National estimates and risk factors associated with early mother-to-child transmission of HIV after implementation of option B+: a cross-sectional analysis

Publication date: Available online 19 November 2018Source: The Lancet HIVAuthor(s): Beth A Tippett Barr, Monique van Lettow, Joep J van Oosterhout, Megan Landes, Ray W Shiraishi, Ermias Amene, Erik Schouten, Nellie Wadonda-Kabondo, Sundeep Gupta, Andrew F Auld, Thokozani Kalua, Andreas JahnSummaryBackgroundRoutine data from Malawi's prevention of mother-to-child transmission (MTCT) option B+ programme suggest high uptake of antiretroviral therapy (ART) among pregnant women. Malawi's Ministry of Health led the National Evaluation of Malawi's PMTCT Program to obtain nationally representative data on maternal ART coverage and prevention of MTCT effectiveness. Here, we present the early transmission data for infants aged 4–12 weeks.MethodsWe used a multistage cluster design to recruit a nationally representative sample of HIV-exposed infants and their mothers in Malawi. Between October 16, 2014, and May 17, 2016, we screened for HIV in all mothers attending an under-5 vaccination or outpatient sick-child clinic with infants aged 4–26 weeks at 54 health facilities selected across ten districts and four regional sampling zones. Infants with mothers identified as HIV-infected were enrolled in the cohort. We calculated weighted MTCT rates for only the subset of infants aged 4–12 weeks at screening, thereby capturing MTCT from early pregnancy, to delivery, and early breastfeeding. We collected data on maternal and infant demographics and self-reported use of HIV services, ART, a...
Source: The Lancet HIV - Category: Infectious Diseases Source Type: research