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Is single-dose NVP relevant in the era of more efficacious PMTCT regimens? Lessons from Zambia

Is single-dose NVP relevant in the era of more efficacious PMTCT regimens? Lessons from Zambia
Is single-dose NVP relevant in the era of more efficacious PMTCT regimens? Lessons from Zambia
For almost a decade, single-dose nevirapine (sdNVP) has been proven to be a safe and effective drug for the prevention of mother-to-child transmission (PMTCT) of HIV. With the advent of the use of more efficacious combination therapy strategy in reducing mother-to-child transmission, sdNVP has been relegated as a lower tier intervention. Availability of infrastructural capacity coupled with the practical reality that very few women attend an antenatal clinic more than once makes universal implementation of combination therapy a challenge. This retrospective review examined PMTCT programmatic indicators following the introduction of sdNVP at first contact in selected sites. Data from 79 PMTCT sites was reviewed from April 2006 to March 2007 (when sdNVP was offered only after 32 weeks) and compared to the period of April 2007–March 2008. In the pre-intervention period (April 2006–March 2007), the monthly average of pregnant women who received sdNVP per site was 5.02. Post-intervention (April 2007–March 2008), the monthly average increased by 59% to 7.97 (p-value<0.05). In pre-intervention period when sdNVP was dispensed at 32 weeks, the average proportion of pregnant women who received antiretroviral prophylaxis was 59%. This increased to 82% after the intervention. Current systems for dispensing sdNVP may be used as a foundation for implementation of more efficacious PMTCT regimens. The sdNVP administered at first contact should be a safety net for women who are unable to receive more efficacious regimen.
hiv, perinatal, mother-to-child transmission, nevirapine, zambia
0954-0121
166-169
Torpey, K.
1dee28b1-d9d8-41eb-a490-acba68f88772
Kasonde, P.
f08d6852-984e-4025-bc39-7034a9ab4519
Dirks, R.
dde25e63-43c6-4dd1-9a53-b5dc8cdac251
Bweupe, M.
bc4dd31b-8075-4c9d-af55-48bdeb787c0f
Kabaso, M.
180b4c6b-f956-4d1e-a371-ea03917ad42a
Mandala, J.
c8407ecb-6459-4332-96fa-73045f8cdb48
Sangiwa, G.
7bdafcc5-7c46-46d9-af48-112dc49c298b
Torpey, K.
1dee28b1-d9d8-41eb-a490-acba68f88772
Kasonde, P.
f08d6852-984e-4025-bc39-7034a9ab4519
Dirks, R.
dde25e63-43c6-4dd1-9a53-b5dc8cdac251
Bweupe, M.
bc4dd31b-8075-4c9d-af55-48bdeb787c0f
Kabaso, M.
180b4c6b-f956-4d1e-a371-ea03917ad42a
Mandala, J.
c8407ecb-6459-4332-96fa-73045f8cdb48
Sangiwa, G.
7bdafcc5-7c46-46d9-af48-112dc49c298b

Torpey, K., Kasonde, P., Dirks, R., Bweupe, M., Kabaso, M., Mandala, J. and Sangiwa, G. (2010) Is single-dose NVP relevant in the era of more efficacious PMTCT regimens? Lessons from Zambia. AIDS Care, 22 (2), 166-169. (doi:10.1080/09540120903038341). (PMID:20390495)

Record type: Article

Abstract

For almost a decade, single-dose nevirapine (sdNVP) has been proven to be a safe and effective drug for the prevention of mother-to-child transmission (PMTCT) of HIV. With the advent of the use of more efficacious combination therapy strategy in reducing mother-to-child transmission, sdNVP has been relegated as a lower tier intervention. Availability of infrastructural capacity coupled with the practical reality that very few women attend an antenatal clinic more than once makes universal implementation of combination therapy a challenge. This retrospective review examined PMTCT programmatic indicators following the introduction of sdNVP at first contact in selected sites. Data from 79 PMTCT sites was reviewed from April 2006 to March 2007 (when sdNVP was offered only after 32 weeks) and compared to the period of April 2007–March 2008. In the pre-intervention period (April 2006–March 2007), the monthly average of pregnant women who received sdNVP per site was 5.02. Post-intervention (April 2007–March 2008), the monthly average increased by 59% to 7.97 (p-value<0.05). In pre-intervention period when sdNVP was dispensed at 32 weeks, the average proportion of pregnant women who received antiretroviral prophylaxis was 59%. This increased to 82% after the intervention. Current systems for dispensing sdNVP may be used as a foundation for implementation of more efficacious PMTCT regimens. The sdNVP administered at first contact should be a safety net for women who are unable to receive more efficacious regimen.

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More information

e-pub ahead of print date: 26 January 2010
Published date: February 2010
Keywords: hiv, perinatal, mother-to-child transmission, nevirapine, zambia
Organisations: Mathematical Sciences

Identifiers

Local EPrints ID: 353690
URI: http://eprints.soton.ac.uk/id/eprint/353690
ISSN: 0954-0121
PURE UUID: 64b0049a-a378-4c88-a9c7-fe729c969a83

Catalogue record

Date deposited: 13 Jun 2013 15:05
Last modified: 09 Jan 2022 02:17

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Contributors

Author: K. Torpey
Author: P. Kasonde
Author: R. Dirks
Author: M. Bweupe
Author: M. Kabaso
Author: J. Mandala
Author: G. Sangiwa

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