Vaginal lavage with chlorhexidine during labour to reduce mother-to-child HIV transmission: clinical trial in Mombasa, Kenya.
Authors & affiliation
P GAILLARD, F MWANYUMBA, Chris Verhofstede, Patricia Claeys, V CHOHAN, Els Goetghebeur, K MANDALIYA, J NDINYA-ACHOLA, Marleen Temmerman
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% Cl 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% Cl 0.3-1.1), and even more with chlorhexidine 0.4% (OR 0.1, 95% Cl 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.
Related publications
Olivier Degomme, Emilie Peeters, Hedwig Deconinck, Alban Ylli, Albana Fico, Gentiana Qirjako, Dorina Ttocaj, Sara De Meyer, Kristien Michielsen, Anna Page, Wina Baeha, Kristi Praptiwi, Miranda van Reeuwijk, Beatriz Manuel, Elin C. Larsson, Carmen Ortiz, Bernardo Vega, Monserrath Jerves, Simukai Shamu, Annemiek Seeuws, Anna Galle, Anne Nobels, Ines Keygnaert, Hazel Barrett, Nina Van Eekert, Tammary Esho, Els Leye, Carles Pericas Escale, Samuel Thuo Kimani, Sofie Thielemans, Dara De Schutter, Remi Moerkerke, Louis De Backer, Viola N. Nyakato, Elizabeth Kemigisha, Wei Hong Zhang, Marleen Temmerman, Lina Hu, Shangchun Wu, Kaiyan Pei, Charlotte Neves de Oliveira, Argyro Chatzinikolaou, Eva Lievens
2022 Barriers and facilitators to cervical cancer screening among under- and neverscreened women in Belgium : a qualitative study on community and healthcare providers’ perspectiveBo Verberckmoes, Elien De Paepe, Janne De Vestele, Heleen Vermandere, Ines Keygnaert, Olivier Degomme
2022 Inhoudelijk eindrapport Opleiding seksueel geweld voor de Family Justice Centers & Ketenaanpak Intrafamiliaal GeweldSaar Baert, Lisa Fomenko, Nele Vaerewijck, Lotte De Schrijver, An-Sofie Van Parys, Ines Keygnaert