Evaluation of a 5-year programme to prevent mother-to-child transmission of HIV infection in Northern Uganda.
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 follow-up (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.
Ahoua
Laurence
L
Epicentre, Paris, France. laurence.ahoua@epicentre.msf.org
Ayikoru
Harriet
H
Gnauck
Katherine
K
Odaru
Grace
G
Odar
Emmanuel
E
Ondoa-Onama
Christine
C
Pinoges
Loretxu
L
Balkan
Suna
S
Olson
David
D
Pujades-Rodríguez
Mar
M
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D003376:Counseling; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000517:prevention & control / Q000635:transmission*; D015497:HIV-1; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control* / Q000706:statistics & numerical data; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009035:Mothers; D011181:Postnatal Care / Q000706:statistics & numerical data; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000453:epidemiology; D011295:Prenatal Care; D012189:Retrospective Studies; D012424:Rural Population; D016896:Treatment Outcome; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult
D019380:Anti-HIV Agents