The NEMAPP Study

The National Evaluation of Malawi’s Prevention of Mother-to-Child Transmission Program

research-context Context

In 2012, mother-to-child HIV transmission accounted for 260,000 of the 2.3 million new HIV infections globally. This figure is down 52% from a peak of 550,000 new childhood infections in 2001. While significant strides towards eliminating mother-to-child transmission have been made, there is a continued need to scale up access to antiretroviral therapy (ART) for HIV+ pregnant and breastfeeding women.

In 2011, Malawi implemented a groundbreaking Prevention of Mother-to-Child Transmission (PMTCT) program by offering all HIV-infected pregnant and breastfeeding women immediate and lifelong ART, regardless of clinical stage or CD4 count. Known as Option B+, this program allows babies to be born HIV-free and enables mothers to remain healthy and able to care for their children.

Option B+ has been adopted by several other countries in the region and was included in the World Health Organization’s updated 2013 guidelines.

research-aim Aim

The purpose of the NEMAPP study is to evaluate the effectiveness of Option B+ in Malawi. This cohort study will measure HIV-exposure in approximately 40,000 infants and will prospectively follow 3,500 mother-infant pairs to measure transmission rates during pregnancy, birth and breastfeeding, and evaluate patient outcomes through 24 months of (child) age. A subset of 1,300 infants will be followed up to 48 months of age.


research-timeline Timeline

September 2013 – March 2018

research-partnerships Partnerships

Funder: U.S. Centers for Disease Control and Prevention (CDC)
Study Lead: Management Sciences for Health

research-team Study Team

Dr. Frank Chimbwandira
Co-Principal Investigator, Malawi Ministry of Health

Dr. Beth Barr
Co-Principal Investigator, CDC

Dr. Erik Schouten
Study Project Director, MSH

Dr. Monique van Lettow
Study Technical Director, Dignitas International

Dr. Joep van Oosterhout
Clinical Study Lead, Dignitas International

Dr. Megan Landes
Extended Cohort Study Lead, Dignitas International

Dr. Fabian Cataldo
Qualitative Study Lead, Dignitas International

research-info Contact

For more info, please email Dr. Monique van Lettow at

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