Preventing perinatal infectionsBMJ 1997; 315 doi: https://doi.org/10.1136/bmj.315.7102.199 (Published 26 July 1997) Cite this as: BMJ 1997;315:199
Need for a simple, inexpensive, safe intervention that can be used routinely in all women
- G Justus Hofmeyr, Professora,
- James McIntyre, Directorb
- a Department of Obstetrics and Gynaecology, Coronation Hospital, University of the Witwatersrand, South Africa
- b Perinatal HIV Research Unit, Department of Obstetrics and Gynaecology, Baragwanath Hospital, University of the Witwatersrand, South Africa
Recent research has highlighted several promising interventions to reduce perinatal infections. Unfortunately, many of these interventions are unaffordable for or inaccessible to women in developing countries, who bear the brunt of these infections, particularly the HIV epidemic. Limiting factors are the cost of the intervention, the cost or availability of diagnostic tests on which some interventions depend, and women's access to health services, particularly before the start of labour. Cost effective alternatives are needed.
Of major concern is the need for methods to reduce perinatal transmission of HIV. Treatment of mother and neonate with zidovudine was effective in one small randomised trial1 and has become the standard of care in many developed countries. Combination antiretroviral therapy is yet to be assessed in this situation. These treatments are unaffordable for most women in developing countries. Short course antiretroviral therapy is being investigated in several trials and, if shown to be effective, may offer a compromise.
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