Author(s)

Pius Tih Muffih¹, Edouard Katayi Tshimwanga^1*, Andrew Abutu², Lem Edith Abongwa¹, Jacques Chirac Awa¹, Pascal Nji Atanga¹, Felix Desembuin¹, Eveline Mboh Khan¹, Kuni Esther Bonje¹, Nshom Emmanuel¹, Ebeny Francois Temgbait Chimoun¹, Thomas Welty¹, Gladys Tayong Fosah³, Jennifer Lim^4,5, Dana Duncan², Leah Petit⁶, Gilbert Tene^5,7, Jembia Mosoko⁵, Omotayo Bolu⁵

¹AIDS Care and Prevention Program, Cameroon Baptist Convention Health Services, Bamenda, Cameroon.
²United States Centers for Disease Control and Prevention (CDC), Atlanta, USA.
³Ministry of Public Health, National AIDs Control Committee, Northwest Region Technical Group, Bamenda, Cameroon.
⁴Association of Schools and Programs of Public Health/Allan Rosenfield Global Health Fellowship, Washington DC, USA.
⁵United States Centers for Disease Control and Prevention (CDC), Yaoundé, Cameroon.
⁶Elizabeth Glazer Pediatric AIDS Foundation (EGPAF), Washington DC, USA.
⁷QED Group, LLC, Washington DC, USA.

Background: Mother to child transmission (MTCT) of HIV constitutes a major source of new pediatric infections in Cameroon. Objective: The aim of this implementation research was to assess outcomes and effectiveness of providing life-long antiretroviral therapy (ART) for HIV-positive pregnant and breastfeeding women (Option B+). Methods: From October 2013 to July 2014, HIV-positive pregnant and breastfeeding women, not on antiretroviral (ARV) prophylaxis and ART, were recruited from 22 purposefully selected health facilities in the Northwest and Southwest regions for a prospective, observational cohort evaluation. Option B+ was offered to participants and outcome indicators were measured. Results: Out of 680 women eligible for this assessment, 669 (98%) were initiated on Option B+. Retention-in-care was 90% (95% CI, 87.85 - 92.61) and 79% (95% CI, 75.20 - 81.88), and loss to follow up (LTFU) was 7% (95% CI: 4.95 - 8.90) and 15% (95% CI: 12.06 - 17.56) at 6 and 12 months respectively. Maternal mortality at 12 months after ART initiation was 2% (13). As of March 2015, 538 HIV exposed infants (HEIs) were enrolled and received postpartum nevirapine prophylaxis within 72 hours of birth and 84% (454) were on cotrimoxazole at 6 to 8 weeks. By 8 weeks of age, 498 (93%) infants had HIV DNA PCR test with 486 (97.6%) negative and 12 (2.4%) positive. Conclusion: In Cameroon, successful implementation of Option B+ increased retention-in-care to 79% at one year for pregnant and breastfeeding women and reduced MTCT rate below 5% for HEIs at 8 weeks of age. Long term retention, maternal and infant mortality and final MTCT rate after cessation of breastfeeding require further evaluation.

Option B+, Implementation Research, Prevention of Mother to Child HIV Transmission, HIV Exposed Infants

Muffih, P. , Tshimwanga, E. , Abutu, A. , Abongwa, L. , Awa, J. , Atanga, P. , Desembuin, F. , Khan, E. , Bonje, K. , Emmanuel, N. , Chimoun, E. , Welty, T. , Fosah, G. , Lim, J. , Duncan, D. , Petit, L. , Tene, G. , Mosoko, J. and Bolu, O. (2018) Outcome Evaluation of Early Implementation of Option B+ in Cameroon: A Prospective Cohort Observational Survey in the Northwest and Southwest Regions. World Journal of AIDS, 8, 90-104. doi: 10.4236/wja.2018.83008.