1
|
Dhillon S, Amoak D, Sano Y, Antabe R, Luginaah I. The association between mother-to-child HIV transmission knowledge and antenatal care utilisation in Cameroon. Int J Health Plann Manage 2023; 38:1877-1888. [PMID: 37553752 DOI: 10.1002/hpm.3700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 06/30/2023] [Accepted: 07/29/2023] [Indexed: 08/10/2023] Open
Abstract
While the health benefits of antenatal care (ANC) utilisation for mothers and their infants have been well documented, very few studies have explored the association between mother-to-child transmission (MTCT) knowledge of human immunodeficiency virus (HIV) and mothers' utilisation of ANC in HIV endemic regions such as Cameroon. To address this void in the literature, we use the 2018 Cameroon Demographic and Health Survey to examine the association between mother's knowledge of MTCT of HIV and the three strands of ANC utilisation (i.e., number of ANC visits, timing to first ANC visit, and place of delivery). We found that women with adequate MTCT knowledge were more likely to have four to seven ANC visits (relative risk ratio [RRR] = 1.39, p < 0.001) and more than eight ANC visits (RRR = 1.43, p < 0.05), compared to their counterparts with inadequate knowledge. Similarly, women with adequate MTCT knowledge were more likely to attend ANC within the first trimester (odds ratio [OR] = 1.16, p < 0.05) and to give birth in a health facility (OR = 1.37, p < 0.001) than their counterparts with inadequate MTCT of HIV knowledge. These results remained robust after controlling for theoretically relevant variables. Based on these findings, we discussed several implications for policymakers and recommendations for future research.
Collapse
Affiliation(s)
- Satveer Dhillon
- Department of Geography and Environment, Western University, London, Ontario, Canada
| | - Daniel Amoak
- Department of Geography and Environment, Western University, London, Ontario, Canada
| | - Yujiro Sano
- Department of Sociology and Anthropology, Nipissing University, North Bay, Ontario, Canada
| | - Roger Antabe
- Department of Health and Society, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Isaac Luginaah
- Department of Geography and Environment, Western University, London, Ontario, Canada
| |
Collapse
|
2
|
Ka’e AC, Nka AD, Yagai B, Domkam Kammogne I, Ngoufack Jagni Semengue E, Nanfack AJ, Nkenfou C, Tommo Tchouaket MC, Takou D, Sosso SM, Fainguem N, Abba A, Pabo W, Kamgaing N, Temgoua E, Tchounga B, Tchendjou P, Tetang S, Njom Nlend AE, Ceccherini-Silberstein F, Mercedes Santoro M, Fokam J. The mother-to-child transmission of HIV-1 and profile of viral reservoirs in pediatric population: A systematic review with meta-analysis of the Cameroonian studies. PLoS One 2023; 18:e0278670. [PMID: 36649370 PMCID: PMC9844886 DOI: 10.1371/journal.pone.0278670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 11/21/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The mother-to-child transmission of HIV-1 (MTCT) remains on the major route of HIV-transmission among pediatric populations in Africa. Though a prevention of MTCT (PMTCT) high-priority country, data on the MTCT burdens in Cameroon remains fragmented. OBJECTIVE We sought to assess the pooled MTCT rate, its risk-factors, and to characterize viral reservoirs of infected-children in Cameroon. METHODS All relevant observational cohort and cross-sectional studies conducted in Cameroon were searched from PubMed, African Journals Online, Google scholar, ScienceDirect and academic medical education databases. Heterogeneity and publication bias were respectively assessed by the I2 statistic and the Egger/funnel plot test. Meta-analysis was performed using the random effects model. MTCT rate >5% was considered as "high". This review was registered in the Prospero database, CRD42021224497. RESULTS We included a total of 29 studies and analyzed 46 684 children born from HIV-positive mothers. The overall rate of MTCT was 7.00% (95% CI = 6.07-8.51). According to regions, the highest burden was in Adamaoua-region (17.51% [95% CI:14.21-21.07]) with only one study found. PMTCT option-B+ resulted in about 25% reduction of MTCT (8.97% [95% CI: 8.71-9.24] without option-B+ versus 2.88% [95% CI: 5.03-9.34] with option-B+). Regarding risk-factors, MTCT was significantly associated with the absence of PMTCT-interventions both in children (OR:5.40 [95% CI: 2.58-11.27]) and mothers (OR: 3.59 [95% CI: 2.15-5.99]). Regarding viral reservoirs, a pro-viral DNA mean of 3.34±1.05 log10/mL was observed among 5/57 children and archived HIV drug resistance mutations were identified in pro-viral DNA marker among 21/79 infected-children. CONCLUSION In spite of the dropdown in MTCT following option-B+ implementation, MTCT remains high in Cameroon, with substantial disparities across regions. Thus, in this era of option-B+, achieving MTCT elimination requires interventions in northern-Cameroon. The variation in pro-viral load in infected-children underlines the relevance of characterizing viral reservoirs for possible infection control in tropical settings.
