Clinical Outcomes and Survival of HIV Exposed Children at 18 Months in Post-Conflict Region: Insight from the Panzi Interdisciplinary PMTCT Cohort (Panzi IPC) study

Clinical Outcomes and Survival of HIV Exposed Children at 18 Months in Post-Conflict Region: Insight from the Panzi Interdisciplinary PMTCT Cohort (Panzi IPC) study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Clinical Outcomes and Survival of HIV Exposed Children at 18 Months in Post-Conflict Region: Insight from the Panzi Interdisciplinary PMTCT Cohort (Panzi IPC) study Berckmans Mukanire Ntakwinja¹, Patrick DMC Katoto², Lampard Omari Mukanga, and 10 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6194709/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 20 Mar, 2026 Read the published version in BMC Infectious Diseases → Version 1 posted 12 You are reading this latest preprint version Abstract Background Vertical transmission is the main mode of acquisition of HIV infection in the Democratic Republic of Congo (DRC). We aimed to determine the vital prognosis of infants born to HIV-infected mothers at 18 months after birth in the gynaecology and obstetrics department of the General Hospital of Reference of Panzi (GHRP) in Prevention of mother-to-child transmission of HIV (PMTCT) department. Methods A retrospective cohort of HIV-positive women who delivered and brought their children before and at 18 months of life in the PMTCT/Panzi program during the period from July 1, 2015, to July 1, 2020. Multivariate logistic regression and a Cox proportional hazards model were performed to assess factors associated with positive HIV serology (couple mother-baby) and the risk of HIV MTCT or death at 18 months of life, respectively. Results There were 6318 moms identified, 400 of whom were HIV positive, and had 144 HIV-exposed children. The study found that the prevalence of HIV-infected mothers was 6.3% (400/6318), and the prevalence of vertical HIV transmission was 6.9% (10/144). Premature rupture of the membranes was the most common maternal-foetal complication and was found in 11.1% of cases. Antiretroviral treatment was based on triple therapy (zidovudine (AZT) + lamivudine (3TC) + efavirenz (EFV)) in the majority of cases (77.1%). Logistic regression analysis showed that the risk of HIV was higher in women with no education or primary education, no antenatal care, primiparity, and primigravida. Survival analysis showed that infant death at 18 months was characterized by maternal HIV positivity (HR = 3.93; 95% CI: 1.39–11.10), prematurity (HR = 4.66; 95% CI: 1.41–15.36), and the development of respiratory disease (HR = 5.37; 95% CI: 1.65–17.47). Conclusion The mother-to-child transmission of HIV remains a public health concern in the region, and children born to seropositive mothers have a poor prognosis, including death. The findings highlight the need for intensified interventions to prevent mother-to-child transmission of HIV and improve the health outcomes of children born to HIV-positive mothers. HIV/AIDS mother-child transmission HIV serology the children prognosis Panzi Hospital Figures Figure 1 Figure 6 Introduction Nearly 36.7 million people worldwide were living with human immunodeficiency virus/Acquired immunodeficiency syndrome (HIV/AIDS) at the end of 2021, with 2.1 million new infections worldwide and 1.7 million children under the age of 14 have tested positive for HIV/AIDS [ 1 , 2 ]. HIV vertical transmission is defined as Mother-To-Child Transmission of HIV (MTCT) during gestation, delivery, or breastfeeding time [ 3 ]. Without intervention, the combined risk of MTCT of HIV in utero and during delivery is estimated at 15–30%, with an increased risk in breastfed infants (20–45%) [ 4 ]. There is gender inequality in HIV/AIDS prevalence, women are 5 to 7 times more likely to be infected with HIV/AIDS than men, and up to 62% of adolescents who contract HIV are girls [ 4 ]. The rollout of Option B + in sub-Saharan Africa (SSA) has increased maternal antiretroviral therapy (ART) coverage [ 3 , 5 ] with a 70% reduction of new HIV infections in children [ 6 ]. However, there is a significant risk of MTCT of HIV among undetected new HIV infections with high maternal viraemia during breastfeeding and the postpartum period [ 6 ]. Without preventive treatment, the rate of MTCT transmission of HIV is evaluated at 15–45% [ 4 ]. Deprived of treatment, half of the children infected with HIV die before their second birthday, with peak mortality occurring between two and three months [ 7 – 9 ]. Scale-up of ART in HIV-infected women, post-exposure prophylaxis in new-borns, and retention in postnatal care are among the strategies for eliminating MTCT of HIV/AIDS [ 10 , 11 ]. The expansion of ART in SSA has reduced the MTCT of HIV. However, there is a lack of clarity regarding the outcomes of children who have been exposed to HIV. It is essential to know how well programs that prevent mother-to-child transmission (PMTCT) are reducing HIV transmission, as well as whether or not the health and growth of children who have been exposed to HIV but have not yet been infected with the virus have normalized. This is because the global goal is to ensure that all children survive, thrive, and lead normal lives [ 12 ]. In SSA, MTCT rates of HIV ranged from 1.9% in Botswana to 31.9% in Somalia in 2019 [ 13 ]. The risk of MTCT of HIV starts at conception and continues during the breastfeeding period, lasting up to 24 months in SSA countries [ 14 – 16 ]. Without intervention, the MTCT risk of HIV is estimated at 5–10% during pregnancy, 10–15% during delivery, and 5–20% during breastfeeding, with the cumulative risk being 30–45% for infants who are breastfed for 18–24 months [ 5 ]. The adoption of Option B + by most treatment programs in SSA, in 2015 has led to significant reductions in MTCT rates [ 16 , 17 ]. Option B + has resulted in a significant rise in the number of pregnant women who have begun antiretroviral therapy (ART); nonetheless, maintaining adherence to treatment is difficult, particularly during the postnatal period [ 18 ]. Feeling healthy, transitioning from pre-menstrual drug therapy (PMTCT) to adult antiretroviral therapy (ART), stigma, and rejecting HIV diagnosis are all factors that might lead to disengagement [ 18 – 21 ]. It was in 2019 that the United Nations Children's Emergency Fund (UNICEF) published their roadmap for the elimination of MTCT of HIV (eMTCT) [ 22 ]. This roadmap identified missed opportunities for eMTCT, such as the failure to prevent seroconversion during pregnancy or breast-feeding, mothers living with HIV (MLHIV) who do not receive antiretroviral therapy (ART), MLHIV who had previously started ART but stopped, and MLHIV who started ART late in their pregnancy. According to the recommendations provided by the World Health Organization (WHO) [ 23 ], a rise in the number of people who begin antiretroviral therapy (ART) quickly after receiving a diagnosis of HIV has, in turn, led to an improved spectrum of participation in care patterns, with a reduction in treatment interruptions [ 24 – 27 ]. In the past, researchers have utilized both cohort and cross-sectional data in order to concentrate on particular events that occur along the treatment cascade. These events include link-age to care, ART start, and ART discontinuation [28 31 , 31 ]. Nevertheless, these pictures do not necessarily convey the intricacy of the individual care trajectories that are being followed. While it is becoming increasingly important to monitor these trajectories and gain an understanding of the factors that underlie patterns of disengagement and reengagement in care, it is also becoming increasingly important to inform interventions in order to accelerate progress towards the second and third targets of the Joint United Nations Programme on HIV and AIDS (UNAIDS) 95–95–95 goals and to reduce the number of people who are becoming MTCT [ 32 ]. According to the UNAIDS statistics, the Democratic Republic of Congo (DRC) has not been spared from this scourge for more than four decades. Despite multiple challenges, the country has made encouraging progress amid insecurity, insufficient funding, and humanitarian crises, especially in the eastern DRC [ 33 – 35 ]. In 2020, 446,036 people lived with HIV/AIDS, including 2 24219 women (aged 15 and above) and 6,6998 children under 15 years. In the same year, 25811 HIV-positive women gave birth, with 9.8% of children infected with HIV [ 36 , 37 ]. In the context of Eastern DRC, where recurrent armed conflicts and their corollaries could favour HIV transmission, the implementation of PMTCT programs is an essential prevention strategy. In the northern region, North Kivu, 76,192 women were seen at the prenatal consultation, of whom 826 were tested HIV-positive. In the same year, in the same region, 666 children born to HIV-positive mothers were registered [ 38 ]. HIV/AIDS infection has significant consequences on the health of infected children and entails substantial economic and social costs for the government, communities, and families. Among the results observed are poverty, delayed psychomotor and cognitive development, HIV-related illnesses, undernutrition, and death, with 25–30% of children dying before their first birthday [ 1 ]. In South Kivu, a post-conflict region with variable resources due to its natural resources, little is known about the clinical outcomes and survival of children exposed to HIV infection. To guide clinical practices and to inform policy as well as humanitarian’ actions, we aimed to determining the vital prognosis of infants born to HIV-positive mothers at 18 months of age at the Panzi Hospital, an excellent centre for treating victims of sexual violence in the region. Methods The STROBE procedure, which stands for Strengthening the Reporting of Observational Studies in Epidemiology, was followed in the process of writing the report for the current study. Study setting The study was conducted at the Panzi General Referral Hospital (GRH), a medical institution in the Ibanda health zone, city of Bukavu, province of South Kivu in the DR Congo. The Panzi Hospital is located eight kilometers from the city centre. Panzi Hospital is a referral facility with an international standard technical platform, built in 1999 with 450 beds. The Panzi Hospital includes related projects such as the Stephen Lewis, which takes care of people living with HIV/AIDS based on WHO recommendations and national protocols. Study design The Panzi Interdisciplinary PMTCTP Cohort (Panzi IPC) study is a cohort study of all HIV-positive women who delivered at Panzi, regardless of their antenatal care (ANC) attendance, and included in the PANZI Interdisciplinary PMTCTP. In this study, clinical outcomes and prognosis of infants were assessed from birth to 18 months of age during the period going from July 1, 2015, to July 1, 2020. We compared these children with their counterparts who visited the postnatal care (PNC) and who were also born at Panzi Hospital at +/- five days period interval but from a mother with HIV-negative serology. Study population and sampling technique We used the birth and post-natal registries to systematically select the paired of mother living with HIV who gave birth at Panzi Hospital and their children enrolled in the PANZI Interdisciplinary PMTCTP during the study period (exposed group). For each paired exposure group, we used a similar method to select three paired mother-children who visited the post-natal consultation and who were also born at Panzi Hospital at +/- five days period interval but with no history of exposure to HIV-infection (unexposed group). HIV diagnosis The HIV testing for adults followed a sequential method using the rapid test (RT) of HIV 1 and 2. The first test is Determine, if negative, we conclude that the patient is HIV seronegative, and pre-exposure prophylaxis (PrEP) is offered. However, if the test is positive, it is followed by the VIKYA HIV ½ as a confirmatory test, if positive, the patient is initiated on ART. The diagnosis of infants is done at birth, from day 0 to day 2, using a polymerase chain reaction (PCR) diagnostic test. While waiting for the results, the infants are initiated on ART prophylaxis according to the risk stratification (Niverapine (NVP) monotherapy for infants born to mothers with undetectable viral load (VL), dual therapy including zidovudine (AZT) and NVP for infants born to mothers with low-level viraemia, and triple therapy for infants born to mothers with high VL > 1000 copies/ml). Infants testing negative are retested at 6 weeks, 9 months, and 18 months. In the absence of PCR availability, a RT is recommended at 9 months, 18 months, or 3 months after cessation of breastfeeding whichever is sooner. Between 9 and 18 months, if the child is symptomatic, a RT is done, and if positive, ART is initiated. Data collection tools and study variables At Panzi Hospital, all pregnant women are systematically tested for HIV at the time of birth. Hence, for data collection, we checked medical record from the obstetrical department that was completed with data abstracted from the HIV clinic. Data were cross-checked using the PMTCTP registry for completeness. Data collection was performed by trained medical officers. Independent variables included: sociodemographic (age, occupation, origin, marital status, average household income in dollars per month), obstetrical history (gravidity, parity, any type of medication received during pregnancy, ART during pregnancy), delivery parameters (place of delivery, risk factors for MTCT, type of delivery), HIV-related (prophylactic ART regimens of mothers and children), new born related variables (sex, weight, height, Apgar, chlorhexidine cord washing, and feeding mode). Dependant variables included: HIV PCR outcome as well as survival status at 18 months of life. Data management and statistical analysis Data were collected from various registries using Microsoft Excel 2016 then brought into Stata SE 14.0 (Stata Corp. LP, College Station, Texas, USA) for cleaning and analysis. To describe data, we used means and their standard deviations (SDs) as well as medians with their interquartile ranges (IQRs) for continuous variables as appropriate. Categorical variables were summarized into frequencies. To compare two means or medians, we used t-test or Wilcoxon rank sum test, respectively. For comparison of proportions, we used the Pearson's chi-square test or the Fisher exact test for lower proportions. To well characterise the relation mother-child in the HIV continuum in this post-conflict area, we built three different analyses. First, we constructed multivariable logistic regression models to assess factors associated with positive HIV status at delivery in the post-conflict region. Second, to estimate the risk of having a positive HIV PCR at 18 months, we used stratified Mantel-Haenszel test. Lastly, to understand factors associated with survival status at 18 months in children exposed to HIV, we performed cox-proportional hazard models by adjusting potential confounders. Factors associated with risk of testing positive for HIV-infection among pregnant women at a p-value < 0.2 in unadjusted logistic regression were included in a multivariable model. Odd ratio, relative risks, and hazards ratio and their 95% confidence intervals were derived to measure the strength of association between the variables. All p-values were two-sided, and we used p-value of less than 0.05 for the level of significance. Ethical considerations The study was conducted in strict accordance with the principles of Helsinki. All participants have provided their free consent to participate in the study. We received