Why did they get infected? Audit of MTCT risk factors among HIV-positive Infants attending Faith Based Health facilities in Uganda

Why did they get infected? 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Audit of MTCT risk factors among HIV-positive Infants attending Faith Based Health facilities in Uganda Joseph Ekong, Anahita Ali, Sam Orach Orochi This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8581206/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 10 You are reading this latest preprint version Abstract Background This study investigated the risk factors for MTCT among HIV positive infants in 29 faith-based health facilities in Uganda. Scope Despite major investments in PMTCT, Uganda continues to record pediatric HIV infections, especially in rural areas where faith based facilities are key providers. The study aimed to identify factors such as maternal ART adherence, healthcare access, and socio cultural influences to guide targeted Ministry of Health interventions. Methodology: A cross-sectional, retrospective design reviewed records of 117 HIV positive mother infant pairs from purposively selected facilities. Data were collected using a Ministry of Health-adapted PMTCT/EID audit tool, capturing socio-demographic, clinical, and service delivery factors. Analysis was conducted in IBM SPSS Version 20 using descriptive statistics and logistic regression. Results Most mothers were 19–24 years (52%), adolescent girls and young women (56%), single (52%), and unemployed (58%). ART initiation occurred before pregnancy (42%), during pregnancy (40%), and postnatally (15%). Key MTCT risk factors were late HIV diagnosis (47%), unsuppressed viral load (12%), obstetric complications (11%), missed infant prophylaxis (10%), and poor ART adherence (3%). Recommendations: Strengthen early HIV testing, ANC linkage, male involvement, ART adherence, infant prophylaxis, viral load monitoring, and data systems; address structural barriers; and leverage church networks to reduce stigma. Conclusion Enhanced community driven PMTCT interventions in faith-based settings are vital to eliminating pediatric HIV in Uganda. MTCT HIV risk factors HIV positive infant faith-based health facilities Figures Figure 1 Figure 2 1. Introduction Mother-to-child transmission (MTCT) of HIV remains a major public health challenge in Uganda and across sub-Saharan Africa. Despite progress in prevention, Uganda continues to rank among the ten countries contributing most to the global burden of vertical transmission (UNAIDS, 2016 ). The global elimination targets are < 2% among non-breastfeeding infants and < 5% among breastfeeding infants, yet Uganda’s rates remain above these thresholds. MTCT is the leading route of pediatric HIV infection in contexts where safe blood transfusion and infection control measures are observed. Without prevention, the risk of transmission from HIV-positive mothers to infants ranges between 25–45%, with 5–10% occurring during pregnancy, 10–20% at delivery, and 5–20% through breastfeeding (WHO, 2010 ; UNAIDS, 2016 ). The introduction of the Prevention of Mother-to-Child Transmission (PMTCT) cascade, a continuum including antenatal HIV testing, ART initiation, delivery care, infant prophylaxis, early infant diagnosis, and final outcome testing at 18 months, has reduced new infections, but persistent HIV-positive infant cases point to gaps in service uptake and adherence (Hamilton et al., 2017 ). Uganda’s demographic and epidemiological profile increases vulnerability to MTCT. The country has a population growth rate of 3.3%, a fertility rate of 5.8, a contraceptive prevalence of only 35% for any method, and an HIV prevalence of 8.3% among women of reproductive age (MoH, 2015). Without the elimination of MTCT (eMTCT) services, as many as 27,000 infants could acquire HIV each year, and approximately 1,560 HIV-infected mothers may die annually (MoH, 2014). In response, Uganda committed to the Global Plan Toward the Elimination of New HIV Infections among Children and Keeping their Mothers Alive, with targets to reduce MTCT to less than 5% and halve HIV-related maternal mortality by 2015 (WHO, 2010 ). However, despite large-scale investments, these ambitious targets still remain unmet. The ideal PMTCT outcome is elimination of new pediatric HIV infections, achievable through early maternal HIV diagnosis, initiation of lifelong ART, sustained adherence, timely infant prophylaxis, and consistent follow-up. In reality, some mothers discontinue ART, some infants miss prophylaxis, and delays in EID or retention in care persist. These systemic and behavioural barriers undermine program effectiveness, increase child morbidity and mortality, and slow progress toward elimination. Faith-based health facilities are central to Uganda’s health system, especially in rural and underserved areas, where they provide essential services to large, often vulnerable populations. Yet, even within these facilities, HIV-positive infant diagnoses continue to emerge. This raises critical questions about the interplay of maternal socio-demographic factors, ART adherence, timing of HIV diagnosis, infant feeding practices, and health system barriers in shaping outcomes. Persistent infant infections, despite the availability of PMTCT services, highlight the need for deeper investigation into the predictors of MTCT. This study, therefore, aimed to audit HIV-positive infant cases in faith-based facilities in Uganda between January 2018 and December 2024 with the following objectives; describe the socio-demographic characteristics of mothers and HIV-positive infants receiving care in faith-based health facilities across Uganda; assess the effectiveness and coverage of maternal adherence to antiretroviral therapy (ART) and infant prophylaxis within these facilities; and identify and examine maternal and infant-related risk factors associated with mother-to-child transmission (MTCT) of HIV among infants diagnosed as HIV-positive in faith-based health facilities in Uganda.. By examining maternal and infant characteristics, ART adherence, prophylaxis coverage, and service delivery gaps, the study aims to generate evidence for targeted, context-sensitive interventions. Findings will help strengthen accountability, inform national strategies, and contribute to Uganda’s broader goal of eliminating pediatric HIV infections and improving maternal and infant health outcomes. 2. Methods 2.1. Study design This was a retrospective, mixed-methods, cross-sectional study design that evaluated the risk factors responsible for HIV-positive status among HIV-exposed infants attending the 152 study sites. This was measured against the recommended Uganda HIV care and prevention guidelines. 2.2. Study variables : The primary outcome of interest in this study was Mother-to-Child Transmission (MTCT) of HIV. To understand the factors influencing this outcome, a range of independent variables were examined. Socio-demographic characteristics included the mother’s age, marital status, occupation, duration on ART, use of Nevirapine prophylaxis, adherence to ART, viral load, mode of delivery, breastfeeding status, gestational age, and the presence of other sexually transmitted infections. Clinical factors considered were the mother’s HIV status, whether negative, known positive, newly tested positive, or unknown, as well as her ART status. Additionally, temporal factors such as the year of diagnosis and the time since the start of treatment were assessed to identify trends and patterns over time. 2.3. Selection criteria We extracted data of all the HIV positive infants from the District Health Information System 2 (DHIS2) using pre-defined variables (e.g., EID test date, maternal ART status, infant prophylaxis). Missing or incomplete records were cross-checked in facility files or resolved by reviewing other facility records (e.g., ART registers, mother-baby follow-up files) to ensure data completeness. We then removed personal identifiers and stored data in a secure, password-protected computers. PRISMA–style flowchart- Audit of MTCT risk factors among HIV positive infants 2.4. Quality control Data were cross-verified with paper-based registers during data collection. A standardized extraction template ensured uniformity across facilities. Missing or implausible values were resolved through follow-up queries or excluded if unresolved. A 10% random sample of records was double checked, achieving > 95% inter-rater reliability (kappa = 0.92) 2.5. Data analysis Data were analyzed using SPSS v20.0 after cleaning for completeness, accuracy, and consistency. Descriptive statistics summarized respondent characteristics, using frequencies and proportions for categorical variables and means or medians for continuous variables. Open-ended responses were transcribed into Excel and analyzed thematically. Thematic analysis followed Braun and Clarke’s six-step framework, capturing perspectives on adherence, stigma, system challenges, and infant care. 2.6. Ethical considerations Ethical clearance to conduct this study was obtained from St Francis Hospital Nsambya Research and Ethics Committee (SFHN-2025-166), James Lind Institute and approval from the Uganda National Council of Science and Technology (HS5987ES). Since the study only uses existing records and does not involve direct contact with participants, no consent was obtained from the participants. Permission was obtained from the Uganda Catholic Medical Bureau and individual facilities before proceeding with data collection. Each script was assigned an anonymous serial number when entering the data so that no individual names or personal identities appeared in the database. 3. Results This chapter presents the major findings on risk factors for mother-to-child transmission (MTCT) of HIV among infants attending faith-based health facilities in Uganda. Data were collected through structured questionnaires and analyzed across three objectives: socio-demographic characteristics, coverage and effectiveness of ART and infant prophylaxis, and maternal/infant risk factors associated with MTCT. A total of 119 HIV-positive infants were identified in 29 health facilities across 11 districts; 117 were eligible for analysis. The burden was concentrated in Kampala, which accounted for 85% of cases despite representing one district and 34% of facilities. West Nile contributed 10%, while other regions reported far fewer cases, highlighting significant disparities in both burden and service distribution. 