Pmtct-Tanzania

17/10/2016

Eliminating mother-to-child transmission of HIV ( ), defined as ≤50 infant HIV infections per 100 000 live births, is a global priority. Since 2011 policies for shifted from maternal antiretroviral treatment or prophylaxis contingent on CD4 cell count to lifelong maternal ARV treatment. This study sought to measure progress with early (4-8 weeks postpartum) MTCT prevention and elimination, 2011-2013, at national and sub-national levels in South Africa, a high antenatal HIV prevalence setting ( ≈ 29%), where early MTCT was 3.5% in 2010.

Two surveys were conducted (August 2011-March 2012 and October 2012-May 2013), in 580 health facilities, randomly selected after two-stage probability proportional to size sampling of facilities (the primary sampling unit), to provide valid national and sub-national-(provincial)-level estimates.

National data from 10 106 and 9120 participants were analyzed (2011-12 and 2012-13 surveys respectively). Infant HIV exposure was 32.2% in 2011-12 and 33.1%, provincial range of 22.1-43.6% in 2012-13. MTCT was 2.7% in 2011-12 and 2.6% , provincial range of 1.9-5.4% in 2012-13. HIV-infected ARV-exposed mothers had significantly lower unadjusted early MTCT compared to HIV-infected ARV-naive mothers. Pooled analyses demonstrated significantly lower early MTCT among exclusive breastfeeding (EBF) mothers receiving >10 weeks ARV prophylaxis or cART compared with EBF and no ARVs among HIV-infected ARV-exposed mothers, 24.9% initiated cART during or before the first trimester, and their early MTCT was 1.2%.

The authors concluded that although sustained national-level PMTCT impact in a high HIV prevalence setting was demonstrated, results are far-removed from EMTCT targets. Reducing maternal HIV prevalence and treating all maternal HIV infection early are critical for further progress.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5032343/

Eliminating mother–to–child transmission of HIV (EMTCT), defined as ≤50 infant HIV infections per 100 000 live births, is a global priority. Since 2011 policies to prevent mother–to–child transmission of ...

03/10/2016

Numerous challenges exist in provision of prevention of mother-to-child transmission of HIV such as linking HIV exposed infants (HEI) and their mothers to chronic care services, and tackling loss to follow up. Limited evidence exists in Ethiopian setting that explains the persisting high HIV infection rate among HEIs and extent of linkage to chronic care. This institution-based cross-sectional study assessed the proportion of HIV infection; children linked to chronic care and determinants of HIV infection among HEI in Northern Ethiopia.
The study was conducted in health centers and hospitals of Amhara Region. A total of 484 HEI-mother pairs selected by multistage random sampling were included in the study. Data were collected from PMTCT and anti-retroviral therapy (ART) clinics using pre-tested and structured questionnaires. Quantitative data were entered in Epi Info version 7.0 and exported to SPSS 20.0 for analysis.
A total of 484 mother-infant pairs with a response rate of 92.4% were included in the analysis. About 94.2% of infants and women were linked to chronic care follow-up sometime after the diagnosis. The proportion of HIV infection was 12.4%. Antenatal care attendance had a significant association with HIV infection among HEI (p < 0.0001). Delivering in health institution (p < 0.005), mode of delivery (p < 0.032), and provision of both infant (p < 0.0001) and maternal (p < 0.0001) prophylaxis showed a highly significant association with HIV infection among HIV exposed infants.

Authors concluded that health facilities should encourage antenatal care that entails increased institutional delivery, high uptake of PMTCT and infant prophylaxis to reduce the vertical transmission of HIV infection and meet national targets.

http://pmtct.or.tz/publication/outcomes-and-linkage-to-chronic-care-of-hiv-exposed-infants-among-health-centers-and-hospitals-in-amhara-region-ethiopia-implications-to-prevention-of-mother-to-child-transmission-of-hiv-program-a/

PMTCT Tanzania National Resource Center for Prevention of Mother to Child HIV Transmission

30/09/2016

Preventing mother-to-child transmission of HIV relies on engagement in care during the prenatal, peripartum, and postpartum periods. Under PMTCT Option B, pregnant women with elevated CD4 counts are provided with antiretroviral prophylaxis until cessation of breastfeeding.

In this study retrospective analysis of retention in care among HIV-infected pregnant women in Haiti was performed. Logistic regression was used to identify risk factors associated with loss to follow-up (LFU) defined as no medical visit for at least 6 months and Kaplan-Meier curves were created to show LFU timing.

Women in the cohort had 463 pregnancies between 2009 and 2012 with retention rates of 80% at delivery, 67% at one year, and 59% at 2 years. Among those who were LFU, the highest risk period was during pregnancy (60%) or shortly afterwards (24.4% by 12 months). Never starting on antiretroviral therapy (aRR 2.29, 95% CI 1.4–3.8) was associated with loss to follow-up.

The authors concluded that loss to follow-up during and after pregnancy was common in HIV-infected women in Haiti under PMTCT Option B. Since sociodemographic factors and distance from home to facility did not predict LFU, future work should elicit and address barriers to retention at the initial prenatal care visit in all women. Better tracking systems to capture engagement in care in the wider network are needed.

http://pmtct.or.tz/publication/retention-in-care-among-hiv-infected-pregnant-women-in-haiti-with-pmtct-option-b/

26/09/2016

Tanzania’s PMTCT National Resource Center website now has a new look with easier navigation!
All your PMTCT news, resources and guidelines at your fingertips!
Visit http://pmtct.or.tz/
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PMTCT Tanzania National Resource Center for Prevention of Mother to Child HIV Transmission

20/09/2016

Sweden has become the first country to achieve the UNAIDS/World Health Organization (WHO) 90-90-90 target, research published in HIV Medicine shows. At the end of 2015, 90% of HIV cases in Sweden were diagnosed, 99.8% of people were linked to care and 95% of people taking antiretrovirals for at least six months had a viral load below 50 copies/ml.
Read more:
http://www.aidsmap.com/page/3083902/?utm_source=NAM-Email-Promotion&utm_medium=aidsmap-news&utm_campaign=aidsmap-news

Sweden has become the first country to achieve the UNAIDS/World Health Organization (WHO) 90-90-90 target, research published in HIV Medicine shows. At the end of 2015, 90% of HIV cases in Sweden were diagnosed, 99.8% of people were linked to care and 95% of people taking antiretrovirals for at leas...

16/09/2016

Over the last decade, Ethiopia adopted different strategies of prevention of mother to child transmission of HIV (PMTCT). Prior to implementation of Option A in 2011, there was no provision of prophylaxis for PMTCT. With 'Option A', PMTCT interventions relied on maternal CD4 count. In early 2013, ''Option B+'' has been started; with this option, antiretroviral therapy is started and continued for life to any HIV positive pregnant mother irrespective of CD4 count with an enhanced treatment for the baby. Though there are a number of studies which evaluated the effectiveness of PMTCT interventions, the current study assessed the real-world effectiveness of PMTCT options in a setting where there is limitation of resources.

This study aimed to address three questions: what proportion of babies tested by DNA-PCR are HIV infected in the first 2 months of life? How does the type of PMTCT intervention affect presence of HIV infection at this age? What are the factors affecting HIV transmission, after controlling for type of PMCT-HIV intervention?

Records of 624 registered HIV exposed infants and 412 mothers who were delivered at Bishoftu Hospital from May 2006 to August 2014 were assessed. Presence of HIV infection at 6-8 weeks of age was assessed from the records. Maternal and infant risk factors for infection at this age were analyzed. Data was collected using standard data abstraction format and were analyzed using SPSS version 20.

Results showed that among all the infants who were delivered at the hospital during the study period, 624/936 (66.7 %) had undergone early infant diagnosis at 6-8 weeks. Twenty-seven (4.3 %) were positive for HIV DNA PCR at the age of 6-8 weeks. None of the infants who received ''Option B+'' had a positive HIV DNA PCR result. HIV infection rate was highest among those who took either no prophylaxis or single dose Nevirapine (11.5 and 11.1 % respectively). Those who took single dose Nevirapine and Zidovudine had HIV positivity rate of 3.9 %. Many of the covariates which were shown to be predictors on bivariate analysis were found not to be independent predictors on multivariate analysis.

