Effectiveness of a project to prevent HIV vertical transmission in the Republic of Congo
| Autor: | Bisio, F., Masini, G., Vacca, E. B., Calzi, A., Cardinale, F., Bruzzone, B., Bruzzi, P., Viscoli, C., Kento-Mwana, K., Nkouendolo, J. P., Moutou, J., Banguissa, H., Nicolini, L., Schenone, E., Repetto, E., Montaldo, C., Ferrando, S., Righi, E., Dentone, C., Farinella, S. T., Vitale, F., Izzo, M., Mularoni, A., Mikulska, M., Di Stefano, L., Malfatto, E., Bernardini, C., Ginocchio, F., Secondo, G., Delfino, E., Nicco, E., Prinapori, R., Parisini, A., De Hoffer, L., Mesini, A., Grignolo, S., Taramasso, L., Giacobbe, D. R., Artom, F., Dini, S., Beltrame, A., Ratto, S., Mbongou, F. A. M., Miguel, L. M., Nzagou, A. C., Mayembo, P., Ibata, D., Ventura, A., Nigro, N., Andrei, C., Icardi, G. |
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| Přispěvatelé: | Bisio, F, Masini, G, Blasi Vacca, E, Calzi, A, Cardinale, F, Bruzzone, B, Bruzz, P, Viscoli, C, Kento-Mwana group. Collaborators: Nkouendolo, JP, Moutou, J, Banguissa, H, Nicolini, L, Schenone, E, Repetto, E, Montaldo, C, Ferrando, S, Righi, E, Dentone, C, Farinella, ST, Vitale, F, Izzo, M, Mularoni, A, Mikulska, M, Di Stefano, L, Malfatto, E, Bernardini, C, Ginocchio,F, Secondo, G, Delfino, E, Nicco, E, Prinapori, R, Parisini, A, De Hoffer, L, esini A, Grignolo S, Taramasso L, Giacobbe DR, Artom F, Dini S, Beltrame A, Ratto S, Mbongou FA, Miguel LM, Nzagou AC, Mayembo P, Ibata D, Ventura A, Nigro N, Andrei C, Icardi G. |
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Male
Infectious Disease Transmission PMTCT Human immunodeficiency virus (HIV) HIV Infections medicine.disease_cause Settore MED/42 - Igiene Generale E Applicata law.invention law Pregnancy Vertical Pharmacology (medical) Prospective Studies Pregnancy Complications Infectious Prospective cohort study Attrition Drop-out Lost to follow-up Mother-to-child transmission Congo Female Humans Infant Infant Newborn Infectious Disease Transmission Vertical Patient Acceptance of Health Care Patient Compliance Health Services Research Pharmacology Infectious Diseases Infectious drop-out Transmission (mechanics) Microbiology (medical) attrition HIV prevention vertical transmission republic of Congo Transmission rate Target population Prenatal care medicine lost to follow-up business.industry mother-to-child transmission medicine.disease Newborn Pregnancy Complications Immunology business Demography |
| Popis: | OBJECTIVES: To evaluate the effectiveness of a prevention programme against the vertical transmission of HIV in a resource-limited setting and to investigate variables associated with compliance. PATIENTS AND METHODS: The Kento-Mwana project (2005-2008) provided counselling, serological and biomolecular testing and prophylaxis/therapy to HIV-positive pregnant women and their children attending four antenatal clinics in Pointe Noire, Republic of Congo. Expected and actual rates of vertical transmission of HIV were compared. Univariate and multivariate analyses were performed in order to identify variables associated with non-compliance. RESULTS: The observed transmission rate in the group who completed follow-up was 5/290 (1.7%, 95% CI 0.6%-4.1%). The overall estimated transmission rate in the target population, computed taking into account the expected vertical transmission of HIV among drop-outs, was 67-115/638 (10.5%-18.0%). A comparison between this rate and the expected transmission rate in the absence of intervention (25%-40%) showed that the programme was able to prevent approximately 50% of vertical transmissions. Older age (OR 0.33, 95% CI 0.16-0.66, P = 0.002), telephone availability (OR 0.42, 95% CI 0.24-0.72, P = 0.002) and occupation (OR 0.57, 95% CI 0.29-1.10, P = 0.092) were associated with better compliance. CONCLUSIONS: Despite the vast majority of women accepting counselling and testing, many of them refused prophylaxis or dropped out, thus reducing the effectiveness of the intervention from an ideal 2% to a still important but less impressive median transmission rate of 15% (range 10.5%-18%). Promoting participation and compliance, rather than increasing the potency of antiretroviral regimens, is crucial for preventing the vertical transmission of HIV in Africa |
| Databáze: | OpenAIRE |
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