Monitoring effectiveness of programmes to prevent mother-to-child HIV transmission in lower-income countries
Bulletin of the World Health Organization
Centre for Infectious Disease Research in Zambia (CIDRZ), Plot 5977, Benakale Road, Northmead, Lusaka, Zambia; Centers for Disease Control and Prevention, Global AIDS Program, Atlanta, GA, United States; PAC-CI Programme, Abidjan, Cote d'Ivoire; School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa; Cameroon Baptist Convention Health Board, Nso, Northwest Province, Cameroon; Institut de Sante Publique d'Epidemiologie et de Developpment (ISPED), Universite Victor Segalen, Boudeaux, France; Elizabeth Glaser Pediatric AIDS Foundation, Chapel Hill, NC, United States
Ambitious goals for paediatric AIDS control have been set by various international bodies, including a 50% reduction in new paediatric infections by 2010. While these goals are clearly appropriate in their scope, the lack of clarity and consensus around how to monitor the effectiveness of programmes to prevent mother-to-child HIV transmission (PMTCT) makes it difficult for policy-makers to mount a coordinated response. In this paper, we develop the case for using population HIV-free child survival as a gold standard metric to measure the effectiveness of PMTCT programmes, and go on to consider multiple study designs and source populations. Finally, we propose a novel community survey-based approach that could be implemented widely throughout the developing world with minor modifications to ongoing Demographic and Health Surveys.
antiretrovirus agent; nevirapine; zidovudine; demography; developing world; disease control; disease transmission; health survey; human immunodeficiency virus; low income population; acquired immune deficiency syndrome; article; developing country; female; gold standard; health program; health survey; human; Human immunodeficiency virus infection; infant; infection prevention; lowest income group; single drug dose; survival; vertical transmission; Developing Countries; Disease Transmission, Vertical; Female; Health Surveys; HIV Infections; Humans; Infant, Newborn; Organizational Objectives; Pregnancy; Pregnancy Complications, Infectious; Program Evaluation; Survival Rate