scholarly journals Monitoring Prevention Impact of Mother-to-Child Transmission of HIV in Concentrated Epidemics With Program and Survey Data (Preprint)

2017 ◽  
Author(s):  
Thi Thuy Van Nguyen ◽  
Keith Sabin ◽  
Thi Quynh Trang Ho ◽  
Ai Kim Anh Le ◽  
Chika Hayashi ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Pregnant Women ◽  
Survey Data ◽  
Hiv Transmission ◽  
Late Diagnosis ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Increased Risk ◽  
The Impact ◽  
Mother To Child

BACKGROUND The prevention of mother-to-child transmission (PMTCT) of HIV program was introduced in Vietnam in 2005. Despite the scaling up of PMTCT programs, the rate of mother-to-child HIV transmission in Vietnam was estimated as high as 20% in 2013. OBJECTIVE The objective of this study was to assess the outcomes of PMTCT and identified factors associated with mother-to-child transmission and infant survival using survey and program data in a high HIV burden province in Vietnam. METHODS This community-based retrospective cohort study observed pregnant women diagnosed with HIV infection in Thai Nguyen province from October 2008 to December 2012. Data were collected through interviews using a structured questionnaire and through reviews of log books and medical charts in antenatal care and HIV clinics. Logistic regression and survival analysis were used to analyze data using Stata (StataCorp). RESULTS A total of 172 pregnant women living with HIV were identified between 2008 and 2012. Most of these women had acquired the HIV infection from their husband (77/119, 64.7%). Significant improvement in the PMTCT program was documented, including reduction in late diagnosis of HIV for pregnant women from 62.5% in 2008 to 30% in 2012. Access to antiretrovirals (ARVs) improved, increasing from a rate of 18.2% (2008) to 70.0% (2011) for mothers and from 36.4% (2008) to 93.3% (2012) for infants. For infants, early diagnosis within 2 months of birth reached 66.7% in 2012 compared with 16.7% in 2009. Transmission rate reduced from 27.3% in 2008 to 6.7% in 2012. Late diagnosis was associated with increased risk for HIV transmission (odds ratio [OR] 14.7, 95% CI 1.8-121.4, P=.01), whereas ARV therapy for mother and infant in combination with infant formula feeding were associated with reduced risk for HIV transmission (OR 0.01, 95% CI 0.001-0.1; P<.001). Overall survival rate for HIV-exposed infants at 12 months was 97.7%. CONCLUSIONS A combination of program and survey data measured the impact of prevention of HIV transmission from mother-to-child interventions. Significant improvement in access to the interventions was documented in Thai Nguyen province. However, factors that increased the risk of HIV transmission, such as late diagnosis, remain to be addressed.

scholarly journals Protocol for a prospective, hospital-based registry of pregnant women with SARS-CoV-2 infection in India: PregCovid Registry study

2021 ◽  
Author(s):  
Rahul Gajbhiye ◽  
Niraj N Mahajan ◽  
Rakesh Waghmare ◽  
Suchitra Vishwambhar Surve ◽  
Prashant Howal ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Post Partum ◽  
Laboratory Data ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Medical Case ◽  
Institutional Ethics ◽  
Increased Risk ◽  
The Impact ◽  
Mother To Child

Introduction: Pregnant women are at increased risk of contracting coronavirus disease 2019 (COVID-19) due to several factors and therefore require special attention. However, consequences of the COVID-19 pandemic on pregnant women and their newborns remain uncharted. The aim of PregCovid registry is to document the impact of SARS-CoV-2 infection on pregnant, post-partum women and their new-borns. The aim of the registry is also to determine mother to child transmission of SARS-CoV-2 infection in India. Methods and analysis: PregCovid is a hospital based registry for capturing information of pregnant, post-partum women with COVID-19 and their new-borns in India. Medical case records of pregnant and post-partum women with laboratory confirmed diagnosis of COVID-19 will be captured in real time using an online electronic patient record (EPR) software. The frequency of each symptom will be calculated. The laboratory data will be analyzed for calculating the frequency of laboratory parameters consistently higher in women with COVID-19. The adverse pregnancy and neonatal outcomes will be analyzed and their frequency will be calculated. Response to treatment will be analyzed for frequency calculation (number of women treated with different treatment regimens). The mother to child transmission data will be analyzed from the RT-PCR and/ antibody data of neonatal and maternal samples tested wherever the information is available. The registry data will be crucial for developing strategies for reducing the adverse impact of COVID-19 on pregnant women and their new-born. Ethics and dissemination: The study is approved by the Institutional Ethics Committee of ICMR-National Institute for Research in Reproductive Health (#55/2020), BYL Nair Hospital, Mumbai, India (# 63/2020); and all the 18 participating study sites under Medical Education and Drugs Department of Government of Maharashtra. The Institutional Ethics Committees granted a waiver of consent as the data is collected from the medical case records. Trial registration number: CTRI/2020/05/025423

scholarly journals Female perspectives of male partners’ inclusion in the prevention of mother-to-child HIV transmission programme in KwaZulu-Natal

