The effectiveness of PMTCT in the Free State - An anonymously linked cord blood survey

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dc.contributor.advisorCoetzee, Daviden_ZA
dc.contributor.authorAmoo, Marian Amaen_ZA
dc.date.accessioned2014-11-08T14:32:41Z
dc.date.available2014-11-08T14:32:41Z
dc.date.issued2010en_ZA
dc.descriptionIncludes bibliographical references.en_ZA
dc.description.abstract[ Background ] PMTCT has become freely available in many African countries however the impact of these interventions at the population level has not been widely estimated. [ Aim ] The aim of this study was to estimate the proportion of HIV infected/exposed mother and infant pairs who received the appropriate prophylaxis. [ Methods ] Cord blood specimens were collected anonymously from women delivering in 10 facilities in the Free State from November 2007 to April 2008. Collected specimens were tested for antibodies to HIV. Specimens found to be seropositive were tested for the presence of nevirapine using chromatography. All PMTCT sites used single dose nevirapine as the minimum prophylaxis, a few used dual therapy including zidovudine and nevirapine and some included nevirapine-based HAART for eligible women. Information was also collected from the clinical records. Maternal PMTCT coverage was determined through cord blood chromatography and infant coverage was determined from documentation of receipt on the clinical records. [ Results ] 1619 specimens were collected from women who gave birth to live infants were collected and tested (3.6% collection rate). 472 specimens tested positive for HIV antibodies on cord blood testing giving an HIV prevalence of 29.2% (95% CI 26.9-31.4%). Only 45.8% (95% CI 41.2-50.4%) of the 472 live infants born to HIV-infected mothers received both the maternal and infant doses of ARV prophylaxis. Reasons for failed dosing included, pre-test counseling not offered, refused testing, positive test resultnot received, prophylaxis was not dispensed, mother did not adhere and infant did not receive the prophylaxis dose. [ Conclusion ] This study showed that coverage in the Free State Province is poor despite the national expansion of PMTCT services to all antenatal sites. Failures occurred at each step of the PMTCT cascade and resulted in low coverage. Interventions should be introduced at each step of the PMTCT cascade to increase coverage.en_ZA
dc.identifier.apacitationAmoo, M. A. (2010). <i>The effectiveness of PMTCT in the Free State - An anonymously linked cord blood survey</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. Retrieved from http://hdl.handle.net/11427/9405en_ZA
dc.identifier.chicagocitationAmoo, Marian Ama. <i>"The effectiveness of PMTCT in the Free State - An anonymously linked cord blood survey."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2010. http://hdl.handle.net/11427/9405en_ZA
dc.identifier.citationAmoo, M. 2010. The effectiveness of PMTCT in the Free State - An anonymously linked cord blood survey. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Amoo, Marian Ama AB - [ Background ] PMTCT has become freely available in many African countries however the impact of these interventions at the population level has not been widely estimated. [ Aim ] The aim of this study was to estimate the proportion of HIV infected/exposed mother and infant pairs who received the appropriate prophylaxis. [ Methods ] Cord blood specimens were collected anonymously from women delivering in 10 facilities in the Free State from November 2007 to April 2008. Collected specimens were tested for antibodies to HIV. Specimens found to be seropositive were tested for the presence of nevirapine using chromatography. All PMTCT sites used single dose nevirapine as the minimum prophylaxis, a few used dual therapy including zidovudine and nevirapine and some included nevirapine-based HAART for eligible women. Information was also collected from the clinical records. Maternal PMTCT coverage was determined through cord blood chromatography and infant coverage was determined from documentation of receipt on the clinical records. [ Results ] 1619 specimens were collected from women who gave birth to live infants were collected and tested (3.6% collection rate). 472 specimens tested positive for HIV antibodies on cord blood testing giving an HIV prevalence of 29.2% (95% CI 26.9-31.4%). Only 45.8% (95% CI 41.2-50.4%) of the 472 live infants born to HIV-infected mothers received both the maternal and infant doses of ARV prophylaxis. Reasons for failed dosing included, pre-test counseling not offered, refused testing, positive test resultnot received, prophylaxis was not dispensed, mother did not adhere and infant did not receive the prophylaxis dose. [ Conclusion ] This study showed that coverage in the Free State Province is poor despite the national expansion of PMTCT services to all antenatal sites. Failures occurred at each step of the PMTCT cascade and resulted in low coverage. Interventions should be introduced at each step of the PMTCT cascade to increase coverage. DA - 2010 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2010 T1 - The effectiveness of PMTCT in the Free State - An anonymously linked cord blood survey TI - The effectiveness of PMTCT in the Free State - An anonymously linked cord blood survey UR - http://hdl.handle.net/11427/9405 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/9405
dc.identifier.vancouvercitationAmoo MA. The effectiveness of PMTCT in the Free State - An anonymously linked cord blood survey. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2010 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/9405en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDepartment of Public Health and Family Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherEpidemiologyen_ZA
dc.titleThe effectiveness of PMTCT in the Free State - An anonymously linked cord blood surveyen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMPHen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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