free consent from the mothers of all children selected for the study before considering their children in the study. All participants (mothers and children) who were diagnosed as HIV-positive, received holistic care via the Panzi PMTCT. The study was authorized by the National Health Ethics Committee and registered under number: CNES001/DPSK/177/2015. Results Prevalence of HIV/AIDS infection among women and their new-born who delivered at the PANZI hospital and characteristic of pregnant women, and their new-born included in the PANZI PMTCT program between July 2015 and July 2020. During the study period (1 July 2015 to 1 July 2020), 9143 cases were registered at the antenatal clinic of which 6318 pregnant women were tested of which 400 cases were positive for HIV infection (Fig. 1 ). The prevalence of HIV-positive mothers was 6.3% (400/6318) and the prevalence of vertical transmission was 6.9% (10/144). Table 1 depicts socio-demographic characteristics of pregnant women and their HIV status. While no difference was observed in age, pregnant women who tested positive for HIV-infection were more likely to be separated or divorced with no schooling at all or just primary or secondary level of education as compared to their counterparts who tested negative for HIV infection. Compared to later, pregnant women who were living with HIV-infection were less likely to attend prenatal consolation and were more likely to attend the lower level of health system pyramid facilities (hospital centres) than general hospital (28% vs. 17%) (Table 2 ) . Further, most pregnant women living with HIV were first-time pregnant or mothers (21% and 23%) as compared to pregnant women who tested negative for HIV-infection (7% and 8%). In contrast, pregnant women living with HIV infection had a low prevalence of delivering by caesarean section (8 vs. 23%) and of receiving psychological support during pregnancy (8% vs. 95%). The majority of pregnant women living with HIV had a CD4 count below 500 cell/m3 and among a portion who received VL testing (newly acquired at the hospital), 17/22 had an undetectable VL, and 77% were under ART as per the national guidelines including tenofovir disoproxil fumarate, lamivudine and efavirenz (TDF/3TC/EFV). Table 1 Sociodemographic characteristics of pregnant women attending Panzi General Hospital by HIV-infection status from July 1. 2015. to July 1. 2020 Characteristics Total = 545 HIV (+) HIV (-) p-Value N = 144 (26.4%) N = 401 (73.6%) Age (years) Means ± SD 30.33 ± 5.88 30.88 ± 6.63 30.14 ± 5.75 <=20 27 (5.0) 7 (4.9) 20 (5.0) 21–29 212 (38.9) 51 (35.4) 161 (40.1) 0.83 30–39 277 (50.8) 74 (51.4) 203 (50.6) 0.93 40–49 29 (5.3) 12 (8.3) 17 (4.2) 0.23 District Bagira 32 (5.9) 13 (9.0) 19 (4.7) Ibanda 321 (58.9) 78 (54.2) 243 (60.6) 0.04 Kadutu 140 (25.7) 25 (17.4) 115 (28.7) 0.005 Out of Bukavu town 52 (9.5) 28 (19.4) 24 (6.0) 0.24 Marital status Single 24 (4.4) 8 (5.6) 16 (4.0) 0.46 Married 506 (92.8) 127 (88.2) 379 (94.5) 0.16 Separated/divorced 9 (1.7) 6 (4.2) 3 (0.7) 0.011 Widowed 6 (1.1) 3 (2.1) 3 (0.7) Profession With 130 (23.9) 39 (27.1) 91 (22.7) Without 415 (76.1) 105 (72.9) 310 (77.3) 0.29 Level of education None 9 (1.7) 4 (2.8) 5 (1.8) 0.010 Primary 129 (23.7) 41 (28.5) 88 (21.9) ˂0.001 Secondary 352 (64.6) 95 (66.0) 257 (64.1) ˂0.001 University 55 (10.1) 4 (2.8) 51 (12.7) Table 2 Clinical characteristics of pregnant women attending Panzi general hospital by HIV-infection status Characteristics Total = 545 HIV (+) N = 144 (%) HIV (-) N = 401 (%) p-Value Place for prenatal care General Hospital 376 (69.0) 84 (58.3) 292 (72.8) Health Center 59 (10.9) 19 (13.2) 40 (10.0) 0.09 Hospital Center 90 (16.5) 31 (21.5) 59 (14.7) 0.02 Not done 20 (3.7) 10 (6.9) 10 (2.5) 0.004 Number of pregnancies Primigeste 56 (10.3) 30 (20.8) 26 (6.5) < 0.001 Paucigeste 164 (30.1) 22 (15.3) 142 (35.4) < 0.001 Multigeste 325 (59.6) 92 (63.9) 233 (58.1) Number of deliveries Primiparous 64 (11.4) 33 (22.9) 31 (7.7) < 0.001 Pauciparous 187 (34.3) 36 (25.0) 151 (37.7) < 0.001 Multiparous 294 (53.9) 75 (52.1) 219 (54.6) Term of pregnancy No 54 (9.9) 11 (7.6) 43 (10.7) 0.30 Yes 491 (90.1) 133 (92.4) 358 (89.3) Place of delivery Health center 16 (2.9) 16 (11.1) 0 (0.0) - Hospital center 27 (5.0) 27 (18.8) 0 (0.0) - General Hospital 502 (92.1) 101 (70.1) 401 (100.0) Alcoholism No 451 (82.8) 123 (85.4) 328 (81.8) 0.32 Yes 94 (17.2) 21 (14.6) 73 (18.2) Opportunistic infections None 541 (99.3) 141 (97.9) 400 (99.8) Chronic diarrhea 1 (0.2) 1 (0.7) 0 (0.0) - Tuberculosis 3 (0.6) 2 (1.4) 1 (0.2) 0.11 Prenatal care performed No 31 (5.7) 12 (8.3) 19 (4.7) 0.11 Yes 514 (94.3) 132 (91.7) 382 (95.3) Other comorbidities No 436 (80.0) 116 (80.6) 320 (79.8) Yes 109 (20.0) 28 (19.4) 81 (20.2) 0.85 Delivery method Caesarean section 123 (22.6) 33 (22.9) 90 (22.4) 0.91 Vaginal mode 422 (77.6) 111 (77.1) 311 (77.6) CD4 Done or achieved (n = 121) - 121 (84.0) - - <500 (Normal) 72 (59.5) 500 (High) 49 (40.5) Viral load Done or achieved (n = 22) - 22 (15.3) - - Undetectable 40 copy 5 (22.7) ARV Triple therapy (TDF/3TC/EFV) - 111 (77.1) - - Other molecules - 333 (22.9) - - *PRM: Premature rupture of the membranes Prevalence of HIV/AIDS infection among new-borns boned at the PANZI hospital and characteristic of new-borns included in the PANZI PMTCT programme and those attending post-natal consultation at PANZI hospital between July 2015 and July 2020. Children born from mothers living with HIV infection were mostly boys with extreme birth weights ( 4000g) at the time of delivery (Table 3 ). In addition, the frequency of hospitalisation for respiratory diseases (19% vs. 9%) and of death (7%% vs. 2%) over the first 18 months of life were common in the former as compared to the latter. Among children exposed to HIV infection, seven percent had their HIV infection status confirmed at 18 months. Table 3 Demographic, Anthropologic, clinical characteristics and 18 moths-survival rates of new-born of pregnant women attending PANZI general hospital by HIV-infection status Characteristics Total = 545 HIV (+) HIV (-) p-Value N = 144 N = 401 Gender Female 249 (45.7) 54 (37.5) 195 (48.6) Male 296 (54.3) 90 (62.5) 206 (51.4) 0.02 Weight (grams) 4000 8 (1.5) 3 (2.1) 5 (1.2) 0.02 Apgar (5th minute) Abnormal (< 7) 47 (8.6) 12 (8.3) 35 (8.7) 0.88 Normal ( < = 7) 498 (91.4) 132 (91.7) 366 (91.3) Respiratory diseases No 483 (88.6) 117 (81.3) 366 (91.3) Yes 62 (11.4) 27 (18.8) 35 (8.7) < 0.001 Survival status at 18 moths Alive 528 (96.9) 134 (93.1) 394 (98.3) Died 17 (3.1) 10 (6.9) 7 (1.7) 0.001 HIV status at 18 months Positive 10 (1.8) 10 (6.9) - - Negative 535 (98.2) 134 (93.1) 401 (100.0) - Factors associated with risk of testing positive for HIV-infection among pregnant women attending PANZI hospital for delivery. Among pregnant women attending the Panzi obstetric service for delivery, those living in urban areas were less likely to test positive for HIV infection (urban city: aOR = 0.46: 95% CI: 0.22–0.99; p = 0.04 and urban suburb, aOR = 0.76; 95% CI: 0.31 − 0.27; p = 0.005) as compared to those living in slams. Further, among these women, factors independently associated with increased risk of testing positive for HIV infection included low level of education (no education: aOR = 10.20; 95% CI: 1.93–53.78; p = 0.001), primary education aOR = 5.94; 95% CI:2.01–17.54; p = 0.001), unbooked pregnancy (aOR = 3.47; 95% CI : 1.39–8.63; p = 0.004), being primipara (aOR = 3.10; 95% CI: 1.78–5.20; p = 0.001), being primigravida (aOR = 2.92; 95% CI: 1.63–5.20; p = 0.001) (Table 4 ). Table 4 Multivariate logistic regression of factors associated with maternal HIV status Characteristics aOR (IC 95%) p-Value Age (years) <=20 1 (reference) 21–29 0.90 (0.36–2.26) 0.83 30–39 1.04 (0.42–2.56) 0.93 40–49 2.01 (0.04–6.27) 0.29 Address Bagira 1 (reference) Ibanda 0.46 (0.22–0.99) 0.040 Kadutu 0.31 (0.13–0.27) 0.005 Out of Bukavu town 1.70 (0.63–4.15) 0.24 Marital status Single 0.50 (0.08–3.05) 0.65 Married 0.33 (0.06–1.68) 0.17 Separated/ Divorced 2.00 (0.24–16.61) 0.62 Widowed 1 (reference) Profession With 1 (reference) Without 0.79 (0.51–1.22) 0.29 Level of education None 10.20 (1.93–53.78) < 0.001 Primary 5.94 (2.01–17.54) < 0.001 Secondary 4.71 (1.65–13.39) < 0.001 University 1 (reference) ANCs achieved No 1.82 (1.86–3.66) 0.040 Yes 1 (reference) Delivery method Caesarean section 1.02 (0.65–1.61) 0.91 Vaginal section 1 (reference) Place for prenatal care General Hospital 1 (reference) Health Center 1.65 (0.90-3.00) 0.09 Centre Hospital 1.82 (1.11-3.00) 0.020 Not done 3.47 (1.39–8.63) 0.004 Number of pregnancies Primigravida 2.92 (1.63–5.20) 0.001 Paucigravida 0.39 (0.24–0.65) < 0.001 Multigravida 1 (reference) Number of deliveries Primipara 3.10 (1.78–5.41) < 0.001 Paucipara 0.69 (0.44–1.08) 0.11 Multipara 1 (reference) Factors associated with risk of testing positive for HIV-infection at the 18 months of birth among children followed at the PANZI postnatal clinic. In this cohort, male children (RR = 1.21; 95% CI: 1.03–1.42; p = 0.02), history of hospitalisation for respiratory diseases (RR = 2.14; 95% CI: 1.35–3.41; p = 0.001) and exposure to HIV infection (RR = 2.31; 95% CI: 1.51–3.41; p = 0.002) were independently associated with the risk of testing positive for HIV infection at the 18th month of birth. However, children boned with a low birthweight, i.e., below or 2500 grams (RR = 0.48; 95% CI: 0.24–0.96; p = 0.30) were less likely of test positive for HIV infection at their 18th month of birth (Table 5 ). Table 5 Factors associated with positive HIV-infection status in children at 18 months Characteristics RR (IC 95%) p-Value Gender of the children Female 1 (reference) Male 1.21 (1.03–1.42) 0.02 Child's weight (grams) 4000 1.55 (0.37–6.40) 0.54 Apgar (5th minute) Abnormal (< 7) 0.95 (0.50–1.76) 0.88 Normal ( < = 7) 1 (reference) Respiratory diseases No 1 (reference) Yes 2.14 (1.35–3.41) ˂0.001 Mothers’ serology HIV- 1 (reference) HIV+ 2.31 (1.51–3.41) 0.002 Factors associated with hazard of death at the 18th month of birth among children followed at the PANZI postnatal clinic. After adjusting for other variables in the model, we found that children exposure to HIV-infection were 3.9 times more likely of dying before their 18th month anniversary as compared to children unexposed to HIV-infection (HR = 3.93; 95% CI: 1.39–11.10; p = 0.01) (Table 6 ). Moreover, the hazard of death increased significantly with premature birth (HR = 4.66; 95% CI: 1.41–15.36; p = 0.01) and history of hospitalisation for respiratory diseases (HR = 5.37; 95% CI: 1.65–17.47; p = 0.005) as compared to term birth and no history of hospitalisation for respiratory illnesses, respectively. The sex of the children, the multiparity of the mothers, illnesses during pregnancy, and prenatal consultation did not explain the deaths in the children before or at 18 months. Table 6 Factors associated with hazard of death in children after 18 months of follow-up Characteristics Haz. Ratio (IC 95%) p-Value Gender of the children Female 1 (reference) Male 1.43 (0.52–3.91) 0.49 Multi-Parity Yes 1 (reference) No 1.87 (0.69–5.03) 0.26 Term of pregnancy Yes 1 (reference) No 4.66 (1.41–15.36) 0.010 Prenatal consultation No 0.69 (0.89–5.35) 0.72 Yes 1 (reference) Illnesses during pregnancy No 1 (reference) Yes 2.13 (0.72–6.29) 0.17 Respiratory diseases No 1 (reference) Yes 5.37 (1.65–17.47) 0.005 Maternal HIV results HIV- 1 (reference) HIV+ 3.93 (1.39–11.10) 0.010 Discussion Our study found a 6.3% (400/6318) HIV positivity rate among pregnant women attending ANC at Panzi Hospital between July 1, 2015, to July 1, 2020, with a 6.9% MTCT HIV rate. Women from urban areas male children had a higher prevalence of HIV as opposed to female children, who were less affected. Lower education levels and low socioeconomic status were associated with HIV-positive status. Poor retention in care was observed, with 36% of women retained in care with their children at 18 months post-natal. Compared to other studies, our study had a lower HIV positivity rate among pregnant women, which is in contrast to the higher prevalence of 13.4% and 30.7% reported in Angola (2021) [ 39 ] and South Africa (2022) [ 40 ], respectively. However, the MTCT of HIV in our study was similar to that found in a study conducted in Malawi [ 41 ], but higher than the MTCT rate observed in Namibia of 1.74%, where the PMTCT program has been well established with Option B-plus since 2013 [ 42 ]. These differences in prevalence rates may be due to variations in the implementation and effectiveness of PMTCT programs across different countries, as well as differences in HIV prevalence in the general population. Our study also found that low education levels of women were associated with HIV positivity, which is consistent with the findings of 33 countries in SSA as shown by Teshale et al. in 2021 [ 43 ]. This highlights the importance of education and information campaigns to promote HIV prevention and reduce stigma, particularly in rural areas where most women are illiterate. On the other hand, Remera et al. in 2021 [ 44 ] found that being single or rape victims were risk factors for HIV/AIDS infection, suggesting that additional efforts are needed to provide comprehensive support and care for women who have experienced trauma, especially in conflict zones. Regarding the location of women, our study showed that the majority of women registered in the PMTCT program were from urban areas, which is consistent with the findings of Liyeh et al. in 2020 in Ethiopia [ 45 ]. This suggests that the presence of PMTCT centres in urban areas may play a crucial role in improving the coverage and effectiveness of PMTCT services. In terms of vertical transmission of HIV, our study found a higher rate of MTCT of HIV compared to the estimates from Cameroon [ 46 ]. This situation may be attributed to differences in the voluntary involvement of women in PMTCT and easy access to quality care services in Cameroon. This underscores the need for efforts to improve access to and utilization of PMTCT services in the DRC and reduce vertical transmission of HIV risk. Moreover, the study revealed that infants born to mothers living with HIV and experiencing respiratory distress, as well as those born from pre-term pregnancies, had a higher likelihood of mortality. These findings are aligned with a study conducted by Fuente-Soro et al. [ 47 ] in rural Mozambique. However, the results differ from those of Rasmussen et al. in Guinea Bissau [ 48 ] who found that maternal HIV was associated with low birth weight but not with stillbirth. HIV/AIDS is a chronic disease that can lead to opportunistic infections and multiorgan failure, ultimately resulting in infants’ deaths in their early months of life. However, well-implemented and coordinated PMTCT services at ANC could prevent these disastrous consequences. In our study, a majority of women had not undergone ANC, increasing the risk of HIV transmission to their children. Astawesegn et al. (2021) [ 49 ] reported a significant association between PMTCT and ANC, which lowered the risk of children developing HIV/AIDS disease. However, women's adherence to ANC is generally compromised in our setting, similar to -HIV negative pregnant women. In addition, only 36% of the women in our study continued with care for their children at 18 months post-natal, which is consistent with findings from Malawi, where 57% of children under the PMTCT program were lost to follow-up by the age of 30 months. The main cause of loss to follow-up in Malawi was mothers not being initiated on ART during pregnancy [ 50 ]. In the Eastern DRC, where our study was conducted, poor retention in care could be due to political instability, armed conflicts, and their impact on the