Abstract:

Introduction: Aids is a pandemic. In 2016, according to UNAIDS, the number of people living with HIV is 36.7 million. New infected children represent 160 000, mostly via their HIV positive mothers during pregnancy, delivery or breastfeeding. Since 2010, different political decisions were adopted and later the option B+ to reduce the transmission rate. Little is known about their implementation at the operational level in the Center Region of Cameroon.

Method: We aimed to draw the evolution of PMTCT services in the Biyem-Assi District Hospital. From 01 to 26 April 2016, through a descriptive retrospective cross sectional study, we used registers of the consultation (pregnant women, children) and HIV test from 2010 to 2015, Excel software to compile data, describe tables and figures.

Results: We found a good response rate of the HIV screening test in the ANC unit. 99.88% in 2015 compare to 95.93% in 2010. The number of pregnant women newly screened in the delivery room was increasing, 99 in 2013, 279 in 2014 and 786 in 2015. Among these pregnant women newly screened, an increasing number of positive cases; from 2 in 2010 to 10 in 2015. There was a high rate of lost to follow up of HIV-exposed infants (HEI).

Conclusion: Training of health care workers is a priority for the early infant diagnosis of HIV. Further studies are needed to reduce the lost to follow up, to screen and treat the HEI registered in the delivery rooms.

Keywords: PMTCT, HEI, option B+, Biyem-Assi District Hospital, HIV, AIDS.

References:

[1].     Abtew, S., Awoke, W., & Asrat, A. (2015, November 9). Acceptability of provider - initiated HIV testing as an intervention for prevention of mother to child transmission of HIV and associated factors among pregnant women attending at Public Health Facilities in Assosa town, Northwest Ethiopia. BioMed Central, p. 661.

[2].     Ahmed, C. V., Jolly, P., Padilla, L., Malinga, M., Harris, C., Mthethwa, N., … Preko, P. (2017). A qualitative analysis of the barriers to antiretroviral therapy initiation among children 2 to 18 months of age in Swaziland. African Journal of AIDS Research: AJAR, 16(4), 321–328. https://doi.org/10.2989/16085906.2017.1380677

[3].     Burton, J., Darbes, L. A., & Operario, D. (2010). Couples-focused behavioral interventions for prevention of HIV: systematic review of the state of evidence. AIDS and Behavior, 14(1), 1–10. https://doi.org/10.1007/s10461-008-9471-4

[4].     Etoori, D., Kerschberger, B., Staderini, N., Ndlangamandla, M., Nhlabatsi, B., Jobanputra, K., … Teck, R. (2018). Challenges and successes in the implementation of option B+ to prevent mother-to-child transmission of HIV in southern Swaziland. BMC Public Health, 18(1), 374. https://doi.org/10.1186/s12889-018-5258-3

[5].     Ghoma-Linguissi, L. S., Ebourombi, D. F., Sidibe, A., Kivouele, T. S., Vouvoungui, J. C., Poulain, P., & Ntoumi, F. (2015). Factors influencing acceptability of voluntary HIV testing among pregnant women in Gamboma, Republic of Congo. BMC Research Notes, 8, 652. https://doi.org/10.1186/s13104-015-1651-5

[6].     Hampanda, K. M., Nimz, A. M., & Abuogi, L. L. (2017). Barriers to uptake of early infant HIV testing in Zambia: the role of intimate partner violence and HIV status disclosure within couples. AIDS Research and Therapy, 14(1), 17. https://doi.org/10.1186/s12981-017-0142-2

[7].     Janz, N. K., & Becker, M. H. (1984). The Health Belief Model: a decade later. Health Education Quarterly, 11(1), 1–47.

[8].     Jasseron, C. (2013). Prise en charge des femmes enceintes infecées par le VIH en France à l’ère des multithérapies: des recommandations aux pratiques. France.

[9].     Kashitala, J., Nyambe, N., Mwalo, S., Musamba, J., Chishinga, N., Kasonde, P., … Welsh, M. (2015). Is Male Involvement in ANC and PMTCT Associated with Increased Facility-Based Obstetric Delivery in Pregnant Women? African Journal of Reproductive Health, 19(2), 117–124.

[10].  Kieffer, M. P., Mattingly, M., Giphart, A., van de Ven, R., Chouraya, C., Walakira, M., … EGPAF Technical Directors Forum. (2014). Lessons learned from early implementation of option B+: the Elizabeth Glaser Pediatric AIDS Foundation experience in 11 African countries. Journal of Acquired Immune Deficiency Syndromes (1999), 67 Suppl 4, S188-194. https://doi.org/10.1097/QAI.0000000000000372

[11]. Kim, M. H., Ahmed, S., Hosseinipour, M. C., Yu, X., Nguyen, C., Chimbwandira, F., … Abrams, E. J. (2015). Brief Report: Impact of Option B+ on the Infant PMTCT Cascade in Lilongwe, Malawi. Journal of Acquired Immune Deficiency Syndromes (1999), 70(1), 99–103. https://doi.org/10.1097/QAI.0000000000000692

[12]. Ministry of Public Health Cameroon. (2012). National Operational Plan for scaling up of Early Infant Diagnosis (EID), continuum of care 2013-2014, DRAFT one December 2012. Cameroon.

[13].  Moodley, T., Moodley, D., Sebitloane, M., Maharaj, N., & Sartorius, B. (2016). Improved pregnancy outcomes with increasing antiretroviral coverage in South Africa. BMC Pregnancy and Childbirth, 16(1), 35. https://doi.org/10.1186/s12884-016-0821-3

[14].  Olana, T., Bacha, T., Worku, W., & Tadesse, B. T. (2016). Early infant diagnosis of HIV infection using DNA-PCR at a referral center: an 8 years retrospective analysis. AIDS Research and Therapy, 13(1), 29. https://doi.org/10.1186/s12981-016-0112-0

[15].  Tariq, S., Elford, J., Cortina-Borja, M., Tookey, P. A., & National Study of HIV in Pregnancy and Childhood. (2012). The association between ethnicity and late presentation to antenatal care among pregnant women living with HIV in the UK and Ireland. AIDS Care, 24(8), 978–985. https://doi.org/10.1080/09540121.2012.668284

[16]. UNAIDS. (2017). UNAIDS DATA 2017.

[17]. W H O. (2013). Consolidated Guidelines on the use of Antiretroviral drugs for treating and preventing HIV infection.

[18]. WHO. (2010). PMTCT strategic vision 2010-2015 Preventing mother-to-child transmission of HIV to rach the UNGASS and Millenium Development Goals.

[19]. WHO. (2016). Consolidated Guidelines on the use of antiretroviral drugs for treating and preventing HIV infection; Recommendations for a public health approach-second edition (p. 480).

[20]. Zeng, H., Chow, E. P. F., Zhao, Y., Wang, Y., Tang, M., Li, L., … Zhang, L. (2016). Prevention of mother-to-child HIV transmission cascade in China: a systematic review and meta-analysis. Sexually Transmitted Infections, 92(2), 116–123. https://doi.org/10.1136/sextrans-2014-051877