PREVALENCE OF HIV AMONG PREGNANT WOMEN ATTENDING ANTENATAL

ABSTRACT

These project work examined “prevalence of HIV among Pregnant women attending antenatal at Otto – Ijanikin Primary Health centre, Ijanikin Lagos state.”

The blood of the antenatal patient were collected using the HIV kits method The result of the patient were recorded into this book. Thus it was recommended that government or private hospitals should always test their antenatal patient for HIV.

TABLE OF CONTENT
CHAPTER ONE
1.0 Introduction                            
1.1  Background of the study                 
1.2    Statement of the problem               
1.3    Aims and objective                     
1.4  Significance of the study                     
1.5  Scope of the study                       
1.6  Limitation of the study                    
1.7  Definition of Terms                 
CHAPTER TWO
2.0 Literature Review                     
2.1   Concept of HIV infection                
2.2  Prevalence of HIV                             
2.3  Effect of HIV                            
2.4 Effect of HIV on pregnancy                   
2.5  Causes of HIV                              
2.6  Diagnosis of HIV                              
2.7  Prevention of HIV                            
2.8 Testing of HIV                           
CHAPTER THREE
3.0    Methodology                       
3.1 Materials                               
3.2 Research Design                      
3.3  Method of Collection                          
CHAPTER FOUR
4.0  Result                                     
4.1  Discussion                              
CHAPTER FIVE
5.0 Conclusion and Recommendation                    
5.1   Conclusion                            
5.2 Recommendation                              
References

CHAPTER ONE
1.0 INTRODUCTION
1.1 BACKGROUND OF THE STUDY
Over 2.1 million children under 15 years in 2009 were affected globally with HIV, 370,000 were new infections and 90% of them were in sub-Saharan Africa. Noteworthy is the fact that 90% of these pediatric infections were through Mother to Child Transmission of the virus Owe-Larsson and Sall (2009). The burden of Mother to Child Transmission of HIV is much higher in sub-Saharan Africa due to higher levels of heterosexual transmission, high male: female ratio, high total fertility rate and high levels of breastfeeding. Nigeria has the largest burden in the West African sub region with about 2.98 million people living with HIV. The children epidemic in Nigeria also followed the global trend Salamon E (2009). Estimated 220,000 children are living with HIV and 90% are from Mother to Child Transmission although a small percentage of "under 15" pediatric infection could be the result of rape or other social abuse.
The virus undergoes a complex interaction with the immune system which results in production of HIV antibodies. The time between infection and antibody development is highly variable and ranges between two weeks to six months with some studies reporting 9 months Anderson, (2013). This period often termed "the window period" or "period of seroconversion" is usually marked with non-specific symptoms or may be completely asymptomatic but with extremely high viral load, associated high vertical and horizontal transmissibility and poses the greatest challenge to HIV diagnosis in pregnancy using antibody detection techniques (Shacham E, et al 2009). This is because; a minimum quantity of antibody in the serum is required for the test result to be reactive. This can lead to high false negative test result in newly infected pregnant women who will eventually seroconvert in the course of the pregnancy. This will amount to "missed opportunity" if these women are not re-tested later in the pregnancy. Also, new infections can occur in pregnancy after an initial antibody screening test and depending on the gestational age, pass through seroconversion and escape detection due to the current practice of single screening test on contact irrespective of the gestational age Campbell (2013). Such women will miss the opportunity to access prevention of mother to child transmission (PMTCT) services which has been proven to reduce MTCT of HIV from as high as 30-45% to less than 2%.
Although (Campbell JC et al 2013), the single antibody test algorithm is widely employed and effective in developed countries like the USA where HIV prevalence is low; the same may not be true in a developing country like Nigeria with high HIV prevalence and large population. It may not be out of place therefore to consider the Center for Disease Controls (CDC) recommendation of a double antibody test algorithm (one in early pregnancy and a repeat in late pregnancy) to minimize false negatives and missed opportunities for diagnosis and PMTCT interventions.
The study was carried out over one month. The total number of antenatal attendees for the period was 50.
1.2 STATEMENT OF THE PROBLEMS
Women who have HIV should talk to their HIV specialist and an obstetrician before trying to become pregnant. Some HIV medications are not safe to take during pregnancy, and it may be necessary to switch before trying to conceive. It is also important to take your HIV medications regularly. Women who have complete viral suppression (no virus detected in their blood) have a much lower risk of passing HIV to their baby than women who have virus detected in their blood. A number of studies have been done to better understand how HIV infection and HIV treatment affect the health of women and infants. Pregnancy does not appear to worsen HIV or increase the risk of death from HIV. It is not clear if HIV or HIV treatments increase the risk of pregnancy complications, such as prematurity, low birth weight, and stillbirth. However, it is very clear that certain HIV medications, such as zidovudine (ZDV or AZT) and other medications that cross the placenta, can significantly reduce the risk that the infant will become infected with HIV when the medication is taken during pregnancy and labor, and then given to the infant after delivery. That is why HIV treatment guidelines strongly recommend a combination of medications to prevent the transmission of HIV to an infant from an HIV-infected mother. Over half the respondents (58%) said that living with HIV had no impact on their working life at the moment. Seventy per cent of gay men living with HIV had taken no HIV-related sickness days in the last 12 months, and took no more sick days than HIV-negative men. Only a third had made any changes to their working lives because of their HIV status, with the most common change being alterations to working hours.
On the other hand, initial diagnosis of HIV was a time when many respondents did report an impact on their working life. Forty-two per cent reported stress or anxiety, 32% needed some time off, and 28% were very tired. However, it is important to note that almost a third of respondents said that their initial diagnosis had no impact on their working life. There was some suggestion from focus group discussions that starting or changing medication was another ‘flash point’ when HIV had an impact on their working lives.
1.3 Aims and objective
To create awareness for the women attending antenatal at Otto Ijanikin Primary Health Centre Ijanikin, Lagos State about dangers of HIV in pregnancy. To identify the number of case of HIV in pregnancy in Otto Ijanikin Primary Health Centre, Ijanikin, Lagos State. To determine the prevalence rate of HIV in pregnancy in Otto Ijanikin Primary Health Centre, Ijanikin, Lagos State.
1.4 Significance of the study
•    The study is of great important to investigate the methods of prevalence of HIV in
pregnancy women attending antenatal at Otto Ijanikin Primary Health Centre,
Ijanikin, Lagos State.
•    The information ascertain from the study will guide as regards to save live of
pregnant women through the prevalence of HIV in pregnancy women attending
antenatal at Otto Ijanikin Primary Health Centre, Ijanikin, Lagos State.
•    The study of the work will expose the predisposing factors and control measures for
HIV attack and the awareness will be very important to the pregnant women
attending antenatal at Ijanikin, Lagos State. This is because it will help them to take
a adequate precautions of preventing HIV.
1.5 Scope of the study
This research work is limited to Lagos and its environments. The scope on the other hand covers the pregnant women of Ijanikin and the effect of HIV on them, especially
those of the Otto Ijanikin Primary Health Centre.
1.6 Limitations of the study
The study did not differentiate between true sero-conversion and new infections in the index pregnancy. Also, this was a hospital based study done in a center of excellence
for HIV services. A multi-center study is needed to collaborate or refute these findings.
1.7 DEFINITION OF TERMS
Prevalence
Prevalence is the proportion of a population that has the condition at some time during a given period (e.g., 12 month prevalence), and includes people who already have the
condition at the start of the study period as well as those who acquire it during that period. Lifetime prevalence (LTP) is the proportion of a population that at some point in their life (up to the time of assessment) have experienced the condition.
HIV
HIV stands for Human Immune Deficiency Virus, if it is left on treat it can leads to AIDS (Acquired Immune Deficiency Syndrome). HIV is not like other viruses, if you  have HIV you have it for life because HIV is an incurable diseases.
Antenatal
Is done Before birth, during or relating to pregnancy, it is also a medical examination during pregnancy.
Antenatal day
Is a day meant for pregnant women who are given care an advise during pregnancy, ultra sound scan.
Primigravidae
A women that has been pregnant for atleast the first time Multigravidae  A Woman who is pregnant for at least the third time.
Trimester
Trimester is the number of times the women has been pregnant, it may be first trimester, second trimester and third trimester