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Mobile health (mHealth) is the proposed solution from digital health intervention to improve the service quality to eliminating mother to child HIV transmission (EMTCT) in Indonesia. The purpose of this study is to develop a mHealth prototype for EMTCT. This study used prototyping Rapid Application Development (RAD). The external entities of the mHealth prototype consist; pregnant women as the main data sources midwives as program implementers who also work as information producers, contact person for EMTCT at the primary health center and health office, as the program manager for dashboard users. Nine data on longitudinal EMTCT services are antenatal visits, pre-test counseling, HIV testing, the results of HIV status, post-test counseling, antiretroviral therapy (ART), adherence for ARV therapy, viral load, and HIV status in children.

Based on World Health Organization (WHO), in 2011 there are 3,5 million people with HIV/AIDS in Southeast Asia. The trend of death caused by AIDS between 2001 and 2010 are different in every country side. In eastern Europe and central Asia, the number of people died from AIDS increased from 7.800 to 90.000, in Middle East and the North Africa increased from 22.000 to 35.000, in East Asia also increased from 24.000 to 56.000. According to WHO, 430.000 newborn child infected with HIV, in 2008, more than 90% infected by mother to child transmission. The purpose of this research is to determine the effect of the CG (Counseling guidance) class application to increasing in adolescent knowledge about HIV – AID. This research using pre experimental research design method with one group pretest posttest project, this design used without using any control group and made the first observation (pretest) which allows researchers to test the changes that occur on the experiment. This study was conducted from 12 August – 12 September, with 30 respondent as a sample, the research data ware univariately and bivariately analysis through the t test with a = 0.05. The result of univariate analyzed shows 4.53 are the average pretest knowledge, while 11.87 are the average posttest knowledge, on the other way by bivariate analysis obtained 0.001 p-value, so it can be concluded that CG (Counseling guidance) class application affect on improving adolescent knowledge about HIV-AID in Puskesmas Talang Banjar before and after given CG class Application.Keyword

In developing countries, despite the availability of proven interventions for the Prevention of Mother-to-Child Transmission, HIV in children is still a largely uncontrolled epidemic. Data of infants were collected from infant’s medical record and mother’s history charts from four states in North central part of Nigeria. Socio-demographic data such as age, occupation, place of delivery and mode of delivery and the rate prevalence in different states were also collected. The data were analyzed using chi-squared test with 95% confidence intervals and p-value (0.05). Out of one thousand four hundred and sixteen data collected on mode of child birth, the percentage mother to child transmission on children delivered through vaginal and cesarean surgery were 17.3% and 16.7%, respectively. Children delivered at home had the highest percentage HIV infection at 19.7%; while children delivered at private hospital had the lowest 16.5%. Younger mothers between the ages of 17-25 had the highest rate of mother to child transmission. Benue and Plateau states had the highest rate of mother to child transmission 21.7% and 20.4%, respectively compared to Nassarawa and Bauchi with infection rate 13.2 and 12.7%, respectively. The data collected in this study demonstrate the factors associated with mother to child transmission of HIV in some states in north central Nigeria.

Background: Human immunodeficiency virus (HIV) transmission remains to be a significant problem in the country despite preventive efforts in the past years. In children, mother-to-child vertical transmission during pregnancy is the most common route. The World Health Organization has implemented the Prevention of Mother-to-Child HIV Transmission (PMTCT) program, which promotes a comprehensive approach in addressing this problem. Male partner involvement in antenatal voluntary HIV counseling and testing has been proposed to be a vital part of this approach. Their role in the process has not been studied in depth in the local setting. Objectives: The study aimed to describe the knowledge, attitudes, and practices of male partners of pregnant women toward antenatal HIV screening in a local private tertiary hospital using a survey created by Belato et al. in 2016. Methodology: A descriptive analysis was done to present the sociodemographic and clinical characteristics of the participants. The association between the level of male partner involvement and independent variables was also tested. Results and Conclusions: The results of the study revealed a high level of male partner involvement in the PMTCT of HIV services at 69.1%. Age of the male partner and the duration of the couple living together were significant factors associated with male partner involvement. However, there was lack of knowledge regarding HIV transmission, antenatal HIV testing, and PMTCT services among majority of the male partners. Community sensitization of men about the benefits of antenatal HIV testing and PMTCT services need to be prioritized to improve their awareness and their involvement in the program.

