title: Outcome of different nevirapine administration strategies in preventing mother-to-child transmission (PMTCT) programs in Tanzania and Uganda.
abstract: OBJECTIVE
  Prevention-of-mother-to-child transmission (PMTCT) interventions based on single-dose nevirapine (NVP) are widely implemented in Africa, but strategies differ regarding how and when to administer the drug to women and infants. The aim of this study was to analyze the outcome of different strategies with regard to NVP intake in pregnant women and their infants in Tanzania and Uganda.
  
  
  METHODS
  In an observational study carried out between March 2002 and December 2004, we compared a directly observed NVP administration strategy in Tanzania (supervised NVP intake for women and infants at a health unit) and a semi-observed administration strategy (self-administered NVP for women at home and supervised intake for infants at a health unit) in Uganda.
  
  
  RESULTS
  The proportions of HIV-positive women accepting receipt of NVP from the health units were similar in the 2 countries (42.4% in Tanzania vs 45.6% in Uganda; P = .06). NVP intake in infants was significantly higher in Tanzania than in Uganda (43.7% vs 24.1%; P > .001). In a multivariate analysis, maternal age above 25 years, secondary education, Catholic faith, and having undergone PMTCT counseling at a hospital were independently associated with infant NVP intake.
  
  
  CONCLUSIONS
  In our settings, the directly observed administration strategy resulted in a higher NVP intake in infants. The semi-observed strategy, which implies that, after home delivery, the infant has to be presented to a health unit for NVP administration, was less successful.
authors.affiliation: GTZ PMTCT Project, Institute of Tropical Medicine and International Health, Charite-University Medicine, Berlin, Germany.
authors.forename: Heiko
authors.initials: H
authors.lastname: Karcher
authors.forename: Andrea
authors.initials: A
authors.lastname: Kunz
authors.forename: Gabriele
authors.initials: G
authors.lastname: Poggensee
authors.forename: Paulina
authors.initials: P
authors.lastname: Mbezi
authors.forename: Kizito
authors.initials: K
authors.lastname: Mugenyi
authors.forename: Gundel
authors.initials: G
authors.lastname: Harms
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D019829:Nevirapine / Q000008:administration & dosage*; D011247:Pregnancy; D013636:Tanzania; D014454:Uganda
chemical_list: D019380:Anti-HIV Agents; D019829:Nevirapine