Prevention of mother-to-child transmission in HIV audit in Xhosa clinic, Mahalapye, Botswana

TL;DR

This study evaluates how well a clinic in Botswana is preventing HIV transmission from mothers to their children, finding areas needing improvement.

Contribution

The study provides a local audit of PMTCT practices in a Botswana clinic, identifying specific gaps in service delivery.

Findings

Only 19% of pregnant women knew their HIV status before or at first prenatal visit.

67% of pregnant women received antiretroviral drugs, and 89% of HIV-exposed infants tested negative at 6 weeks.

Only 73% of children received cotrimoxazole prophylaxis by 6-8 weeks.

Abstract

The Mahalapye district health management team (DHMT) conducts regular audits to evaluate the standard of services delivered to patients, one of which is the prevention of mother-to-child-transmission (PMTCT) programme. Xhosa clinic is one of the facilities in Mahalapye which provides a PMTCT programme.

This audit aimed to identify gaps between the current PMTCT clinical practice in Xhosa clinic and the Botswana PMTCT national guidelines.

This audit took place in Xhosa clinic in the urban village of Mahalapye, in the Central District of Botswana.

This was a retrospective audit using PMTCT Xhosa clinic records of pregnant mothers and HIV-exposed babies seen from January 2013 to June 2013.

One hundred and thirty-three pregnant women registered for antenatal care. Twenty-five (19%) knew their HIV-positive status as they had been tested before their pregnancy or had tested HIV positive at their first antenatal clinic visit. More than two-thirds of the 115 pregnant women (69%) were seen at a gestational age of between 14 and 28 weeks. About two-thirds of the pregnant women (67%) took antiretroviral drugs. Of the 44 HIV-exposed infants, 39 (89%) were HIV DNA PCR negative at 6 weeks. Thirty-two (73%) children were given cotrimoxazole prophylaxis between 6 and 8 weeks.

The PMTCT programme service delivery was still suboptimal and could potentially increase the mother-to-child transmission of HIV. Daily monitoring mechanism to track those eligible could help to close the gap.

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