Background: Estimating the HIV seroprevalence in a low-risk population such as pregnant women provide essential information for monitoring trend of HIV in the general population and assist in prevention from mother-to-child transmission. Aim and Objectives: To assess and compare the prevalence of HIV among pregnant women during the past 5 years in Jalandhar dist. of Punjab (2016–2021). Materials and Methods: All pregnant women coming to Antenatal Clinic in urban and rural areas, in Government health institutions were tested for HIV as a mandatory procedure, to prevent transmission of HIV from mother to child. The results of these tests were taken from HIMS reports of rural and urban health institutions in Jalandhar district, from local health authority for the past 5 years (2016–2021), after taking permission from Institutional Ethics Committee. Comparison of year-wise positivity was done after statistical analysis. It was a retrospective cross-sectional study of rural and urban population. Results: The data shows that HIV prevalence among pregnant women in Jalandhar District for the past 5 years shows a decreasing trend. Prevalence which was 0.17% in 2016–2017 was reduced to 0.11% in 2020–2021. Conclusion: Prevalence of HIV among pregnant women has shown a decreasing trend in Jalandhar district during the past 5 years (2016–2021).

El tratamiento antirretroviral (TARV) en mujeres embarazadas ha contribuido a la prevención de la transmisión del VIH de madre a hijo. Sin embargo, el desarrollo de resistencia del VIH-1 a la TARV es un problema latente y puede reducir la eficacia del tratamiento en las mujeres embarazadas, generar un riesgo de transmisión de madre a hijo e impactar el manejo clínico de las mujeres embarazadas o de los niños que resulten infectados.Este estudio determinó la presencia de resistencia en mujeres embarazadas VIH-1 positivo (recibiendo TARV) de Tegucigalpa y San Pedro Sula durante el año 2015. Un total de 63 participantes fueron analizadas y en 35 de ellas se obtuvo amplificación exitosa del gen pol del VIH-1 para evaluar la presencia de mutaciones asociadas a resistencia.La cuantificación de carga viral y conteo de CD4 fue realizado a todas las participantes. La prevalencia global de resistencia fue del 17 %. Un 62 % de las participantes presentaron carga viral detectable y en el 16 % recuentos celulares ≤200 celulas/ mm3. La prevalencia de resistencia, la viremia y bajos recuentos celulares indican que podría existir un riesgo de transmisión vertical en esta cohorte.Este estudio proporciona datos actuales sobre la prevalencia de la resistencia a la TARV en población femenina embarazada VIH-1 positivo de Honduras y refleja la necesidad de realizar de forma rutinaria y permanente pruebas de resistencia, carga viral y conteo de CD4, con el fin de apoyar en la prevención de la tramision del VIH-1 en el binomio madre-hijo.

Latar belakang. Penularan infeksi HIV (Human Immunodeficiency Virus) dari seorang ibu HIV (+) pada bayinya dapat terjadi selama kehamilan, persalinan, ataupun menyusui. Hal ini dinamakan penularan HIV dari ibu-ke-bayi atau dikenal dengan istilah Mother To Child HIV Transmission(MTCT). Penularan HIV dari ibu ke bayi tersebut dapat dicegah yang dikenal dengan sebutan PMTCT (Prevention of Mother To Child HIV Transmission) Tujuan. Melakukan evaluasi terhadap kemungkinan infeksi HIV yang terjadi pada bayi yang mengikuti program PMTCT di RSAB Harapan Kita. Metode. Penelitian deskriptif dengan menggunakan data retrospektif dari rekam medik RSAB Harapan Kita Jakarta dan Rumah Sakit Kanker Dharmais Jakarta. Subyek penelitian adalah bayi dan ibu HIV (+) yang melahirkan di RSAB Harapan Kita Jakarta pada periode 1 Januari 2007–30 November 2010 dan telah mengikuti program PMTCT. Hasil. Delapanbelas dari 19 bayi yang dilahirkan ibu HIV positif diikutsertakan dalam penelitian ini. Terdapat 3 (16,7%) bayi yang telah melakukan uji diagnostik HIV secara lengkap. Untuk pemeriksaan PCR-RNA HIV pertama, dijumpai 15 (83,3%) bayi telah melakukan pemeriksaan dengan hasil negatif. Sedangkan untuk pemeriksaan PCR-RNA HIV kedua, 10 bayi (58,8%) telah melakukan pemeriksaan, semua memberikan hasil negatif. Untuk pemeriksaan ELISA HIV dilakukan saat usia bayi 18 bulan, dijumpai 5 bayi (50%) dari 10 bayi yang seharusnya melakukan ELISA HIV sampai dengan November 2010, juga memberikan hasil negatif (virus HIV tidak terdeteksi). Kesimpulan. Pada semua bayi yang telah menjalani pemeriksaan ELISA HIV, tidak ada satupun yang terdeteksi virus HIV.

