Implementation of single-dose nevirapine for prevention of MTCT of HIV--lessons from Cape Town.

Abstract

The HIVNET 012 study in Uganda demonstrated the efficacy of the single-dose nevirapine regimen in prevention of mother-to-child transmission (PMTCT) of HIV in developing countries. However recent reports of implementation studies in Kenya Botswana Zimbabwe and West Africa show that there may be an important gap between the efficacy in clinical trial circumstances and the effectiveness of PMTCT programmes when implemented in field conditions. Return rates for test results and collection of the drugs adherence to infant feeding recommendations and the antiretroviral drug regimen and follow-up turned out to be suboptimal thereby limiting the reduction of MTCT of HIV. These findings indicate serious obstacles for future interventions. As many PMTCT programmes based on the HIVNET 012 nevirapine regimen have been gradually set up in the Western Cape from January 2001 lessons learned in this region could be useful in other settings. Therefore the objectives of this study were: (i) to explore barriers limitations pitfalls and potential solutions in implementing the single-dose nevirapine regimen for PMTCT; and (ii) to propose and discuss potential solutions to overcome the drawbacks and improve implementation at other sites. (excerpt)