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Background Uganda has registered a reduction in new HIV infections among children in recent years. However, mother-to-child transmission of HIV still occurs, especially among pregnant women who present late. To eliminate this transmission, all HIV-positive pregnant women should be identified during antenatal HIV testing. We described women newly identified HIV-positive during pregnancy and postnatal period 2015–2018. Methods We extracted surveillance data for women identified as HIV-positive during pregnancy and the postnatal period reported through the Health Management Information System from 2015–2018. We calculated proportions newly positive at antenatal, labor, and postnatal periods nationally and at district levels. We disaggregated data into ‘tested early’ (during antenatal care) and ‘tested late’ (during labor or postnatal period) and calculated the proportion positive. We evaluated trends in these parameters at national and district levels. Results Overall, 8,485,854 mothers were tested for HIV during this period. Of these, 2.4% tested HIV-positive for the first time. While the total number of mothers tested increased from 1,327,022 in 2015 to 2,514,212 in 2018, the proportion testing HIV-positive decreased from 3.0% in 2015 to 1.7% in 2018 (43% decline over the study period, p Conclusion The proportion of women newly testing HIV-positive during pregnancy and postnatal declined significantly during 2015–2018. A higher proportion of mothers who tested late vs early were HIV-positive. Failure to identify HIV early represents an increased risk of transmission. Ministry of Health should strengthen Elimination of Mother to Child Transmission (eMTCT) services to sustain this decrease through targeted interventions for poorly-performing districts. It should strengthen community-based health education on antenatal care and HIV testing and enhance the implementation of other primary prevention strategies targeting adolescents and young women.

Background: To define the best timing for the treatment of high maternal viral DNA levels in order to block the mother-to-child transmission (MTCT).Methods: From a total of 820 HBsAg-positive pregnant women, 229 who satisfied the selection criteria were enrolled for the final analysis. These patients were divided into thress groups: Group A: 62 patients received telbivudine (LdT) (600 mg/day, orally) treatment before pregnant; Group B: 101 patients received LdT treatment at 24-28 weeks of gestation; and Group C: 66 patienst with high viral load received LdT at the third trimester. All infants born to the enrolled women were vaccinated with 100 IU of hepatitis B immune globulin (HBIG) and 10 μg of hepatitis B vaccine within 2 hours of birth. The second and third does of recombinant HBV vaccine were administered at 1 and 6 months of age, respectively.Results: LdT can effectively reduce serum HBV DNA and normalize ALT levels before delivery (p

Breastfeeding provides numerous short- and long-term health benefits for both mother and newborn by protecting the latter against infectious and chronic diseases. However, despite decades of research establishing its importance, the pandemic has uncovered the hidden assumption that breastfeeding is dispensable with no consequences for the mother or child. The objective was to examine evidence of vertical transmission of COVID-19 from mother to child through breastfeeding. An electronic search was carried out for articles related to breastfeeding and COVID-19 in the PUBMED indexing source, from the results in the systematic search, 16 articles were selected that contained research results in accordance with the inclusion criteria, as well as 3 reports containing mixed recommendations on optimal breastfeeding practices. Breast milk is the best food for the infant. However, confidence in their safety and certainty regarding best practices around breastfeeding during maternal COVID-19 infection has been compromised by the lack of studies and representative samples. It is necessary to carry out interdisciplinary research on the subject, at the same time, documents should be created with consensual and standardized guidelines regarding the choices of breast milk feeding from mothers infected by COVID-19 to their babies.

Background: Hepatitis B is highly endemic in south-east Asia with the most common route of transmission being from mother to child. In rural settings, current preventive strategies with hepatitis B immunoglobulins and vaccinations fail due to costs, need for cold chain, homebirths, and transportation difficulties. A new strategy for prevention of mother to child transmission (PMTCT) could be early ( Methods & Materials: Narrative and visual review of start-up challenges encountered during implementation of a study of TDF for PMTCT before 20 weeks gestation in rural areas on the Thailand-Myanmar border. ClinicalTrials.gov Identifier: NCT02995005. Results: Major challenges of implementation from June 2018 to September 2019 included: gestation of pregnancy at presentation, point-of-care (POC)-testing reliability, tablet storage and handling. Overall, 156 women tested positive for HBsAg by Rapid Diagnostic Test (RDT) POC-testing but late presentation (≥20 weeks) was common: 53% (83/156). In women Conclusion: Improved public awareness of the benefits or early antenatal care, better RDT-tests, and confirmation of TDF bioavailability at higher ambient temperatures, are important in the rural tropics for prevention of mother to child transmission for hepatitis B programs.

