Upload
elwin-lane
View
220
Download
0
Tags:
Embed Size (px)
Citation preview
Determinants of infant feeding intent and appropriateness of choices for formula feeding in the Djoungolo Prevention of Mother-To-Child Transmission of HIV programme, Yaounde,
Cameroon
(M0PDD0303)
XIX AIDS Conference Washington DC,July 2012
A.E. Njom Nlend1, B. Bagfegue Ekani2, A. Tchouamo2, A. Mbi3, and the Mother & Child Djoungolo Network
Background
• The dilemma of infant feeding in HIV context of poor resource setting remains unresolved and the practice of replacement feeding can contribute to lower child survival. (De Paoli, 20, Coutsoudis 2009
• Appropriate infant feeding counseling can reverse such risk as well as limiting spill-over (WHO,2010.)
Objective
• To describe infant feeding intents of HIV positive women and determine the appropriateness of choice of those opting for formula-feeding after the counseling process.
Methods
• Routine infant feeding counseling of HIV positive mother offered by short-course trained counselors during the pregnancy or in the early-post partum.
• Intents of formula FEEDING assessed FOR feasibility by using a generic acceptable, feasible, affordable sustainable , secure( AFASS) score composed of 7 variables grading from 0 to 2
Generic Score for Assessing feasibility accessibility affordability sustainability ( AFASS) score
1-Which kind of water are you using ? 5- Shall you be able to prepare formula feeding and clean t
Tap water he bottle even during the night ?
Pump No
River,:stream Yes not easily
2- What kind of fecal disposal is available in your house Yes easily
Modern water closet 6 Which financial amount can you get monthly to buy milk
Traditional latrines and attend facility appointments for the follow-up of the baby
No latrines 10000 FCFA/month
3- Have you disclosed your status to your husband? 20000 FCFA/month
No > 20000 FCFA /month
Yes 7- Which kind of energy do you use
4-Which reason will you give to your family if you were Wood
asked to explain why you don’t breastfeed your child Charcoal
Don’t know Gas
Confused Each item ranking from 0 to 2 Coherent reason clearly explained Total score 14
Measurement
• % of women who had an AFASS >10 and or who fullfilled at least 4 conditions
• Factors predicting replacement feeding choice (univariate)
RESULTS (1)SOCIOECONOMICS CHARACTERISTICS OF THE COHORT
N % N %
MATRIMONIAL 950 FECAL DISPOSAL 928
SINGLE 323 34 MODERN 299 32
COHABITING 457 48 TRADITIONAL 699 68
MARRIED 170 18 WATER 928
LEVEL OF EDUCATION 890 tap water 848 91
PRIMARY 228 26 others (public taps, streams) 81 9
SECONDARY 560 63 FINANCES 919
>SECONDARY 102 11 <10000 582 63
PARITY 920 10000-20000 261 28
NULLIPAROUS 266 29 ≥20000 76 8
MULTIPAROUS 654 71 source of energy 927
FEEDING OF PREVIOUS CHILD 660 Wood or charcoal 172 19
breastfeeding 322 49 gas 712 77
formula feeding 95 14 kerosene 43 5
mixed feeding 243 37 Preparation BF 925
OPTION CHOSEN* 924 yes 23 2,5
exclusive formula feeding 578 63 yes but not easily 115 12,5
exclusive breastfeeding 346 37 yes easily 787 85
STATUS DISCLOSED 922 AFASS SCORE 920
NO 228 25 <10 223 24
YES 694 75 ≥10 697 76
0tan28a566028
0tan9a56609
0tan19a566019
0tan29a566029
0tan9a56609
0tan19a566019
0tan29a566029
0tan9a56609
0tan19a566019
0tan29a566029
0tan10a5660100tan7a56607
0tan25a566025
0tan13a566013
0tan2a56602
0tan17a5660170tan22a566022
0tan28a566028
AA AME
Cumulative access from one to 4 conditions : safe water, préparation of RFHability to explain, kind of energy, additional condition : disclosure .
Among 924 women counseled, 63% intended to formula feed their babies while 37% where planning to breastfeed. The AFASS criteria >10 was met by 87% who intend to practise formula
feeding compared to 57 of those who intend to breastfeed. Inappropriate formula feeding choice ( AFASS <10) was twice likely in women counseled during post partum period as against
during pregnancy ( 0R: 1,8 1.3-2.4, p=0.02).
RESULTS(2)Factors associated with artificial feeding intentVariable OR 95%CI p-valueMarried 1,5 1.08-2,25 0.02Tertiary education 2,17 1.36-3.46 ≤0.001
Non BF of the previous child 1,8 1.33-2.19 ≤0.001
AFASS score > 105.04 3.64-6.57 ≤0.001
HIV status disclosed to the partner 1.68 2.24-2.28 ≤0.001
CONCLUSION
• in Djoungolo, after infant feeding counseling, replacement feeding intent is mostly appropriate fitting mother's environment and livelihood. In addition,
• The desire to breastfeed remains real as more than ½ women who choose to breastfeed met the conditions to practice formula feeding.
THANKS
ACAPFAS
B.P. 5777 Nlongkak Yaoundé