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S Afr Med J. 2008 Jun;98(6):458-62.

Prevention of mother-to-child transmission of HIV programme: low vertical transmission in KwaZulu-Natal, South Africa.

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1
Department of Public Health, School of Family and Public Health Medicine, University of KwaZulu-Natal. murose@saol.com

Abstract

OBJECTIVE:

To describe the operational effectiveness of the prevention of mother-to-child transmission (PMTCT) of HIV programme at McCord Hospital during the period 1 March 2004 - 31 August 2005.

DESIGN:

Observational cohort study.

SETTING:

McCord Hospital, Durban, South Africa.

SUBJECTS:

Antenatal patients attending the PMTCT clinic.

MEASUREMENTS AND RESULTS:

During the 18 months all 2 624 women (100%) attending the antenatal clinic received HIV counselling, resulting in 91% (2 388) being tested for HIV. The prevalence of HIV in the total cohort was 13% (95% confidence interval (CI) 11.6 - 14.2). Of the HIV-positive mothers 302 (89%) completed their pregnancy at the hospital, and in this group there were 3 intrauterine deaths, 1 miscarriage, 1 maternal death (with the baby in utero) and 297 live births with 1 early neonatal death. Only 11% (36 out of 338) were lost to follow-up. A quarter (668) of the partners of all women attending the antenatal clinic were tested for HIV. Delivery in 70% (209) of live births was by caesarean section. Nevirapine was administered to 98% (290) of live babies and 75% (224) received zidovudine (AZT) as well. The 6-week polymerase chain reaction (PCR) baby test uptake was 81% (239 out of 296 live babies). Of those tested, 2.9% (95% CI 1.3 - 6.2) tested HIV positive.

CONCLUSION:

Despite challenges faced by PMTCT providers in a resource-constrained setting, this state-aided hospital provides a comprehensive and integrated service and has achieved outcomes that compare favourably with those in the developed world.

PMID:
18683379
[Indexed for MEDLINE]
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