health system, leading to increased child and maternal mortality (Mohammed J et al., 2021) [ 51 ]. The findings of this study have important policy implications for the PMTCT of HIV in the DRC and other similar settings. Firstly, it highlights the need to increase access to ANC for pregnant women, particularly those from rural areas and with low socioeconomic status. This could be achieved by improving the availability and quality of ANC services, as well as by implementing strategies to encourage women to attend ANC, such as community-based education and outreach programs. Secondly, the study highlights the need to address social determinants of health, such as education and marital status, which were found to be significant predictors of HIV-positive status among pregnant women. This could involve implementing programs to increase access to education for women, particularly in rural areas, as well as promoting gender equality and addressing gender-based violence. Thirdly, the study emphasizes the importance of improving retention in care for women and their children in the PMTCT program. This could involve implementing strategies to improve adherence to ART during pregnancy and breastfeeding, as well as promoting ongoing engagement in care for women and their children, such as through peer support groups and mobile health interventions. Finally, dolutegravir (DTG)-based regimens should be pushed during pregnancy and breast-feeding since they provide high virological suppression, lowering MTCT. The limitations of this study should be acknowledged, as they may have influenced the results. Firstly, the study was conducted in a single province in the DRC, and the findings may not be generalizable to other regions or countries with different cultural and socio-economic contexts. Additionally, the sample size was relatively small at 18th months, and therefore, the study may not have had sufficient power to detect statistically significant differences in some of the variables. Another limitation is that data were collected retrospectively, which may have introduced recall bias, and there was a possibility of missing data, especially for women who were lost to follow-up. The study also did not explore in-depth the reasons for poor retention in care, such as political instability in the study area, which would have provided valuable insights into how to improve PMTCT services. Finally, the study did not explore the long-term outcomes of the children, such as their cognitive development and school performance, which would have provided a more comprehensive understanding of the impact of PMTCT services on children's lives. One of the strengths of this study is the large sample size of 400 mother-child pairs, which increases the power of the study to detect associations and reduces the likelihood of chance findings. Additionally, the study was conducted in a resource-limited setting, which is an important context for understanding the challenges and barriers to effective PMTCT implementation. This may increase the generalizability of the findings to other similar settings. Another strength is that the study collected data on multiple factors that could affect PMTCT outcomes, including maternal health status, infant feeding practices, and ART adherence. This allowed for a more comprehensive analysis of the complex factors that contribute to PMTCT success. Conclusion In this study conducted over a period from July 1, 2015 to July 1, 2020, 9143 cases were registered at the antenatal clinic of which 6318 pregnant women were tested, among which 400 cases were positive for HIV infection. The prevalence of HIV-positive mothers was 6.3% and vertical transmission was 6.9%. Overall, the findings of this study highlight the need for a comprehensive and coordinated approach to PMTCT in the DRC and other similar settings to improve retention and achieve eMTCT by 2030. This could involve addressing social determinants of health, improving access to quality ANC services, and promoting retention in care for women and their children. By implementing these strategies, it may be possible to reduce the burden of HIV among women and children in these settings and improve health outcomes for this vulnerable population. Need to intensify interventions on PMTCT by making early diagnosis of decentralized HIV infection and the latest generation of ART availabe. Training of health actors coupled with a Community Learning Model (CLM) approach, and a task-shitting policy should be carried out in the DR. As the DRC is a member of the Pediatric Alliance to end AIDS by 2030, we can be optimistic for an AIDS-free generation in the DRC. Abbreviations ANC: antenatal care, ART : Antiretroviral Therapy, AZT : zidovudine, CHEU : children HIV- exposed and uninfected, DTG : dolutegravir, -DRC: Democratic Republic of Congo, EFV: efavirenz, eMTCT : elimination of Mother-to-Child Transmission, GRH : General Referral Hospital, HIV/AIDS : human immunodeficiency virus/ Acquired immunodeficiency syndrome, MLHIV: mothers living with HIV, MTCT: Mother-To-Child Transmission, NVP: Niverapine, PCR: polymerase chain reaction, PMTCT: Prevention of Mother-to-Child Transmission, PNC: postnatal care, PrEP: pre-exposure prophylaxis, RT: rapid test, SSA: sub-Saharan Africa, TDF: tenofovir disoproxil fumarate, 3TC: lamivudine, STROBE: Strengthening the Reporting of Observational studies in Epidemiology, UNAIDS: the Joint United Nations Programme on HIV and AIDS, UNICEF: United Nations Children’s Emergency Fund, VL: viral load, WHO: World Health Organization. Declarations Ethics approval and consent to participate Ethical approval was obtained from the South-Kivu national health ethics committee under reference (CNES001/DPSK/177/2015) in the city of Bukavu in the Democratic Republic of Congo. A letter requesting support was sent to the health facility selected for this study in order to obtain the necessary authorisations for the research. In addition, after explaining the purpose of the study and the importance of their participation, the participants agreed to take part in the study. Written informed consent was obtained for both the interview and access to records. and access to records, and those who agreed to participate were included in the study. Participants were not remunerated for their participation, nor were they penalised for failure, as all received the necessary interventions regardless of their participation in the study. The study did not use any invasive procedures, the data being extracted from the records and from the interview with the mother. Confidentiality of information was maintained throughout the study process and later health professionals to whom the mothers had already disclosed their HIV status collected the data. Participants' privacy was protected by interviewing them in a separate room. Clinical Trial Not applicable Consent for publication Not applicable Availability of data and material The datasets generated and/or analysed as part of this study are not accessible to the public due to the sensitivity of the subject and in order to guarantee the confidentiality of the information. Competing interests All authors have declared that they have no competing interests. Funding No financing received for this research Author’s contribution Study design and implementation: BMN, LOM, PKDM and DM designed and implemented the study. Methodology: LOM, BMN under the supervision of PKDM. Data collection and entry: LOM and BMN Data analysis and interpretation: LOM and PKDM. Laboratory analysis: the entire Panzi laboratory team under the supervision of Balthazar and BM. Validation and addition of inputs: LOM, AB, PB, MM, BA, BT, MS, BMN, PKDM and DM. Editing of the final text: LOM, JLT, MK, DM and PKDM. Acknowledgements We thank all those who contributed to the writing of this article. All the laboratory team of the General Hospital of Reference of Panzi and all the participants in the study. We would also like to thank the UNAIDS team for making some of the PMTCT literature available and for their contribution to the writing process. References Mutabazi JC, Gray C, Muhwava L, Trottier H, Ware LJ, Norris S, et al. Integrating the prevention of mother-to-child transmission of HIV into primary healthcare services after AIDS denialism in South Africa: perspectives of experts and health care workers - a qualitative study. BMC Health Serv Res déc. 2020;20(1):582. 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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-6194709","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":435887737,"identity":"baa786e0-e780-44d0-87ad-e6a13dc25192","order_by":0,"name":"Berckmans Mukanire Ntakwinja¹","email":"","orcid":"","institution":"Hopital Général de Référence de Panzi","correspondingAuthor":false,"prefix":"","firstName":"Berckmans","middleName":"Mukanire","lastName":"Ntakwinja¹","suffix":""},{"id":435887739,"identity":"36d5f961-0233-4a4d-9197-503a71e809ca","order_by":1,"name":"Patrick DMC Katoto²","email":"","orcid":"","institution":"Université Catholique de Bukavu","correspondingAuthor":false,"prefix":"","firstName":"Patrick","middleName":"DMC","lastName":"Katoto²","suffix":""},{"id":435887740,"identity":"673759a7-4e66-4238-b17c-6a012f97334e","order_by":2,"name":"Lampard Omari Mukanga","email":"data:image/png;base64,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","orcid":"","institution":"International center for the Advanced Research and Training","correspondingAuthor":true,"prefix":"","firstName":"Lampard","middleName":"Omari","lastName":"Mukanga","suffix":""},{"id":435887741,"identity":"d2cc5b44-0dfe-425b-80aa-aa45e994a1d7","order_by":3,"name":"Mireille AM Kakubu","email":"","orcid":"","institution":"Université Catholique de Bukavu","correspondingAuthor":false,"prefix":"","firstName":"Mireille","middleName":"AM","lastName":"Kakubu","suffix":""},{"id":435887742,"identity":"e36e006c-b389-4440-8284-accb44f72046","order_by":4,"name":"Benjamin Tshizubu⁴","email":"","orcid":"","institution":"UNAIDS Country office and Region Support Team","correspondingAuthor":false,"prefix":"","firstName":"Benjamin","middleName":"","lastName":"Tshizubu⁴","suffix":""},{"id":435887743,"identity":"d3154b55-6386-432b-9ced-40eec3595eaa","order_by":5,"name":"Mamadou Sakho⁴","email":"","orcid":"","institution":"UNAIDS Country office and Region Support Team","correspondingAuthor":false,"prefix":"","firstName":"Mamadou","middleName":"","lastName":"Sakho⁴","suffix":""},{"id":435887744,"identity":"c0ddf862-b223-46b5-b494-b986ae673627","order_by":6,"name":"Aline Byabene⁵","email":"","orcid":"","institution":"Hopital général de référence de Panzi","correspondingAuthor":false,"prefix":"","firstName":"Aline","middleName":"","lastName":"Byabene⁵","suffix":""},{"id":435887745,"identity":"cabb2878-3057-41cb-b1b3-465c5ef827e7","order_by":7,"name":"Jacques L. Tamuzi","email":"","orcid":"","institution":"Division of Epidemiology \u0026 Biostatistics","correspondingAuthor":false,"prefix":"","firstName":"Jacques","middleName":"L.","lastName":"Tamuzi","suffix":""},{"id":435887746,"identity":"445e1c42-bbcb-4025-91a8-0cb98fc93e80","order_by":8,"name":"Parvine Bisimwa⁵","email":"","orcid":"","institution":"Hopital général de référence de Panzi","correspondingAuthor":false,"prefix":"","firstName":"Parvine","middleName":"","lastName":"Bisimwa⁵","suffix":""},{"id":435887747,"identity":"55547c48-630d-4c38-828a-1a19c86251ac","order_by":9,"name":"Bihehe Masemo⁵","email":"","orcid":"","institution":"Hopital général de référence de Panzi","correspondingAuthor":false,"prefix":"","firstName":"Bihehe","middleName":"","lastName":"Masemo⁵","suffix":""},{"id":435887748,"identity":"3f43083f-9921-4ee2-9734-e1be0d8f83c9","order_by":10,"name":"Mambo Mwilo⁶","email":"","orcid":"","institution":"Hopital général de Référence de Panzi","correspondingAuthor":false,"prefix":"","firstName":"Mambo","middleName":"","lastName":"Mwilo⁶","suffix":""},{"id":435887749,"identity":"ca6cd53e-6996-4be5-960b-c0829e9e56ce","order_by":11,"name":"Birindwa Archippe","email":"","orcid":"","institution":"Hopital général de Référence de Panzi","correspondingAuthor":false,"prefix":"","firstName":"Birindwa","middleName":"","lastName":"Archippe","suffix":""},{"id":435887750,"identity":"23501c42-d47b-4f14-b3ed-79cebcb91c68","order_by":12,"name":"Denis Mukwege¹'⁸","email":"","orcid":"","institution":"Hopital Général de Référence de Panzi","correspondingAuthor":false,"prefix":"","firstName":"Denis","middleName":"","lastName":"Mukwege¹'⁸","suffix":""}],"badges":[],"createdAt":"2025-03-10 10:53:35","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6194709/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6194709/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12879-026-13072-5","type":"published","date":"2026-03-20T15:59:19+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":79677470,"identity":"e03fc639-092c-4394-b5f8-b845783f390f","added_by":"auto","created_at":"2025-04-01 12:23:07","extension":"jpeg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":392477,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eFlow chart of study participants\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-6194709/v1/6903bca35403852a75ba36bf.jpeg"},{"id":79678824,"identity":"c7bbd07f-7f9b-4bf0-8aff-bd7cf7d8f5fc","added_by":"auto","created_at":"2025-04-01 12:31:07","extension":"jpeg","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":392477,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eFlow chart of study participants\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-6194709/v1/35fa973dfe8403bcef333374.jpeg"},{"id":105224488,"identity":"cd35fcfa-8f5c-4b03-a6b5-894a4e65b293","added_by":"auto","created_at":"2026-03-23 16:14:42","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2326049,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6194709/v1/e2c1d542-6298-42ce-b7fe-bb847c63a4b6.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Clinical Outcomes and Survival of HIV Exposed Children at 18 Months in Post-Conflict Region: Insight from the Panzi Interdisciplinary PMTCT Cohort (Panzi IPC) study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eNearly 36.7\u0026nbsp;million people worldwide were living with human immunodeficiency virus/Acquired immunodeficiency syndrome (HIV/AIDS) at the end of 2021, with 2.1\u0026nbsp;million new infections worldwide and 1.7\u0026nbsp;million children under the age of 14 have tested positive for HIV/AIDS [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eHIV vertical transmission is defined as Mother-To-Child Transmission of HIV (MTCT) during gestation, delivery, or breastfeeding time [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Without intervention, the combined risk of MTCT of HIV in utero and during delivery is estimated at 15\u0026ndash;30%, with an increased risk in breastfed infants (20\u0026ndash;45%) [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. There is gender inequality in HIV/AIDS prevalence, women are 5 to 7 times more likely to be infected with HIV/AIDS than men, and up to 62% of adolescents who contract HIV are girls [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. The rollout of Option B\u0026thinsp;+\u0026thinsp;in sub-Saharan Africa (SSA) has increased maternal antiretroviral therapy (ART) coverage [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e] with a 70% reduction of new HIV infections in children [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. However, there is a significant risk of MTCT of HIV among undetected new HIV infections with high maternal viraemia during breastfeeding and the postpartum period [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Without preventive treatment, the rate of MTCT transmission of HIV is evaluated at 15\u0026ndash;45% [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eDeprived of treatment, half of the children infected with HIV die before their second birthday, with peak mortality occurring between two and three months [\u003cspan additionalcitationids=\"CR8\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Scale-up of ART in HIV-infected women, post-exposure prophylaxis in new-borns, and retention in postnatal care are among the strategies for eliminating MTCT of HIV/AIDS [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. The expansion of ART in SSA has reduced the MTCT of HIV. However, there is a lack of clarity regarding the outcomes of children who have been exposed to HIV. It is essential to know how well programs that prevent mother-to-child transmission (PMTCT) are reducing HIV transmission, as well as whether or not the health and growth of children who have been exposed to HIV but have not yet been infected with the virus have normalized. This is because the global goal is to ensure that all children survive, thrive, and lead normal lives [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn SSA, MTCT rates of HIV ranged from 1.9% in Botswana to 31.9% in Somalia in 2019 [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. The risk of MTCT of HIV starts at conception and continues during the breastfeeding period, lasting up to 24 months in SSA countries [\u003cspan additionalcitationids=\"CR15\" citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Without intervention, the MTCT risk of HIV is estimated at 5\u0026ndash;10% during pregnancy, 10\u0026ndash;15% during delivery, and 5\u0026ndash;20% during breastfeeding, with the cumulative risk being 30\u0026ndash;45% for infants who are breastfed for 18\u0026ndash;24 months [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. The adoption of Option B\u0026thinsp;+\u0026thinsp;by most treatment programs in SSA, in 2015 has led to significant reductions in MTCT rates [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Option B\u0026thinsp;+\u0026thinsp;has resulted in a significant rise in the number of pregnant women who have begun antiretroviral therapy (ART); nonetheless, maintaining adherence to treatment is difficult, particularly during the postnatal period [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Feeling healthy, transitioning from pre-menstrual drug therapy (PMTCT) to adult antiretroviral therapy (ART), stigma, and rejecting HIV diagnosis are all factors that might lead to disengagement [\u003cspan additionalcitationids=\"CR19 CR20\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. It was in 2019 that the United Nations Children's Emergency Fund (UNICEF) published their roadmap for the elimination of MTCT of HIV (eMTCT) [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. This roadmap identified missed opportunities for eMTCT, such as the failure to prevent seroconversion during pregnancy or breast-feeding, mothers living with HIV (MLHIV) who do not receive antiretroviral therapy (ART), MLHIV who had previously started ART but stopped, and MLHIV who started ART late in their pregnancy. According to the recommendations provided by the World Health Organization (WHO) [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e], a rise in the number of people who begin antiretroviral therapy (ART) quickly after receiving a diagnosis of HIV has, in turn, led to an improved spectrum of participation in care patterns, with a reduction in treatment interruptions [\u003cspan additionalcitationids=\"CR25 CR26\" citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. In the past, researchers have utilized both cohort and cross-sectional data in order to concentrate on particular events that occur along the treatment cascade. These events include link-age to care, ART start, and ART discontinuation [28 \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. Nevertheless, these pictures do not necessarily convey the intricacy of the individual care trajectories that are being followed. While it is becoming increasingly important to monitor these trajectories and gain an understanding of the factors that underlie patterns of disengagement and reengagement in care, it is also becoming increasingly important to inform interventions in order to accelerate progress towards the second and third targets of the Joint United Nations Programme on HIV and AIDS (UNAIDS) 95\u0026ndash;95\u0026ndash;95 goals and to reduce the number of people who are becoming MTCT [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAccording to the UNAIDS statistics, the Democratic Republic of Congo (DRC) has not been spared from this scourge for more than four decades. Despite multiple challenges, the country has made encouraging progress amid insecurity, insufficient funding, and humanitarian crises, especially in the eastern DRC [\u003cspan additionalcitationids=\"CR34\" citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. In 2020, 446,036 people lived with HIV/AIDS, including 2 24219 women (aged 15 and above) and 6,6998 children under 15 years. In the same year, 25811 HIV-positive women gave birth, with 9.8% of children infected with HIV [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. In the context of Eastern DRC, where recurrent armed conflicts and their corollaries could favour HIV transmission, the implementation of PMTCT programs is an essential prevention strategy. In the northern region, North Kivu, 76,192 women were seen at the prenatal consultation, of whom 826 were tested HIV-positive. In the same year, in the same region, 666 children born to HIV-positive mothers were registered [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. HIV/AIDS infection has significant consequences on the health of infected children and entails substantial economic and social costs for the government, communities, and families. Among the results observed are poverty, delayed psychomotor and cognitive development, HIV-related illnesses, undernutrition, and death, with 25\u0026ndash;30% of children dying before their first birthday [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn South Kivu, a post-conflict region with variable resources due to its natural resources, little is known about the clinical outcomes and survival of children exposed to HIV infection. To guide clinical practices and to inform policy as well as humanitarian\u0026rsquo; actions, we aimed to determining the vital prognosis of infants born to HIV-positive mothers at 18 months of age at the Panzi Hospital, an excellent centre for treating victims of sexual violence in the region.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e The STROBE procedure, which stands for Strengthening the Reporting of Observational Studies in Epidemiology, was followed in the process of writing the report for the current study.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy setting\u003c/h2\u003e \u003cp\u003eThe study was conducted at the Panzi General Referral Hospital (GRH), a medical institution in the Ibanda health zone, city of Bukavu, province of South Kivu in the DR Congo. The Panzi Hospital is located eight kilometers from the city centre. Panzi Hospital is a referral facility with an international standard technical platform, built in 1999 with 450 beds. The Panzi Hospital includes related projects such as the Stephen Lewis, which takes care of people living with HIV/AIDS based on WHO recommendations and national protocols.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy design\u003c/h3\u003e\n\u003cp\u003e The Panzi Interdisciplinary PMTCTP Cohort (Panzi IPC) study is a cohort study of all HIV-positive women who delivered at Panzi, regardless of their antenatal care (ANC) attendance, and included in the PANZI Interdisciplinary PMTCTP. In this study, clinical outcomes and prognosis of infants were assessed from birth to 18 months of age during the period going from July 1, 2015, to July 1, 2020. We compared these children with their counterparts who visited the postnatal care (PNC) and who were also born at Panzi Hospital at +/- five days period interval but from a mother with HIV-negative serology.\u003c/p\u003e\n\u003ch3\u003eStudy population and sampling technique\u003c/h3\u003e\n\u003cp\u003eWe used the birth and post-natal registries to systematically select the paired of mother living with HIV who gave birth at Panzi Hospital and their children enrolled in the PANZI Interdisciplinary PMTCTP during the study period (exposed group). For each paired exposure group, we used a similar method to select three paired mother-children who visited the post-natal consultation and who were also born at Panzi Hospital at +/- five days period interval but with no history of exposure to HIV-infection (unexposed group).\u003c/p\u003e\n\u003ch3\u003eHIV diagnosis\u003c/h3\u003e\n\u003cp\u003eThe HIV testing for adults followed a sequential method using the rapid test (RT) of HIV 1 and 2. The first test is Determine, if negative, we conclude that the patient is HIV seronegative, and pre-exposure prophylaxis (PrEP) is offered. However, if the test is positive, it is followed by the VIKYA HIV \u0026frac12; as a confirmatory test, if positive, the patient is initiated on ART. The diagnosis of infants is done at birth, from day 0 to day 2, using a polymerase chain reaction (PCR) diagnostic test. While waiting for the results, the infants are initiated on ART prophylaxis according to the risk stratification (Niverapine (NVP) monotherapy for infants born to mothers with undetectable viral load (VL), dual therapy including zidovudine (AZT) and NVP for infants born to mothers with low-level viraemia, and triple therapy for infants born to mothers with high VL\u0026thinsp;\u0026gt;\u0026thinsp;1000 copies/ml). Infants testing negative are retested at 6 weeks, 9 months, and 18 months. In the absence of PCR availability, a RT is recommended at 9 months, 18 months, or 3 months after cessation of breastfeeding whichever is sooner. Between 9 and 18 months, if the child is symptomatic, a RT is done, and if positive, ART is initiated.\u003c/p\u003e\n\u003ch3\u003eData collection tools and study variables\u003c/h3\u003e\n\u003cp\u003eAt Panzi Hospital, all pregnant women are systematically tested for HIV at the time of birth. Hence, for data collection, we checked medical record from the obstetrical department that was completed with data abstracted from the HIV clinic. Data were cross-checked using the PMTCTP registry for completeness. Data collection was performed by trained medical officers. Independent variables included: sociodemographic (age, occupation, origin, marital status, average household income in dollars per month), obstetrical history (gravidity, parity, any type of medication received during pregnancy, ART during pregnancy), delivery parameters (place of delivery, risk factors for MTCT, type of delivery), HIV-related (prophylactic ART regimens of mothers and children), new born related variables (sex, weight, height, Apgar, chlorhexidine cord washing, and feeding mode). Dependant variables included: HIV PCR outcome as well as survival status at 18 months of life.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData management and statistical analysis\u003c/h2\u003e \u003cp\u003eData were collected from various registries using Microsoft Excel 2016 then brought into Stata SE 14.0 (Stata Corp. LP, College Station, Texas, USA) for cleaning and analysis. To describe data, we used means and their standard deviations (SDs) as well as medians with their interquartile ranges (IQRs) for continuous variables as appropriate. Categorical variables were summarized into frequencies. To compare two means or medians, we used t-test or Wilcoxon rank sum test, respectively. For comparison of proportions, we used the Pearson's chi-square test or the Fisher exact test for lower proportions. To well characterise the relation mother-child in the HIV continuum in this post-conflict area, we built three different analyses. First, we constructed multivariable logistic regression models to assess factors associated with positive HIV status at delivery in the post-conflict region. Second, to estimate the risk of having a positive HIV PCR at 18 months, we used stratified Mantel-Haenszel test. Lastly, to understand factors associated with survival status at 18 months in children exposed to HIV, we performed cox-proportional hazard models by adjusting potential confounders. Factors associated with risk of testing positive for HIV-infection among pregnant women at a p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.2 in unadjusted logistic regression were included in a multivariable model. Odd ratio, relative risks, and hazards ratio and their 95% confidence intervals were derived to measure the strength of association between the variables. All p-values were two-sided, and we used p-value of less than 0.05 for the level of significance.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eEthical considerations\u003c/h3\u003e\n\u003cp\u003e The study was conducted in strict accordance with the principles of Helsinki. All participants have provided their free consent to participate in the study. We received free consent from the mothers of all children selected for the study before considering their children in the study. All participants (mothers and children) who were diagnosed as HIV-positive, received holistic care via the Panzi PMTCT. The study was authorized by the National Health Ethics Committee and registered under number: CNES001/DPSK/177/2015.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e \u003cb\u003ePrevalence of HIV/AIDS infection among women and their new-born who delivered at the PANZI hospital and characteristic of pregnant women, and their new-born included in the PANZI PMTCT program between July 2015 and July 2020.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eDuring the study period (1 July 2015 to 1 July 2020), 9143 cases were registered at the antenatal clinic of which 6318 pregnant women were tested of which 400 cases were positive for HIV infection (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The prevalence of HIV-positive mothers was 6.3% (400/6318) and the prevalence of vertical transmission was 6.9% (10/144).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e depicts socio-demographic characteristics of pregnant women and their HIV status. While no difference was observed in age, pregnant women who tested positive for HIV-infection were more likely to be separated or divorced with no schooling at all or just primary or secondary level of education as compared to their counterparts who tested negative for HIV infection. Compared to later, pregnant women who were living with HIV-infection were less likely to attend prenatal consolation and were more likely to attend the lower level of health system pyramid facilities (hospital centres) than general hospital (28% vs. 17%) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e. Further, most pregnant women living with HIV were first-time pregnant or mothers (21% and 23%) as compared to pregnant women who tested negative for HIV-infection (7% and 8%). In contrast, pregnant women living with HIV infection had a low prevalence of delivering by caesarean section (8 vs. 23%) and of receiving psychological support during pregnancy (8% vs. 95%). The majority of pregnant women living with HIV had a CD4 count below 500 cell/m3 and among a portion who received VL testing (newly acquired at the hospital), 17/22 had an undetectable VL, and 77% were under ART as per the national guidelines including tenofovir disoproxil fumarate, lamivudine and efavirenz (TDF/3TC/EFV).