3.1. Socio-demographic characteristics of Mothers and HIV-positive Infants Most mothers were young, with 52% aged 19–24 years and 24% between 30–34 years. Over half (52%) were single and 58% unemployed, while 56% were categorized as adolescent girls and young women. Late entry into ANC was common, with 85% booking in the third trimester. Delivery mostly occurred in health facilities (93%), and all mothers had vaginal deliveries. Male partner HIV status was largely unknown (56%), with 40% documented as positive. Among infants, 88% were aged 2–12 months, suggesting transmission during breastfeeding. Most HIV infections were detected at first PCR (72%), with 89% of confirmatory tests conducted, 97% of which confirmed positivity. Table 1 Sociodemographic characteristics of Mothers and HIV positive infants attending Faith based health facilities Characteristic Frequency Percent 1 Maternal Information Mothers age (N = 117) 15–18 years 4 3% 19–24 years 61 52% 25–29 year 13 11% 30–34 years 28 24% 36–40 years 11 9% Above 40 years 0 0% Mothers Marital status (N = 117) Single 61 52% Married 56 48% Cohabiting 0 0% Widowed 0 0% Divorced 0 0% Separated 0 0% Mothers occupation (N = 117) Unemployed 68 58% Employed 49 42% Special categories of the Mother (N = 117) Adolescent girls and young women 65 56% Uncategorized 52 44% Gestation age at 1st ANC in weeks (N = 117) Third Trimester (28–40 weeks) 100 85% Second Trimester (13–27 weeks) 17 15% First trimester (0–12 weeks) 0 0% Place of delivery (N = 117) Health facility 109 93% Home 8 7% Mode of delivery (N = 117) Safe vaginal delivery 117 100% Caesarean Section 0 0% Instrumental delivery 0 0% Did the mother have other STIs (N = 117) No 117 100% Syphilis 0 0% Hepatitis B 0 0% Male partners HIV status (N = 117) Unknown 66 56% Positive 47 40% Negative 4 3% 2 Infant Information Infant age 2–12 months 103 88% 13–18 months 13 11% < 2months 1 1% Test done at POC (N = 117) No 104 89% Yes 13 11% Indicate which PCR was done (N = 117) 1st 84 72% 2nd 25 21% 18 Months rapid test 6 5% 3rd 2 2% Was confirmatory PCR done Yes 104 88.9% No 13 11.1% Results of confirmatory PCR test (N = 104) Positive 101 97% Inconclusive 2 2% Negative 1 1% 3.2. Coverage of maternal adherence to antiretroviral therapy (ART) and infant prophylaxis Infant prophylaxis coverage was high, with 90% receiving Nevirapine or ARV prophylaxis, and 91% initiated at birth. ART initiation was also strong, with 91% enrolled, predominantly on Abacavir + Lamivudine + Lopinavir/Ritonavir regimens. However, 3% of infants died before initiation, underscoring delays in early diagnosis and linkage to care. Feeding practices were encouraging, with 91% exclusively breastfed for six months, followed by 93% on complementary feeding thereafter. Maternal ART coverage was robust, with 42% initiated before pregnancy and 40% during pregnancy, though most (91%) of those starting in pregnancy began in the third trimester, reducing suppression time before delivery. Retention was relatively good, with 75% on ART for > 6 months. Adherence was high, with 91% reporting no missed doses, though barriers such as transport costs and long distances persisted. Psychosocial challenges included stigma (3%) and denial (2%), highlighting ongoing structural and cultural barriers. Viral load (VL) monitoring coverage was commendable: 95% had testing during ANC or postpartum. Suppression was achieved in 91%, with only one mother failing therapy and undergoing resistance testing. Of those with unsuppressed VL, 82% received intensive adherence counselling and 18% were switched to second-line regimens, with nearly half achieving suppression. Table 2 Coverage of Maternal and Infant adherence to ART treatment and prophylaxis Characteristic Frequency Percent Child received Nevirapine or ARV prophylaxis (n = 117) Yes 105 90% No 12 10% Age received ARVs for prophylaxis (n = 105) At birth 96 91% Weeks 6 6% After 72 hours 3 3% Was the infant started on ART Yes 106 91% No 11 9% If no, circle the reason (n = 11) Referred to another facility 10 91% Dead 1 9% If referred to another facility, state facility name (N = 100) JCRC 5 50% Baylor Uganda 4 40% Mulago Hospital 1 10% Was the child initiated where she or he was referred (N = 10) Yes 9 90% Unknown 1 10% What ART regimen was the baby started on? (N = 117) Abacavir + Lamivudine + Lopinavir / Ritonavir 74 63% Abacavir + Lamivudine + Doutegravir 21 18% Abacavir + Lamivudine + Lopinavir / Ritonavir pellets 11 9% Baby died before ART 4 3% Tenofovir + Lamivudine + Doutegravir 3 3% Abacavir + Lamivudine + Nevirapine 2 2% Tenofovir + Lamivudine + Efavirenz 1 1% Unknown 1 1% Infant feeding option before 6 months (N = 117) Exclusive breastfeeding (EBF) 107 91% Mixed feeding 9 8% Early replacement feeding (ERF) 1 1% Infant feeding option after 6 months (N = 117) Complementary 109 93% Early replacement feeding (ERF) 5 4% Exclusive breastfeeding (EBF) 2 2% Unknown 1 1% Select a period mother was initiated on ART (N = 117) Before pregnancy 49 42% During pregnancy 47 40% During post-natal period 17 15% At birth 4 3% If ART was initiated during pregnancy, what was the mother's gestational age in weeks (N = 47) Third Trimester (28–40 weeks) 43 91% Second Trimester (13–27 weeks) 4 9% First trimester (0–12 weeks) 0 0% Duration of mothers' retention on ART (N = 117) Less or than or equal to 3 months 26 22% 4–6 months 45 38% 7–12 months 41 35% 13 months plus 5 4% Duration of the mother in ART in months (N = 117) 0–3 months 12 10% 4–6 months 4 3% 7–12 months 54 46% 13 months plus 47 40% Has the mother ever missed her dose (N = 117) No 106 91% Yes 11 9% If yes, for how long? (N = 11) Weeks 6 55% Months 5 45% Days 0 0% What hesitation did the mother have in initiating ART? (N = 117) None 111 95% stigma 4 3% Denial 2 What are the reasons for the missed ART medication by the mother (N = 11) None 3 27% Distance to the health facility 2 18% Travelled 2 18% Lack of treatment supporter 1 9% No drugs 1 9% No money for transport 1 9% Illness 1 9% Period when the last viral load was done (N = 117) At 1st ANC during pregnancy 59 50% Post-partum 53 45% Not due 5 4% Is the mother failing on ART treatment (N = 117) No 116 99% Yes 1 1% If yes, has drug resistance been done (N = 1) Yes 1 100% No 0 0% Latest viral load copies / ML (N = 117) Suppressed (Viral load below 1000 copies / Ml 106 91% Unsuppressed (Viral load1000 copies / ml and above) 11 9% Interventions to improve Viral load (N = 11) Intensive adherence counselling sessions (123 IAC) 9 82% Switched to second line 2 18% Results of repeat viral load (N = 11) Suppressed (Viral load below 1000 copies / Ml 5 45% Unsuppressed (Viral load 1000 copies/ml and above) 3 27% Not due for repeat 3 27% 3.3. Maternal and HIV positive Infant risk factors associated with MTCT of HIV among infants diagnosed as HIV-positive Key maternal and infant risk factors for MTCT were identified. Late maternal HIV diagnosis accounted for 47% of cases, followed by unsuppressed VL (12%), obstetric complications such as obstructed labour (11%), and missed infant prophylaxis at birth (10%). Poor ART adherence, home deliveries, maternal chronic illness, and infections contributed marginally. In 11% of cases, the cause was undocumented. 4. Discussion 4.1. Socio-demographic characteristics of Mothers and HIV-positive infants The study revealed that most mothers were aged 19–24 years (52%), followed by 30–34 years (24%), with a mean age of 26.03 years (SD 5.6). A study in India showed that women aged 30 and above had a sevenfold increased risk of MTCT (NIH, 2024), though other literature links older age with improved ART adherence due to maturity (Gedefaw A. et al., 2024 ). This contrast highlights the need for age-specific PMTCT interventions. In terms of marital status, 52% of mothers were single, while 48% were married. Single mothers face reduced access to PMTCT services, lack of partner support, and poorer maternal-child health outcomes (Mbonye et al., 2010 ; Medley et al., 2004 ). Employment was reported by only 42% of mothers, with unemployment (58%) linked to food insecurity, limited autonomy, and poor ART adherence (Dlamini et al., 2009 ). Male involvement may serve as both a barrier and an enabler to retention in care (Tekakwo, A. et al., 2023 ). Adolescent girls and young women (AGYW) comprised 56% of participants, confirming their vulnerability to HIV acquisition and transmission due to structural and socio-behavioral factors (Murewanhema et al., 2022 ). UNAIDS ( 2016 ) notes that AGYW in sub-Saharan Africa account for 77% of new HIV infections, driven by poverty, gender-based violence, and unequal power dynamics. Regarding delivery, 93% of mothers gave birth in health facilities while 7% delivered at home. Facility births reduce MTCT through skilled attendance and timely prophylaxis (Sserwanja Q. et al., 2021 ), with faith-based health facilities offering affordability, accessibility, and holistic care (Opara U.C., et al., 2024). Male partner HIV status remained unknown in 56% of cases, while 40% were HIV-positive and 4% HIV-negative. Male involvement strongly influences adherence and ANC attendance (Aluisio et al., 2011 ; Byamugisha et al., 2010 ), yet cultural perceptions hinder men’s participation, with many fearing stigma or HIV testing. Among HIV-positive infants, 88% were diagnosed between 2–12 months, aligning with Uganda’s DNA PCR guidelines at 6 weeks (MOH Uganda, 2023). Most (72%) were identified at first PCR, 21% at second PCR, and 5% at the 18-month rapid test, indicating possible breastfeeding-related transmission. Encouragingly, 90% of infants received prophylaxis, mainly Nevirapine, with 91% initiated at birth (MOH, 2023). Prompt prophylaxis prevents intrapartum transmission, while delays heighten risk (Luo R. et al., 2022 ). Similarly, 91% of infants were initiated on ART, with delays largely due to referral, though 90% of referred infants started ART at the receiving facility. The most common regimen was Abacavir + Lamivudine + Lopinavir/Ritonavir (63%), consistent with WHO and MOH recommendations, while 18% received Dolutegravir-based regimens (Zakumumpa, A, 2021). A small proportion (3%) died before ART initiation. Infant feeding practices largely adhered to WHO guidelines, with 91% exclusively breastfeeding (EBF) for six months, 8% mixed feeding, and 1% early replacement feeding. After six months, 93% transitioned to complementary feeding. EBF combined with maternal ART reduces postnatal HIV transmission compared to mixed feeding, which increases gut inflammation and permeability (Kuhn & Kroon, 2015 ). 