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Effectiveness of the prevention of HIV mother -to-child transmission (PMTCT) program via early infant diagnosis (EID) data in Senegal.
PLoS One 2019; 14(5):e0215941Plos

Abstract

BACKGROUND

To improve the care and treatment of HIV-exposed children, early infant diagnosis (EID) using dried blood spot (DBS) sampling has been performed in Senegal since 2007, making molecular diagnosis accessible for patients living in decentralized settings. This study aimed to determine the evolution of the HIV transmission rate in children from 2008 to 2015 and to analyze associated factors, particularly the mother's treatment status and/or child's prophylaxis status and the feeding mode.

METHODS

The data were analyzed using EID reports from the reference laboratory. Information related to sociodemographic characteristics, HIV profiles, the mother's treatment status, the child's prophylaxis status, and the feeding mode was included. Descriptive statistics were calculated, and bivariate and multivariate logistic regression analyses were performed.

RESULTS

During the study period, a total of 5418 samples (5020 DBS and 398 buffy coat) from 168 primary prevention of HIV mother-to-child transmission (PMTCT) intervention sites in Senegal were tested. The samples were collected from 4443 children with a median age of 8 weeks (1-140 weeks) and a sex ratio (M/F) of 1.1 (2309/2095). One-third (35.2%; N = 1564) of the children were tested before 6 weeks of age. Twenty percent (N = 885) underwent molecular diagnostic testing more than once. An increased number of mothers receiving treatment (57.4%; N = 2550) and children receiving prophylaxis (52.1%; N = 2315) for protection against HIV infection during breastfeeding was found over the study period. The transmission rate decreased from 14.8% (95% confidence interval (CI): 11.4-18.3) in 2008 to 4.1% (95% CI: 2.5-7.5) in 2015 (p < 0.001). However, multivariate logistic regression analysis revealed that independent predictors of HIV mother-to-child transmission included lack of mother's treatment (adjusted odd ratio (aOR) = 3.8, 95% CI: 1.9-7.7; p˂0.001), lack of child's prophylaxis (aOR = 7.8, 95% CI: 1.7-35.7; p = 0.009), infant age at diagnosis (aOR = 2.2, 95% CI: 1.1-4.3 for ≤6 weeks versus 12-24 weeks; p = 0.025) and protective effect of breastfeeding on ART against formula feeding (aOR = 0.4, 95% CI: 0.2, 0.7; p = 0.005).

CONCLUSION

This study demonstrates the effectiveness of PMTCT interventions in Senegal but indicates also that increased efforts should be continued to reduce the MTCT rate to less than 2%.

Authors+Show Affiliations

Laboratoire Bactériologie-Virologie, CHU Aristide Le Dantec, Université Cheikh Anta Diop de Dakar, Dakar, Senegal.Laboratoire Bactériologie-Virologie, CHU Aristide Le Dantec, Université Cheikh Anta Diop de Dakar, Dakar, Senegal.Laboratoire Bactériologie-Virologie, CHU Aristide Le Dantec, Université Cheikh Anta Diop de Dakar, Dakar, Senegal. Institut de Recherche en Santé, de Surveillance Epidémiologique et de Formations (IRESSEF), Diamniado, Senegal.Laboratoire Bactériologie-Virologie, CHU Aristide Le Dantec, Université Cheikh Anta Diop de Dakar, Dakar, Senegal.Laboratoire Bactériologie-Virologie, CHU Aristide Le Dantec, Université Cheikh Anta Diop de Dakar, Dakar, Senegal.Division de la Lutte contre le Sida et les IST (DLSI), Ministère de la Santé et de l'Action Sociale, Dakar, Senegal. United Nations Children's Fund - UNICEF Senegal, Dakar, Senegal.Laboratoire Bactériologie-Virologie, CHU Aristide Le Dantec, Université Cheikh Anta Diop de Dakar, Dakar, Senegal.Laboratoire Bactériologie-Virologie, CHU Aristide Le Dantec, Université Cheikh Anta Diop de Dakar, Dakar, Senegal.Conseil National de Lutte contre le Sida (CNLS), Primature, Dakar, Senegal.Laboratoire Bactériologie-Virologie, CHU Aristide Le Dantec, Université Cheikh Anta Diop de Dakar, Dakar, Senegal.Laboratoire Bactériologie-Virologie, CHU Aristide Le Dantec, Université Cheikh Anta Diop de Dakar, Dakar, Senegal. Institut de Recherche en Santé, de Surveillance Epidémiologique et de Formations (IRESSEF), Diamniado, Senegal.Division de la Lutte contre le Sida et les IST (DLSI), Ministère de la Santé et de l'Action Sociale, Dakar, Senegal.Laboratoire Bactériologie-Virologie, CHU Aristide Le Dantec, Université Cheikh Anta Diop de Dakar, Dakar, Senegal.Laboratoire Bactériologie-Virologie, CHU Aristide Le Dantec, Université Cheikh Anta Diop de Dakar, Dakar, Senegal.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31112547

