Page 340 - SAHCS HIVMed Journal Vol 20 No 1 2019

Page 2 of 5 Original Research

antenatal clinic, a maternity ward and a paediatric clinic, Pilot study
and provides comprehensive HIV management for adults The pilot study was conducted at MUCPP CHC. The first 10
and children. Only uncomplicated normal vaginal files of HIV-positive mothers of January 2016 with an
deliveries (NVD) are performed on site, while complicated uncomplicated NVD were selected. During the pilot study, it
deliveries and caesarean sections are referred to the became clear that the information to achieve our objectives
Pelonomi Academic Hospital for specialist management. was not noted in the patient files and the methodology had to
As MUCPP CHC uses the 2015 national guidelines, the be amended to obtain PCR results from the Virology database.
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authors were interested in how strictly these guidelines It was thus not possible to determine whether infants who
were adhered to. tested HIV-positive were initiated on ART within a week of
diagnosis, whether follow-up dates were given to mothers
Aim and whether mothers collected birth PCR results. Changes
were made to the data sheet, which included removing the
The aim of this study was to determine whether the neonatal fields for the infant’s weight, height and if the infant was on
component of the 2015 ‘National consolidated guidelines for medication, because this information was found to be
PMTCT of HIV and the management of HIV in children, unavailable and did not contribute to the study aim.
adolescents and adults’ was being implemented in the Demographic information, hospital number, the option of
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management of HIV-exposed infants on a PHC level at ‘unknown’, the clinic’s name for antenatal care and dates of
MUCPP CHC in Bloemfontein, Free State.
all the HIV PCR tests were added. The information gathered
from the pilot study was included in the main study.
Specific objectives included the following:
• Whether all HIV-exposed infants received an HIV PCR Analysis of data
test at birth
• Whether the infants who tested HIV-positive were The researchers entered the data into Microsoft Excel. Data
initiated on ART within a week of diagnosis were analysed by the Department of Biostatistics, Faculty of
• Whether a follow-up date for the 10-week follow-up test Health Sciences, University of Free State. Numerical variables
was given to the mother or caregiver of the infant who were summarised by medians and ranges because of skewed
tested HIV-negative at birth distributions. Categorical variables were summarised by
• The percentage of mothers or caregivers who returned to frequencies and percentages.
collect the birth HIV PCR results.
The 10-week HIV PCR test results were categorised as follows:
Methods • Before 10 weeks (1–55 days)
Study design and sampling • At 10 weeks (56–89 days)
• After 3 months (90+ days)
This was a retrospective descriptive file audit. The study
population included all mothers who gave birth to a live Ethical consideration
baby via NVD at MUCPP CHC from 01 January 2016 to 31 The protocol was approved by the Health Sciences Research
December 2016.
Ethics Committee (HSREC) of UFS [HSREC-S 06/2017] and
the Free State Department of Health. The data were handled
Measurement confidentially, and each patient file received a unique study
The mothers’ files are kept at the maternity ward of MUCPP number. Access to the information on the NHLS electronic
CHC. The researchers counted every file from 01 January to database was granted by the Head of the Department of
31 December 2016. The mothers’ files were used to identify Virology, UFS.
whether they were HIV-positive or not and whether they had
an uncomplicated NVD. The mother’s age, parity and Results
gravidity, HIV status and whether she was on ART were The file review showed that 1304 live babies were born via
captured on a data sheet. uncomplicated NDV during 2016. There were, however, 20
duplicate data entries and 10 cases were thus removed. Eight
The 2016 birth register was used to collect the HIV-exposed incorrect entries were also removed leaving 1286 patient files.
infants’ PCR barcodes and any information that was missing The number of deliveries per month ranged between 65
from the mothers’ files, for example whether the mother was (minimum, recorded in July) and 151 (maximum, recorded in
on ART. The researchers collected the HIV PCR results using August). The study sample included 428 (33.3%) babies born
these PCR barcodes for the birth tests, while the date of birth to HIV-positive mothers. Just over half of these babies were
and surname of the infant were used to obtain the HIV PCR male (n = 214, 50.4%).
test results, including the 10-week HIV PCR test results. This
was performed using the National Health Laboratory System The median age of the HIV-positive mothers was 23.3 years
(NHLS) electronic database at the Department of Virology, (range: 16.4–44.5 years). Most mothers were between the ages
University of the Free State (UFS). of 20 and 35 years (82.6%). There were 31 (7.3%) teenage

http://www.sajhivmed.org.za 333 Open Access