\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 pregnant women attending Panzi General Hospital by HIV-infection status from July 1. 2015. to July 1. 2020\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\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=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTotal\u0026thinsp;=\u0026thinsp;545\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHIV (+)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHIV (-)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ep-Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;144 (26.4%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;401 (73.6%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years)\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 \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMeans\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30.33\u0026thinsp;\u0026plusmn;\u0026thinsp;5.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30.88\u0026thinsp;\u0026plusmn;\u0026thinsp;6.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30.14\u0026thinsp;\u0026plusmn;\u0026thinsp;5.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;=20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27 (5.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7 (4.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20 (5.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e21\u0026ndash;29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e212 (38.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e51 (35.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e161 (40.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.83\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e30\u0026ndash;39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e277 (50.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e74 (51.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e203 (50.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.93\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e40\u0026ndash;49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e29 (5.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12 (8.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17 (4.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.23\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDistrict\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 \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBagira\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32 (5.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13 (9.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19 (4.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIbanda\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e321 (58.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e78 (54.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e243 (60.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.04\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKadutu\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e140 (25.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25 (17.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e115 (28.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.005\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOut of Bukavu town\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e52 (9.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28 (19.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24 (6.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.24\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital status\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 \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24 (4.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8 (5.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16 (4.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.46\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e506 (92.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e127 (88.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e379 (94.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.16\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSeparated/divorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (1.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (4.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3 (0.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.011\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (1.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (2.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3 (0.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProfession\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 \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWith\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e130 (23.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39 (27.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e91 (22.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWithout\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e415 (76.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e105 (72.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e310 (77.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.29\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLevel of education\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 \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\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=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (1.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (2.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5 (1.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.010\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e129 (23.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41 (28.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e88 (21.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e˂0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e352 (64.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95 (66.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e257 (64.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e˂0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUniversity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e55 (10.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (2.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e51 (12.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \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\u003eClinical characteristics of pregnant women attending Panzi general hospital by HIV-infection status\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\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 \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u0026thinsp;=\u0026thinsp;545\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHIV (+)\u003c/p\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;144 (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHIV (-)\u003c/p\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;401 (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep-Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlace for prenatal care\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 \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGeneral Hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e376 (69.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e84 (58.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e292 (72.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHealth Center\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e59 (10.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19 (13.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40 (10.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.09\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHospital Center\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e90 (16.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31 (21.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e59 (14.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.02\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot done\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20 (3.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10 (6.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10 (2.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber of pregnancies\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 \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimigeste\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e56 (10.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30 (20.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26 (6.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePaucigeste\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e164 (30.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22 (15.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e142 (35.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMultigeste\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e325 (59.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e92 (63.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e233 (58.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber of deliveries\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 \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimiparous\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e64 (11.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33 (22.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31 (7.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePauciparous\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e187 (34.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36 (25.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e151 (37.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMultiparous\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e294 (53.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e75 (52.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e219 (54.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTerm of pregnancy\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 \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\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=\"left\" colname=\"c2\"\u003e \u003cp\u003e54 (9.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11 (7.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e43 (10.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.30\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=\"left\" colname=\"c2\"\u003e \u003cp\u003e491 (90.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e133 (92.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e358 (89.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlace of delivery\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 \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHealth center\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16 (2.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16 (11.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHospital center\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27 (5.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27 (18.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGeneral Hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e502 (92.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e101 (70.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e401 (100.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlcoholism\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 \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\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=\"left\" colname=\"c2\"\u003e \u003cp\u003e451 (82.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e123 (85.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e328 (81.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.32\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=\"left\" colname=\"c2\"\u003e \u003cp\u003e94 (17.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21 (14.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e73 (18.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOpportunistic infections\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 \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\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=\"left\" colname=\"c2\"\u003e \u003cp\u003e541 (99.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e141 (97.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e400 (99.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChronic diarrhea\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (0.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1 (0.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTuberculosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (0.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (1.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (0.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.11\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrenatal care performed\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 \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\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=\"left\" colname=\"c2\"\u003e \u003cp\u003e31 (5.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12 (8.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19 (4.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.11\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=\"left\" colname=\"c2\"\u003e \u003cp\u003e514 (94.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e132 (91.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e382 (95.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther comorbidities\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 \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\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=\"left\" colname=\"c2\"\u003e \u003cp\u003e436 (80.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e116 (80.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e320 (79.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\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=\"left\" colname=\"c2\"\u003e \u003cp\u003e109 (20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28 (19.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e81 (20.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.85\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDelivery method\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 \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCaesarean section\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e123 (22.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33 (22.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e90 (22.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.91\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVaginal mode\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e422 (77.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e111 (77.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e311 (77.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCD4\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 \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDone or achieved (n\u0026thinsp;=\u0026thinsp;121)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e121 (84.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;500 (Normal)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e72 (59.