239591 RESULTS of the 1ST SOUTH African NATIONAL Pmtct 6 WEEK Infant Survey

Monday, October 31, 2011

Debra Jackson, RN MPH DSc , School of Public Health, University of the Western Cape, Cape Town, South Africa
Ameena Goga, MBCHB , Health Systems Research Unit, Medical Research Council, Tygerberg, South Africa
Carl Lombard , Biostatistics Unit, Medical Research Council, Tygerberg, South Africa
Selamawit Woldesenbet, MPH , Health Systems Research Unit, Medical Research Council, Tygerberg, South Africa
Wesley Solomon, MPH , Health Systems Research Unit, Medical Research Council, Tygerberg, South Africa
Vundli Ramokolo , Health Systems Research Unit, Medical Research Council, Tygerberg, South Africa
Nothemba Khula , Health Systems Research Unit, Medical Research Council, Pretoria, South Africa
Yogan Pillay, PhD , Strategic Health Programmes, Department of Health, Pretoria, South Africa
Nonhlanhla Dlamini , Strategic Health Programmes, South African National Department of Health, Pretoria, South Africa
Thabang Mosala , Strategic Health Programmes, South African National Department of Health, Pretoria, South Africa
Siobhan Crowley , South Africa, UNICEF, Pretoria, South Africa
Gayle Sherman , HIV Research Unit, WITS Health Consortium, Johannesburg, South Africa
Adrien Puren , Nicd, NHLS, Johannesburg, South Africa
Wondwossen Lerebo , School of Public Health, University of the Western Cape, Bellville, South Africa
Thu-Ha Dinh , Global AIDS Program, Centers for Disease Control & Prevention, Atlanta
Background: The South African National Strategic plan (2007-2011) prioritises scaling up of PMTCT to reduce MTCT to less than 5% by 2011. The aim of this study is to conduct facility-based survey to monitor the effectiveness of the South African National PMTCT programme with a primary objective to measure rates of early MTCT at 6-weeks postpartum. Methods: A national cross-sectional facility-based survey, using a biomedical marker to determine MTCT, was conducted. The study population comprised infants aged 4-8 weeks visiting public health facilities for their 1st DTP dose between June-December 2010. Data were gathered by trained nurses using a questionnaire adapted from validated tools. Data entry was completed using a novel cell phone based technology. Infant DBSs were screened for the presence of HIV-antibody. HIV DNA PCR testing was undertaken on all ELISA positive samples to establish infant HIV infection status. Results: By 6 December 2010, data from 9610 (78.8%) of consenting participants are available for analysis. Final weighted results will be available February 2011. On the current sample available for analysis: The presumed maternal HIV prevalence is similar to that expected based on the ANC HIV Surveillance - 30.1% (95% CI 29.1-31.0). Crude infant HIV prevalence is approximately 1.2%. The HIV PCR results suggest a perinatal transmission rate of 4.0% (95% CI 3.3-4.8%) overall. Conclusion: While the early transmission rate of 4% is encouraging, expected rates of postnatal transmission due to mixed breastfeeding suggest that overall MTCT will likely exceed the national target of 5%.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Epidemiology
Program planning
Public health or related organizational policy, standards, or other guidelines
Public health or related research

Learning Objectives:
1) Describe the effectiveness of the South African PMTCT program. 2) Discuss implications for improving the PMTCT program in South Africa

Keywords: HIV Interventions, Infant Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a co-principal investigator for this project
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.