Effectiveness of the first district-wide programme for the prevention of mother-to-child transmission of HIV in South Africa.

Hdl Handle:
http://hdl.handle.net/10144/22392
Title:
Effectiveness of the first district-wide programme for the prevention of mother-to-child transmission of HIV in South Africa.
Authors:
Coetzee, D; Hilderbrand, K; Boulle, A; Draper, B; Abdullah, F; Goemaere, E
Journal:
Bulletin of the World Health Organization
Abstract:
OBJECTIVE: The aim of this study was to estimate the field efficacy of the first routine programme for the prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) initiated in South Africa, in the subdistrict of Khayelitsha. METHODS: A consecutive sample of 658 mother-infant pairs, identified from the PMTCT register from 1 March to 30 November 2003, were identified for enrolment in this study. Details of the regimen received were established and HIV status of the infants at between 6 and 10 weeks of age was determined by qualitative DNA polymerase chain reaction. Zidovudine (AZT) was provided antenatally from week 34 of gestation and during labour. Infant formula milk was-offered to mothers who chose not to breastfeed. The protocol was amended in July 2003 such that women who had received < 2 weeks of treatment with AZT were given a single dose of nevirapine (NVP) at the onset of labour, and the infant received a weight-adjusted dose of NVP within 72 h of delivery. RESULTS: Of the 535 mother-infant pairs (81%) eventually included in the study, 410 (77%) received an effective PMTCT intervention according to the protocol. The rate of transmission of HIV from mother to child was 8.8% (95% confidence interval (CI), 6.2-10.9). A maternal age of > 25 years was the only significant independent risk factor for transmission (odds ratio, 2.12; 95% CI, 1.14-4.07). CONCLUSION: The results of this study demonstrate the feasibility and effectiveness of a large-scale PMTCT programme in an urban public-sector setting.
Affiliation:
Infectious Disease Epidemiology Unit, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa. dcoetzee@phfm.uct.ac.za
Publisher:
WHO
Issue Date:
Jul-2005
URI:
http://hdl.handle.net/10144/22392
PubMed ID:
16175822
Language:
en
ISSN:
0042-9686
Appears in Collections:
Womens/Reproductive Health; HIV/AIDS

Full metadata record

DC FieldValue Language
dc.contributor.authorCoetzee, D-
dc.contributor.authorHilderbrand, K-
dc.contributor.authorBoulle, A-
dc.contributor.authorDraper, B-
dc.contributor.authorAbdullah, F-
dc.contributor.authorGoemaere, E-
dc.date.accessioned2008-04-04T15:00:16Z-
dc.date.available2008-04-04T15:00:16Z-
dc.date.issued2005-07-
dc.identifier.citationEffectiveness of the first district-wide programme for the prevention of mother-to-child transmission of HIV in South Africa. 2005, 83 (7):489-94 Bull. World Health Organ.en
dc.identifier.issn0042-9686-
dc.identifier.pmid16175822-
dc.identifier.urihttp://hdl.handle.net/10144/22392-
dc.description.abstractOBJECTIVE: The aim of this study was to estimate the field efficacy of the first routine programme for the prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) initiated in South Africa, in the subdistrict of Khayelitsha. METHODS: A consecutive sample of 658 mother-infant pairs, identified from the PMTCT register from 1 March to 30 November 2003, were identified for enrolment in this study. Details of the regimen received were established and HIV status of the infants at between 6 and 10 weeks of age was determined by qualitative DNA polymerase chain reaction. Zidovudine (AZT) was provided antenatally from week 34 of gestation and during labour. Infant formula milk was-offered to mothers who chose not to breastfeed. The protocol was amended in July 2003 such that women who had received < 2 weeks of treatment with AZT were given a single dose of nevirapine (NVP) at the onset of labour, and the infant received a weight-adjusted dose of NVP within 72 h of delivery. RESULTS: Of the 535 mother-infant pairs (81%) eventually included in the study, 410 (77%) received an effective PMTCT intervention according to the protocol. The rate of transmission of HIV from mother to child was 8.8% (95% confidence interval (CI), 6.2-10.9). A maternal age of > 25 years was the only significant independent risk factor for transmission (odds ratio, 2.12; 95% CI, 1.14-4.07). CONCLUSION: The results of this study demonstrate the feasibility and effectiveness of a large-scale PMTCT programme in an urban public-sector setting.en
dc.language.isoenen
dc.publisherWHOen
dc.rightsArchived with thanks to the World Health Organizationen
dc.subject.meshAdulten
dc.subject.meshAnti-HIV Agentsen
dc.subject.meshBreast Feedingen
dc.subject.meshCross-Sectional Studiesen
dc.subject.meshDisease Transmission, Verticalen
dc.subject.meshFemaleen
dc.subject.meshHIV Infectionsen
dc.subject.meshHumansen
dc.subject.meshInfanten
dc.subject.meshInfant, Newbornen
dc.subject.meshNevirapineen
dc.subject.meshPolymerase Chain Reactionen
dc.subject.meshPregnancyen
dc.subject.meshPregnancy Complications, Infectiousen
dc.subject.meshPregnancy Outcomeen
dc.subject.meshProgram Developmenten
dc.subject.meshProgram Evaluationen
dc.subject.meshSouth Africaen
dc.subject.meshTreatment Outcomeen
dc.subject.meshZidovudineen
dc.titleEffectiveness of the first district-wide programme for the prevention of mother-to-child transmission of HIV in South Africa.en
dc.contributor.departmentInfectious Disease Epidemiology Unit, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa. dcoetzee@phfm.uct.ac.zaen
dc.identifier.journalBulletin of the World Health Organizationen

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