An impact evaluation of the national prevention of mother to child HIV transmission program and MTCT associated factors in Uganda 2017–2019

Abstract Uganda is consistently one of the highest burden countries for mother-to-child transmission of HIV (MTCT). This study assessed Uganda’s progress toward elimination of MTCT and factors associated with MTCT. Mother-infant pairs (MIP) were recruited at immunization clinics at randomly sampled...

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Main Authors: Linda Kisaakye Nabitaka, Augustina Delaney, Phoebe M. Namukanja, Fred Nalugoda, Fredrick E. Makumbi, Emilio Dirlikov, Lisa Nelson, Wilford Kirungi, Sam Sendagala, Rose B. Nakityo, Jingo Kasule, Doreen Ondo, Peter Mudiope, Isaac Ssewanyana, Joel Opio, Dinh Thu-Ha, Michelle R. Adler, Hilda Asiimwe, Estella Birabwa, Esther Nyamugisa Ochora, David Serwadda, Tom Lutalo
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Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-09511-z
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author Linda Kisaakye Nabitaka
Augustina Delaney
Phoebe M. Namukanja
Fred Nalugoda
Fredrick E. Makumbi
Emilio Dirlikov
Lisa Nelson
Wilford Kirungi
Sam Sendagala
Rose B. Nakityo
Jingo Kasule
Doreen Ondo
Peter Mudiope
Isaac Ssewanyana
Joel Opio
Dinh Thu-Ha
Michelle R. Adler
Hilda Asiimwe
Estella Birabwa
Esther Nyamugisa Ochora
David Serwadda
Tom Lutalo
author_facet Linda Kisaakye Nabitaka
Augustina Delaney
Phoebe M. Namukanja
Fred Nalugoda
Fredrick E. Makumbi
Emilio Dirlikov
Lisa Nelson
Wilford Kirungi
Sam Sendagala
Rose B. Nakityo
Jingo Kasule
Doreen Ondo
Peter Mudiope
Isaac Ssewanyana
Joel Opio
Dinh Thu-Ha
Michelle R. Adler
Hilda Asiimwe
Estella Birabwa
Esther Nyamugisa Ochora
David Serwadda
Tom Lutalo
author_sort Linda Kisaakye Nabitaka
collection DOAJ
description Abstract Uganda is consistently one of the highest burden countries for mother-to-child transmission of HIV (MTCT). This study assessed Uganda’s progress toward elimination of MTCT and factors associated with MTCT. Mother-infant pairs (MIP) were recruited at immunization clinics at randomly sampled public and private health facilities in Uganda during 2017–2019. Using a multistage sampling method, a nationally representative sample of MIP aged 4–12 weeks were recruited and followed longitudinally for 18 months or until the infant acquired HIV. Early MTCT was defined as an infant with confirmed HIV infection at study enrollment and was calculated using logistic regression to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) for associated factors. Poisson regression was used to estimate incidence rate and incidence rate ratio (IRR) for infants acquiring HIV at any time during the study after enrollment (late MTCT) and associated factors. Early MTCT was 2.2% (95% CI: 1.3–3.6) and late MTCT rate was 5.2 per 1000 person-years (95% CI: 2.5–10.9). In the adjusted model, only detectable maternal HIV viral load (≥ 1,000 copies/mL) was significantly associated with early MTCT (aOR: 6.8, 95% CI: 2.3–19.9). Similarly, ever having a detectable viral load (at any visit) was significantly associated with late MTCT (IRR: 6.2, 95% CI: 1.2–31.7). Uganda’s program has made large strides to eliminate MTCT. Identifying and addressing elevated maternal HIV viral load, especially during pregnancy and the early breastfeeding period could further reduce the number of new childhood infections in Uganda.
