Prevention of mother-to-child transmission of HIV in a refugee camp setting in Tanzania

Abstract

The objective of this article is to describe the results of a 2-year pilot programme implementing prevention of mother to child HIV transmission (PMTCT) in a refugee camp setting. Interventions used were: community sensitization, trainings of healthcare workers, voluntary counselling and HIV testing (VCT), infant feeding, counselling, and administration of Nevirapine. Main outcome measures include: HIV testing acceptance rates, percentage of women receiving post test counselling, Nevirapine uptake, and HIV prevalence among pregnant women and their infants. Ninety-two percent of women (n=9,346) attending antenatal clinics accepted VCT. All women who were tested for HIV received their results and posttest counselling. The HIV prevalence rate among the population was 3.2%. The overall Nevirapine uptake in the camp was 97%. Over a third of women were repatriated before receiving Nevirapine. Only 14% of male counterparts accepted VCT. Due to repatriation, parent's refusal, and deaths, HIV results were available for only 15% of infants born to HIV-infected mothers. The PMTCT programme was successfully integrated into existing antenatal care services and was acceptable to the majority of pregnant women. The major challenges encountered during the implementation of this programme were repatriation of refugees before administration of Nevirapine, which made it difficult to measure the impact of the PMTCT programme.

Missed opportunities to prevent mother-to-child-transmission

“…The number of patients in each publication ranged from 22 to 14,815 (Table 1) [7, 8]. Eight studies reported on the gestational age at presentation to antenatal care [9-16] the majority of women were in the late second or third trimester (webappendix Table S1). Many studies provided information on HIV testing (N=27) or antiretroviral prophylaxis without cART-eligibility assessment (N=23).…”

HIV/AIDS health care challenges for cross- country migrants in low- and middle-income countries: a scoping review

“…This study also revealed several types of collaborations between different agencies, both domestic and international, in managing HIV/AIDS services for migrants 63. It is clear that there was a growing role for international agencies in filling health care gaps where the government was not willing or able to cover these, as in the case of Tanzania reported by Stephen and Roberts, where bilateral collaborations and global health initiatives supported ART for refugees 32.…”

“…Of these 16 articles, 14 provided information about general services, including both treatment programs and HIV/AIDS prevention and promotion of interventions. These comprised subactivities as follows: prevention of mother-to-child transmission (PMTCT),36,47,63 ART,41 health education and public campaigns,32,34,39,42,53,59,62,64 condom distribution,45,64 supple mentary breastfeeding,63 mobile clinics for HIV/AIDS screening,45 voluntary counseling and testing,35,41,63 and mandatory HIV testing for pregnant women 42. Busza and Baker39 and Mooney and Sarangi59 also urged for the strengthening of communities’ capacity to cope with HIV/AIDS problems.…”

“…Six articles reported the management of financial resources to cope with HIV/AIDS problems in the migrant population 32,36,45,50,56,63. Rutta et al emphasized the important roles of international development partners, ie, the United Nations Children’s Fund and the United Nations High Commissioner for Refugees, in providing support for HIV/AIDS services in refugee camps since the support by Tanzanian government did not cover this population subgroup 63.…”

“…Rutta et al emphasized the important roles of international development partners, ie, the United Nations Children’s Fund and the United Nations High Commissioner for Refugees, in providing support for HIV/AIDS services in refugee camps since the support by Tanzanian government did not cover this population subgroup 63. Rachlis et al raised the importance of continuity of finances for HIV/AIDS-related programs 45.…”