Egypt got back on track in t heir 2010 World Cup/African nations cup qualification campaign with a solid 2-0 victory over Malawi here Sunday.
The win came less than a week after the reigning African champions were defeated in Malawi in a shock upset that left them third in the group table.
Netting a goal in each half, the Pharaohs made certain of victory, keeping alive its hopes of finishing top of the group.
Egypt’s counterpart atop the standings is the DR Congo, who easily defeated Djibouti 5-1 to lead the table on goal difference.
Egypt, which defeated the DR Congo in Cairo earlier this month, will travel to face DR Congo in a match that will likely see the winner qualify for the second round of the World Cup qualifying.
All winners of the group stage will advance to the final round of qualification, while the top eight second-place finishers will also make it to the final group stage.
The 20 teams will be split into five groups of four teams with the winner of each group earning a trip to the World Cup finals in South Africa in 2010.
Monday, 23 June 2008
Minister of State Peter Power opens Irish Embassy in Malawi and announces additional €10m aid package
Later today Minister of State for Overseas Development, Peter Power T.D., will officially open a new Irish Embassy in Lilongwe, Malawi. The Ministers of Foreign Affairs, Joyce Banda MP, and Finance, Goodall Gondwe MP, are expected to participate in the ceremony.
Speaking in advance of the opening, Minister of State Power remarked:
‘The opening of an Embassy in Malawi considerably strengthens our bilateral relations and our partnership in the development area. Irish Aid will finalise a comprehensive assistance strategy early next year. This is a tribute to the commitment of the Government of Malawi to reducing poverty and it is part of our joint effort to reach the Millennium Development Goals.’
Earlier today, Minister of State Power had an opportunity to meet with the President of Malawi, His Excellency Bingu wa Mutharika.
Minister Power also announced today an interim package of €10m in Irish Aid assistance for Malawi for 2008. The Minister commented:
‘The package of support announced today will go a long way to helping the most vulnerable communities in Malawi to respond to food insecurity and rising food prices. It will also build on efforts to promote good governance. I am particularly pleased that Ireland will be supporting Malawi in its preparations for the national elections in May next year. I am delighted that we are in a position to offer this assistance at a crucial time for Malawi.’
The interim package of support for 2008 is very closely aligned with Malawi’s national plan for poverty reduction. It will provide a firm foundation for a multi-year programme of support to Malawi in the years ahead and will allow the country to respond to key challenges, including in the areas of agricultural production and rural development, to help offset rising food prices.
Yesterday the Minister of State visited Khulumgira village in Dedza District where he saw at first hand the benefit of funding from Irish taxpayers in improving food yields among vulnerable communities.
Seven of the nine Irish Aid programme countries are in Africa, reflecting the concentration of poverty on the continent. Malawi is one of the poorest countries in the world and faces considerable development challenges including in the areas of HIV and AIDS, food security and education.
Note to Editors:
Ireland has provided significant humanitarian assistance to Malawi since 2002 when the country suffered a serious food crisis. Between 2002 and 2007, Irish Aid assistance totalled €27m.
The funding package of €10m announced today will focus on support for food security and vulnerability, governance and the One UN initiative. In addition, Irish Aid will provide €4.5m to non-governmental organisations based in Malawi this year through its Multi-Annual Programming and Block Grants schemes. These include Concern, Self-Help Development International, Trócaire and Goal.
Programmes and activities to be funded under the package announced today include:
a) €1 million in support of the 2009 Elections
b) €1.5 million for Food Security programmes in Central Region, implemented in cooperation with Concern Universal.
c) €320,000 for the introduction of new varieties of seed potato in Malawi, through the International Potato Centre.
d) €1 million to improve the fertility of soil, by organic means, in cooperation with the World Agro-Forestry Centre and the Ministry of Agriculture.
e) €400,000 for the implementation of a national micronutrients survey in partnership with the Office of the President & Cabinet and UNICEF, and in support of a pilot Vitamin A fortification programme.
f) €300,000 in support of the improvement of the quality of primary education in Mzuzu region, in cooperation with the Catholic Diocese of Mzuzu and the Ministry of Education.
g) €110,000 in support of Reforms within the UN System in Malawi, through the One UN Transformation Fund.
h) Opportunities for an Irish Aid contribution to the governmen’ts Agricultural Inputs Subsidy, in the order of approximately €1m are currently being advanced.
In addition, €2m of funding is earmarked for work in support of the National Population Census.
