Preventing mother-to-child transmission of HIV: Paediatric audit cycles between 2004 and 2010

Abstract

Background: Between 1986–March 2012 a total of 15979 children werereported to be born to HIV positive mothers to the National Study of HIV in Pregnancy and Childhood (NSHPC). Since 2000 Mother To Child Transmission (MTCT) of HIV among women on antiretroviral treatment has been as low as 0.7%.

Aim: This audit was undertaken firstly to look at the performance of a localregional Paediatric team over a 6 year period and secondly to estimate the impact of several service changes, such as introduction of training and aregional guideline or a separate nurse led baby clinic against the BHIVA Pregnancy Guideline from 2005 and 2008 respectively.

Methods: Three cycles of retrospective case note audit of all babies exposedto HIV and followed up in a large Regional Centre were performed using a nearidentical standard proforma.

Discussion: In line with the data from NSHPC we have also seen a higher proportion of mothers diagnosed before conception and a decreasing delivery rate of babies exposed to HIV in 2010. It has been noted that most of the significant outcome measures have improved over the audit period. As the care of HIV in Pregnancy requires a multidisciplinary approach the improvements have to be attributed to the joint effort of the whole team involved. Some of the improved outcome measures are also related to the Paediatric service changes as shown in the selected outcome measures above.