Transcript Helen Joseph Hospital

PMTCT
Presented by:
Ms T. Nondanyana (PMTCT COORDINATOR)
Room: 129
Tel:053 8300 637
[email protected]
Background
What is PMTCT?
-
Prevention of Mother To Child Transmission of HIV



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The PMTCT programme was conceptualized in
2000,piloted in 2001 and was implemented in 2002
nationally with single dose Nevirapine, updated in
2008 to a dual therapy protocol (AZT and NVP)
2010 added Truvada (FTC+TDF) post delivery
NVP stat dose for babies then up to six weeks or for
the duration of breastfeeding
Its aim to reduce (MTCT) to less than 5%
(NSP 2007-2011)
MTCT can occur in three stages

Ante-partum (During pregnancy)
 Intra-partum (Labour and delivery)
 Post-partum ( After delivery)
FACTORS THAT INCREASE
THE RISK OF MTCT DURING
PREGNANCY

Any disruption in the maternal-foetal blood
barrier, e.g. abruptio placenta.
 Sexually transmitted diseases
 Increased viral load
 Low CD4 count

Cigarette smoking
FACTORS DURING LABOUR
AND DELIVERY

Chorioamnonitis
 Mixing of blood during the birth process
 Prematurity
 Multiple pregnancy
 Prolonged rapture of membranes
 Episiotomy
 Assisted deliveries such as vacuum extraction
and forceps delivery
FACTORS POST-NATALLY
(DURING BREASTFEEDING)

Maternal factors
-Primary infections
-CD4 count
-High viral load
 Breast pathologies
-Mastitis
-Abscess
-Nipple fissure or crack
FACTORS POST-NATALLY
(DURING
BREASTFEEDING)2

Infant factors
-Breastfeeding patterns (mixed feeding)
-Breastfeeding duration
-Condition of the baby’s mouth such as ulcers
and oral thrush
CHALLENGES
 Disclosure
 Mixed
feeding
 Re- infection
STRATEGIES TO PREVENT
MTCT

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Encouraging couples/partners to go for HIV
Counseling and testing if they are planning for
pregnacy.
Awareness campaigns
Male involvement
If tested HIV negative they should remain so (ABC)
and retested at 32 weeks or before delivery
If tested HIV positive they will be assessed and
referred accordingly.
Pregnant woman will receive AZT at 14 weeks or
ARVs , AZT and NVP during labour and Truvada
post delivery the baby will also receive syrup of NVP
until six weeks or as long as is breastfed.
Stick on the chosen method of feeding
STRATEGIES TO PREVENT
MTCT2


Use condoms to avoid re-infection
Baby to be taken to the clinic at six
weeks(1month and 2 weeks) for immunizations,
test for HIV(PCR) and receive cotrimoxazole.
 To be tested again at eighteen months (1year 6
months)
Progress
Progress…
Progress…
QUESTIONS?
THANK YOU