scholarly journals Elimination of mother-to-child transmission of HIV in Oman: a success story from the Middle East

2021 ◽  
Vol 27 (4) ◽  
pp. 381-389
Author(s):  
Ali Elgalib ◽  
Fatma Al-Hinai ◽  
Jamila Al-Abri ◽  
Samir Shah ◽  
Zeyana Al-Habsi ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Service Providers ◽  
Mode Of Delivery ◽  
World Health ◽  
Obstetric Outcomes ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Hiv Viral Load ◽  
The Impact ◽  
Mother To Child

Background: In January 2016, the National AIDS Programme (NAP) in Oman introduced a package of interventions, including capacity building for service providers, to improve the quality of HIV services. Aims: To report the impact of these interventions on the rate of vertical HIV transmission in the period from January 2016 to December 2019. We also describe the virological and obstetric outcomes for HIV-infected pregnant women. Methods: This was a medical record review of 94 HIV-positive pregnant women (median age 32 years; interquartile range 25-34 years) reported to NAP in 2016–2019. Results: There were 110 pregnancies in 94 women. The majority (75.3%, 61/81) of women were diagnosed with HIV infection from routine antenatal screening, with 60% (66/110) of pregnancies occurring in women who knew their HIV status at conception. Caesarean section was the most common (50%) mode of delivery. The preterm labour and low birth weight rates were 21.2% and 15.9%, respectively. The antiretroviral coverage during pregnancy was 95.5%, with most (87.8%) women reporting excellent or good adherence. The majority (81.6%) of women achieved HIV viral load of < 400 copies/ml at or near delivery. Almost all infants (99%) were given prophylactic antiretrovirals. The rate of mother-to-child transmission of HIV was 1%. Conclusion: The obstetric and virological outcomes for HIV-infected pregnant women delivered in 2016–2019 were favourable, with a low rate of mother-to-child transmission of HIV. Oman is now in the process of finalizing application of World Health Organization validation of elimination of mother-to-child transmission of HIV.

scholarly journals Towards Elimination of Mother-to-Child Transmission of HIV: The Impact of a Rapid Results Initiative in Nyanza Province, Kenya

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Lisa L. Dillabaugh ◽  
Jayne Lewis Kulzer ◽  
Kevin Owuor ◽  
Valerie Ndege ◽  
Arbogast Oyanga ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Highly Active Antiretroviral Therapy ◽  
Cohort Analysis ◽  
Hiv Positive ◽  
Maternal Child Health ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Nyanza Province ◽  
The Impact ◽  
Mother To Child

Many HIV-positive pregnant women and infants are still not receiving optimal services, preventing the goal of eliminating mother-to-child transmission (MTCT) and improving maternal child health overall. A Rapid Results Initiative (RRI) approach was utilized to address key challenges in delivery of prevention of MTCT (PMTCT) services including highly active antiretroviral therapy (HAART) uptake for women and infants. The RRI was conducted between April and June 2011 at 119 health facilities in five districts in Nyanza Province, Kenya. Aggregated site-level data were compared at baseline before the RRI (Oct 2010–Jan 2011), during the RRI, and post-RRI (Jul–Sep 2011) using pre-post cohort analysis. HAART uptake amongst all HIV-positive pregnant women increased by 40% (RR 1.4, 95% CI 1.2–1.7) and continued to improve post-RRI (RR 1.6, 95% CI 1.4–1.8). HAART uptake in HIV-positive infants remained stable (RR 1.1, 95% CI 0.9–1.4) during the RRI and improved by 30% (RR 1.3, 95% CI 1.0–1.6) post-RRI. Significant improvement in PMTCT services can be achieved through introduction of an RRI, which appears to lead to sustained benefits for pregnant HIV-infected women and their infants.

scholarly journals Prevention of Mother to Child Transmission (PMTCT) Program at Paropakar Maternity and Women’s Hospital: A Review

2014 ◽  
Vol 7 (2) ◽  
pp. 25-28
Author(s):  
M Shrestha ◽  
P Chaudhary ◽  
M Tumbhahangphe ◽  
J Poudel
Keyword(s):  
Hiv Infection ◽  
Pregnant Women ◽  
Migrant Worker ◽  
Mode Of Delivery ◽  
Perinatal Transmission ◽  
Feeding Practice ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Antiretroviral Prophylaxis ◽  
Mother To Child

Aims: Vertical transmission from mother to fetus is the main route of HIVinfection among children. This study is an effort to review utilization of prevention of mother to child transmission (PMTCT) services by pregnant women seeking care in Paropakar Maternity and Women’s Hospital (PMWH). Methods: Case records of 165 pregnant women with HIV positive status who delivered at Paropakar Maternity and Women’s Hospital, Kathmandu from April 2005 to Dec 2011 were reviewed. Demographic profile of these women and interventions to prevent mother to child transmission (MTCT) including antiretroviral prophylaxis (ARV), mode of delivery, infant feeding practice as well as HIV status of their children were recorded. Results: Hospital records showed 109262 antenatal attendees and 120823 deliveries including 165 HIV infected women who delivered in this facility. Prevalence of HIV infection among antenatal attendees was 0.11 % and 0.13% in hospital deliveries. Migrant worker spouse (44.2%) was the main source of infection in their wives. Eighty eight (55.7%) out of 150 eligible women received ARV drugs and 97% babies received antiretroviral prophylaxis . Spontaneous vaginal delivery occurred in 60% women and caesarean section performed in the rest. While 60.8% women opted for exclusive breast feeding, remaining 39.2% chose formula feeding. For prophylaxis of opportunistic infection, Cotrimoxazole was given to 70.3% children. The incidence of HIV infection in babies born to HIV infected mother was 5.1%. Conclusions: Integrating PMTCT services into existing maternal and child health system can significantly reduce perinatal transmission of HIV infection to children. DOI: http://www.dx.doi.org/10.3126/njog.v7i2.11138 Nepal Journal of Obstetrics and Gynaecology / Vol 7 / No. 2 / Issue 14 / July-Dec, 2012 / 25-28

scholarly journals Maternal SARS-CoV-2 infection during pregnancy: possible impact on the infant

2021 ◽  
Author(s):  
Patrick Morhart ◽  
Christian Mardin ◽  
Manfred Rauh ◽  
Jörg Jüngert ◽  
Johanna Hammersen ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Pregnant Women ◽  
Mother To Child Transmission ◽  
Long Term Effects ◽  
Child Transmission ◽  
Healthy Infants ◽  
Vaccination Recommendations ◽  
Registration Number ◽  
The Impact ◽  
Mother To Child

AbstractThe risk and potential consequences of mother-to-child transmission of severe acute respiratory syndrome-coronavirus type 2 (SARS-CoV-2) during pregnancy are still a matter of debate. We studied the impact of SARS-CoV-2 infection on 56 complete households, including 27 newborns whose mothers were pregnant when exposed to the virus. Two PCR-confirmed perinatal SARS-CoV-2 transmissions with mild symptoms in affected neonates were recorded. In addition, we observed a severe eye malformation (unilateral microphthalmia, optic nerve hypoplasia, and congenital retinopathy) associated with maternal SARS-CoV-2 infection in weeks 5 and 6 of embryonic development. This embryopathy could not be explained by other infectious agents, genetic factors, drug use, or maternal disease during pregnancy. Eight other women with a history of SARS-CoV-2 infection prior to gestational week 12, however, delivered healthy infants.Conclusion: The repeated occurrence of mother-to-child transmission in our cohort with risks that remain incompletely understood, such as long-term effects and the possibility of an embryopathy, should sensitize researchers and stimulate further studies as well as support COVID-19 vaccination recommendations for pregnant women. Trial registration number: NCT04741412. Date of registration: November 18, 2020 What is Known:•Materno-fetal transmission of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) during pregnancy has rarely been reported so far, but was demonstrated in isolated cases. What is New:•In a study of complete households with documented SARS-CoV-2 infection, including a cohort of pregnant women, we observed perinatal coronavirus transmission at a higher frequency than expected.•We also describe a newborn boy with an eye malformation reminiscent of rubella embryopathy but associated with early gestation SARS-CoV-2 infection of his mother.•A coronavirus-related embryopathy, reported here for the first time, is a finding that requires further investigation.

scholarly journals Progress and Challenges of Implementing Decentralized HIV Testing For Prevention of Mother-to-Child Transmission of HIV – Myanmar

2019 ◽  
Vol 8 (1) ◽  
pp. 44-53
Author(s):  
San Hone ◽  
Li Li ◽  
Sung-Jae Lee ◽  
W. Scott Comulada ◽  
Roger Detels
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Hiv Testing ◽  
Service Providers ◽  
Point Of Care ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Stigma And Discrimination ◽  
Testing Uptake ◽  
Mother To Child

Background: Myanmar has adopted point-of-care (POC) HIV testing for its prevention of mother-to-child transmission of HIV program, and was initiated in 84 townships in 2013. This study assessed the progress of HIV testing uptake from 2012, one year prior to POC testing, to 2015, and the challenges faced by service providers during the rapid rollout of this testing strategy. Methods: This serial cross-sectional study included 23 townships randomly selected from the 84 townships. An open-question survey was used to collect information on the challenges faced by service providers. A random effects logistic model was used for assessing the progress of HIV testing uptake among urban and rural health center groups. Results: HIV testing uptake for antenatal care (ANC) attendees increased from 60% to 90% for rural and from 70% to 90% for urban attendees. The proportion of ANC attendees who were tested at their first visit increased from 70% to 80% for rural and from 70% to 90% for urban attendees. In addition, the proportion receiving same-day test results increased from less than 10% to 90% for both groups. Major challenges faced during the initial rollout included low health awareness among pregnant women, fear of stigma and discrimination, long travel times and costs, and increased workloads of providers in rural settings. Conclusions and Global Health Implications: The program should consider recruiting local volunteers to help reduce the workloads of service providers. Professional education based on need and continued mentoring and quality control schemes for HIV testing need to be in place. This decentralized strategy would be applicable to other resource-limited countries. Key words:  • HIV/AIDS • Pregnant Women • Point-of-Care (POC) HIV Testing • Antenatal Care (ANC) • Prevention of Mother-to-Child Transmission of HIV (PMCT) • Service Cascade • Stigma and Discrimination   Copyright © 2019 Hone et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Mother-to-child transmission of Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis in HIV-infected pregnant women in South Africa

2021 ◽  
pp. 095646242199021
Author(s):  
Remco PH Peters ◽  
Ute D Feucht ◽  
Lindsey de Vos ◽  
Phuti Ngwepe ◽  
James A McIntyre ◽  
...  
Keyword(s):  
South Africa ◽  
Chlamydia Trachomatis ◽  
Neisseria Gonorrhoeae ◽  
Pregnant Women ◽  
Trichomonas Vaginalis ◽  
Newborn Health ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
The Impact ◽  
Mother To Child

Background: Sexually transmitted infections (STIs) can be transmitted from mother to neonate. We determined the frequency of mother-to-child transmission (MTCT) of Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis to the newborn nasopharynx. Methods: This study was nested in a cohort study of etiologic testing versus syndromic management for STIs among pregnant women living with human immunodeficiency virus in South Africa. Mothers were tested for STIs using the GeneXpert platform within 60 days after delivery. Nasopharyngeal swabs were obtained from newborns of mothers with a positive STI test; these were then tested by Xpert® on the same day based on the maternal STI diagnosis. Results. We tested nasopharyngeal swabs from 85 STI-exposed newborns; 74 (87%) were tested within 2 weeks after birth (median five; range 2–12 days). MTCT frequency of any STI was 30/74 (41%); 43% (23/53) for C. trachomatis, 29% (2/7) for N. gonorrhoeae, and 24% (6/25) for T. vaginalis. Also, 4/11 (36%) swabs obtained between 14 and 60 days after delivery tested positive for STI. Conclusions: There was a high frequency of MTCT of STIs to the nasopharynx of newborns in our setting. The impact of nasopharyngeal colonization and the benefits of STI testing on newborn health remain to be determined.

scholarly journals Early retention among pregnant women on ‘Option B + ’ in urban and rural Zimbabwe

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Anesu N. Chimwaza ◽  
Hannock Tweya ◽  
Owen Mugurungi ◽  
Angela Mushavi ◽  
Solomon Mukungunugwa ◽  
...  
Keyword(s):  
Pregnant Women ◽  
World Health Organisation ◽  
World Health ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Mtct Rate ◽  
Post Test ◽  
Early Retention ◽  
Mother To Child

Abstract Background In 2013, the World Health Organisation (WHO) recommended Option B+ as a strategy to prevent mother-to-child transmission (PMTCT) of HIV. In option B+ , lifelong antiretroviral therapy (ART) is offered to all HIV positive pregnant and breastfeeding women to reduce MTCT rate to less than or equal to 5%. Its success depends on retaining women on ART during pregnancy, delivery and breast-feeding period. There is limited data on early retention on ART among pregnant women in Zimbabwe. We therefore assessed early retention among women on Option B + from antenatal care (ANC) until 6 months post ANC booking and at delivery in Bulawayo city and Mazowe rural district of Zimbabwe. Methods We collected data for pregnant women booking for ANC between January and March 2018, comparing early retention among ART naïve women and those already on ART. The two cohorts were followed up for 6 months post ANC booking, and this was done in two districts. Data were collected from routine tools used at facility level which include ANC, delivery and ART registers. The Kaplan-Meier survival analysis was used to estimate retention probabilities at 1, 3 and 6 months post-delivery and for retention at delivery proportions were used. Poisson regression was used to investigate factors associated with non-retention at 6 months post ANC booking. Results A total of 388 women were included in the study with median age of 29 years (IQR: 25–34). Two-thirds booked in their second trimester. Retention at 3 and 6 months post ANC booking was 84% (95% CI 80–88) and 73% (95% CI 69–78) respectively. At delivery 81% (95% CI 76–84) were retained in care, 18% lost-to-follow-up and 1% transferred out. In this study we did not find marital status, gestation age, facility location, ART status at ANC booking, to be associated with loss to follow-up. Conclusion In this study, we found low retention at 3, 6 months and delivery, a threat to elimination of Mother-to-child Transmission of HIV in Zimbabwe. Our findings emphasize the need for enhanced interventions to improve early retention such as post-test counselling, patient tracing and visit reminders.

scholarly journals Evaluation of preventive measures for mother-to-child transmission of HIV in Aracaju, State of Sergipe, Brazil

2012 ◽  
Vol 45 (6) ◽  
pp. 682-686 ◽  
Author(s):  
Lígia Mara Dolce de Lemos ◽  
Thaísa Fonseca Siqueira Rocha ◽  
Marcos Vinícius da Conceição ◽  
Eduardo de Lemos Silva ◽  
Alessandro Henrique da Silva Santos ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Preventive Measures ◽  
Mode Of Delivery ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Hiv Positive Women ◽  
Aids Clinical Trial Group ◽  
Conclusive Diagnosis ◽  
Brazilian Northeast ◽  
Mother To Child

INTRODUCTION: The main route of human immunodeficiency virus (HIV) infection in children is from mother to child. The preventive measures established for the Aids Clinical Trial Group protocol 076 (ACTG 076) significantly reduces HIV vertical transmission rates. This study aims to evaluate the implementation of the ACTG 076 protocol in the maternity units of State of Sergipe, Brazilian northeast. METHODS: This is a descriptive, retrospective study with a quantitative approach, with HIV positive women and children exposed, attending a Maternity reference for high-risk pregnancies. Data were obtained from patient records registered in the years 1994 to 2010. RESULTS: Amongst the 110 pregnant women and exposed newborns, the ACTG 076 protocol was fully utilized in only 31.8% of the participants. During the prenatal period, zidovudine (ZDV) was taken by 79.1% of the pregnant women. Only 49.1% of HIV seropositive patients used ZDV during delivery. Two (1.8%) children were considered infected and 50 (45.5%) do not have a conclusive diagnosis to date. CONCLUSIONS: There were significant deficiencies in the prevention of mother-to-child transmission of HIV, including lack of compliance with the three phases of the ACTG 076 protocol; inadequacies in prenatal care; inappropriate mode of delivery and lack of adequate follow up of exposed children.

scholarly journals Protocol for a prospective, hospital-based registry of pregnant women with SARS-CoV-2 infection in India: PregCovid Registry study

2021 ◽  
Author(s):  
Rahul Gajbhiye ◽  
Niraj N Mahajan ◽  
Rakesh Waghmare ◽  
Suchitra Vishwambhar Surve ◽  
Prashant Howal ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Post Partum ◽  
Laboratory Data ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Medical Case ◽  
Institutional Ethics ◽  
Increased Risk ◽  
The Impact ◽  
Mother To Child

Introduction: Pregnant women are at increased risk of contracting coronavirus disease 2019 (COVID-19) due to several factors and therefore require special attention. However, consequences of the COVID-19 pandemic on pregnant women and their newborns remain uncharted. The aim of PregCovid registry is to document the impact of SARS-CoV-2 infection on pregnant, post-partum women and their new-borns. The aim of the registry is also to determine mother to child transmission of SARS-CoV-2 infection in India. Methods and analysis: PregCovid is a hospital based registry for capturing information of pregnant, post-partum women with COVID-19 and their new-borns in India. Medical case records of pregnant and post-partum women with laboratory confirmed diagnosis of COVID-19 will be captured in real time using an online electronic patient record (EPR) software. The frequency of each symptom will be calculated. The laboratory data will be analyzed for calculating the frequency of laboratory parameters consistently higher in women with COVID-19. The adverse pregnancy and neonatal outcomes will be analyzed and their frequency will be calculated. Response to treatment will be analyzed for frequency calculation (number of women treated with different treatment regimens). The mother to child transmission data will be analyzed from the RT-PCR and/ antibody data of neonatal and maternal samples tested wherever the information is available. The registry data will be crucial for developing strategies for reducing the adverse impact of COVID-19 on pregnant women and their new-born. Ethics and dissemination: The study is approved by the Institutional Ethics Committee of ICMR-National Institute for Research in Reproductive Health (#55/2020), BYL Nair Hospital, Mumbai, India (# 63/2020); and all the 18 participating study sites under Medical Education and Drugs Department of Government of Maharashtra. The Institutional Ethics Committees granted a waiver of consent as the data is collected from the medical case records. Trial registration number: CTRI/2020/05/025423

Assessment of Mother-to-Child transmission of Hepatitis C Virus in Egyptian Pregnant Women

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Manal Hamdy El-Sayed ◽  
Fatma Soliman Elsayed Ebeid ◽  
Aya Mostafa Kamal El-Din ◽  
Rania Hassan Mostafa ◽  
Belal Khaled Abd El-Monem Mohammed
Keyword(s):  
Risk Factors ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Pregnant Women ◽  
Significant Risk ◽  
World Health ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Previous Hospitalization ◽  
Mother To Child

Abstract Background The World Health Organization (WHO) has an ambitious plan to eliminate HCV by 2030. This new approach was fueled by increased appreciation of the global morbidity and mortality caused by hepatitis C, and the remarkable recent treatment developments. Objectives To assess the mother-to-child transmission of hepatitis C virus in Egyptian pregnant women to inform on screening policies and strategy development. To measure prevelance of hepatitis C virus infection in pregnant women Methods The current study was conducted to six thousand and seven hundred and thirty four (6734) women delivered in El Demerdash Maternity Hospital in the period from January 2018 till June 2018. Collection of detailed data from Patients files and divided them into non screened and screened by antibodies and who do PCR for HCV and data of their neonatal outcome Results Comparison according to HCV PCR regarding labor characteristics show that cases with positive HCV PCR significantly had more frequent CS. Logistic regression for risk factors for HCV PCR among the studied cases show that only Previous hospitalization and previous transfusion were significant risk factors for positive HCV PCR. Conclusion Previous hospitalization and previous transfusion were significant risk factors for positive HCV PCR. Pregnants with positive HCV PCR significantly had more lower hemoglobin than non-infected pregnant one and previous abortion and hospitalization may play a role in that.

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