Outcomes of indicators for the eMTCT HIV cascade in Barbados

ABSTRACT

OBJECTIVE: To evaluate the outcomes of indicators for the elimination of mother to child transmission (eMTCT) HIV Cascade. DESIGN AND METHODS: Pregnant patients seen in the public sector health care clinics delivering between Jan 1st, 2009 and Dec 31st, 2013 were studied retrospectively. HIV infected women and live births were identified from the Ladymeade Reference Unit and the Queen Elizabeth Hospital records. Extracted data was logged on an Excel Spread sheet, categorised in specific targets identified through a 5 year Regional initiative. Analysis was performed to determine the indicators for the eMTCT Cascade to evaluate outcomes in reaching the targets. RESULTS: In 5 years 15,436 births were recorded, 15,189 were live births. There were 9003 pregnant women who booked, and 8806 (98%) were HIV tested. There were 125 women (1.5%), averaging 25 per annum (ranging 1.2%-1.6%) who tested positive for HIV; 108 (86%) of these women (range 79%-100%) received ARVs during pregnancy. One hundred and twenty-one delivered infants, there were 124 live births and 1 stillbirth. Two infants tested positive by 2 successive DNA PCR tests during the period of study, in 2013. The eMTCT HIV rate was 0 for each of the first 4 successive years of study and 8% in 2013 (overall 1.7%). The eMTCT incidence rate x 1000 live births ranged 0 -0.7% (overall 0.13%). CONCLUSIONS: This study revealed that the 3 specific goals for eMTCT had been met during the previous 5 years. Efforts for continuing sustainability were needed.