Human immunodeficiency seropositivity among mother-child pairs in South west Nigeria: a community-based survey.

Abstract

A community based survey to determine the prevelence of human immunodeficiency infection in Nigeira women and children in south western Nigeria is reported. A multi-stage cluster random sampling procedure was used to select mother-child pairs from 35 enumeration areas in south western Nigeria. The final study sample consisted of 460 mothers and 476 children (including 16 sets of twins). A commercially available recombinant antigen-based ELISA method was used to test for HIV-I and HIV-2 anti-body in sera and western blotting was used as a confirmatory test for initially reactive samples. Only one mother-child pair (out of 460 mother-child pairs) was found to the positive for HIV antibody giving a mother-child concordance for HIV infection of 0.22%. Antibody to either HIV-1 of HIV-2 was detected in 3.8% (18/476) of the children's sera and in 4.3% (20/460) of mothers sera. HIV-1 reactivity was commoner than HIV-2 reactivity (2.9% versus 0.8% among children and 2.8% versus 1.5% among mothers). There were many more positive samples in the rural than in urban areas among children (7.1% versus 1.1%) and also among mothers (6.8% versus 2.4%),(p<0.001). Ths, HIV infection appears to be a real problem in south western Nigeria. The lack of concordance between mother-child sera suggests that vertical transmission may not be a major route of tansmission of HIV infection in children in South western Nigeria. It suggested that certain high risk practices(such as the re-use of unsterillised hypodermic needles for injections and surgical knives in local scarfication) which are common practices, especially in rural areas, need to be investigated as potential major modes of transmission of the infection. Control programmes need to take note of these finidngs in order to adequatly paln comprhensive health education which will cover the whole population, invluding children.