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

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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

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dc.contributor.author Ruton, Hinda
dc.contributor.author Mugwaneza, Placidie
dc.contributor.author Shema, Nadine
dc.contributor.author Lyambabaje, Alexandre
dc.contributor.author Bizimana, Jean de Dieu
dc.contributor.author Tsague, Landry
dc.contributor.author Nyankesha, Elevanie
dc.contributor.author Wagner, Claire M
dc.contributor.author Mutabazi, Vincent
dc.contributor.author Nyemazi, Jean Pierre
dc.contributor.author Nsanzimana, Sabin
dc.contributor.author Karema, Corine
dc.contributor.author Binagwaho, Agnes
dc.date.accessioned 2012-09-10T18:16:54Z
dc.date.issued 2012
dc.identifier.citation Ruton, Hinda, Placidie Mugwaneza, Nadine Shema, Alexandre Lyambabaje, Jean de Dieu Bizimana, Landry Tsague, Elevanie Nyankesha, et al. 2012. 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. Journal of the International AIDS Society 15: 4. en_US
dc.identifier.issn 1758-2652 en_US
dc.identifier.uri http://nrs.harvard.edu/urn-3:HUL.InstRepos:9527629
dc.description.abstract 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. en_US
dc.language.iso en_US en_US
dc.publisher BioMed Central en_US
dc.relation.isversionof http://www.jiasociety.org/index.php/jias en_US
dc.relation.hasversion http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3293013/pdf/ en_US
dash.license LAA
dc.subject children and HIV en_US
dc.subject vertical transmission of HIV en_US
dc.subject PMTCT en_US
dc.subject programme effectiveness en_US
dc.subject elimination of MTCT en_US
dc.subject HIV-free survival en_US
dc.subject Africa en_US
dc.subject Rwanda en_US
dc.title 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 en_US
dc.type Journal Article en_US
dc.description.version Version of Record en_US
dc.relation.journal Journal of the International AIDS Society en_US
dash.depositing.author Binagwaho, Agnes
dc.date.available 2012-09-10T18:16:54Z

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