PMID- 22289641
OWN - NLM
STAT- MEDLINE
DCOM- 20120724
LR  - 20220316
IS  - 1758-2652 (Electronic)
IS  - 1758-2652 (Linking)
VI  - 15
IP  - 1
DP  - 2012 Jan 30
TI  - HIV-free survival among nine- to 24-month-old children born to HIV-positive 
      mothers in the Rwandan national PMTCT programme: a community-based household 
      survey.
PG  - 4
LID - 10.1186/1758-2652-15-4 [doi]
AB  - BACKGROUND: Operational effectiveness of large-scale national programmes for the 
      prevention of mother to child transmission (PMTCT) of HIV in sub-Saharan Africa 
      remains limited. We report on HIV-free survival among nine- to 24-month-old 
      children born to HIV-positive mothers in the national PMTCT programme in Rwanda. 
      METHODS: We conducted a national representative household survey between February 
      and May 2009. Participants were mothers who had attended antenatal care at least 
      once during their most recent pregnancy, and whose children were aged nine to 24 
      months. A two-stage stratified (geographic location of PMTCT site, maternal HIV 
      status during pregnancy) cluster sampling was used to select mother-infant pairs 
      to be interviewed during household visits. Alive children born from HIV-positive 
      mothers (HIV-exposed children) were tested for HIV according to routine HIV 
      testing protocol. We calculated HIV-free survival at nine to 24 months. We 
      subsequently determined factors associated with mother to child transmission of 
      HIV, child death and HIV-free survival using logistic regression. RESULTS: Out of 
      1448 HIV-exposed children surveyed, 44 (3.0%) were reported dead by nine months 
      of age. Of the 1340 children alive, 53 (4.0%) tested HIV positive. HIV-free 
      survival was estimated at 91.9% (95% confidence interval: 90.4-93.3%) at nine to 
      24 months. Adjusting for maternal, child and health system factors, being a 
      member of an association of people living with HIV (adjusted odds ratio: 0.7, 95% 
      CI: 0.1-0.995) improved by 30% HIV-free survival among children, whereas the 
      maternal use of a highly active antiretroviral therapy (HAART) regimen for PMTCT 
      (aOR: 0.6, 95% CI: 0.3-1.07) had a borderline effect. CONCLUSIONS: HIV-free 
      survival among HIV-exposed children aged nine to 24 months is estimated at 91.9% 
      in Rwanda. The national PMTCT programme could achieve greater impact on child 
      survival by ensuring access to HAART for all HIV-positive pregnant women in need, 
      improving the quality of the programme in rural areas, and strengthening linkages 
      with community-based support systems, including associations of people living 
      with HIV.
FAU - Ruton, Hinda
AU  - Ruton H
AD  - Rwanda Biomedical Center, Kigali, Rwanda. rutonh@gmail.com
FAU - Mugwaneza, Placidie
AU  - Mugwaneza P
FAU - Shema, Nadine
AU  - Shema N
FAU - Lyambabaje, Alexandre
AU  - Lyambabaje A
FAU - de Dieu Bizimana, Jean
AU  - de Dieu Bizimana J
FAU - Tsague, Landry
AU  - Tsague L
FAU - Nyankesha, Elevanie
AU  - Nyankesha E
FAU - Wagner, Claire M
AU  - Wagner CM
FAU - Mutabazi, Vincent
AU  - Mutabazi V
FAU - Nyemazi, Jean Pierre
AU  - Nyemazi JP
FAU - Nsanzimana, Sabin
AU  - Nsanzimana S
FAU - Karema, Corine
AU  - Karema C
FAU - Binagwaho, Agnes
AU  - Binagwaho A
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120130
PL  - Switzerland
TA  - J Int AIDS Soc
JT  - Journal of the International AIDS Society
JID - 101478566
RN  - 0 (Anti-HIV Agents)
SB  - IM
MH  - Adult
MH  - Anti-HIV Agents/therapeutic use
MH  - Child, Preschool
MH  - Data Collection
MH  - Family Characteristics
MH  - Female
MH  - HIV Infections/drug therapy/*mortality/*prevention & control/transmission
MH  - Humans
MH  - Infant
MH  - *Infectious Disease Transmission, Vertical
MH  - Male
MH  - *National Health Programs
MH  - Pregnancy
MH  - *Program Evaluation
MH  - Residence Characteristics/statistics & numerical data
MH  - Rwanda
MH  - Young Adult
PMC - PMC3293013
EDAT- 2012/02/01 06:00
MHDA- 2012/07/25 06:00
PMCR- 2012/01/30
CRDT- 2012/02/01 06:00
PHST- 2011/04/23 00:00 [received]
PHST- 2012/01/30 00:00 [accepted]
PHST- 2012/02/01 06:00 [entrez]
PHST- 2012/02/01 06:00 [pubmed]
PHST- 2012/07/25 06:00 [medline]
PHST- 2012/01/30 00:00 [pmc-release]
AID - 1758-2652-15-4 [pii]
AID - 10.1186/1758-2652-15-4 [doi]
PST - epublish
SO  - J Int AIDS Soc. 2012 Jan 30;15(1):4. doi: 10.1186/1758-2652-15-4.