C A T Cissé1, M A Inzale2, N F Wade2, M M Niang2, D Diallo3, N Ndiaye Seye2. 1. Université Cheikh Anta DIOP de Dakar, faculté de Médecine, BP 15 745, Dakar, Sénégal. 2. Service Gynécologie-Obstétrique, EPS1 IHS, Dakar, Sénégal. 3. Service de Gynécologie-Obstétrique, EPS Aristide L, Dakar, Sénégal.
Abstract
OBJECTIVES: To assess the feasibility and results of the implementation of systematic HIV screening of pregnant women and antiretroviral (ARV) treatment for those found to be HIV-positive and their newborns at the IHS Gynecology-Obstetrics Department in Dakar, Senegal. PATIENTS AND METHODS: This cross-sectional prospective study took place in 2014-1016 and examined the results of screening pregnant women for HIV during their prenatal consultations and treating those found to be HIV-positive and their infants with ARV. RESULTS: HIV screening was routinely proposed to the 1616 pregnant women attending antenatal clinics, and 93.9 % accepted. The test was positive for 5 of these women, for an HIV prevalence of 0.3 % of pregnant women. In addition, another 23 HIV-positive pregnant women were referred to the IHS for their prenatal care and delivery, for a total of 28 women with HIV. Their mean age was 30 years, their mean parity 1.6, and all had HIV-1. Triple therapy was initiated for all HIV-positive pregnant women, in line with the WHO guidelines' "B + option", currently adopted by Senegal. During follow-up, only 35.7 % of the women had access to a viral load assay. The outcome of pregnancy was favorable in 91.6 % of cases; 72.2% of the women had vaginal deliveries. All live-born infants were given antiretroviral prophylaxis at birth. The mode of breastfeeding used was mainly exclusive protected breastfeeding (72.2 %). During postnatal follow-up, 2 of the 17 live-born infants were lost to follow-up, and 15 had PCR testing for HIV, which was positive in only 1 case, for a transmission rate of 6.6 %. CONCLUSION: The systematic offer and performance of HIV testing in all pregnant women is feasible and acceptable. Good organization of care can provide ARV treatment for all HIV-positive pregnant women and their newborns. The accessibility of viral load testing and of PCR screening for neonates still requires improvement.
OBJECTIVES: To assess the feasibility and results of the implementation of systematic HIV screening of pregnant women and antiretroviral (ARV) treatment for those found to be HIV-positive and their newborns at the IHS Gynecology-Obstetrics Department in Dakar, Senegal. PATIENTS AND METHODS: This cross-sectional prospective study took place in 2014-1016 and examined the results of screening pregnant women for HIV during their prenatal consultations and treating those found to be HIV-positive and their infants with ARV. RESULTS: HIV screening was routinely proposed to the 1616 pregnant women attending antenatal clinics, and 93.9 % accepted. The test was positive for 5 of these women, for an HIV prevalence of 0.3 % of pregnant women. In addition, another 23 HIV-positive pregnant women were referred to the IHS for their prenatal care and delivery, for a total of 28 women with HIV. Their mean age was 30 years, their mean parity 1.6, and all had HIV-1. Triple therapy was initiated for all HIV-positive pregnant women, in line with the WHO guidelines' "B + option", currently adopted by Senegal. During follow-up, only 35.7 % of the women had access to a viral load assay. The outcome of pregnancy was favorable in 91.6 % of cases; 72.2% of the women had vaginal deliveries. All live-born infants were given antiretroviral prophylaxis at birth. The mode of breastfeeding used was mainly exclusive protected breastfeeding (72.2 %). During postnatal follow-up, 2 of the 17 live-born infants were lost to follow-up, and 15 had PCR testing for HIV, which was positive in only 1 case, for a transmission rate of 6.6 %. CONCLUSION: The systematic offer and performance of HIV testing in all pregnant women is feasible and acceptable. Good organization of care can provide ARV treatment for all HIV-positive pregnant women and their newborns. The accessibility of viral load testing and of PCR screening for neonates still requires improvement.
Authors: Joseph Nyandwi; Sylvestre Bazikamwe; Désiré Nisubire; Pontien Ndabashinze; Mohamed Elsayed Shaker; Eman Said Journal: East Afr Health Res J Date: 2018-11-23
Authors: Selamawit A Woldesenbet; Tendesayi Kufa-Chakezha; Carl Lombard; Samuel Manda; Mireille Cheyip; Kassahun Ayalew; Adrian Puren Journal: HIV Med Date: 2021-07-01 Impact factor: 3.094