A cluster-randomized trial of enhanced labor ward-based PMTCT services to increase nevirapine coverage in Lusaka, Zambia

AIDS
Karen M MegazziniJeffrey S A Stringer

Abstract

Determine whether enhanced labor ward-based services for prevention of mother-to-child transmission of HIV (PMTCT) would improve nevirapine (NVP) coverage. Cluster-randomized trial at 12 public-sector delivery centers in Lusaka, Zambia. Following a baseline surveillance period, 12 labor wards were randomized, six to offer opt-in HIV testing to women of unknown serostatus (with NVP administration as indicated) and to assess NVP adherence among known HIV-infected women. The six control labor wards provided the standard of care. The NVP coverage endpoint was defined as the proportion of HIV-infected/exposed women/infant pairs with confirmed NVP ingestion. We used generalized estimating equations (GEE) to determine the odds of coverage associated with the intervention and ultimately used the parameters for the estimated GEE model to estimate relative risk. Between October 2005 and January 2006, 7664 women gave birth at participating clinics. We collected anonymous-linked blood from 7592 (99%) umbilical cords; tested 7438 (97%) for HIV, 1618 (22%) were seropositive, and of these, 1279 (79%) were tested for NVP. At baseline (preintervention), the probability of HIV-infected/exposed women/infant pairs receiving NVP in treatment clinic...Continue Reading

References

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Jul 2, 2009·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Karen M MegazziniJeffrey S A Stringer

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Citations

Jan 18, 2013·HIV/AIDS : Research and Palliative Care·Michael L Scanlon, Rachel C Vreeman
Aug 23, 2011·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Sten H Vermund
May 17, 2013·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Sten H VermundCarolyn M Audet

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