Yinglan Wu1, Jie Gao1, Jiabi Qin2, Jian He3, Aihua Wang3, Hua Wang1, Qiyun Du1, Junqun Fang1, Xiaoqi Sheng1, Ruoping Wang4, Zhanghua Wang4, Tubao Yang5. 1. Department of Women Health Care, Hunan Provincial Maternal and Child Health Hospital, Hunan, China. 2. Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China. Electronic address: qinjiabi123@163.com. 3. Department of Information Management, Hunan Provincial Maternal and Child Health Hospital, Hunan, China. 4. Department of Maternal and Child Health Care, Health and Family Planning Commission of Hunan Province, Hunan, China. 5. Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China. Electronic address: 1064960669@qq.com.
Abstract
BACKGROUND: China is the first country to initiate a nationwide program for prevention of mother-to-child transmission of human immunodeficiency virus, syphilis and hepatitis B virus by an integrated approach. However, the progress of this program remains unreported at national or local level for China. Therefore, we performed a hospital-based longitudinal study to assess the integrated prevention effect in Hunan, South-central China. METHODS: This study was conducted at 123 counties in Hunan and covered all local hospitals providing midwifery and antenatal care services from 2010 to 2016. We used the Cochran-Armitage test to examine the temporal changes of the indicators related with prevention of mother-to-child transmission. Besides, we used Spearman rank correlation analysis to assess the association between mother-to-child transmission rates and the process indicators related with prevention of mother-to-child transmission. RESULTS: After implementation of integrated prevention program, the indicators related with prevention of mother-to-child transmission are moving in the right direction. From 2010 to 2016, mother-to-child transmission rates significantly decreased from 19.4% to 9.6% for human immunodeficiency virus, and from 116.3 to 13.6 cases per 100,000 live births for syphilis. The proportion of children receiving hepatitis B immunoglobulin injection within 24h after birth increased from 95.2% to 98.9% among exposed neonates. Mother-to-child transmission rates were negatively associated with the process indicators related with prevention of mother-to-child transmission (all P<0.05). CONCLUSIONS: Our prevention program of mother-to-child transmission for three diseases by an integrated approach proved to be viable and effective. Our model may be of interest to other countries.
BACKGROUND: China is the first country to initiate a nationwide program for prevention of mother-to-child transmission of human immunodeficiency virus, syphilis and hepatitis B virus by an integrated approach. However, the progress of this program remains unreported at national or local level for China. Therefore, we performed a hospital-based longitudinal study to assess the integrated prevention effect in Hunan, South-central China. METHODS: This study was conducted at 123 counties in Hunan and covered all local hospitals providing midwifery and antenatal care services from 2010 to 2016. We used the Cochran-Armitage test to examine the temporal changes of the indicators related with prevention of mother-to-child transmission. Besides, we used Spearman rank correlation analysis to assess the association between mother-to-child transmission rates and the process indicators related with prevention of mother-to-child transmission. RESULTS: After implementation of integrated prevention program, the indicators related with prevention of mother-to-child transmission are moving in the right direction. From 2010 to 2016, mother-to-child transmission rates significantly decreased from 19.4% to 9.6% for human immunodeficiency virus, and from 116.3 to 13.6 cases per 100,000 live births for syphilis. The proportion of children receiving hepatitis B immunoglobulin injection within 24h after birth increased from 95.2% to 98.9% among exposed neonates. Mother-to-child transmission rates were negatively associated with the process indicators related with prevention of mother-to-child transmission (all P<0.05). CONCLUSIONS: Our prevention program of mother-to-child transmission for three diseases by an integrated approach proved to be viable and effective. Our model may be of interest to other countries.
Authors: Jennifer Cohn; Morkor N Owiredu; Melanie M Taylor; Philippa Easterbrook; Olufunmilayo Lesi; Bigirimana Francoise; Laura N Broyles; Angela Mushavi; Judith Van Holten; Catherine Ngugi; Fuqiang Cui; Dalila Zachary; Sirak Hailu; Fatima Tsiouris; Monique Andersson; Dorothy Mbori-Ngacha; Wame Jallow; Shaffiq Essajee; Anna L Ross; Rebecca Bailey; Jesal Shah; Meg M Doherty Journal: Bull World Health Organ Date: 2021-01-21 Impact factor: 9.408