Citation

Gueye, Sokhna Bousso, et al. "Effectiveness of the Prevention of HIV Mother -to-child Transmission (PMTCT) Program Via Early Infant Diagnosis (EID) Data in Senegal." PloS One, vol. 14, no. 5, 2019, pp. e0215941.
Gueye SB, Diop-Ndiaye H, Diouf O, et al. Effectiveness of the prevention of HIV mother -to-child transmission (PMTCT) program via early infant diagnosis (EID) data in Senegal. PLoS ONE. 2019;14(5):e0215941.
Gueye, S. B., Diop-Ndiaye, H., Diouf, O., Sow-Ndoye, A., Touré, F., Ngom-Faye, N. F., ... Touré-Kane, C. (2019). Effectiveness of the prevention of HIV mother -to-child transmission (PMTCT) program via early infant diagnosis (EID) data in Senegal. PloS One, 14(5), pp. e0215941. doi:10.1371/journal.pone.0215941.
Gueye SB, et al. Effectiveness of the Prevention of HIV Mother -to-child Transmission (PMTCT) Program Via Early Infant Diagnosis (EID) Data in Senegal. PLoS ONE. 2019;14(5):e0215941. PubMed PMID: 31112547.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effectiveness of the prevention of HIV mother -to-child transmission (PMTCT) program via early infant diagnosis (EID) data in Senegal. AU - Gueye,Sokhna Bousso, AU - Diop-Ndiaye,Halimatou, AU - Diouf,Ousmane, AU - Sow-Ndoye,Aissatou, AU - Touré,Fatoumata, AU - Ngom-Faye,Ndèye Fatou, AU - Diagne-Gueye,Diabou, AU - Mbow-Ndiaye,Khady, AU - Niang Diallo,Papa Amadou, AU - Gaye-Diallo,Aïssatou, AU - Mboup,Souleymane, AU - Ndour,Cheikh Tidiane, AU - Boye,Cheikh Saad-Bouh, AU - Touré-Kane,Coumba, Y1 - 2019/05/21/ PY - 2016/11/21/received PY - 2019/04/11/accepted PY - 2019/5/22/entrez PY - 2019/5/22/pubmed PY - 2019/5/22/medline SP - e0215941 EP - e0215941 JF - PloS one JO - PLoS ONE VL - 14 IS - 5 N2 - BACKGROUND: To improve the care and treatment of HIV-exposed children, early infant diagnosis (EID) using dried blood spot (DBS) sampling has been performed in Senegal since 2007, making molecular diagnosis accessible for patients living in decentralized settings. This study aimed to determine the evolution of the HIV transmission rate in children from 2008 to 2015 and to analyze associated factors, particularly the mother's treatment status and/or child's prophylaxis status and the feeding mode. METHODS: The data were analyzed using EID reports from the reference laboratory. Information related to sociodemographic characteristics, HIV profiles, the mother's treatment status, the child's prophylaxis status, and the feeding mode was included. Descriptive statistics were calculated, and bivariate and multivariate logistic regression analyses were performed. RESULTS: During the study period, a total of 5418 samples (5020 DBS and 398 buffy coat) from 168 primary prevention of HIV mother-to-child transmission (PMTCT) intervention sites in Senegal were tested. The samples were collected from 4443 children with a median age of 8 weeks (1-140 weeks) and a sex ratio (M/F) of 1.1 (2309/2095). One-third (35.2%; N = 1564) of the children were tested before 6 weeks of age. Twenty percent (N = 885) underwent molecular diagnostic testing more than once. An increased number of mothers receiving treatment (57.4%; N = 2550) and children receiving prophylaxis (52.1%; N = 2315) for protection against HIV infection during breastfeeding was found over the study period. The transmission rate decreased from 14.8% (95% confidence interval (CI): 11.4-18.3) in 2008 to 4.1% (95% CI: 2.5-7.5) in 2015 (p < 0.001). However, multivariate logistic regression analysis revealed that independent predictors of HIV mother-to-child transmission included lack of mother's treatment (adjusted odd ratio (aOR) = 3.8, 95% CI: 1.9-7.7; p˂0.001), lack of child's prophylaxis (aOR = 7.8, 95% CI: 1.7-35.7; p = 0.009), infant age at diagnosis (aOR = 2.2, 95% CI: 1.1-4.3 for ≤6 weeks versus 12-24 weeks; p = 0.025) and protective effect of breastfeeding on ART against formula feeding (aOR = 0.4, 95% CI: 0.2, 0.7; p = 0.005). CONCLUSION: This study demonstrates the effectiveness of PMTCT interventions in Senegal but indicates also that increased efforts should be continued to reduce the MTCT rate to less than 2%. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/31112547/Effectiveness_of_the_prevention_of_HIV_mother_-to-child_transmission_(PMTCT)_program_via_early_infant_diagnosis_(EID)_data_in_Senegal L2 - http://dx.plos.org/10.1371/journal.pone.0215941 DB - PRIME DP - Unbound Medicine ER -