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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Effectiveness of a prevention of mother-to-child HIV transmission programme in an urban hospital in Angola
PLoS ONE, Volume 7, No. 4, Article e36381, Year 2012
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Description
Background: Antiretroviral therapy is effective in reducing rates of mother-to child transmission of HIV to low levels in resource-limited contexts but the applicability and efficacy of these programs in the field are scarcely known. In order to explore such issues, we performed a descriptive study on retrospective data from hospital records of HIV-infected pregnant women who accessed in 2007-2010 the Luanda Municipal Hospital service for prevention of mother-to-child transmission (PMTCT). The main outcome measure was infant survival and HIV transmission. Our aim was to evaluate PMTCT programme in a local hospital setting in Africa. Results: Data for 104 pregnancies and 107 infants were analysed. Sixty-eight women (65.4%) had a first visit before or during pregnancy and received combination antiretroviral treatment (ART) in pregnancy. The remaining 36 women (34.6%) presented after delivery and received no ART during pregnancy. Across a median cohort follow-up time of 73 weeks, mortality among women with and without ART in pregnancy was 4.4% and 16.7%, respectively (death hazard ratio: 0.30, 95% CI 0.07-1.20, p = 0.089). The estimated rates of HIV transmission or death in the infants over a median follow up time of 74 weeks were 8.5% with maternal ART during pregnancy and 38.9% without maternal ART during pregnancy. Following adjustment for use of oral zidovudine in the newborn and exposure to maternal milk, no ART in pregnancy remained associated with a 5-fold higher infant risk of HIV transmission or death (adjusted odds ratio: 5.13, 95% CI: 1.31-20.15, p = 0.019). Conclusions: Among the women and infants adhering to the PMTCT programme, HIV transmission and mortality were low. However, many women presented too late for PMTCT, and about 20% of infants did not complete follow up. This suggests the need of targeted interventions that maintain the access of mothers and infants to prevention and care services for HIV. © 2012 Lussiana et al.
Authors & Co-Authors
Lussiana, Cristina
Angola, Luanda
Hospital Divina Providencia
van Clemente, Sofiada Lôa
Angola, Luanda
Hospital Divina Providencia
Ghelardi, Angelo
Angola, Luanda
Hospital Divina Providencia
Lonardi, Magda
Angola, Luanda
Hospital Divina Providencia
Tarquino, Ivan Alejandro Pulido
Angola, Luanda
Hospital Divina Providencia
Floridia, Marco
Italy, Rome
Istituto Superiore Di Sanita
Statistics
Citations: 35
Authors: 6
Affiliations: 2
Identifiers
Doi:
10.1371/journal.pone.0036381
e-ISSN:
19326203
Research Areas
Environmental
Health System And Policy
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Cross Sectional Study
Cohort Study
Case-Control Study
Study Locations
Angola
Participants Gender
Female