Mother-to-child transmission is the highest mode of acquisition of HIV infection in children, with a 15-45% risk of an infant acquiring HIV from an infected mother without any medical intervention. The objectives of this study were to evaluate the implementation of prevention of mother-to-child transmission (PMTCT) guidelines and determine its clinical outcome in a PEPFAR Clinic in Nigeria from 2008 to 2012. A retrospective review of data of patients who accessed PMTCT from the Clinic in the University of Nigeria Teaching Hospital (UNTH), Enugu was conducted. Data were retrieved from the clinic’s database and analyzed. The result showed that three hundred and seventy-three (373) pregnant women (aged 30.22±4.88) and three hundred and sixty-seven (367) children from the pregnancies were enrolled into PMTCT. Ten (10) regimens were used for the mothers: AZT/3TC/NVP, TDF/3TC+NVP and AZT/3TC+EFV accounting for 80.00, 11.00 and 2.65%, respectively. AZT (15.80%) and NVP (84.20%) were used for the infants, 8 (2.18%) of whom tested positive for HIV. The study concluded that PEPFAR Clinic, UNTH Enugu substantially followed the guidelines in its PMTCT programme which was found to drastically reduce the transmission of HIV from mother to child. Key words: APIN-CDC, ARVs, highly active antiretroviral therapy (HAART), HIV, prevention of mother-to-child transmission (PMTCT).

Hepatitis C virus (HCV) infection is a leading cause of chronic liver disease in adults and children, affecting more than 180 million individuals worldwide. Vertical transmission is the primary route of HCV acquisition in children. Studies have not found effective management strategies to reduce risk for transmission. Pediatric HCV infection is different from adult infection in several aspects. This review will provide a comprehensive understanding of the current knowledge of HCV and its impact on pregnant women and infants and will offer specific recommendations for diagnosis and management.

An analysis of validated National Prevention of Mother-to-Child Transmission (PMTCT) data from 2008 to 2014 showed that Nigeria has recorded steady progress. However, to achieve elimination of mother-to-child transmission of HIV, service scale-up and active testing of pregnant women are required, as a large number of HIV-infected women in Nigeria are not aware of their HIV status. Focusing on efforts that will improve access and uptake of antenatal care/PMTCT services will significantly reduce new infant HIV infection.

Acquired immune deficiency syndrome is a clinical condition caused by human immunodeficiency virus (HIV) which can be transmitted either vertically or horizontally. More than 90% of children living with HIV in developing countries have been infected through mother to child transmission during pregnancy, around the time of birth, or through breastfeeding. In order to reduce the number of infected children, increasing emphasis should be placed on preventing mother to child transmission programs with the use of antiretroviral medications in the pregnant woman during pregnancy and at delivery and, starting immediately after birth for the exposed infant. Here, we present the case of a 60-day-old infant heavily immunocompromised due to an extremely high viral burden of HIV, which was acquired perinatally from an undiagnosed and untreated mother, leading to severe bronchopneumonia, sepsis, septic shock and death.

To evaluate immunogenicity and efficacy of a 10μg recombinant Saccharomyces cerevisiae-derived hepatitis B vaccine (Kangtai Biological Products Co. Ltd, Shenzhen, China) (Hep-KSC) in newborns.Overall 1197 infants born to mothers negative for HBV markers (NM group) and 534 born to HBsAg-positive mothers (PM Group) were enrolled. Infants in NM group were given 10μg Hep-KSC, 10μg Engerix-B or 5μg Hep-KSC and those in PM group received 10μg Hep-KSC or 10μg Engerix-B at 0, 1 and 6 months, with an additional 200IU HBIG at birth for the latter.For NM Group, 10μg Hep-KSC paralleled 10μg Engerix-B but outperformed 5μg Hep-KSC regarding seroprotective rate (95.06% vs 94.83% vs 89.67%, p=0.0077) and anti-HBs geometric mean concentration (GMC) (798.87mIU/ml vs 790.16mIU/ml vs 242.04mIU/ml, p0.0001) at 7 months. The proportion of infants with anti-HBs greater than 1000mIU/ml was higher in 10μg Hep-KSC than 5μg Hep-KSC group (45.77% vs 11.93%, p0.0001) at 7 and 12 months. For PM Group, the HBsAg positivity rate in 10μg Hep-KSC and 10μg Engerix-B group was 1.60% and 4.27% at 7 months, respectively. In 10μg Hep-KSC group, 93.61% and 91.29% achieved seroprotection at 7 and 12 months, respectively, and correspondingly 90.24% and 86.96% in 10μg Engerix-B group. The anti-HBs GMC was comparable between 10μg Hep-KSC and 10μg Engerix-B group at 7 and 12 months (575.31mIU/ml vs 559.64mIU/ml; 265.79mIU/ml vs 264.48mIU/ml).10μg Hep-KSC might be appropriate for neonatal immunization with good immunogenicity and efficacy, especially for infants born to HBsAg-positive mothers.

