The cascade of care to prevent mother-to-child transmission in Rio de Janeiro, Brazil, 1996-2013: improving but still some way to go.

Hofer, Cristina Barroso; Egger, Matthias; Davies, Mary-Ann; Frota, Ana Cristina Cisne; de Oliveira, Ricardo Hugo; Abreu, Thalita Fernandes; Araújo, Lúcia Evangelista; Witthlin, Bernardo Bastos; Carvalho, Alice Weber; Cordeiro, Janaína Rivas; Lima, Giulia Pasqualini; Keiser, Olivia (2017). The cascade of care to prevent mother-to-child transmission in Rio de Janeiro, Brazil, 1996-2013: improving but still some way to go. Tropical medicine and international health TM&IH, 22(10), pp. 1266-1274. Blackwell Science 10.1111/tmi.12925

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To describe the cascade of care to HIV mother-to-child transmission (PMTCT) in a Rio de Janeiro reference paediatric clinic and evaluate the main factors possibly associated with HIV transmission.


Data on antenatal care (ANC), perinatal and neonatal assistance to HIV-infected and HIV-exposed but uninfected children assisted in the clinic from 1996 to 2013 were collected. The cascade of care was graphically demonstrated, and possible factors associated with HIV infection were described using regression models for bivariate and multivariate analysis. We imputed missing values of explanatory variables for the final model.


A total of 989 children were included in the analysis: 211 were HIV and 778 HEU. Graphically, the HIV PMTCT cascade of care improved from 1996/2000 to the later periods, but not from 2001/2006 to 2007/2013. The main factor independently associated with the HIV infection over time was breastfeeding. In the period 1996/2000, the lack of antiretroviral use during labour was associated HIV transmission. While in 2001/2007, other modes of delivery but elective Caesarean section, and lack of maternal antiretroviral use during ANC were associated with HIV transmission. In the last period, the main factor associated with transmission was the lack of maternal ANC.


The HIV PMTCT cascade improved over time, but HIV vertical transmission remains a problem, and better access to ANC is needed.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Egger, Matthias and Keiser, Olivia


600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services




Blackwell Science




Tanya Karrer

Date Deposited:

15 Feb 2018 10:21

Last Modified:

23 Oct 2019 04:23

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

HIV VIH Rio de Janeiro cascada cascade children enfants maternal-to-child transmission niños transmisión madre-hijo transmission mère-enfant




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