Show simple item record

dc.contributor.advisor Cunningham, Coleen en_US
dc.contributor.author Dow, Dorothy Elizabeth en_US
dc.date.accessioned 2012-05-25T20:09:12Z
dc.date.available 2013-05-20T04:30:05Z
dc.date.issued 2012 en_US
dc.identifier.uri http://hdl.handle.net/10161/5432
dc.description Thesis en_US
dc.description.abstract <p>Background: In Tanzania, 70% of the estimated 84,000 HIV-infected pregnant women who deliver annually receive some intervention to prevent mother to child transmission (PMTCT) of HIV. Few data exist concerning the effectiveness of various treatment approaches in a field setting across a large geographic area. Dried blood spot (DBS) HIV DNA PCR testing of HIV-exposed infants was first rolled out in Tanzania in 2008. Using data gathered for DBS testing, we evaluated the prevalence of perinatal HIV transmission based on PMTCT regimen across three regions of Tanzania.</p><p>Methods: This was a retrospective review of all mother/infant pairs enrolled in the National PMTCT program in the Kilimanjaro, Arusha, and Tanga Regions of Tanzania from January 1, 2008 to September 30, 2010. Enrollment registries at health facilities that submit DBS PCR were reviewed to document infant date of birth, weight, feeding practice, maternal and infant PMTCT regimen, and date and result of first DBS PCR. The present analysis included mother/infant pairs for whom DBS PCR was performed at infant age < 75 days. Maternal ARV regimens included: 1) none; 2) single-dose nevirapine (sdNVP); 3) sdNVP + zidovudine (combination prophylaxis); or 4) highly active antiretroviral therapy (HAART).</p><p>Results: In this field setting PMTCT is working better than hypothesized based on clinical trial results. Overall seroprevalence was 6.4% HIV transmission in the first 75 days of life. Women on HAART had the lowest transmission (2.1%), followed by those receiving combination prophylaxis (3.9%), sdNVP (8.9%), and no treatment having the highest rates (15.8%).</p><p>Conclusion: PMTCT regimens in resource-limited settings are effective and transmission rates are less than demonstrated by clinical trials data. Use of DBS for diagnosis of HIV provides an opportunity to evaluate use and effectiveness of PMTCT regimens.</p> en_US
dc.subject Public health en_US
dc.subject DNA HIV PCR en_US
dc.subject Early Infant Diagnosis en_US
dc.subject Neonatal HIV transmission en_US
dc.subject Nevirapine en_US
dc.subject PMTCT en_US
dc.subject Tanzania en_US
dc.title Performance of PMTCT Among HIV Exposed Infants in Tanzania en_US
dc.type Thesis en_US
dc.department Global Health en_US
duke.embargo.months 12 en_US

Files in this item

This item appears in the following Collection(s)

Show simple item record