OBJECTIVE: We evaluated the impact of Option A on HIV-free infant survival and mother-to-child transmission (MTCT) in Zimbabwe. DESIGN: Serial cross-sectional community-based serosurveys. METHODS: We analyzed serosurvey data collected in 2012 and 2014 among mother-infant pairs from catchment areas of 132 health facilities from five of 10 provinces in Zimbabwe. Eligible infants (alive or deceased) were born 9-18 months before each survey to mothers at least 16 years old. We randomly selected mother-infant pairs and conducted questionnaires, verbal autopsies, and collected blood samples. We estimated the HIV-free infant survival and MTCT rate within each catchment area and compared the 2012 and 2014 estimates using a paired t test and number of HIV infections averted because of the intervention. RESULTS: We analyzed 7249 mother-infant pairs with viable maternal specimens collected in 2012 and 8551 in 2014. The mean difference in the catchment area level MTCT between 2014 and 2012 was -5.2 percentage points (95% confidence interval = -8.1, -2.3, P < 0.001). The mean difference in the catchment area level HIV-free survival was 5.5 percentage points (95% confidence interval = 2.6, 8.5, P < 0.001). Between 2012 and 2014, 1779 infant infections were averted compared with the pre-Option A regimen. The association between HIV-free infant survival and duration of Option A implementation was NS at the multivariate level (P = 0.093). CONCLUSION: We found a substantial and statistically significant increase in HIV-free survival and decrease in MTCT among infants aged 9-18 months following Option A rollout in Zimbabwe. This is the only evaluation of Option A and shows the effectiveness of Option A and Zimbabwe's remarkable progress toward eMTCT.
OBJECTIVE: We evaluated the impact of Option A on HIV-free infant survival and mother-to-child transmission (MTCT) in Zimbabwe. DESIGN: Serial cross-sectional community-based serosurveys. METHODS: We analyzed serosurvey data collected in 2012 and 2014 among mother-infant pairs from catchment areas of 132 health facilities from five of 10 provinces in Zimbabwe. Eligible infants (alive or deceased) were born 9-18 months before each survey to mothers at least 16 years old. We randomly selected mother-infant pairs and conducted questionnaires, verbal autopsies, and collected blood samples. We estimated the HIV-free infant survival and MTCT rate within each catchment area and compared the 2012 and 2014 estimates using a paired t test and number of HIV infections averted because of the intervention. RESULTS: We analyzed 7249 mother-infant pairs with viable maternal specimens collected in 2012 and 8551 in 2014. The mean difference in the catchment area level MTCT between 2014 and 2012 was -5.2 percentage points (95% confidence interval = -8.1, -2.3, P < 0.001). The mean difference in the catchment area level HIV-free survival was 5.5 percentage points (95% confidence interval = 2.6, 8.5, P < 0.001). Between 2012 and 2014, 1779 infant infections were averted compared with the pre-Option A regimen. The association between HIV-free infant survival and duration of Option A implementation was NS at the multivariate level (P = 0.093). CONCLUSION: We found a substantial and statistically significant increase in HIV-free survival and decrease in MTCT among infants aged 9-18 months following Option A rollout in Zimbabwe. This is the only evaluation of Option A and shows the effectiveness of Option A and Zimbabwe's remarkable progress toward eMTCT.
Authors: B Lopman; A Cook; J Smith; G Chawira; M Urassa; Y Kumogola; R Isingo; C Ihekweazu; J Ruwende; M Ndege; S Gregson; B Zaba; T Boerma Journal: J Epidemiol Community Health Date: 2009-10-23 Impact factor: 3.710
Authors: Benjamin H Chi; Patrick Musonda; Mwila K Lembalemba; Namwinga T Chintu; Matthew G Gartland; Saziso N Mulenga; Maximillian Bweupe; Eleanor Turnbull; Elizabeth M Stringer; Jeffrey S A Stringer Journal: Bull World Health Organ Date: 2014-06-05 Impact factor: 9.408
Authors: Jeffrey S A Stringer; Kathryn Stinson; Pius M Tih; Mark J Giganti; Didier K Ekouevi; Tracy L Creek; Thomas K Welty; Benjamin H Chi; Catherine M Wilfert; Nathan Shaffer; Elizabeth M Stringer; Francois Dabis; David Coetzee Journal: PLoS Med Date: 2013-05-07 Impact factor: 11.069
Authors: Michele A Sinunu; Erik J Schouten; Nellie Wadonda-Kabondo; Enock Kajawo; Michael Eliya; Kundai Moyo; Frank Chimbwandira; Lee Strunin; Scott E Kellerman Journal: PLoS One Date: 2014-06-26 Impact factor: 3.240
Authors: Benjamin H Chi; Wilbroad Mutale; Jennifer Winston; Winifreda Phiri; Joan T Price; Angel Mwiche; Helen Ayles; Jeffrey S A Stringer Journal: Pediatr Infect Dis J Date: 2018-11 Impact factor: 2.129
Authors: I Ochoa-Moreno; S Bautista-Arredondo; S I McCoy; R Buzdugan; C Mangenah; N S Padian; F M Cowan Journal: PLoS One Date: 2020-05-20 Impact factor: 3.240
Authors: Mary Mahy; Martina Penazzato; Andrea Ciaranello; Lynne Mofenson; Constantin T Yianoutsos; Mary-Ann Davies; John Stover Journal: AIDS Date: 2017-04 Impact factor: 4.177