Nearly 257 million individuals have contracted hepatitis B infection around the world. However, only 10% of them know about their illness. Mother to child transmission, nosocomial spread, and sexual transmission are the major etiological factors. Finding the missing millions is a global issue. Hepatitis B care is more difficult compared to hepatitis C as not all patients require treatment and the selection of patients is not straightforward. To eliminate hepatitis B infection, the program should screen pregnant women and start antiviral therapy from the 28th week of pregnancy if hepatitis B virus (HBV) DNA≥ 200,000 IU/mL or hepatitis B e-antigen (HBeAg) reactive. Prevention of perinatal infection, birth dose and neonatal vaccination, post-vaccination monitoring of high-risk groups, catch-up vaccination, and registration of the carriers should be an integral part of the program. Continuum of care is important when planning the elimination program from addressing the risk factors, testing, and referral for treatment. The program should integrate test and treat hepatitis services with existing local health care services. There is a need to create the right environment, raise awareness, remove stigma, and increase screening of those at risk and manage those who require treatment. A national policy should be prepared for capacity building, fund allocation, and implementation strategies. Micro-elimination strategies should boost national elimination effects. Guidelines to diagnose and treat patients with hepatitis B should be simplified. Surveillance should be done to monitor progress, and determine the impact of the elimination program on incidence and mortality, and services.

In 2015, 3.5% of the world population, around 257 million people, was estimated to live with chronic hepatitis B virus (HBV) infection, mostly in the African and Western Pacific regions (68% of HBs...

All too frequent, valuable research output and scholarly materials from expensively conducted research work in different parts of the world end up in research desks, academic libraries, and scientific journals. Muhimbili University of Health and Allied Science (MUHAS) through the Directorate of Research and Publications initiated a series of symposia that aim to disseminate the evidence generated by the researchers to the policy makers and the community. In two of the six conducted University-wide symposia in the last one year, MUHAS produced two important policy briefs summarizing the impact of MUHAS research in two important—though distinct areas of local and global health impact—Elimination of Mother to Child Transmission (EMTCT) of HIV, and Diarrhea diseases.

BACKGROUND: Although mother-to-child human immunodeficiency virus (HIV) transmission has dramatically decreased with maternal antiretroviral therapy, breast milk transmission accounts for most of the 180 000 new infant HIV infections annually. Broadly neutralizing antibodies (bNAb) may further reduce transmission. METHODS: A Phase 1 safety and pharmacokinetic study was conducted: a single subcutaneous (SC) dose of 20 or 40 mg/kg (Dose Groups 1 and 2, respectively) of the bNAb VRC01 was administered to HIV-exposed infants soon after birth. Breastfeeding infants (Dose Group 3) received 40 mg/kg SC VRC01 after birth and then 20 mg/kg/dose SC monthly. All infants received appropriate antiretroviral prophylaxis. RESULTS: Forty infants were enrolled (21 in the United States, 19 in Africa). Subcutaneous VRC01 was safe and well tolerated with only mild-to-moderate local reactions, primarily erythema, which rapidly resolved. For multiple-dose infants, local reactions decreased with subsequent injections. VRC01 was rapidly absorbed after administration, with peak concentrations 1–6 days postdose. The 40 mg/kg dose resulted in 13 of 14 infants achieving the serum 50 micrograms (mcg)/mL target at day 28. Dose Group 3 infants maintained concentrations greater than 50 mcg/mL throughout breastfeeding. CONCLUSIONS: Subcutaneous VRC01 as single or multiple doses is safe and well tolerated in very young infants and is suitable for further study to prevent HIV transmission in infants.

Background: Mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV) has become an essential global health issue and its elimination is a crucial target. A prenatal “opt-out” HIV screening program was initiated in 2005 in Taiwan. In recent 3 years, approximate screening and MTCT rates were 99% and 2.27% (1/44), respectively. Here, we describe the clinical management of mothers infected with HIV and MTCT rate at National Taiwan University Hospital (NTUH), Taipei, Taiwan, in the years after the program was initiated. Methods: We retrospectively reviewed charts of pregnant women infected with HIV, who were managed at NTUH between January 2005 and December 2016. HIV infection status of 39 infants born to mothers infected with HIV was available. Results: Between 2005 and December 2016, 50 pregnant women infected with HIV, with 57 parities were managed at NTUH, and 57 live infants were born. We excluded 18 parities because of missing data. Maternal antiviral treatment was administered in 37 of 39 infants. Only one infant tested positive for an HIV antibody test at 18 months, but showed definitive HIV exclusion at 20 months after a series of tests without administration of antiviral treatment. MTCT rate was 0%. Conclusion: Successful implementation of available perinatal HIV intervention dramatically reduced vertical transmission rate of HIV. MTCT rate was 0% in NTUH after the program. However, as NTUH is an HIV referral center, additional efforts are needed to achieve the World Health Organization criteria of lowering the vertical transmission rate of HIV to