Irish Embassy in Malawi:
H.E Ambassador Liam MacGabhann presented credentials to His Excellency President Bingu wa Mutharika in November 2007, paving the way for the establishment of an Irish Embassy.
Speaking in advance of the opening, Minister of State Power remarked:
‘The opening of an Embassy in Malawi considerably strengthens our bilateral relations and our partnership in the development area. Irish Aid will finalise a comprehensive assistance strategy early next year. This is a tribute to the commitment of the Government of Malawi to reducing poverty and it is part of our joint effort to reach the Millennium Development Goals.’
Earlier today, Minister of State Power had an opportunity to meet with the President of Malawi, His Excellency Bingu wa Mutharika.
Minister Power also announced today an interim package of €10m in Irish Aid assistance for Malawi for 2008. The Minister commented:
‘The package of support announced today will go a long way to helping the most vulnerable communities in Malawi to respond to food insecurity and rising food prices. It will also build on efforts to promote good governance. I am particularly pleased that Ireland will be supporting Malawi in its preparations for the national elections in May next year. I am delighted that we are in a position to offer this assistance at a crucial time for Malawi.’
The interim package of support for 2008 is very closely aligned with Malawi’s national plan for poverty reduction. It will provide a firm foundation for a multi-year programme of support to Malawi in the years ahead and will allow the country to respond to key challenges, including in the areas of agricultural production and rural development, to help offset rising food prices.
Yesterday the Minister of State visited Khulumgira village in Dedza District where he saw at first hand the benefit of funding from Irish taxpayers in improving food yields among vulnerable communities.
Seven of the nine Irish Aid programme countries are in Africa, reflecting the concentration of poverty on the continent. Malawi is one of the poorest countries in the world and faces considerable development challenges including in the areas of HIV and AIDS, food security and education.
Note to Editors:
Ireland has provided significant humanitarian assistance to Malawi since 2002 when the country suffered a serious food crisis. Between 2002 and 2007, Irish Aid assistance totalled €27m.
The funding package of €10m announced today will focus on support for food security and vulnerability, governance and the One UN initiative. In addition, Irish Aid will provide €4.5m to non-governmental organisations based in Malawi this year through its Multi-Annual Programming and Block Grants schemes. These include Concern, Self-Help Development International, Trócaire and Goal.
Programmes and activities to be funded under the package announced today include:
a) €1 million in support of the 2009 Elections
b) €1.5 million for Food Security programmes in Central Region, implemented in cooperation with Concern Universal.
c) €320,000 for the introduction of new varieties of seed potato in Malawi, through the International Potato Centre.
d) €1 million to improve the fertility of soil, by organic means, in cooperation with the World Agro-Forestry Centre and the Ministry of Agriculture.
e) €400,000 for the implementation of a national micronutrients survey in partnership with the Office of the President & Cabinet and UNICEF, and in support of a pilot Vitamin A fortification programme.
f) €300,000 in support of the improvement of the quality of primary education in Mzuzu region, in cooperation with the Catholic Diocese of Mzuzu and the Ministry of Education.
g) €110,000 in support of Reforms within the UN System in Malawi, through the One UN Transformation Fund.
h) Opportunities for an Irish Aid contribution to the governmen’ts Agricultural Inputs Subsidy, in the order of approximately €1m are currently being advanced.
In addition, €2m of funding is earmarked for work in support of the National Population Census.
Irish Embassy in Malawi:
H.E Ambassador Liam MacGabhann presented credentials to His Excellency President Bingu wa Mutharika in November 2007, paving the way for the establishment of an Irish Embassy.
Budget row doesn't threaten Malawi spending - finance minister
Malawi government spending can continue for up to four months if the opposition-led parliament does not adopt the budget by July 1, the start of the new financial year, its finance minister said on Monday.
However Goodall Gondwe warned that donors could be dissuaded from advancing funds if the impasse over the 2008/09 budget caused by a political feud continued.
The southern African country's President Bingu wa Mutharika on Friday suspended parliament until opposition legislators give him guarantees that they will adopt the budget.
"If the budget is not passed by July 1, I will have to spend for four months on essential services without parliament approval because the law allows me to," Gondwe told Reuters.
The opposition alliance of United Democratic Front (UDF) and Malawi Congress Party say according to the constitution wa Mutharika's Democratic Progressive Party should lose 60 legislators he is accused of poaching when he quit the UDF.
But analysts said that the finance minister may still need parliament's permission to let him to spend.
"He will still need parliament because the law says that even in such a case, he will have to ask parliament to authorise him to withdraw from the consolidated fund for government to meet expenditure necessary to carry out services for only four months," Edwin Banda, a constitutional lawyer said.
