title: Eliminating mother-to-child HIV transmission in South Africa.
abstract: OBJECTIVE
  The World Health Organization has produced clear guidelines for the prevention of mother-to-child transmission (PMTCT) of the human immunodeficiency virus (HIV). However, ensuring that all PMTCT programme components are implemented to a high quality in all facilities presents challenges.
  
  
  METHODS
  Although South Africa initiated its PMTCT programme in 2002, later than most other countries, political support has increased since 2008. Operational research has received more attention and objective data have been used more effectively.
  
  
  METHODS
  In 2010, around 30% of all pregnant women in South Africa were HIV-positive and half of all deaths in children younger than 5 years were associated with the virus.
  
  
  RESULTS
  Between 2008 and 2011, the estimated proportion of HIV-exposed infants younger than 2 months who underwent routine polymerase chain reaction (PCR) tests to detect early HIV transmission increased from 36.6% to 70.4%. The estimated HIV transmission rate decreased from 9.6% to 2.8%. Population-based surveys in 2010 and 2011 reported transmission rates of 3.5% and 2.7%, respectively.
  
  
  CONCLUSIONS
  CRITICAL ACTIONS FOR IMPROVING PROGRAMME OUTCOMES INCLUDED: ensuring rapid implementation of changes in PMTCT policy at the field level through training and guideline dissemination; ensuring good coordination with technical partners, such as international health agencies and international and local nongovernmental organizations; and making use of data and indicators on all aspects of the PMTCT programme. Enabling health-care staff at primary care facilities to initiate antiretroviral therapy and expanding laboratory services for measuring CD4+ T-cell counts and for PCR testing were also helpful.
authors: School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, York Road, Johannesburg, Gauteng 2193, South Africa. pbarron@iafrica.com
authors: Peter
authors: P
authors: Barron
authors: Yogan
authors: Y
authors: Pillay
authors: Tanya
authors: T
authors: Doherty
authors: Gayle
authors: G
authors: Sherman
authors: Debra
authors: D
authors: Jackson
authors: Sanjana
authors: S
authors: Bhardwaj
authors: Precious
authors: P
authors: Robinson
authors: Ameena
authors: A
authors: Goga
mesh_terms: D005260:Female; D015658:HIV Infections / Q000635:transmission*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology; D013019:South Africa / Q000453:epidemiology
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references: BMC Public Health. 2009 Nov 05;9:406
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references: Bull World Health Organ. 2012 Mar 1;90(3):176-82
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