{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T11:01:42Z","timestamp":1784890902327,"version":"3.55.0"},"reference-count":13,"publisher":"Pan African Medical Journal","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pan Afr Med J"],"abstract":"<jats:p>Introduction: mother-to-child transmission of Human Immunodeficiency Virus (HIV) remains a significant contributor to pediatric HIV infections in Kenya despite expanded prevention services. Persistent gaps along the prevention of mother-to-child transmission (PMTCT) cascade continue to undermine elimination efforts.\n\n \n\nMethods: we conducted a retrospective, unmatched case-control study using routinely collected PMTCT data from selected health facilities in Kilifi County, Kenya. The cases were HIV-positive mothers whose HIV-exposed infants tested HIV-positive by deoxyribonucleic acid polymerase chain reaction (DNA PCR), while controls were HIV-positive mothers whose infants tested HIV-negative during the same period. Maternal and infant PMTCT cascade indicators were assessed. Associations between PMTCT service uptake and infant HIV status were examined using chi-square tests and multivariable logistic regression.\n\n \n\nResults: a total of 161 mother-infant pairs were included (59 cases and 101 controls). Failure to attend antenatal care, lack of maternal antiretroviral therapy (ART) during pregnancy, non-disclosure of HIV status, and home delivery were significantly associated with infant HIV infection. Maternal ART uptake during pregnancy was the strongest protective factor against vertical transmission (adjusted odds ratio 30.23; 95% CI: 7.56-120.96).\n\n \n\nConclusion: missed opportunities along the PMTCT cascade, particularly poor antenatal care (ANC) attendance and delayed or absent maternal ART, remain key drivers of residual mother-to-child HIV transmission in Kilifi County. Strengthening retention, timely ART initiation, and continuity of care across the PMTCT cascade is critical to achieving elimination of vertical HIV transmission.<\/jats:p>","DOI":"10.11604\/pamj.2026.53.97.49652","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T10:15:53Z","timestamp":1784888153000},"source":"Crossref","is-referenced-by-count":0,"title":["Determinants of vertical transmission of HIV infection in Kilifi County, Kenya: a case-control study"],"prefix":"10.11604","author":[{"given":"Rukiya Mohammed","family":"Koriow","sequence":"first","affiliation":[{"name":"University of Nairobi Institute of Tropical and Infectious Diseases (UNITID), Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julius Otieno","family":"Oyugi","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Nairobi (UON), Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Muasya","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Therapeutics, University of Nairobi (UON), Nairobi, Kenya,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodgers Onsomu","family":"Moindi","sequence":"additional","affiliation":[{"name":"Department of Health, Research Unit, County Government of Kilifi, Kilifi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4870","published-online":{"date-parts":[[2026,2,24]]},"reference":[{"key":"ref0","unstructured":"UNAIDS. AIDS, crisis and the power to transform: UNAIDS Global AIDS Update 2025. Geneva: Joint United Nations Programme on HIV\/AIDS; 2025. Accessed on October 9, 2025."},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Gunn JK, Asaolu IO, Center KE, Gibson SJ, Wightman P, Ezeanolue EE et al. Antenatal care and uptake of HIV testing among pregnant women in sub-Saharan Africa: a cross-sectional study. J Int AIDS Soc. 2016 Jan 18;19(1):20605. PubMed | Google Scholar","DOI":"10.7448\/IAS.19.1.20605"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Vrazo AC, Sullivan D, Ryan Phelps B. Eliminating Mother-to-Child Transmission of HIV by 2030: 5 Strategies to Ensure Continued Progress. Glob Health Sci Pract. 