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

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%.