| dc.contributor |
Médecins sans Frontières-Luxembourg, Thyolo district, Luxembourg, Malawi. m.manzi@belgacom.net |
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| dc.creator |
Manzi, M |
|
| dc.creator |
Zachariah, R |
|
| dc.creator |
Teck, R |
|
| dc.creator |
Buhendwa, L |
|
| dc.creator |
Kazima, J |
|
| dc.creator |
Bakali, E |
|
| dc.creator |
Firmenich, P |
|
| dc.creator |
Humblet, P |
|
| dc.date |
2005-12 |
|
| dc.date.accessioned |
2017-01-31T07:09:28Z |
|
| dc.date.available |
2017-01-31T07:09:28Z |
|
| dc.identifier |
High acceptability of voluntary counselling and HIV-testing but unacceptable loss to follow up in a prevention of mother-to-child HIV transmission programme in rural Malawi: scaling-up requires a different way of acting. 2005, 10 (12):1242-50 Trop. Med. Int. Health |
|
| dc.identifier |
1360-2276 |
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| dc.identifier |
16359404 |
|
| dc.identifier |
10.1111/j.1365-3156.2005.01526.x |
|
| dc.identifier |
http://hdl.handle.net/10144/17663 |
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| dc.identifier |
http://fieldresearch.msf.org/msf/handle/10144/17663 |
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| dc.identifier |
Tropical Medicine & International Health |
|
| dc.identifier.uri |
http://dspace.mediu.edu.my:8181/xmlui/handle/10144/17663 |
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| dc.description |
SETTING: Thyolo District Hospital, rural Malawi. OBJECTIVES: In a prevention of mother-to-child HIV transmission (PMTCT) programme, to determine: the acceptability of offering 'opt-out' voluntary counselling and HIV-testing (VCT); the progressive loss to follow up of HIV-positive mothers during the antenatal period, at delivery and to the 6-month postnatal visit; and the proportion of missed deliveries in the district. DESIGN: Cohort study. METHODS: Review of routine antenatal, VCT and PMTCT registers. RESULTS: Of 3136 new antenatal mothers, 2996 [96%, 95% confidence interval (CI): 95-97] were pre-test counselled, 2965 (95%, CI: 94-96) underwent HIV-testing, all of whom were post-test counselled. Thirty-one (1%) mothers refused HIV-testing. A total of 646 (22%) individuals were HIV-positive, and were included in the PMTCT programme. Two hundred and eighty-eight (45%) mothers and 222 (34%) babies received nevirapine. The cumulative loss to follow up (n=646) was 358 (55%, CI: 51-59) by the 36-week antenatal visit, 440 (68%, CI: 64-71) by delivery, 450 (70%, CI: 66-73) by the first postnatal visit and 524 (81%, CI: 78-84) by the 6-month postnatal visit. This left just 122 (19%, CI: 16-22) of the initial cohort still in the programme. The great majority (87%) of deliveries occurred at peripheral sites where PMTCT was not available. CONCLUSIONS: In a rural district hospital setting, at least 9 out of every 10 mothers attending antenatal services accepted VCT, of whom approximately one-quarter were HIV-positive and included in the PMTCT programme. The progressive loss to follow up of more than three-quarters of this cohort by the 6-month postnatal visit demands a 'different way of acting' if PMTCT is to be scaled up in our setting. |
|
| dc.language |
en |
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| dc.publisher |
Wiley-Blackwell |
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| dc.relation |
http://www.blackwell-synergy.com/loi/tmi |
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| dc.rights |
Archived on this site with the kind permission of Wiley-Blackwell |
|
| dc.title |
High acceptability of voluntary counselling and HIV-testing but unacceptable loss to follow up in a prevention of mother-to-child HIV transmission programme in rural Malawi: scaling-up requires a different way of acting. |
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