Collapse
Affiliation(s)
- Aude Christelle Ka’e
- Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
- University of Rome “Tor Vergata” (UTV-Rome), Rome, Italy
- * E-mail: (ACK); (JF)
| | - Alex Durand Nka
- Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
- University of Rome “Tor Vergata” (UTV-Rome), Rome, Italy
| | - Bouba Yagai
- Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
- University of Rome “Tor Vergata” (UTV-Rome), Rome, Italy
| | | | - Ezechiel Ngoufack Jagni Semengue
- Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
- University of Rome “Tor Vergata” (UTV-Rome), Rome, Italy
| | - Aubin Joseph Nanfack
- Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Celine Nkenfou
- Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
- Higher Teachers Training College, University of Yaounde I, Yaounde, Cameroon
| | - Michel Carlos Tommo Tchouaket
- Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
- Catholic University of Central Africa (UCAC), Yaounde, Cameroon
| | - Desire Takou
- Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Samuel Martin Sosso
- Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Nadine Fainguem
- Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
- University of Rome “Tor Vergata” (UTV-Rome), Rome, Italy
| | - Aissatou Abba
- Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Willy Pabo
- Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
- University of Buea, Buea, Cameroon
| | - Nelly Kamgaing
- Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Edith Temgoua
- National AIDS Control Committee (CNLS), Yaounde, Cameroun
| | - Boris Tchounga
- Elisabeth Glaser Pediatric AIDS Foundation (EGPAF), Douala, Cameroon
| | - Patrice Tchendjou
- Elisabeth Glaser Pediatric AIDS Foundation (EGPAF), Douala, Cameroon
| | - Suzie Tetang
- National Social Welfare Hospital (CHE), Yaounde, Cameroon
| | | | | | | | - Joseph Fokam
- Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
- University of Buea, Buea, Cameroon
- * E-mail: (ACK); (JF)
| |
Collapse
|
3
|
Tiam A, Gill MM, Machekano R, Tukei V, Mokone M, Viana S, Letsie M, Tsietso M, Seipati I, Khachane C, Nei M, Mohai F, Tylleskär T, Guay L. 18-24-month HIV-free survival as measurement of the effectiveness of prevention of mother-to-child transmission in the context of lifelong antiretroviral therapy: Results of a community-based survey. PLoS One 2020; 15:e0237409. [PMID: 33002002 PMCID: PMC7529246 DOI: 10.1371/journal.pone.0237409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 07/24/2020] [Indexed: 11/21/2022] Open
Abstract
Introduction Population-based HIV-free survival at 18–24 months of age among HIV-exposed infants in high prevalence settings in the era of treatment for all is largely unknown. We conducted a community-based survey to determine outcomes of HIV-exposed infants at 18–24 months in Lesotho. Methods Between November 2015 and December 2016, we conducted a survey among households with a child born 18–24 months prior to data collection. Catchment areas from 25 health facilities in Butha-Buthe, Maseru, Mohale’s Hoek and Thaba-Tseka districts were randomly selected using probability proportional to size sampling. Consecutive households were visited and eligible consenting caregivers and children were enrolled. Rapid HIV antibody testing was performed on mothers of unknown HIV status (never tested or tested HIV-negative >3 months prior) and their children, and to children born to known HIV-positive mothers. Information on demographics, health-seeking behavior, HIV, and mortality were captured for mothers and children, including those who died. The difference in survival between subgroups was determined using the log-rank test. Results Of the 1,852 mothers/caregivers enrolled, 570 mothers were HIV-positive. The mother-to-child HIV transmission rate was 5.7% [95% CI: 4.0–8.0]. The mortality rate was 2.6% [95% CI: 1.6–4.2] among HIV-exposed children compared to 1.4% (95% CI: 0.9–2.3) among HIV-unexposed children. HIV-free survival was 91.8% [95% CI: 89.2–93.8] among HIV-exposed infants. Disclosure of mother’s HIV status (aOR = 4.9, 95% CI: 1.3–18.2) and initiation of cotrimoxazole prophylaxis in the child (aOR = 3.9, 95% CI: 1.2–12.6) were independently associated with increased HIV-free survival while child growth problems (aOR = 0.2, 95% CI: 0.09–0.5) were independently associated with reduced HIV-free survival. Conclusion Even in the context of lifelong antiretroviral therapy among pregnant and breastfeeding women, HIV has a significant effect on survival among HIV-exposed children compared to unexposed children. Lesotho has not reached elimination of HIV transmission from mother to child.
Collapse
Affiliation(s)
- Appolinaire Tiam
- Centre for International Health, University of Bergen, Bergen, Norway
- Elizabeth Glaser Pediatric AIDS Foundation, Washington D.C., United State of America
- * E-mail:
| | - Michelle M. Gill
- Centre for International Health, University of Bergen, Bergen, Norway
- Elizabeth Glaser Pediatric AIDS Foundation, Washington D.C., United State of America
| | - Rhoderick Machekano
- Centre for International Health, University of Bergen, Bergen, Norway
- Elizabeth Glaser Pediatric AIDS Foundation, Washington D.C., United State of America
| | - Vincent Tukei
- Elizabeth Glaser Pediatric AIDS Foundation, Maseru, Lesotho
- Ministry of Health, Maseru, Lesotho
| | | | - Shannon Viana
- Centre for International Health, University of Bergen, Bergen, Norway
- Elizabeth Glaser Pediatric AIDS Foundation, Washington D.C., United State of America
| | - Mosilinyane Letsie
- Milken Institute School of Public Health, The George Washington University, Washington D.C., United States of America
| | - Mots’oane Tsietso
- Milken Institute School of Public Health, The George Washington University, Washington D.C., United States of America
| | - Irene Seipati
- Milken Institute School of Public Health, The George Washington University, Washington D.C., United States of America
| | - Cecilia Khachane
- Milken Institute School of Public Health, The George Washington University, Washington D.C., United States of America
| | | | | | | | - Laura Guay
- Centre for International Health, University of Bergen, Bergen, Norway
- Elizabeth Glaser Pediatric AIDS Foundation, Washington D.C., United State of America
- Milken Institute School of Public Health, The George Washington University, Washington D.C., United States of America
| |
Collapse
|