ObjectiveThis study was performed to explore the correlation between the characteristics of hepatitis B virus (HBV) quasispecies in HBV-infected pregnant women and the risk of immunoprophylaxis failure for their infants.DesignIn this prospective nested case–control study, the characteristics of HBV quasispecies in mothers whose infants were immunoprophylaxis success (control group) and those whose infants were immunoprophylaxis failure (case group) were analysed by the clone-based sequencing of full-length HBV genome and next-generation sequencing (NGS) of “a” determinant region, and were compared between the two groups.ResultsThe quasispecies characteristics including mutant frequency, Shannon entropy and mean genetic distance at amino acid level of “a” determinant region were significantly lower in case group than that in control group, using the full-length HBV genome clone-based sequencing assay. These results were confirmed by NGS assay. Notably, we discovered that the differences were also significant at nucleotide level by NGS assay. Furthermore, the risk of immunoprophylaxis failure could be predicted by analysing the three HBV quasispecies characteristics either at nucleotide level or at amino acid level of “a” determinant region, and the corresponding predictive values were tentatively set up.ConclusionsHBV quasispecies with a more complex mutant spectrum in “a” determinant region might be more vulnerable to extinct through mother-to-child-transmission (MTCT). More importantly, analysing HBV quasispecies characteristics in pregnant women with high HBV DNA load might be helpful to predict the high-risk population of immunoprophylaxis failure, and consequently provide accurate intervention against MTCT of HBV.

Chronic hepatitis B is a global health problem affecting approximately 350 million to 400 million individuals worldwide, and mother to child transmission remains the major mode of transmission. Approximately 50% of chronically infected individuals acquire infection, either perinatally or early in childhood, predominantly in areas where hepatitis B virus (HBV) is endemic. Management of HBV in pregnancy presents a unique set of challenges. All infants born of hepatitis B surface antigen-positive mothers should receive postexposure immune prophylaxis with hepatitis B immunoglobulin and HBV vaccination within 24 hours of birth and need close follow-up for the first few years of life.

Background We carried out analyses of early infant testing results at Livingstone Central Hospital in Zambia to assess time of testing, linkages to care and availability of test results for clinical decision making. Methods We abstracted data from registers of HIV-exposed infants who had dried blood spots cards (DBS) collected for DNA-PCR from January 2009 to December 2017. Only those tested from 2014 to 2017 had additional data which were used to estimate risk factors for mother-to-child HIV transmission using logistic regression models. Results DBS were collected from 2630 children. The proportion of HIV-positive tests decreased from 21% in 2009 to 2% in 2016 and 2017. Median turnaround time for results was 9 weeks (IQR: 5, 15) for HIV-negative, 7 weeks (IQR: 5, 13) for HIV-positive children. Only 2% of infants whose mothers took antiretroviral therapy (ART) were HIV positive, while 18% of infants whose mothers took short course antiretroviral drugs (ARVs) were infected. Infants of mothers who did not take ARVs had 9 times the odds of an HIV positive test (OR = 8.9, 95% CI: 3.6, 22.6). Infants of mothers who received short course ARVs were 40% less likely to get an HIV test within the first 2 months of life (OR = 0.6, 95% CI: 0.4, 0.9) compared to infants of mothers who received ART. Only 52% had a third test at median age 52 weeks (IQR: 50, 54). Conclusions Long turnaround time for test results and low retention in care after the initial HIV test were critical challenges to clinical decision making.

The authors studied microbial composition and metabolic activity of the intestinal microbiota in 20 babies born by caesarean section (main group) and 20 babies born vaginally (control group). There were isolated bifidobacteria from meconium at a concentration of 105– 1010 CFU/g by the bacteriological method in 4 (20%) children of the main group and 6 (30%) children in the control group. The gas-liquid chromatography revealed the metabolic activity of various representatives of the intestinal microflora in children of both groups, regardless of the mode of delivery; the indicators of metabolic activity were significantly lower than in the infants. The children in both groups had similar absolute and relative content of short-chain fatty acids in meconium. The data of gas-liquid chromatography indicate the metabolic activity of the meconium microbiota, which is dominated by anaerobic microbial populations and there is a high proportion of proteolytic and conditionally pathogenic flora. The data obtained confirm the process of intrauterine translocation of microbes from mother to child and indicate the importance of the microflora of the future mother in the process of forming the intestinal microbiota of the child.

