Conference abstract
Reaching HIV epidemic control by 2030 will require focused attention on the PMTCT cascade: a comparison of PEPFAR Versus non-PEPFAR supported sites in Tanzania
Pan African Medical Journal - Conference Proceedings. 2024:21(1).29
Apr 2024.
doi: 10.11604/pamj-cp.2024.21.1.2312
Archived on: 29 Apr 2024
Contact the corresponding author
Keywords: HIV epidemic control, PMTCT cascade
Oral presentation
Reaching HIV epidemic control by 2030 will require focused attention on the PMTCT cascade: a comparison of PEPFAR Versus non-PEPFAR supported sites in Tanzania
Roland van de Ven1,&, Catherine Nnko1, Frank Lyimo1, Fredrick Haraka1, Hellen Magige1, Mukome Nyamhagatta3, Michael Msangi3, Fatima Tsiouris2, Matthew Rosenthal4, Sajida Kimambo1, Moses Bateganya4, Veena Sampathkumar2
1Elizabeth Glaser Paediatric AIDS Foundation, Dar es Salaam, Tanzania, 2Elizabeth Glaser Paediatric AIDS Foundation, Washington, United States of America, 3Ministry of Health, Prevention of Mother-to-Child Transmission Unit, Tanzania, 4United States Agency for International Development, Dar es Salaam, Tanzania
&Corresponding author
Introduction: the Tanzania HIV response is mainly funded by donors; however, decreasing donor funding poses a risk to sustaining gains and ending AIDS in children by 2030. Tanzania endorsed the global goal of eliminating mother-to-child transmission (MTCT) of HIV, but progress has fallen short, with a current MTCT rate of 7% in 2022. We reviewed national MTCT data to describe the current performance of MTCT prevention (PMTCT) at sites supported by PEPFAR versus non-PEPFAR-supported sites.
Methods: a cross-sectional retrospective analysis was conducted on the PMTCT program for the year 2022 using the national DHIS2 database. Annual routine PMTCT data were abstracted from the monthly site-level DHIS2 reports and aggregated by PEPFAR and non-PEPFAR supported sites. The standard PMTCT cascade indicators were calculated using Excel, and numbers and proportions were presented to compare the PMTCT program performance between supported and non-supported sites.
Results: in 2022, 7,501 health facilities offered PMTCT services, of which 61% (4,560/7,501) were non-PEPFAR-supported sites. A total of 2,365,940 pregnant women (99%) attending antenatal care (ANC) were tested for HIV at their first ANC visit. Of those tested, 0.8% (18,646) were newly diagnosed HIV positive during the current pregnancy; 74% (13,766) of them were seen at PEPFAR-supported sites, compared to 26% (4,880) at non-PEPFAR sites. ART initiation was 108% at PEPFAR-supported sites vs 43% at non-PEPFAR-supported sites, and testing of HIV-exposed infants (HEI) in the first two months after birth was 75% at supported sites vs 28% at non-supported sites. Other notable differences are shown in the table.
Conclusion: the PMTCT performance is low in non-PEPFAR supported facilities; however, these sites serve 26% of newly identified pregnant women each year. This calls for adaptation of the current program and resource prioritization to address the gaps and support Tanzania on the path to the elimination of MTCT.
Reaching HIV epidemic control by 2030 will require focused attention on the PMTCT cascade: a comparison of PEPFAR Versus non-PEPFAR supported sites in Tanzania
Roland van de Ven1,&, Catherine Nnko1, Frank Lyimo1, Fredrick Haraka1, Hellen Magige1, Mukome Nyamhagatta3, Michael Msangi3, Fatima Tsiouris2, Matthew Rosenthal4, Sajida Kimambo1, Moses Bateganya4, Veena Sampathkumar2
1Elizabeth Glaser Paediatric AIDS Foundation, Dar es Salaam, Tanzania, 2Elizabeth Glaser Paediatric AIDS Foundation, Washington, United States of America, 3Ministry of Health, Prevention of Mother-to-Child Transmission Unit, Tanzania, 4United States Agency for International Development, Dar es Salaam, Tanzania
&Corresponding author
Introduction: the Tanzania HIV response is mainly funded by donors; however, decreasing donor funding poses a risk to sustaining gains and ending AIDS in children by 2030. Tanzania endorsed the global goal of eliminating mother-to-child transmission (MTCT) of HIV, but progress has fallen short, with a current MTCT rate of 7% in 2022. We reviewed national MTCT data to describe the current performance of MTCT prevention (PMTCT) at sites supported by PEPFAR versus non-PEPFAR-supported sites.
Methods: a cross-sectional retrospective analysis was conducted on the PMTCT program for the year 2022 using the national DHIS2 database. Annual routine PMTCT data were abstracted from the monthly site-level DHIS2 reports and aggregated by PEPFAR and non-PEPFAR supported sites. The standard PMTCT cascade indicators were calculated using Excel, and numbers and proportions were presented to compare the PMTCT program performance between supported and non-supported sites.
Results: in 2022, 7,501 health facilities offered PMTCT services, of which 61% (4,560/7,501) were non-PEPFAR-supported sites. A total of 2,365,940 pregnant women (99%) attending antenatal care (ANC) were tested for HIV at their first ANC visit. Of those tested, 0.8% (18,646) were newly diagnosed HIV positive during the current pregnancy; 74% (13,766) of them were seen at PEPFAR-supported sites, compared to 26% (4,880) at non-PEPFAR sites. ART initiation was 108% at PEPFAR-supported sites vs 43% at non-PEPFAR-supported sites, and testing of HIV-exposed infants (HEI) in the first two months after birth was 75% at supported sites vs 28% at non-supported sites. Other notable differences are shown in the table.
Conclusion: the PMTCT performance is low in non-PEPFAR supported facilities; however, these sites serve 26% of newly identified pregnant women each year. This calls for adaptation of the current program and resource prioritization to address the gaps and support Tanzania on the path to the elimination of MTCT.