4.2. Coverage of maternal adherence to ART and infant prophylaxis in faith-based health facilities In this study, 42% of mothers initiated ART before pregnancy, 40% during pregnancy, 15% postnatally, and 3% at delivery. Among those started in pregnancy, 91% initiated in the third trimester, representing missed opportunities for earlier initiation, which is crucial for viral suppression before delivery (Woldesenbet SA et al., 2020 ). Retention patterns showed 38% of mothers on ART for 4–6 months, 35% for 7–12 months, and 4% for more than 13 months, with overlapping data showing 46% on ART for 7–12 months and 40% for ≥ 13 months. These trends suggest many women were newly initiated during pregnancy, reflecting late ANC attendance; in Uganda, only 29% of women attend ANC in the first trimester (Acup. W, et.al, 2023). Short ART duration before delivery increases MTCT risk, though test-and-treat policies adopted since 2013 have boosted initiation rates (Gamell A., et al., 2017 ). Non-adherence was reported by 9% of mothers, with missed doses spanning weeks (55%) or months (45%). Barriers included distance, transport costs, stockouts, lack of treatment supporters, and stigma, echoing findings from sub-Saharan Africa (Nachega et al., 2012 ). Hesitation in ART initiation due to stigma (3%) and denial (2%) was also noted, reinforcing the need for stigma reduction and partner disclosure support (Turan et al., 2016 ). Disclosure to partners was strongly associated with better retention and uptake of PMTCT services (Waddell & Messeri, 2006 ). Viral load monitoring showed that 50% of women were tested during ANC and 45% postpartum, with 91% achieving suppression (< 1000 copies/ml). Among 11 unsuppressed mothers, 82% underwent intensive adherence counselling (IAC), while 18% were switched to second-line therapy. On follow-up, 45% suppressed, 27% remained unsuppressed, and 27% were not due for retesting. Only one mother failed ART and tested drug-resistant, in line with national HIV resistance protocols. These results emphasize the importance of viral load monitoring and IAC in preventing MTCT (Palanee-Phillips T., et al., 2022 ). 4.3. Maternal and infant risk factors for MTCT in faith-based health facilities The leading factor contributing to MTCT was late maternal HIV diagnosis (47%), highlighting gaps in early antenatal testing. WHO ( 2021 ) confirms that early maternal diagnosis and ART can reduce MTCT to < 5% in breastfeeding settings and < 2% in non-breastfeeding contexts. Late ANC attendance has been consistently associated with MTCT (Woldesenbet et al., 2020 ; Karl-Günter Technau et al., 2014 ). Barriers such as stigma, denial, and fear of disclosure may further delay ART initiation. Unsuppressed maternal viral load contributed 12% of cases, reinforcing its role as a biological predictor of MTCT (Woldesenbet SA, et.al.,2020). Contributing factors include poor adherence, drug resistance, or late ART initiation. Poor adherence alone was reported by 3% of respondents, but underreporting likely masks its true burden. Adherence < 80% significantly increases virologic failure and MTCT risk (Nachega et al., 2012 ). Obstetric complications such as obstructed labour accounted for 11% of cases, heightening exposure risks when ART coverage is incomplete (Ciaranello et al., 2012 ). Another 10% of infants missed Nevirapine prophylaxis, a key intervention proven to reduce transmission by up to 50% (Ciaranello et al., 2012 ). Systemic causes such as stockouts and documentation gaps likely contributed. Finally, home deliveries (2%) limited access to skilled birth attendance and prophylaxis, aligning with evidence that institutional deliveries reduce MTCT compared to home births (UDHS, 2016). 4.4. Limitations: This study was limited to a period of the of the post graduate studies, and this does not give room for a re-audit to show if the recommendations of this audit have improved services. We presented the findings to the health facilities, and the Uganda Catholic Medical Bureau will follow through with the findings. Also, retrospective data collection may encounter missing data from participants, leading to their exclusion from the study. We attempted to trace the patients with missing results so that they would be included in the study. This study was conducted at the facilities, as clinical management of these children was still ongoing, and these details will not be captured during this audit. We will, however, pick up missing information if it has become available on revisit. This study may have limited generalizability due to the study focusing on faith-based health facilities only. We do recommend that a similar study be done in non-faith-based health facilities. 4.5. Conclusion Despite 93% facility-based deliveries and 91% infant prophylaxis uptake, MTCT persisted in faith-based facilities. Nearly 47% of cases were linked to late maternal HIV diagnosis, while 56% of male partners had unknown HIV status. Although 91% of mothers achieved viral suppression, adherence gaps, treatment fatigue, and system barriers limited outcomes. Missed prophylaxis (10%) and undocumented MTCT causes (11%) underscore the need for integrated strategies to close clinical and systemic gaps. Declarations Funding Declaration: This study did not receive any specific funding from public, commercial, or not-for-profit funding agencies. Ethics consent to participate: Ethical approval was obtained from St Francis Hospital Nsambya Research and Ethics Committee (SFHN-2025-166), James Lind Institute, and the Uganda National Council for Science and Technology (HS5987ES). The study used routinely collected program data with no direct participant contact; therefore, informed consent was waived. All data were anonymized before analysis. Consent to publish: Not applicable. This study utilized routinely collected, anonymized program data with no identifying information about individual participants. Data Availability: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request, subject to institutional and ethical approvals. Competing Interest: The authors declare that they have no competing interests. Author Contribution: Conceptualized the study and design: Joseph Ekong Methodology: Joseph Ekong, Anahita Ali Supervision: Anahita Ali, Sam Orach Orochi Conducted the data analysis and wrote the original manuscript: Joseph Ekong and Anahita Ali Reviewed and improved the manuscript: Anahita Ali, Sam Orach Orochi All authors read and approved the final manuscript. Corresponding author: Correspondence to Joseph Ekong Acknowledgements: Uganda Catholic Medical Bureau, and participating Health facilities for their support. References UNAIDS. On the fast track to an AIDS-free generation: The incredible journey of the global plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive. 2016;108. http://www.unaids.org/sites/default/files/media_asset/ GlobalPlan2016_en.pdf WHO. PMTCT Strategic Vision 2010–2015: Preventing Mother-to-Child Transmission of HIV to Reach The UNGASS and Millennium Development Goals. 2010. UNAIDS. AIDS by the Numbers. 2016. 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Assessed on 1st June 2025. Woldesenbet SA, Kufa T, Barron P, Chirombo BC, Cheyip M, Ayalew K, Lombard C, Manda S, Diallo K, Pillay Y, Puren AJ. (2020). Viral suppression and factors associated with failure to achieve viral suppression among pregnant women in South Africa. AIDS. 2020;34(4):589–597. doi: 10.1097/QAD.0000000000002457. PMID: 31821189; PMCID: PMC7050794. Acup W, Opollo MS, Akullo BN, Musinguzi M, Kigongo E, Opio B, Kabunga A. Factors associated with first antenatal care (ANC) attendance within 12 weeks of pregnancy among women in Lira City, Northern Uganda: a facility-based cross-sectional study. BMJ Open. 2023;13(7):e071165. 10.1136/bmjopen-2022-071165 . PMID: 37524555; PMCID: PMC10391812. Assessed on 10th July 2025. Gamell A, Luwanda LB, Kalinjuma AV, Samson L, Ntamatungiro AJ, Weisser M, Gingo W, Tanner M, Hatz C, Letang E, Battegay M, Group KS. Prevention of mother-to-child transmission of HIV Option B + cascade in rural Tanzania: The One Stop Clinic model. PLoS ONE. 2017;12(7):e0181096. https://doi.org/10.1371/journal.pone.0181096 . Assessed on 1st June 2025. Nachega JB, Uthman OA, Anderson J, Peltzer K, Wampold S, Cotton MF, Mills EJ, Ho YS, Stringer JS, McIntyre JA, Mofenson LM. (2012). Adherence to antiretroviral therapy during and after pregnancy in low-income, middle-income, and high-income countries: a systematic review and meta-analysis. AIDS. 2012;26(16):2039-52. 10.1097/QAD.0b013e328359590f . PMID: 22951634; PMCID: PMC5061936. Assessed on 1st June 2025. Turan JM, et al. HIV-related Stigma and PMTCT Program Engagement: A Systematic Review. Matern Child Health J. 2016;20(1):30–45. Assessed on 22nd January 2025. Waddell EN, Messeri PA. Social support, disclosure and use of antiretroviral therapy. J AIDS Behav. 2006;10(3):263–72. Assessed on 1st June 2025. Palanee-Phillips T, Rees HV, Heller KB, Ahmed K, Batting J, Beesham I, et al. High HIV incidence among young women in South Africa: Data from a large prospective study. PLoS ONE. 2022;17(6):e0269317. https://doi.org/10.1371/journal . pone.0269317. Assessed on 1st June 2025. WHO. (2021) Global HIV Program, Mother-to-child transmission of HIV. https://www.who.int/teams/global-hiv-hepatitis-and-stis-programmes/hiv/prevention/mother-to-child-transmission-of-hiv.Assessed on 25th March 2025. Woldesenbet S, Kufa T, Cheyip M, Ayalew K, Lombard C, Manda S, et al. Awareness of HIV-positive status and linkage to treatment prior to pregnancy in the test and treat era: A national antenatal sentinel survey, 2017, South Africa. PLoS ONE. 2020;15(3):e0229874. https://doi.org/10.1371/journal.pone.0229874 . Assessed on 1st March 2025. Technau KG, Kalk E, Coovadia A, Black V, Pickerill S, Mellins CA, Abrams EJ, Strehlau R, Kuhn L. Timing of maternal HIV testing and uptake of prevention of mother-to-child transmission interventions among women and their infected infants in Johannesburg, South Africa. J Acquir Immune Defic Syndr. 2014;65(5):e170–8. PMID: 24759066; PMCID: PMC3999509. Assessed on 1st June 2025. Ciaranello AL, Perez F, Keatinge J, Park J-E, Engelsmann B, et al. What Will It Take to Eliminate Pediatric HIV? Reaching WHO Target Rates of Mother-to-Child HIV Transmission in Zimbabwe: A Model-Based Analysis. PLoS Med. 2012;9(1):e1001156. 10.1371/journal.pmed.1001156 . Assessed on 1st June 2025. Uganda Bureau of Statistics (UBOS) and ICF. Uganda Demographic and Health Survey 2016. Maryland, USA: UBOS and ICF: Kampala, Uganda and Rockville; 2018. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 10 Feb, 2026 Reviews received at journal 06 Feb, 2026 Reviews received at journal 29 Jan, 2026 Reviewers agreed at journal 29 Jan, 2026 Reviewers agreed at journal 26 Jan, 2026 Reviewers agreed at journal 23 Jan, 2026 Reviewers invited by journal 23 Jan, 2026 Editor assigned by journal 14 Jan, 2026 Submission checks completed at journal 14 Jan, 2026 First submitted to journal 12 Jan, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8581206","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":580593058,"identity":"1ee16258-76ad-49cf-80b8-a69d4acb08a6","order_by":0,"name":"Joseph Ekong","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA90lEQVRIiWNgGAWjYDACHmTiA5BiYydFC+MMkBZmorRAWcxgDiEt/DyHjz38ImNjzy/de/i1za9t8nzMDIwfPubg1iLZ25ZuLMOTljhzzrk069y+24ZtzAzMkjO34dZicJ7HTFqC53CCwY0cM+PcntuMQC1szLx4tNhDtdjbg7RY9ty2J6jFgLfHTPIDz2HGDRI5xo8ZftxOJKhF4syxNGkGoF9m3DljxtjbcDu5jZmxGa9f+HuSj0n+7AGG2Owe4w8//ty2nd/efPDDRzxaQICZtwdkHwObBGMbiM/YgF89SMmPH2AtzB8Y/hBUPApGwSgYBSMQAAAXe0yVyztCsAAAAABJRU5ErkJggg==","orcid":"","institution":"Uganda Catholic Medical Bureau","correspondingAuthor":true,"prefix":"","firstName":"Joseph","middleName":"","lastName":"Ekong","suffix":""},{"id":580593059,"identity":"c6ad30a1-fe57-4591-a584-a16836efe119","order_by":1,"name":"Anahita Ali","email":"","orcid":"","institution":"James Lind Institute","correspondingAuthor":false,"prefix":"","firstName":"Anahita","middleName":"","lastName":"Ali","suffix":""},{"id":580593060,"identity":"e2cd4aa0-16c8-44a4-8a9c-6532e364842b","order_by":2,"name":"Sam Orach Orochi","email":"","orcid":"","institution":"Uganda Catholic Medical Bureau","correspondingAuthor":false,"prefix":"","firstName":"Sam","middleName":"Orach","lastName":"Orochi","suffix":""}],"badges":[],"createdAt":"2026-01-12 11:38:21","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8581206/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8581206/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":101364279,"identity":"88d98eb3-61ac-447f-8950-4771c97dd6e8","added_by":"auto","created_at":"2026-01-29 00:47:29","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":59990,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003e\u003cstrong\u003eRegional distribution of HIV Positive infants attending Faith Based Health facilities in Uganda\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e","description":"","filename":"drawingimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-8581206/v1/d5ae1365caca6f99b9af4487.png"},{"id":101364280,"identity":"723ca831-cb8b-4e53-8231-5cef429e2f0b","added_by":"auto","created_at":"2026-01-29 00:47:29","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":82094,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003e\u003cstrong\u003eShows Maternal and HIV positive Infant risk factors associated with MTCT of HIV among infants diagnosed as HIV positive attending faith based health facilities\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e","description":"","filename":"drawingimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-8581206/v1/efeb3fc46e1f6ae48d01f75f.png"},{"id":101880455,"identity":"232d149a-a786-4396-888f-8d6cea940dc6","added_by":"auto","created_at":"2026-02-04 15:02:13","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1402660,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8581206/v1/2e970125-5a4a-4bfc-9b4e-40f8159f2c76.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eWhy did they get infected? Audit of MTCT risk factors among HIV-positive Infants attending Faith Based Health facilities in Uganda\u003c/p\u003e","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003eMother-to-child transmission (MTCT) of HIV remains a major public health challenge in Uganda and across sub-Saharan Africa. Despite progress in prevention, Uganda continues to rank among the ten countries contributing most to the global burden of vertical transmission (UNAIDS, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). The global elimination targets are \u0026lt;\u0026thinsp;2% among non-breastfeeding infants and \u0026lt;\u0026thinsp;5% among breastfeeding infants, yet Uganda\u0026rsquo;s rates remain above these thresholds. MTCT is the leading route of pediatric HIV infection in contexts where safe blood transfusion and infection control measures are observed. Without prevention, the risk of transmission from HIV-positive mothers to infants ranges between 25\u0026ndash;45%, with 5\u0026ndash;10% occurring during pregnancy, 10\u0026ndash;20% at delivery, and 5\u0026ndash;20% through breastfeeding (WHO, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2010\u003c/span\u003e; UNAIDS, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). The introduction of the Prevention of Mother-to-Child Transmission (PMTCT) cascade, a continuum including antenatal HIV testing, ART initiation, delivery care, infant prophylaxis, early infant diagnosis, and final outcome testing at 18 months, has reduced new infections, but persistent HIV-positive infant cases point to gaps in service uptake and adherence (Hamilton et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2017\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eUganda\u0026rsquo;s demographic and epidemiological profile increases vulnerability to MTCT. The country has a population growth rate of 3.3%, a fertility rate of 5.8, a contraceptive prevalence of only 35% for any method, and an HIV prevalence of 8.3% among women of reproductive age (MoH, 2015). Without the elimination of MTCT (eMTCT) services, as many as 27,000 infants could acquire HIV each year, and approximately 1,560 HIV-infected mothers may die annually (MoH, 2014). In response, Uganda committed to the Global Plan Toward the Elimination of New HIV Infections among Children and Keeping their Mothers Alive, with targets to reduce MTCT to less than 5% and halve HIV-related maternal mortality by 2015 (WHO, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). However, despite large-scale investments, these ambitious targets still remain unmet.\u003c/p\u003e \u003cp\u003eThe ideal PMTCT outcome is elimination of new pediatric HIV infections, achievable through early maternal HIV diagnosis, initiation of lifelong ART, sustained adherence, timely infant prophylaxis, and consistent follow-up. In reality, some mothers discontinue ART, some infants miss prophylaxis, and delays in EID or retention in care persist. These systemic and behavioural barriers undermine program effectiveness, increase child morbidity and mortality, and slow progress toward elimination.\u003c/p\u003e \u003cp\u003eFaith-based health facilities are central to Uganda\u0026rsquo;s health system, especially in rural and underserved areas, where they provide essential services to large, often vulnerable populations. Yet, even within these facilities, HIV-positive infant diagnoses continue to emerge. This raises critical questions about the interplay of maternal socio-demographic factors, ART adherence, timing of HIV diagnosis, infant feeding practices, and health system barriers in shaping outcomes.\u003c/p\u003e \u003cp\u003ePersistent infant infections, despite the availability of PMTCT services, highlight the need for deeper investigation into the predictors of MTCT. This study, therefore, aimed to audit HIV-positive infant cases in faith-based facilities in Uganda between January 2018 and December 2024 with the following objectives; describe the socio-demographic characteristics of mothers and HIV-positive infants receiving care in faith-based health facilities across Uganda; assess the effectiveness and coverage of maternal adherence to antiretroviral therapy (ART) and infant prophylaxis within these facilities; and identify and examine maternal and infant-related risk factors associated with mother-to-child transmission (MTCT) of HIV among infants diagnosed as HIV-positive in faith-based health facilities in Uganda.. By examining maternal and infant characteristics, ART adherence, prophylaxis coverage, and service delivery gaps, the study aims to generate evidence for targeted, context-sensitive interventions. Findings will help strengthen accountability, inform national strategies, and contribute to Uganda\u0026rsquo;s broader goal of eliminating pediatric HIV infections and improving maternal and infant health outcomes.\u003c/p\u003e \u003c/div\u003e \u003c/p\u003e"},{"header":"2. Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n \u003ch2\u003e2.1. Study design\u003c/h2\u003e\n \u003cp\u003eThis was a retrospective, mixed-methods, cross-sectional study design that evaluated the risk factors responsible for HIV-positive status among HIV-exposed infants attending the 152 study sites. This was measured against the recommended Uganda HIV care and prevention guidelines.\u003c/p\u003e\u003cspan\u003e\u003cstrong\u003e2.2. Study variables\u003c/strong\u003e: The primary outcome of interest in this study was Mother-to-Child Transmission (MTCT) of HIV. To understand the factors influencing this outcome, a range of independent variables were examined. Socio-demographic characteristics included the mother\u0026rsquo;s age, marital status, occupation, duration on ART, use of Nevirapine prophylaxis, adherence to ART, viral load, mode of delivery, breastfeeding status, gestational age, and the presence of other sexually transmitted infections. Clinical factors considered were the mother\u0026rsquo;s HIV status, whether negative, known positive, newly tested positive, or unknown, as well as her ART status. Additionally, temporal factors such as the year of diagnosis and the time since the start of treatment were assessed to identify trends and patterns over time.\u003cbr\u003e\u003c/span\u003e \u003cspan\u003e\u003cstrong\u003e2.3. Selection criteria\u003c/strong\u003e\u003cbr\u003e\u003c/span\u003eWe extracted data of all the HIV positive infants from the District Health Information System 2 (DHIS2) using pre-defined variables (e.g., EID test date, maternal ART status, infant prophylaxis). Missing or incomplete records were cross-checked in facility files or resolved by reviewing other facility records (e.g., ART registers, mother-baby follow-up files) to ensure data completeness. We then removed personal identifiers and stored data in a secure, password-protected computers.