Project Lead(s): Tesfalem Teshome
Issue
Since the beginning of the HIV pandemic, 3.4 million children have been infected and the majority of these children live in Sub-Saharan Africa.
For HIV-infected mothers, due to the risk of HIV transmission with breast milk, formula feeding is recommended but this can be a difficult recommendation to follow in most low- and middle- income countries, including Ethiopia.
Solution
A prospective, non-randomized experimental study was undertaken in Ethiopia to assess the effectiveness of flash-heat treatment of breast milk.
At project sites, HIV-infected pregnant women were recruited and assigned to either a flash-heat treatment group or a regular breast-feeding group, based on their infant feeding choice.
The heat-treatment group was provided with all the necessary materials required to implement the method.
Research nurses conducted home visits to monitor the protocol adherence of study subjects, and infants also had regular clinical follow-up. For qualitative study, focus group discussion, and key informant interviews were used to explore issues related to the acceptability and feasibility of the method.
Outcome
Based on six-month PCR laboratory test results, flash-heat treatment of breast milk reduces the risk of vertical HIV transmission.
Furthermore, infant nutritional status for those receiving flash-heated milk was within the standard normal margin, as measured by regular anthropometric assessment.
As evidenced by the qualitative study, most mothers using flash-heated milk indicated that the new methods alleviated their intense fear and guilt about transmitting the HIV virus to their infant.
Because of the intensive home-based follow-up and health education, which were part of the project activities, all infants in both the experimental and control groups had 100% immunization coverage.
Additionally, as a result of the friendly contact between field workers making home-based follow-ups and the participating mothers, most of the barriers affecting the health-seeking behaviour of mothers were addressed. Subsequently, the health seeking-behaviour of all participating mothers was improved and mothers became more satisfied with the integrated care provided by the project and the participating health institutions.
Results from this work have been reported at conferences.