First population-level effectiveness evaluation of a national programme to prevent HIV transmission from mother to child, South Africa

Goga, Ameena; Dinh, Thu–Ha; Jackson, Debra; Lombard, Carl; Delaney, Kevin P.; Puren, Adrian; Sherman, Gayle; Woldesenbet, Selamawit; Ramokolo, Vundli; Crowley, Siobhan; Doherty, Tanya; Chopra, Mickey; Shaffer, Nathan; Pillay, Yogan

doi:10.1136/jech-2014-204535

Cited by 87 publications

(106 citation statements)

References 32 publications

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“…Mother-to-child-transmission risk Compared to two studies of population-level MTCT rates, the 2016 modelled estimates are within the confidence intervals (CIs), or comparable, to the study results [22,23]. The modelled transmission rates for South Africa at age 6 weeks in the calendar year 2011 was 4.0%, whereas the transmission rate from the South African Impact Assessment was 3.5% (2.9-4.1%) [22] (see Fig.…”

Section: Validation Of Spectrum Projectionssupporting

confidence: 57%

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Improving estimates of children living with HIV from the Spectrum AIDS Impact Model

2017

Aids

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Objective: Estimated numbers of children living with HIV determine programmatic and treatment needs. We explain the changes made to the UNAIDS estimates between 2015 and 2016, and describe the challenges around these estimates.Methods: Estimates of children newly infected, living with HIV, and dying of AIDS are developed by country teams using Spectrum software. Spectrum files are available for 160 countries, which represent 98% of the global population. In 2016, the methods were updated to reflect the latest evidence on mother-to-child HIV transmission and improved assumptions on the age children initiate antiretroviral therapy. We report updated results using the 2016 model and validate these estimates against mother-to-child transmission rates and HIV prevalence from population-based surveys for the survey year.Results: The revised 2016 model estimates 27% fewer children living with HIV in 2014 than the 2015 model, primarily due to changes in the probability of mother-to-child transmission among women with incident HIV during pregnancy. The revised estimates were consistent with population-based surveys of HIV transmission and HIV prevalence among children aged 5-9 years, but were lower than surveys among children aged 10-14 years. Conclusions:The revised 2016 model is an improvement on previous models. Paediatric HIV models will continue to evolve as further improvements are made to the assumptions. Commodities forecasting and programme planning rely on these estimates, and increasing accuracy will be critical to enable effective scale-up and optimal use of resources. Efforts are needed to improve empirical measures of HIV prevalence, incidence, and mortality among children.

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Section: Validation Of Spectrum Projectionssupporting

confidence: 57%

“…The modelled transmission rates for South Africa at age 6 weeks in the calendar year 2011 was 4.0%, whereas the transmission rate from the South African Impact Assessment was 3.5% (2.9-4.1%) [22] (see Fig. 4).…”

Section: Validation Of Spectrum Projectionsmentioning

confidence: 97%

Improving estimates of children living with HIV from the Spectrum AIDS Impact Model

2017

Aids

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“…The methods have been explained in detail elsewhere [11,13]. In summary, two cross-sectional, facility-based, national epidemiological surveys were conducted between August 2011-March 2012 and October 2012-May 2013.…”

Section: Methodsmentioning

confidence: 99%

Population–level effectiveness of PMTCT Option A on early mother–to–child (MTCT) transmission of HIV in South Africa: implications for eliminating MTCT

Goga¹,

Dinh²,

Jackson³

et al. 2016

Journal of Global Health

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“…According to the 2010 South African National Antenatal Survey, 30.2% of pregnant women in South Africa were HIV-positive (Goga et al, 2014). However, maternal antiretroviral therapy (ART) in pregnancy is beneficial and substantially reduces known risks to the mother and her infant (National Consolidated Guidelines for the Prevention of Mother-to-Child Transmission, 2015).…”

Section: Introductionmentioning

confidence: 99%

“…In 2010, the first national population-based survey of the effect of the South African prevention of mother-tochild HIV transmission (PMTCT) programme on early HIV transmission from mother to child reported an overall transmission rate of 3.5%. When the survey was repeated in 2011, the transmission rate was found to be 2.7% (Goga et al, 2014). Therefore, the overall transmission rate of 3.5% in 2010 and 2.7% in 2011 represent strong progress which would support the efficacy of prevention of mother-to-child HIV transmission (PMTCT) programmes in reducing motherto-child HIV transmission (MTCT).…”

Section: Introductionmentioning

confidence: 99%

The effects of in utero exposure to antiretroviral therapy (ART) on the language abilities of HIV exposed uninfected infants

Stevens¹,

Schwartz²,

Mupawose³

et al. 2017

J. AIDS HIV Res.

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This study investigates the possible effects of in-utero antiretroviral therapy (ART) exposure on early language development in HIV exposed uninfected infants. 27 mother-infant pairs consented to the study. Early language development was assessed using the Rossetti Infant Toddler Language Scale. Descriptive statistics were used to describe the caregiver and infant characteristics, as well as the language and communication abilities of infants exposed to in-utero ART. T-test statistics compared the early linguistic development of infants conceived while taking efavirenz and infants that were conceived on a nevirapine or protease-inhibitor (PI lopinavir/ritonavir) containing regimen. Similarly, ttests or ANOVA statistics assessed maternal and infant characteristics associated with total language development. Results obtained in the study revealed no significant differences between the overall language abilities of infants exposed to regimen containing nevirapine or a PI versus regimen that contained efavirenz. The comparison of mean total Rossetti Infant-Toddler Language scores by infant age and maternal and infant characteristics revealed no significant association between variables except for hospitalization. Results obtained suggest that overall language development may not be significantly affected by in utero ART exposure however, further research is warranted to assess whether these infants are at an increased risk of late language emergence.

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First population-level effectiveness evaluation of a national programme to prevent HIV transmission from mother to child, South Africa

Cited by 87 publications

References 32 publications

Improving estimates of children living with HIV from the Spectrum AIDS Impact Model

Improving estimates of children living with HIV from the Spectrum AIDS Impact Model

Population–level effectiveness of PMTCT Option A on early mother–to–child (MTCT) transmission of HIV in South Africa: implications for eliminating MTCT

The effects of in utero exposure to antiretroviral therapy (ART) on the language abilities of HIV exposed uninfected infants

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