Paediatric and perinatal HIV/AIDS in Jamaica an international leadership initiative, 2002-2007.

摘要: BACKGROUND: Paediatric and Perinatal HIV/AIDS remain significant health challenges in the Caribbean where HIV seroprevalence is second only to Sub-Saharan Africa. METHOD: We describe a collaborative approach prevention treatment care ofHIVin pregnant women infants children Jamaica. A team of academic government healthcare personnel collaborated address paediatric perinatal epidemic Greater Kingston as model for Jamaica (population 2.6 million 1.5%). five-point plan was utilized included leadership training preventing mother-to-child transmission (pMTCT) outcomes-based research local regional international outreach. RESULTS: core group paediatric/perinatal professionals were trained including paediatricians obstetricians public practitioners nurses microbiologists data managers information technology students serve (birth cohort 20000). During September 2002 August 2007 over 69 793 presented antenatal care. these five years improvements occurred uptake voluntary counselling (40% 91%) HIV-testing (53% 102%). Eight hundred eighty-three tested HIV-positive with rates 1-2% each year The use modified short course zidovudine or nevirapine first three significantly reduced (MTCT) from 29% 6% (RR 0.27; 95%0 CI--0.10 0.68). 2005 using maternal highly active antiretroviral therapy (HAART) lamivudine either nelfinavir lopinavir/ritonavir infant MTCT further an estimated 1.6% 4.75% islandwide. In we evaluated 1570 four-weekly infectious diseases clinics St Andrew Catherine six rural outreach sites throughout Jamaica; 24% (377) had 76% (1193) HIV-exposed. Among infected 79% (299 377) initiated HAART resulting HIV-attributable childhood morbidity mortality An programme successfully implemented. CONCLUSION: Working collaboratively our mission pMTCT improving quality life families living affected by being achieved.