Prevention of vertical transmission of HIV in South Africa

BMJ 1999;319:1431 ( 27 November )

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Prevention of vertical transmission of HIV in South Africa

Findings probably do not apply to rest of sub-Saharan Africa

Paper did not include as a factor suboptimal effects that arise

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Findings probably do not apply to rest of sub-Saharan Africa

The first 150 words of the full text of this article appear below.

EDITOR $---$ Söderlund et al report the cost effectiveness of options available in South Africa to prevent the vertical transmissionof HIV.¹ I have concerns about the applicability of their findings(from an urban South African hospital setting) to the rest ofsub-Saharan Africa.¹ The paper's conclusion that the treatmentis cost effective assumes that each child in whom seroconversionis prevented would otherwise have consumed substantial hospitalresources.

From the figures in the paper, I calculate that at least £0.33-1.73 ($0.50-2.60) per capita is spent just on HIV positivechildren aged under 1 in an average sub-Saharan country. Thisclearly does not apply to a country like Malawi, whose healthexpenditure is around £2.70 ($4) per capita. This cost-benefitconclusion is not applicable to most of sub-Saharan Africa, wherechildren with HIV infection are generally treated at home andat health centres. Altogether 70-80% of public health costs in. . . [Full text of this article]

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Relevant Article

Prevention of vertical transmission of HIV: analysis of cost effectiveness of options available in South Africa: Neil Söderlund, Karen Zwi, Anthony Kinghorn, and Glenda Gray
BMJ 1999 318: 1650-1656. [Abstract] [Full Text] [PDF]