowledge (AOR = 0.10; 95% CI: 0.03, 0.30). CONCLUSION In this study, the prevalence of prelacteal feeding was high. Furthermore, father's education, colostrum feeding, infant feeding counseling, ANC visit, and IYCF knowledge were significantly associated with prelacteal feeding. As a result, strengthening maternal health care utilization, breastfeeding counseling, and IYCF knowledge are essential to address the high burden of prelacteal feeding.
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