Background Eliminating mother-to-child transmission (MTCT) of HIV has been one of New York State's public health priorities, and the goal has been virtually accomplished by meeting criteria established by the Centers for Disease Control and Prevention. Methods We use a return on investment (ROI) approach, from the perspective of the state, to compare expenditures incurred to prevent MTCT of HIV in NYS during the period 1998-2013 to benefits realized, as expressed as HIV treatment costs saved from averting an estimated number of HIV infections among newborns. Extrapolating from the 11.5% incidence rate of HIV-infected newborns in 1997, we projected the number of cases of MTCT of HIV that were averted over the 16-year period. A published estimate of lifetime HIV treatment costs was used to estimate HIV treatment costs saved from the averted infections; expenditures for clinical protocols and other services directly associated with preventing MTCT of HIV were also estimated. The ROI was then calculated by dividing program benefits by the expenditures incurred to achieve these benefits. Results We estimate that 898 cases of MTCT of HIV were averted between 1998 and 2013, resulting in a savings of $321.03 million in HIV treatment costs. Expenditures to achieve these benefits totaled $81.07 million, yielding an ROI of $3.96. Conclusions Aside from the human suffering from MTCT of HIV that is averted, expenditures for treatment protocols and interventions to prevent MTCT of HIV are relatively inexpensive and can result in almost 4 times their value in HIV treatment cost savings realized.

Chronic hepatitis B virus (HBV) infection due to mother-to-child transmission (MTCT) during perinatal period remains an important global health problem. Despite standard passive–active immunoprophylaxis with hepatitis B immunoglobulin (HBIG) and hepatitis B vaccine in neonates, up to 9% of newborns still acquire HBV infection, especially these from hepatitis B e antigen (HBeAg) positive mothers. Management of HBV infection in pregnancy still need to draw careful attention because of some controversial aspects, including the failure of passive-active immunoprophylaxis in a fraction of newborns, the effect and necessity of periodical hepatitis B immunoglobulin (HBIG) injection to the mothers, the safety of antiviral prophylaxis with nucleoside/nucleotide analogs, the benefit of different delivery ways, and the safety of breastfeeding. In this review, we highlight these unsettled issues of preventive strategies in perinatal period, and we further aim to provide an optimal approach to the management of preventing MTCT of HBV infection.

Introduction The sexual and reproductive health of people living with HIV is fundamental for their well-being. Antiretroviral therapy and reproductive technologies have significantly improved quality of life of people living with HIV in developed countries. In sub-Saharan Africa, the epicenter of HIV, the sexual practices and fertility of women infected with HIV have been understudied. Aim To assess the sexual behavior, fertility intentions, and awareness of preventing mother-to-child transmission of HIV in pregnant women with HIV-negative partners in Yaounde Central Hospital (Yaounde, Cameroon). Methods A cross-sectional survey using a semistructured, interviewer-administered questionnaire was conducted at the antenatal unit and HIV clinic in 2014. Main Outcome Measures Ninety-four pregnant women infected with HIV provided consistent information on (i) sociodemographic characteristics, (ii) sexual and fertility patterns, (iii) awareness of preventing mother-to-child transmission of HIV, and (iv) their unmet needs. Results Although sexual desire had significantly changed since their HIV diagnosis, the women were highly sexually active. Approximately 19% of women had more than one sexual partner and 40% had regular unprotected sex during the 12-month period before the interviews (P < .0001). Twenty-nine percent of women preferred intermittent sexual intercourse and inconsistent condom use to delay pregnancy, but the abortion rate remained high. Age, marital status, and education affected women's awareness of mother-to-child transmission (P < .05); and no association existed between the number of living children and future pregnancies (rs = −0.217; P = .036). Conclusion HIV-infected women living with HIV-negative partners in Cameroon expressed high sexual and fertility intentions with several unmet needs, including safer sexual practices and conception. Incorporating and supporting safe sexual educational practices and conception services in maternal care can decrease risky sexual behavior and vertical transmission.

