Despite the goal of eliminating new human immunodeficiency virus (HIV) infections
in children, mother-to-child transmission is still common in resource-poor countries. The aims of
this study were to assess the occurrence of mother-to-child transmission of HIV (MTCT) by age 18
months, risk factors for transmission, and the implementation of the national prevention of MTCT
(PMTCT) program in a rural hospital in Tanzania. Data were collated from various medical registers
and records. We included 172 children and 167 HIV-infected mothers. Among 88 children (51%)
with adequate information, 9 (10.2%) were infected. Increased risk of MTCT was associated with late
testing of the child (>2 months) [OR = 9.5 (95% CI: 1.8–49.4)], absence of antiretroviral therapy during
pregnancy [OR = 9.7 (95% CI: 2.1–46.1)], and maternal CD4 cell count <200 cells/mm3 [OR = 15.3
(95% CI: 2.1–111)]. We were unable to determine the occurrence of MTCT transmission in 84 children
(49%). The results from this study highlight that there is an urgent need for enhanced efforts to
improve follow-up of HIV-exposed children, to improve documentation in registries and records,
and to facilitate ease of linkage between these.
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