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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Reducing pediatric HIV infection: Estimating mother-to-child transmission rates in a program setting in Zambia
Journal of Acquired Immune Deficiency Syndromes, Volume 54, No. 4, Year 2010
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Description
Background: Vertical transmission of HIV remains the main source of pediatric HIV infection in Africa with transmission rates as high as 25%-45% without intervention. Even though effective interventions to reduce vertical transmission of HIV are now available and remarkable progress has been made in scaling up prevention of mother-to-child transmission (PMTCT) services, the effectiveness of PMTCT interventions is unknown in Zambia. In this study, we estimate HIV vertical transmission rates at different age bands among perinatally exposed children. Methods: The study analyzed program data of DNA polymerase chain reaction results and selected client information on dried blood spot samples from perinatally exposed children aged 0-12 months sent to the polymerase chain reaction laboratory from 5 provinces between September 2007 and January 2009. Results: Samples of 8237 babies between 0 and 12 months were analyzed, with 84% of the mothers having ever breastfed their children. The observed transmission rate was 6.5% (5.1%, 7.8%) among infants aged 0-6 weeks when both mother and infant received interventions compared with 20.9% (12.3%, 29.5%) where no intervention was given to either mother or baby. Observed HIV transmission with single-dose nevirapine (sdNVP) was 8.5% (5.9%, 11.0%) among infants aged 0-6 weeks, whereas zidovudine with sdNVP (zidovudine + NVP) and highly active antiretroviral therapy were associated with observed transmission rates of 6.8% (4.5%, 9.1%) and 5.0% (3.0%, 7.0%), respectively; whereas these estimates were not significantly different from one another, they were all significantly lower than no intervention for which the estimated rate was 20.9%. Regardless of the intervention, the observed transmission rates were higher among infants aged 6-12 months. Conclusions: PMTCT interventions, including sdNVP, are working in program settings. However, postnatal transmission especially after 6 months through suboptimal feeding practises remains an important challenge to further reduce pediatric HIV. © 2010 by Lippincott Williams & Wilkins.
Authors & Co-Authors
Torpey, Kwasi E.
Zambia, Lusaka
Technical Support Department
Kasonde, Prisca
Zambia, Lusaka
Technical Support Department
Kabaso, Mushota E.
Zambia, Lusaka
Technical Support Department
Weaver, Mark A.
United States, Durham
Quantitative Sciences
Bryan, Gail
Zambia, Lusaka
Technical Support Department
Mukonka, Victor Munyongwe
Zambia, Lusaka
Zambian Ministry of Health
Bweupe, Maxmillian
Zambia, Lusaka
Zambian Ministry of Health
Zimba, Chilunje
Zambia, Lusaka
Technical Support Department
Mwale, Felicitas
Zambia, Lusaka
Technical Support Department
Colebunders, Robert Leon
Belgium, Antwerpen
Prins Leopold Instituut Voor Tropische Geneeskunde
Statistics
Citations: 36
Authors: 10
Affiliations: 4
Identifiers
Doi:
10.1097/QAI.0b013e3181e36616
ISSN:
15254135
Research Areas
Genetics And Genomics
Infectious Diseases
Maternal And Child Health
Study Design
Randomised Control Trial
Study Locations
Zambia