Progress Toward Eliminating Mother to Child Transmission of HIV in Kenya: Review of Treatment Guidelines Uptake and Pediatric Transmission Between 2013 and 2016-A Follow Up.

Journal: Maternal and child health journal

Volume: 22

Issue: 12

Year of Publication: 2018

Affiliated Institutions:  Department of Community Medicine, Low Cost Effective Care Unit, Christian Medical College, Schell Eye Hospital Campus, Vellore, Tamil Nadu, India. rubykarl@yahoo.com. Department of Family Medicine, University of Kansas Medical Center, Kansas City, KS, USA. Global Health Innovations, Kansas City, USA.

Abstract summary 

Background Prevention of mother to child transmission of HIV (PMTCT) services are critical to achieve national and global targets of 90% antiretroviral therapy (ART) coverage in PMTCT, and mother to child transmission rates less than 5%. In 2012, Kenya adopted WHO's recommended ART regimen for PMTCT "Option B+". Aims This study assesses progress made in adopting these new guidelines and associated outcomes. Methods We analysed programmatic data of 2604 mother-infant pairs enrolled in the HIV Infant Tracking System (HITSystem) at four government hospitals in Kenya between January, 2013 and December, 2016. We then compared PMTCT trends between 2010 and 2012 and 2013-2016 for the same four government hospitals. Results A total of 2,371 (91.1%) received some ART regimen, however; only 911 (56.2%) mothers received ART regimens compliant with WHO Option B+. From 2013 to 2016, the percent of mothers on WHO Option B + doubled from 42 to 84% (p < 0.001), the mean week of ART initiation decreased from 19.0 to 9.7 weeks (p < 0.001), the percent of pregnant women who were already on ART at the time of PMTCT enrolment increased from 5.8 to 31.7% (p < 0.001), and the paediatric transmission rate decreased from 5.9 to 2.5% (p = 0.002). Conclusion Comparing data at these four Kenyan hospitals indicates significant progress has been made from 2010 to 2016. To continue these positive gains, concerted focus will be needed to target and improve the integration of new guidelines into clinical practice at the facility level, adherence to treatment and retention in care.

Authors & Co-authors:  Pricilla Brown Wexler Maloba Gautney Finocchario-Kessler

Study Outcome 

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Statistics
Citations :  AVERT. (2017). PMTCT of HIV (2017). https://www.avert.org/professionals/hiv-programming/prevention/prevention-mother-child. Accessed 10 January 2018.
Authors :  6
Identifiers
Doi : 10.1007/s10995-018-2612-0
SSN : 1573-6628
Study Population
Women,Mothers
Mesh Terms
Adult
Other Terms
Gestational week of initiation;Option B+;Pediatric HIV transmission;Preventing mother to child transmission (PMTCT);WHO guidelines
Study Design
Study Approach
Country of Study
Kenya
Publication Country
United States