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Journal of Tropical Pediatrics Advance Access originally published online on July 13, 2009
Journal of Tropical Pediatrics 2010 56(1):43-52; doi:10.1093/tropej/fmp054
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© The Author [2009]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Evaluation of a 5-year Programme to Prevent Mother-to-child Transmission of HIV Infection in Northern Uganda

Laurence Ahouaa, Harriet Ayikorua,b, Katherine Gnauckb, Grace Odaruc, Emmanuel Odarc, Christine Ondoa–Onamac, Loretxu Pinogesa, Suna Balkand, David Olsond and Mar Pujades-Rodrígueza

aEpicentre, Paris, France
bMédecins Sans Frontières, Kampala, Uganda
cArua Regional District Hospital, Ministry of Health, Arua, Uganda
dMédecins Sans Frontières, Paris, France

Correspondence: Laurence Ahoua, Epicentre, 8 rue Saint Sabin, 75011 Paris, France. Tel.: +33 1 40 21 28 48. E-mail: <laurence.ahoua{at}epicentre.msf.org>.


  Abstract

Prevention of mother-to-child transmission (PMTCT) is essential in HIV/AIDS control. We analysed 2000-05 data from mother-infant pairs in our PMTCT programme in rural Uganda, examining programme utilization and outcomes, HIV transmission rates and predictors of death or loss to follow-up (LFU). Out of 19 017 women, 1 037 (5.5%) attending antenatal care services tested HIV positive. Of these, 517 (50%) enrolled in the PMTCT programme and gave birth to 567 infants. Before tracing, 303 (53%) mother–infant pairs were LFU. Reasons for dropout were infant death and lack of understanding of importance of follow-up. Risk of death or LFU was higher among infants with no or incomplete intrapartum prophylaxis (OR = 1.90, 95% CI 1.07–3.36) and of weaning age <6 months (OR 2.55, 95% CI 1.42–4.58), and lower in infants with diagnosed acute illness (OR 0.30, 95% CI 0.16–0.55). Mother-to-child HIV cumulative transmission rate was 8.3%, and 15.5% when HIV-related deaths were considered. Improved tracking of HIV-exposed infants is needed in PMTCT programmes where access to early infant diagnosis is still limited.


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