scholarly journals Modifiable factors within the prevention of mother-to-child transmission programme associated with failure to prevent HIV transmission in the Onandjokwe district of Namibia

2019 ◽  
Vol 61 (1) ◽  
Author(s):  
Flavia Strato Shayo ◽  
Bob Mash
Keyword(s):  
Hiv Transmission ◽  
Health Workers ◽  
Hiv Infections ◽  
Coordination Of Care ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Pmtct Programme ◽  
Paediatric Hiv ◽  
Modifiable Factors ◽  
Mother To Child

Background: Ending new paediatric HIV infections continues to be a global health priority. Cuba and other countries have demonstrated that elimination of mother-to-child transmission is possible through Prevention of Mother-to-Child Transmission (PMTCT) interventions. As Namibia works on improving PMTCT there is a need to identify the local modifiable factors to achieve zero new HIV infections.Aim: This study aimed to identify the modifiable factors within the PMTCT programme, which contributed to the acquisition of HIV infection among children.Setting: The study was carried out in the Onandjokwe District, Northern Namibia.Methods: A descriptive audit was undertaken of 59 medical records of mothers and their children under two years, who acquired HIV despite the PMTCT programme between 2014 and 2016.Results: The study found that overall HIV transmission was only 2%, but 80% of the paediatric HIV infections could be prevented by implementing the existing Namibian PMTCT recommendations. Overall 61% of modifiable factors were related to mothers, 30% to health workers and 10% to the health system. The top three modifiable factors were the mother defaulting on ART during pregnancy or breastfeeding, the health worker not intervening when the mother failed the first-line ART regimen, and poor coordination of care between the hospital and primary care.Conclusion: Although overall transmission is low with the PMTCT programme, the majority of remaining HIV infections among children under two years could be prevented by addressing the modifiable factors identified in this study.

scholarly journals Call To action - Prevention of mother To child transmission of HIV

2009 ◽  
Vol 10 (4) ◽  
pp. 12
Author(s):  
Ashraf Hassen Coovadia ◽  
Ameena Ebrahim Goga ◽  
Laurie Schowalter
Keyword(s):  
Hiv Transmission ◽  
Hiv Infections ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Pmtct Programme ◽  
Is Implementation ◽  
Main Challenge ◽  
Drug Regimens ◽  
Development Goals ◽  
Mother To Child

The Prevention of Mother to Child Transmission of HIV (PMTCT)programme is a critical intervention to reduce the incidence of paediatric HIV infections . It is also a key intervention to decrease infant, child and maternal mortality. The optimal implementation of a sound, evidence-based PMTCT programme is essential to meet both the HIV reduction targets in the National Strategic Plan1 and to achieve Millennium Development Goals(MDGs) 4 (reducing infant and child mortality) and 5 (reducing maternal mortalty).2 Since 2001, South Africa has been implementing a programme to prevent mother-to-child transmission of HIV. Since 2007, national PMTCT policy has evolved into a strong, enabling framework that should reduce vertical transmission significantly. This paper reviews the milestone studies that have contributed to our knowledge about drug regimens to reduce MTCT (mother-to-child transmission of HIV), reviews the latest South African PMTCT guidelines and the possible future changes. Strengthened / revised drug regimens for PMTCT are, essential but insufficient for measureable decreases in HIV transmission and improvements in maternal and childl health. The main challenge is implementation. Until the enhanced PMTCT policy is effectively operationalised, measureable achievements will remain elusive.

Young Women’s Knowledge and Utilization of Prevention of Mother-to-Child Transmission (PMTCT) of HIV Services: Is There Any Relationship?

2012 ◽  
Vol 2 (3) ◽  
pp. 163-172
Author(s):  
Sadandaula R. Muheriwa ◽  
Angela Chimwaza ◽  
Alfred Maluwa ◽  
Martha Kamanga
Keyword(s):  
Hiv Transmission ◽  
Health Workers ◽  
Monitoring And Evaluation ◽  
Hiv Positive ◽  
Hiv Education ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Major Barrier ◽  
Behavior Change Interventions ◽  
Mother To Child