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spelling doaj-art-f66403cdd2034bc69fdc461f2e794cc22025-08-20T04:02:46ZengNature PortfolioScientific Reports2045-23222025-07-0115111010.1038/s41598-025-09511-zAn impact evaluation of the national prevention of mother to child HIV transmission program and MTCT associated factors in Uganda 2017–2019Linda Kisaakye Nabitaka0Augustina Delaney1Phoebe M. Namukanja2Fred Nalugoda3Fredrick E. Makumbi4Emilio Dirlikov5Lisa Nelson6Wilford Kirungi7Sam Sendagala8Rose B. Nakityo9Jingo Kasule10Doreen Ondo11Peter Mudiope12Isaac Ssewanyana13Joel Opio14Dinh Thu-Ha15Michelle R. Adler16Hilda Asiimwe17Estella Birabwa18Esther Nyamugisa Ochora19David Serwadda20Tom Lutalo21Uganda Ministry of Health, AIDS Control ProgrammeGlobal Health Center, Division of Global HIV and Tuberculosis, US Centers for Disease Control and Prevention (CDC)Division of Global HIV and Tuberculosis, US Centers for Disease Control and Prevention (CDC)Rakai Health Sciences Program (RHSP)Rakai Health Sciences Program (RHSP)Division of Global HIV and Tuberculosis, US Centers for Disease Control and Prevention (CDC)Division of Global HIV and Tuberculosis, US Centers for Disease Control and Prevention (CDC)Uganda Ministry of Health, AIDS Control ProgrammeDivision of Global HIV and Tuberculosis, US Centers for Disease Control and Prevention (CDC)Division of Global HIV and Tuberculosis, US Centers for Disease Control and Prevention (CDC)Rakai Health Sciences Program (RHSP)Uganda Ministry of Health, AIDS Control ProgrammeUganda Ministry of Health, AIDS Control ProgrammeUganda National Health Laboratory and Diagnostic Services (UNHLDS)Division of Global HIV and Tuberculosis, US Centers for Disease Control and Prevention (CDC)Global Health Center, Division of Global HIV and Tuberculosis, US Centers for Disease Control and Prevention (CDC)Division of Global HIV and Tuberculosis, US Centers for Disease Control and Prevention (CDC)US Agency for International Development (USAID) US Department of Defense, Walter Reed Institute for Army Research (DOD WRIAR)UNICEFRakai Health Sciences Program (RHSP)Rakai Health Sciences Program (RHSP)Abstract Uganda is consistently one of the highest burden countries for mother-to-child transmission of HIV (MTCT). This study assessed Uganda’s progress toward elimination of MTCT and factors associated with MTCT. Mother-infant pairs (MIP) were recruited at immunization clinics at randomly sampled public and private health facilities in Uganda during 2017–2019. Using a multistage sampling method, a nationally representative sample of MIP aged 4–12 weeks were recruited and followed longitudinally for 18 months or until the infant acquired HIV. Early MTCT was defined as an infant with confirmed HIV infection at study enrollment and was calculated using logistic regression to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) for associated factors. Poisson regression was used to estimate incidence rate and incidence rate ratio (IRR) for infants acquiring HIV at any time during the study after enrollment (late MTCT) and associated factors. Early MTCT was 2.2% (95% CI: 1.3–3.6) and late MTCT rate was 5.2 per 1000 person-years (95% CI: 2.5–10.9). In the adjusted model, only detectable maternal HIV viral load (≥ 1,000 copies/mL) was significantly associated with early MTCT (aOR: 6.8, 95% CI: 2.3–19.9). Similarly, ever having a detectable viral load (at any visit) was significantly associated with late MTCT (IRR: 6.2, 95% CI: 1.2–31.7). Uganda’s program has made large strides to eliminate MTCT. Identifying and addressing elevated maternal HIV viral load, especially during pregnancy and the early breastfeeding period could further reduce the number of new childhood infections in Uganda.https://doi.org/10.1038/s41598-025-09511-zHIVPMTCTPregnancyBreastfeeding
spellingShingle Linda Kisaakye Nabitaka
Augustina Delaney
Phoebe M. Namukanja
Fred Nalugoda
Fredrick E. Makumbi
Emilio Dirlikov
Lisa Nelson
Wilford Kirungi
Sam Sendagala
Rose B. Nakityo
Jingo Kasule
Doreen Ondo
Peter Mudiope
Isaac Ssewanyana
Joel Opio
Dinh Thu-Ha
Michelle R. Adler
Hilda Asiimwe
Estella Birabwa
Esther Nyamugisa Ochora
David Serwadda
Tom Lutalo
An impact evaluation of the national prevention of mother to child HIV transmission program and MTCT associated factors in Uganda 2017–2019
Scientific Reports
HIV
PMTCT
Pregnancy
Breastfeeding
title An impact evaluation of the national prevention of mother to child HIV transmission program and MTCT associated factors in Uganda 2017–2019
title_full An impact evaluation of the national prevention of mother to child HIV transmission program and MTCT associated factors in Uganda 2017–2019
title_fullStr An impact evaluation of the national prevention of mother to child HIV transmission program and MTCT associated factors in Uganda 2017–2019
title_full_unstemmed An impact evaluation of the national prevention of mother to child HIV transmission program and MTCT associated factors in Uganda 2017–2019
title_short An impact evaluation of the national prevention of mother to child HIV transmission program and MTCT associated factors in Uganda 2017–2019
title_sort impact evaluation of the national prevention of mother to child hiv transmission program and mtct associated factors in uganda 2017 2019
topic HIV
PMTCT
Pregnancy
Breastfeeding
url https://doi.org/10.1038/s41598-025-09511-z
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