Screening and management of HIV infection in pregnant women in Dakar

Cissé, C. T.; Inzale, M.A.; Wade, N.F.; Niang, Mouhamadou Mansour; Diallo, Dázon Dixon; Seye, N. Ndiaye

doi:10.1684/mst.2018.0794

Cited by 5 publications

(7 citation statements)

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“…Both viral load testing and documentation of viral load test result were much higher in this study compared with data previously reported in South Africa and elsewhere in Sub-Saharan African countries. For pregnant women, previous studies reported between 30% and 72% coverage of viral load testing [9,[18][19][20]. Among adults in the general population, viral load monitoring is reported to be 73% in South Africa [8].…”

Section: Discussionmentioning

confidence: 99%

Coverage of maternal viral load monitoring during pregnancy in South Africa: Results from the 2019 national Antenatal HIV Sentinel Survey

et al. 2021

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Section: Discussionmentioning

confidence: 99%

Coverage of maternal viral load monitoring during pregnancy in South Africa: Results from the 2019 national Antenatal HIV Sentinel Survey

et al. 2021

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“…Very limited prior data on VL testing uptake in Sub-Saharan African PMTCT programs suggest that only 35-50% of pregnant women on lifelong ART regimens receive any VL testing. [9,10,22] We are aware of no prior reports tracking the uptake of a consecutive baseline and repeat VL test sequence that fulfills PMTCT guidelines. Our data show that more than 70% of women in these four Kenyan facilities received a baseline VL test sometime during PMTCT, superior to the uptake levels reported previously.…”

Section: Discussionmentioning

confidence: 99%

“…Our data show that more than 70% of women in these four Kenyan facilities received a baseline VL test sometime during PMTCT, superior to the uptake levels reported previously. [9,10,22] However, only 6% of women received a baseline and repeat testing sequence adherent to the schedule in Kenya's guidelines. Though, significant variations were observed in the uptake of guideline-adherent testing across study sites and between the newly ART-initiated and previously initiated patient populations, no site achieved more than 11% guideline adherent testing sequence for newly or previously diagnosed patients.…”

Section: Discussionmentioning

confidence: 99%

“…[19][20][21] Results of studies from Senegal, Mozambique, and Kenya indicate that uptake of VL testing among pregnant women receiving ART are low: ranging from 36%-57%. [9,10,22] To the best of our knowledge, no studies to date have evaluated actual VL monitoring against the recommended guidelines to assess the timing of VL monitoring and compliance with repeat testing.…”

Section: Introductionmentioning

confidence: 99%

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Maternal viral load monitoring: Coverage and clinical action at 4 Kenyan hospitals

et al. 2020

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Background Kenya's guidelines for prevention of mother-to-child transmission of HIV (PMTCT) recommend routine viral load (VL) monitoring for pregnant and breastfeeding women. Method We assessed PMTCT VL monitoring and clinical action occurring between last menstrual period (LMP) and 6 months postpartum at 4 Kenyan government hospitals. Pregnant women enrolled in the HIV Infant Tracking System from May 2016-March 2018 were included. We computed proportions who received VL testing within recommended timeframes and who received clinical action after unsuppressed VL result. Results Of 424 participants, any VL testing was documented for 305 (72%) women and repeat VL testing was documented for 79 (19%). Only 115 women (27%) received a guideline-adherent baseline VL test and 27 (6%) received a guideline-adherent baseline and repeat VL test sequence. Return of baseline and repeat VL test results to the facility was high (average 96%), but patient notification of VL results was low (36% baseline and 49% repeat). Clinical action for unsuppressed VL results was even lower: 11 of 38 (29%) unsuppressed baseline results and 2 of 14 (14%) unsuppressed repeat results triggered clinical action. Discussion Guideline-adherent VL testing and clinical intervention during PMTCT must be prioritized to improve maternal care and reduce the risk of HIV transmission to infants.

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“…17 However, high MTCT rates have still been reported relatively recently in Africa, specifically 6.3% at a tertiary hospital in Ado-Ekiti, Nigeria; 6.5% among public health-care facilities in Lusaka, Zambia; and 2.8% among public health-care facilities in South Africa. 16,18,19 In our study, 98 (80.3%) women underwent vaginal deliveries and 24 (20%) underwent caesarean sections. This was in line with national guidelines that recommend against systematic caesarean deliveries for HIV-infected pregnant women.…”

Section: Resultsmentioning

confidence: 52%

Prevention of Mother-to-Child Transmission and Early Real-Time DNA Polymerase Chain Reaction Results Among HIV-Exposed Infants in Bujumbura, Burundi

Nyandwi¹,

Bazikamwe²,

Nisubire³

et al. 2018

EAHRJ

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Background: Prevention of mother-to-child transmission (PMTCT) programmes aim to both eliminate vertical transmission of HIV and optimise the health and survival of infants born with HIV. Therefore, early infant diagnosis (EID) of HIV infection via DNA polymerase chain reaction (PCR) testing is a key component of PMTCT programming. We assessed the effectiveness of EID and PMTCT interventions at health-care facilities in Bujumbura, Burundi. Methods: This was a prospective analytical study of infants born to HIV-positive mothers on antiretroviral therapy (ART), who were followed from December 2016 to March 2017 at 3 centres providing PMTCT services in Bujumbura. Babies enrolled in this study received once-daily nevirapine from birth through to 6 weeks of life, after which HIV DNA PCR testing was conducted. Results: Of 122 HIV-exposed infants, 60 were boys and 62 were girls. The mother-to-child transmission rate at 6 weeks of life was 0.9%. Eighty-three (68%) of the women had commenced ART before pregnancy and 39 (32%) during pregnancy. The mean CD4 lymphocyte count was 6536308 cells/ll. Ninety-two (75.4%) of the pregnancies were planned, and 98 (80%) of the births were via spontaneous vaginal delivery. After birth, 111 (91.0%) infants were exclusively breastfed, and 11 (9.0%) infants received exclusive replacement feeding. Conclusion: There was a low rate of transmission of HIV from women taking ART to children who were given nevirapine for the first 6 weeks of life. Infants of HIV-positive women can live healthy lives free from HIV infection if their mothers participate in PMTCT programmes.

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Screening and management of HIV infection in pregnant women in Dakar

Cited by 5 publications

References 0 publications

Coverage of maternal viral load monitoring during pregnancy in South Africa: Results from the 2019 national Antenatal HIV Sentinel Survey

Coverage of maternal viral load monitoring during pregnancy in South Africa: Results from the 2019 national Antenatal HIV Sentinel Survey

Maternal viral load monitoring: Coverage and clinical action at 4 Kenyan hospitals

Prevention of Mother-to-Child Transmission and Early Real-Time DNA Polymerase Chain Reaction Results Among HIV-Exposed Infants in Bujumbura, Burundi

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