Background: Transmission of HIV from mother to child is by far the most common route of HIV infection in children. It is estimated that without effective interventions, between 67,500 and 125,000 infants will be infected with HIV annually in Nigeria. Traditional birth attendants assist in 60–80% of all deliveries and even more in the rural areas of developing countries including Nigeria. Objective: This study is aimed at assessing the knowledge and practice of Prevention of Mother-To-Child-Transmission of HIV among Traditional Birth Attendants practicing in Akwa Ibom, Nigeria. Methods: A descriptive, cross-sectional survey using well structured, validated and pre-tested questionnaires to interview 600 TBAs from 21 randomly selected local government areas of Akwa Ibom State to assess their knowledge and practice of prevention of mother to child transmission (PMTCT) of HIV. Results: 96.8% (581) of the study population were aware of the existence of HIV/AIDS, however only 194(32.3%) of these respondents who were aware of the existence HIV/AIDS were also aware of mother-to-child-transmission (MTCT) of HIV. Furthermore only 83 (42.8%) of the 194 respondents who were aware of MTCT of HIV were able to state correctly the various routes through which MTCT of HIV could occur. In addition 174(89.7%) of our respondents who were aware of MTCT of HIV also believed that MTCT of HIV could be prevented. However only 121(69.5%) of these 174 respondents knew that PMTCT can be achieved through proper medical interventions. Conclusion: The knowledge and practice of PMTCT of HIV by the TBAs practicing in Akwa Ibom, Nigeria is less than adequate thus increasing the risk of vertical transmission of HIV. There’s an urgent need for the education and training of TBAs to improve their knowledge and enhance their practice.

Globally, countries have made significant achievements in reducing rates of mother-to-child transmission (MTCT) of HIV. In Kenya, MTCT rates were most recently estimated at 8%, with 220,000 children under 15 years of age living with HIV. In 2013, the World Health Organization recommended highly active antiretroviral therapy (HAART) for all HIV-infected pregnant and lactating women. APHIAPLUSKAMILI supported rollout of a county-level, targeted, rapid scale-up of HAART in 152 high-volume facilities in Kenya. A review and comparison of data from these facilities in 2013 and 2014 revealed a significant increase in the proportion of women started on HAART and a reduction in MTCT.

Background Global reduction in new infant HIV infections is largely due to the expansion of prevention of mother-to-child transmission (PMTCT) programs. Identification of gaps in healthcare services is paramount in targeting interventions that identify high-risk populations and healthcare barriers that could lead to increased risk of mother to child transmission (MTCT) of HIV. Methods HIV infected women from 5 regions of Africa enrolled in the African Cohort Study (AFRICOS) were followed prospectively with assessments performed every 6 months. Sociodemographic factors, pregnancy outcomes, and access of PMTCT resources were reviewed for retrospectively reported pregnancies and those followed prospectively from study enrollment. Statistical analysis compared the impact of clinical factors on infant mortality and preterm delivery. Results The study reported 5591 pregnancies from January 2013 to June 2019 of which 5363 were retrospectively reported prior to study enrollment and 228 occurred after enrollment. Pregnancies followed prospectively had higher rates of linkage to PMTCT services prenatally (92.5% vs 6.8%, P< 0.001), intrapartum (64.5% vs 3.5%, P< 0.001), and post-partum (64.5% vs 2.9%, P< 0.001). This group had higher rates of delivery by a skilled birth attendant (93.4% vs 66.7%, P< 0.001) and antiretroviral therapy (ART) prescribed antepartum (96.1% vs 5.5%, P< 0.001) and post-partum (74.6% vs 3.6%, P< 0.001). Both groups had similar rates of prescriptions for intrapartum ART (98.7% vs 97.9%). The majority of women reported ART adherence (96.5%, P< 0.001) which was associated with a decrease in both preterm delivery and infant mortality (adjusted OR 0.24, 95% CI 0.15-0.39). A significant proportion of women followed prospectively reported their infants received ART with good adherence (51.8% vs 0.3% and 93.4% vs 6.3%, respectively P< 0.001). Conclusion Participation in AFRICOS increased linkage to PMTCT programs which resulted in increased likelihood of skilled delivery and appropriate ART use for women and their infants. It highlights that linkage to care continues to be a crucial factor in limiting MTCT of HIV especially in resource-limited settings. Limitations in this study exist due to the low number of prospectively followed pregnancies. Disclosures All Authors: No reported disclosures