PURPOSE:To determine knowledge and practices of young women on utilization of prevention of mother-to-child transmission (PMTCT) of HIVservices.DESIGN:A cross-section descriptive study that used quantitative and qualitative data analysis methodologies.FINDINGS:Knowledge of PMTCT of HIV among respondents was universal. All respondents (100%,N= 184) stated that utilization of PMTCT services reduces transmission of HIV from mother to child. Respondents knew that HIV transmission can be reduced with exclusive breastfeeding (93%,n= 172), abrupt weaning at 6 months (44%,n= 81), taking single-dose nevirapine (SD-NVP; 43%,n= 79), and giving NVP to the baby (65%,n= 120). Very few respondents (4%,n= 7) stated that avoiding pregnancy is one way of preventing HIV transmission and that a mother who is HIV positive who has received SD-NVP or antiretroviral (ARV) therapy can still deliver a baby who is HIV positive. Actual practice was very low; only 14% breastfed exclusively and only 3% weaned their babies abruptly. Although all the 184 mothers were given NVP to take at onset of labor, very few respondents (22%) took NVP as recommended. Although it was recommended that all babies take NVP at birth and within 72 hr of birth, only 58% of the babies received NVP as recommended and only 3% of the women avoided pregnancy.CONCLUSION:There was a big discrepancy between knowledge and practice of PMTCT services. Culture was the major barrier because traditionally, babies are expected to be breastfed and supplements are fed to babies, too. Most mothers did not adhere to the taking of NVP at onset of labor. Therefore, there is a need to mobilize communities on PMTCT of HIV. The HIV education programmes should emphasize behavior-change interventions and should focus on both men and women, their partners, and significant others. There is also need to intensify monitoring and evaluation of health workers’ activities to ensure that knowledge is put into practice.

scholarly journals Preventing Mother-To-Child Transmission of HIV in Benin City, Edo State, Nigeria: The Health Workers’ Perspective

2017 ◽  
pp. 1-10
Author(s):  
Temitope Ashipa ◽  
Antoinette Ngozi Ofili
Keyword(s):  
Health Workers ◽  
The State ◽  
Health Facilities ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Pmtct Programme ◽  
Benin City ◽  
Key Informant ◽  
Edo State ◽  
Mother To Child

Introduction: Mother-to-child transmission of HIV threatens the survival of children of below five years of age. Health workers play an important role in preventing mother-to-child transmission of HIV. Objective: The objective of this study was to evaluate the programme for preventing mother-to-child transmission of HIV (PMTCT) in Benin City, Edo State from the perspective of the health workers involved in the programme. Methodology: This was a qualitative study evaluating the PMTCT programme in Benin City from the perspective of health workers and PMTCT programme officers. Data was collected through key informant interviews held with health workers at seven health facilities providing comprehensive PMTCT services. Key informant interviews were also held with government officials supervising the PMTCT programme in the state. Results: Fifteen key informant interviews were conducted with health workers and PMTCT programme officers in the state. The key informants had been involved in the PMTCT programme for between three years and eight years. The respondents identified several benefits of the PMTCT programme during the course of the study. The benefits included reduction in stigmatisation, improved quality of life for HIV positive mothers and reduction in mother-to-child transmission of HIV. Several challenges to the implementation of the programme were identified by the respondents including inadequate manpower, stock-outs of antiretroviral medications and patients’ preference for home deliveries. Recommendations to overcome these challenges included increased programme funding, training and re-training of health workers, sustained mass media campaigns to reduce stigmatisation of persons living with HIV among others. Conclusion: The health workers were generally positive in their perception of the programme for preventing mother-to-child transmission of HIV in Benin City, Edo State as the programme had provided numerous benefits for the patients, the community in addition to upgrading existing health facilities. Factors hindering the implementation of the programme from the health workers’ perspective were staff shortages, inadequate supply of drugs and other commodities and poor adherence by patients. Achieving the goal of reducing mother-to-child transmission of HIV in Benin City and Nigeria as a whole requires combined efforts by all stakeholders including patients, health workers, members of the community, non-governmental organisations and the various tiers of government.

scholarly journals Reduction of HIV transmission rates from mother to child in the era of antiretroviral therapy in the Lake Victoria zone, Tanzania

2015 ◽  
Vol 17 (3) ◽  
Author(s):  
Mariam M. Mirambo ◽  
Celine Simon ◽  
Alphaxard Kajura ◽  
Benson Kidenya ◽  
Mtebe Majigo ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Transmission ◽  
Lake Victoria ◽  
Published Data ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Pmtct Programme ◽  
Positive Rate ◽  
Mother To Child ◽  
Hiv 1