The main objective of this study was to determine the frequency and patterns of HIV drug resistance-associated mutations among children under 18 months of age born to HIV-1-positive mothers enrolled in the prevention of mother-to-child transmission services in Haiti.Between January 1, 2013 and December 31, 2014, HIV-positive remnant dried blood spots collected from children under 18 months of age for Early Infant Diagnosis at the National Public Health Laboratory were used for HIV-1 genotyping. HIV drug resistance mutations were analyzed using the Stanford Drug Resistance HIVdb program.Of the 3555 dried blood spots collected for Early Infant Diagnosis, 360 (10.1%) were HIV-positive and 355 were available for genotyping. Of these, 304 (85.6%) were successfully genotyped and 217 (71.4%) had ≥1 drug resistance mutation. Mutations conferring resistance to nucleoside reverse transcriptase inhibitor (NRTIs) and non-NRTIs were present in 40.5% (123) and 69.1% (210), respectively. The most frequent mutations were K103N/S (48.0%), M184V (37.5%), G190A/S (15.1%), and Y181C/G/V (14.1%). Predicted drug resistance analysis revealed that 68.8% of the children had high-level resistance to non-NRTIs and 11.5% had intermediate to high-level resistance to abacavir.This study showed high rates of resistance to NRTIs and non-NRTIs among newly HIV-diagnosed children in Haiti, suggesting that in the era of "Option B+" (initiation of lifelong combination antiretroviral therapy to pregnant women with HIV), the majority of children who acquire HIV infection through mother-to-child transmission of HIV have resistant HIV. These results have led the National HIV Program to revise the pediatric guidelines to include protease inhibitors in first-line regimens for all HIV-positive newborns.

HIV/AIDS is one of the major barriers to community development. It is a global pandemic with high prevalence rates worldwide. This research was carried out to determine the prevalence of HIV among pregnant women attending the antenatal clinic at the University College Hospital, Ibadan using Enzyme Linked Immunosorbent Assay (ELISA) Gen Screen TM ULTRA HIV Ag-Ab Kit. HIV prevalence was found to be 26.4%. A total of 91 samples were tested, 24 (26.4%) were found to be positive and 67 (73.6%) negative. Women between the ages 25 – 31 had the highest prevalence rate of 16.5% while those between the ages of 39 – 45 years had the least prevalence rate of 1.1%. The results revealed a relatively high prevalence rate for HIV among pregnant women which suggests the need for active surveillance and implementation of preventive measures to avoid further spread of the virus. Pregnant women need to be continually tested for HIV and those infected monitored closely to prevent mother to child transmission.

Background: Mother-to-child transmission (MTCT) is a major means through which HIV infected pregnant mothers pass the virus to their infants. This study aimed to assess the implications of MTCT of HIV among infected Pregnant Women and their Infants.Methods:60 consenting HIV infected pregnant women attending a PMTCT ARV clinic in Ibadan, were followed up for eighteen months. Data were captured using structured questionnaire and analyzed to identify associations. Results: The mother’s age range was 24-41 years with a mean of 32.9 years, while the infant’s median age was 35 days. 32 (72.7%) of them were females with mean birth weight of 3.10 Kg. MTCT of HIV was 4.5% (2/44). Majority of the respondents were of parity 1 (22.7%) and parity 2 (27.3%) and are in monogamous marriage (81.8%), while predominant religion and occupation were Christianity (59.1%) and Trading (56.8%). Viral load was negatively correlated with hemoglobin (r=-0.334), lymphocyte (r=-0.188), and neutrophil (- 0.151) but positively correlated with WBC count (r=0.141). However, between pregnancy and birth CD4 count increased from 503 to 716 (p

Introduction: The global burden of human immunodeficiency virus (HIV) infection/acquired immunodeficiency syndrome has significantly decreased; however, new HIV infections decline slowly; this pose...

The article presents the hypothesis that in the formation of judgements about a man’s biological fatherhood based on similarity of physical characteristics, people may take into consideration not only the similarity of father to child, but also of mother to child. The objective of the experiment was to conduct an initial investigation of that assumption. In the experiment, participants were presented with descriptions in which information was manipulated concerning the similarity of child to mother vs. to father vs. to neither of them. A total of 312 students of both sexes took participation in the experiment, having agreed to take part in a short psychological study immediately after classes were over. They were asked to read some short stories and to give their opinion as to whether the man described is the biological father of the child. It turned out that in conditions where the child’s appearance was dissimilar to both of the parents, the participants doubted the biological parenthood of the father. In conditions where the child was similar to the mother, the certainty of participants that the man was the biological father was as high as in conditions where the story indicated that the child was similar to him. The results thus suggest that information about a child’s similarity to its mother may, in some situations, be significant in the formulation of judgements on the biological fatherhood of a man.

Objectives: The objectives of this article are to: 1) Determine the prevalence of parturient that escapes from the ETME, 2) Determine the rate of acceptability or non-acceptability of the HIV tests, 3) Describe the epidemiological profile and 4) Describe the factors explaining the lack of screening during pregnancy. Methodology: This report is based on an eventual descriptive study carried out in the Maternity Ward at the Ratoma Medical Centre for the past six months. The study took place over six (6) months from June 15 to December 15, 2016. The data were collected by individual interviews using a data collection sheet and prenatal consultation booklet that were administered to parturients in their language of comprehension. Each unscreened parturient received in the delivery room or in immediate postpartum received pre- and post-test HIV/AIDS counseling with immediate announcement of the outcome for all those who accepted the principle. For parturients who were in the active phase of work, counseling/testing was done in the immediate postpartum period. The data were manually collected from the pre-established fact sheets, captured using the Word, Excel and PowerPoint software packages of the 2007 Office and analyzed by the Epi-Info software (version 3.5.4). The limitations of the study were the lack of adequate room for the HIV testing council, the refusal of HIV testing by some parturients and the lack of achievement of CD4 levels in the hospital laboratory. Outcomes: The survey indicated that out of the 41.80% (177/423) of pregnant women that have recently given birth, ignore their HIV status. About 36.90% (66/177) rejected the screening and the 6.4% (7/111) that accepted were HIV/AIDS positive. The epidemiological study revolved around the following categories of women aged between 24 and 33 (42.85%), 1) Married (100%), 2) Housewives (57.14%), 3) Out-of-school (57.14), 4) Lack prenatal follow-up (42.85%), 5) Ignorance of the existence of HIV (71.42%). Reason Invoked for the Unawareness: No screening was proposed for prenatal follow-up (90.40%). Conclusion: The HIV testing approach in the work room could serve as a catch-up strategy to reduce vertical transmission and thus increase the operational coverage of the PMTCT service. The upgrading providers of basic facilities would be necessary in order to offer the HIV screening in refocused prenatal consultations, which could reduce the catch-up/contamination in the work room.

Background: Mother-to-child-transmission (MTCT) is the main route of HIV-1 infection in children. Genetic studies suggest HLA-B alleles play an important role on HIV-1 transmission, progression, and control of HIV-1 infection. Objective: To evaluate which polymorphisms of HLA-B are involved in HIV-1 MTCT. Methods: Two independent reviewers performed a systematic review on search engines PubMed, Europe PMC, Cochrane, Scientific Electronic Library Online (SciELO), and Literatura Latino-americana e do Caribe em Ciências da Saúde (Lilacs), using the following key terms: “HIV infection”, “HIV newborn”, “HLA polymorphisms”, “HLA-B”, and “Mother to child transmission”. All studies focusing on evaluation of HIV-1 MTCT, HIV infection evolution, and molecular analyses of HLA-B in children were selected. Results: Nine studies fulfilled the inclusion criteria. Sixteen HLA-B alleles groups were associated with HIV-1 infection; seven of them (43.8%) were related to slow disease progression or reduced risk of MTCT, while six (37.5%) alleles groups were linked to a faster progression of HIV infection in children and to increased risk of MTCT. The available evidence suggest that HLA-B*57 group allele is associated with slow disease progression, while HLA-B*35 group allele is associated to increased risk of MTCT and rapid disease progression in infected children. The role of HLA-B*18, B*58 and B*44 are still controversial because they were associated to both, protection against MTCT, and to higher HIV replicative capacity, in different studies. Conclusion: HLA-B*57 group allele can be protective against MTCT while HLA-B*35 groups alleles are consistently associated with HIV-1 MTCT. Keywords: “Mother to child transmission”, “HIV”, “HLA-B”

Despite significant advances in antiretroviral treatment (ARV) and HIV infection prevention, about 400 children worldwide are still diagnosed daily with HIV infection, most cases due to perinatal transmission. It is estimated that the knowledge and rigorous application of prophylactic measures to reduce the vertical transmission of infection would significantly reduce this risk to less than 1%. We report the case of a 5 months old infant coming from a pregnancy with HIV risk and multiple risk factors for transmission of the vertical infection, who did not receive postnatal testing and treatment. The diagnosis was established during infancy, falling into the AIDS stage by cytomegalovirus (CMV) disease with retinal sequelae occlusion. ARV treatment was initiated late, but from the moment of diagnosis, requiring further changes due to drug interactions, lack of availability and resistance to TARV. Although the patient’s progression was marked by severe comorbidities: sequelae of CMV disease, mixed HIV and CMV encephalopathy, pulmonary tuberculosis, repetitive respiratory and digestive opportunistic infections, the evolution of immunological parameters was slowly favorable under treatment. Proper implementation of prophylactic measures in the newborn and the pregnant woman could have significantly reduced the risk of HIV transmission to the patient, with a high probability that she would not have been infected. The case reported reflects the failure of strategies to prevent HIV / AIDS infection in pregnant women and newborns; conclusions must be drawn to avoid similar situations.

Background In Cambodia, access to hepatitis B surface antigen (HBsAg) screening is low for pregnant women and Hepatitis B Virus (HBV) DNA quantification is poorly accessible. Objectives To evaluate the performance of a serial algorithm using two HBV rapid diagnostic tests (RDTs), in which samples positive for HBsAg were further tested for HBeAg as a surrogate marker for HBV DNA quantification. Study design In 2015, we prospectively collected plasma samples from 250 pregnant women consulting for antenatal care in one hospital in Phnom Penh including 128 with a known positive HBsAg status. All specimens were tested with the SD BIOLINE HBsAg RDT and HBsAg ELISA assay. In ELISA-positive samples, HBeAg status was determined using the SD BIOLINE HBeAg RDT and HBV DNA quantification was assessed. Results Sensitivity and specificity of HBsAg RDT were 99.2% (97.7–99.9) and 100% (97.0–100), respectively. Among the 128 ELISA-positive samples, 29 (23%) tested HBeAg positive and 34 (26.5%) had HBV DNA > 5.3 Log10 IU/mL. Sensitivity and specificity of HBeAg RDT in identifying viremic samples were 76.5% (62.2.0–90.7) and 96.8% (93.3–100) for HBV DNA > 5.3 Log10 IU/mL and 89.3% (77.8–100) and 96.0% (92.2–99.8) for HBV DNA > 7.3 Log10IU/mL. Among the 99 negative HBeAg RDT women, 8 had HBV DNA > 5.3 Log10 IU/mL and 7 of them harbored BCP/PC HBV mutants. Conclusions A combination of HBsAg and HBeAg RDTs could be a low-cost strategy to identify HBV-infected pregnant women at risk of perinatal transmission in a country were HBV DNA quantification is not routinely available.

Cases of mother-to-child-transmission in the Surveillance Monitoring of ART Toxicities Study of Pediatric HIV/AIDS Cohort Study were identified from 2007 to 2015. Among 2123 births, 9 infants were HIV infected, giving a mother-to-child-transmission rate of 0.5% (95% confidence interval: 0.3%-1.0%). Mothers with perinatal HIV infections had a higher mother-to-child-transmission rate (1.1%; 95% confidence interval: 0.3%-4.3%) than mothers without perinatal HIV infections (0.4%; 95% confidence interval: 0.2%-1.0%), associated with a greater likelihood of detectable viral load at delivery.

Background: The Nelson Mandela Academic Hospital (NMAH) in Mthatha, Eastern Cape, is a rural central hospital, serving one of the poorest districts in South Africa. The prevalence of and risk factors for congenital cytomegalovirus (CMV) in this area are not known. The aim was to evaluate the prevalence of congenital CMV and associated risk factors for babies born at NMAH.Methods: This was a cross-sectional study to determine the prevalence of congenital CMV infection among babies born at Nelson Mandela Academic Hospital. Mother–baby pairs delivered consecutively from Monday to Friday, who gave informed consent, were included. Demographic information was collected on a questionnaire. All babies were tested for congenital CMV using a saliva swab PCR within the first week of life.Results: A total of 302 births were assessed. Congenital CMV was prevalent in 18 births (5.96%; 95% CI 3.29–8.63) and had an equal prevalence between HIV-exposed and HIV-unexposed newborns (prevalence ratio [PR] = 1.00; 95% CI 0.94–1.06; p = 0.869).Conclusions: The prevalence of congenital CMV of 5.96% is similar to findings from other resource-limited settings. There was no significant association between maternal HIV status and congenital CMV. With the prevalence of congenital CMV being as high as it is in the studied setting, clinicians are advised to have a high index of suspicion, especially when mothers are CMV seropositive.

According to this study: Case reports indicate that mother-to-child transmission of uterine cervical cancer is possible during vaginal delivery.Cesarean section should be recommended for mothers who have uterine cervical cancer.

Background: Uganda has an estimated 1.4 million people living with HIV with about 52,000 infections occurring every year. In 2018, 160,000 children were reported to have become infected with HIV. Globally, HIV exposed infants have delayed access to Early Infant Diagnosis (EID) of HIV, thus hampering efforts towards zero new infections. In Uganda, the prevalence of HIV among infants is not recorded, peak mortality for infants born with HIV occurs between 2 and 3 months of age. Vertical transmission of HIV from mother to child is the second commonest route of transmission of HIV in Uganda accounting for 18% of all new infections. This study assessed the prevalence of HIV and associated risk factors among infants born to HIV positive mothers attending Entebbe regional referral hospital. Methodology: a cross-sectional study was conducted at a paediatric ward and Mother-Child Health (MCH) General Department of Entebbe Regional Referral Hospital. The study included 78 HIV-exposed infants whose blood samples were collected and analyzed to know their HIV status and data about risk factors was also collected. Data were collected using questionnaires from mothers. Data were then entered into an Excel spreadsheet and analysed by SPSS Version 20. Results: The prevalence of HIV infection among HIV exposed infants is 5.1%. Delay in child diagnosis, breastfeeding was the factors that increased the risk of mother-to-child transmission of HIV in this study. Conclusion and recommendations: Having such a significant figure greater than the proposed WHO recommendation of less than 5% new infections in infants in the era of the world’s pledge to eliminate MTCT of HIV is unbearable therefore, interventions need to be done to lower this prevalence

