Statistical modelling of mother-to-child transmission rate of HIV infection and incubation period of paediatric AIDS using data from an Eastern Cape hospital, South Africa
| dc.contributor.author | Ndenge, James Onyango | |
| dc.date.accessioned | 2026-10-01T13:13:37Z | |
| dc.date.available | 2026-10-01T13:13:37Z | |
| dc.date.issued | 2015-01 | |
| dc.description | PhD Thesis | |
| dc.description.abstract | HIV/ AIDS pandemic has caused many deaths and it has also impacted negatively on households, communities, and entire societies. This disease has posed many health challenges in Sub-Saharan Africa, particularly in South Africa, which is still believed to have one of the highest number of HIV/ AIDS infections in the world ( South African National HIV survey, 2012). The impact of this disease on children is equally devastating. About 30% of pregnant women in South Africa are living with HIV. Maternal and infant mortality in the country are still high with about 700 babies being infected with HIV daily. Also, HIV accounts for 35% of under-five child mortality, and nearly 44% of maternal deaths are due to AIDS-related causes especially in the rural communities ( UNIAIDS, 2012). Paediatric HIV/ AIDS infection therefore still poses a big challenge in South Africa. This Study discusses the estimation of the rate of vertical human immunodeficiency virus (HIV) transmission and the pediatric acquired immune deficiency syndrome (AIDS) incubation period using birth cohort data collected from Cecilia Makiwane (Mdantsane ) Provincial Hospital in East London, Eastern Cape. A total of 1000 children were sampled for the study using their file records from the Hospital. These were ( children) cases presented to the hospital between 1st January 2003 to 30th June 2010. Standard methods of analysis, which ignore children whose infection status is not established, sometimes lead to biased estimates. Methods based on modeling the disappearance of HIV antibody or appearance of virus are inefficient, as they mostly rely on a single variable. The study examines an alternative model that takes into account clinical, immunological, and virological data. Maximum likelihood estimates of rate of vertical transmission, sensitivity of virus tests, pediatric AIDS incubation period, and age distribution of antibody loss are obtained by EM algorithm. This new approach, with possible modifications, can also be used in analysis of data from randomized controlled trials of interventions to reduce vertical transmission. It may also be applied to other vertically transmissible infectious diseases. Using this method yielded maximum likelihood ( ML) estimates of 0.173 with a standard error (SE) of 0.021 for the vertical transmission rate; 0.798 with SE of O .036 for sensitivity of viral culture; and 0. 947 with SE of 0.049 for sensitivity of PCR. An estimated 0.154 (90% confidence interval of 0.099- 0.204) of infected children were diagnosed with AIDS by age 6 months, with a fairly constant hazard thereafter (approximately 0.091 per year). The median duration of anti-body persistence among uninfected children was 11 months, with all children losing antibody by 22 months of age. The study also indicates that more women should be encouraged and incentivized to attend antenatal clinics during their early pregnancy period and be tested so that infected mothers can start early ART treatment to reduce the rate of mother-to-child transmission. | |
| dc.identifier.citation | Ndenge,J.O.Statistical modelling of mother-to-child transmission rate of HIV infection and incubation period of paediatric AIDS using data from an Eastern Cape hospital, South Africa.Alice.University of Fort Hare. | |
| dc.identifier.uri | http://hdl.handle.net/20.500.11837/5237 | |
| dc.language.iso | en | |
| dc.publisher | University of Fort Hare | |
| dc.relation.ispartofseries | N/A | |
| dc.subject | Child care | |
| dc.subject | Mother and infants | |
| dc.subject | Child health services | |
| dc.title | Statistical modelling of mother-to-child transmission rate of HIV infection and incubation period of paediatric AIDS using data from an Eastern Cape hospital, South Africa | |
| dc.type | Thesis |