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e500 (High)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49 (40.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eViral load\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 \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDone or achieved (n\u0026thinsp;=\u0026thinsp;22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22 (15.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUndetectable\u0026thinsp;\u0026lt;\u0026thinsp;40copy)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17 (77.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;40 copy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5 (22.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eARV\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 \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTriple therapy (TDF/3TC/EFV)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e111 (77.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther molecules\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e333 (22.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cem\u003e*PRM: Premature rupture of the membranes\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003ePrevalence of HIV/AIDS infection among new-borns boned at the PANZI hospital and characteristic of new-borns included in the PANZI PMTCT programme and those attending post-natal consultation at PANZI hospital between July 2015 and July 2020.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eChildren born from mothers living with HIV infection were mostly boys with extreme birth weights (\u0026lt;\u0026thinsp;2500g or \u0026gt;\u0026thinsp;4000g) at the time of delivery (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). In addition, the frequency of hospitalisation for respiratory diseases (19% vs. 9%) and of death (7%% vs. 2%) over the first 18 months of life were common in the former as compared to the latter. Among children exposed to HIV infection, seven percent had their HIV infection status confirmed at 18 months.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic, Anthropologic, clinical characteristics and 18 moths-survival rates of new-born of pregnant women attending PANZI general hospital by HIV-infection status\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\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=\"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 \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTotal\u0026thinsp;=\u0026thinsp;545\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHIV (+)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHIV (-)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ep-Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;144\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;401\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\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 \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e249 (45.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e54 (37.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e195 (48.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e296 (54.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e90 (62.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e206 (51.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.02\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeight (grams)\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 \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;2500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e61 (11.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9 (6.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e52 (13.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.03\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2500\u0026ndash;4000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e476 (87.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e132 (91.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e344 (85.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;4000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8 (1.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3 (2.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5 (1.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.02\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eApgar (5th minute)\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 \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAbnormal (\u0026lt;\u0026thinsp;7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e47 (8.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12 (8.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35 (8.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.88\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNormal (\u0026thinsp;\u0026lt;\u0026thinsp;=\u0026thinsp;7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e498 (91.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e132 (91.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e366 (91.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRespiratory diseases\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 \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\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\u003e483 (88.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e117 (81.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e366 (91.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\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\u003e62 (11.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27 (18.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35 (8.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSurvival status at 18 moths\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 \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e528 (96.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e134 (93.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e394 (98.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17 (3.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10 (6.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7 (1.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHIV status at 18 months\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 \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10 (1.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10 (6.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e535 (98.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e134 (93.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e401 (100.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\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\u003eFactors associated with risk of testing positive for HIV-infection among pregnant women attending PANZI hospital for delivery.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eAmong pregnant women attending the Panzi obstetric service for delivery, those living in urban areas were less likely to test positive for HIV infection (urban city: aOR\u0026thinsp;=\u0026thinsp;0.46: 95% CI: 0.22\u0026ndash;0.99; p\u0026thinsp;=\u0026thinsp;0.04 and urban suburb, aOR\u0026thinsp;=\u0026thinsp;0.76; 95% CI: 0.31\u0026thinsp;\u0026minus;\u0026thinsp;0.27; p\u0026thinsp;=\u0026thinsp;0.005) as compared to those living in slams. Further, among these women, factors independently associated with increased risk of testing positive for HIV infection included low level of education (no education: aOR\u0026thinsp;=\u0026thinsp;10.20; 95% CI: 1.93\u0026ndash;53.78; p\u0026thinsp;=\u0026thinsp;0.001), primary education aOR\u0026thinsp;=\u0026thinsp;5.94; 95% CI:2.01\u0026ndash;17.54; p\u0026thinsp;=\u0026thinsp;0.001), unbooked pregnancy (aOR\u0026thinsp;=\u0026thinsp;3.47; 95% CI : 1.39\u0026ndash;8.63; p\u0026thinsp;=\u0026thinsp;0.004), being primipara (aOR\u0026thinsp;=\u0026thinsp;3.10; 95% CI: 1.78\u0026ndash;5.20; p\u0026thinsp;=\u0026thinsp;0.001), being primigravida (aOR\u0026thinsp;=\u0026thinsp;2.92; 95% CI: 1.63\u0026ndash;5.20; p\u0026thinsp;=\u0026thinsp;0.001) (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMultivariate logistic regression of factors associated with maternal HIV status\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=\"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 \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eaOR (IC 95%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ep-Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years)\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\u003e\u0026lt;=20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (reference)\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\u003e21\u0026ndash;29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.90 (0.36\u0026ndash;2.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.83\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e30\u0026ndash;39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.04 (0.42\u0026ndash;2.56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.93\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e40\u0026ndash;49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.01 (0.04\u0026ndash;6.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.29\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAddress\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\u003eBagira\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (reference)\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\u003eIbanda\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.46 (0.22\u0026ndash;0.99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.040\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKadutu\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.31 (0.13\u0026ndash;0.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.005\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOut of Bukavu town\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.70 (0.63\u0026ndash;4.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.24\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital status\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\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.50 (0.08\u0026ndash;3.05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.65\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.33 (0.06\u0026ndash;1.68)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.17\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSeparated/ Divorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.00 (0.24\u0026ndash;16.61)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.62\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (reference)\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\u003eProfession\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\u003eWith\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (reference)\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\u003eWithout\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.79 (0.51\u0026ndash;1.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.29\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLevel of education\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=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.20 (1.93\u0026ndash;53.78)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.94 (2.01\u0026ndash;17.54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.71 (1.65\u0026ndash;13.39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUniversity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (reference)\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\u003eANCs achieved\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=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.82 (1.86\u0026ndash;3.66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.040\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=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (reference)\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\u003eDelivery method\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\u003eCaesarean section\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.02 (0.65\u0026ndash;1.61)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.91\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVaginal section\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (reference)\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\u003ePlace for prenatal care\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\u003eGeneral Hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (reference)\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\u003eHealth Center\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.65 (0.90-3.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.09\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCentre Hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.82 (1.11-3.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.020\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot done\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.47 (1.39\u0026ndash;8.63)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber of pregnancies\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\u003ePrimigravida\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.92 (1.63\u0026ndash;5.20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePaucigravida\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.39 (0.24\u0026ndash;0.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMultigravida\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (reference)\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\u003eNumber of deliveries\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\u003ePrimipara\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.10 (1.78\u0026ndash;5.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePaucipara\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.69 (0.44\u0026ndash;1.08)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.11\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMultipara\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (reference)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eFactors associated with risk of testing positive for HIV-infection at the 18 months of birth among children followed at the PANZI postnatal clinic.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eIn this cohort, male children (RR\u0026thinsp;=\u0026thinsp;1.21; 95% CI: 1.03\u0026ndash;1.42; p\u0026thinsp;=\u0026thinsp;0.02), history of hospitalisation for respiratory diseases (RR\u0026thinsp;=\u0026thinsp;2.14; 95% CI: 1.35\u0026ndash;3.41; p\u0026thinsp;=\u0026thinsp;0.001) and exposure to HIV infection (RR\u0026thinsp;=\u0026thinsp;2.31; 95% CI: 1.51\u0026ndash;3.41; p\u0026thinsp;=\u0026thinsp;0.002) were independently associated with the risk of testing positive for HIV infection at the 18th month of birth. However, children boned with a low birthweight, i.e., below or 2500 grams (RR\u0026thinsp;=\u0026thinsp;0.48; 95% CI: 0.24\u0026ndash;0.96; p\u0026thinsp;=\u0026thinsp;0.30) were less likely of test positive for HIV infection at their 18th month of birth (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e\u003cb\u003e).