Full Text Available
Note: Clicking the button above will open the full text document at the original institutional repository in a new window.
A comparative analysis of the medicine use and exposures in infants who are HIV exposed uninfected and HIV unexposed uninfected in the first year in Cape Town, South Africa
Background: Despite several studies investigating medicine exposures in infants, the administration and monitoring of medications in infants who are HIV-exposed uninfected (HEU), a growing population, remains poorly studied. This study aimed to describe and compare medication consumption patterns, i...
Saved in:
| Main Author: | |
|---|---|
| Other Authors: | |
| Format: | Thesis |
| Language: | English English |
| Published: |
Department of Public Health and Family Medicine
2025
|
| Subjects: | |
| Tags: |
No Tags, Be the first to tag this record!
|
| _version_ | 1867613160974843904 |
|---|---|
| access_status_str | Open Access |
| author | Mlunga, Hilkka |
| author2 | Mehta, Ushma |
| author_browse | Mehta, Ushma Mlunga, Hilkka |
| author_facet | Mehta, Ushma Mlunga, Hilkka |
| author_sort | Mlunga, Hilkka |
| collection | Thesis |
| description | Background: Despite several studies investigating medicine exposures in infants, the administration and monitoring of medications in infants who are HIV-exposed uninfected (HEU), a growing population, remains poorly studied. This study aimed to describe and compare medication consumption patterns, including immunization coverage, between infants who are HEU and HIV-unexposed uninfected (HUU) during their first year of life. Methods: This was a secondary analysis of a birth cohort study of pregnant women living with and without HIV and their infants between 2017 and 2019 in Cape Town, South Africa. Interviewer- administered questionnaires captured sociodemographic factors, self-reported medication use, infant feeding practices, and vaccine use over four postnatal visits (<7 days, 10 weeks, 6 and 12 months). Data was manually classified and coded by a clinical pharmacist and student. Logistic regression models were employed to compare patterns of use among infants who are HEU and HUU, as well as identify other maternal and infant factors associated with medication use and vaccine coverage. Findings: A total of 772 mother-infant pairs were analyzed. Compared to infants who are HUU, HEU infants were preterm (64/393 vs. 39/379; p = 0.02), less often breastfed (314/393 vs. 322/379; p <0.001), and weighed less (median, 3288g vs. 3405 g; p = 0.03). HEU infants were found to take at least one medication at a significantly higher rate 388/393 (98.7%) vs 345/379 (91.0%) than infants who are HUU (p <0.001). HEU infants reported lower use of over-the-counter (OTC) medicine (69.2% vs. 80.2%; p <0.01) and traditional, complementary, and alternative medicine (TCAM) (16.8% vs. 26.1%; p <0.001) compared to HUU infants. Mothers of HEU infants were less likely to forget a medicine's name (29.3% vs. 36.9%, p<0.001) than HUU mothers. Prescription medicine use, excluding antiretroviral (ARV) prophylaxis medicines routinely administered to infants who are HEU at birth, was significantly higher among infants who are HEU compared to HUU (65.4%. vs. 23.0%; p <0.01). Vaccine coverage showed no significant difference between infants who are HEU and HUU but steadily declined over the year (95.0% coverage with birth immunizations, vs 70.0% at 9 months) across the entire cohort. Only 293 infants (38.0%) had complete immunization coverage at 1 year. In the adjusted models, being a HEU infant was a protective factor against self-medication. (aOR 0.45; 95% CI 0.31 –0.65; p <0.001). Conversely, being breastfed (aOR 2.46; 95% CI 1.56 –3.83; p <0.001) was a significant risk factor for self-medication infants. Prescription medicine use (excluding ARV prophylaxis medicines) was significantly associated with increased maternal age (aOR 1.06; 95% CI 1.03 – 1.08; p <0.001) and infants who are HEU (aOR 6.52; 95% CI 4.66 – 9.21; p <0.001). No significant associations were found between maternal and infant characteristics and full vaccine coverage. Interpretation: The study revealed that infants who are HEU were more exposed to prescribed medicine (excluding ARV prophylaxis medicines) compared to their HUU counterparts, however, mothers of HUU infants, generally reported higher usage of both TCAM and OTC compared to HEU infants. The study also revealed drops in vaccine coverage rates among infants over the first year of life, indicating a gap in protection against vaccine-preventable diseases. Further research is needed to study medication patterns in different settings. Medication literacy efforts need to be prioritized in pregnant women and mothers of newborns to support rational and safe medicine (including vaccine) usage and subsequently improve the health outcomes for all infants, irrespective of HIV status. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/41790 |
| institution | University of Cape Town (South Africa) |
| language | English eng |
| last_indexed | 2026-06-10T12:31:43.046Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2025 |
| publishDateRange | 2025 |
| publishDateSort | 2025 |
| publisher | Department of Public Health and Family Medicine |
