Integrating prevention of mother-to-child HIV transmission into routine antenatal care - The key to program expansion in Cameroon
Integrating prevention of mother-to-child HIV transmission into routine antenatal care - The key to program expansion in Cameroon
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DOI：
10.1097/01.qai.0000163196.36199.89
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发表时间：
2005-12-01
影响因子：
3.6
通讯作者：
Wilfert, CM
中科院分区：
文献类型：
--
作者：
Welty, TK;Bulterys, M;Wilfert, CM
在伊丽莎白·格拉泽儿童艾滋病基金会的资助下，喀麦隆浸礼会卫生委员会实施了一项方案，作为其常规产前护理的一部分，预防母婴传播艾滋病毒-1，对艾滋病毒阳性母亲及其婴儿进行单剂量母婴围产期奈韦拉平预防。护士、助产士、护士助理和受过培训的助产士为孕妇提供咨询，获得风险因素数据，并提供免费的艾滋病毒检测，当天就能得到结果。从2000年2月至2004年12月，该方案迅速扩大到喀麦隆6个国家的115个设施。10个省，不仅是大型医院，而且是配备训练有素的助产士的偏远保健中心。我们对690名卫生工作者进行了预防母婴传播培训，并为68 635名妇女提供了咨询，其中91.9%接受了艾滋病毒检测。在接受检测的63 094名妇女中，8.7%的人艾滋病毒-1呈阳性。HIV-1感染的独立危险因素包括首次性行为年龄小、多性伴和梅毒血清学阳性（各P < 0.001）。我们对98.7%的阳性和阴性母亲进行了后测咨询。在5550名HIV阳性母亲中，我们对5433名（97.9%）进行了单剂量NVP预防性治疗。持续的培训和方案支助有助于迅速扩大规模，提高接受率和咨询率。
With funds from Elizabeth Glaser Pediatric AIDS Foundation, the Cameroon Baptist Convention Health Board implemented a program to prevent mother-to-child transmission of HIV-1 (PMTCT) as part of its routine antenatal care, with single-dose maternal and infant peripartum nevirapine (NVP) prophylaxis of HIV-positive mothers and their babies. Nurses, midwives, nurse aides, and trained birth attendants counseled pregnant women, obtained risk factor data, and offered free HIV testing with same-day results. From February 2000 through December 2004, this program rapidly expanded to 115 facilities in 6 of Cameroon's. 10 provinces, not only to large hospitals but to remote health centers staffed by trained birth attendants. We trained 690 health workers in PMTCT and counseled 68,635 women, 91.9% of whom accepted HIV testing. Of 63,094 women tested, 8.7% were HIV-1-positive. Independent risk factors for HIV-1 infection included young age at first sexual intercourse, multiple sex partners, and positive syphilis serology (P < 0.001 for each). We counseled 98.7% of positive and negative mothers on a posttest basis. Of 5550 HIV-positive mothers, we counseled 5433 (97.9%) on single-dose NVP prophylaxis. Consistent training and programmatic support contributed to rapid upscaling and high uptake and counseling rates.