| Public health lessons from a pilot programme to reduce mother-to-child transmission of HIV-1 in Khayelitsha. | |
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MedLine Citation:
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PMID: 11544974 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Short-course antiretroviral therapy (ART) has been shown to be effective in reducing mother-to-child transmission (MTCT) of HIV-1. This article details the public health lessons learnt from a district-based pilot programme where a short-course zidovudine (ZDV) regimen has been used in a typical South African peri-urban setting. METHODS: The pilot programme was initiated at two midwife obstetric units in January 1999. Lay counsellors conducted pre- and post-test counselling and nurses took blood for HIV enzyme-linked immunosorbent assay (ELISA) testing. Short-course ZDV was administered antenatally (from 36 weeks' gestation) and during labour. Mother-infant pairs were followed up at eight child health clinics where free formula feed was dispensed weekly. Infants received co-trimoxazole prophylaxis and were ELISA tested for HIV at 9 and 18 months. After 17 months protocol changes aimed at eliminating weaknesses included initiation of ZDV at 34 weeks, self-administration of the first dose of ZDV with the onset of labour, and rapid HIV testing for both mothers and infants. RESULTS: Voluntary counselling and testing was shown to be highly acceptable, with individual counselling more effective than group counselling. Based on less than optimal availability of records, ZDV utilisation was encouraging with up to 59% of subjects initiating treatment, 3 weeks' median duration of ZDV use, and up to 88% receiving at least one intrapartum ZDV dose. Self-administration of the intrapartum dose reached 41%. CONCLUSIONS: Short-course antenatal and intrapartum ART to prevent MTCT of HIV1 was shown to be feasible. |
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Authors:
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M F Abdullah; T Young; L Bitalo; N Coetzee; J E Myers |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde Volume: 91 ISSN: 0256-9574 ISO Abbreviation: S. Afr. Med. J. Publication Date: 2001 Jul |
Date Detail:
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Created Date: 2001-09-06 Completed Date: 2001-09-20 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 0404520 Medline TA: S Afr Med J Country: South Africa |
Other Details:
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Languages: eng Pagination: 579-83 Citation Subset: IM |
Affiliation:
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Department of Public Health and Primary Health Care, Faculty of Health Sciences, University of Cape Town. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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AIDS Serodiagnosis Anti-HIV Agents / administration & dosage* Counseling Female HIV Infections / drug therapy*, prevention & control, transmission Health Plan Implementation Humans Infectious Disease Transmission, Vertical / prevention & control* Outcome Assessment (Health Care)* Pilot Projects Pregnancy Prenatal Care* South Africa Zidovudine / administration & dosage* |
| Chemical | |
Reg. No./Substance:
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0/Anti-HIV Agents; 30516-87-1/Zidovudine |
| Comments/Corrections | |
Comment In:
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S Afr Med J. 2001 Jul;91(7):529
[PMID:
11544955
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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