Why are children still being infected with HIV? Experiences in the prevention of mother-to-child transmission of HIV in south London

McDonald, Candice; Lambert, John S.; Nayagam, Daya; Welz, Tanya; Poulton, Mary; Aleksin, Devi; Welch, Jan

doi:10.1136/sti.2006.021535

Cited by 6 publications

(5 citation statements)

References 17 publications

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“…When women return, staff members must be available to meet them. Training for program staff may be necessary in interaction skills, for instance, Thailand reported success in PMTCT services by providing training and retraining for staff on a periodic basis; enhancing counseling skills of staff; encouraging open communication and clear delineation of tasks and responsibilities [56]. A related study in Ukraine also found similar findings [57].…”

Section: Discussionmentioning

confidence: 85%

Loss to Followup: A Major Challenge to Successful Implementation of Prevention of Mother-to-Child Transmission of HIV-1 Programs in Sub-Saharan Africa

Kalembo

Zgambo

2012

ISRN AIDS

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Purpose. The purpose of this paper was to explore how loss to followup (LFTU) has affected the successful implementation of prevention of mother to child transmission of HIV-1 (PMTCT) programs in sub-Saharan Africa. Methods. We conducted an electronic search from the following databases PubMed, ScienceDirect, Directory of Open Access Journals (DOAJs), and PyscINFO. Additional searches were made in WHO, UNAIDS, UNICEF, Google, and Google scholar websites for (1) peer-reviewed published research, (2) scientific and technical reports, and (3) papers presented on scientific conferences. Results. A total of 678 articles, published from 1990 to 2011, were retrieved. Only 44 articles met our inclusion criteria and were included in the study. The rates of LTFU of mother-child pairs ranged from 19% to 89.4 in the reviewed articles. Health facility factors, fear of HIV-1 test, stigma and discrimination, home deliveries and socioeconomic factors were identified as reasons for LTFU. Conclusion. There is a great loss of mother-child pairs to follow up in PMTCT programs in sub-Saharan Africa. There is need for more research studies to develop public health models of care that can help to improve followup of mother-child pairs in PMTCT programs in Sub-Saharan Africa.

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Section: Discussionmentioning

confidence: 85%

Loss to Followup: A Major Challenge to Successful Implementation of Prevention of Mother-to-Child Transmission of HIV-1 Programs in Sub-Saharan Africa

Kalembo

Zgambo

2012

ISRN AIDS

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“…In a UK study, the rate of MTCT of HIV was 2% [18], comparable to less than 2% reported from clinical trials in other developed countries [19]. The UK study further noted that 70.6% of their subjects received HAART consisting of 3 or more drugs [18]. …”

Section: Discussionmentioning

confidence: 89%

“…In economically-developed countries, perinatal transmission of HIV has been reduced to 1% as a result of the use of Pediatric AIDS Clinical Trials Group study (PACTG 076) regimen, highly active anti-retroviral therapy (HAART), appropriate management of labor and delivery; and avoidance of breastfeeding [17]. In a UK study, the rate of MTCT of HIV was 2% [18], comparable to less than 2% reported from clinical trials in other developed countries [19]. The UK study further noted that 70.6% of their subjects received HAART consisting of 3 or more drugs [18].…”

Section: Discussionmentioning

confidence: 99%

Mother-to-child transmission of HIV: the pre-rapid advice experience of the university of Nigeria teaching hospital Ituku/Ozalla, Enugu, South-east Nigeria

et al. 2012

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Background Mother-to-child transmission of human immune deficiency virus (HIV) is the most common route of HIV transmission in the pediatric age group. A number of risk factors contribute to the rate of this transmission. Such risk factors include advance maternal HIV disease, lack of anti-viral prophylaxis in the mother and child, mixing of maternal and infant blood during delivery and breastfeeding. This study aims to determine the cumulative HIV infection rate by 18 months and the associated risk factors at the University of Nigeria Teaching Hospital, Enugu. Results A retrospective study, involving HIV exposed infants seen at the pediatric HIV clinic of UNTH between March 2006 and September 2008. Relevant data were retrieved from their medical records. The overall rate of mother to child transmission of HIV in this study was 3.9% (95% CI 1.1%- 6.7%). However, in children breastfed for 3 months or less, the rate of transmission was 10% (95% CI −2.5%-22.5%), compared to 3.5% (95% CI 0.5%-6.5%) in children that had exclusive replacement feeding. Conclusions This retrospective observational study shows a 3.9% cumulative rate of mother-to-child transmission of HIV by 18 months of age in Enugu. Holistic but cost effective preventive interventions help in reducing the rate of mother-to-child transmission of HIV even in economically-developing settings like Nigeria.

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“…Following HIV acquisition, HIV antibody tests may remain negative for 4–5 weeks 57 . Evidence is accumulating reporting infant perinatal infection arising from maternal HIV infection acquired during pregnancy or the postpartum period 58–60 . As some pregnant women are at increased risk of acquiring HIV during pregnancy as a consequence of concurrent sexually transmitted infections (STIs), intravenous drug abuse, or multiple partners, 61 enhanced HIV testing strategies should be considered, especially in parts of the world where HIV is common 3–5 .…”

Section: Repeat Hiv Testing Is Important To Detect Hiv Infection Acqumentioning

confidence: 99%

Prevention of mother‐to‐child transmission of HIV in resource‐rich and ‐poor settings

Bland

Newell

2010

BJOG

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Without prevention, a third of HIV-exposed infants acquire HIV in breastfeeding populations before, during, or after delivery through mother-to-child transmission (MTCT). Whereas MTCT is now a sentinel event in resource-rich countries with antiretroviral prophylaxis, caesarean section, and avoidance of breastfeeding, this is not yet the case in resource-poor settings because breastfeeding is crucial to infant survival. Recent advances in postpartum maternal and infant prophylaxis enables safer breastfeeding, and increasing numbers of women accessing treatment and prevention of MTCT services in sub-Saharan Africa is leading to optimism that MTCT could be eliminated here also, as reflected in the UNAIDS target of 2015.

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Why are children still being infected with HIV? Experiences in the prevention of mother-to-child transmission of HIV in south London

Abstract: The overall transmission rate of 2% attests to the efforts of the multidisciplinary care team in managing this population which is often hard to reach. Clearly, good systems are needed to trace those women who default. Further data are needed regarding in utero transmissions.

Cited by 6 publications

References 17 publications

Loss to Followup: A Major Challenge to Successful Implementation of Prevention of Mother-to-Child Transmission of HIV-1 Programs in Sub-Saharan Africa

Loss to Followup: A Major Challenge to Successful Implementation of Prevention of Mother-to-Child Transmission of HIV-1 Programs in Sub-Saharan Africa

Mother-to-child transmission of HIV: the pre-rapid advice experience of the university of Nigeria teaching hospital Ituku/Ozalla, Enugu, South-east Nigeria

Prevention of mother‐to‐child transmission of HIV in resource‐rich and ‐poor settings

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