Analysis of the national early infant diagnosis dataset, Zimbabwe: 2007 to 2010

Abstract

Zimbabwe introduced the early infant diagnosis (EID) for human immunodeficiency virus (HIV) exposed infants in 2007. Data captured through this initiative has never been analysed in detail. A detailed EID data analysis was carried out to evaluate the effectiveness of the prevention of mother to child transmission (PMTCT) of HIV in reducing HIV transmission. A retrospective record review of the national EID dataset for the period of January, 2007 to August, 2011 was conducted. Secondary data analysis was done to calculate EID population coverage and HIV positivity amongst samples tested, to compare effectiveness of PMTCT regimens among tested children, and to determine the correlation between mode of delivery and infant outcomes. EID population coverage increased from 1% in January, 2007 to 38% by August, 2011, far below universal access target of 80%. Of the samples tested, HIV positivity showed an apparent decline from 38% in 2007 to 11% in 2011. HIV positivity in infants born vaginally was comparable to those delivered by caesarean section for the years 2010 (p-trend 0.427) and 2011 (p-trend 0.99). Both maternal and infant antiretroviral (ARV) prophylactic regimens were found to reduce HIV positivity significantly (p-trend < 0.001). The national EID database is an important and readily available tool for monitoring and evaluating the PMTCT program and paediatric HIV trends. The Ministry of Health through its PMTCT programme should regularly use this data to inform prioritization of PMTCT interventions. Increased access to both maternal and infant ARV prophylactic drug regimens is critical, if the target of eliminating paediatric HIV by 2015 is to be met in Zimbabwe.   Key words: Early infant diagnosis, PMTCT, ARV prophylaxis, Zimbabwe.