Identifying Gaps in Prevention of Mother to Child Transmission of HIV: A Case Series of HIV-positive Infants in Zambia
Abstract
BACKGROUND: To determine the timing of prevention of mother-to-child transmission cascade programmatic barriers to understand the service gaps in preparation for scale up of Option B+ in the Southern Province of Zambia. METHODS: A database search of the National Dried Blood Spot Registry in Zambia for DNA polymerase chain reaction identified human immunodeficiency virus (HIV)-infected infants from 5 facilities in 2 districts in Southern Province, Zambia over a 6-month observation period (January 2013 to June 2013). RESULTS: Seventeen HIV-positive infants out of 459 infants tested were identified from 5 health facilities that provided antiretroviral therapy (ART) initiation within the antenatal care (ANC) clinic, for a transmission rate of 3.7%. Possible risk factors identified for mother to child transmission of HIV included late ANC presentation, home delivery, provision of maternal short course prophylaxis, maternal refusal to initiate treatment and loss to follow-up. CONCLUSIONS: As Zambia transitions to life-long combination ART initiation for HIV-positive pregnant women under Option B+, and subsequent ART integration into ANC facilities, it is crucial to understand prevention of mother-to-child transmission program gaps to achieve the goal of eliminating mother to child transmission of HIV in Zambia.
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In practice, HIV transmission rates are several times higher than trial rates because of high drop-out rates of HIV-positive women along the PMTCT care cascade.
“the rates are several times higher in practice because of the high drop-out rates of HIV-positive women along the PMTCT care cascade [1-3,6-9].”
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- Authors
- Bonawitz, R., Sambambi, K., Vickery, M., Hamomba, L., Hammond, E., Duncan, J., Musokotwane, K., Thea, D., & Herlihy, J. M.
- Affiliations
- Boston University (US)
- Corresponding author
- Bonawitz, Rachael
- Venue
- Pediatric Infectious Disease Journal
- Published
- 2016-07
- Volume
- 35
- Issue
- 7
- Pages
- 772-776
- ISSN
- 0891-3668 (ISSN-L)
- OpenAlex
- W2338843200
- Cited by
- 5
- References
- 23
- Citations by year
- 2026: 1 · 2022: 1 · 2020: 1 · 2019: 1 · 2018: 1
- FWCI
- 0.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Pediatric Infectious Disease Journal (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS drug development and treatment
- Keywords
- mother-to-child transmission of HIV, Option B+, antiretroviral therapy in pregnancy, prenatal care, service gaps, HIV-infected infants, home delivery, loss to follow-up, Southern Province, Zambia
- MeSH terms
- Child, Preschool, Female, Humans, Infant, Mothers, Pregnancy, Pregnancy Complications, Infectious, Prenatal Care, Risk Factors, Zambia, HIV Infections, Infectious Disease Transmission, Vertical, CD4 Lymphocyte Count, Anti-HIV Agents, Early Diagnosis, Anti-Retroviral Agents, Standard of Care
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