ArticleJournal of acquired immune deficiency syndromes (1999)2015
Implementation and Operational Research: Reconstructing the PMTCT Cascade Using Cross-sectional Household Survey Data: The PEARL Study.
Article in Journal of acquired immune deficiency syndromes (1999), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Closing Diagnostic Gaps in Pediatric HIV: Innovations in Point-of-Care and Digital Monitoring with an Asia-Pacific Implementation Lens-A Systematic Review.Diagnostics (Basel, Switzerland) · 2026Review
- Prevention of mother-to-child transmission of HIV at the second immunization visit: a cross-sectional study, Burkina Faso.Bulletin of the World Health Organization · 2022Article
- Use of data from various sources to evaluate and improve the prevention of mother-to-child transmission of HIV programme in Zimbabwe: a data integration exercise.Journal of the International AIDS Society · 2020Article
- HIV testing, test results and factors influencing among infants born to HIV positive mothers in public hospitals of Mekelle City, North Ethiopia: a cross-sectional study.BMC infectious diseases · 2020Article
- Cascade Analysis: An Adaptable Implementation Strategy Across HIV and Non-HIV Delivery Platforms.Journal of acquired immune deficiency syndromes (1999) · 2019Article
- Protocol for the evaluation of the population-level impact of Zimbabwe's prevention of mother-to-child HIV transmission program option B+: a community based serial cross-sectional study.BMC pregnancy and childbirth · 2019Article
- Maternal Decision-Making and Uptake of Health Services for the Prevention of Mother-to-Child HIV Transmission: A Secondary Analysis.Maternal and child health journal · 2019Article
- "Well, not me, but other women do not register because..."- Barriers to seeking antenatal care in the context of prevention of mother-to-child transmission of HIV among Zimbabwean women: a mixed-methods study.BMC pregnancy and childbirth · 2018Article
- Women's decision-making and uptake of services to prevent mother-to-child HIV transmission in Zambia.AIDS care · 2018Article
- Assessment of the effectiveness of PMTCT program in eight service delivery points in North Central Nigeria.HIV/AIDS (Auckland, N.Z.) · 2018Article
- Active tracking of rejected dried blood samples in a large program in Nigeria.World journal of virology · 2016Article
- Factors Associated with PMTCT Cascade Completion in Four African Countries.AIDS research and treatment · 2016Article
- A New Look at Care in Pregnancy: Simple, Effective Interventions for Neglected Populations.PloS one · 2016Review
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12 authors.
Funding
Abstract
backgroundGiven the ambitious targets to reduce pediatric AIDS worldwide, ongoing assessment of programs to prevent mother-to-child HIV transmission (PMTCT) is critical. The concept of a "PMTCT cascade" has been used widely to identify bottlenecks in program implementation; however, most efforts to reconstruct the cascade have relied on facility-based approaches that may limit external validity.
methodsWe analyzed data from the PEARL household survey, which measured PMTCT effectiveness in 26 communities across Zambia, South Africa, Cote d'Ivoire, and Cameroon. We recruited women who reported a delivery in the past 2 years. Among mothers confirmed to be HIV infected at the time of survey, we reconstructed the PMTCT cascade with self-reported participant information. We also analyzed data about the child's vital status; for those still alive, HIV testing was performed by DNA polymerase chain reaction testing.
resultsOf the 976 eligible women, only 355 (36%) completed every step of the PMTCT cascade. Among the 621 mother-child pairs who did not, 22 (4%) reported never seeking antenatal care, 103 (17%) were not tested for HIV during pregnancy, 395 (64%) reported testing but never received their HIV-positive result, 48 (8%) did not receive maternal antiretroviral prophylaxis, and 53 (9%) did not receive infant antiretroviral prophylaxis. The lowest prevalence of infant HIV infection or death was observed in those completing the cascade (10%, 95% confidence interval: 7% to 12%).
conclusionsFuture efforts to measure population PMTCT impact should incorporate dimensions explored in the PEARL study-including HIV testing of HIV-exposed children in household surveys-to better understand program effectiveness.
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