Contact investigation in the prevention of mother-to-child transmission of HIV comparing urban and rural outcomes in Jamaica.
OBJECTIVE
The contact investigators played a significant role in the decline of infectious syphilis in Jamaica and are likely important players in the prevention of mother-to-child transmission (PMTCT) in the HIV programme. A brief evaluation was done comparing the outcomes of contact investigation in Kingston and St. Andrew (KSA) with that of the contact investigation in two rural parishes.


METHODS
The interview and field records for the seropositive antenatal clinic attendees for the period October 2004 to September 2005, in urban KSA, were compared with those for rural Clarendon and Portland.


RESULTS
HIV seropositive pregnant women (n=88) were notified and/or referred to the parish contact investigators: 36 in KSA, 9 in Portland and 43 in Clarendon. The time from test date to interview date was almost twice as long for KSA (mean 27 days) than Portland (mean 15.7 days) and thrice that of Clarendon (mean 9 days). Mean disposition (case closure) times were for KSA: 19 days; Portland: 28 days and Clarendon: 15 days. Only 40% of the contacts were located for KSA and 48% of these tested positive for HIV For Portland, 73% were located and 8% tested positive. For Clarendon, 45% were located and 35% of these tested positive.


CONCLUSIONS
On site same day HIV rapid testing is not always available so the contact investigator is an essential member of the pMTCT team in Jamaica. One of the programme outcomes (time to interview) was longer in the urban than the rural parishes while others (time to resolution of the case and percentage of contacts located and tested) had no consistent urban-rural differences.
Hylton-Kong
T
T
Ministry of Health, Jamaica, West Indies. tinak@cwjamaica.com
Alveranga
H
H
Norrine
D
D
Harris
H
H
Daubon
G
G
D000293:Adolescent; D000328:Adult; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000517:prevention & control / Q000635:transmission; D006679:HIV Seropositivity; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control* / Q000706:statistics & numerical data; D007563:Jamaica / Q000453:epidemiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D011256:Pregnancy Outcome; D012424:Rural Population / Q000706:statistics & numerical data; D013997:Time Factors; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult