Pmtct program in uganda

Prevention of mother-to-child transmission PMTCT guidelines in Burkina-Faso, initiated in the year , were revised in , and The guideline document has since undergone several stages of improvement, largely based on recommendations from WHO, with adaptations by local experts in the field.

This study had the following objectives: 1 describing the historical perspective of PMTCT implementation in Burkina-Faso; 2 presenting the effectiveness of interventions at improving PMTCT service delivery and promoting retention of mothers and babies in care; and 3 determining the impact of male partner involvement on PMTCT in Burkina-Faso. A literature search was conducted in PubMed and Google. Data collection took place from May to October The search was limited to articles published between January and December Efforts still need to be made about the involvement of male partners.

Globally, 2. Despite significant efforts and achievements in prevention of mother-to-child transmission PMTCT over the past decade, approximately , children worldwide became newly infected with HIV in The research projects implemented have led to feasible and effective interventions to reduce the risk of mother-to-child transmission of HIV. Improving access to care for the mother—baby pair also requires interventions such as HIV testing, therapeutic management and infant feeding policies.

HIV counseling and testing plays a major role in that care is extended not only to the child but also to the partner of the infected pregnant woman. Early detection by testing for viral antigen in infants born to infected mothers as early as 6 weeks of life significantly improves follow-up of infected children.

Efforts are being made to facilitate the monitoring of women and newborns during prenatal and postpartum consultations. Achieving program targets requires improvement and availability of services, and mobilization of beneficiaries to use them. Literature search was conducted in PubMed and google. We systematically searched for articles written in both English and French. Data collection took place from May to December Articles were then manually selected. All search results were subsequently downloaded by two of the authors into an electronic register using Zotero.

PMTCT programs were introduced in three major cities: Ouagadougou, Bobo-Dioulasso and Ouahigouya in and just over a decade later, this program has been rolled out over the 63 health districts in Burkina-Faso. Studies conducted among women and children were eligible for inclusion. Studies that examined broader experiences of PMTCT associated with partners were also eligible for inclusion. A group of authors chose articles, using keywords, based on titles and abstracts.

Two authors independently screened all titles and abstracts retrieved from the database searches according to the inclusion and exclusion criteria described. Another group of authors reviewed the full text and summarized the key result for final inclusion. By examining the findings of each included study, descriptive themes were independently coded.

Once all the included studies had been examined and coded, the resulting themes and sub-themes were discussed to examine their relationship to the research questions.

We synthesized the data by summarizing the key results of each study. We then listed all relevant targeted topics of relevance identified in the individual studies as well as relevant study information: WHO scheme, location, biological analysis, mutation profile and year of publication. A total of references were identified from online literature search. Based on title and abstract screening, references were identified as potentially relevant.

In the last round of full-text screening, from the 60 relevant papers, the focus was to identify studies that examined perspectives on, or experiences of, PMTCT. There were many articles excluded in this review: 74 duplicated studies identified as potentially relevant, 34 studies found as unrelated articles, 10 articles on Burkina-Faso or articles on women in Burkina-Faso.

The process of study selection is summarized in Figure 1. Eighty-three publications were identified. After the first and second rounds of screening of the 83 publications based on the titles and abstracts, 40 studies were pre-selected for the final screening using the full text. Details related to the search workflow are represented in the flow diagram Figure 1. Between May and January , of the 2, women receiving prenatal counseling, On the other hand, almost all the women who participated in counseling were determined to test and know the outcome.

This efficacy could be attributed to the use of rapid tests to perform pre- and post-test at one sitting with results being available to the women in 15—20 mins. Many studies showed that the rate of vertical transmission of HIV-1 was 0. Initially, studies showed that when mothers had received only the mono-prophylaxis of Nevirapine, residual transmission risk was 9. It was shown that, in addition to resistance mutations found in the reverse transcriptase [RT] Y18CY , protease-associated mutations such as V8IV can mitigate the efficacy of protease inhibitors PI in the same context.

It is noteworthy that there have been many changes in programs to reduce the risk of transmission. Among the positive screened women, the majority had accessed the different stages of PMTCT during pregnancy, childbirth, postpartum and breastfeeding. The guideline has since undergone several stages of improvement, largely based on recommendations from the WHO, with adaptations by local experts in the field.

The main treatment was the single-dose Nevirapine for women during labor and a single dose of Nevirapine to infants within 72 hrs after birth.

Management of mothers and children is improving in Burkina-Faso due to better treatment guidelines and to the availability of real-time PCR rtPCR for viral load quantification and availability of CD4 T cells measurement. The early management of pregnant women include the HIV diagnosis in the first trimester of pregnancy and ARV treatment of choice as soon as test is positive. Only 5. This new combination was revealed to be even more effective in women whose viral load was high.

The Kesho Bora trial showed that the triple antiretroviral prophylaxis during pregnancy and breastfeeding is safe and reduces the risk of HIV transmission to infants. With the guidelines implemented in , the national option was option A, this option will be used until , followed by the implementation of option B from However, in the study by Soubeiga et al , for HIV-positive pregnant women followed on this protocol, no child was being infected with HIV after six weeks of birth.

This protocol for PMTCT is proven effective and significantly reduced the risk of transmission of HIV-1 from mother to child, but there is still a need to have a large number of women for confirmation.

The absence of doctors and mismanagement of time for post-test counseling were the main reasons why women did not receive test results. PMTCT programs are beneficial in Burkina Faso because they can also serve as an example for other prevention programs, especially since the government announced in September a new therapeutic option for all people infected with HIV for treatment regardless of their clinical or viro-immunological level.