\u003cp\u003e\u003cstrong\u003ePRISMA\u0026ndash;style flowchart- Audit of MTCT risk factors among HIV positive infants\u003c/strong\u003e\u003c/p\u003e\n \u003ch2\u003e2.4. Quality control\u003c/h2\u003e\n \u003cp\u003eData were cross-verified with paper-based registers during data collection. A standardized extraction template ensured uniformity across facilities. Missing or implausible values were resolved through follow-up queries or excluded if unresolved. A 10% random sample of records was double checked, achieving\u0026thinsp;\u0026gt;\u0026thinsp;95% inter-rater reliability (kappa\u0026thinsp;=\u0026thinsp;0.92)\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\n \u003ch2\u003e2.5. Data analysis\u003c/h2\u003e\n \u003cp\u003eData were analyzed using SPSS v20.0 after cleaning for completeness, accuracy, and consistency. Descriptive statistics summarized respondent characteristics, using frequencies and proportions for categorical variables and means or medians for continuous variables. Open-ended responses were transcribed into Excel and analyzed thematically. Thematic analysis followed Braun and Clarke\u0026rsquo;s six-step framework, capturing perspectives on adherence, stigma, system challenges, and infant care.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\n \u003ch2\u003e2.6. Ethical considerations\u003c/h2\u003e\n \u003cp\u003eEthical clearance to conduct this study was obtained from St Francis Hospital Nsambya Research and Ethics Committee (SFHN-2025-166), James Lind Institute and approval from the Uganda National Council of Science and Technology (HS5987ES). Since the study only uses existing records and does not involve direct contact with participants, no consent was obtained from the participants. Permission was obtained from the Uganda Catholic Medical Bureau and individual facilities before proceeding with data collection. Each script was assigned an anonymous serial number when entering the data so that no individual names or personal identities appeared in the database.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"3. Results","content":"\u003cp\u003eThis chapter presents the major findings on risk factors for mother-to-child transmission (MTCT) of HIV among infants attending faith-based health facilities in Uganda. Data were collected through structured questionnaires and analyzed across three objectives: socio-demographic characteristics, coverage and effectiveness of ART and infant prophylaxis, and maternal/infant risk factors associated with MTCT.\u003c/p\u003e \u003cp\u003eA total of 119 HIV-positive infants were identified in 29 health facilities across 11 districts; 117 were eligible for analysis. The burden was concentrated in Kampala, which accounted for 85% of cases despite representing one district and 34% of facilities. West Nile contributed 10%, while other regions reported far fewer cases, highlighting significant disparities in both burden and service distribution.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e3.1. Socio-demographic characteristics of Mothers and HIV-positive Infants\u003c/h2\u003e \u003cp\u003eMost mothers were young, with 52% aged 19\u0026ndash;24 years and 24% between 30\u0026ndash;34 years. Over half (52%) were single and 58% unemployed, while 56% were categorized as adolescent girls and young women. Late entry into ANC was common, with 85% booking in the third trimester. Delivery mostly occurred in health facilities (93%), and all mothers had vaginal deliveries. Male partner HIV status was largely unknown (56%), with 40% documented as positive. Among infants, 88% were aged 2\u0026ndash;12 months, suggesting transmission during breastfeeding. Most HIV infections were detected at first PCR (72%), with 89% of confirmatory tests conducted, 97% of which confirmed positivity.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSociodemographic characteristics of Mothers and HIV positive infants attending Faith based health facilities\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCharacteristic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMaternal Information\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMothers age (N\u0026thinsp;=\u0026thinsp;117)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15\u0026ndash;18 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19\u0026ndash;24 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e52%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25\u0026ndash;29 year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30\u0026ndash;34 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36\u0026ndash;40 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAbove 40 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMothers Marital status (N\u0026thinsp;=\u0026thinsp;117)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e52%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e48%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCohabiting\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSeparated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMothers occupation (N\u0026thinsp;=\u0026thinsp;117)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e58%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEmployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSpecial categories of the Mother (N\u0026thinsp;=\u0026thinsp;117)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAdolescent girls and young women\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e56%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUncategorized\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e44%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGestation age at 1st ANC in weeks (N\u0026thinsp;=\u0026thinsp;117)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThird Trimester (28\u0026ndash;40 weeks)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e85%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecond Trimester (13\u0026ndash;27 weeks)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFirst trimester (0\u0026ndash;12 weeks)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePlace of delivery (N\u0026thinsp;=\u0026thinsp;117)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHealth facility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e109\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e93%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHome\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMode of delivery (N\u0026thinsp;=\u0026thinsp;117)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSafe vaginal delivery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e117\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e100%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCaesarean Section\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInstrumental delivery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDid the mother have other STIs (N\u0026thinsp;=\u0026thinsp;117)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e117\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e100%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSyphilis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHepatitis B\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale partners HIV status (N\u0026thinsp;=\u0026thinsp;117)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnknown\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e56%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eInfant Information\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInfant age\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u0026ndash;12 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e103\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e88%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13\u0026ndash;18 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;2months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTest done at POC (N\u0026thinsp;=\u0026thinsp;117)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e104\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e89%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIndicate which PCR was done (N\u0026thinsp;=\u0026thinsp;117)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1st\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e72%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2nd\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18 Months rapid test\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3rd\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWas confirmatory PCR done\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e104\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e88.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eResults of confirmatory PCR test (N\u0026thinsp;=\u0026thinsp;104)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e101\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e97%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInconclusive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e3.2. Coverage of maternal adherence to antiretroviral therapy (ART) and infant prophylaxis\u003c/h2\u003e \u003cp\u003eInfant prophylaxis coverage was high, with 90% receiving Nevirapine or ARV prophylaxis, and 91% initiated at birth. ART initiation was also strong, with 91% enrolled, predominantly on Abacavir\u0026thinsp;+\u0026thinsp;Lamivudine\u0026thinsp;+\u0026thinsp;Lopinavir/Ritonavir regimens. However, 3% of infants died before initiation, underscoring delays in early diagnosis and linkage to care. Feeding practices were encouraging, with 91% exclusively breastfed for six months, followed by 93% on complementary feeding thereafter.\u003c/p\u003e \u003cp\u003eMaternal ART coverage was robust, with 42% initiated before pregnancy and 40% during pregnancy, though most (91%) of those starting in pregnancy began in the third trimester, reducing suppression time before delivery. Retention was relatively good, with 75% on ART for \u0026gt;\u0026thinsp;6 months. Adherence was high, with 91% reporting no missed doses, though barriers such as transport costs and long distances persisted. Psychosocial challenges included stigma (3%) and denial (2%), highlighting ongoing structural and cultural barriers.\u003c/p\u003e \u003cp\u003eViral load (VL) monitoring coverage was commendable: 95% had testing during ANC or postpartum. Suppression was achieved in 91%, with only one mother failing therapy and undergoing resistance testing. Of those with unsuppressed VL, 82% received intensive adherence counselling and 18% were switched to second-line regimens, with nearly half achieving suppression.