Rapid assessment of infant feeding support to HIV-positive women accessing prevention of mother-to-child transmission services in Kenya, Malawi and Zambia

@article{Chopra2009RapidAO,
  title={Rapid assessment of infant feeding support to HIV-positive women accessing prevention of mother-to-child transmission services in Kenya, Malawi and Zambia},
  author={Mickey Chopra and Tanya Doherty and Saba Mehatru and Mark Tomlinson},
  journal={Public Health Nutrition},
  year={2009},
  volume={12},
  pages={2323 - 2328}
}
Abstract Objective The possibility of mother-to-child transmission (MTCT) of HIV through breast-feeding has focused attention on how best to support optimal feeding practices especially in low-resource and high-HIV settings, which characterizes most of sub-Saharan Africa. To identify strategic opportunities to minimize late postnatal HIV transmission, we undertook a review of selected country experiences on HIV and infant feeding, with the aims of documenting progress over the last few years… 
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References

SHOWING 1-10 OF 18 REFERENCES
Infant feeding in the time of HIV: rapid assessment of infant feeding policy and programmes in four African countries scaling up prevention of mother to child transmission programmes
TLDR
There was an almost universal belief that an HIV positive mother who breastfeeds her child will always infect the child and intentional avoidance of breastfeeding by the mother indicates that she is HIV positive.
Effectiveness of the WHO/UNICEF guidelines on infant feeding for HIV-positive women: results from a prospective cohort study in South Africa
TLDR
Within operational settings, the WHO/UNICEF guidelines were not being implemented effectively, leading to inappropriate infant-feeding choices and consequent lower infant HIV-free survival.
Effectiveness of the first district-wide programme for the prevention of mother-to-child transmission of HIV in South Africa.
TLDR
The results of this study demonstrate the feasibility and effectiveness of a large-scale PMTCT programme in an urban public-sector setting.
Operational effectiveness of single-dose nevirapine in preventing mother-to-child transmission of HIV.
TLDR
Rates of early transmission of HIV in an operational setting using single-dose nevirapine administered both to mother and child are similar to those obtained in clinical trials.
Operational effectiveness and 36 week HIV-free survival in the South African programme to prevent mother-to-child transmission of HIV-1
TLDR
Ever breastfeeding and underlying inequities in healthcare quality within South Africa are predictors of PMTCT programme performance and will need to be addressed to optimizePMTCT effectiveness.
High Uptake of Exclusive Breastfeeding and Reduced Early Post-Natal HIV Transmission
TLDR
EBF is an affordable, feasible, acceptable, safe and sustainable practice that also reduces HIV transmission providing HIV-infected women with a means to protect their children's lives and programs to support EBF should be expanded universally in low resource settings.
Early exclusive breastfeeding reduces the risk of postnatal HIV-1 transmission and increases HIV-free survival
TLDR
EBF may substantially reduce breastfeeding-associated HIV transmission, and early mixed breastfeeding was associated with a greater PNT risk at 6, 12, and 18 months, compared with EBF.
Low efficacy of nevirapine (HIVNET012) in preventing perinatal HIV-1 transmission in a real-life situation
TLDR
The nevirapine regimen was implemented in a real-life situation in Kenya and the perinatal HIV-1 transmission rate at 14 weeks was 18.1%, similar to the 21.7% before the intervention.
A new global strategy for infant and young child feeding.
TLDR
The growing scale, variety and frequency of major emergencies, the HIV/AIDS pandemic, complexities of modern lifestyles, coupled with continued promulgation of mixed messages and changing fashion with regard to breastfeeding complicate meeting the nutritional needs of infants and young children.
...
...