Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
9016
pubmed:dateCreated
1996-7-18
pubmed:abstractText
Perinatal transmission of human immunodeficiency virus (HIV) type 1 contributes significantly to infant mortality. Exposure in the birth canal may account for some transmission. We examined the efficacy of a birth canal washing procedure in reducing perinatal transmission in Malawi.
pubmed:grant
pubmed:keyword
http://linkedlifedata.com/resource/pubmed/keyword/Africa, http://linkedlifedata.com/resource/pubmed/keyword/Africa South Of The Sahara, http://linkedlifedata.com/resource/pubmed/keyword/Age Factors, http://linkedlifedata.com/resource/pubmed/keyword/Clinical Research, http://linkedlifedata.com/resource/pubmed/keyword/Clinical Trials, http://linkedlifedata.com/resource/pubmed/keyword/Demographic Factors, http://linkedlifedata.com/resource/pubmed/keyword/Developing Countries, http://linkedlifedata.com/resource/pubmed/keyword/Diseases, http://linkedlifedata.com/resource/pubmed/keyword/Eastern Africa, http://linkedlifedata.com/resource/pubmed/keyword/English Speaking Africa, http://linkedlifedata.com/resource/pubmed/keyword/Hiv Infections--prevention and..., http://linkedlifedata.com/resource/pubmed/keyword/Infant, http://linkedlifedata.com/resource/pubmed/keyword/Malawi, http://linkedlifedata.com/resource/pubmed/keyword/Population, http://linkedlifedata.com/resource/pubmed/keyword/Population Characteristics, http://linkedlifedata.com/resource/pubmed/keyword/Research Methodology, http://linkedlifedata.com/resource/pubmed/keyword/Vertical Transmission, http://linkedlifedata.com/resource/pubmed/keyword/Viral Diseases, http://linkedlifedata.com/resource/pubmed/keyword/Youth
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Jun
pubmed:issn
0140-6736
pubmed:author
pubmed:issnType
Print
pubmed:day
15
pubmed:volume
347
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1647-50
pubmed:dateRevised
2008-11-21
pubmed:otherAbstract
PIP: In light of evidence that birth canal exposure to HIV may be a major means of maternal-fetal transmission of the infection, a clinical trial was performed to determine the safety and efficacy of cleansing the birth canal with a cotton pad soaked in 0.25% chlorhexidine. This cleansing took place on admission in labor and every four hours until delivery. After a pilot study in 160 women ensured the safety of the procedure, the study was designed so that all women giving birth in June, July, and November 1994 were part of the control group and those giving birth from August to October were assigned to the intervention group. The mother's HIV status was established, and infants were seen at 6 and 12 weeks postpartum. After adjustment of the sample, data were analyzed on 3327 controls and 3637 cases. 2094 of the total enrolled were infected with HIV. Of these, 59% brought their infants to follow-up at least once as did 61.5% of the mothers who were not infected. The mother-to-infant transmission rate in this study was 27.4%. There was no evidence that the intervention prevented transmission. The only case in which washing reduced transmission rates was in babies born to women whose membranes were ruptured for more than four hours before delivery (in these, the transmission rate was significantly lower in intervention women [25%] than in control women [39.4%]). This result points to a role for ascending infection, but, if this were the case, washing before rupture of the membranes should have and did not reduce risk. Possible reasons for the failure of this intervention are that there may have been inadequate cleansing, the chlorhexidine solution may have been too weak, or the role of birth canal exposure in transmitting the infection may be less than previously believed. It is also difficult to quantify peripartum transmission in infants who are breast fed. The multiple modes by which infection may be transmitted will make it difficult to discover a simple, effective, and affordable way to reduce maternal-child transmission in developing countries.
pubmed:meshHeading
pubmed:year
1996
pubmed:articleTitle
Perinatal intervention trial in Africa: effect of a birth canal cleansing intervention to prevent HIV transmission.
pubmed:affiliation
Viral Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA.
pubmed:publicationType
Journal Article, Clinical Trial, Comparative Study, Research Support, U.S. Gov't, P.H.S., Controlled Clinical Trial