TITLE:
Status Report on the Elimination of Mother-to-Child Transmission (EMCT) of HIV at the Pikine National Hospital Center (CHNP), Dakar/Senegal
AUTHORS:
Fatou Ly, Ablaye Faye, Adjaratou Fatou Kane Sakho, Codou Sene, Ndèye Fatou Sarr
KEYWORDS:
Elimination of Mother-to-Child Transmission, HIV, Pikine
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.13 No.5,
September
28,
2023
ABSTRACT: Introduction: For several years, the fight against the human
immunodeficiency virus (HIV) has been a major public health issue in Africa.
Since 2012, Senegal has adopted WHO option B+, consisting of systematic triple
therapy for HIV-positive pregnant women, combined with breastfeeding and
antiretroviral (ARV) prophylaxis for exposed newborns. It is in this dynamic
that we set ourselves the objectives of evaluating the rate of transmission of
HIV from mother to child and taking stock of the monitoring of children born to
HIV-positive mothers at the Pediatric Department of the CHN of Pikine located
in the Dakar suburbs. Methodology: Thus, we conducted a descriptive and
analytical cross-sectional cohort follow-up study from 11/25/2014 to 03/09/2022
including all children born to HIV-positive mothers followed at the Pikine CHN
since the start of care. Results: We had collected 51 children exposed
to HIV and followed in our structure. They were exposed to HIV1 in 92% of cases.
The HIV status of the mothers was known before pregnancy in more than half of
the cases. The couples were serodiscordant in 56% of cases. The mothers were in
clinical stage 1 of the disease in 69.6% of cases and were already under
treatment in 47% of cases. The most used treatment regimen was ATRIPLA with
Tenofovir (TDF) + Emtracitabine (FTC) + Efavirenz (EFV) in 59% of cases.
Compliance was good in the majority of cases. The CD4 count during pregnancy
was low in 10.6% of cases. The pregnancy was well followed in only 36.2% of
cases. The mothers had given birth in our structure in 91.4% of cases. The
vaginal route was found in 72.5% of cases and delivery was carried out by a
midwife in 69.4% of cases. The average birth weight was 2733 ± 564. The
majority of newborns had received antiretroviral (ARV) prophylaxis after birth,
half of them between 12 and 24 hours. The most used therapeutic protocol was
Zidovudine (AZT) + Lamivudine (3TC) + Lopinavir/Ritonavir (LPV/r). Protected
breastfeeding was the option chosen in 76.8% of cases. The PCR performed at 6
weeks was negative in more than half of the cases. Retroviral serology was carried out after 14 months in 43% of cases. We
noted a single positive case with a negative initial PCR, representing an
overall transmission rate of 1.96%. Conclusion: Senegal’s current
policy targeting EMTCT of HIV is on good momentum with a fairly low
transmission rate thanks to screening of pregnant women and prophylaxis with
antiretrovirals (ARV) for HIV-positive mothers during pregnancy and for life. And
children exposed from birth and during breastfeeding up to 6 weeks with regular
monitoring.