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCoverage of Maternal and Infant adherence to ART treatment and prophylaxis\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChild received Nevirapine or ARV prophylaxis (n\u0026thinsp;=\u0026thinsp;117)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e105\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e90%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge received ARVs for prophylaxis (n\u0026thinsp;=\u0026thinsp;105)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAt birth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e91%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeeks\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAfter 72 hours\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWas the infant started on ART\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e106\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e91%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIf no, circle the reason (n\u0026thinsp;=\u0026thinsp;11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReferred to another facility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e91%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDead\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIf referred to another facility, state facility name (N\u0026thinsp;=\u0026thinsp;100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eJCRC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBaylor Uganda\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMulago Hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWas the child initiated where she or he was referred (N\u0026thinsp;=\u0026thinsp;10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e90%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnknown\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhat ART regimen was the baby started on? (N\u0026thinsp;=\u0026thinsp;117)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAbacavir\u0026thinsp;+\u0026thinsp;Lamivudine\u0026thinsp;+\u0026thinsp;Lopinavir / Ritonavir\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e63%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAbacavir\u0026thinsp;+\u0026thinsp;Lamivudine\u0026thinsp;+\u0026thinsp;Doutegravir\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAbacavir\u0026thinsp;+\u0026thinsp;Lamivudine\u0026thinsp;+\u0026thinsp;Lopinavir / Ritonavir pellets\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBaby died before ART\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTenofovir\u0026thinsp;+\u0026thinsp;Lamivudine\u0026thinsp;+\u0026thinsp;Doutegravir\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAbacavir\u0026thinsp;+\u0026thinsp;Lamivudine\u0026thinsp;+\u0026thinsp;Nevirapine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTenofovir\u0026thinsp;+\u0026thinsp;Lamivudine\u0026thinsp;+\u0026thinsp;Efavirenz\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnknown\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInfant feeding option before 6 months (N\u0026thinsp;=\u0026thinsp;117)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExclusive breastfeeding (EBF)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e107\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e91%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMixed feeding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEarly replacement feeding (ERF)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInfant feeding option after 6 months (N\u0026thinsp;=\u0026thinsp;117)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eComplementary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e109\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e93%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEarly replacement feeding (ERF)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExclusive breastfeeding (EBF)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnknown\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelect a period mother was initiated on ART (N\u0026thinsp;=\u0026thinsp;117)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBefore pregnancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDuring pregnancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDuring post-natal period\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAt birth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIf ART was initiated during pregnancy, what was the mother's gestational age in weeks (N\u0026thinsp;=\u0026thinsp;47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThird Trimester (28\u0026ndash;40 weeks)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e91%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecond Trimester (13\u0026ndash;27 weeks)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFirst trimester (0\u0026ndash;12 weeks)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDuration of mothers' retention on ART (N\u0026thinsp;=\u0026thinsp;117)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLess or than or equal to 3 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4\u0026ndash;6 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e7\u0026ndash;12 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e13 months plus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDuration of the mother in ART in months (N\u0026thinsp;=\u0026thinsp;117)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e0\u0026ndash;3 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4\u0026ndash;6 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e7\u0026ndash;12 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e46%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e13 months plus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHas the mother ever missed her dose (N\u0026thinsp;=\u0026thinsp;117)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e106\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e91%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIf yes, for how long? (N\u0026thinsp;=\u0026thinsp;11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeeks\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e55%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMonths\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDays\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhat hesitation did the mother have in initiating ART? (N\u0026thinsp;=\u0026thinsp;117)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e111\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003estigma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDenial\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhat are the reasons for the missed ART medication by the mother (N\u0026thinsp;=\u0026thinsp;11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDistance to the health facility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTravelled\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLack of treatment supporter\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo drugs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo money for transport\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIllness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePeriod when the last viral load was done (N\u0026thinsp;=\u0026thinsp;117)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAt 1st ANC during pregnancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePost-partum\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot due\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIs the mother failing on ART treatment (N\u0026thinsp;=\u0026thinsp;117)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e116\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e99%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIf yes, has drug resistance been done (N\u0026thinsp;=\u0026thinsp;1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLatest viral load copies / ML (N\u0026thinsp;=\u0026thinsp;117)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSuppressed (Viral load below 1000 copies / Ml\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e106\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e91%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnsuppressed (Viral load1000 copies / ml and above)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInterventions to improve Viral load (N\u0026thinsp;=\u0026thinsp;11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntensive adherence counselling sessions (123 IAC)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e82%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSwitched to second line\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eResults of repeat viral load (N\u0026thinsp;=\u0026thinsp;11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSuppressed (Viral load below 1000 copies / Ml\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnsuppressed (Viral load 1000 copies/ml and above)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot due for repeat\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003e3.3. Maternal and HIV positive Infant risk factors associated with MTCT of HIV among infants diagnosed as HIV-positive\u003c/b\u003e \u003c/p\u003e \u003cp\u003eKey maternal and infant risk factors for MTCT were identified. Late maternal HIV diagnosis accounted for 47% of cases, followed by unsuppressed VL (12%), obstetric complications such as obstructed labour (11%), and missed infant prophylaxis at birth (10%). Poor ART adherence, home deliveries, maternal chronic illness, and infections contributed marginally. In 11% of cases, the cause was undocumented.