Abstract：
BACKGROUND: The success of prevention of mother to child transmission of HIV (PMTCT) programs dependents on pregnant women accessing antenatal care (ANC) services. Failure to access ANC throughout the course of pregnancy presents a missed opportunity to fully utilize PMTCT services and a high risk for vertical HIV transmission. Whilst not booking for ANC was about 6% in Zimbabwe, according to the 2015 Zimbabwe Demographic and Health Survey, it is important to determine the local burden of pregnant women both un-booked for ANC and living with HIV. in Chitungwiza city, to inform local response. This study aimed at determining the proportion of women un-booked for antenatal care and among them, the proportion of women who were with HIV and to identify risk factors associated with not-booking for ANC in Chitungwiza city in Zimbabwe.
METHODS: A cross-sectional study was conducted involving a review of clinic records for 4400 women who received postnatal care at all 4 maternity clinics in Chitungwiza city between 01 January 2017 and 31 December 2017. Bivariate and multiple logistic regression analysis with Chi squared test were used to determine risk factors associated with booking status while adjusting for other study variables. All statistics tests\' decisions were concluded at 5% level of significance. All data analysis was performed using STATA (version 13) statistical package.
RESULTS: A total of 4400 women were attended to and of these, 19% were un-booked for ANC, while a total of 3% of the women were both un-booked and living with HIV. The women with HIV were 0.24 times less likely to book for ANC than HIV negative women, adjusted OR = 0.76 (95% CI: 0.61-0.98). Women aged 20-34 years were 1.3 times more likely to book than the teenagers, adjusted OR = 1.3 (95% CI: 1.04-1.62).
CONCLUSIONS: The proportion of women not booked for ANC of 19% was unexpectedly high. With 3% of pregnant women in Chitungwiza having both HIV and no access to ANC, the risk for vertical HIV transmission remains. More need to be done to improve ANC access, targeting teenage mothers and those living with HIV who are more less likely to access ANC.
METHODS: A cross-sectional study was conducted involving a review of clinic records for 4400 women who received postnatal care at all 4 maternity clinics in Chitungwiza city between 01 January 2017 and 31 December 2017. Bivariate and multiple logistic regression analysis with Chi squared test were used to determine risk factors associated with booking status while adjusting for other study variables. All statistics tests\' decisions were concluded at 5% level of significance. All data analysis was performed using STATA (version 13) statistical package.
RESULTS: A total of 4400 women were attended to and of these, 19% were un-booked for ANC, while a total of 3% of the women were both un-booked and living with HIV. The women with HIV were 0.24 times less likely to book for ANC than HIV negative women, adjusted OR = 0.76 (95% CI: 0.61-0.98). Women aged 20-34 years were 1.3 times more likely to book than the teenagers, adjusted OR = 1.3 (95% CI: 1.04-1.62).
CONCLUSIONS: The proportion of women not booked for ANC of 19% was unexpectedly high. With 3% of pregnant women in Chitungwiza having both HIV and no access to ANC, the risk for vertical HIV transmission remains. More need to be done to improve ANC access, targeting teenage mothers and those living with HIV who are more less likely to access ANC.
摘要：
背景：预防艾滋病毒母婴传播（PMTCT）计划的成功取决于孕妇获得产前护理（ANC）服务。在整个怀孕过程中未能获得ANC将错过充分利用PMTCT服务的机会，并且有垂直传播艾滋病毒的高风险。虽然在津巴布韦，非国大的预订量约为6%，根据2015年津巴布韦人口和健康调查，重要的是要确定未预订ANC和感染艾滋病毒的孕妇的当地负担。在Chitungwiza市,通知当地回应。这项研究旨在确定未预约接受产前护理的妇女比例，在津巴布韦的Chitungwiza市，感染艾滋病毒的女性比例以及确定与未预订ANC相关的危险因素。
方法：进行了一项横断面研究，回顾了2017年1月1日至2017年12月31日期间在Chitungwiza市所有4个产科诊所接受产后护理的4400名妇女的临床记录。使用卡方检验的双变量和多元逻辑回归分析来确定与预订状态相关的危险因素，同时调整其他研究变量。所有统计学检验的决定都是在5%的显著性水平下得出的。所有数据分析均使用STATA（版本13）统计软件包进行。
结果：共有4400名妇女参加了治疗，其中，19%的非国大没有预订，而总共有3%的妇女既未被登记，又感染了艾滋病毒。感染艾滋病毒的女性为ANC预订的可能性比艾滋病毒阴性的女性低0.24倍，校正OR=0.76（95%CI：0.61-0.98）。20-34岁的女性预订的可能性是青少年的1.3倍，校正OR=1.3（95%CI：1.04-1.62）。
结论：未预订ANC的女性比例为19％，出乎意料地高。Chitungwiza有3％的孕妇既感染了艾滋病毒，又无法获得ANC，艾滋病毒垂直传播的风险仍然存在。需要做更多的工作来改善ANC的访问，针对青少年母亲和感染艾滋病毒的人，他们更不可能获得ANC。
方法：进行了一项横断面研究，回顾了2017年1月1日至2017年12月31日期间在Chitungwiza市所有4个产科诊所接受产后护理的4400名妇女的临床记录。使用卡方检验的双变量和多元逻辑回归分析来确定与预订状态相关的危险因素，同时调整其他研究变量。所有统计学检验的决定都是在5%的显著性水平下得出的。所有数据分析均使用STATA（版本13）统计软件包进行。
结果：共有4400名妇女参加了治疗，其中，19%的非国大没有预订，而总共有3%的妇女既未被登记，又感染了艾滋病毒。感染艾滋病毒的女性为ANC预订的可能性比艾滋病毒阴性的女性低0.24倍，校正OR=0.76（95%CI：0.61-0.98）。20-34岁的女性预订的可能性是青少年的1.3倍，校正OR=1.3（95%CI：1.04-1.62）。
结论：未预订ANC的女性比例为19％，出乎意料地高。Chitungwiza有3％的孕妇既感染了艾滋病毒，又无法获得ANC，艾滋病毒垂直传播的风险仍然存在。需要做更多的工作来改善ANC的访问，针对青少年母亲和感染艾滋病毒的人，他们更不可能获得ANC。
