Monitoring effectiveness of programmes to prevent mother-to-child HIV transmission in lower-income countries.
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.
Stringer
Elizabeth M
EM
Centre for Infectious Disease Research in Zambia, Lusaka, Zambia. eli@uab.edu
Chi
Benjamin H
BH
Chintu
Namwinga
N
Creek
Tracy L
TL
Ekouevi
Didier K
DK
Coetzee
David
D
Tih
Pius
P
Boulle
Andrew
A
Dabis
Francois
F
Shaffer
Nathan
N
Wilfert
Catherine M
CM
Stringer
Jeffrey S A
JS
D003906:Developing Countries; D005260:Female; D015658:HIV Infections / Q000401:mortality / Q000517:prevention & control / Q000635:transmission*; D006306:Health Surveys; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control* / Q000706:statistics & numerical data; D009937:Organizational Objectives; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control*; D015397:Program Evaluation / Q000379:methods*; D015996:Survival Rate