Wa Mutharika's decision to suspended parliament has been widely condemned by public interest groups and the opposition because it deepens a political crisis and threatens mediation talks led by the Catholic Church to resolve the impasse.
There are fears that failure to pass the budget may undermine donor confidence.
"Delaying passage of the budget would not only affect the fertilizer subsidy programme meant for the poor but it would also have the potential of diminishing donor aid," Gondwe said.
The draft 2008/09 budget allocates more resources to the agriculture sector with more spending on food production and health care, and proposes 20 percent salary increases for civil servants.
The political crisis delayed passage of the budget last year until pressure from the international community and civil society forced opposition legislators to back down.
However Goodall Gondwe warned that donors could be dissuaded from advancing funds if the impasse over the 2008/09 budget caused by a political feud continued.
The southern African country's President Bingu wa Mutharika on Friday suspended parliament until opposition legislators give him guarantees that they will adopt the budget.
"If the budget is not passed by July 1, I will have to spend for four months on essential services without parliament approval because the law allows me to," Gondwe told Reuters.
The opposition alliance of United Democratic Front (UDF) and Malawi Congress Party say according to the constitution wa Mutharika's Democratic Progressive Party should lose 60 legislators he is accused of poaching when he quit the UDF.
But analysts said that the finance minister may still need parliament's permission to let him to spend.
"He will still need parliament because the law says that even in such a case, he will have to ask parliament to authorise him to withdraw from the consolidated fund for government to meet expenditure necessary to carry out services for only four months," Edwin Banda, a constitutional lawyer said.
Wa Mutharika's decision to suspended parliament has been widely condemned by public interest groups and the opposition because it deepens a political crisis and threatens mediation talks led by the Catholic Church to resolve the impasse.
There are fears that failure to pass the budget may undermine donor confidence.
"Delaying passage of the budget would not only affect the fertilizer subsidy programme meant for the poor but it would also have the potential of diminishing donor aid," Gondwe said.
The draft 2008/09 budget allocates more resources to the agriculture sector with more spending on food production and health care, and proposes 20 percent salary increases for civil servants.
The political crisis delayed passage of the budget last year until pressure from the international community and civil society forced opposition legislators to back down.
Power to open embassy in Malawi
LOCAL TD and Minister of State for Overseas Development, Peter Power has travelled to Malawi where he will open a new Irish Embassy in Lilongwe later on today.
As well as presiding over the opening ceremony Minister of State Power also announced an aid package of 10 million euro in Irish Aid assistance for Malawi for 2008.
Minister of State Power said that the opening of an Embassy in Malawi considerably strengthens Irish bilateral relations and partnership in the area.
"Irish Aid will finalise a comprehensive assistance strategy early next year. This is a tribute to the commitment of the Government of Malawi to reducing poverty and it is part of our joint effort to reach the Millennium Development Goals."
He added that the 10 million euro aid package would help vulnerable communities in Malawi to respond to food insecurity and rising food prices.
"The interim package of support for 2008 is very closely aligned with Malawi’s national plan for poverty reduction. It will provide a firm foundation for a multi-year programme of support to Malawi in the years ahead and will allow the country to respond to key challenges, including in the areas of agricultural production and rural development, to help offset rising food prices," he said.
Earlier Minister of State Power had an opportunity to meet with the President of Malawi, His Excellency Bingu wa Mutharika.
Yesterday he visited Khulumgira village in Dedza District where he saw at first hand the benefit of funding from Irish taxpayers in improving food yields among vulnerable communities.
As well as presiding over the opening ceremony Minister of State Power also announced an aid package of 10 million euro in Irish Aid assistance for Malawi for 2008.
Minister of State Power said that the opening of an Embassy in Malawi considerably strengthens Irish bilateral relations and partnership in the area.
"Irish Aid will finalise a comprehensive assistance strategy early next year. This is a tribute to the commitment of the Government of Malawi to reducing poverty and it is part of our joint effort to reach the Millennium Development Goals."
He added that the 10 million euro aid package would help vulnerable communities in Malawi to respond to food insecurity and rising food prices.
"The interim package of support for 2008 is very closely aligned with Malawi’s national plan for poverty reduction. It will provide a firm foundation for a multi-year programme of support to Malawi in the years ahead and will allow the country to respond to key challenges, including in the areas of agricultural production and rural development, to help offset rising food prices," he said.
