OBJECTIVE: Prevention-of-mother-to-child transmission (PMTCT) interventions based on single-dose nevirapine (NVP) are widely implemented in Africa, but strategies differ regarding how and when to administer the drug to women and infants. The aim of this study was to analyze the outcome of different strategies with regard to NVP intake in pregnant women and their infants in Tanzania and Uganda. METHODS: In an observational study carried out between March 2002 and December 2004, we compared a directly observed NVP administration strategy in Tanzania (supervised NVP intake for women and infants at a health unit) and a semi-observed administration strategy (self-administered NVP for women at home and supervised intake for infants at a health unit) in Uganda. RESULTS: The proportions of HIV-positive women accepting receipt of NVP from the health units were similar in the 2 countries (42.4% in Tanzania vs 45.6% in Uganda; P = .06). NVP intake in infants was significantly higher in Tanzania than in Uganda (43.7% vs 24.1%; P > .001). In a multivariate analysis, maternal age above 25 years, secondary education, Catholic faith, and having undergone PMTCT counseling at a hospital were independently associated with infant NVP intake. CONCLUSION: In our settings, the directly observed administration strategy resulted in a higher NVP intake in infants. The semi-observed strategy, which implies that, after home delivery, the infant has to be presented to a health unit for NVP administration, was less successful.
OBJECTIVE: Prevention-of-mother-to-child transmission (PMTCT) interventions based on single-dose nevirapine (NVP) are widely implemented in Africa, but strategies differ regarding how and when to administer the drug to women and infants. The aim of this study was to analyze the outcome of different strategies with regard to NVP intake in pregnant women and their infants in Tanzania and Uganda. METHODS: In an observational study carried out between March 2002 and December 2004, we compared a directly observed NVP administration strategy in Tanzania (supervised NVP intake for women and infants at a health unit) and a semi-observed administration strategy (self-administered NVP for women at home and supervised intake for infants at a health unit) in Uganda. RESULTS: The proportions of HIV-positive women accepting receipt of NVP from the health units were similar in the 2 countries (42.4% in Tanzania vs 45.6% in Uganda; P = .06). NVP intake in infants was significantly higher in Tanzania than in Uganda (43.7% vs 24.1%; P > .001). In a multivariate analysis, maternal age above 25 years, secondary education, Catholic faith, and having undergone PMTCT counseling at a hospital were independently associated with infant NVP intake. CONCLUSION: In our settings, the directly observed administration strategy resulted in a higher NVP intake in infants. The semi-observed strategy, which implies that, after home delivery, the infant has to be presented to a health unit for NVP administration, was less successful.
Authors: M Manzi; R Zachariah; R Teck; L Buhendwa; J Kazima; E Bakali; P Firmenich; P Humblet Journal: Trop Med Int Health Date: 2005-12 Impact factor: 2.622
Authors: Jeffrey S A Stringer; Moses Sinkala; Julia P Stout; Robert L Goldenberg; Edward P Acosta; Victoria Chapman; Rosemary Kumwenda-Phiri; Sten H Vermund Journal: J Acquir Immune Defic Syndr Date: 2003-04-15 Impact factor: 3.731
Authors: S H Eshleman; M Mracna; L A Guay; M Deseyve; S Cunningham; M Mirochnick; P Musoke; T Fleming; M Glenn Fowler; L M Mofenson; F Mmiro; J B Jackson Journal: AIDS Date: 2001-10-19 Impact factor: 4.177
Authors: Elizabeth M Stringer; Moses Sinkala; Jeffrey S Stringer; Elizabeth Mzyece; Ida Makuka; Robert L Goldenberg; Pascal Kwape; Martha Chilufya; Sten H Vermund Journal: AIDS Date: 2003-06-13 Impact factor: 4.177