Curationis ◽  
2016 ◽  
Vol 39 (1) ◽  
Author(s):  
Mondli Miya ◽  
Tennyson Mgutshini
Keyword(s):  
Pregnant Women ◽  
Hiv Transmission ◽  
Public Hospitals ◽  
Sub Saharan Africa ◽  
Child Health Services ◽  
Mother To Child Transmission ◽  
Male Partners ◽  
Child Transmission ◽  
Financial Investment ◽  
Mother To Child

Background: The South African government intervened by implementing the prevention of mother–to-child transmission programme (PMTCT) to curb the HIV transmission from mother to child during and after pregnancy. The PMTCT programme has been at the forefront of global prevention efforts since 1998. Without treatment, the risk of transmission ranges from one in five to one in two newborns; however, the risk of mother-to-child transmission can be reduced to as low as 2%–5% with evidenced interventions. Sub-Saharan Africa, and most particularly South Africa, is the most affected by the pandemic despite having the largest financial investment in PMTCT services across the continent.Objectives: The objectives of the study were to describe and explore the female perspectives of male inclusion in the prevention of mother-to-child HIV transmission programme in KwaZulu-Natal.Methodology: A qualitative, descriptive, explorative study was conducted through in-depth individual interview of pregnant women until data saturation.Results: The findings of the study revealed that the existing design of public hospitals was not wholly conducive to facilitating male inclusion in maternal and child health services. Resources were largely insufficient to support the participation of pregnant mothers and any attempts to support the inclusion of males needed to be based on a clear increase in service provision.Conclusion: The study recommended male partners’ inclusion in the prevention of mother- to-child HIV transmission to support effective management of HIV in pregnancy and PMTCT programmes. The inclusion of men will provide the holistic support needed by pregnant women on PMTCT programmes.

scholarly journals Towards Elimination of Mother-to-Child Transmission of HIV: The Impact of a Rapid Results Initiative in Nyanza Province, Kenya

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Lisa L. Dillabaugh ◽  
Jayne Lewis Kulzer ◽  
Kevin Owuor ◽  
Valerie Ndege ◽  
Arbogast Oyanga ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Highly Active Antiretroviral Therapy ◽  
Cohort Analysis ◽  
Hiv Positive ◽  
Maternal Child Health ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Nyanza Province ◽  
The Impact ◽  
Mother To Child

Many HIV-positive pregnant women and infants are still not receiving optimal services, preventing the goal of eliminating mother-to-child transmission (MTCT) and improving maternal child health overall. A Rapid Results Initiative (RRI) approach was utilized to address key challenges in delivery of prevention of MTCT (PMTCT) services including highly active antiretroviral therapy (HAART) uptake for women and infants. The RRI was conducted between April and June 2011 at 119 health facilities in five districts in Nyanza Province, Kenya. Aggregated site-level data were compared at baseline before the RRI (Oct 2010–Jan 2011), during the RRI, and post-RRI (Jul–Sep 2011) using pre-post cohort analysis. HAART uptake amongst all HIV-positive pregnant women increased by 40% (RR 1.4, 95% CI 1.2–1.7) and continued to improve post-RRI (RR 1.6, 95% CI 1.4–1.8). HAART uptake in HIV-positive infants remained stable (RR 1.1, 95% CI 0.9–1.4) during the RRI and improved by 30% (RR 1.3, 95% CI 1.0–1.6) post-RRI. Significant improvement in PMTCT services can be achieved through introduction of an RRI, which appears to lead to sustained benefits for pregnant HIV-infected women and their infants.

scholarly journals Prevention of Mother to Child Transmission (PMTCT) Program at Paropakar Maternity and Women’s Hospital: A Review

2014 ◽  
Vol 7 (2) ◽  
pp. 25-28
Author(s):  
M Shrestha ◽  
P Chaudhary ◽  
M Tumbhahangphe ◽  
J Poudel
Keyword(s):  
Hiv Infection ◽  
Pregnant Women ◽  
Migrant Worker ◽  
Mode Of Delivery ◽  
Perinatal Transmission ◽  
Feeding Practice ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Antiretroviral Prophylaxis ◽  
Mother To Child