Mother-to-child transmission (MTCT) of Human Immunodeficiency Virus (HIV) is the most significant route of HIV infection in children. Over 90% of HIV infections in children are acquired through the mother-to-child transmission route. This study aimed to evaluate the effectiveness of prevention of mother to child transmission (PMTCT) of HIV interventions. It employed a retrospective approach. Records of HIV positive pregnant women who registered and received ANC between January 1st 2015 to December 31st 2018 and HIV exposed infants followed-up for 6 weeks until HIV status was determined by DNA polymerase chain reaction techniques were collected and analysed. 87 pregnant women were HIV positive during the 4 years period, among these group, only 80 had their babies followed up till 6 weeks to determine HIV status by DNA polymerase chain reaction. There were three set of twins making a total of 83 exposed infants. The overall MTCT rate was 4.8%, maternal and infant ART was found to have significant influence on mother to child transmission of HIV with χ2=41.41, P

There are concerns regarding the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from mother to child during this COVID pandemic. This descriptive study was done to check the possible transmission of the virus through breastfeeding in the Indian context. RT-qPCR for SARS-CoV-2 was done in breast milk samples from 30 COVID-positive mothers. Paired oropharyngeal swabs of the same neonates were also sent for RT-PCR at 48 h and on day 5 of life. All the breast milk samples were negative for SARS-CoV-2 except one. A repeat sample of breast milk from the same mother was also negative when rechecked the next day. All the paired neonatal oropharyngeal swabs were also negative for SARS-CoV-2. The authors could not find evidence for transmission of SARS-CoV-2 from mother to child through breastmilk in the population studied.

Researchers report two cases of children with lung tumors that are genetically similar to the cervical tumors of their mothers. Researchers report two cases of children with lung tumors that are genetically similar to the cervical tumors of their mothers.

The lack of sufficient knowledge of mother to child transmission (MTCT) of human immunodeficiency virus (HIV) among pregnant women is considered a major contributor to new pediatric HIV infections globally, and increasing HIV related infant mortality especially in developing countries. Nigeria has the highest number of new HIV infections among children in the world. This study was designed to examine the spatial pattern and determinants of acquisition of sufficient knowledge of MTCT and prevention of mother to child transmission (PMTCT) in Nigeria. The data used in the study were extracted from the 2018 Nigeria Democratic Health Survey. The spatial modeling was through a Bayesian approach with appropriate prior distributions assigned to the different parameters of the model and inference was through the integrated nested Laplace approximation technique (INLA). Results show considerable spatial variability in the acquisition of sufficient knowledge of MTCT and its prevention with women in the southwestern and southeastern part of the country having higher likelihood. The nonlinear effects findings show that acquisition of sufficient knowledge of MTCT and PMTCT increased with age of women and peaked at around age 35yearswhere it thereafter dropped drastically among the older women. Furthermore, sufficient knowledge of MTCT and PMTCT was found to be driven by ethnicity, respondents’ education and wealth status.

Objective To describe changes in maternal viral control over time in South African women living with HIV (WLHIV) using surveillance data from the National Health Laboratory Service's Corporate Data Warehouse (NHLS CDW). Design A retrospective cohort analysis of maternal viral load during pregnancy and up to 15 months postpartum was performed amongst WLHIV (15-49 years) within the public-health sector between 2016 and 2017. Methods HIV and pregnancy-related test data were used to create a synthetic cohort of pregnant WLHIV from the NHLS CDW. Syphilis-screening, in association with ward type and/or postpregnancy cervical screening and/or birth HIV test and/or positive β-hCG, was used as a proxy for pregnancy. The syphilis-screening date marked the first antenatal care visit (fANC). Fractional polynomial models described viral load evolution from fANC up to 15 months postdelivery. Piecewise linear regression models determined factors associated with viral load decline. Findings Among 178 319 pregnant WLHIV, 345 174 viral load tests were performed [median = 2 (IQR: 2-3) per woman]. At fANC, 85 545 (48%) women were antiretroviral therapy (ART) experienced; 88 877 (49.8%) were not and 3897 (2.2%) unknown. Proportions of viraemia (viral load ≥50 copies/ml) were 39 756 (53.6%) at first viral load performed during pregnancy, 14 780 (36.9%) at delivery and 24 328 (33.5%) postpartum. Maternal age at least 25 years, CD4+ cell count at least 500 cells/μl and viral load less than 50 copies/ml at baseline predicted sustained viral load suppression during follow-up. Conclusion Despite high-ART coverage among pregnant women in South Africa, only 63% of WLHIV achieved viral load less than 50 copies/ml at delivery. Maternal viral load monitoring requires prioritization for maternal health and eMTCT.