Background: HIV pandemic still remains an issue of major concern on a global scale with more than 37.9 million people estimated to be living with HIV in 2019 globally -an increase from 36.7 million in 2015. India has the third largest HIV epidemic in the world, with 2.1 million people living with HIV, with higher prevalence among men (0.25%) than women (0.19%) out of which children (15 years) accounts for 6.54%, while two fifth (40.5%) of total HIV infections are among females.Methods: A cross-sectional hospital based study was conducted over a time period of 03 months and a total of 366 pregnant women attending the health care facilities of Block Hazratbal were included in the study.Results: Among the study participants, only 15 (4.1%) women had not heard about HIV/AIDS, 314 (85.8%) were aware of sexual transmission as a mode of transmission and only half of the study subjects (50.8%) knew about MTCT, more than half of the subjects (68.3%) were aware that the transmission of HIV infection can occur during pregnancy.Conclusions: Although the study population showed adequate knowledge about HIV infection, there was a considerable lack of knowledge regarding mother-to-child transmission of HIV infection and its prevention.

Background: This study aims at evaluating the benefits and harms of hepatitis B immune globulin (HBIG) and hepatitis B vaccine (HBVac) in preventing mother to child transmission in HBV surface antigen (HBsAg) positive pregnant women during antenatal period. Methods: Seven electronic databases including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), WanFang Database, Chinese Biomedical Literature Database (CBM), VIP Database for Chinese Technical Periodicals (VIP), and 3 clinical trial registry platforms were searched from inception date to December 2017. Only randomized controlled trials (RCTs) were included in this study. The Cochrane risk of bias tool was applied to assessing the risk of bias. The outcomes were analyzed by Review Manager 5.3 software. Results: Sixteen RCTs involving 2440 HBsAg positive pregnant women were included in the meta-analysis. Compared with placebo group, HBIG and HBVac group had a significant decrease in the number of newborns who were HBsAg positive (relative risks [RR]: 0.2, 95% confidence interval [CI] [0.18, 0.40], P

Mother-to-child transmission (MTCT) is the major source of HIV infection among children under the age of 15 years. There were limited studies on the MTCT rate in Amhara Region, Ethiopia. Therefore, this study aimed to measure mother-to-child transmission and to identify factors associated with MTCT. An institutional-based retrospective cohort study was conducted among HIV-exposed infants (HEIs). The HEIs who booked in mother–baby pair cohort register between January 2014 and December 2016 were abstracted and included in the study. A structured pretested questionnaire was used for data abstraction. The collected data were coded and double entered into EPI Info version 3.5.4 and exported to STATA version 14 for analysis. A penalized logistic regression model was used. p-value 350 CD4 count at the first antenatal care visit. Overall, MTCT of HIV was 1.5%, and 59.2% of HEIs were discharged from the PMTCT care at the age of 12-18 months. The vertical transmission of HIV was significantly associated with the duration of ART (AOR 0.16; 95% CI: 0.02, 0.96). The MTCT was 84.0% less likely in mothers who did receive Antiretrovirals (ARVs) >12 months compared with mothers who did receive ARVs

ObjectivesSyphilis morbidity is high among pregnant women in lower income countries with limited laboratory capacity. We evaluated a long-standing global Syphilis Serology Proficiency Programme (SSPP) that supports testing quality in national reference laboratories to determine if participation affects congenital syphilis elimination strategies.DesignIn this observational cross-sectional study, we calculated coverage on type, frequency and quality of syphilis testing reported by laboratories enrolled in the SSPP from 2008 to 2015. We used country-reported data to WHO on four congenital syphilis (CS) indicators and World Bank country economic data to compare coverage and completeness of reporting of indicators in lower income countries with and without an SSPP-enrolled laboratory.ParticipantsFrom 2008–2015, 78 laboratories from 51 countries participated in>1 SSPP evaluation; 56% were national reference laboratories, of which most (93%) participated for>3 years and 11 (22%) in all 24 cycles.ResultsMedian proficiency performance score was >95% regardless of test conducted. Of the 51 countries with an SSPP-enrolled laboratory, 22 (43%) were lower-income countries, of which 21 reported CS data during 2008–2015. Comparing CS data from 87 (90% of total) lower income countries with and without an SSPP-enrolled laboratory, countries with an SSPP-laboratory had stronger reporting on antenatal syphilis testing (p=0.04). For 2015, an estimated 74% of prenatal syphilis tests and 63% of positive tests reported to WHO from countries with an SSPP-enrolled laboratory.ConclusionThe SSPP has focused well on national reference laboratories, but has been only partially successful in recruiting laboratories from lower income countries. The finding that over half of syphilis infections in pregnant women living in countries with SSPP-enrolled laboratories suggests wide reach of the current quality assurance programme. However, reach could expand with focussed recruitment of laboratories from lower income countries.