| publisherStr | Department of Public Health and Family Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/41790 A comparative analysis of the medicine use and exposures in infants who are HIV exposed uninfected and HIV unexposed uninfected in the first year in Cape Town, South Africa Mlunga, Hilkka Mehta, Ushma Honwana, Frissiano Nyemba, Dorothy HIV Exposed Uninfected Infant Medicine pattern or exposure Vaccine coverage South Africa Background: Despite several studies investigating medicine exposures in infants, the administration and monitoring of medications in infants who are HIV-exposed uninfected (HEU), a growing population, remains poorly studied. This study aimed to describe and compare medication consumption patterns, including immunization coverage, between infants who are HEU and HIV-unexposed uninfected (HUU) during their first year of life. Methods: This was a secondary analysis of a birth cohort study of pregnant women living with and without HIV and their infants between 2017 and 2019 in Cape Town, South Africa. Interviewer- administered questionnaires captured sociodemographic factors, self-reported medication use, infant feeding practices, and vaccine use over four postnatal visits (<7 days, 10 weeks, 6 and 12 months). Data was manually classified and coded by a clinical pharmacist and student. Logistic regression models were employed to compare patterns of use among infants who are HEU and HUU, as well as identify other maternal and infant factors associated with medication use and vaccine coverage. Findings: A total of 772 mother-infant pairs were analyzed. Compared to infants who are HUU, HEU infants were preterm (64/393 vs. 39/379; p = 0.02), less often breastfed (314/393 vs. 322/379; p <0.001), and weighed less (median, 3288g vs. 3405 g; p = 0.03). HEU infants were found to take at least one medication at a significantly higher rate 388/393 (98.7%) vs 345/379 (91.0%) than infants who are HUU (p <0.001). HEU infants reported lower use of over-the-counter (OTC) medicine (69.2% vs. 80.2%; p <0.01) and traditional, complementary, and alternative medicine (TCAM) (16.8% vs. 26.1%; p <0.001) compared to HUU infants. Mothers of HEU infants were less likely to forget a medicine's name (29.3% vs. 36.9%, p<0.001) than HUU mothers. Prescription medicine use, excluding antiretroviral (ARV) prophylaxis medicines routinely administered to infants who are HEU at birth, was significantly higher among infants who are HEU compared to HUU (65.4%. vs. 23.0%; p <0.01). Vaccine coverage showed no significant difference between infants who are HEU and HUU but steadily declined over the year (95.0% coverage with birth immunizations, vs 70.0% at 9 months) across the entire cohort. Only 293 infants (38.0%) had complete immunization coverage at 1 year. In the adjusted models, being a HEU infant was a protective factor against self-medication. (aOR 0.45; 95% CI 0.31 –0.65; p <0.001). Conversely, being breastfed (aOR 2.46; 95% CI 1.56 –3.83; p <0.001) was a significant risk factor for self-medication infants. Prescription medicine use (excluding ARV prophylaxis medicines) was significantly associated with increased maternal age (aOR 1.06; 95% CI 1.03 – 1.08; p <0.001) and infants who are HEU (aOR 6.52; 95% CI 4.66 – 9.21; p <0.001). No significant associations were found between maternal and infant characteristics and full vaccine coverage. Interpretation: The study revealed that infants who are HEU were more exposed to prescribed medicine (excluding ARV prophylaxis medicines) compared to their HUU counterparts, however, mothers of HUU infants, generally reported higher usage of both TCAM and OTC compared to HEU infants. The study also revealed drops in vaccine coverage rates among infants over the first year of life, indicating a gap in protection against vaccine-preventable diseases. Further research is needed to study medication patterns in different settings. Medication literacy efforts need to be prioritized in pregnant women and mothers of newborns to support rational and safe medicine (including vaccine) usage and subsequently improve the health outcomes for all infants, irrespective of HIV status. 2025-09-12T09:14:25Z 2025-09-12T09:14:25Z 2025 2025-09-12T08:07:59Z Thesis / Dissertation Masters MPH http://hdl.handle.net/11427/41790 en eng application/pdf Department of Public Health and Family Medicine Faculty of Health Sciences University of Cape Town |
| spellingShingle | HIV Exposed Uninfected Infant Medicine pattern or exposure Vaccine coverage South Africa Mlunga, Hilkka A comparative analysis of the medicine use and exposures in infants who are HIV exposed uninfected and HIV unexposed uninfected in the first year in Cape Town, South Africa |
| thesis_degree_str | Master's |
| title | A comparative analysis of the medicine use and exposures in infants who are HIV exposed uninfected and HIV unexposed uninfected in the first year in Cape Town, South Africa |
| title_full | A comparative analysis of the medicine use and exposures in infants who are HIV exposed uninfected and HIV unexposed uninfected in the first year in Cape Town, South Africa |
| title_fullStr | A comparative analysis of the medicine use and exposures in infants who are HIV exposed uninfected and HIV unexposed uninfected in the first year in Cape Town, South Africa |
| title_full_unstemmed | A comparative analysis of the medicine use and exposures in infants who are HIV exposed uninfected and HIV unexposed uninfected in the first year in Cape Town, South Africa |
| title_short | A comparative analysis of the medicine use and exposures in infants who are HIV exposed uninfected and HIV unexposed uninfected in the first year in Cape Town, South Africa |
| title_sort | comparative analysis of the medicine use and exposures in infants who are hiv exposed uninfected and hiv unexposed uninfected in the first year in cape town south africa |
| topic | HIV Exposed Uninfected Infant Medicine pattern or exposure Vaccine coverage South Africa |
| url | http://hdl.handle.net/11427/41790 |
| work_keys_str_mv | AT mlungahilkka acomparativeanalysisofthemedicineuseandexposuresininfantswhoarehivexposeduninfectedandhivunexposeduninfectedinthefirstyearincapetownsouthafrica AT mlungahilkka comparativeanalysisofthemedicineuseandexposuresininfantswhoarehivexposeduninfectedandhivunexposeduninfectedinthefirstyearincapetownsouthafrica |