HIV Sero-Status and Risk Factors of Sero-Positivity of HIV Exposed Children Below Two Years of Age at Mityana General Hospital in Mityana District, Uganda

Lubuye Denis Senyonga

Faculty of Clinical Medicine and Dentistry Kampala International University Western Campus Uganda.


The aim of this study was to identify the factors linked to HIV serostatus and the risks of HIV positivity among children under two years old exposed to HIV at Mityana General Hospital in Mityana district, Uganda. This was a cross-sectional descriptive survey utilizing quantitative data from administered questionnaires and routine service data obtained from the mother’s HIV care card and the exposed infant clinical chart. Data analysis was performed using Epi Info version 7.2.4 for entry and Stata version 16 for analysis. Descriptive statistics characterized both infant and mother traits. Logistic regression was employed to determine the factors associated with HIV serostatus. Among the 102 mother–infant pairs recruited, most mothers were between 25–34 years old (53/102, 52.0%), married (67/102, 65.7%), had attained at least primary education (49/102, 48.1%), and were involved in farming for their livelihood (89/102, 87.3%). The HIV prevalence among the infants stood at 8.8%. In the bivariate analysis, factors such as place of delivery (OR = 4.6, 95% CI: 1.340-9.413, p = 0.003), normal delivery (OR = 4.7, 95% CI:0.682-5.522, p= <0.001), poor adherence to ART (OR=3.11, 95% CI: 0.983-8.344, p=0.026), and the mothers’ level of education (OR=6.2, 95% CI: 3.00-14.476, p= <0.001) were associated with HIV-positive outcomes in infants below two years old. This study underscores that 8.8% of children under 2 years attending Mityana General Hospital are HIV-infected due to exposure from their mothers. Factors contributing to this burden include maternal non-adherence to ART, delivery in facilities lacking PMTCT protocols, maternal education levels, and the absence of prophylaxis administration to exposed infants, collectively propagating HIV transmission among these infants.

Keywords: Pediatric HIV, Mother-to-child transmission, HIV serostatus, Infants below 2 years.


Children infected with Human Immunodeficiency Virus (HIV) as infants, when their immune systems are still immature, can experience very rapid, uninhibited viral multiplication and disease progression. Early immune depletion occurs when the CD4 cell count drops and the viral load increases [1, 2]. HIV is a virus that attacks cells that help the body fight infection, making a person more vulnerable to other infections and diseases [3, 4]. It is spread by contact with certain bodily fluids of a person with HIV, most commonly during unprotected sex, or through sharing injection drug equipment [5, 6]. Acquired Immune Deficiency Syndrome (AIDS) was first clinically reported in 1981 in the United States and the following year The New York Times published an alarming article about the new immune system disorder, which, by that time, had affected 335 people, killing 136 of them [7]. Between 1981 and 1983, there were 5,660 AIDS cases in the US compared to only 17 for the entire of Africa, suggesting that the US was the epicenter and origin of HIV and AIDS [8]. AIDS has since then become a global epidemic with evidence of the number of people living with HIV globally rising from 37.2 million people in 2017 to 37.9 million people in 2018 [9]. The statistics further indicate that Eastern and Southern Africa are the most affected by the epidemic with an estimated 20.6 million people living with HIV as of 2018 [10]. Worldwide, an estimated 180,000 new pediatric infections occurred in 2017 (UNAIDS, 2018), with East and South Africa contributing to 59% of all pediatric HIV infections globally, and in Uganda alone, 5.3% of infants were exposed to HIV [11]. Despite the recommendation of WHO that mother-to-child transmission (MTCT) of HIV should be prevented using lifelong treatment with antiretroviral (ARVs) for all pregnant HIV-infected women, exclusive breastfeeding during the first 6 months, and unrestricted duration of breastfeeding [12]. Despite the tremendous contribution of preventive mother-to-child transmission (PMTCT) programs in the 21 global priority countries, 3 out of 10 pregnant women living with HIV did not receive ARVs to prevent MTCT of HIV, and 4 out 10 HIV-positive women or their infants did not receive ARVs during breastfeeding to prevent MTCT of HIV in 2013 [13]. In 2018 alone, figures from WHO indicate that an estimated 100,000 pregnant women living with HIV in Uganda needed antiretroviral for preventing mother-to-child transmission but only 94,800 of those pregnant women received antiretroviral (excluding single dose Nevirapine) for preventing mother-to-child transmission accounting for 93% [14]. Uganda has made remarkable progress towards the elimination of vertical transmission of HIV [15]. However, some bottlenecks remain in ensuring wider access to and utilization of services across the PMTCT cascade and there are still several challenges in scaling up PMTCT services in the Uganda public healthcare sector [16]. These relate to coverage at different steps of the PMTCT cascade, and the quality of PMTCT services rendered at the health facilities [17]. Pediatric cases of HIV are becoming a growing problem in Uganda where MTCT is still a concern as HIV progresses much faster in children than it does in adults and if a positive infant is left untreated for 2 years, they face a 50% mortality rate [18]. Unless these children are promptly commenced on lifelong antiretroviral treatment (ART), HIV-positive infants invariably record their highest mortality in the first three months of life [19]. There is no data concerning serostatus of HIV-exposed infants at Mityana General Hospital in Mityana District and children are continuing to die despite PMTCT and eMTCT implementation in all districts of Uganda. Thus, this study was designed to determine the prevalence of HIV seropositivity and associated factors among exposed children below 2 years of age attending care at Mityana General Hospital in Mityana District.


Our study has been able to show that 8.8% of children below 2 years old attending Mityana General Hospital are infected with HIV as a result of exposure from their infected mothers. This HIV burden among infants is being propagated by several factors that include non-adherence to ART regimen by mothers, delivery from facilities that don’t apply PMTCT protocols that may reduce the risk for the baby, the education level of mothers and non-administration of prophylaxis to exposed infants.


We recommend a community-based survey among the whole community serviced by Mityana General Hospital to establish the extent of the HIV burden amongst infants in the community as our study could have missed a good percentage that wasn’t enrolled and receiving care from the hospital. Our study has shown that level of education is significantly associated with HIV seropositivity at bivariate analysis, however when the model was adjusted, it showed that increased education was a protective factor against the contraction of HIV by infants from mothers. We, therefore, recommend the design of tailor-made education programs that can help mothers from across all spheres to appreciate PMTCT.


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CITE AS: Lubuye Denis Senyonga (2023). HIV Sero-Status and Risk Factors of Sero-Positivity of HIV Exposed Children Below Two Years of Age at Mityana General Hospital in Mityana District, Uganda. IDOSR JOURNAL OF BIOCHEMISTRY, BIOTECHNOLOGY AND ALLIED FIELDS 8(3): 87-100.