Abstract
A study of the outcomes of the Prevention of Mother-to-Child Transmission Project in
Nakhon Ratchasima Province was aimed at assessing the achievements of 29 government
hospitals in the period from October 1, 2002 to September 30, 2007, and determining strategies for improving the effectiveness of the project.
This study follows a descriptive epidemiological study design. Secondary data on pregnant women attending antenatal clinics and giving birth at those hospitals, together with
the outcomes of children born to HIV-infected mothers during fiscal years 2003-2007, were
analyzed by the Epi Info V. 3.3.2. descriptive statistics program.
The percentage of pregnant women who were tested for HIV increased from 97.1 percent in 2003 to 99.7 percent in 2007. The HIV-positive rate among pregnant women peaked
in 2004 at 1.2 percent before declining to 0.8 percent in 2007. Women giving birth had relatively stable HIV infection rates (0.6-0.8%). However, the proportion of pregnant women
with HIV- positive status who received antiviral drugs (AZT) rose from 86 percent to 100
percent in the period from 2003 to 2007. Those who received AZT for at least four weeks
increased from 72.7 percent in 2003 to 91.9 percent in 2007, while the remainder received the
antivirals for fewer than four weeks. Newborn babies receiving AZT also increased from
46.2 percent to 78.4 in 2007.
The surviving babies had been monitored for HIV infection until reaching the age of
18 -24 months and the follow-up rates rose from 73.5 percent in 2003 to 81.6 percent in 2007.
Every baby (100%) was provided with infant formula powdered milk before leaving the
hospital. The rate of loss to follow-up decreased from 35.3 percent to 18.4 percent during the
period 2003-2007. The main reason was change of address (87.5%), followed by guardians
not wanting to know the HIV status of their child (12.5%). Among those infants whose
blood was available for HIV testing, the HIV-positive rate was highest in 2003 at 6.4 percent
(9 cases), then the number of HIV-positive infants decreased to 5 (2.6%), 6 (3.7%), 2 (1.6%),
and 1 case (0.7%), respectively, during the period 2004-2007.
Conclusions: Overall, the Prevention of Mother-to-Child Transmission Project in fiscal years 2003-2007 successfully achieved its objectives and was implemented at all government hospitals in Nakhon Ratchasima Province. The outcomes of the project improved during that period. The percentage of mothers and infants who were tested for HIV and received antiviral drugs increased and resulted in a drop in maternal HIV transmission in the
province. Given the significant decline in the trends of the HIV infection rate among children aged 18-24 months, the project achieved the national target of lowering maternal HIV
transmission below 6 percent.