\u003c/b\u003e\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFactors associated with positive HIV-infection status in children at 18 months\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=\"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 \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRR (IC 95%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ep-Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender of the children\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\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (reference)\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\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.21 (1.03\u0026ndash;1.42)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.02\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChild's weight (grams)\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\u003e\u0026lt;2500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.48 (0.24\u0026ndash;0.96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.03\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2500\u0026ndash;4000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (reference)\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\u003e\u0026gt;\u0026thinsp;4000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.55 (0.37\u0026ndash;6.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.54\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eApgar (5th minute)\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\u003eAbnormal (\u0026lt;\u0026thinsp;7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.95 (0.50\u0026ndash;1.76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.88\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNormal (\u0026thinsp;\u0026lt;\u0026thinsp;=\u0026thinsp;7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (reference)\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\u003eRespiratory diseases\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=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (reference)\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\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.14 (1.35\u0026ndash;3.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e˂0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMothers\u0026rsquo; serology\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\u003eHIV-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (reference)\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\u003eHIV+\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.31 (1.51\u0026ndash;3.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.002\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\u003eFactors associated with hazard of death at the 18th month of birth among children followed at the PANZI postnatal clinic.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eAfter adjusting for other variables in the model, we found that children exposure to HIV-infection were 3.9 times more likely of dying before their 18th month anniversary as compared to children unexposed to HIV-infection (HR\u0026thinsp;=\u0026thinsp;3.93; 95% CI: 1.39\u0026ndash;11.10; p\u0026thinsp;=\u0026thinsp;0.01) (Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e). Moreover, the hazard of death increased significantly with premature birth (HR\u0026thinsp;=\u0026thinsp;4.66; 95% CI: 1.41\u0026ndash;15.36; p\u0026thinsp;=\u0026thinsp;0.01) and history of hospitalisation for respiratory diseases (HR\u0026thinsp;=\u0026thinsp;5.37; 95% CI: 1.65\u0026ndash;17.47; p\u0026thinsp;=\u0026thinsp;0.005) as compared to term birth and no history of hospitalisation for respiratory illnesses, respectively. The sex of the children, the multiparity of the mothers, illnesses during pregnancy, and prenatal consultation did not explain the deaths in the children before or at 18 months.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFactors associated with hazard of death in children after 18 months of follow-up\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=\"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 \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHaz. Ratio (IC 95%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ep-Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender of the children\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\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (reference)\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\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.43 (0.52\u0026ndash;3.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.49\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMulti-Parity\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=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (reference)\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\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.87 (0.69\u0026ndash;5.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.26\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTerm of pregnancy\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=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (reference)\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\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.66 (1.41\u0026ndash;15.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.010\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrenatal consultation\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=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.69 (0.89\u0026ndash;5.35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.72\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=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (reference)\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\u003eIllnesses during pregnancy\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=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (reference)\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\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.13 (0.72\u0026ndash;6.29)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.17\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRespiratory diseases\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=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (reference)\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\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.37 (1.65\u0026ndash;17.47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.005\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaternal HIV results\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\u003eHIV-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (reference)\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\u003eHIV+\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.93 (1.39\u0026ndash;11.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.010\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eOur study found a 6.3% (400/6318) HIV positivity rate among pregnant women attending ANC at Panzi Hospital between July 1, 2015, to July 1, 2020, with a 6.9% MTCT HIV rate. Women from urban areas male children had a higher prevalence of HIV as opposed to female children, who were less affected. Lower education levels and low socioeconomic status were associated with HIV-positive status. Poor retention in care was observed, with 36% of women retained in care with their children at 18 months post-natal.\u003c/p\u003e \u003cp\u003eCompared to other studies, our study had a lower HIV positivity rate among pregnant women, which is in contrast to the higher prevalence of 13.4% and 30.7% reported in Angola (2021) [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e] and South Africa (2022) [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e], respectively. However, the MTCT of HIV in our study was similar to that found in a study conducted in Malawi [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e], but higher than the MTCT rate observed in Namibia of 1.74%, where the PMTCT program has been well established with Option B-plus since 2013 [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. These differences in prevalence rates may be due to variations in the implementation and effectiveness of PMTCT programs across different countries, as well as differences in HIV prevalence in the general population.\u003c/p\u003e \u003cp\u003eOur study also found that low education levels of women were associated with HIV positivity, which is consistent with the findings of 33 countries in SSA as shown by Teshale et al. in 2021 [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]. This highlights the importance of education and information campaigns to promote HIV prevention and reduce stigma, particularly in rural areas where most women are illiterate. On the other hand, Remera et al. in 2021 [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e] found that being single or rape victims were risk factors for HIV/AIDS infection, suggesting that additional efforts are needed to provide comprehensive support and care for women who have experienced trauma, especially in conflict zones. Regarding the location of women, our study showed that the majority of women registered in the PMTCT program were from urban areas, which is consistent with the findings of Liyeh et al. in 2020 in Ethiopia [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]. This suggests that the presence of PMTCT centres in urban areas may play a crucial role in improving the coverage and effectiveness of PMTCT services.\u003c/p\u003e \u003cp\u003eIn terms of vertical transmission of HIV, our study found a higher rate of MTCT of HIV compared to the estimates from Cameroon [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e]. This situation may be attributed to differences in the voluntary involvement of women in PMTCT and easy access to quality care services in Cameroon. This underscores the need for efforts to improve access to and utilization of PMTCT services in the DRC and reduce vertical transmission of HIV risk. Moreover, the study revealed that infants born to mothers living with HIV and experiencing respiratory distress, as well as those born from pre-term pregnancies, had a higher likelihood of mortality. These findings are aligned with a study conducted by Fuente-Soro et al. [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e] in rural Mozambique. However, the results differ from those of Rasmussen et al. in Guinea Bissau [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e] who found that maternal HIV was associated with low birth weight but not with stillbirth.\u003c/p\u003e \u003cp\u003eHIV/AIDS is a chronic disease that can lead to opportunistic infections and multiorgan failure, ultimately resulting in infants\u0026rsquo; deaths in their early months of life. However, well-implemented and coordinated PMTCT services at ANC could prevent these disastrous consequences. In our study, a majority of women had not undergone ANC, increasing the risk of HIV transmission to their children. Astawesegn et al. (2021) [\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e] reported a significant association between PMTCT and ANC, which lowered the risk of children developing HIV/AIDS disease. However, women's adherence to ANC is generally compromised in our setting, similar to -HIV negative pregnant women. In addition, only 36% of the women in our study continued with care for their children at 18 months post-natal, which is consistent with findings from Malawi, where 57% of children under the PMTCT program were lost to follow-up by the age of 30 months. The main cause of loss to follow-up in Malawi was mothers not being initiated on ART during pregnancy [\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e]. In the Eastern DRC, where our study was conducted, poor retention in care could be due to political instability, armed conflicts, and their impact on the health system, leading to increased child and maternal mortality (Mohammed J et al., 2021) [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe findings of this study have important policy implications for the PMTCT of HIV in the DRC and other similar settings. Firstly, it highlights the need to increase access to ANC for pregnant women, particularly those from rural areas and with low socioeconomic status. This could be achieved by improving the availability and quality of ANC services, as well as by implementing strategies to encourage women to attend ANC, such as community-based education and outreach programs. Secondly, the study highlights the need to address social determinants of health, such as education and marital status, which were found to be significant predictors of HIV-positive status among pregnant women. This could involve implementing programs to increase access to education for women, particularly in rural areas, as well as promoting gender equality and addressing gender-based violence. Thirdly, the study emphasizes the importance of improving retention in care for women and their children in the PMTCT program. This could involve implementing strategies to improve adherence to ART during pregnancy and breastfeeding, as well as promoting ongoing engagement in care for women and their children, such as through peer support groups and mobile health interventions. Finally, dolutegravir (DTG)-based regimens should be pushed during pregnancy and breast-feeding since they provide high virological suppression, lowering MTCT.\u003c/p\u003e \u003cp\u003eThe limitations of this study should be acknowledged, as they may have influenced the results. Firstly, the study was conducted in a single province in the DRC, and the findings may not be generalizable to other regions or countries with different cultural and socio-economic contexts. Additionally, the sample size was relatively small at 18th months, and therefore, the study may not have had sufficient power to detect statistically significant differences in some of the variables. Another limitation is that data were collected retrospectively, which may have introduced recall bias, and there was a possibility of missing data, especially for women who were lost to follow-up. The study also did not explore in-depth the reasons for poor retention in care, such as political instability in the study area, which would have provided valuable insights into how to improve PMTCT services. Finally, the study did not explore the long-term outcomes of the children, such as their cognitive development and school performance, which would have provided a more comprehensive understanding of the impact of PMTCT services on children's lives. One of the strengths of this study is the large sample size of 400 mother-child pairs, which increases the power of the study to detect associations and reduces the likelihood of chance findings. Additionally, the study was conducted in a resource-limited setting, which is an important context for understanding the challenges and barriers to effective PMTCT implementation. This may increase the generalizability of the findings to other similar settings. Another strength is that the study collected data on multiple factors that could affect PMTCT outcomes, including maternal health status, infant feeding practices, and ART adherence. This allowed for a more comprehensive analysis of the complex factors that contribute to PMTCT success.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn this study conducted over a period from July 1, 2015 to July 1, 2020, 9143 cases were registered at the antenatal clinic of which 6318 pregnant women were tested, among which 400 cases were positive for HIV infection. The prevalence of HIV-positive mothers was 6.3% and vertical transmission was 6.9%.\u003c/p\u003e \u003cp\u003eOverall, the findings of this study highlight the need for a comprehensive and coordinated approach to PMTCT in the DRC and other similar settings to improve retention and achieve eMTCT by 2030. This could involve addressing social determinants of health, improving access to quality ANC services, and promoting retention in care for women and their children. By implementing these strategies, it may be possible to reduce the burden of HIV among women and children in these settings and improve health outcomes for this vulnerable population.