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e4.1. Socio-demographic characteristics of Mothers and HIV-positive infants\u003c/h2\u003e \u003cp\u003eThe study revealed that most mothers were aged 19\u0026ndash;24 years (52%), followed by 30\u0026ndash;34 years (24%), with a mean age of 26.03 years (SD 5.6). A study in India showed that women aged 30 and above had a sevenfold increased risk of MTCT (NIH, 2024), though other literature links older age with improved ART adherence due to maturity (Gedefaw A. et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). This contrast highlights the need for age-specific PMTCT interventions. In terms of marital status, 52% of mothers were single, while 48% were married. Single mothers face reduced access to PMTCT services, lack of partner support, and poorer maternal-child health outcomes (Mbonye et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2010\u003c/span\u003e; Medley et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2004\u003c/span\u003e). Employment was reported by only 42% of mothers, with unemployment (58%) linked to food insecurity, limited autonomy, and poor ART adherence (Dlamini et al., \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2009\u003c/span\u003e). Male involvement may serve as both a barrier and an enabler to retention in care (Tekakwo, A. et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAdolescent girls and young women (AGYW) comprised 56% of participants, confirming their vulnerability to HIV acquisition and transmission due to structural and socio-behavioral factors (Murewanhema et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). UNAIDS (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2016\u003c/span\u003e) notes that AGYW in sub-Saharan Africa account for 77% of new HIV infections, driven by poverty, gender-based violence, and unequal power dynamics. Regarding delivery, 93% of mothers gave birth in health facilities while 7% delivered at home. Facility births reduce MTCT through skilled attendance and timely prophylaxis (Sserwanja Q. et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2021\u003c/span\u003e), with faith-based health facilities offering affordability, accessibility, and holistic care (Opara U.C., et al., 2024).\u003c/p\u003e \u003cp\u003eMale partner HIV status remained unknown in 56% of cases, while 40% were HIV-positive and 4% HIV-negative. Male involvement strongly influences adherence and ANC attendance (Aluisio et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2011\u003c/span\u003e; Byamugisha et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2010\u003c/span\u003e), yet cultural perceptions hinder men\u0026rsquo;s participation, with many fearing stigma or HIV testing. Among HIV-positive infants, 88% were diagnosed between 2\u0026ndash;12 months, aligning with Uganda\u0026rsquo;s DNA PCR guidelines at 6 weeks (MOH Uganda, 2023). Most (72%) were identified at first PCR, 21% at second PCR, and 5% at the 18-month rapid test, indicating possible breastfeeding-related transmission.\u003c/p\u003e \u003cp\u003eEncouragingly, 90% of infants received prophylaxis, mainly Nevirapine, with 91% initiated at birth (MOH, 2023). Prompt prophylaxis prevents intrapartum transmission, while delays heighten risk (Luo R. et al., \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Similarly, 91% of infants were initiated on ART, with delays largely due to referral, though 90% of referred infants started ART at the receiving facility. The most common regimen was Abacavir\u0026thinsp;+\u0026thinsp;Lamivudine\u0026thinsp;+\u0026thinsp;Lopinavir/Ritonavir (63%), consistent with WHO and MOH recommendations, while 18% received Dolutegravir-based regimens (Zakumumpa, A, 2021). A small proportion (3%) died before ART initiation.\u003c/p\u003e \u003cp\u003eInfant feeding practices largely adhered to WHO guidelines, with 91% exclusively breastfeeding (EBF) for six months, 8% mixed feeding, and 1% early replacement feeding. After six months, 93% transitioned to complementary feeding. EBF combined with maternal ART reduces postnatal HIV transmission compared to mixed feeding, which increases gut inflammation and permeability (Kuhn \u0026amp; Kroon, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2015\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e4.2. Coverage of maternal adherence to ART and infant prophylaxis in faith-based health facilities\u003c/h2\u003e \u003cp\u003eIn this study, 42% of mothers initiated ART before pregnancy, 40% during pregnancy, 15% postnatally, and 3% at delivery. Among those started in pregnancy, 91% initiated in the third trimester, representing missed opportunities for earlier initiation, which is crucial for viral suppression before delivery (Woldesenbet SA et al., \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Retention patterns showed 38% of mothers on ART for 4\u0026ndash;6 months, 35% for 7\u0026ndash;12 months, and 4% for more than 13 months, with overlapping data showing 46% on ART for 7\u0026ndash;12 months and 40% for \u0026ge;\u0026thinsp;13 months. These trends suggest many women were newly initiated during pregnancy, reflecting late ANC attendance; in Uganda, only 29% of women attend ANC in the first trimester (Acup. W, et.al, 2023). Short ART duration before delivery increases MTCT risk, though test-and-treat policies adopted since 2013 have boosted initiation rates (Gamell A., et al., \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). Non-adherence was reported by 9% of mothers, with missed doses spanning weeks (55%) or months (45%). Barriers included distance, transport costs, stockouts, lack of treatment supporters, and stigma, echoing findings from sub-Saharan Africa (Nachega et al., \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). Hesitation in ART initiation due to stigma (3%) and denial (2%) was also noted, reinforcing the need for stigma reduction and partner disclosure support (Turan et al., \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). Disclosure to partners was strongly associated with better retention and uptake of PMTCT services (Waddell \u0026amp; Messeri, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2006\u003c/span\u003e). Viral load monitoring showed that 50% of women were tested during ANC and 45% postpartum, with 91% achieving suppression (\u0026lt;\u0026thinsp;1000 copies/ml). Among 11 unsuppressed mothers, 82% underwent intensive adherence counselling (IAC), while 18% were switched to second-line therapy. On follow-up, 45% suppressed, 27% remained unsuppressed, and 27% were not due for retesting. Only one mother failed ART and tested drug-resistant, in line with national HIV resistance protocols. These results emphasize the importance of viral load monitoring and IAC in preventing MTCT (Palanee-Phillips T., et al., \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2022\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e4.3. Maternal and infant risk factors for MTCT in faith-based health facilities\u003c/h2\u003e \u003cp\u003eThe leading factor contributing to MTCT was late maternal HIV diagnosis (47%), highlighting gaps in early antenatal testing. WHO (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) confirms that early maternal diagnosis and ART can reduce MTCT to \u0026lt;\u0026thinsp;5% in breastfeeding settings and \u0026lt;\u0026thinsp;2% in non-breastfeeding contexts. Late ANC attendance has been consistently associated with MTCT (Woldesenbet et al., \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Karl-G\u0026uuml;nter Technau et al., \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). Barriers such as stigma, denial, and fear of disclosure may further delay ART initiation. Unsuppressed maternal viral load contributed 12% of cases, reinforcing its role as a biological predictor of MTCT (Woldesenbet SA, et.al.,2020). Contributing factors include poor adherence, drug resistance, or late ART initiation. Poor adherence alone was reported by 3% of respondents, but underreporting likely masks its true burden. Adherence\u0026thinsp;\u0026lt;\u0026thinsp;80% significantly increases virologic failure and MTCT risk (Nachega et al., \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). Obstetric complications such as obstructed labour accounted for 11% of cases, heightening exposure risks when ART coverage is incomplete (Ciaranello et al., \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). Another 10% of infants missed Nevirapine prophylaxis, a key intervention proven to reduce transmission by up to 50% (Ciaranello et al., \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). Systemic causes such as stockouts and documentation gaps likely contributed. Finally, home deliveries (2%) limited access to skilled birth attendance and prophylaxis, aligning with evidence that institutional deliveries reduce MTCT compared to home births (UDHS, 2016).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003e4.4. Limitations:\u003c/h2\u003e \u003cp\u003eThis study was limited to a period of the of the post graduate studies, and this does not give room for a re-audit to show if the recommendations of this audit have improved services. We presented the findings to the health facilities, and the Uganda Catholic Medical Bureau will follow through with the findings. Also, retrospective data collection may encounter missing data from participants, leading to their exclusion from the study. We attempted to trace the patients with missing results so that they would be included in the study. This study was conducted at the facilities, as clinical management of these children was still ongoing, and these details will not be captured during this audit. We will, however, pick up missing information if it has become available on revisit. This study may have limited generalizability due to the study focusing on faith-based health facilities only. We do recommend that a similar study be done in non-faith-based health facilities.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003e4.5. Conclusion\u003c/h2\u003e \u003cp\u003eDespite 93% facility-based deliveries and 91% infant prophylaxis uptake, MTCT persisted in faith-based facilities. Nearly 47% of cases were linked to late maternal HIV diagnosis, while 56% of male partners had unknown HIV status. Although 91% of mothers achieved viral suppression, adherence gaps, treatment fatigue, and system barriers limited outcomes. Missed prophylaxis (10%) and undocumented MTCT causes (11%) underscore the need for integrated strategies to close clinical and systemic gaps.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding Declaration:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study did not receive any specific funding from public, commercial, or not-for-profit funding agencies.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics consent to participate:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval was obtained from St Francis Hospital Nsambya Research and Ethics Committee (SFHN-2025-166), James Lind Institute, and the Uganda National Council for Science and Technology (HS5987ES). The study used routinely collected program data with no direct participant contact; therefore, informed consent was waived. All data were anonymized before analysis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to publish:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable. This study utilized routinely collected, anonymized program data with no identifying information about individual participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request, subject to institutional and ethical approvals.