A systematic review and document analysis on the prevention of mother-to-child programmes to prevent vertical transmission of human immuno-deficiency virus
- Authors: Sobetwa, Nwabisa Nokuzola
- Date: 2017
- Subjects: AIDS (Disease) in pregnancy , Maternal health services , HIV infections -- Children -- Transmission -- Prevention
- Language: English
- Type: Thesis , Masters , MSoc
- Identifier: http://hdl.handle.net/10353/7957 , vital:31282
- Description: Background: The National Strategic Plan 2012-2016 is advocating for zero new infections due to vertical transmission. This goal has not yet been achieved. This study evaluated whether the prevention of mother-to-child vertical transmission (PMTCT) of Human Immuno-deficiency Virus (HIV) programmes in South Africa are based on evidence. Aim: The aim of this study was to conduct a systematic review of the available literature comparing PMTCT antiretroviral regimens published between the years 2000 to 2015 and to do a document analysis of the current implemented PMTCT programme to evaluate if it is based on best evidence. Rational: The rational of the systematic review and the document analysis were to assess whether the latest PMTCT policy was based on evidence and to critically analyse published articles that addressed aspects related to efficacy and efficiency of PMTCT programmes to reduce transmission of HIV from mothers to their infants. Methods: Overall 25 randomised controlled trials and primary studies that assessed efficacy of ARV regimens to prevent mother-to-child transmission of the HIV during pregnancy, labour and the postnatal periods were systematically reviewed. In 1997 the first trial began and the last one ended in 2012. Twelve guidelines referring to PMTCT were sampled and they were published by WHO and Department of Health South Africa from 2001 to 2015. The document analysis was only based on National consolidated guidelines for the prevention of mother-to-child transmission of HIV (PMTCT) and the management of HIV in children, adolescents and adults April, 2015. Findings: The systematic review illustrated that significantly fewer infants tested HIV-positive when exposed to a longer ARV regime although there was no significant difference once the infants reached six months of age. Different ARVs have a similar Preamble effect on maternal deaths; however, a double or triple combination of ARVs is superior to monotherapy to decrease infant deaths. Common maternal adverse reactions to ARVs include anaemia, bronchopneumonia, and maculopapular rash. Infant adverse events included septicaemia, pneumonia, gastroenteritis, fever and maculopapular rash. The document analysis has shown that the PMTCT policy is mainly based on evidence from randomised controlled trials and systematic reviews. Occasionally some statements are still based on lower categories of evidence such as non-experimental descriptive studies. Conclusion: The systematic review showed that double and triple ARV therapy is superior to monotherapy and that the longer the mother and her infant are exposed to ARV therapy the better the results are to prevent MTCT. Adverse events are always posing a challenge and as with any other medication, caregivers must be aware of potential adverse reactions. The National consolidated guidelines for the prevention of mother-to-child transmission of HIV (PMTCT) and the management of HIV in children, adolescents and adults April 2015 is based on evidence, but the policy itself does not include any reference to evidence.
- Full Text:
- Authors: Sobetwa, Nwabisa Nokuzola
- Date: 2017
- Subjects: AIDS (Disease) in pregnancy , Maternal health services , HIV infections -- Children -- Transmission -- Prevention
- Language: English
- Type: Thesis , Masters , MSoc
- Identifier: http://hdl.handle.net/10353/7957 , vital:31282
- Description: Background: The National Strategic Plan 2012-2016 is advocating for zero new infections due to vertical transmission. This goal has not yet been achieved. This study evaluated whether the prevention of mother-to-child vertical transmission (PMTCT) of Human Immuno-deficiency Virus (HIV) programmes in South Africa are based on evidence. Aim: The aim of this study was to conduct a systematic review of the available literature comparing PMTCT antiretroviral regimens published between the years 2000 to 2015 and to do a document analysis of the current implemented PMTCT programme to evaluate if it is based on best evidence. Rational: The rational of the systematic review and the document analysis were to assess whether the latest PMTCT policy was based on evidence and to critically analyse published articles that addressed aspects related to efficacy and efficiency of PMTCT programmes to reduce transmission of HIV from mothers to their infants. Methods: Overall 25 randomised controlled trials and primary studies that assessed efficacy of ARV regimens to prevent mother-to-child transmission of the HIV during pregnancy, labour and the postnatal periods were systematically reviewed. In 1997 the first trial began and the last one ended in 2012. Twelve guidelines referring to PMTCT were sampled and they were published by WHO and Department of Health South Africa from 2001 to 2015. The document analysis was only based on National consolidated guidelines for the prevention of mother-to-child transmission of HIV (PMTCT) and the management of HIV in children, adolescents and adults April, 2015. Findings: The systematic review illustrated that significantly fewer infants tested HIV-positive when exposed to a longer ARV regime although there was no significant difference once the infants reached six months of age. Different ARVs have a similar Preamble effect on maternal deaths; however, a double or triple combination of ARVs is superior to monotherapy to decrease infant deaths. Common maternal adverse reactions to ARVs include anaemia, bronchopneumonia, and maculopapular rash. Infant adverse events included septicaemia, pneumonia, gastroenteritis, fever and maculopapular rash. The document analysis has shown that the PMTCT policy is mainly based on evidence from randomised controlled trials and systematic reviews. Occasionally some statements are still based on lower categories of evidence such as non-experimental descriptive studies. Conclusion: The systematic review showed that double and triple ARV therapy is superior to monotherapy and that the longer the mother and her infant are exposed to ARV therapy the better the results are to prevent MTCT. Adverse events are always posing a challenge and as with any other medication, caregivers must be aware of potential adverse reactions. The National consolidated guidelines for the prevention of mother-to-child transmission of HIV (PMTCT) and the management of HIV in children, adolescents and adults April 2015 is based on evidence, but the policy itself does not include any reference to evidence.
