Journal of Medical Society

ORIGINAL ARTICLE
Year
: 2013  |  Volume : 27  |  Issue : 1  |  Page : 39--42

Knowledge on PPTCT program among married women in an urban community of Imphal West, Manipur


Sanayaima H Devi1, Vikram L Singh1, Ranjan RK Singh1, Sh Praveen2, Th Netajini Devi3,  
1 Department of Community Medicine, Regional Institute of Medical Sciences, Imphal, Manipur, India
2 Department of Microbiology, Regional Institute of Medical Sciences, Imphal, Manipur, India
3 Department of OBG, Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India

Correspondence Address:
Sanayaima H Devi
Department of Community Medicine, Regional Institute of Medical Sciences, Imphal - 795 004
India

Abstract

Objectives: To assess the knowledge of Preventions of parent to child transmission (PPTCT) among married women and to assess the association between knowledge level with some important variables. Materials and Methods: A cross sectional study was conducted during September to December 2010 among married women between the age group of 18-45 years in an urban community of Imphal West, Manipur. After taking an informed consent, a face to face interview was conducted using a pretested, predesigned structured questionnaire. Chi-square test was used for analysis. Results: Only one third of the study population had adequate knowledge on PPTCT program with the mean score of 6.4 ± 2.5 (range; 1 to 12) out of total 14 score. All of them had heard of HIV/AIDS however, only 58% knew PPTCT program. Knowledge of the respondents was significantly associated with age and parity. Conclusion: Only one third of the participants have adequate knowledge on PPTCT. Information, education and communication effort to increase awareness about PPTCT program among married women is urgently needed to reduce this deadly disease among children.



How to cite this article:
Devi SH, Singh VL, Singh RR, Praveen S, Devi TN. Knowledge on PPTCT program among married women in an urban community of Imphal West, Manipur.J Med Soc 2013;27:39-42


How to cite this URL:
Devi SH, Singh VL, Singh RR, Praveen S, Devi TN. Knowledge on PPTCT program among married women in an urban community of Imphal West, Manipur. J Med Soc [serial online] 2013 [cited 2020 Nov 24 ];27:39-42
Available from: https://www.jmedsoc.org/text.asp?2013/27/1/39/116636


Full Text

 Introduction



Mother to child transmission (MTCT) can occur during pregnancy, birth or through breastfeeding. As a mode of transmission, MTCT accounts for more than 10% of all new HIV infections globally. Prevention of mother-to-child transmission (PMTCT) of HIV has been at the forefront of global HIV prevention activities since 1998, following the success of the short-course zidovudine and single-dose nevirapine clinical trials. These offered the promise of a relatively simple, low-cost intervention that could substantially reduce the risk of HIV transmission from mother to baby. [1]

It was estimated that 430, 000 children were newly infected with HIV in 2008 and over 90% of them get infected through mother-to-child transmission (MTCT). Without treatment, about half of these infected children will die before their second birthday. The risk of MTCT ranges from 20 to 45% however, with specific interventions along with breast feeding, the risk can be reduced to 5% or less and even lesser to less than 2% when infant is not breast fed. [1]

According to National AIDS Control Organization (NACO), it is estimated that about 30,000 infants acquire HIV infection each year. The joint technical mission on PPTCT (2006) estimated that out of 27 million annual pregnancies in India, 189,000 occur in HIV positive pregnant women. In the absence of any intervention, an estimated cohort of 56,700 infected babies will be born annually. [2]

Manipur is one of the six high prevalent states in India with HIV prevalence rate among pregnant women attending ANC being 1.4% (Sentinel Surveillance 2006). [3] As the HIV/AIDS epidemic in Manipur has penetrated into the general population from the Injecting Drug Users through sexual route, the situation among the women and children has become alarming day by day. The trend is not stabilized. Nowadays, the priority of AIDS prevention is undeniable and a potential strategy to fight against HIV/AIDS should focus on raising women's awareness about HIV, its spread, treatment and prevention of new infections. [4] So this study was undertaken as a preliminary study to assess the knowledge on PPTCT among 18 to 45 years married women in an urban community of Imphal west and to find out any association between knowledge level with selected variables like age, parity, educational and occupational status of the respondents and their husbands'.

 Materials and Methods



This Cross sectional study was conducted during September to December 2010 in an urban community of Imphal West. In this study, we selected purposively an urban area and included all married women between 18 to 45 years of age residing in that community. Data were collected using a pretested, predesigned structured questionnaire which consisted of socio-demographic characteristics and questions pertaining to knowledge on PPTCT program. After taking an informed consent, participants were interviewed face to face at their residence. Those women who were not willing to participate and were not at home even after two visits were excluded from the study.

Statistical Analysis

Data so collected were checked for consistency and completeness and fitted in data base software. Descriptive statistics were used to assess the level of knowledge of PPTCT program. Analysis was done using Chi-square test and P < 0.05 was taken as significant.

