Evaluation of the prevention of mother-to-child transmission programme at a primary health care centre in South Africa

Abstract

Aim: To evaluate the effectiveness of the prevention of mother-to-child  transmission (PMTCT) of the HIV programme at Levai Mbatha Community Health Centre (CHC), Evaton, South Africa.
Methods: A retrospective analysis of HIV-infected mother–infant pairs was  conducted between 1 August 2009 and 31 July 2010. The infants’ HIV status was determined using HIV-specific qualitative DNA polymerase chain reaction (PCR). Demographic characteristics, mode of mother to child transmission (MTCT), choice of infant feeding, mode of delivery and CD4 count were included.
Results: Of the 206 mothers, 10 infants had positive DNA PCR results at 6 weeks. The MTCT rate was 4.9%. The mean age of HIVinfected mothers was 28 years (SD 5.7, range 16–42 years). Overall, 74.2% (152) of HIV-positive mothers received dual therapy and 28.8% (53) were on HAART alone. Mothers with CD4 count < 200cells/μl (OR = 0.09 [CI, 0.01–0.75]; p = 0.026) and lack of prophylaxis during labour (OR = 9.50 [CI, 1.59–56.66]; p = 0.013) were identified as significant risk factors associated with MTCT.
Conclusions: The PMTCT programme at Levai Mbatha CHC is effective in reducing the MTCT of HIV. Lack of ART prophylaxis and low CD4 count were the significant determinants of MTCT in the study.

Keywords: DNA PCR, HIV infection, prevention of mother-to-child transmission, rates, South Africa