\u003c/p\u003e \u003cp\u003eNeed to intensify interventions on PMTCT by making early diagnosis of decentralized HIV infection and the latest generation of ART availabe. Training of health actors coupled with a Community Learning Model (CLM) approach, and a task-shitting policy should be carried out in the DR. As the DRC is a member of the Pediatric Alliance to end AIDS by 2030, we can be optimistic for an AIDS-free generation in the DRC.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eANC: antenatal care, ART : Antiretroviral Therapy, AZT : zidovudine, CHEU : children HIV- exposed and uninfected, DTG : dolutegravir, -DRC: Democratic Republic of Congo, EFV: efavirenz, eMTCT : elimination of Mother-to-Child Transmission, GRH : General Referral Hospital, HIV/AIDS : human immunodeficiency virus/ Acquired immunodeficiency syndrome, MLHIV: mothers living with HIV, MTCT: Mother-To-Child Transmission, NVP: Niverapine, PCR: polymerase chain reaction, PMTCT: Prevention of Mother-to-Child Transmission, PNC: postnatal care, PrEP: \u0026nbsp; pre-exposure prophylaxis, RT: rapid test, SSA: sub-Saharan Africa, TDF: tenofovir disoproxil fumarate, 3TC: lamivudine, STROBE: Strengthening the Reporting of Observational studies in Epidemiology, UNAIDS: the Joint United Nations Programme on HIV and AIDS, UNICEF: United Nations Children\u0026rsquo;s Emergency Fund, VL: viral load, WHO: World Health Organization.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval was obtained from the South-Kivu national health ethics committee under reference (CNES001/DPSK/177/2015) in the city of Bukavu in the Democratic Republic of Congo. A letter requesting support was sent to the health facility selected for this study in order to obtain the necessary authorisations for the research.\u003c/p\u003e\n\u003cp\u003eIn addition, after explaining the purpose of the study and the importance of their participation, the participants agreed to take part in the study. Written informed consent was obtained for both the interview and access to records. and access to records, and those who agreed to participate were included in the study. Participants were not remunerated for their participation, nor were they penalised for failure, as all received the necessary interventions regardless of their participation in the study. The study did not use any invasive procedures, the data being extracted from the records and from the interview with the mother. Confidentiality of information was maintained throughout the study process and later health professionals to whom the mothers had already disclosed their HIV status collected the data. Participants\u0026apos; privacy was protected by interviewing them in a separate room.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical Trial\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNot applicable\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and material\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analysed as part of this study are not accessible to the public due to the sensitivity of the subject and in order to guarantee the confidentiality of the information.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors have declared that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo financing received for this research\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor\u0026rsquo;s contribution \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStudy design and implementation: BMN, LOM, PKDM and DM designed and implemented the study.\u003c/p\u003e\n\u003cp\u003eMethodology: LOM, BMN under the supervision of PKDM.\u003c/p\u003e\n\u003cp\u003eData collection and entry: LOM and BMN\u003c/p\u003e\n\u003cp\u003eData analysis and interpretation: LOM and PKDM.\u003c/p\u003e\n\u003cp\u003eLaboratory analysis: the entire Panzi laboratory team under the supervision of Balthazar and BM.\u003c/p\u003e\n\u003cp\u003eValidation and addition of inputs: LOM, AB, PB, MM, BA, BT, MS, BMN, PKDM and DM.\u003c/p\u003e\n\u003cp\u003eEditing of the final text: LOM, JLT, MK, DM and PKDM.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe thank all those who contributed to the writing of this article.\u003c/p\u003e\n\u003cp\u003eAll the laboratory team of the General Hospital of Reference of Panzi and all the participants in the study.\u003c/p\u003e\n\u003cp\u003eWe would also like to thank the UNAIDS team for making some of the PMTCT literature available and for their contribution to the writing process.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eMutabazi JC, Gray C, Muhwava L, Trottier H, Ware LJ, Norris S, et al. 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Journal of personnality and social psychology, 2017, ONUSIDA/RDC, le VIH/Sida en chiffres.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePlan d\u0026rsquo;action pour. le boostage de la mesure de la charge virale et du diagnostic pr\u0026eacute;coce de l\u0026rsquo;enfant expos\u0026eacute; dans les DPS appuy\u0026eacute;es par le FM, PNLS, juillet 2021.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRapport national de suivi de la. riposte au VIH/Sida, PNMLS, Octobre 2020.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRapport mondial |. 2020, Rapport de l\u0026rsquo;ONUSIDA sur l\u0026rsquo;\u0026eacute;pid\u0026eacute;mie mondiale de sida 2020-Agissons Mayntenant pour combattre les profondes in\u0026eacute;galit\u0026eacute;s et mettre fin aux pand\u0026eacute;mies (reliefweb.int).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRapport GAM. Rapport Annuel de suivi de la riposte au VIH/Sida, PNMLS Octobre 2020.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVueba AN, Almendra R, Santana P, Faria C, Do C\u0026eacute;u Sousa M. Prevalence of HIV and hepatitis B virus among pregnant women in Luanda (Angola): geospatial distribution and its association with socio-demographic and clinical-obstetric determinants. Virol J d\u0026eacute;c. 2021;18(1):239.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNtombela NP, Kharsany ABM, Soogun A, Yende-Zuma N, Baxter C, Kohler HP, et al. Viral suppression among pregnant adolescents and women living with HIV in rural KwaZulu-Natal, South Africa: a cross sectional study to assess progress towards UNAIDS indicators and Implications for HIV Epidemic Control. Reprod Health d\u0026eacute;c. 2022;19(1):116.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNg\u0026rsquo;ambi WF, Merzouki FA, Estill J, Orel E, Chimpandule T, Nyirenda R, et al. Factors associated with the risk of HIV infection among HIV-exposed infants in Malawi: 2013\u0026ndash;2020. bmjpo janv. 2022;6(1):e001275.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAgabu A, Baughman AL, Fischer-Walker C, De Klerk M, Mutenda N, Rusberg F, et al. National-level effectiveness of ART to prevent early mother to child transmission of HIV in Namibia. Nelson JA, \u0026eacute;diteur. PLoS ONE 10 nov. 2020;15(11):e0233341.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTeshale AB, Tessema ZT, Alem AZ, Yeshaw Y, Liyew AM, Alamneh TS et al. Knowledge about mother to child transmission of HIV/AIDS, its prevention and associated factors among reproductive-age women in sub-Saharan Africa: Evidence from 33 countries recent Demographic and Health Surveys. Januraga PP, \u0026eacute;diteur. PLoS ONE. 11 juin. 2021;16(6):e0253164.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRemera E, Mugwaneza P, Chammartin F, Mulindabigwi A, Musengimana G, Forrest JI, et al. Towards elimination of mother-to‐child transmission of HIV in Rwanda: a nested case‐control study of risk factors for transmission. BMC Pregnancy Childbirth d\u0026eacute;c. 2021;21(1):339.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLiyeh TM, Cherkose EA, Limenih MA, Yimer TS, Tebeje HD. Knowledge of prevention of mother to child transmission of HIV among women of reproductive age group and associated factors at Mecha district, Northwest Ethiopia. BMC Res Notes d\u0026eacute;c. 2020;13(1):166.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePenda CI, Tejiokem MC, Sofeu CL, Ndiang ST, Ateba Ndongo F, Kfutwah A, et al. Low rate of early vertical transmission of HIV supports the feasibility of effective implementation of the national PMTCT guidelines in routine practice of referral hospitals in Cameroon. Paediatrics Int Child Health 3 juill. 2019;39(3):208\u0026ndash;15.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFuente-Soro L, Fern\u0026aacute;ndez-Luis S, L\u0026oacute;pez-Varela E, Augusto O, Nhampossa T, Nhacolo A, et al. Community-based progress indicators for prevention of mother-to-child transmission and mortality rates in HIV-exposed children in rural Mozambique. BMC Public Health d\u0026eacute;c. 2021;21(1):520.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRasmussen DN, Vieira N, H\u0026oslash;nge BL, Da Silva T\u0026eacute; D, Jespersen S, Bjerregaard-Andersen M, et al. HIV-1 and HIV-2 prevalence, risk factors and birth outcomes among pregnant women in Bissau, Guinea-Bissau: a retrospective cross-sectional hospital study. Sci Rep 22 juill. 2020;10(1):12174.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAstawesegn FH, Stulz V, Agho KE, Mannan H, Conroy E, Ogbo FA. Prenatal HIV Test Uptake and Its Associated Factors for Prevention of Mother to Child Transmission of HIV in East Africa. IJERPH. 16 mai. 2021;18(10):5289.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHaas AD, Van Oosterhout JJ, Tenthani L, Jahn A, Zwahlen M, Msukwa MT, et al. HIV transmission and retention in care among HIV-exposed children enrolled in Malawi\u0026rsquo;s prevention of mother‐to‐child transmission programme. J Int AIDS Soc janv. 2017;20(1):21947.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJawad M, Hone T, Vamos EP, Cetorelli V, Millett C. Implications of armed conflict for maternal and child health: A regression analysis of data from 181 countries for 2000\u0026ndash;2019. Bhutta ZA, \u0026eacute;diteur. PLoS Med. sept 2021;28(9):e1003810.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-infectious-diseases","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"infd","sideBox":"Learn more about [BMC Infectious Diseases](http://bmcinfectdis.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/infd","title":"BMC Infectious Diseases","twitterHandle":"#bmcinfectdis","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"HIV/AIDS, mother-child transmission, HIV serology, the children prognosis, Panzi Hospital","lastPublishedDoi":"10.21203/rs.3.rs-6194709/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6194709/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eVertical transmission is the main mode of acquisition of HIV infection in the Democratic Republic of Congo (DRC). We aimed to determine the vital prognosis of infants born to HIV-infected mothers at 18 months after birth in the gynaecology and obstetrics department of the General Hospital of Reference of Panzi (GHRP) in Prevention of mother-to-child transmission of HIV (PMTCT) department.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA retrospective cohort of HIV-positive women who delivered and brought their children before and at 18 months of life in the PMTCT/Panzi program during the period from July 1, 2015, to July 1, 2020. Multivariate logistic regression and a Cox proportional hazards model were performed to assess factors associated with positive HIV serology (couple mother-baby) and the risk of HIV MTCT or death at 18 months of life, respectively.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThere were 6318 moms identified, 400 of whom were HIV positive, and had 144 HIV-exposed children. The study found that the prevalence of HIV-infected mothers was 6.3% (400/6318), and the prevalence of vertical HIV transmission was 6.9% (10/144). Premature rupture of the membranes was the most common maternal-foetal complication and was found in 11.1% of cases. Antiretroviral treatment was based on triple therapy (zidovudine (AZT)\u0026thinsp;+\u0026thinsp;lamivudine (3TC)\u0026thinsp;+\u0026thinsp;efavirenz (EFV)) in the majority of cases (77.1%). Logistic regression analysis showed that the risk of HIV was higher in women with no education or primary education, no antenatal care, primiparity, and primigravida. Survival analysis showed that infant death at 18 months was characterized by maternal HIV positivity (HR\u0026thinsp;=\u0026thinsp;3.93; 95% CI: 1.39\u0026ndash;11.10), prematurity (HR\u0026thinsp;=\u0026thinsp;4.66; 95% CI: 1.41\u0026ndash;15.36), and the development of respiratory disease (HR\u0026thinsp;=\u0026thinsp;5.37; 95% CI: 1.65\u0026ndash;17.47).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe mother-to-child transmission of HIV remains a public health concern in the region, and children born to seropositive mothers have a poor prognosis, including death. The findings highlight the need for intensified interventions to prevent mother-to-child transmission of HIV and improve the health outcomes of children born to HIV-positive mothers.\u003c/p\u003e","manuscriptTitle":"Clinical Outcomes and Survival of HIV Exposed Children at 18 Months in Post-Conflict Region: Insight from the Panzi Interdisciplinary PMTCT Cohort (Panzi IPC) study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-04-01 12:23:02","doi":"10.21203/rs.3.rs-6194709/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-10-06T09:59:34+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-22T02:51:29+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"330261156959039076353131653482419539202","date":"2025-05-16T10:51:33+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"237335810992436907915465867899320385016","date":"2025-05-16T07:39:01+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"18617478144926276178899151278888146457","date":"2025-05-16T01:09:59+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-12T13:26:08+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"295783267423703068829708225122496559715","date":"2025-04-29T14:27:11+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-04-26T07:00:33+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-04-23T07:23:08+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-04-01T05:03:27+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-03-30T09:55:27+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Infectious Diseases","date":"2025-03-30T09:54:20+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-infectious-diseases","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"infd","sideBox":"Learn more about [BMC Infectious Diseases](http://bmcinfectdis.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/infd","title":"BMC Infectious Diseases","twitterHandle":"#bmcinfectdis","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"006771e4-af14-4eb6-bf39-028f89d8cd6f","owner":[],"postedDate":"April 1st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-03-23T16:11:15+00:00","versionOfRecord":{"articleIdentity":"rs-6194709","link":"https://doi.org/10.1186/s12879-026-13072-5","journal":{"identity":"bmc-infectious-diseases","isVorOnly":false,"title":"BMC Infectious Diseases"},"publishedOn":"2026-03-20 15:59:19","publishedOnDateReadable":"March 20th, 2026"},"versionCreatedAt":"2025-04-01 12:23:02","video":"","vorDoi":"10.1186/s12879-026-13072-5","vorDoiUrl":"https://doi.org/10.1186/s12879-026-13072-5","workflowStages":[]},"version":"v1","identity":"rs-6194709","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6194709","identity":"rs-6194709","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}