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PMTCT

PMTCT. Presented by: Ms T. Nondanyana (PMTCT COORDINATOR) Room: 129 Tel:053 8300 637 tnondanyana@ncpg.gov.za. Background. What is PMTCT? - Prevention of Mother To Child Transmission of HIV

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PMTCT

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  1. PMTCT Presented by: Ms T. Nondanyana (PMTCT COORDINATOR) Room: 129 Tel:053 8300 637 tnondanyana@ncpg.gov.za

  2. Background What is PMTCT? - Prevention of Mother To Child Transmission of HIV • The PMTCT programme was conceptualized in 2000,piloted in 2001 and was implemented in 2002 nationally with single dose Nevirapine, updated in 2008 to a dual therapy protocol (AZT and NVP) • 2010 added Truvada (FTC+TDF) post delivery • NVP stat dose for babies then up to six weeks or for the duration of breastfeeding • Its aim to reduce (MTCT) to less than 5% (NSP 2007-2011)

  3. MTCT can occur in three stages • Ante-partum (During pregnancy) • Intra-partum (Labour and delivery) • Post-partum ( After delivery)

  4. FACTORS THAT INCREASE THE RISK OF MTCT DURING PREGNANCY • Any disruption in the maternal-foetal blood barrier, e.g. abruptio placenta. • Sexually transmitted diseases • Increased viral load • Low CD4 count • Cigarette smoking

  5. FACTORS DURING LABOUR AND DELIVERY • Chorioamnonitis • Mixing of blood during the birth process • Prematurity • Multiple pregnancy • Prolonged rapture of membranes • Episiotomy • Assisted deliveries such as vacuum extraction and forceps delivery

  6. FACTORS POST-NATALLY (DURING BREASTFEEDING) • Maternal factors -Primary infections -CD4 count -High viral load • Breast pathologies -Mastitis -Abscess -Nipple fissure or crack

  7. FACTORS POST-NATALLY (DURING BREASTFEEDING)2 • Infant factors -Breastfeeding patterns (mixed feeding) -Breastfeeding duration -Condition of the baby’s mouth such as ulcers and oral thrush

  8. CHALLENGES • Disclosure • Mixed feeding • Re- infection

  9. STRATEGIES TO PREVENT MTCT • Encouraging couples/partners to go for HIV Counseling and testing if they are planning for pregnacy. • Awareness campaigns • Male involvement • If tested HIV negative they should remain so (ABC) and retested at 32 weeks or before delivery • If tested HIV positive they will be assessed and referred accordingly. • Pregnant woman will receive AZT at 14 weeks or ARVs , AZT and NVP during labour and Truvada post delivery the baby will also receive syrup of NVP until six weeks or as long as is breastfed. • Stick on the chosen method of feeding

  10. STRATEGIES TO PREVENT MTCT2 • Use condoms to avoid re-infection • Baby to be taken to the clinic at six weeks(1month and 2 weeks) for immunizations, test for HIV(PCR) and receive cotrimoxazole. • To be tested again at eighteen months (1year 6 months)

  11. Progress

  12. Progress…

  13. Progress…

  14. QUESTIONS?

  15. THANK YOU

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