Background: Globally at the end of 2011, 3.2 million children under the age of 15 were living with HIV, among these children 91% found in Africa. In Ethiopia, one of every three children born to these women is infected with HIV. This study was done to determine mother-to-child transmission of HIV infection and its factors among HIV-exposed infants on PMTCT service. Method: An institutional-based cross-sectional study was conducted among randomly selected 423 HIV exposed infants on PMTCT service in Bahir Dar city public health facility. Data were collected through chart review by using a pre-tested and structured checklist. Data was entered into Epi-data version 3.1 and exported to SPSS version 20 for analysis. The dependent variable association with explanatory variables was determined using logistic regression. Statistical significance was considered at p-value Result: The proportion of mother-to-child transmission of HIV infection among HIV-exposed infants on PMTCT services was 9.9%. Maternal educational status (AOR=3.196; 95% CI: 1.161-8.797), ANC follow-up (AOR=5.414; 95% CI: 1.860-15.761), age of infant at HIV infection confirmed (AOR=0.088; 95% CI: 0.033-0.238), and maternal CD4 count (AOR=3.162; 95% CI: 1.295-7.720) were factors significantly associated with mother-to-child transmission of HIV.Conclusion: The overall proportion of mother-to-child transmission of HIV infection among HIV exposed infants on PMTCT service were significantly high. This was due to low maternal educational status, absence of ANC follow-up, age of the infant at HIV infection confirmed, and low maternal CD4 count. Therefore, promoting women’s education, antenatal care, age of the infant at HIV test, and maintaining maternal CD4 count should be a great concern for health policymakers and health service providers.

Background Diagnosis of congenital Chagas disease (CChD) in most endemic areas is based on low-sensitive microscopy at birth and 9-month immunoglobulin G (IgG), which has poor adherence. We aim to evaluate the accuracy of the Immunoglobulin M (IgM)-Shed Acute Phase Antigen (SAPA) test in the diagnosis of CChD at birth. Methods Two cohort studies (training and validation cohorts) were conducted in 3 hospitals in the department of Santa Cruz, Bolivia. Pregnant women were screened for Chagas disease, and all infants born to seropositive mothers were followed for up to 9 months to diagnose CChD. A composite reference standard was used to determine congenital infection and was based on the parallel use of microscopy, quantitative polymerase chain reaction (qPCR), and IgM–trypomastigote excreted-secreted antigen (TESA) blot at birth and/or 1 month, and/or the detection of anti–Trypanosoma cruzi IgG at 6 or 9 months. The diagnostic accuracy of the IgM-SAPA test was calculated at birth against the composite reference standard. Results Adherence to the 6- or 9-month follow-up ranged from 25.3% to 59.7%. Most cases of CChD (training and validation cohort: 76.5% and 83.7%, respectively) were detected during the first month of life using the combination of microscopy, qPCR, and/or IgM-TESA blot. Results from the validation cohort showed that when only 1 infant sample obtained at birth was evaluated, the qPCR and the IgM-SAPA test have similar accuracy (sensitivity: range, 79.1%–97.1% and 76.7%–94.3%, respectively, and specificity: 99.5% and 92.6%, respectively). Conclusions The IgM-SAPA test has the potential to be implemented as an early diagnostic tool in areas that currently rely only on microscopy.

Although the rates of vertical transmission of HIV in the developing world have improved to around 3% in countries like South Africa, resistance to antiretrovirals (ARV) used in Prevention of Mother-to-Child transmission (pMTCT) strategies may thwart such outcomes and affect the efficacy of future ARV regimens in mothers and children. This study conducted in Durban, South Africa, between 2010 and 2013 found a high rate of nevirapine (NVP) resistance among women receiving Zidovudine (AZT) from 14 weeks gestation, single dose nevirapine (sd NVP) at the onset of labor and a single dose of coformulated Tenofovir/Emtricitabine (TDF/FTC) postpartum. Using Sanger sequencing, high and intermediate levels of nevirapine (NVP) resistance were detected in 15/44 (34%) and in 1/44 (2%) of women tested, respectively. Most subjects selected the K103N mutation (22% (10/45) of all patients and 66% (10/15) of those with high-level NVP resistance). Such rate of NVP resistance is comparable to studies where only sd NVP was used. In conclusion, a post-partum single-dose TDF/FTC tail does not prevent the selection of NNRTI resistance in women receiving pre-partum ZDV and intrapartum sd NVP to prevent mother-tochild HIV-1 transmission.

Objectives: China has implemented universal hepatitis B vaccination since 2002 and provided charge-free hepatitis B immunoglobulin (HBIG) to infants of HBV-infected mothers since July 2011. We aimed to compare mother-to-child transmission (MTCT) in children born before and since July 2011.Methods: In total, 5,149 children of HBV-infected mothers were tested for HBV markers. Group one contained 1,160 children born during August 2002-June 2011 and group two contained 3,989 children born during July 2011-June 2016.Results: In total, 92 (1.8%, 95% confidence interval [95%CI] 1.4-2.2) children were infected with HBV. None (0%, 95%CI 0.0-0.1) of 3,716 children of mothers with negative hepatitis B e antigen (HBeAg) was infected, whereas 92 (6.4%, 95%CI 5.2-7.8) of 1,433 children of HBeAg-positive mothers were infected (p