Estimating vertically acquired HIV infections and the impact of the prevention of mother-to-child transmission program in Zimbabwe: insights from decision analysis models.

摘要: The World Health Organization recommends a single-dose nevirapine (NVP) regimen for prevention of mother-to-child transmission (PMTCT) HIV in settings without the capacity to deliver more complex regimens but population-level impact this intervention has rarely been assessed. A decision analysis model was developed parameterized and applied using local epidemiologic demographic data estimate vertical PMTCT program Zimbabwe up 2005. Between 1980 2005 approximately 10 million children born cumulative 504000 (range: 362000 665000) were vertically infected with HIV; 59% these infections occurred nonurban areas. Mother-to-child (MTCT) decreased from 8.2% 6.0% 10.7%) 2000 6.2% 4.9% 8.9%) predominantly attributable declining maternal prevalence rather than program. 2002 NVP may have averted 4600 3900 7800) infections. In 32% 26% 44%) 4.0% 2.7% 6.2%) breast-feeding seroconversion respectively reduced infant by 8.8% 5.5% 12.1%). Twice as many could had efficacious logistically + zidovudine implemented similar coverage (50%) acceptance (42%). decline MTCT is concurrent decrease pregnant women at current level rollout. To improve must be increased especially rural areas infrastructure then strengthened so that can replaced regimen. (authors)