Sexually transmitted infections (STIs) are infectious diseases which spread through sexual contact. It is estimated 50 out of 100 new STIs happen among children. HIV, HBV and Syphilis accounted more than 80% of the overall STI infections among children. The major route of transmission of STI among children is mother to child transmission (MTCT) that accounted 96.2% while the remaining 3.8% were reported to be through sexual abuse. Though the ability to decrease transmission of STIs, pregnant women and their children in many countries face difficulties since these infections are not diagnosed early primarily due to the limited access to services.
Despite the success HIV screening and prevention of mother-to-child HIV transmission (PMTCT) programs, the global strategy towards elimination of the triple infections (HIV, Hepatitis B and syphilis) is yet a challenge. As a result of which, studies indicate prevalence of sexually transmitted infections (STIs) among children exceeds overtime than the general population. The Joint United Nations Programme on HIV/AIDS (UNAIDS), reported 630,000 children become HIV infected and 490,000 die every year from AIDS-related illness. This could be worse in resource limited countries like Ethiopia. A systematic review involved 3,688 mother baby pairs showed prevalence of MTCT of HIV in Ethiopia was 9.93%. The 2021 HIV estimation Projection in Ethiopia revealed MTCT to be 16.4%. According to the global target by 2030, it is assumed MTCT of HIV to be less than 2%. Moreover, the global strategy is towards elimination of MTCT for the triple infections (HIV, HBV and syphilis).
Highly effective interventions for PMTCT, such as antiretroviral agents during pregnancy and labor, caesarean section delivery, post-exposure prophylaxis to the infant and avoidance of breastfeeding can reduce risk for MTCT to less than 2%. Unfortunately, these interventions are not uniformly administered particularly in resource-limited countries. Transmission of STIs from pregnant mothers to infants is preventable with proper intervention during pregnancy and the postnatal period. The risk of MTCT can be decreased from 13% to 30% to less than 2% in appropriate intervention. One of the prevention strategies for prevention of HBV among newborn children is through, passive post-exposure prophylaxis of hepatitis B which is 85% to 95% effective in preventing HBV infection. However, access to HBV post-exposure for new born children was limited. As a result, the burden of HBV among new born infants in resource limited countries were reported to be 0.74%-3.41%. Congenital syphilis is preventable with penicillin injection and screening programs are also reported to be highly cost-effective. Millions of pregnancies each year are affected by congenital syphilis. The burden of syphilis among children in sub-Saharan African countries was reported to be 0.32%-0.91%. This could explain the potential high burden of syphilis among children.
Hence, lack of prenatal and postnatal care and access to perinatal interventions are yet a challenge in Ethiopia. Moreover, evidence on burden of STIs and its determinants among children in Ethiopia is lacking. Hence, this study reports on the burden of HIV, HBV and syphilis among children in urban Ethiopia. Moreover, we assessed determinants of HIV, HBV and Syphilis infection among children in urban Ethiopia.
This study documented, prevalence of HIV, HBV and Syphilis among urban children in Ethiopia was 0.36%, 1.48% and 0.28%, respectively. Children from HIV positive mothers, those who were born from HIV positive mothers with viral load ≥1000 copies/ml and history of breast feeding were risk of HIV infection. Moreover, those from HIV positive mothers and if the mother were not taking HAART was also risk factor for HBV transmission. Children from HIV positive mothers were at risk of acquiring active syphilis.
Penulis: Prof. Maria inge Lusida, dr., Ph.D., M.Kes., Sp.MK(K)
Informasi detail dari riset ini dapat dilihat pada tulisan kami di:
Getaneh .Y, SitiQ K, Husada D., Kuntaman K, Lusida M.I., “Burden of HIV, HBV and syphilis among children in urban Ethiopia: Community-based cross-sectional study,” December 2022, pp. 1–15, 2023, doi: 10.1111/hiv.13457. HIV Medicine