Knowledge Score

Each respondent's level of knowledge was determined using a scoring system. Fourteen questions on knowledge of PPTCT were scored, each right answer attracting one point. Maximum score that a respondent could get was 14. The score obtained out of 14 was calculated for each respondent. We classified adequate knowledge as a score of 9 or above (i.e., 75 th percentile of the score).

Ethical issue: The study proposal was approved by the Ethics committee, RIMS, Imphal. Confidentiality of the respondents was maintained.

 Results



Out of 359 eligible women approached for the study fifteen were refused to participate and 30 of them could not be contacted even after two visits. Most of the study subjects (63%) were above 30 years and majority (98.1%) were literate. 63% of them were housewives and having less than three children (68.8%). Majority of the respondent's husbands were literate (99.3%) and nearly sixty percent were self employed [Table 1].{Table 1}

Respondents' knowledge about PPTCT is shown in [Table 2]. On the basis of the scoring scale, the proportion of married women having adequate knowledge was 26.2%. The mean score of knowledge level was 6.7 ± 2.5 with a minimum score of 1 and maximum score of 12 out of total 14 scores. All of them had heard of HIV/AIDS but only 58% of them knew PPTCT program. However, majority of them did not know what the PPTCT facilities are available. About the route of transmission of HIV infection from mother to child, 72% of them knew that it is transmitted during pregnancy, 60.5% during delivery and 58.6% through breastfeeding. But, majority of the respondents did not know how to reduce the transmission of this infection from mother to child. Most (84.7%) of the respondents knew that there is medicine for HIV/AIDS but more than half (51.6%) did not know where to get these medicines.{Table 2}

[Table 3] shows that knowledge on PPTCT was significantly associated with age of 30 years and above (P = 0.01) and parity, having three or more children (P = 0.04). Whereas other variables like respondents' literacy and occupational status were not significantly associated with their knowledge of PPTCT. No significant difference was observed in knowledge level and their husbands' educational status and occupation.{Table 3}

 Discussion



Our study show that all of the respondents had heard about HIV/AIDS which is consistent with other findings. [5],[6],[7],[8] In the present study, 26% of the respondents had adequate knowledge of PPTCT. Seventy two percent of the study participants revealed that HIV infection can be transmitted during pregnancy and 60.5% cited during delivery. While only 58.6% mention that it can be transmitted through breast feeding. Other studies which were conducted in Nigeria, Iran and Malaysia show similar results especially the knowledge of transmission during breast feeding. [2],[5],[9] However according to NFHS-III [9] and other studies, [7],[8],[10] a higher level of knowledge on HIV transmission was reported. Moreover in our study only 15.3% of the respondents could tell correctly the chance of HIV transmission from infected mother to child.

Majority of the participants (84.7%) in this study were aware of ART, but they had very poor knowledge of methods to reduce MTCT which is consistent with other studies. [9],[6] But another studies in Tanzania [10] and Uganda [11] show a higher knowledge regarding transmission reduction and also 92.5% of the respondents in that Tanzania study had heard about PMTCT whereas in our study only 58% are aware of the program. Moreover more than half of the respondents didn't know any ART centre which is in contrast to a study conducted in Malaysia. [5]

In the present study, there was no statistically significant association between knowledge level of PPTCT with educational status of respondents nor with their occupational status which is in contrast to other studies. [5],[8],[12],[13] A similar finding was reported in a study [11] where they explained that it might be due to high and equal level of education in that region. Moreover no significant difference in Knowledge level was found among high school and university degree holders in a study in Iran. [9] Our study shows a statistically significant difference in knowledge level with age and parity. Age above 30 years and parity three or more had more knowledge of PPTCT which is supported by other findings. [6],[12]

This study found three main areas where the mother seemed to have insufficient knowledge- 1) the possibility of MTCT during pregnancy, during delivery and during breastfeeding 2) the methods to reduce MTCT 3) the centre where they can get the facilities including ART. Thus there is the need for adequate counseling and focus should be on specific routes of MTCT and various interventions available to prevent MTCT. Also there is a need for further study among health professionals who will be providing the services. A more encompassing evaluation of knowledge and attitudes of the community about HIV/AIDS and PPTCT including male partners will provide added information for establishing a community intervention program.

Since it is conducted in an urban community of Imphal West it is representative of that community only, that could be the limitation of our study. Furthermore, there is chance of social desirability bias where the respondents answered with what they assumed would be the right thing to say rather than what they actually know. Still our study could give some important insight regarding knowledge of PPTCT among married women and in our knowledge probably, this is the first survey conducted in Manipur and particularly in RIMS.

 Conclusion



Only one third of the participants have adequate knowledge on PPTCT. Such inadequate knowledge may place the risk of HIV transmission from mother to child thereby indirectly impacting the achievement of national goals in particular Millennium Development Goals 4, 5 and 6. So, information, education and communication activities and proper counseling need to be addressed to improve the knowledge about PPTCT program among married women so as to help in reducing this deadly preventable disease among children.

References

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