Abstract
Zimbabwe introduced the early infant diagnosis (EID) for human immunodeficiency virus (HIV) exposed infants in 2007. Data captured through this initiative has never been analysed in detail. A detailed EID data analysis was carried out to evaluate the effectiveness of the prevention of mother to child transmission (PMTCT) of HIV in reducing HIV transmission. A retrospective record review of the national EID dataset for the period of January, 2007 to August, 2011 was conducted. Secondary data analysis was done to calculate EID population coverage and HIV positivity amongst samples tested, to compare effectiveness of PMTCT regimens among tested children, and to determine the correlation between mode of delivery and infant outcomes. EID population coverage increased from 1% in January, 2007 to 38% by August, 2011, far below universal access target of 80%. Of the samples tested, HIV positivity showed an apparent decline from 38% in 2007 to 11% in 2011. HIV positivity in infants born vaginally was comparable to those delivered by caesarean section for the years 2010 (p-trend 0.427) and 2011 (p-trend 0.99). Both maternal and infant antiretroviral (ARV) prophylactic regimens were found to reduce HIV positivity significantly (p-trend < 0.001). The national EID database is an important and readily available tool for monitoring and evaluating the PMTCT program and paediatric HIV trends. The Ministry of Health through its PMTCT programme should regularly use this data to inform prioritization of PMTCT interventions. Increased access to both maternal and infant ARV prophylactic drug regimens is critical, if the target of eliminating paediatric HIV by 2015 is to be met in Zimbabwe. Key words: Early infant diagnosis, PMTCT, ARV prophylaxis, Zimbabwe.
Highlights
Transmission of human immunodeficiency virus (HIV) in Zimbabwe is primarily heterosexual and vertical
Our study found that most infants were being tested through the PMTCT follow-up in maternal and child health units
The national early infant diagnosis (EID) coverage has been increasing during the period under review with urban provinces having better than rural provinces
Summary
Transmission of HIV in Zimbabwe is primarily heterosexual and vertical. Mother to child transmission (MTCT) of HIV (vertical) occurs when an HIV infected woman passes on the virus to her child during pregnancy (30 to 50%), in labour and delivery (50 to 70%) or through breastfeeding (15 to 25%) (Paediatric HIV Training Manual, 2010). 15 to 45% of infants born to mothers living with HIV will become infected J. The Prevention of Mother to child transmission of HIV (PMTCT) program was introduced in Zimbabwe in 1999, with an overall goal of reducing HIV infection among children as well as reducing HIV related morbidity and mortality. The PMTCT program has evolved through the years, to incorporate and adopt new strategies based on new technologies
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