Gender differences on the risk of mother to child transmission of HIV-1 during postpartum period in Ghana. Case Study: Korle-Bu Teaching Hospital, HIV Unit

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June 2015
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This study sought to find the association of some risk factors with the detection of HIV in infants born to HIV positive mothers in Ghana. A secondary data, from April 2011 to April 2014, from the Korle-Bu Teaching Hospital in Accra was used in this study. The data obtained involved some two thousand and seventy eight (2,078) mothers with clinical and outcome of birth history. For the purpose and interest of this study, only mothers on the PMTCT program were considered and this brought the total number of subjects to 950. Due to inconsistencies and missing information for some data points, some were dropped and this finally brought the total number of observations to 244 infants. The Chi-square test (p-value of 0.7211) showed that the type of delivery does not associate with detection of HIV; the test also showed (p-value of 0.1584) that breastfeeding practices was not associated with the outcome of detection of HIV. Gender of baby and the outcome of the HIV detection were associated (p-value of 0.0184). It was observed that there was an association between breastfeeding and gender of baby. In the final model, gender was significant with a p-value of 0.0198 at 5% level of significance. From the maximum likelihood estimates, the effect of gender based on the odds ratio estimate was 2.127 with 95% confidence interval between 1.127 and 4.012. The log-rank test showed border line significant results with (p-value of 0.0495) that there existed a significant time to detection of HIV between female babies and male babies, with male babies showing a shorter duration for HIV positive detection than females in general. This study concludes that delivery mode and breastfeeding practices are not significant routes through which HIV is transferred from mother to child, for mothers on PMTCT. The study again showed that male babies have almost twice the risk of HIV-1 infection compared to female babies and that the time to positive detection is shorter for male babies than female babies with a median time to detection of 343 days for male babies.
A thesis submitted to the Department of Mathematics, Kwame Nkrumah University of Science and Technology In partial fulfillment of the requirement for the Degree of Master of Science in Industrial Mathematics, 2015