MEDIAADVISORY
SECONDSOUTHAFRICANPREVENTIONOFMOTHER-TO-CHILDTRANSMISSIONEVALUATIONSHOWSREDUCTIONINPERINATAL(EARLY)MOTHER-TO-CHILDTRANSISSIONOFHIVThursday,JULY192012,09hOOPMTCTInterventionsinSouthAfrica
TheSouthAfricanPMTCTprogramme,firstimplementedin2001,hasmadegreatstrides,andseveralsignificantmilestoneshavebeenachieved:
•2001-2008:
Implementationofsingle-dosenevirapine(sd-NVP)formotherattheonsetoflabourandbabywithin72hoursofbirth(2001-2008)
•2008:
AZTfrom28weekswithmaternalsd-NVPinlabourormaternalantiretroviraldrugs(ARVs)iftheCD4cellcount:5250.AZTforbaby(4-28daysdependingondurationofmaternalAZT/ARVs).
•April2010(PresidentialannouncementonWorldAIDSDay2009):
AZTfrom14weekswithmaternalsd-NVPinlabourandTDF/FTCduringorimmediatelyafterlabour,ormaternalARVs(HAART)iftheCD4cellcount:5350.NVPforbabyforsixweeksorthroughoutbreastfeeding.
THESAPMTCTEvaluation
ThesecondSouthAfricanPMTCTevaluation(SAPMTCTE),conductedbetweenAugust2011andMarch2012,focusedontheeffectivenessoftheSouthAfricanPMTCTprogrammeatsixweekspostpartum.ThisSAPMTCTEwasconductedbytheHealthSystemsResearchUnitoftheMedicalResearchCouncil(MRC),CentresforDiseaseControlandPrevention(CDC),withtheassistanceofUNICEF,NationalInstituteforCommunicableDiseases,WitsInfantHIVDiagnostics,andtheUniversityoftheWesternCape(UWC).ThestudywasfundedbyCDC,GlobalFundandNICD/NHLS.
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Researchnursesvisited580facilitiesthroughoutSouthAfrica,andinterviewedconsentingcaregiversofinfantsaged4-8weeks.Driedbloodspots(DBS)werealsocollectedfromenrolledinfants,andtheseweretestedforHIV-exposureusingELISA.AllELISApositiveDBSwerethentestedforDNAPCRtodetectHIVtransmission.AllinfanttestresultswerereturnedtomothersthroughtheroutinehealthcaresystemandHIV-infectedinfantswerefast-trackedintocare.AllmotherswereencouragedtoaccessHIVcounsellingandtestingservices.ThenationalHIVMTCTrate,measuredinthese10106infantswasapproximately2.7%in2011.Thiswasasignificantreductionfromthe3.5%transmissionrecordedamong10182infantsenrolledinthefirstevaluation,conductedin2010.Atpopulationlevel117000infantswouldhavebecomeHIVinfectedby8weekspost-delivery
in
SouthAfricaintheabsenceofanyPMTCTprogramme(assuminga30%transmissionratewithoutanyPMTCTinterventions).In2011,107000ofthese117000infantswereHIVnegativeat4-8weeksafterbirthandwerethussavedfromearlyHIVinfectionthroughPMTCTinterventions.
Table1:RatesofInfantExposureandHIVMTCTbyProvince
2010survey2011survey
InfantHIV~MTCT%(95%CI)
InfantHIV-
MTCT
Oft.
(95%CI)
ExposedExposed
30.0(26.3-33.7)4.7(2.4-7.0)*32.0(29.6-35.5)3.8(2.1-5.5)31.1(28.9-33.3)5.9(3.8-8.0)30.9(28.6-33.3)3.8(2.3-5.3)30.2(27.7-32.8)2.5(1.5-3.6)33.1(29.8-36.4)2.1(0.9-3.4)43.9(39.7-48.0)2.9(1.7-4.0)44.4(39.8-48.9)2.1(0.9-3.3)22.6(20.4-24.8)3.6(1.4-5.8)23.0(19.9-26.2)3.1(1.2-4.9)36.2(33.6-38.9)5.7(4.1-7.3)35.6(33.3-37.8)3.3(2.2-4.5)15.6(13.0-18.3)1.4(0.1-3.4)*15.1(12.7-17.5)6.1(2.5-9.6)'30.9(28.6-33.1)4.4(2.9-5.9)30.8(28.5-33.1)2.6
(1.1A.O)
20.8(16.8-24.9)3.9(1.9-5.8)17.8(14.8-20.8)1.98(0.6-3.3)31.4(30.1-32.6)3.5(2.9-4.1)32.2(30.7-33.6)2.7(2.1-3.2)
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TheNationalDepartmentofHealthwouldliketothankallhealthcarepersonnelfortheircontinuedcommitmenttowardsprovidingoptimalhealthcareingeneralandforintensifyingHIV-relatedcareinparticular.TheNationalDepartmentofHealthwouldalsoliketothankcivilsocietyincludingnon-governmentalorganisation,civicorganisation,mothers,caregivers,partnersandfamiliesforcontinuingtodemandhighqualityhealthcareservicesingeneralandservicesforHIVdiagnosis,care,treatmentandsupportinparticular.Finallywewouldliketothankourdevelopmentpartnersfortheirfinancialandtechnicalsupportinbothconductingthesurveyandinassistingustostrengthenourhealthsystem.Letusworktogethertoensurethat:•100%ofSouthAfricancitizensknowtheirHIVstatus;•newadultHIVinfectionsareprevented;•100%ofpregnantwomenknowtheirHIVstatusand100%ofHIVpositivepregnantwomenandtheirchildrenreceiveappropriatePMTCTinterventionssothatwecurbtheHIVepidemicandeliminatepaediatricHIVinfection.
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Media Brief 19 July 2012 - Mother-to-child HIV transmission rates fall to 2.7 percent in South Africa
Figures from the second annual South African PMTCT evaluation
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