We examined the current status of syphilis-infected pregnant Japanese women, according to the results of syphilis screening and confirmation tests of women who gave birth in Japan between October, 2015 and March, 2016. We requested 2458 obstetrical facilities to provide information of syphilis screening tests and 78.1% of them responded. Considering the response rate and the rate of implementation of confirmation tests, the number of syphilis-infected pregnant Japanese women was estimated to be 250 (1/4022) per year.

Resume L’allaitement maternel protege par une tritherapie antiretrovirale comme strategie de prevention de la transmission mere-enfant du VIH : l’experience du Centre hospitalier National d’Enfants Albert Royer de Dakar.

Has President's Emergency Plan for AIDS Relief's (PEPFAR) funding been effective in reducing the rate of HIV new infections and AIDS-related deaths among women and children? While previous studies have found HIV/AIDS aid to be ineffective and PEPFAR funding to produce negative externalities, there is lack of empirical examination of the impact of PEPFAR on women and children despite the emphasis on prevention of mother-to-child transmission of HIV during the Bush and Obama administrations. Using descriptive analysis and difference-in-differences (DID) regression, this study finds that PEPFAR's funding has reduced the HIV new infections and AIDS-related death rates of women and children for both focus countries and recipient countries, which are those that were added in a second phase. These findings show that PEPFAR's strategy for women and children has been effective and that it should be continued. However, while PEPFAR has contributed to the fight against HIV/AIDS, the effects of its work have been underestimated.

Objectives: to analyze both frequency and risk factors for seroconversion among newborns of HIV-positive mothers to HIV. Methods: a cohort study was conducted with children residing in Southern Region of Santa Catarina. Secondary data from the notification files and medical records of newborn's mothers of infected infants were used. The participants were all the newborns from 2005 to 2015 that were exposed to HIV through vertical transmission and attended a municipal health care center. Results: there were 104 cases of infant exposure to HIV. Seroconversion was confirmed in three cases, two of them died of AIDS during the study period. Breastfeeding (PR= 32.7; CI95%= 10.7-99.5; p= 0.002) and non-use of antiretroviral drugs during pregnancy (PR=18.2; CI95%= 2.0-163.0; p= 0.008) were risk factors for HIV seroconversion. Conclusions: seroconversion rates among neonates in Southern Region of Santa Catarina were similar to the national average. Seroconversion was associated with non-use of antiretroviral therapy during pregnancy and breastfeeding. Resumo Objetivos: investigar a frequência e analisar os fatores de risco para soroconversão entre nascidos vivos de mães soropositivas ao HIV. Métodos: foi realizado estudo de coorte, com crianças residentes na Região Sul de Santa Catarina. Foram usados dados secundários referentes a ficha de notificação e acompanhamento de criança exposta ao HIV e revisão do prontuário das mães das crianças infectadas. Participaram do estudo todos os nascidos vivos no período de 2005 a 2015 expostos ao HIV por transmissão vertical atendidos no serviço municipal de saúde. Resultados: houve 104 exposições ao HIV, sendo que em três casos se confirmou soroconversão e dois foram a óbito por Aids.O aleitamento materno (RP=32,7; IC95%=10,7-99,5); p=0,002) e o não uso de antirretroviral durante a gestação (RP=18,2; IC95%=2,0-163,0); p=0,008) foram fatores de risco para a soroconversão. Conclusões: a soroconversão em neonatos na Região Sul de Santa Catarina foi similar à média nacional. Houve associação com não utilização de terapia antirretroviral durante a gestação e aleitamento materno.

BACKGROUND Some risk factors for mother-to-child transmission (MTCT) of HIV have been identified. To further reduce MTCT, other risk factors were evaluated. MATERIALS AND METHODS A retrospective study on early infant diagnosis was conducted. Two-sided chi-square test was used to assess associations with infant HIV status. RESULTS A total of 15 233 HIV-infected mothers and 15 404 infants were recruited. MTCT rate was 9.34%. Only 3.8% of infants born to mothers on antiretroviral treatment were infected. Under nevirapine, 4.1% of infants were infected. MTCT increased with infant' age at testing. Younger mothers tend to transmit more HIV (P = 0.003). More children were infected in single pregnancies compared with multiple pregnancies, P

