Prevention of mother-to-child transmission of HIV programme: low vertical transmission in KwaZulu-Natal, South Africa
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 2624 women (100%) attending the antenatal clinic received HIV counselling resulting in 91% (2388) being tested for HIV. The prevalence of HIV in this cohort was 12.9% (95% confidence interval (CI) 11.6 to 14.2).
Of the 302 (89%) HIV positive mothers who completed their pregnancy at the hospital, there were 3 intra-uterine deaths, 1 miscarriage, 1 maternal death (with baby in utero) and 297 live births with one early neonatal death. Only 11% (36 out of 338) were lost to follow-up. Of all women attending the antenatal clinic, a quarter (668) of partners was tested for HIV.
Delivery in 70% (209) of live births was by caesarean section. Nevirapine was administered to 98% (290) of live babies and 76% (224) received AZT as well.
The six week PCR baby test uptake was 81% (239 out of 296 live babies). Out of those tested 2.9% (95% CI 1.3-6.2) tested HIV positive.
Conclusion. Despite the challenges faced by PMTCT providers in a resource constrained setting this state-aided hospital provides a comprehensive and integrated service and has achieved outcomes which compare favourably with those in the developed world.
Rosemary Geddes MB ChB, University of KwaZulu-Natal
Stephen Knight, MB BCh, FCPHM (SA), University of KwaZulu-Natal
Tonya Esterhuizen, MSc, University of KwaZulu-Natal
Sandy Reid, RN, McCord Hospital, Durban
Janet Giddy, MB ChB, Dip.PHC.Ed, MFamMed, McCord Hospital, Durban
Candice Roberts, MB ChB, FCOG (SA), McCord Hospital, Durban
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Date published: 2008-04-29
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