Toward elimination of mother–to–child transmission of HIV in South Africa : how best to monitor early infant infections within the prevention of mother–to–child transmission program

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dc.contributor.author Sherman, Gayle G.
dc.contributor.author Mazanderani, Ahmad Haeri
dc.contributor.author Barron, Peter
dc.contributor.author Bhardwaj, Sanjana
dc.contributor.author Niit, Ronelle
dc.contributor.author Okobi, Margaret
dc.contributor.author Puren, Adrian
dc.contributor.author Jackson, Debra J.
dc.contributor.author Goga, Ameena Ebrahim
dc.date.accessioned 2017-09-14T05:50:12Z
dc.date.available 2017-09-14T05:50:12Z
dc.date.issued 2017-06
dc.description.abstract BACKGROUND : South Africa has utilized three independent data sources to measure the impact of its program for the prevention of mother–to–child transmission (PMTCT) of HIV. These include the South African National Health Laboratory Service (NHLS), the District Health Information System (DHIS), and South African PMTCT Evaluation (SAPMTCTE) surveys. We compare the results of each, outlining advantages and limitations, and make recommendations for monitoring transmission rates as South Africa works toward achieving elimination of mother–to–child transmission (eMTCT). METHODS : HIV polymerase chain reaction (PCR) test data, collected between 1 January 2010 to 31 December 2014, from the NHLS, DHIS and SAPMTCTE surveys were used to compare early mother–to–child transmission (MTCT) rates in South Africa. Data from the NHLS and DHIS were also used to compare early infant diagnosis (EID) coverage. RESULTS : The age–adjusted NHLS early MTCT rates of 4.1% in 2010, 2.6% in 2011 and 2.3% in 2012 consistently fall within the 95% confidence interval as measured by three SAPMTCTE surveys in corresponding time periods. Although DHIS data over–estimated MTCT rates in 2010, the MTCT rate declines thereafter to converge with age–adjusted NHLS MTCT rates by 2012. National EID coverage from NHLS data increases from around 52% in 2010 to 87% in 2014. DHIS data over–estimates EID coverage, but this can be corrected by employing an alternative estimate of the HIV–exposed infant population. CONCLUSION : NHLS and DHIS, two routine data sources, provide very similar early MTCT rate estimates that fall within the SAPMTCTE survey confidence intervals for 2012. This analysis validates the usefulness of routine data sources to track eMTCT in South Africa. en_ZA
dc.description.department Medical Virology en_ZA
dc.description.department Paediatrics and Child Health en_ZA
dc.description.librarian am2017 en_ZA
dc.description.sponsorship The President’s Emergency Plan for AIDS Relief through United States Agency for International Development. A.H.M. acknowledges support from the Discovery Foundation [034203]. en_ZA
dc.description.uri http://www.jogh.org en_ZA
dc.identifier.citation Sherman, G.G., Mazanderani, A.H., Barron, P., Bhardwaj, S., Niit, R., Okobi, M., Puren, A., Jackson, D.J. & Goga, A.E. 2017, 'Toward elimination of mother–to–child transmission of HIV in South Africa : how best to monitor early infant infections within the prevention of mother–to–child transmission program', Journal of Global Health, vol. 7, no. 1, art. no. 10701, pp. 1-8. en_ZA
dc.identifier.issn 2047-2978 (print)
dc.identifier.issn 2047-2986 (online)
dc.identifier.other 10.7189/jogh.07.010701
dc.identifier.uri http://hdl.handle.net/2263/62258
dc.language.iso en en_ZA
dc.publisher Edinburgh University Global Health Society en_ZA
dc.rights This work is licensed under a Creative Commons Attribution 4.0 International License. en_ZA
dc.subject National Health Laboratory Service (NHLS) en_ZA
dc.subject Prevention of mother–to–child transmission (PMTCT) en_ZA
dc.subject Human immunodeficiency virus (HIV) en_ZA
dc.subject Elimination of mother–to–child transmission (eMTCT) en_ZA
dc.subject District Health Information System (DHIS) en_ZA
dc.subject South African PMTCT Evaluation (SAPMTCTE) en_ZA
dc.subject Mother–to–child transmission (MTCT) en_ZA
dc.subject Polymerase chain reaction (PCR) en_ZA
dc.subject Early infant diagnosis (EID) en_ZA
dc.title Toward elimination of mother–to–child transmission of HIV in South Africa : how best to monitor early infant infections within the prevention of mother–to–child transmission program en_ZA
dc.type Article en_ZA


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