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    Vaginal Lavage With Chlorhexidine During Labour To Reduce Mother-to-child HIV Transmission: Clinical Trial In Mombasa, Kenya

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    Date
    2001-02
    Author
    Gaillard, P
    Mwanyumba, F
    Verhofstede, C
    Claeys, P
    Chohan, V
    Goetghebeur, E
    Mandaliya, K
    Ndinya-Achola, JO
    Temmerman, M
    Type
    Article
    Language
    en
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    Abstract
    OBJECTIVES: To evaluate the effect of vaginal lavage with diluted chlorhexidine on mother-to child transmission of HIV (MTCT) in a breastfeeding population. METHODS: This prospective clinical trial was conducted in a governmental hospital in Mombasa, Kenya. On alternating weeks, women were allocated to non-intervention or to intervention consisting of vaginal lavage with 120 ml 0.2% chlorhexidine, later increased to 0.4%, repeated every 3 h from admission to delivery. Infants were tested for HIV by DNA polymerase chain reaction within 48 h and at 6 and 14 weeks of life. RESULTS: Enrolment and follow-up data were available for 297 and 309 HIV-positive women, respectively, in the non-lavage and the lavage groups. There was no evidence of a difference in intrapartum MTCT (17.2 versus 15.9%, OR 0.9, 95% CI 0.6-1.4) between the groups. Lavage solely before rupture of the membranes tended towards lower MTCT with chlorhexidine 0.2% (OR 0.6, 95% CI 0.3-1.1), and even more with chlorhexidine 0.4% (OR 0.1, 95% CI 0.0-0.9). CONCLUSION: The need remains for interventions reducing MTCT without HIV testing, often unavailable in countries with a high prevalence of HIV. Vaginal lavage with diluted chlorhexidine during delivery did not show a global effect on MTCT in our study. However, the data suggest that lavage before the membranes are ruptured might be associated with a reduction of MTCT, especially with higher concentrations of chlorhexidine.
    URI
    Http://profiles.uonbi.ac.ke/jndinya/publications/gaillard-p-mwanyumba-f-verhofstede-c-claeys-p-chohan-v-goetghebeur-e-mandaliya-
    http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/28297
    Citation
    Gaillard P, Mwanyumba F, Verhofstede C, Claeys P, Chohan V, Goetghebeur E, Mandaliya K, Ndinya-achola J, Temmerman M.vaginal Lavage With Chlorhexidine During Labour To Reduce Mother-to-child Hiv Transmission: Clinical Trial In Mombasa, Kenya. Aids. 2001 F, O., Prof. Ndinya-achola J. , Aids. 2001 Feb 16;15(3):389-96., (2001)
    Publisher
    University of Nairobi
     
    School of medicine (Obstetrics and gynaecology)
     
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    • Faculty of Health Sciences (FHS) [10214]

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