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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Mother-to-child HIV transmission in resource poor settings: How to improve coverage?
AIDS, Volume 17, No. 8, Year 2003
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Description
Objectives: To review coverage of the current nevirapine prevention model in Coast Provincial General Hospital (CPGH) in Mombasa, Kenya, and to reflect on alternative models to reduce mother-to-child transmission (MTCT) of HIV. Methods: At the antenatal clinic, health information is provided, followed by pre-test HIV voluntary counselling and testing (VCT). Because many women deliver at home, HIV-infected women are provided with a tablet of 200 mg nevirapine for themselves, and with 0.6 ml (6 mg) nevirapine in a luer lock syringe for the baby. Data on coverage are provided from antenatal records and delivery registers. Results: Out of 3564 first-visit pregnant women receiving health education, 2516 were counselled (71%) and 2483 were tested (97%); 348 were HIV positive (14%), and 106 women took nevirapine in labour, resulting in an overall coverage rate of 20%. In the same period, approximately 6000 women gave birth in CPGH, of whom 21% had attended a facility with VCT services. Assuming an overall HIV prevalence of 14%, 840 mother-infant pairs could have received a preventative intervention with a hospital policy of antepartum as well as intrapartum testing and treatment in place. Conclusion: The coverage of perinatal MTCT was low as a result of a variety of programme elements requiring urgent improvement at different levels. Alternative models, including intrapartum testing, should be considered as a safety net for women without access to VCT before delivery, and recommendations for nevirapine should be considered in the light of home deliveries. © 2003 Lippincott Williams & Wilkins.
Authors & Co-Authors
Temmerman, Marleen I.L.
Belgium, Ghent
Universiteit Gent
Quaghebeur, Ann
Belgium, Ghent
Universiteit Gent
Kenya, Mombasa
International Centre for Reproductive Health Kenya
Mwanyumba, Fabian
Belgium, Ghent
Universiteit Gent
Kenya, Mombasa
International Centre for Reproductive Health Kenya
Mandaliya, Kishor N.
Kenya, Mombasa
International Centre for Reproductive Health Kenya
Kenya, Mombasa
Coast Provincial General Hospital, Kenya
Statistics
Citations: 139
Authors: 4
Affiliations: 3
Identifiers
Doi:
10.1097/00002030-200305230-00016
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Randomised Control Trial
Cross Sectional Study
Study Locations
Kenya
Participants Gender
Female