Prevention of mother-to-child transmission in HIV audit in Xhosa clinic, Mahalapye, Botswana

Background: The Mahalapye district health management team (DHMT) conducts regular audits to evaluate the standard of services delivered to patients, one of which is the prevention of mother-to-child-transmission (PMTCT) programme. Xhosa clinic is one of the facilities in Mahalapye which provides a PMTCT programme. Aim: This audit aimed to identify gaps between the current PMTCT clinical practice in Xhosa clinic and the Botswana PMTCT national guidelines. Setting: This audit took place in Xhosa clinic in the urban village of Mahalapye, in the Central District of Botswana. Methods: This was a retrospective audit using PMTCT Xhosa clinic records of pregnant mothers and HIV-exposed babies seen from January 2013 to June 2013. Results: One hundred and thirty-three pregnant women registered for antenatal care. Twenty-five (19%) knew their HIV-positive status as they had been tested before their pregnancy or had tested HIV positive at their first antenatal clinic visit. More than two-thirds of the 115 pregnant women (69%) were seen at a gestational age of between 14 and 28 weeks. About two-thirds of the pregnant women (67%) took antiretroviral drugs. Of the 44 HIV-exposed infants, 39 (89%) were HIV DNA PCR negative at 6 weeks. Thirty-two (73%) children were given cotrimoxazole prophylaxis between 6 and 8 weeks. Conclusion: The PMTCT programme service delivery was still suboptimal and could potentially increase the mother-to-child transmission of HIV. Daily monitoring mechanism to track those eligible could help to close the gap.