Earlier Minister of State Power had an opportunity to meet with the President of Malawi, His Excellency Bingu wa Mutharika.
Yesterday he visited Khulumgira village in Dedza District where he saw at first hand the benefit of funding from Irish taxpayers in improving food yields among vulnerable communities.
Egypt Beats Malawi In Revenge World Cup Match
Cairo, Egypt (AHN) - Egypt got back on track in their World Cup qualification campaign with a solid 2-0 victory over Malawi in Cairo on Sunday. The win came less than a week after the reigning African champions were defeated in Malawi in a shock upset that left them third in the group table.
Netting a goal in each half, the Pharaohs made certain of victory, keeping alive its hopes of finishing top of the group. Egypt's counterpart atop the standings is the Democratic Republic of Congo, who easily defeated Djibouti 5-1 to lead the table on goal difference.
Egypt, which defeated the DR Congo in Cairo earlier this month, will travel to face DR Congo in a match that will likely see the winner qualify for the second round of World Cup qualifying.
All winners of the group stage will advance to the final round of qualification, while the top 8 second place finishers will also make it to the final group stage.
The 20 teams will be split into five groups of four teams with the winner of each group earning a trip to the World Cup finals in South Africa in 2010.
Netting a goal in each half, the Pharaohs made certain of victory, keeping alive its hopes of finishing top of the group. Egypt's counterpart atop the standings is the Democratic Republic of Congo, who easily defeated Djibouti 5-1 to lead the table on goal difference.
Egypt, which defeated the DR Congo in Cairo earlier this month, will travel to face DR Congo in a match that will likely see the winner qualify for the second round of World Cup qualifying.
All winners of the group stage will advance to the final round of qualification, while the top 8 second place finishers will also make it to the final group stage.
The 20 teams will be split into five groups of four teams with the winner of each group earning a trip to the World Cup finals in South Africa in 2010.
Guitarist Thibault Cauvin thrills Malawi
French guitarist Thibault Cauvin on Saturday night produced a scintillating performance showing the power of the guitar during his concert held at French Cultural Centre (FCC) in Malawi's commercial city of Blantyre.
Cauvin who is on a world tour sponsored by Cultures French showed as to why he is among the best guitarist as he played Jazz songs using his guitar.
He plucked his guitar so well attracting applause from the French Cultural Centre auditorium.
Thibault’s show was spiced up by Malawi’s Kaligo Melodies led by Collen Ali who also won the hearts of many as he plucked his guitar playing local tracks.
“This is my first time to play alongside an international artist but I am happy with the support I got from the audience. The audience was special and listened so attentively,” said Ali.
The Malawi musician hailed FCC for bringing the French guitarist to play alongside local artists saying this would help sharpen their skills.
Cauvin said before he jumped on stage that he was happy to be in Malawi as part of his tour adding that its people were very friendly.
“Mwaswera bwanji? (How has been your day?). I am happy to be in Malawi and hold shows,” said the French artist who finished the show with a track which was done by his father Philip, a guitarist and composer.
The artist said he had been in about 25 countries in Africa and that he was coming to Malawi after visiting Zambia.
The French guitarist who has received several awards, among them the “prize of the Arts” from the Rotary Club of Bordeaux in 2003, was born on July 6, 1984. He began learning classical guitar at the age of 6.
In another development Malawi achieved yet another feat in the film industry when its celebrated writer Shemu Joyah launched his first ever film titled Seasons of Life at Comesa hall in Blantyre on Saturday night.
The movie explores what happens when a housemaid is coaxed into love, made pregnant and is forced by circumstances to keep away from – and almost lose – her baby.
Fourteen-week nevirapine prophylaxis for infants reduces postnatal HIV infection
A randomised clinical trial conducted in Malawi has found that extending prophylaxis with nevirapine (Viramune), with or without AZT (zidovudine, Retrovir), from one week to fourteen weeks of life, significantly reduces HIV infection in infants born to HIV-positive mothers. At nine months of age, estimated rates of HIV infection were 10.6% for infants treated for one week, versus 5.2% for those treated with fourteen weeks of nevirapine and 6.4% for those treated with fourteen weeks of nevirapine and AZT. The results were reported in the June 4th online edition of the New England Journal of Medicine.
Breastfeeding by HIV-positive mothers poses a substantial risk of HIV transmission, with up to 16% of untreated infants becoming infected when breast feeding continues into the second year of life. However, more recent research has shown that weaning and formula feeding in resource-poor areas exposes babies to severe health risks from other causes. Interventions to allow safer breast feeding are needed.
In Malawi, the standard course of HIV prophylaxis for infants is a single dose of nevirapine plus one week of daily AZT. In this study, the Post-Exposure Prophylaxis of Infants (PEPI) trial, American and Malawian researchers investigated longer courses of prophylactic treatment for infants.
Women who presented for antenatal care or delivery at any of six health centres in Blantyre, Malawi – including the main hospital, Queen Elizabeth Central Hospital – were offered HIV counselling and testing. Study enrollment began in April 2004, and the published analysis is based on data through August 2007. During this time, a total of 46,186 women were screened. Of these, 3216 who were found (or previously known) to be HIV-positive prior to delivery, and were eligible for and consented to the study, were enrolled. Median age was just over 26 years and, despite their HIV status, the women were mostly in good health.
A total of 3276 infants were born to these women during the study period. Excluding the 260 children who were born HIV-infected or with indeterminate results (i.e., those who could not be confirmed as HIV-uninfected at birth), study analysis was based on the remaining 3016. At birth, infants were randomly assigned to one of three treatment regimens (all drugs given orally):
* The control group (n=1003): single-dose nevirapine (2 mg/kg of body weight) plus one week of AZT (4 mg/kg given twice daily).
* The extended-nevirapine group (n=1016): same as the control regimen, plus nevirapine given at 2 mg/kg once daily during the second week, then 4 mg/kg once daily up to fourteen weeks.
* The extended-dual-prophylaxis group (n=997): same as the extended-nevirapine regimen, plus AZT given at 4 mg/kg twice daily during weeks two through five, then 4 mg/kg three times daily during weeks six through eight, then 6 mg/kg three times daily up to fourteen weeks.
The fourteen-week duration was chosen to coincide with the recommended fourteen-week infant immunisation schedule in Malawi. Prophylaxis was discontinued in any infants found to be HIV-infected during the fourteen weeks, but these infants were still followed for the study duration.
Of the 3016 infants analysed, outcomes were as follows: in the control group, 1003 at baseline, 69 deaths (all HIV-uninfected), 146 lost to follow-up, 788 reached the nine-month study endpoint. In the extended-nevirapine group, 1016 at baseline, 69 deaths (all HIV-uninfected), 147 lost to follow-up, 800 reached study endpoint. In the extended-dual-prophylaxis group, 997 at baseline, 68 deaths (all HIV-uninfected), 128 lost to follow-up, 801 reached study endpoint.
At nine months, rates of HIV infection were: for the control group, 10.6% (95% confidence interval [CI], 8.7 to 12.8), for the extended-nevirapine group, 5.2% (95% CI, 3.9 to 7.0, p < 0.001), and for the extended-dual-prophylaxis group, 6.4% (95% CI, 4.9 to 8.3, p = 0.002). (HIV diagnosis was based on a positive HIV-1 DNA PCR assay at any visit or a positive ELISA and confirmatory Western blot analysis at fifteen months of age or later. Thirteen of the infections were classified as "presumptive"; these presumptive diagnoses were distributed equally across the treatment groups.) There were no statistically significant differences between the two extended-prophylaxis groups at any time point.
Overall, 1283 serious adverse events were reported in 887 infants – most frequently, respiratory (329 events), gastrointestinal (227 events), and haematologic (191 events). Most serious adverse events (87.3%) were not significantly associated with a study drug, but significantly more possibly drug-related serious adverse event were seen in extended-dual-prophylaxis group (p = 0.02 for all comparisons).
The team concluded that "both extended prophylaxis regimens significantly reduced the risk of postnatal transmission at 14 weeks with a protective efficacy of more than 60%." The addition of AZT to the extended nevirapine regimen appeared to increase toxicities but added no significant benefit. Higher rates of HIV infection in the babies who received standard, one-week prophylaxis resulted in higher rates of mortality in this group after the age of six months, although overall mortality rates from all causes, over the course of follow-up, were similar across all groups.
The researchers state that, on the basis of their data, a fourteen-week nevirapine prophylactic regimen for infants "appears to be safe, with the rate of adverse events similar to that in the control group. This infant-only antiretroviral prophylaxis is practical and effective in reducing HIV-1 transmission and in improving HIV-1–free survival in settings in which breast-feeding is common. The question of whether infants … should receive antiretroviral prophylaxis for the entire duration of breast-feeding needs to be assessed."
