Prevention of mother-to-child transmission of HIV programme: low vertical transmission in KwaZulu-Natal, South Africa

Geddes, R.; Knight, S.; Reid, S.; Giddy, J.; Esterhuizen, T.; Roberts, C.

South African Medical Journal 98(6): 458-462

2008


ISSN/ISBN: 0256-9574
PMID: 18683379
Document Number: 204732
Objective. To describe the operational effectiveness of the prevention of mother-to-child transmission (PMTCT) of HIV programme at McCord Hospital during the period 1 March 2004 - 31 August 2005.Design. Observational cohort study.Setting. McCord Hospital, Durban, South Africa.Subjects. Antenatal patients attending the PMTCT clinic.Measurements and results. During the 18 months all 2 624 women (100%) attending the antenatal clinic received HIV counselling, resulting in 91% (2 388) being tested for HIV. The prevalence of HIV in the total cohort was 13% (95% confidence interval (CI) 11.6 - 14.2).Of the HIV-positive mothers 302 (89%) completed their pregnancy at the hospital, and in this group there were 3 intrauterine deaths, 1 miscarriage, 1 maternal death (with the baby in utero) and 297 live births with 1 early neonatal death. Only 11% (36 out of 338) were lost to follow-up. A quarter (668) of the partners of all women attending the antenatal clinic were tested for HIV.Delivery in 70% (209) of live births was by caesarean section. Nevirapine was administered to 98% (290) of live babies and 75% (224) received zidovudine (AZT) as well.The 6-week polymerase chain reaction (PCR) baby test uptake was 81% (239 out of 296 live babies). Of those tested, 2-9% (95% CI 1.3 - 6.2) tested HIV positive.Conclusion. Despite challenges faced by PMTCT providers in a resource-constrained setting, this state-aided hospital provides a comprehensive and integrated service and has achieved outcomes that compare favourably with those in the developed world.

Document emailed within 1 workday
Secure & encrypted payments