The authors concluded that PMTCT ''Option B+'' resulted in zero HIV infection rates among the included infants. There was a high loss to follow up rate at 6-8 weeks of age. The authors recommend that a better strategy of linkage to care and treatment should be devised for HIV exposed infants.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5016933/

13/09/2016

Delays in adopting the World Health Organization’s 2015 recommendation of HIV treatment for all threaten the achievement of the 90-90-90 targets for HIV diagnosis and viral suppression by 2020, research carried out by the International Association of Physicians in Aids Care (IAPAC) indicates.
Read more :
http://www.aidsmap.com/Delays-in-updating-HIV-treatment-guidelines-in-Africa-blocking-early-treatment-for-millions/page/3084546/

09/09/2016

The aim of this study was to assess male partner's involvement in HCT and its associated factors.The study was based on institution based cross-sectional study design that used systematic random sampling technique. A total of 416 partners were interviewed in the data collection. Multivariable logistic regression model was fitted to identify the independent predictors.
In this study, the prevalence of male involvement in HCT was found to be 40.1% (95% CI: 35.3%-44.7%). The independent predictors of male involvement were partners who were younger, were cohabitant, were with multigravida wives, were knowledgeable on route of mother-to-child transmission, and discussed HCT.
Authors concluded that the prevalence of male involvement in HCT was found to be suboptimal compared to similar studies in Ethiopia. There is a need of interventions on partners who are older, separated, and with lower gravidity wife. Awareness creation campaign should also be created on the route of mother-to-child transmission of HIV and on the importance of discussion with the spouse.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4983370/

Background. Despite the existence of several programmes promoting male involvement in HIV counselling and testing during their wife's pregnancy as a part of PMTCT, few men have heeded the call. The aim of this study was to assess male partner's involvement ...

05/09/2016

We are very excited to announce that the PMTCT website will soon go live with a new design! Our goal with this new design is to provide our visitors easier navigation and access to the latest news and updates.
Keep visiting our page for more updates!

26/08/2016

Increasing access to HIV-related care and treatment for children aged 0–18 years in resource-limited settings is an urgent global priority. In 2009 approximately 5.1 million young people aged 15–24 years were living with HIV globally. By 2011 although the number of new paediatric HIV infections had decreased substantially, 300,000 new paediatric infections were detected at birth and 3.4 million children were estimated to be living with HIV. More than 90 % of these children live in resource-constrained settings in Sub-Saharan Africa. In 2011–2012, in the 22 countries with the highest burden of antenatal HIV infection only 31 % (29–33 %) of children aged 15 years and below, eligible for antiretroviral (ARV) treatment received it; additionally, the percentage increase in children accessing antiretroviral therapy was approximately half that of adults (11 % vs. 21 %)/
The authors proposed a model for increasing access to, and retention in, paediatric HIV care and treatment in resource-limited settings, after they had identified gaps to optimal pediatric HIV care through rapid assessment of recent literature.

http://pmtct.or.tz/publication/enhancing-hiv-treatment-access-and-outcomes-amongst-hiv-infected-children-and-adolescents-in-resource-limited-settings/

PMTCT Tanzania National Resource Center for Prevention of Mother to Child HIV Transmission

19/08/2016

HIV-positive adolescents and young adults are especially likely to experience the virological failure of their antiretroviral treatment when they move from paediatric to adult HIV care, according to Dutch research published in the online edition of Clinical Infectious Diseases. The risk of virological failure was increased over four-fold at the time of care transition, 18 to 19 years of age. Risk factors associated with viral breakthrough were low educational attainment, poor knowledge of HIV and lack of independence regarding HIV treatment adherence.

Read more :
http://nchiv.org/wp-content/uploads/2015/02/24_Weijsenfeld.pdf

15/08/2016

Approximately 85% of patients switched to protease inhibitor-based second-line antiretroviral (ART) in sub-Saharan Africa achieve and maintain an undetectable viral load with their new regimen, according to research in the online edition of Clinical Infectious Diseases.
Read more:
http://www.ncbi.nlm.nih.gov/pubmed/27402780

J Infect Dis. 2016 Jul 11. pii: jiw219. [Epub ahead of print]