An approach for evaluating early and long term mother-to-child transmission of HIV (MTCT) in low and middle income countries : a South African experience

dc.contributor.authorJackson, Debra J.
dc.contributor.authorDinh, Thu-Ha
dc.contributor.authorLombard, Carl J.
dc.contributor.authorSherman, Gayle G.
dc.contributor.authorGoga, Ameena Ebrahim
dc.date.accessioned2020-07-10T12:11:35Z
dc.date.available2020-07-10T12:11:35Z
dc.date.issued2019-09-16
dc.description.abstractBACKGROUND : Eliminating mother-to-child transmission of HIV is a global public health target. Robust, feasible methodologies to measure population level impact of programmes to prevent mother-to-child transmission of HIV (PMTCT) are needed in high HIV prevalence settings. We present a summary of the protocol of the South African PMTCT Evaluation (SAPMTCTE) with its revision over three repeated rounds of the survey, 2010–2014. METHODS : Three cross sectional surveys (2010, 2011–2012 and 2012–2013) were conducted in 580 primary health care immunisation service points randomly selected after stratified multistage probability proportional to size sampling. All infants aged 4–8 weeks receiving their six-week immunisation at a sampled facility on the day of the visit were eligible to participate. Trained research nurses conducted interviews and took infant dried blood spot (iDBS) samples for HIV enzyme immunoassay (EIA) and total nucleic acid polymerase chain reaction (PCR) testing. Interviews were conducted using mobile phones and iDBS were sent to the National Health Laboratory for testing. All findings were adjusted for study design, non-response, and weighted for number of South African live-birth in each study round. In 2012 a national closed cohort of these 4 to 8-week old infants testing EIA positive (HIV Exposed Infants) from the 2012–2013 cross-sectional survey was established to estimate longer-term PMTCT impact to 18 months. Follow-up analyses were to estimate weighted cumulative MTCT until 18 months, postnatal MTCT from 6 weeks until 18 months and a combined outcome of MTCT-or-death, using a competing risks model, with death as a competing risk. HIV-free survival was defined as a child surviving and HIV-negative up to 18 months or last visit seen. A weighted cumulative incidence analysis was conducted, adjusting for survey design effects. DISCUSSION : In the absence of robust high-quality routine medical recording systems, in the context of a generalised HIV epidemic, national surveys can be used to monitor PMTCT effectiveness; however, monitoring long-term outcomes nationally is difficult due to poor retention in care.en_ZA
dc.description.departmentPaediatrics and Child Healthen_ZA
dc.description.librarianam2020en_ZA
dc.description.sponsorshipThe President’s Emergency Plan for AIDS Relief under the Cooperative Agreement between CDC and MRC (1U2GPS001137 –02 and 1U2GPS001137–03), The United Nations Children’s Fund (UNICEF), the National Department of Health, South Africa, the South African National AIDS Council, the South Africa National Research Foundation and the South African Medical Research Council.en_ZA
dc.description.urihttps://bmcinfectdis.biomedcentral.comen_ZA
dc.identifier.citationJackson, D.J., Dinh, T.H., Lombard, C.J. et al. 2019, 'An approach for evaluating early and long term mother-to-child transmission of HIV (MTCT) in low and middle income countries: a South African experience', BMC Infectious Diseases, vol. 19, art. 784, suppl. 1, pp. 1-8.en_ZA
dc.identifier.issn1471-2334 (online)
dc.identifier.other10.1186/s12879-019-4336-1
dc.identifier.urihttp://hdl.handle.net/2263/75124
dc.language.isoenen_ZA
dc.publisherBioMed Centralen_ZA
dc.rights© The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License.en_ZA
dc.subjectStudy designen_ZA
dc.subjectPMTCT effectivenessen_ZA
dc.subjectSurveyen_ZA
dc.subjectSouth Africa (SA)en_ZA
dc.subjectMother-to-child transmission (MTCT)en_ZA
dc.subjectHuman immunodeficiency virus (HIV)en_ZA
dc.subjectPrevention of mother-to-child transmission (PMTCT)en_ZA
dc.subjectPolymerase chain reaction (PCR)en_ZA
dc.subjectTotal nucleic aciden_ZA
dc.subjectInfant dried blood spot (iDBS)en_ZA
dc.subjectEnzyme immunoassay (EIA)en_ZA
dc.titleAn approach for evaluating early and long term mother-to-child transmission of HIV (MTCT) in low and middle income countries : a South African experienceen_ZA
dc.typeArticleen_ZA

Files

Original bundle

Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
Jackson_Approach_2019.pdf
Size:
1.25 MB
Format:
Adobe Portable Document Format
Description:
Article

License bundle

Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
license.txt
Size:
1.75 KB
Format:
Item-specific license agreed upon to submission
Description: