BackgroundUptake of and adherence to the prevention of mother to child transmission of HIV (PMTCT) interventions are a challenge to most women if there is no male partner involvement. Organizations which include the National AIDS Council and the Zimbabwe AIDS Prevention Project- University of Zimbabwe have been working towards mobilizing men for couple HIV testing and counseling (HTC) in antenatal care (ANC). In 2013, Midlands province had 19 % males who were tested together with their partners in ANC, an increase by 9 % from 2011. However, this improvement was still far below the national target, hence this study was conducted to determine the associated factors.MethodsA1:1 unmatched case control study was conducted. A case was a man who did not receive HIV testing and counseling together with his pregnant wife in ANC in Midlands province from January to June 2015. A control was a man who received HIV testing and counseling together with his pregnant wife in ANC in Midlands province from January to June 2015. Simple random sampling was used to select 112 cases and 112 controls. Epi Info statistical software was used to analyze data. Written informed consent was obtained from each study participant.ResultsIndependent factors that predicted male involvement in PMTCT were: having been previously tested as a couple (aOR) 0.22, 95 % CI = 0.12, 0.41) and having time to visit the clinic (aOR) 0.41, 95 % CI = 0.21, 0.80). Being afraid of knowing one’s HIV status (aOR 2.22, 95 % CI = 1.04, 4.76) was independently associated with low male involvement in PMTCT.ConclusionMultiple factors were found to be associated with male involvement in PMTCT. Routine PMTCT educational campaigns in places where men gather, community based couple HTC and accommodating the working class during weekends are essential in fostering male involvement in PMTCT thereby reducing HIV transmission to the baby.

BackgroundMidlands Province started implementing the Isoniazid (INH) preventive therapy (IPT) program in January 2013. Shurugwi and Gokwe North were the piloting district hospitals. In May 2014, four more districts hospitals (Gokwe South, Gweru, Kwekwe and Zvishavane) started implementing IPT. Shurugwi District decentralized the program to its rural health facilities in January 2014. A review of the Shurugwi IPT program, 2013 data, indicated that the majority of eligible clients were not started on IPT. None out of the 400 eligible clients were started on IPT in November against the 100 % target according to the World Health Organization and the National Tuberculosis (TB) Program. We conducted a study to evaluate the IPT program in Shurugwi District from January 2013 to August 2014.MethodsThe logical framework approach was used to evaluate inputs, processes, outputs and outcomes of the IPT program. An interviewer administered questionnaire was used to collect data from key informants. Checklists were used to collect data from IPT program records.ResultsSixteen health facilities were implementing IPT in Shurugwi District. All the facilities had TB screening tools and three did not have TB screening algorithms. The district experienced medicine stock outs in 2013. One formal training at district level and on job trainings in implementing health facilities were done. From January 2013 to August 2014, Shurugwi District screened 6794 antiretroviral (ART) clients for TB. Out of those screened, 5255 were eligible for IPT and 2831 (54 %) were started on IPT. A total of 700 clients had completed the IPT 6 month’s course by August 2014. The dropout rate due to INH toxicity and TB was 0.6 % (n = 18) and 0.3 % (n = 8) respectively. Fifty-three advocacy and community sensitization meetings were done. The program had no Information Education and Communication (IEC) materials.ConclusionThe IPT program in Shurugwi District achieved half its target. This could be due to inadequate formally trained staff, lack of IEC materials, inadequate advocacy and community sensitization, non-availability of the INH 300 mg single dose and inadequate INH 100 mg dose tablets in 2013. To improve the IPT program, there is need for routine advocacy, communication and social mobilization.

IntroductionAFP surveillance was adopted globally as a key strategy for monitoring the progress of the polio eradication initiative. Gokwe North district with an estimated 119 655 children <15 years detected 2 cases, 4 cases and 1 case of AFP in 2012, 2013 and 2014 respectively against a target of 5 cases per year. We therefore set out to evaluate the system and find out why it was failing to detect at least 5 cases per year.MethodsA descriptive cross sectional study was carried out. All three hospitals in the district were purposively selected. Twelve of the nineteen health facilities were randomly selected and forty nine health workers were purposively recruited. An interviewer administered questionnaire and key informant interview guide were used to collect data. Quantitative data was analysed using Epi info.ResultsOut of the 49 respondents, 17(34.7%) knew the target age group for AFP surveillance. Twelve (24.5%) knew the number of notification forms to be filled. Seven (14.3%) and ten (20.4%) respondents knew when to follow up an AFP case and when an AFP case should be followed up and completely notified and investigated respectively. Forty one (83.7%) respondents were not trained on AFP surveillance. Nineteen (39%) had AFP notification forms at the clinic and 33(67%) had displayed AFP case definitions. All the 22 health facilities in the district participate in AFP surveillance; however, all have hard to reach areas. Seventeen (34.7%) reportedly took public health actions based on AFP data.ConclusionThe system was found to be useful, simple, acceptable, timely, unstable, not representative and not sensitive. The system was threatened by lack of health worker knowledge and community active search. Advocacy, communication and social mobilization on AFP surveillance might improve the performance of the system in Gokwe North district.

A 12-year-old Zimbabwean girl presented with tuberculous monoarthritis. She was moderately wasted, stunted and sexually immature. These clinical findings lead to the diagnosis of underlying HIV infection, which was thought to have been acquired from mother-to-child transmission.

IntroductionRubella is a contagious disease, caused by rubella virus and transmitted via the respiratory route. Rubella in pregnancy may cause Congenital Rubella Syndrome (CRS), characterized by multiple defects to the brain, heart, eyes and ears. Gokwe North experienced an increase in rubella cases from 6 cases (24 June 2014) to 374 cases (12 August 2014). The study was conducted to determine risk factors associated with contracting rubella.MethodsA 1:1 unmatched case control study was conducted. A case was a child <15 years, resided in Gokwe North, with maculopapular rash and tested positive for rubella specific IgM or was linked epidemiologically to a laboratory confirmed case. Blood was collected for laboratory diagnosis. An interviewer administered questionnaire was used. Epi Info™ was used to analyze data.ResultsEighty eight cases and 88 controls were recruited, median age for cases was 7 years (Q1 = 4, Q3 = 8) and 6 years (Q1 = 3, Q3 = 9) for controls. Independent risk factors for contracting rubella were; classmate contact (AOR 9.44; (95% CI 4.29-20.77)) and having >3 children in a household (AOR 2.59; 95%CI (1.23-5.42)). Only 10.2% and 6.8% of the caregivers’ cases and controls respectively, knew rubella is spread through contact with an infected person (p = 0.57). Majority of caregivers (97.8%) reported to the health facility within two days of onset of rash.ConclusionOutbreak was driven by contact at school and was spread into the community through school children. Screening and isolation of the sick controlled the outbreak. Routine rubella vaccination could be considered to prevent similar outbreaks.