Breastfeeding by HIV-positive mothers poses a substantial risk of HIV transmission, with up to 16% of untreated infants becoming infected when breast feeding continues into the second year of life. However, more recent research has shown that weaning and formula feeding in resource-poor areas exposes babies to severe health risks from other causes. Interventions to allow safer breast feeding are needed.
In Malawi, the standard course of HIV prophylaxis for infants is a single dose of nevirapine plus one week of daily AZT. In this study, the Post-Exposure Prophylaxis of Infants (PEPI) trial, American and Malawian researchers investigated longer courses of prophylactic treatment for infants.
Women who presented for antenatal care or delivery at any of six health centres in Blantyre, Malawi – including the main hospital, Queen Elizabeth Central Hospital – were offered HIV counselling and testing. Study enrollment began in April 2004, and the published analysis is based on data through August 2007. During this time, a total of 46,186 women were screened. Of these, 3216 who were found (or previously known) to be HIV-positive prior to delivery, and were eligible for and consented to the study, were enrolled. Median age was just over 26 years and, despite their HIV status, the women were mostly in good health.
A total of 3276 infants were born to these women during the study period. Excluding the 260 children who were born HIV-infected or with indeterminate results (i.e., those who could not be confirmed as HIV-uninfected at birth), study analysis was based on the remaining 3016. At birth, infants were randomly assigned to one of three treatment regimens (all drugs given orally):
* The control group (n=1003): single-dose nevirapine (2 mg/kg of body weight) plus one week of AZT (4 mg/kg given twice daily).
* The extended-nevirapine group (n=1016): same as the control regimen, plus nevirapine given at 2 mg/kg once daily during the second week, then 4 mg/kg once daily up to fourteen weeks.
* The extended-dual-prophylaxis group (n=997): same as the extended-nevirapine regimen, plus AZT given at 4 mg/kg twice daily during weeks two through five, then 4 mg/kg three times daily during weeks six through eight, then 6 mg/kg three times daily up to fourteen weeks.
The fourteen-week duration was chosen to coincide with the recommended fourteen-week infant immunisation schedule in Malawi. Prophylaxis was discontinued in any infants found to be HIV-infected during the fourteen weeks, but these infants were still followed for the study duration.
Of the 3016 infants analysed, outcomes were as follows: in the control group, 1003 at baseline, 69 deaths (all HIV-uninfected), 146 lost to follow-up, 788 reached the nine-month study endpoint. In the extended-nevirapine group, 1016 at baseline, 69 deaths (all HIV-uninfected), 147 lost to follow-up, 800 reached study endpoint. In the extended-dual-prophylaxis group, 997 at baseline, 68 deaths (all HIV-uninfected), 128 lost to follow-up, 801 reached study endpoint.
At nine months, rates of HIV infection were: for the control group, 10.6% (95% confidence interval [CI], 8.7 to 12.8), for the extended-nevirapine group, 5.2% (95% CI, 3.9 to 7.0, p < 0.001), and for the extended-dual-prophylaxis group, 6.4% (95% CI, 4.9 to 8.3, p = 0.002). (HIV diagnosis was based on a positive HIV-1 DNA PCR assay at any visit or a positive ELISA and confirmatory Western blot analysis at fifteen months of age or later. Thirteen of the infections were classified as "presumptive"; these presumptive diagnoses were distributed equally across the treatment groups.) There were no statistically significant differences between the two extended-prophylaxis groups at any time point.
Overall, 1283 serious adverse events were reported in 887 infants – most frequently, respiratory (329 events), gastrointestinal (227 events), and haematologic (191 events). Most serious adverse events (87.3%) were not significantly associated with a study drug, but significantly more possibly drug-related serious adverse event were seen in extended-dual-prophylaxis group (p = 0.02 for all comparisons).
The team concluded that "both extended prophylaxis regimens significantly reduced the risk of postnatal transmission at 14 weeks with a protective efficacy of more than 60%." The addition of AZT to the extended nevirapine regimen appeared to increase toxicities but added no significant benefit. Higher rates of HIV infection in the babies who received standard, one-week prophylaxis resulted in higher rates of mortality in this group after the age of six months, although overall mortality rates from all causes, over the course of follow-up, were similar across all groups.
The researchers state that, on the basis of their data, a fourteen-week nevirapine prophylactic regimen for infants "appears to be safe, with the rate of adverse events similar to that in the control group. This infant-only antiretroviral prophylaxis is practical and effective in reducing HIV-1 transmission and in improving HIV-1–free survival in settings in which breast-feeding is common. The question of whether infants … should receive antiretroviral prophylaxis for the entire duration of breast-feeding needs to be assessed."
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