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> (2007-2009) >
Operational effecti...
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Jackson, Debra J.
(författare)
Operational effectiveness and 36 week HIV-free survival in the South African programme to prevent mother-to-child transmission of HIV-1
- Artikel/kapitelEngelska2007
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Nummerbeteckningar
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LIBRIS-ID:oai:DiVA.org:uu-97660
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-97660URI
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Språk:engelska
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Sammanfattning på:engelska
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:art swepub-publicationtype
Anmärkningar
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OBJECTIVE: Previous studies on the operational effectiveness of programmes to reduce transmission of HIV from mother-to-child (PMTCT) in Africa have generally been hospital-based pilot studies with short follow-up periods. METHOD: Prospective cohort study to evaluate the routine operational effectiveness of the South African National PMTCT Programme, primarily measured by HIV-free survival at 36 weeks post-delivery. Three of eighteen pilot sites participating in the programme were selected as they reflected differences in circumstances, such as HIV prevalence, socioeconomic status and rural-urban location. A total of 665 HIV-positive mothers and their infants were followed. RESULTS: HIV-free survival at 36 weeks varied significantly across sites with 84% in Paarl, 74% in Umlazi and 65% in Rietvlei (P = 0.0003). Maternal viral load was the single most important factor associated with HIV transmission or death [hazard ratio (HR), 1.54; 95% confidence interval (CI), 1.21-1.95]. Adjusting for health system variables (fewer than four antenatal visits and no antenatal syphilis test) explained the difference between Rietvlei and Paarl (crude HR, 2.27; 95% CI, 1.36-3.77; adjusted HR, 1.81; 95% CI, 0.93-3.50). Exposure to breastmilk feeding explained the difference between Umlazi and Paarl (crude HR, 1.74; 95% CI, 1.06-2.84; adjusted HR, 1.41; 95% CI, 0.81-2.48). CONCLUSION: Ever breastfeeding and underlying inequities in healthcare quality within South Africa are predictors of PMTCT programme performance and will need to be addressed to optimize PMTCT effectiveness.
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Biuppslag (personer, institutioner, konferenser, titlar ...)
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Chopra, MickeyUppsala universitet,Institutionen för kvinnors och barns hälsa(Swepub:uu)micho169
(författare)
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Doherty, Tanya
(författare)
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Colvin, Mark S.E.
(författare)
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Levin, Jonathan B.
(författare)
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Willumsen, Juana F.
(författare)
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Goga, Ameena E.
(författare)
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Moodley, Pravi
(författare)
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Uppsala universitetInstitutionen för kvinnors och barns hälsa
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:AIDS21:4, s. 509-5160269-93701473-5571
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AIDS
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