Abstract #370  -  Towards eliminating pediatric HIV in Botswana: the experience at the Botswana-Baylor childrens clinical centre of excellence (COE)
Authors:   Presenting Author:   Refilwe Sello -
Additional Authors:  Mr/s Tafireyi Marukutira, Ms Victoria Nakimbugwe, Mr Edwin Machine, Mr Vincent Mabikwa, Mr/s Shimane Lekalake, Mr Ryan Phelps, Mr Gabriel Anabwani,
Aim: BACKGROUND Recently, the Botswana National AIDS Coordinating Agency warned that the ARV programme may become unsustainable and that prospects of initiating new patients on free HAART after 2016 could be uncertain. Thus, it is imperative to intensify prevention efforts in order to minimize the number of new infections. In this regard, the national PMTCT programme uptake of 95% has been celebrated for its success in decreasing MTCT rates from an estimated 40% before the HAART era to the current rates of 7.8% overall and 3.8% among PMTCT participants. OBJECTIVES To summarize PMTCT-related data pertaining to HIV infected mothers and infants attending the COE testing and counseling clinic, and to compare this with national data.
Method / Issue: Infants aged <6 months who were screened at the COE in 2008 were identified through our electronic medical record and infant registry. The data pertaining to prenatal and postnatal ARV exposure and feeding were collected for analysis. Their mothers gestation at PMTCT enrollment and ARVs taken during pregnancy were also noted.
Results / Comments: Of the 150 infants aged <6 months who were screened in 2008, 148 (98%) had been enrolled in PMTCT. Median gestation at the time of the 148 mothers PMTCT enrollment was 28 weeks (range 24-36wks). Overall, 6% of all infants tested DNA-PCR positive for HIV. The respective MTCT rates among groups were: 2% among 36 infants whose mothers were receiving HAART at the time of screening, 6% among 136 babies who had received sdNVP; and 5% among 145 infants who had received AZT. All babies who received sdNVP went on to receive AZT and a few received AZT only. One infant had been breastfed but tested negative. This infant had received AZT and sdNVP at birth and his mother had received AZT during pregnancy. The mothers of 2 infants had not participated in the PMTCT programme. Of these, one infant tested positive while the other tested negative.
Discussion: The MTCT rates among infants presenting to the COE are similar to those reported nationally. PMTCT uptake and avoidance of breastfeeding among this population of mothers were high. Nonetheless, much still needs to be done in order to eliminate paediatric HIV in Botswana.
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