2018 Jun 29;6(2):249-256. PubMed | Google Scholar","DOI":"10.9745\/GHSP-D-17-00097"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Gedefie A, Muche A, Mohammed A, Ayres A, Melak D, Abeje ET et al. Prevalence and determinants of HIV among reproductive-age women (15-49 years) in Africa from 2010 to 2019: a multilevel analysis of demographic and health survey data. Front Public Health. 2025 Jan 24;12:1376235. PubMed | Google Scholar","DOI":"10.3389\/fpubh.2024.1376235"},{"key":"ref4","unstructured":"National Syndemic Diseases Control Council. Kenya AIDS Progress Report 2025: A Year of Resilience. 2025. Accessed on October 9, 2025."},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Lovero KL, de Oliveira TRD, Cosme EM, Cabrera NB, Guimar\u00e3es MF, de Avelar JG et al. Retrospective analysis of risk factors and gaps in prevention strategies for mother-to-child HIV transmission in Rio de Janeiro, Brazil. BMC Public Health. 2018 Sep 10;18(1):1110. PubMed | Google Scholar","DOI":"10.1186\/s12889-018-6002-8"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Azcoaga-Lorenzo A, Ferreyra C, Alvarez A, Palma PP, Velilla E, del Amo J. Effectiveness of a PMTCT programme in rural Western Kenya. AIDS Care. 2011 Mar;23(3):274-80. PubMed | Google Scholar","DOI":"10.1080\/09540121.2010.507750"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Technau KG, Kalk E, Coovadia A, Black V, Pickerill S, Mellins CA et al. Timing of maternal HIV testing and uptake of prevention of mother-to-child transmission interventions among women and their infected infants in Johannesburg, South Africa. J Acquir Immune Defic Syndr. 2014 Apr 15;65(5):e170-8. PubMed | Google Scholar","DOI":"10.1097\/QAI.0000000000000068"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"Ogalo EA, Adina JO, Ooko H, Batuka J, Kimaiyo S. Mother-baby dyads enrolled in PMTCT care in western Kenya: characteristics and implications for ART programmes. Afr J AIDS Res. 2018 Sep;17(3):241-247. PubMed | Google Scholar","DOI":"10.2989\/16085906.2018.1508044"},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Ewenighi-Amankwah CO, Onyenekwe CC, Udemba O, Muogbo P, Rong L. A Mother-to-Child Transmission Study in Nigeria: The Impact of Maternal HIV Infection and HAART on Plasma Immunoglobulins, Cytokine Profiles and Infant Outcome. Virol Sin. 2020 Aug;35(4):468-477. PubMed | Google Scholar","DOI":"10.1007\/s12250-020-00202-9"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"Beyene GA, Dadi LS, Mogas SB. Determinants of HIV infection among children born to mothers on prevention of mother to child transmission program of HIV in Addis Ababa, Ethiopia: a case control study. BMC Infect Dis. 2018 Jul 13;18(1):327. PubMed | Google Scholar","DOI":"10.1186\/s12879-018-3217-3"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Spangler SA, Onono M, Bukusi EA, Cohen CR, Turan JM. HIV-positive status disclosure and use of essential PMTCT and maternal health services in rural Kenya. J Acquir Immune Defic Syndr. 2014 Dec 1;67 Suppl 4(Suppl 4):S235-42. PubMed | Google Scholar","DOI":"10.1097\/QAI.0000000000000376"},{"key":"ref12","doi-asserted-by":"crossref","unstructured":"Kinuthia J, Singa B, McGrath CJ, Odeny B, Langat A, Katana A et al. Prevalence and correlates of non-disclosure of maternal HIV status to male partners: a national survey in Kenya. BMC Public Health. 2018 May 30;18(1):671. PubMed | Google Scholar","DOI":"10.1186\/s12889-018-5567-6"}],"container-title":["Pan African Medical Journal"],"original-title":[],"deposited":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T10:15:55Z","timestamp":1784888155000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.panafrican-med-journal.com\/content\/article\/53\/97\/full\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,24]]},"references-count":13,"URL":"https:\/\/doi.org\/10.11604\/pamj.2026.53.97.49652","relation":{},"ISSN":["1937-8688"],"issn-type":[{"value":"1937-8688","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,24]]},"article-number":"49652"}}