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interest:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003cstrong\u003eAuthor Contribution:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConceptualized the study and design: Joseph Ekong\u003cbr\u003e\u0026nbsp;Methodology: Joseph Ekong, Anahita Ali\u003cbr\u003e\u0026nbsp;Supervision: Anahita Ali, Sam Orach Orochi\u003cbr\u003e\u0026nbsp;Conducted the data analysis and wrote the original manuscript: Joseph Ekong and Anahita Ali\u003cbr\u003e\u0026nbsp;Reviewed and improved the manuscript: Anahita Ali, Sam Orach Orochi\u003cbr\u003e\u0026nbsp;All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCorresponding author:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCorrespondence to\u0026nbsp;Joseph Ekong\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Uganda Catholic Medical Bureau, and participating Health facilities for their support.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eUNAIDS. 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PMID: 31821189; PMCID: PMC7050794.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAcup W, Opollo MS, Akullo BN, Musinguzi M, Kigongo E, Opio B, Kabunga A. Factors associated with first antenatal care (ANC) attendance within 12 weeks of pregnancy among women in Lira City, Northern Uganda: a facility-based cross-sectional study. BMJ Open. 2023;13(7):e071165. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1136/bmjopen-2022-071165\u003c/span\u003e\u003cspan address=\"10.1136/bmjopen-2022-071165\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 37524555; PMCID: PMC10391812. Assessed on 10th July 2025.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGamell A, Luwanda LB, Kalinjuma AV, Samson L, Ntamatungiro AJ, Weisser M, Gingo W, Tanner M, Hatz C, Letang E, Battegay M, Group KS. Prevention of mother-to-child transmission of HIV Option B\u0026thinsp;+\u0026thinsp;cascade in rural Tanzania: The One Stop Clinic model. PLoS ONE. 2017;12(7):e0181096. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1371/journal.pone.0181096\u003c/span\u003e\u003cspan address=\"10.1371/journal.pone.0181096\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Assessed on 1st June 2025.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNachega JB, Uthman OA, Anderson J, Peltzer K, Wampold S, Cotton MF, Mills EJ, Ho YS, Stringer JS, McIntyre JA, Mofenson LM. (2012). Adherence to antiretroviral therapy during and after pregnancy in low-income, middle-income, and high-income countries: a systematic review and meta-analysis. AIDS. 2012;26(16):2039-52. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1097/QAD.0b013e328359590f\u003c/span\u003e\u003cspan address=\"10.1097/QAD.0b013e328359590f\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 22951634; PMCID: PMC5061936. Assessed on 1st June 2025.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTuran JM, et al. HIV-related Stigma and PMTCT Program Engagement: A Systematic Review. Matern Child Health J. 2016;20(1):30\u0026ndash;45. Assessed on 22nd January 2025.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWaddell EN, Messeri PA. Social support, disclosure and use of antiretroviral therapy. J AIDS Behav. 2006;10(3):263\u0026ndash;72. Assessed on 1st June 2025.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePalanee-Phillips T, Rees HV, Heller KB, Ahmed K, Batting J, Beesham I, et al. High HIV incidence among young women in South Africa: Data from a large prospective study. PLoS ONE. 2022;17(6):e0269317. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1371/journal\u003c/span\u003e\u003cspan address=\"10.1371/journal\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. pone.0269317. Assessed on 1st June 2025.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWHO. (2021) Global HIV Program, Mother-to-child transmission of HIV. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.who.int/teams/global-hiv-hepatitis-and-stis-programmes/hiv/prevention/mother-to-child-transmission-of-hiv.Assessed\u003c/span\u003e\u003cspan address=\"https://www.who.int/teams/global-hiv-hepatitis-and-stis-programmes/hiv/prevention/mother-to-child-transmission-of-hiv.Assessed\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e on 25th March 2025.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWoldesenbet S, Kufa T, Cheyip M, Ayalew K, Lombard C, Manda S, et al. Awareness of HIV-positive status and linkage to treatment prior to pregnancy in the test and treat era: A national antenatal sentinel survey, 2017, South Africa. PLoS ONE. 2020;15(3):e0229874. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1371/journal.pone.0229874\u003c/span\u003e\u003cspan address=\"10.1371/journal.pone.0229874\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Assessed on 1st March 2025.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTechnau KG, Kalk E, Coovadia A, Black V, Pickerill S, Mellins CA, Abrams EJ, Strehlau R, Kuhn L. Timing of maternal HIV testing and uptake of prevention of mother-to-child transmission interventions among women and their infected infants in Johannesburg, South Africa. J Acquir Immune Defic Syndr. 2014;65(5):e170\u0026ndash;8. PMID: 24759066; PMCID: PMC3999509. Assessed on 1st June 2025.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCiaranello AL, Perez F, Keatinge J, Park J-E, Engelsmann B, et al. What Will It Take to Eliminate Pediatric HIV? Reaching WHO Target Rates of Mother-to-Child HIV Transmission in Zimbabwe: A Model-Based Analysis. PLoS Med. 2012;9(1):e1001156. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1371/journal.pmed.1001156\u003c/span\u003e\u003cspan address=\"10.1371/journal.pmed.1001156\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Assessed on 1st June 2025.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUganda Bureau of Statistics (UBOS) and ICF. Uganda Demographic and Health Survey 2016. Maryland, USA: UBOS and ICF: Kampala, Uganda and Rockville; 2018.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-pregnancy-and-childbirth","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prch","sideBox":"Learn more about [BMC Pregnancy and Childbirth](http://bmcpregnancychildbirth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/prch/default.aspx","title":"BMC Pregnancy and Childbirth","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"MTCT, HIV, risk factors, HIV positive infant, faith-based health facilities","lastPublishedDoi":"10.21203/rs.3.rs-8581206/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8581206/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThis study investigated the risk factors for MTCT among HIV positive infants in 29 faith-based health facilities in Uganda. Scope Despite major investments in PMTCT, Uganda continues to record pediatric HIV infections, especially in rural areas where faith based facilities are key providers. The study aimed to identify factors such as maternal ART adherence, healthcare access, and socio cultural influences to guide targeted Ministry of Health interventions.\u003c/p\u003e\u003ch2\u003eMethodology:\u003c/h2\u003e \u003cp\u003eA cross-sectional, retrospective design reviewed records of 117 HIV positive mother infant pairs from purposively selected facilities. Data were collected using a Ministry of Health-adapted PMTCT/EID audit tool, capturing socio-demographic, clinical, and service delivery factors. Analysis was conducted in IBM SPSS Version 20 using descriptive statistics and logistic regression.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eMost mothers were 19\u0026ndash;24 years (52%), adolescent girls and young women (56%), single (52%), and unemployed (58%). ART initiation occurred before pregnancy (42%), during pregnancy (40%), and postnatally (15%). Key MTCT risk factors were late HIV diagnosis (47%), unsuppressed viral load (12%), obstetric complications (11%), missed infant prophylaxis (10%), and poor ART adherence (3%).\u003c/p\u003e\u003ch2\u003eRecommendations:\u003c/h2\u003e \u003cp\u003eStrengthen early HIV testing, ANC linkage, male involvement, ART adherence, infant prophylaxis, viral load monitoring, and data systems; address structural barriers; and leverage church networks to reduce stigma.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eEnhanced community driven PMTCT interventions in faith-based settings are vital to eliminating pediatric HIV in Uganda.\u003c/p\u003e","manuscriptTitle":"Why did they get infected? Audit of MTCT risk factors among HIV-positive Infants attending Faith Based Health facilities in Uganda","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-29 00:47:22","doi":"10.21203/rs.3.rs-8581206/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-02-10T05:22:35+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-06T21:27:01+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-29T08:56:09+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"302465429018224297324956150269332209422","date":"2026-01-29T08:49:43+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"176643200931276734471966608754029537030","date":"2026-01-26T08:11:54+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"234296908007305555290183530984092069392","date":"2026-01-23T16:41:50+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-01-23T15:26:36+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-01-14T08:49:34+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-01-14T08:46:38+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Pregnancy and Childbirth","date":"2026-01-12T11:19:15+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-pregnancy-and-childbirth","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prch","sideBox":"Learn more about [BMC Pregnancy and Childbirth](http://bmcpregnancychildbirth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/prch/default.aspx","title":"BMC Pregnancy and Childbirth","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c2dd42f1-7060-4fc1-bd68-7818970ebf32","owner":[],"postedDate":"January 29th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-14T20:53:13+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-29 00:47:22","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8581206","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8581206","identity":"rs-8581206","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}