| dc.description.abstract | HIV exposed infants are vulnerable to adverse health outcomes, which includes; mortality, HIV infections, other infections and poor growth and development. This susceptibility is witnessed even among infants enrolled in Prevention of Mother-to-Child Transmission of HIV program, a program aimed at reducing the number of vertical transmissions and improving their health outcomes. Nevertheless, characterization of these outcomes and the risk factors associated to them remains poor. This study sought to bridge this gap. A quantitative retrospective cohort study design reviewing records of HIV exposed Infants enrolled at a Prevention of Mother-to-Child Transmission of HIV program in Kisumu County Referral Hospital from January 2015- December 2017 was conducted. A sample of 260 records were obtained using simple random sampling and a structured checklist used to abstract data from the records. Data analysis was done using SPSS. Descriptive statistics were used to describe the adverse outcomes to follow-up while association between risk factors and occurrence infections was assessed using binary logistic regression and all factors with p value of = 0.05 were fitted in a multivariate regression model after adjusting for age of infant at enrollment. Only 248 infant records were retrieved and included in analysis. 46(18.55%, cumulative incidence of 18 infants per 100 persons) infants presented with different infections during the follow-up. 13(5.24% cumulative incidence of 5 infants per 100 persons) infants reported poor development while 5(2.0%, cumulative incidence of 2 infants per 100 persons) died by 18 months. 16 new HIV infections were recorded resulting into an 18 months Motherto-child transmission of HIV rate of 6.45% (cumulative incidence 6 infants per 100 persons). Low birth weight (OR 1.88, CI 0.89-3.98), high viral load (OR 7.79 CI 3.1919.04), incomplete immunization (OR 1.65,CI 0.86-3.17), Incomplete Cotrimoxazole prophylaxis dosage ( OR 2.42 CI 1.01-5.79), breastfeeding less than one year (OR 1.55,CI 0.67-3.56) mixed feeding (OR 2.57 CI 1.05-6.27) and home delivery ( OR 1.75, CI0.72-4.23) increased the odds to infections in these children. On multivariate analysis, only mixed feeding (AOR 2.59, p=0.04), incomplete Cotrimoxazole prophylaxis (AOR 2.23, p=0.05) and high maternal viral load [AOR 8.20, p <0.01] were significantly associated with infections. Enrolling the infants late to care increased the odds of infections. The study reported relatively low cumulative incidence of mortality, poor development and new HIV infections indicating the success of the Prevention of Motherto-child-transmission of HIV interventions. However, the incidence proportion of infections among these infants is high and should raise public health concern. Mothers should be encouraged to adhere to antiretroviral drugs to reduce their viral load during the period of exposure. In cases where the high viral load is independent of adherence then the health care providers should seek alternative ways of reducing the viral load. In addition, policy-makers should incorporate health promotions on benefits of completion of co-trimoxazole dosages and uptake exclusive breastfeeding into the programs. | en_US |