Prevention of mother-to-child transmission of HIV Option B+ cascade in rural Tanzania: The One Stop Clinic model

Anna Gamell, Lameck Bonaventure Luwanda, Aneth Vedastus Kalinjuma, Leila Samson, Alex John Ntamatungiro, Maja Weisser, Winfrid Gingo, Marcel Tanner, Christoph Hatz, Emilio Letang, Manuel Battegay

Background

Strategies to improve the uptake of Prevention of Mother-To-Child Transmission of HIV (PMTCT) are needed. We integrated HIV and maternal, newborn and child health services in a One Stop Clinic to improve the PMTCT cascade in a rural Tanzanian setting.

Methods

The One Stop Clinic of Ifakara offers integral care to HIV-infected pregnant women and their families at one single place and time. All pregnant women and HIV-exposed infants attended during the first year of Option B+ implementation (04/2014-03/2015) were included. PMTCT was assessed at the antenatal clinic (ANC), HIV care and labour ward, and compared with the pre-B+ period. We also characterised HIV-infected pregnant women and evaluated the MTCT rate.

Results

1,579 women attended the ANC. Seven (0.4%) were known to be HIV-infected. Of the remainder, 98.5% (1,548/1,572) were offered an HIV test, 94% (1,456/1,548) accepted and 38 (2.6%) tested HIV-positive. 51 were re-screened for HIV during late pregnancy and one had seroconverted. The HIV prevalence at the ANC was 3.1% (46/1,463). Of the 39 newly diagnosed women, 35 (90%) were linked to care. HIV test was offered to >98% of ANC clients during both the pre- and post-B+ periods. During the post-B+ period, test acceptance (94% versus 90.5%, p

Conclusions

The implementation of Option B+ through an integrated service delivery model resulted in universal HIV testing in the ANC, high rates of linkage to care, and MTCT below the elimination threshold. However, HIV testing in late pregnancy and labour, and retention during early ART need to be improved.

October 4, 2017
Year of publication
2017
Resource types
Journal and research articles
Countries
Tags
prevention of mother-to-child transmission (PMTCT), PMTCT, option B+, maternal newborn and child health (MNCH), MNCH services, integrated services, PMTCT cascade, Tanzania, HIV-infected pregnant women, HIV-exposed infants, universal HIV testing, antenatal clinic, antenatal care, mother-to-child transmission (MTCT), retention in care