It is imperative to establish a permanent interaction between researchers, physicians and pharmacists for better care of mothers and their children. There should be strengthening of a network of monitoring and surveillance of drug resistance in Burkina-Faso. This review demonstrates that effective approaches and techniques are deployed for reducing the HIV transmission risk in the mother—baby pair although there is the need to improve PMTCT strategy perhaps by promoting retention of mothers and babies in care, by involving male partners.

The authors gratefully acknowledge the support of Montari Soumou Arsinel Diorfis for proofreading the manuscript. All authors contributed towards data analysis, drafting and critically revising the paper, gave final approval of the version to be published, and agreed to be accountable for all aspects of the work.

National Center for Biotechnology Information , U. Published online Jul Author information Article notes Copyright and License information Disclaimer. Received Feb 9; Accepted Jun This work is published and licensed by Dove Medical Press Limited. By accessing the work you hereby accept the Terms.

Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4. This article has been cited by other articles in PMC.

Aims of study This study had the following objectives: 1 describing the historical perspective of PMTCT implementation in Burkina-Faso; 2 presenting the effectiveness of interventions at improving PMTCT service delivery and promoting retention of mothers and babies in care; and 3 determining the impact of male partner involvement on PMTCT in Burkina-Faso. We excluded women from the analyses if they had never been pregnant, were not sexually active during the past 12 months, had a tubal ligation, or had a partner or partners who reported vasectomy or infertility.

Only women with complete demographic and behavioral baseline data were included in the analyses. We examined the outcome of fertility desires among previously and currently pregnant women. Fertility desires were defined by whether or not a woman desired an additional child.

Enrollment in the Rakai ART program before or during pregnancy, or b. Along with HIV care and treatment services, the following are also offered at no cost to all HIV positive women: free family planning counseling, condoms, and long-acting reversible contraceptive methods, including hormonal contraceptives, diagnosis and treatment of STIs, education about HIV and STI prevention, violence counseling and referral to services that were not available at the clinic [ 20 ].

The analyses were adjusted for age, categorized as , , , and years; education defined as never attended school, primary school years of education , and secondary school or higher 8 or more years of education ; current marital status was categorized as not married, monogamous marriage if husband had one wife, or polygamous marriage if husband had two or more wives.

Behavioral covariates in the model were sex with a non-marital partner within the past 12 months; current hormonal contraceptive use, including use of oral contraceptive pills, implants, or injectable contraceptives; and current condom use. These covariates were all self-reported. At baseline, t-tests and Pearson's chi-squared tests were used to compare the demographic and behavioral characteristics of women by desire for another child.

We controlled for clustering so as to obtain robust standard errors because individual participants had repeated observations. Analyses were performed for the entire study population, and also stratified by HIV status.

STATA A total of 4, eligible women were enrolled in this study, contributing 13, woman observations throughout the study period. At baseline, Table 1 summarizes baseline characteristics associated with desire for more children among previously pregnant women. HIV-positive women were significantly less likely to desire another child compared with HIV-negative women 6. Approximately However, current hormonal contraceptive users were less likely to desire another child On average, women who desired another child were younger than women who did not desire another child mean: Desire for a child in the future decreased with duration of time since last pregnancy; At baseline, women who reported sex with a non-marital partner within the past 12 months were less likely to desire another child 7.

Table 2 summarizes the unadjusted and adjusted prevalence rate ratios adj. Within the overall study population, HIV-positive women were significantly less likely to desire another child than HIV-negative women adj.

In the entire population, women who reported current use of condoms adj. While HIV-positive condom users adj. Married women were significantly more likely to report desiring another child overall adj. Compared to 15 to 19 year old women, fertility desires decreased in older age groups years, adj.

Among the entire study population and the subset of HIV-positive women, those who reported a current non-marital sexual partnership, had significantly lower fertility desires in the unadjusted model overall unadj.

The adjusted model showed that women in a non-marital sexual partnership were more likely to desire an additional child overall, adj. Fertility desires did not differ by education level overall, adj. Among HIV-positive women, the number of years since a previous pregnant did not influence fertility desires years, adj. Overall, women who had been pregnant within the past years adj. The factor associated with lower probability of desire for another child was being over 25 years relative to years old years, adj.

Older women had a lower prevalence of desiring another child at the subsequent visit relative to year olds years, adj. Reproductive health decision making among HIV positive women is influenced by numerous environmental and individual level factors [ 21 ].

Our results corroborated a recent meta-analysis, which showed that ART use was not associated with fertility desires of people living with HIV [ 14 ]. Overall, HIV positive women in our study were significantly less likely to report a desire for having an additional child. Reproductive health decision making and fertility desires of HIV positive women may differ due to a woman's individual health beliefs as well as contextual factors.

Fear of adverse maternal health outcomes associated with pregnancy, as well as concerns about MTCT could reduce fertility desires among HIV positive women [ 22 - 25 ]. However, women who are well-informed about PMTCT and believe that it is effective in reducing MTCT may be more likely to desire and plan for a future pregnancy [ 26 - 28 ]. Audio 4 Your browser does not support the audio element. Your browser does not support the audio element.

The exercise whose results are expected in December is said to be a situation analysis to feed into the planning process and to establish how PMCTC is helping in reducing new infections.

The programme involves following up women of reproductive age living with or at risk of acquiring HIV from the time of conception through pregnancy to the time they finish breastfeeding their babies. Under the PMTCT programme, mothers who seek antenatal care are tested for HIV, enrolled on treatment and also followed up until they deliver in order to maintain their health and stop their infants from acquiring HIV.

PMTCT services also include early infant diagnosis at four to six weeks after birth, testing at 18 months and when breastfeeding ends, as well as ART initiation for HIV-exposed infants.

Cue out…. Will be there.