the HIV aids statistics in Kwazulu-natal.?

Answer 1

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Answer 2

The pilot programme in KZN
So in order to evaluate the effectiveness of the PMTCT programme in KwaZulu Natal, a pilot programme was set up to perform routine anonymous, unlinked, HIV prevalence testing on all infants aged between four to eight weeks old, attending 6-week immunisation clinics at seven primary health care clinics offering PMTCT services.

After obtaining the consent of the parent or legal guardian, dried blood spot (DBS) samples were collected from the infant’s heel, the eardrum or the thumb and screened for HIV antibodies. Antibody testing in infants is a fairly reliable way of determining HIV exposure (and maternal status) since babies carry their mother’s antibodies for several months after delivery and/or breastfeeding. Samples that were antibody-positive were then tested for HIV RNA by PCR.

In addition to testing the infants, the staff also asked all mothers, irrespective of the age of the child being immunised, about any pregnancy that they had had, and whether the child was alive or dead. This was done in order to determine child mortality rates over the previous fifteen year period.

Over a period of two and a half years, over 6500 such interviews were conducted and information was gathered on around 11,000 children (of various ages). Dried blood spots have been collected from 2,439 infants between the ages of 4-8 weeks who were brought in for their first DTP immunisation. About 11% of the mothers refused, knowing that the sample was going to be tested for HIV (even though the testing was unlinked and anonymous).

Results
HIV antibodies were detected in 907 infants (37.6%, CI 35.7 - 39.6), which indicated the maternal seroprevalence rate — in mothers between 20-29 years old the rate was 46.9% (CI 42.9 – 50.9). “This reflects very closely the maternal prevalence rates in KZN,” said Dr. Rollins.

Of the exposed children, 189 were HIV-infected, (7.6% of the entire 6 week old population) indicating a vertical transmission rate (VTR) of 20.9% (CI 18.2 – 23.6%).

“Going back to the 012 trial, if every women had been identified, and everyone had received nevirapine and everyone of their children, then this number (the VTR) should have been 11.9%,” said Dr. Rollins.

In the women who reported that they had previously tested positive for HIV (virtually all of whom had received sdNVP), the VTR was between 15-16%.

However, a number of the women who claimed to be uninfected were actually HIV-positive, and among their infants the VTR was 31.2%. These women may have been in the window period before antibodies appear when they were previously tested, or they may have become infected during the antenatal period. Either way, they did not receive sdNVP, and high viral loads experienced during acute primary infection may have contributed to the high VTR.

Infant mortality rates have also been increasing dramatically in the last fifteen years. In children born before 1990, the infant mortality rate had been 48 per 1000 but between 1990-1994, a point at which things were improving, the infant mortality rate dropped to 31 per 1000. But in the fifteen years since the HIV epidemic, the infant mortality rate has been swinging up again, trebling in the last five years to 99 per 1000 births.