- Full Text:
The impact of HIV/AIDS on the delivery of maternal health care services of selected primary health care clinics of Peddie in the Eastern Cape Province
- Mangi, Nozuko Glenrose https://orcid.org/0000-0001-9158-8820
- Authors: Mangi, Nozuko Glenrose https://orcid.org/0000-0001-9158-8820
- Date: 2011
- Subjects: Maternal health services , Primary health care , HIV infections -- Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/24576 , vital:63209
- Description: The aim of this descriptive study was to explore the impact of HIV/AIDS on the maternal health programme at selected Primary Health Care (PHC) clinics in the Peddie sub-district, in the Eastern Cape, South Africa. This study showed that the HIV/AIDS epidemic has had major influences on the rendering of maternal health services in this sub-district. An understanding of the impact of HIV/AIDS on the delivery of the maternal health programme in the Peddie Primary Health Clinics will potentially help the District Health Service office, as well as the clinic managers and professional nurses to formulate strategies to strengthen the maternal health programme. This data will also be helpful when developing plans to cope with the heavy work-load of the clinics offering maternal health services, and to address the attitudes and concerns of the professional nurses working in the PHC clinics in this area. Thirty professional nurses working at 10 clinics responded to the questionnaires which elicited questions pertaining to the impact of HIV/AIDS on the rendering of their services. As part of the data gathering procedures, standardised notice boards at the PHC clinics were used to document the services rendered. The numbers of ANC clients attended to each of the clinics per week were collected in routine attendance tick registers used in the clinics for recording and monitoring statistics in the maternal health programme. The data was analysed to examine the possible impact of HIV/AIDS on maternal health services rendered by registered nurses/midwives working in the PHC clinics. The registered nurses who responded to the questionnaires (Annexure H) made several suggestions. These included the following: (i) encouraged more training (11 nurses), (ii) addition of more staff members, (iii) to have specialized staff for management of maternal HIV. Because of the study limitations such as the sample size of 10 clinics with a total of 30 nurses who were studied, the study may not be generalised to the whole of the Eastern Cape Province. The study however did provide baseline information on the impact of HIV/AIDS on the maternal health programme. The study findings were that HIV/AIDS has had an impact on the delivery of the maternal health programme due to the extra services brought about by the response to the HIV/AIDS pandemic. This study will contribute to a better understanding of the impact of HIV/AIDS on the maternal health programme at the PHC level in Peddie. The research provided insight into issues that are crucial to the delivery of maternal health programmes in rural areas. , Thesis (MCur) -- Faculty of Science and Agriculture, 2011
- Full Text:
- Authors: Mangi, Nozuko Glenrose https://orcid.org/0000-0001-9158-8820
- Date: 2011
- Subjects: Maternal health services , Primary health care , HIV infections -- Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/24576 , vital:63209
- Description: The aim of this descriptive study was to explore the impact of HIV/AIDS on the maternal health programme at selected Primary Health Care (PHC) clinics in the Peddie sub-district, in the Eastern Cape, South Africa. This study showed that the HIV/AIDS epidemic has had major influences on the rendering of maternal health services in this sub-district. An understanding of the impact of HIV/AIDS on the delivery of the maternal health programme in the Peddie Primary Health Clinics will potentially help the District Health Service office, as well as the clinic managers and professional nurses to formulate strategies to strengthen the maternal health programme. This data will also be helpful when developing plans to cope with the heavy work-load of the clinics offering maternal health services, and to address the attitudes and concerns of the professional nurses working in the PHC clinics in this area. Thirty professional nurses working at 10 clinics responded to the questionnaires which elicited questions pertaining to the impact of HIV/AIDS on the rendering of their services. As part of the data gathering procedures, standardised notice boards at the PHC clinics were used to document the services rendered. The numbers of ANC clients attended to each of the clinics per week were collected in routine attendance tick registers used in the clinics for recording and monitoring statistics in the maternal health programme. The data was analysed to examine the possible impact of HIV/AIDS on maternal health services rendered by registered nurses/midwives working in the PHC clinics. The registered nurses who responded to the questionnaires (Annexure H) made several suggestions. These included the following: (i) encouraged more training (11 nurses), (ii) addition of more staff members, (iii) to have specialized staff for management of maternal HIV. Because of the study limitations such as the sample size of 10 clinics with a total of 30 nurses who were studied, the study may not be generalised to the whole of the Eastern Cape Province. The study however did provide baseline information on the impact of HIV/AIDS on the maternal health programme. The study findings were that HIV/AIDS has had an impact on the delivery of the maternal health programme due to the extra services brought about by the response to the HIV/AIDS pandemic. This study will contribute to a better understanding of the impact of HIV/AIDS on the maternal health programme at the PHC level in Peddie. The research provided insight into issues that are crucial to the delivery of maternal health programmes in rural areas. , Thesis (MCur) -- Faculty of Science and Agriculture, 2011
- Full Text:
- «
- ‹
- 1
- ›
- »