Background: Since the introduction of prevention of mother to child transmission (PMTCT) in Tanzania, HIV infection rates have been reduced in different regions across the country. However, there is limited published data from the Lake Victoria zone of Tanzania regarding the effectiveness of various regimens used for PMTCT. This study was done to assess the effectiveness of antiretroviral therapy in preventing mother to child transmission of HIVMethods: Infants aged ≤18 months born to HIV positive mothers undertaking PMTCT programme and those with no intervention program from Mara, Kagera, Mwanza and Shinyanga were tested for HIV-1 DNA polymerase chain reaction (PCR). Data were analysed using STATA version 10.0 to assess factors associated with outcome.Results: A total of 1,005 study subjects were enrolled in the study. Of these 55% (554/1005) were females. Majority (82.6%; 830/1005) of the infants studied were aged 1-6 months. The median age of the infant studied was 3 months (IQR 2-4). Out of 1005 non-repetitive samples; 61(6.1%) were HIV-1 DNA PCR positive. Positive dried blood spots (DBS) rates by region were 6.4%, 5.9%, 5.6% and 5.1% in Mwanza, Mara, Kagera and Shinyanga, respectively. During pregnancy interventions, the positive rate for women with no therapy was 12.6% and for zidovudine alone was 5.4% while for triple antiretroviral therapy was 0.5%. Women who were in highly active antiretroviral therapy (HAART) during pregnancy had significantly lower positive rate than those without HAART treatment (p=0.001). Of 755 infants who received nevirapine, 3.9% were DBS positive compared to 12.8% of those who didn’t receive nevirapine (p=0.001).Conclusion: The use of antiretroviral therapy in the PMTCT programme is effective in reducing HIV transmission from mother to child.

scholarly journals Achievements and Challenges in the Prevention of Mother-to-Child Transmission of HIV—A Retrospective Cohort Study from a Rural Hospital in Northern Tanzania

2021 ◽  
Vol 18 (5) ◽  
pp. 2751
Author(s):  
Sunniva Marie Nydal ◽  
Yuda Munyaw ◽  
Johan N. Bruun ◽  
Arne Broch Brantsæter
Keyword(s):  
Hiv Infections ◽  
Rural Hospital ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Cd4 Cell Count ◽  
Poor Countries ◽  
Northern Tanzania ◽  
Increased Risk ◽  
Hiv Exposed ◽  
Mother To Child

Despite the goal of eliminating new human immunodeficiency virus (HIV) infections in children, mother-to-child transmission is still common in resource-poor countries. The aims of this study were to assess the occurrence of mother-to-child transmission of HIV (MTCT) by age 18 months, risk factors for transmission, and the implementation of the national prevention of MTCT (PMTCT) program in a rural hospital in Tanzania. Data were collated from various medical registers and records. We included 172 children and 167 HIV-infected mothers. Among 88 children (51%) with adequate information, 9 (10.2%) were infected. Increased risk of MTCT was associated with late testing of the child (>2 months) [OR = 9.5 (95% CI: 1.8–49.4)], absence of antiretroviral therapy during pregnancy [OR = 9.7 (95% CI: 2.1–46.1)], and maternal CD4 cell count <200 cells/mm3 [OR = 15.3 (95% CI: 2.1–111)]. We were unable to determine the occurrence of MTCT transmission in 84 children (49%). The results from this study highlight that there is an urgent need for enhanced efforts to improve follow-up of HIV-exposed children, to improve documentation in registries and records, and to facilitate ease of linkage between these.

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 Situation of PMTCT in Bhutan, 14 Years’ Experience

2020 ◽  
Vol 6 (1) ◽  
pp. 49-54
Author(s):  
Phurb Dorji ◽  
Ripa Chakma ◽  
Lekey Khandu
Keyword(s):  
Scientific Evidence ◽  
Hiv Infections ◽  
Pmtct Program ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Effective Strategies ◽  
First Case ◽  
Mtct Rate ◽  
Slow Rise ◽  
Mother To Child

Introduction: Prevention of mother-to-child transmission activities form important part of HIV/AIDS prevention program of any community or country. Methods: Information from the PMTCT Programme from the Ministry of Health and other published literature on HIV in Bhutan were reviewed. Results: The first case of mother to child transmission was reported in Bhutan in 2001. However, the retrospective study shows that one of the earliest mothers-to- child transmissions could have taken place back in 1997. Strategies for the prevention of mother-to-child transmission (PMTCT) of HIV in Bhutan have endured substantial advancement based on global scientific evidence. It is a concern as there is a slow rise in the number of HIV cases. The main modeof transmission is unsafe heterosexual practice in Bhutan. Before the planned PMTCT program, 3 children were infected. After launch of proper PMTCT program, we had all the components of effective strategies in PMCT program which have evolved with better ones with time. Due to this, MTCT was 3.2%. With undetected HIV infections, 32 children were born outside of the program and actual national MTCT rate is 5.5%. Conclusion: There is increasing number of people every year with new HIV infections. In addition, our detection gap is 45% with about 602 undiagnosed in the community. Every effort should be put forward to upscale the PMTCT program for Bhutan to eliminate Mother-to-Child transmission (MTCT) of HIV by 2020 and beyond.

scholarly journals Prevention of mother-to-child transmission of HIV guidelines: Nurses’ views at four primary healthcare facilities in the Limpopo Province

