scholarly journals Progress of preventing mother-to-child transmission of HIV at primary healthcare facilities and district hospitals in three South African provinces

2012 ◽  
Vol 102 (2) ◽  
pp. 81 ◽  
Author(s):  
Ashraf Grimwood ◽  
Geoffrey Fatti ◽  
Eula Mothibi ◽  
Brian Eley ◽  
Debra Jackson
Keyword(s):  
South African ◽  
Primary Healthcare ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Healthcare Facilities ◽  
District Hospitals ◽  
Mother To Child

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.

Operational effectiveness and 36 week HIV-free survival in the South African programme to prevent mother-to-child transmission of HIV-1

AIDS ◽  
2007 ◽  
Vol 21 (4) ◽  
pp. 509-516 ◽  
Author(s):  
Debra J Jackson ◽  
Mickey Chopra ◽  
Tanya M Doherty ◽  
Mark SE Colvin ◽  
Jonathan B Levin ◽  
...  
Keyword(s):  
South African ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
The South ◽  
Operational Effectiveness ◽  
Free Survival ◽  
Mother To Child ◽  
Hiv 1

scholarly journals The case for Option B and Optional B+: Ensuring that South Africa’s commitment to eliminating mother-to-child transmission of HIV becomes a reality

2012 ◽  
Vol 13 (4) ◽  
pp. 178 ◽  
Author(s):  
D Besada ◽  
G Van Cutsem ◽  
E Goemaere ◽  
N Ford ◽  
H Bygrave ◽  
...  
Keyword(s):  
South African ◽  
Population Level ◽  
World Health ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Trade Offs ◽  
The Individual ◽  
Mother To Child ◽  
African Journal ◽  
In Pregnancy

In a previous issue of the Southern African Journal of HIV Medicine, Pillay and Black summarised the trade-offs of the safety of efavirenz use in pregnancy (Pillay P, Black V. Safety, strength and simplicity of efavirenz in pregnancy. Southern African Journal of HIV Medicine 2012;13(1):28-33.). Highlighting the benefits of the World Health Organization’s proposed options for the prevention of mother-to-child transmission (PMTCT) of HIV, the authors argued that the South African government should adopt Option B as national PMTCT policy and pilot projects implementing Option B+ as a means of assessing the individual- and population-level effect of the intervention. We echo this call and further propose that the option to remain on lifelong antiretroviral therapy, effectively adopting PMTCT Option B+, be offered to pregnant women following the cessation of breastfeeding, for their own health, following the provision of counselling on associated benefits and risks. Here we highlight the benefits of Options B and B+.

scholarly journals An approach for evaluating early and long term mother-to-child transmission of HIV (MTCT) in low and middle income countries: a South African experience

2019 ◽  
Vol 19 (S1) ◽  
Author(s):  
Debra J. Jackson ◽  
Thu-Ha Dinh ◽  
Carl J. Lombard ◽  
Gayle G. Sherman ◽  
Ameena E. Goga
Keyword(s):  
South African ◽  
Survey Design ◽  
Population Level ◽  
Global Public Health ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Mother To Child

Abstract Background Eliminating mother-to-child transmission of HIV is a global public health target. Robust, feasible methodologies to measure population level impact of programmes to prevent mother-to-child transmission of HIV (PMTCT) are needed in high HIV prevalence settings. We present a summary of the protocol of the South African PMTCT Evaluation (SAPMTCTE) with its revision over three repeated rounds of the survey, 2010–2014. Methods Three cross sectional surveys (2010, 2011–2012 and 2012–2013) were conducted in 580 primary health care immunisation service points randomly selected after stratified multistage probability proportional to size sampling. All infants aged 4–8 weeks receiving their six-week immunisation at a sampled facility on the day of the visit were eligible to participate. Trained research nurses conducted interviews and took infant dried blood spot (iDBS) samples for HIV enzyme immunoassay (EIA) and total nucleic acid polymerase chain reaction (PCR) testing. Interviews were conducted using mobile phones and iDBS were sent to the National Health Laboratory for testing. All findings were adjusted for study design, non-response, and weighted for number of South African live-birth in each study round. In 2012 a national closed cohort of these 4 to 8-week old infants testing EIA positive (HIV Exposed Infants) from the 2012–2013 cross-sectional survey was established to estimate longer-term PMTCT impact to 18 months. Follow-up analyses were to estimate weighted cumulative MTCT until 18 months, postnatal MTCT from 6 weeks until 18 months and a combined outcome of MTCT-or-death, using a competing risks model, with death as a competing risk. HIV-free survival was defined as a child surviving and HIV-negative up to 18 months or last visit seen. A weighted cumulative incidence analysis was conducted, adjusting for survey design effects. Discussion In the absence of robust high-quality routine medical recording systems, in the context of a generalised HIV epidemic, national surveys can be used to monitor PMTCT effectiveness; however, monitoring long-term outcomes nationally is difficult due to poor retention in care.