Background: Hispanic Americans consistently exhibit an intergenerational increase in the prevalence of many noncommunicable chronic physical and mental disorders. Methods: We review and synthesize evidence suggesting that a constellation of prenatal and postnatal factors may play crucial roles in explaining this trend. We draw from relevant literature across several disciplines, including epidemiology, anthropology, psychology, medicine (obstetrics, neonatology), and developmental biology. Results: Our resulting model is based on evidence that among women, the process of postmigration cultural adjustment (i.e., acculturation) is associated, during pregnancy and after delivery, with psychological and behavioral states that can affect offspring development in ways that may alter susceptibility to noncommunicable chronic disease risk in subsequent-generation Hispanic Americans. We propose one integrated process model that specifies the biological, behavioral, psychological, and sociocultural pathways by which maternal acculturation may influence the child's long-term health. We synthesize evidence from previous studies to describe how acculturation among Hispanic American mothers is associated with alterations to the same biobehavioral systems known to participate in the processes of prenatal and postnatal developmental programming of disease risk. In this manner, we focus on the concepts of biological and cultural mother-to-child transmission across the prenatal and postnatal life phases. We critique and draw from previous hypotheses that have sought to explain this phenomenon (of declining health across generations). We offer recommendations for examining the transgenerational effects of acculturation. Conclusion: A life course model with a greater focus on maternal health and well-being may be key to understanding transgenerational epidemiological trends in minority populations, and interventions that promote women's wellness may contribute to the elimination or reduction of health disparities.

Introduction: Chronic periodontitis is an infectious disease. Porphyromonas gingivalis is the major pathogen associated with it and can be found in all ecosystems in the oral cavity. The presence of this organism is highly correlated with preterm and low birth weight babies. So, this study aimed to assess vertical transmission of P.gingivalis from pregnant women to their new born. Methods: Forty six pregnant women with chronic periodontitis were recruited for this cross-sectional study. Whole unstimulated saliva was collected from them before delivery and from their new-borns within forty eight hours of birth. Quantification of P.gingivalis in the saliva samples was carried out by quantitative real time polymerase chain reaction. The obtained data were analysed by SPSS 16 program. Results: The results showed a significant correlation (P=0.002) between the number of P.gingivalis present in the mother’s saliva with that of the new-borns’ saliva. DNA copies of more than 5000/μl of P.gingivalis was found in 20 (43.5%) maternal saliva and 21 (45.7%) in new-borns’ saliva. Both Plaque index and Extent and Severity index showed no correlation (P>0.05) with DNA copies of P.gingivalis in new-borns’ saliva. Conclusions: The DNA copies of P.gingivalis found in new-borns’ saliva are in par with mother saliva, as the saliva sample obtained from new-borns’ were within forty eight hours of birth, no other environmental factor can have a direct role in its transmission. Thus, it can be concluded that P.gingivalis is vertically transmitted from mother to child.

Sub-Saharan Africa (SSA) accounts for more than two thirds of the world’s HIV infection. Despite scaled-up prevention of mother-to-child transmission of HIV (PMTCT) programmes, mother to child transmission of HIV (MTCT) continues to escalate. We describe the challenges faced by PMTCT in MTCT in SSA. The study reviewed articles and reports published online. The most common barriers and challenges were non-disclosure of HIV status, late initiation of ARVs treatment/adherence, STIs screening, long clinics waiting time, non-involvement of men in ANC/PMTCT, infant feeding methods and sensitization of community members on ANC/PMTCT programmes. The study highlights the need to expand PMTCT coverage and the implementation of the 90-90-90 programme toward MTCT elimination in SSA. That is “ ≥90% of pregnant and breast-feeding mothers must know their HIV status; ≥90% of those that are positive are enrolled on ARVs treatment and care; ≥90% of those on ARVs treatment and care are virally suppressed. Keywords: HIV, Pregnancy, MTCT, PMTCT, Sub-Saharan Africa

The vertical transmission of HIV, from mother to child remains one of the biggest challenges all over the world. This study evaluated the implementation and effectiveness of the prevention of mother to child HIV transmission (PMTCT) program from 2011 to 2017 in Suzhou. A total of 107 HIV positive women were enrolled in the program, of which 11 were diagnosed through premarital examination, and 96 women were diagnosed through prenatal examination. Among the 96 pregnant women, 67 gave birth to 68 live neonates. Only one infant was diagnosed HIV infected because the HIV positive mother did not enter the PMTCT program until delivery. The HIV prevalence in Suzhou city showed a low-level tendency. To increase the prenatal health utility and antiretroviral medication compliance of the migrant population in Suzhou, there are improvements to make in order to achieve the 90-90-90 targets.

This review reinforces the lack of a single maternal risk factor that is highly associated with vertical transmission (VT) of the infection with hepatitis C virus (HCV): indeed HCV RNA levels, mode of delivery, breast feeding, viral genotype or maternal IL28B status were not associated with HCV VT.