2017 ◽  
Vol 18 (1) ◽  
Author(s):  
Barbara A. Hanrahan ◽  
Adri Williams
Keyword(s):  
Patient Education ◽  
Registered Nurses ◽  
Primary Healthcare ◽  
Limpopo Province ◽  
World Health ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Pmtct Programme ◽  
Healthcare Facilities ◽  
Mother To Child

Background: When new guidelines for existing programmes are introduced, it is often the clinicians tasked with the execution of the guidelines who bear the brunt of the changes. Frequently their opinions are not sought. In this study, the researcher interviewed registered nurses working in the field of the prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) to gain an understanding of their perspectives on the changes introduced to the guidelines. The guideline changes in 2014 were to move from the World Health Organization (WHO) Option B to Option B + which prescribes lifelong antiretroviral therapy (ART) for all HIV-positive pregnant women regardless of CD4 cell count.Objective: To determine what the registered nurses’ perspectives are on the PMTCT programme as implemented at four PHC facilities in the Limpopo Province.Method: For this qualitative investigation, a descriptive research design was implemented. The data were collected during semi-structured interviews with nurses from four primary healthcare facilities in the Limpopo Province of South Africa. Data were analysed using thematic analysis.Results: Challenges preventing effective implementation (e.g. increased workloads, viz. staff shortages; poor planning of training; equipment and medication shortages and long lead times; poor patient education) were identified.Conclusion: In spite of the successes of the PMTCT programme, considerable challenges still prevail; lack of patient education, poor facilities management and staff shortages could potentially influence the implementation of the PMTCT guidelines negatively.

Behandlung von HIV in der Schwangerschaft – Entwicklung über eine Dekade

2018 ◽  
Vol 223 (01) ◽  
pp. 26-32 ◽  
Author(s):  
Isabelle Pitzen ◽  
Lucia Otten ◽  
Till Dresbach ◽  
Christoph Boesecke ◽  
Jan-Christian Wasmuth ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Interdisziplinäre Zusammenarbeit ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Mother To Child ◽  
Hiv 1

Zusammenfassung Einleitung Mehr als 50% der rund 37 Mio. Menschen, die weltweit mit HIV leben, sind Frauen. Heutzutage kann die MTCT (Mother-to-child Transmission) auf<1% reduziert werden. Intention der vorliegenden Untersuchung war es, die Entwicklung (1) des Schwangerschaftsverlaufs HIV-positiver Frauen, (2) des Entbindungsmodus und (3) der Postexpositionsprophylaxe der Neugeborenen, über den Verlauf der letzten Dekade aufzuzeigen. Methodik Im Zeitraum 2005–2016 wurden die HIV- und geburtshilflichen Daten aller HIV-positiver, schwangerer Frauen, der Bonner HIV-Kohorte und die neonatalen Daten der HIV-exponierten Kinder ausgewertet. Die HIV-MTCT wurde für diesen Zeitraum untersucht. Ergebnisse Es wurden 87 Schwangerschaften bei 61 Frauen identifiziert. 70 Kinder wurden an der Universitätsfrauenklinik Bonn lebend geboren. Die Frauen waren zu 53% afrikanischer Herkunft. Der Median der CD4+-Zellzahl betrug präpartal 510 Zellen/μl (IQR 444) und lag bei 32 Frauen (52%) über 500 Zellen/μl. Die HI-Viruslast war präpartal bei 77% vollständig supprimiert (<50 HIV-1-RNA Kopien/ml) und lag bei 92% präpartal<400 HIV-1-RNA Kopien/ml. Im Vergleich zu dem Zeitraum 2005–2011 kam es zu einer deutlichen Reduktion der primären Sectiorate von 77 auf 58% im Zeitraum 2012–2016. Der Anteil der Kinder, die nach der 37 Schwangerschaftswoche geboren wurden, stieg nach 2012 von 60 auf 69% erkennbar an. Während im Zeitraum 2005–2011 78% der Neugeborenen mit ihrem Geburtsgewicht zwischen der 10. und 90. Perzentile lagen, nahm der Anteil nach 2012 auf 92% zu. 54 der 70 Neugeborenen (77%) wurden einem niedrig-normalen Transmissionsrisiko zugeordnet. In keinem Fall (0/70) kam es zu einer HIV-Transmission von Mutter zu Kind. Zusammenfassung In den Jahren 2005–2016 der Analyse hat keine vertikale HIV-Transmission von Mutter zu Kind stattgefunden. Es kam zu einer deutlichen Reduktion der primären Sectiorate und und zu einem Rückgang der Frühgeborenenrate, was die Änderung der Behandlungsstrategie in diesem Zeitraum widerspiegelt. Eine optimale interdisziplinäre Zusammenarbeit bleibt Grundlage für eine erfolgreiche Versorgung HIV-positiver, schwangerer Frauen.

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