THE PREVALENCE OF HIV IN PATIENTS WITH MISCARRIAGES AT PELONOMI HOSPITAL

Transcription

1 THE PREVALENCE OF HIV IN PATIENTS WITH MISCARRIAGES AT PELONOMI HOSPITAL Dr Magopa 1 Dr Mohosho 1 Prof Joubert 2 1 Dept Obs & Gyn 2 Dept of Biostatistics June 12, 2014 T: info@ufs.ac.za

2 BACKGROUND National antenatal HIV prevalence % 29.4% 29.3% 29.4% 29.5% T: info@ufs.ac.za 1. The 2011 National Antenatal Sentinel HIV & Syphilis Prevalence Survey in South Africa

3 BACKGROUND Free State district antenatal HIV prevalence % 30,5% 30,7% 31,1% Xhariep Lejweleputswa Thaba Mofutsanyana Mangaung 32,9% Fezile Dabi T: info@ufs.ac.za 1. The National Antenatal Sentinel HIV & Syphilis Prevalence Survey in South Africa

4 BACKGROUND women admitted for incomplete miscarriage in 1994 in South African hospitals[1] Studies showed that women are more likely to attempt falling pregnant after a pregnancy loss[2] 1. Helen Rees et al. Epidemiology of incomplete abortion in South Africa. S Afr Med J 1997;87: Moyo W et al. Desire for a future pregnancy among women in Zimbabwe in relation to their selfperceived risk of HIV infection, child mortality and spontaneous abortion. Aids & Behaviour 8(1) March 2004: 9-15

5 BACKGROUND Association between HIV and miscarriages is controversial[4,5] HIV can be transmitted across placenta early in pregnancy[6,7] 4. Dubaldo C et al. Giusseppe Ippolito and DIANAIDS Collaboration Study Group. Association between HIV-1 infection and miscarriages: a retrospective study. AIDS 1998;12: Massad LS et al. Pregnancy rates and predictors of conception, miscarriage and abortion in US women with HIV. AIDS 2004;18: Maury W et al. HIV-1 infection of first trimester and term human placental tissue: A possible mode of maternal-fetal transmission. J Infect Dis 1989;160: Sprecher S et al. Vertical transmission of HIV-1 in 15 weeks fetus. Lancet 1986,ii:

6 THE OBJECTIVES OF THE STUDY Primary objective: Secondary objective To establish the prevalence of HIV in patients with miscarriages at Pelonomi hospital Compare with existing national antenatal HIV prevalence

7 METHODOLOGY Study design - Retrospective descriptive Study period- 1 March February 2011 Sample - All women with miscarriages <24wks - Target 500 women Pilot study - 20 patients 504 Women were included in the study The SAS-system - data analysis

8 DATA COLLECTION Gynae. admission book Diagnoses used: miscarriage or pv bleeding Files retrieved from records All files with diagnosis of miscarriage < 24wks gestation HIV blood results: Files / MEDITECH / NHLS-DISA

9 OUTCOME MEASURES HIV status Pos/Neg/Unkn Demographic information Types of miscarriages Methods of treatment

10 RESULTS 504 Women included HIV Prevalence 39,7% n=200 60,3% n=304 Known HIV Unknown 70,1% n=213 29,9% n=91 HIV POS HIV NEG

11 RESULTS AGE 14,7% n=74 10,3% n=52 75% n=378 <20yrs 20-34yrs >34yrs

12 RESULTS 40% 35% 30% Gravidity 34.7% 29.9% 45% 40% 35% 30% 38.4% 34.3% Parity 25% 20% 15% 21.2% 25% 20% 15% 17.9% 10% 5% 0% 9.7% 4.4% > 4 10% 5% 0% 6.6% 2.2% 0.6% >4

13 RESULTS Spontaneous miscarriages- 470(93.3%) Induced miscarriages- 34(6.7%) 33.4% n= % n=313 Incomplete All other types 5.9% n=2 94.1% n=32 Medical Criminal (Threatened, inevitable, Complete, missed)

14 RESULTS Septic miscarriages 3.6% n= % n=485 No Yes

15 RESULTS Treatment 0.4% n=2 18.1% n= % n=411 Uterine evacuation Hysterectomy Conservative

16 RESULTS Marital status Occupation 13.3% n=67 Single 86.7% n=437 Married 7.5% n= % n= % n=112 Employed Unemploy ed Student

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19 DISCUSSION Seropositivity prevalence in our study(29.9% CI %) is similar to antenatal seropositivity prevalence nationally and provincially. A striking 39.7% of patients with miscarriages left health care system without knowledge of HIV status Majority of patients were unemployed(70.2%) and unmarried(86.7%) Limitations of the study is its retrospective nature and the window period that some tested negative could fall under

20 CONCLUSION HIV seropositivity in patients with miscarriages is similar to overall maternal seropositivity rate in South Africa Our study does not show an increase of HIV prevalence in patients with miscarriages Our study highlights lack of health care professionals to offer HIV- VCT

21 ACKNOWLEDGEMENTS Dr Mohosho: Study supervision Prof G Joubert: Statistical analysis SASOG Research Council: Sponsorship

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