Aims: Vertical transmission from mother to fetus is the main route of HIVinfection among children. This study is an effort to review utilization of prevention of mother to child transmission (PMTCT) services by pregnant women seeking care in Paropakar Maternity and Women’s Hospital (PMWH). Methods: Case records of 165 pregnant women with HIV positive status who delivered at Paropakar Maternity and Women’s Hospital, Kathmandu from April 2005 to Dec 2011 were reviewed. Demographic profile of these women and interventions to prevent mother to child transmission (MTCT) including antiretroviral prophylaxis (ARV), mode of delivery, infant feeding practice as well as HIV status of their children were recorded. Results: Hospital records showed 109262 antenatal attendees and 120823 deliveries including 165 HIV infected women who delivered in this facility. Prevalence of HIV infection among antenatal attendees was 0.11 % and 0.13% in hospital deliveries. Migrant worker spouse (44.2%) was the main source of infection in their wives. Eighty eight (55.7%) out of 150 eligible women received ARV drugs and 97% babies received antiretroviral prophylaxis . Spontaneous vaginal delivery occurred in 60% women and caesarean section performed in the rest. While 60.8% women opted for exclusive breast feeding, remaining 39.2% chose formula feeding. For prophylaxis of opportunistic infection, Cotrimoxazole was given to 70.3% children. The incidence of HIV infection in babies born to HIV infected mother was 5.1%. Conclusions: Integrating PMTCT services into existing maternal and child health system can significantly reduce perinatal transmission of HIV infection to children. DOI: http://www.dx.doi.org/10.3126/njog.v7i2.11138 Nepal Journal of Obstetrics and Gynaecology / Vol 7 / No. 2 / Issue 14 / July-Dec, 2012 / 25-28

Factors associated with mother to child transmission of HIV despite overall low transmission rates in HIV-exposed infants in rural Kenya

2017 ◽  
Vol 28 (12) ◽  
pp. 1215-1223 ◽  
Author(s):  
Nicollate A Okoko ◽  
Kevin O Owuor ◽  
Jayne L Kulzer ◽  
George O Owino ◽  
Irene A Ogolla ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Hiv Transmission ◽  
Poor Adherence ◽  
Pmtct Service ◽  
Hiv Education ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Hiv Exposed Infants ◽  
Hiv Exposed ◽  
Mother To Child

Despite the availability of efficacious prevention of mother-to-child transmission (PMTCT) interventions and improved access to preventive services in many developing countries, vertical HIV transmission persists. A matched case–control study of HIV-exposed infants between January and June 2012 was conducted at 20 clinics in Kenya. Cases were HIV-infected infants and controls were exposed, uninfected infants. Conditional logistic regression analysis was conducted to determine characteristics associated with HIV infection. Forty-five cases and 45 controls were compared. Characteristics associated with HIV-infection included poor PMTCT service uptake such as late infant enrollment (odds ratio [OR]: 7.1, 95% confidence interval [CI]: 2.6–16.7) and poor adherence to infant prophylaxis (OR: 8.3, 95%CI: 3.2–21.4). Maternal characteristics associated with MTCT included lack of awareness of HIV status (OR: 5.6, 95%CI: 2.2–14.5), failure to access antiretroviral prophylaxis (OR: 22.2, 95%CI: 5.8–84.6), and poor adherence (OR: 8.1, 95%CI: 3.7–17.8). Lack of clinic-based HIV education (OR: 7.7, 95%CI: 2.0–25.0) and counseling (OR: 8.3, 95%CI: 2.2–33.3) were reported by mothers of cases. Poor uptake of PMTCT services and a reported absence of HIV education and counseling at the clinic were associated with MTCT. More emphasis on high-quality, comprehensive PMTCT service provision are urgently needed to minimize HIV transmission to children.

scholarly journals Mother-to-child transmission of HIV: positive impacts

2008 ◽  
Vol 29 (4) ◽  
pp. 215
Author(s):  
Pamela Palasanthiran
Keyword(s):  
Hiv Infection ◽  
Pregnant Women ◽  
Rare Event ◽  
Standard Of Care ◽  
Adverse Outcomes ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Major Mode ◽  
The Usa ◽  
Mother To Child

Mother-to-child-transmission (MTCT) of HIV remains the major mode of paediatric HIV infection. Advances in the prevention of MTCT over the past decade and a half represent a major public health achievement. Strategies to prevent MTCT are now the standard of care for countries rich enough to afford the interventions. As such, perinatally acquired HIV in countries like the USA and Europe is now a rare event. With clearly documented declines in MTCT rates in resource rich countries, the focus is shifting towards any downsides of these strategies in pregnant women and for fetuses exposed in utero to antiretroviral (ARV) drugs and to infants postnatally. Cumulative evidence still supports the benefits of these strategies in preventing MCTC of HIV, with continued benefits for HIV pregnant women and their infants, and with minimal adverse outcomes. Knowledge of HIV infection status in pregnancy is critical for identifying the need for MTCT prevention. However, antenatal testing rates to identify HIV infected women is variable and an area that warrants attention. The overwhelming challenge in the 21st century is up scaling the availability of MTCT interventions in resource poor areas where more than 90% of the world?s HIV infected children now reside, and to develop optimal MTCT regimens that can be practically adopted in these settings.

scholarly journals Relationship between placenta malaria and mother to child transmission of HIV infection in pregnant women in South East Nigeria

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Ikechukwu I. Mbachu ◽  
Samson D. Ejikunle ◽  
Frederick Anolue ◽  
Chioma N. Mbachu ◽  
Ephraim Dike ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Pregnant Women ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Mother To Child
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