Evaluation of a 5-year programme to prevent mother-to-child transmission of HIV infection in Northern Uganda
Journal of Tropical Pediatrics
Epicentre, Paris, France; Médecins Sans Frontières, Kampala, Uganda; Arua Regional District Hospital, Ministry of Health, Arua, Uganda; Médecins Sans Frontières, Paris, France
Prevention of mother-to-child transmission (PMTCT) is essential in HIV/AIDS control. We analysed 2000-05 data from mother-infant pairs in our PMTCT programme in rural Uganda, examining programme utilization and outcomes, HIV transmission rates and predictors of death or loss to followup (LFU). Out of 19 017 women, 1 037 (5.5%) attending antenatal care services tested HIV positive. Of these, 517 (50%) enrolled in the PMTCT programme and gave birth to 567 infants. Before tracing, 303 (53%) mother-infant pairs were LFU. Reasons for dropout were infant death and lack of understanding of importance of follow-up. Risk of death or LFU was higher among infants with no or incomplete intrapartum prophylaxis (OR = 1.90, 95% CI 1.07-3.36) and of weaning age <6 months (OR 2.55, 95% CI 1.42-4.58), and lower in infants with diagnosed acute illness (OR 0.30, 95% CI 0.16-0.55). Mother-to-child HIV cumulative transmission rate was 8.3%, and 15.5% when HIV-related deaths were considered. Improved tracking of HIV-exposed infants is needed in PMTCT programmes where access to early infant diagnosis is still limited. © The Author . Published by Oxford University Press. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
nevirapine; zidovudine; anti human immunodeficiency virus agent; acute disease; adult; article; birth; child death; death; early diagnosis; female; follow up; health program; human; Human immunodeficiency virus infection; infant; intrapartum care; major clinical study; male; outcome assessment; prediction; prenatal care; prophylaxis; rural area; Uganda; vertical transmission; weaning; counseling; disease transmission; evaluation; Human immunodeficiency virus 1; Kaplan Meier method; middle aged; mother; postnatal care; pregnancy; pregnancy complication; retrospective study; rural population; statistics; treatment outcome; Uganda; utilization review; vertical transmission; Adult; Anti-HIV Agents; Counseling; Female; HIV Infections; HIV-1; Humans; Infectious Disease Transmission, Vertical; Kaplan-Meiers Estimate; Male; Middle Aged; Mothers; Postnatal Care; Pregnancy; Pregnancy Complications, Infectious; Prenatal Care; Retrospective Studies; Rural Population; Treatment Outcome; Uganda; Young Adult