scholarly journals AIDS-related stigmatisation in the healthcare setting: a study of primary healthcare centres that provide services for prevention of mother-to-child transmission of HIV in Lagos, Nigeria

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e026322 ◽  
Author(s):  
John E Ehiri ◽  
Halimatou S Alaofè ◽  
Victoria Yesufu ◽  
Mobolanle Balogun ◽  
Juliet Iwelunmor ◽  
...  
Keyword(s):  
Infection Control ◽  
Primary Healthcare ◽  
Service Providers ◽  
Healthcare Setting ◽  
Pmtct Service ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Living With Hiv ◽  
Mother To Child ◽  
Hiv Aids

ObjectiveTo assess AIDS stigmatising attitudes and behaviours by prevention of mother-to-child transmission (PMTCT) service providers in primary healthcare centres in Lagos, Nigeria.DesignCross-sectional survey.SettingThirty-eight primary healthcare centres in Lagos, Nigeria.ParticipantsOne hundred and sixty-one PMTCT service providers.Outcome measuresPMTCT service providers’ discriminatory behaviours, opinions and stigmatising attitudes towards persons living with HIV/AIDS (PLWHAs), and nature of the work environment (HIV/AIDS-related policies and infection-control guidelines/supplies).ResultsReported AIDS-related stigmatisation was low: few respondents (4%) reported hearing coworkers talk badly about PLWHAs or observed provision of poor-quality care to PLWHAs (15%). Health workers were not worried about secondary AIDS stigmatisation due to their occupation (86%). Opinions about PLWHAs were generally supportive; providers strongly agreed that women living with HIV should be allowed to have babies if they wished (94%). PMTCT service providers knew that consent was needed prior to HIV testing (86%) and noted that they would get in trouble at work if they discriminated against PLWHAs (83%). A minority reported discriminatory attitudes and behaviours; 39% reported wearing double gloves and 41% used other special infection-control measures when providing services to PLWHAs. Discriminatory behaviours were correlated with negative opinions about PLWHAs (r=0.21, p<0.01), fear of HIV infection (r=0.16, p<0.05) and professional resistance (r=0.32, p<0.001). Those who underwent HIV training had less fear of contagion.ConclusionsThis study documented generally low levels of reported AIDS-related stigmatisation by PMTCT service providers in primary healthcare centres in Lagos. Policies that reduce stigmatisation against PLWHA in the healthcare setting should be supported by the provision of basic resources for infection control. This may reassure healthcare workers of their safety, thus reducing their fear of contagion and professional resistance to care for individuals who are perceived to be at high risk of HIV.

scholarly journals Reasons for failure of prevention of mother-to-child HIV transmission in a rural South African district hospital

2015 ◽  
Vol 16 (1) ◽  
Author(s):  
Clifford Kendall ◽  
Lore Claessens ◽  
Jienchi Dorward ◽  
Gloria Mfeka ◽  
Kelly Gate
Keyword(s):  
South African ◽  
Hiv Transmission ◽  
False Negative ◽  
Hiv Positive ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Rural South ◽  
Antenatal Consultation ◽  
Polymerase Chain ◽  
Mother To Child

Further reduction of mother-to-child transmission (MTCT) of HIV requires improved understanding of the reasons for MTCT. We reviewed maternal and infant case notes for HIV- positive infants diagnosed by polymerase chain reaction at Bethesda Hospital. Nineteen cases were analysed. Median gestation at first antenatal consultation (ANC) was 22.5 (interquartile range [IQR] 19.25–24). Eleven (57.9%) mothers were HIV positive at first ANC, whilst eight tested negative and later positive (2 antepartum, 6 postpartum). Median maternal CD4 was 408 cells/μL (IQR 318–531). Six (31.6%) received no antenatal antiretroviral therapy (ART) because they were diagnosed as HIV positive postpartum; 9 (47.3%) received antenatal ART and 3 (15.8%) were never initiated on ART. At 6 weeks postpartum, 5 infants (26.3%) were not on prophylactic nevirapine (NVP) because their mothers had not yet been diagnosed. Maternal seroconversion in pregnancy and breastfeeding, and possibly false-negative HIV tests, were important reasons for prevention of mother-to-child transmission (PMTCT) failure.

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