Impact of the COVID-19 pandemic on the provision and uptake of services for the prevention of mother-to-child transmission of HIV in Zimbabwe.
Zimbabwe is targeting elimination of mother-to-child transmission of HIV by December 2025, however the COVID-19 pandemic challenged health service delivery globally. Monthly aggregated data were extracted from DHIS-2 for all facilities delivering antenatal care (ANC). ZIMSTAT and Spectrum demographi...
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Public Library of Science (PLoS)
2023-01-01
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| Series: | PLOS Global Public Health |
| Online Access: | https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0002296&type=printable |
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| author | Elizabeth Chappell Anesu Chimwaza Ngoni Manika Catherine J Wedderburn Zivai Mupambireyi Nenguke Hannah Gannon Frances Cowan Tom Gibb Michelle Heys Felicity Fitzgerald Andrew Phillips Simbarashe Chimhuya Diana M Gibb Deborah Ford Angela Mushavi Mutsa Bwakura-Dangarembizi |
| author_facet | Elizabeth Chappell Anesu Chimwaza Ngoni Manika Catherine J Wedderburn Zivai Mupambireyi Nenguke Hannah Gannon Frances Cowan Tom Gibb Michelle Heys Felicity Fitzgerald Andrew Phillips Simbarashe Chimhuya Diana M Gibb Deborah Ford Angela Mushavi Mutsa Bwakura-Dangarembizi |
| author_sort | Elizabeth Chappell |
| collection | DOAJ |
| description | Zimbabwe is targeting elimination of mother-to-child transmission of HIV by December 2025, however the COVID-19 pandemic challenged health service delivery globally. Monthly aggregated data were extracted from DHIS-2 for all facilities delivering antenatal care (ANC). ZIMSTAT and Spectrum demographic estimates were used for population-level denominators. Programme indicators are among those in HIV care and population indicators reflect the total population. The mean estimated proportion of pregnant women booking for ANC per month did not change (91% pre-pandemic vs 91% during pandemic, p = 0.95), despite dropping to 47% in April 2020. At a programme-level, the estimated proportion of women who received at least one HIV test fell in April 2020 (3.6% relative reduction vs March (95% CI 2.2-5.1), p<0.001) with gradual recovery towards pre-pandemic levels. The estimated proportion of women who were retested among those initially negative in pregnancy fell markedly in April 2020 (39% reduction (32-45%), p<0.001) and the subsequent increase was much slower, only reaching 39% by September 2021 compared to average 53% pre-pandemic. The mean estimated proportion of pregnant women with HIV on ART was unchanged at programme-level (98% vs 98%, p = 0.26), but decreased at population-level (86% vs 80%, p = 0.049). Antiretroviral prophylaxis coverage decreased among HIV-exposed infants, at programme- (94% vs 87%, p = 0.001) and population-levels (76% vs 68%, p<0.001). There was no significant change in HIV-exposed infants receiving EID (programme: 107% vs 103%, p = 0.52; population: 87% vs 79%, p = 0.081). The estimated proportion of infants with HIV diagnosed fell from 27% to 18%, (p<0.001), while the estimated proportion on ART was stable at a programme (88% vs 90%, p = 0.82) but not population (22% vs 16%, p = 0.004) level. Despite a drop at the start of the pandemic most programme indicators rapidly recovered. At a population-level indicators were slower to return, suggesting less women with HIV identified in care. |
| format | Article |
| id | doaj-art-56beee322d504b3dadde81623cc9129f |
| institution | OA Journals |
| issn | 2767-3375 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLOS Global Public Health |
| spelling | doaj-art-56beee322d504b3dadde81623cc9129f2025-08-20T02:33:19ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752023-01-0138e000229610.1371/journal.pgph.0002296Impact of the COVID-19 pandemic on the provision and uptake of services for the prevention of mother-to-child transmission of HIV in Zimbabwe.Elizabeth ChappellAnesu ChimwazaNgoni ManikaCatherine J WedderburnZivai Mupambireyi NengukeHannah GannonFrances CowanTom GibbMichelle HeysFelicity FitzgeraldAndrew PhillipsSimbarashe ChimhuyaDiana M GibbDeborah FordAngela MushaviMutsa Bwakura-DangarembiziZimbabwe is targeting elimination of mother-to-child transmission of HIV by December 2025, however the COVID-19 pandemic challenged health service delivery globally. Monthly aggregated data were extracted from DHIS-2 for all facilities delivering antenatal care (ANC). ZIMSTAT and Spectrum demographic estimates were used for population-level denominators. Programme indicators are among those in HIV care and population indicators reflect the total population. The mean estimated proportion of pregnant women booking for ANC per month did not change (91% pre-pandemic vs 91% during pandemic, p = 0.95), despite dropping to 47% in April 2020. At a programme-level, the estimated proportion of women who received at least one HIV test fell in April 2020 (3.6% relative reduction vs March (95% CI 2.2-5.1), p<0.001) with gradual recovery towards pre-pandemic levels. The estimated proportion of women who were retested among those initially negative in pregnancy fell markedly in April 2020 (39% reduction (32-45%), p<0.001) and the subsequent increase was much slower, only reaching 39% by September 2021 compared to average 53% pre-pandemic. The mean estimated proportion of pregnant women with HIV on ART was unchanged at programme-level (98% vs 98%, p = 0.26), but decreased at population-level (86% vs 80%, p = 0.049). Antiretroviral prophylaxis coverage decreased among HIV-exposed infants, at programme- (94% vs 87%, p = 0.001) and population-levels (76% vs 68%, p<0.001). There was no significant change in HIV-exposed infants receiving EID (programme: 107% vs 103%, p = 0.52; population: 87% vs 79%, p = 0.081). The estimated proportion of infants with HIV diagnosed fell from 27% to 18%, (p<0.001), while the estimated proportion on ART was stable at a programme (88% vs 90%, p = 0.82) but not population (22% vs 16%, p = 0.004) level. Despite a drop at the start of the pandemic most programme indicators rapidly recovered. At a population-level indicators were slower to return, suggesting less women with HIV identified in care.https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0002296&type=printable |
| spellingShingle | Elizabeth Chappell Anesu Chimwaza Ngoni Manika Catherine J Wedderburn Zivai Mupambireyi Nenguke Hannah Gannon Frances Cowan Tom Gibb Michelle Heys Felicity Fitzgerald Andrew Phillips Simbarashe Chimhuya Diana M Gibb Deborah Ford Angela Mushavi Mutsa Bwakura-Dangarembizi Impact of the COVID-19 pandemic on the provision and uptake of services for the prevention of mother-to-child transmission of HIV in Zimbabwe. PLOS Global Public Health |
| title | Impact of the COVID-19 pandemic on the provision and uptake of services for the prevention of mother-to-child transmission of HIV in Zimbabwe. |
| title_full | Impact of the COVID-19 pandemic on the provision and uptake of services for the prevention of mother-to-child transmission of HIV in Zimbabwe. |
| title_fullStr | Impact of the COVID-19 pandemic on the provision and uptake of services for the prevention of mother-to-child transmission of HIV in Zimbabwe. |
| title_full_unstemmed | Impact of the COVID-19 pandemic on the provision and uptake of services for the prevention of mother-to-child transmission of HIV in Zimbabwe. |
| title_short | Impact of the COVID-19 pandemic on the provision and uptake of services for the prevention of mother-to-child transmission of HIV in Zimbabwe. |
| title_sort | impact of the covid 19 pandemic on the provision and uptake of services for the prevention of mother to child transmission of hiv in zimbabwe |
| url | https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0002296&type=printable |
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