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Vaginal lavage with chlorhexidine during labour to reduce mother-to-child HIV transmission: clinical trial in Mombasa, Kenya.

(2001) AIDS. 15(3). p.389-396
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Organization
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.

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Chicago
GAILLARD, P, F MWANYUMBA, Chris Verhofstede, Patricia Claeys, V CHOHAN, Els Goetghebeur, K MANDALIYA, J NDINYA-ACHOLA, and Marleen Temmerman. 2001. “Vaginal Lavage with Chlorhexidine During Labour to Reduce Mother-to-child HIV Transmission: Clinical Trial in Mombasa, Kenya.” Aids 15 (3): 389–396.
APA
GAILLARD, P., MWANYUMBA, F., Verhofstede, C., Claeys, P., CHOHAN, V., Goetghebeur, E., MANDALIYA, K., et al. (2001). Vaginal lavage with chlorhexidine during labour to reduce mother-to-child HIV transmission: clinical trial in Mombasa, Kenya. AIDS, 15(3), 389–396.
Vancouver
1.
GAILLARD P, MWANYUMBA F, Verhofstede C, Claeys P, CHOHAN V, Goetghebeur E, et al. Vaginal lavage with chlorhexidine during labour to reduce mother-to-child HIV transmission: clinical trial in Mombasa, Kenya. AIDS. 2001;15(3):389–96.
MLA
GAILLARD, P, F MWANYUMBA, Chris Verhofstede, et al. “Vaginal Lavage with Chlorhexidine During Labour to Reduce Mother-to-child HIV Transmission: Clinical Trial in Mombasa, Kenya.” AIDS 15.3 (2001): 389–396. Print.
@article{137424,
  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.},
  author       = {GAILLARD, P and MWANYUMBA, F and Verhofstede, Chris and Claeys, Patricia and CHOHAN, V and Goetghebeur, Els and MANDALIYA, K and NDINYA-ACHOLA, J and Temmerman, Marleen},
  issn         = {0269-9370},
  journal      = {AIDS},
  language     = {eng},
  number       = {3},
  pages        = {389--396},
  title        = {Vaginal lavage with chlorhexidine during labour to reduce mother-to-child HIV transmission: clinical trial in Mombasa, Kenya.},
  volume       = {15},
  year         = {2001},
}

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