TITLE:
Prevention of Mother-to-Child Transmission of HIV: Experience of a Level 2 Health Center in Senegal
AUTHORS:
Soukeynatou Dia Ndour, Papa Malick Ngom, Louise Fortes, Anna Mody Seck, Thérèse Ndong, Kadiatou Diallo, Fatoumata Bintou Sall, ModouThioro Mbaye
KEYWORDS:
Mother-to-Child Transmission, HIV Infection, Prevention, Antiretroviral Treatment
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.13 No.5,
May
26,
2023
ABSTRACT: The
elimination of vertical transmission of HIV from
mother to child is a major global goal. In Senegal, the transmission rate was
estimated at 3.2% in 2017. To reduce or even eliminate this transmission,
Senegal has implemented various strategies and programs adopted and applied
nationally. Thus access to services for the prevention of mother-to-child
transmission of HIV has been extended to the level of the health post (the
lowest level of the country’s health pyramid) with a delegation of tasks to
paramedical staff (nurse, midwife) in the diagnosis and therapeutic management. Objectives: To describe the epidemiological profile of HIV (Human
Immunodeficiency Virus)-positive mothers, to assess the care of children born
to HIV-positive mothers, to determine the rate of HIV transmission from mother
to child. Patients and Method: We carried out a retrospective,
cross-sectional and descriptive study of all live newborns of HIV-positive
mothers who gave birth at the Gaspard Kamara Health Center (a level 2 health
center in Dakar, Senegal) between January 1, 2015 and December 31, 2018. The
data were collected from prevention of mother-to-child transmission (PMTCT)
prenatal follow-up registers and files, delivery files and registers, and
neonatology and pediatric follow-up files, and exploited using the Epi info 7
software. Results: There were 98 children of seropositive mothers. The
epidemiological profile of the HIV-positive woman was that of a young woman
aged between 16 and 43 with an average of 31.31 years, pauciparous (>65% of cases)
from Dakar center (>75% of cases), housewife with a
low socio-economic level (63.1% of cases), married in almost all cases, with
HIV profile (in almost all cases) and diagnosed before pregnancy (51.02%). The analysis of the children’s data revealed a predominance of girls (52.04%) with a good birth weight
(2964g on average) and a pregnancy carried to term in more than 95% of cases.
ARV prophylaxis was almost entirely respected with triple therapy (AZT + 3TC + NVP)
in a fixed combination as protocol. Protected breastfeeding (80.21%), including
6 months of exclusive protected breastfeeding, was the rule for the mode of
feeding. Three children were diagnosed positive with PCR1 as with serology (3.06%). Discussion and Conclusion: the initiatives and strategies put in place
in Senegal have enabled a significant reduction in mother-to-child transmission
of HIV and deserve to be supported by insisting on primary prevention,
programming and good follow-up of pregnancies, and a good support for
HIV-positive women.