ArticleBMJ open2019
Implementation of prevention of mother-to-child transmission (PMTCT) in South Africa: outcomes from a population-based birth cohort study in Paarl, Western Cape.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
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Who cites it
28 citing papers in PubMed, 42 citations in OpenAlex.
- Patterns of Infectious Disease Identified in Clinical Autopsy at a South African Tertiary Care Setting: A 10-Year Retrospective Study.Diseases (Basel, Switzerland) · 2026Article
- Persistent neuroimmune alterations in children who are HIV-exposed but uninfected at age 6-7 years: Associations with language development in a South African birth cohort.bioRxiv : the preprint server for biology · 2026Article
- Prevention of mother-to-child transmission of HIV in the MENA region: A systematic review with comparative evidence from Sub-Saharan Africa.Infectious medicine · 2026Review
- Associations between maternal lipid profiles and cardiovascular and metabolic outcomes among children who are HIV-exposed uninfected vs. HIV-unexposed children aged 5-8 years in a South African birth cohort.AIDS (London, England) · 2026Article
- Maternal and early-life longitudinal cytokine profiles in a South African birth cohort: the impact of HIV.bioRxiv : the preprint server for biology · 2025Article
- Maternal and child immune profiles are associated with neurometabolite measures of early-life neuroinflammation in children who are HIV-exposed and uninfected: a South African birth cohort.Wellcome open research · 2025Article
- The impact of evolving maternal antiretroviral therapy guidelines on vertical transmission of HIV in the Western Cape, South Africa.PloS one · 2025Article
- Mycobacterium tuberculosis infection and tuberculosis disease in the first decade of life: a South African birth cohort study.The Lancet. Child & adolescent health · 2024Article
- Exploring Intervention Frameworks to Improve Utilization of Elimination of Mother-to-Child Transmission Services in Africa: A Scoping Review.Nursing reports (Pavia, Italy) · 2024Article
- Subcortical Brain Volumes and Neurocognitive Function in Children With Perinatal HIV Exposure: A Population-Based Cohort Study in South Africa.Open forum infectious diseases · 2024Article
- Factors affecting antenatal care attendance in Soweto, Johannesburg: The three-delay model.African journal of primary health care & family medicine · 2024Article
- Association of in utero HIV exposure with child brain structure and language development: a South African birth cohort study.BMC medicine · 2024Article
- Language outcomes of preschool children who are HIV-exposed uninfected: An analysis of a South African cohort.PloS one · 2024Article
- Risk and rates of hospitalisation in young children: A prospective study of a South African birth cohort.PLOS global public health · 2024Article
- Prevention-of-mother-to-child-transmission (PMTCT) program outcomes in South Africa in the pre-COVID and COVID eras.BMC public health · 2023Article
- Maternal perinatal depression and child brain structure at 2-3 years in a South African birth cohort study.Translational psychiatry · 2023Article
- Klebsiella pneumoniae Lower Respiratory Tract Infection in a South African Birth Cohort: a Longitudinal Study.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2022Article
- Vitamin D Concentrations in Infancy and the Risk of Tuberculosis Disease in Childhood: A Prospective Birth Cohort in Cape Town, South Africa.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Article
- Subcortical brain volumes in young infants exposed to antenatal maternal depression: Findings from a South African birth cohort.NeuroImage. Clinical · 2022Article
- Early structural brain development in infants exposed to HIV and antiretroviral therapy in utero in a South African birth cohort.Journal of the International AIDS Society · 2022Article
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Authors and funding
7 authors at 4 institutions in 3 countries.
Funding
Abstract
objectivesThe coverage of prevention of mother-to-child transmission (PMTCT) services in South Africa is variable. Identifying gaps in the implementation of these services is necessary to isolate steps needed to further reduce paediatric infections and eliminate transmission.
settingTwo primary care clinics in Paarl, South Africa.
participants1225 pregnant women; inclusion criteria were 18 years or older, clinic attendance and remaining in area for at least 1 year.
methodsData were collected through the Drakenstein Child Health Study, a population-based birth cohort in a periurban area of the Western Cape, South Africa. A combination of clinic records, hospital records, national database searches and maternal self-report were collected during the study.
resultsOf the 1225 mothers enrolled in the cohort between 2012 and 2015, 260 (21%) were confirmed HIV infected antenatally and 1 mother tested positive in the postnatal period. Of those with documentation (n=250/260, 96%), the majority (99%) received antiretroviral prophylaxis or therapy (ART) before labour; however, there was a high rate of defaulting from ART noted during pregnancy (20%). All HIV-exposed infants with data received antiretroviral prophylaxis, 35% were exclusively breast fed until 6 weeks and 16% for 6 months. There were two cases of infant HIV infection (0.8%) who were initiated on ART but had complicated histories.
conclusionDespite the low transmission rate in this cohort, reaching elimination will require further work, and this study illustrates several areas to improve implementation of PMTCT services and reduce paediatric infections including retesting at-risk HIV-negative mothers through the duration of breast feeding, infant HIV testing at any admission in addition to routine testing and improved counselling to prevent defaulting from treatment. Better data surveillance systems are essential for determining the implementation of PMTCT guidelines.
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