Progress of preventing mother-to-child transmission of HIV at primary healthcare facilities and district hospitals in three South African provinces

Grimwood, Ashraf; Fatti, Geoffrey; Mothibi, Eula; Eley, Brian; Jackson, Debra

doi:10.7196/samj.5294

Cited by 25 publications

(23 citation statements)

References 4 publications

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“…Further testing of middle ear function is needed in children who are HIV-exposed, but uninfected (HEU). With the mother-to-child-transmission rates decreasing [18,19] due to better perinatal care for HIVinfected mothers, there will be increasing numbers of HEU children seen at clinics. Determining the effects of HIV and ART exposure on middle ear function will further contribute to the literature on perinatal HIV and overall auditory function.…”

Section: Discussionmentioning

confidence: 99%

Middle Ear Function in Human Immunodeficiency Virus (HIV)-Infected South African Children

Torre¹

2016

J.Paedi.Care.Inol

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Section: Discussionmentioning

confidence: 99%

Middle Ear Function in Human Immunodeficiency Virus (HIV)-Infected South African Children

Torre¹

2016

J.Paedi.Care.Inol

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“…The MTCTrelated (primary) out comes analysed were: (i) proportions of HIVpositive pregnant women who were unaware of their positive HIV status at the booking visit; [12] (ii) duration of time from booking visit until initiation of lifelong ART antenatally, i.e. rate of antenatal ART takeup; [13] (iii) proportions of women who were receiving lifelong ART by delivery (initiated either before or Owing to zero maternal deaths among women aged >24 years, ages ≥20 years was used as the comparison group.…”

Section: Definitions and Outcomesmentioning

confidence: 99%

Adolescent and young pregnant women at increased risk of mother-to-child transmission of HIV and poorer maternal and infant health outcomes: A cohort study at public facilities in the Nelson Mandela Bay Metropolitan district, Eastern Cape, South Africa

et al. 2014

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Background. South Africa (SA) has the highest burden of childhood HIV infection globally, and has high rates of adolescent and youth pregnancy. Objective. To explore risks associated with pregnancy in young HIVinfected women, we compared mothertochild transmission (MTCT) of HIV and maternal and infant health outcomes according to maternal age categories. Methods. A cohort of HIVpositive pregnant women and their infants were followed up at three sentinel surveillance facilities in the Nelson Mandela Bay Metropolitan (NMBM) district, Eastern Cape Province, SA. Young women were defined as ≤24 years old and adolescents as ≤19 years. The effect of younger maternal age categories on MTCT and maternal and child health outcomes was assessed using logbinomial and Cox regression controlling for confounding, using women aged >24 years as the comparison group. Results. Of 956 mothers, 312 (32.6%) were young women; of these, 65 (20.8%) were adolescents. The proportion of young pregnant women increased by 24% between 2009/10 and 2011/12 (from 28.3% to 35.1%). Young women had an increased risk of being unaware of their HIV status when booking (adjusted risk ratio (aRR) 1.37; 95% confidence interval (CI) 1.21 1.54), a reduced rate of antenatal antiretroviral therapy (ART) uptake (adjusted hazard ratio 0.46; 95% CI 0.31 0.67), reduced early infant HIV diagnosis (aRR 0.94; 95% CI 0.94 0.94), and increased MTCT (aRR 3.07; 95% CI 1.18 7.96; adjusted for ART use). Of all vertical transmissions, 56% occurred among young women. Additionally, adolescents had increased risks of first presentation during labour (aRR 3.78; 95% CI 1.06 13.4); maternal mortality (aRR 35.1; 95% CI 2.89 426) and stillbirth (aRR 3.33; 95% CI 1.53 7.25).Conclusion. An increasing proportion of pregnant HIVpositive women in NMBM were young, and they had increased MTCT and poorer maternal and infant outcomes than older women. Interventions targeting young women are increasingly needed to reduce pregnancy, HIV infection and MTCT and improve maternal and infant outcomes if SA is to attain its Millennium Development Goals.

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“…This is especially observed in developing countries and regions of emerging and economical growth [8]. The overall transmission rates (without any form of medical intervention) are between 25% and 45% of all children born to HIV-positive mothers in Africa [9]. The main route of transmission of HIV from mother to child is via the placenta (in utero), especially during labour and delivery and post natally through breast feeding.…”

Section: Hiv and Childrenmentioning

confidence: 99%

Growing Up With HIV in Southern Africa-HIV-Infected Children and Adolescents

Morobadi¹

2014

JHVRV

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In South Africa according to the 2013 mid-year population estimates the overall HIV prevalence is 10% with the total number of people living with HIV-infection estimated at approximately 5.26 million. Thus Southern Africa has been declaring a long war against the HIV epidemic and South Africa is still bearing the brunt of this epidemic. In sub-Sharan Africa, where there is ongoing prevention-of-mother-tochild transmission (PMTCT) of HIV infection and disease, there remains an expanding number of young individuals who will spend the rest of their lifetime coping with the reality of HIV infection, being managed with a chronic disease and expected to remain on lifetime chronic antiretroviral medication. The effects on HIV infected children and adolescents are multi-faceted and complex, but emerging problems such as HIV drug resistance and transition programme difficulties with distant and perhaps unknown goals need to be tackled. In addition, as children are growing and maturing with HIVinfection and being treated with long-term antiretroviral medication and regimens, more clinical complications, other than death, and complications of their medications are observed, including cardiac diseases, malignancies, growth failure, a wide range of skin diseases, renal and bone complications, neurocognitive problems, co-infections, neuropsychiatric co-morbidities, dyslipidaemias and earlier lung conditions. Practical issues regarding disclosure to young HIV-infected individuals, transitioning care and HIV-infection in the adolescent years will be addressed and this article will highlight certain considerations, including caring and monitoring of children and adolescents living with HIV, exposing vulnerable populations, establishing research interests and identifying some challenges between resource-rich and resource-poor settings.

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Progress of preventing mother-to-child transmission of HIV at primary healthcare facilities and district hospitals in three South African provinces

Cited by 25 publications

References 4 publications

Middle Ear Function in Human Immunodeficiency Virus (HIV)-Infected South African Children

Middle Ear Function in Human Immunodeficiency Virus (HIV)-Infected South African Children

Adolescent and young pregnant women at increased risk of mother-to-child transmission of HIV and poorer maternal and infant health outcomes: A cohort study at public facilities in the Nelson Mandela Bay Metropolitan district, Eastern Cape, South Africa

Growing Up With HIV in Southern Africa-HIV-Infected Children and Adolescents

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