Njom Nlend A E, Nguedou Marcelle K, Koki Ndombo P, Brunelle Sandié A
Centre hospitalier d'ESSOS, caisse nationale de prévoyance sociale, Yaoundé, Cameroun; Institut de technologies médicales Nkolondom, université de Douala, Yaoundé, Cameroun.
Institut de technologies médicales Nkolondom, université de Douala, Yaoundé, Cameroun.
Rev Epidemiol Sante Publique. 2019 May;67(3):163-167. doi: 10.1016/j.respe.2019.03.119. Epub 2019 Apr 13.
Cameroon has adopted the option B+ for the prevention of mother-to-child transmission (MTCT) program of HIV in August 2014 in order to eradicate MTCT of HIV.
To analyze in routine life settings, efficacy of option B+ for PMTCT and associate factors.
We conducted a cross-sectional study over a 6-month period in the ESSOS hospital center. Study population comprised HIV-positive mothers and their infants aged 0-24 months. Variables included were : moment of HIV maternal testing, timing of commencement of maternal antiretroviral therapy (ART) and self-reported adherence to ART. Efficacy was measured through early and late MTCT rate and associated factors.
We included 200 mothers and 124 infants. Under option B+, the rate of transmission was at 4.20% at 6 weeks and 5.83% at 12 months. The rate of HIV transmission in breastfed infants stood at 3.7%. In unadjusted analysis, bottle-feeding, term at birth, early screening and management during pregnancy were associated with lower risk of HIV transmission. After adjustment, term at delivery after 37 weeks adjusted odds ratio (AOR) [0.059; (0.0061; 0.56)] was protective; while lack of prophylaxis was among HIV-exposed infants emerged as the main factor associated with residual transmission of HIV [AOR 117.23 ; (3.55 ; 3874.9)].
In this setting of Yaoundé, routine option B+ posted laudable results at 12 months even amongst breastfed children and should therefore be made sustainable.
喀麦隆于2014年8月采用了B+方案用于预防艾滋病毒母婴传播（MTCT）项目，以消除艾滋病毒的母婴传播。
在日常生活环境中分析B+方案预防母婴传播艾滋病毒的效果及相关因素。
我们在ESSOS医院中心进行了为期6个月的横断面研究。研究人群包括艾滋病毒呈阳性的母亲及其0至24个月大的婴儿。纳入的变量有：母亲艾滋病毒检测时间、母亲开始抗逆转录病毒治疗（ART）的时间以及自我报告的抗逆转录病毒治疗依从性。通过早期和晚期母婴传播率及相关因素来衡量效果。
我们纳入了200名母亲和124名婴儿。在B+方案下，6周时传播率为4.20%，12个月时为5.83%。母乳喂养婴儿的艾滋病毒传播率为3.7%。在未调整分析中，人工喂养、足月出生、孕期早期筛查和管理与较低的艾滋病毒传播风险相关。调整后，37周后分娩的足月调整优势比（AOR）[0.059；（0.0061；0.56）]具有保护作用；而未对暴露于艾滋病毒的婴儿进行预防是与艾滋病毒残留传播相关的主要因素[AOR 117.23；（3.55；3874.9）]。
在雅温得的这种环境下，常规的B+方案在12个月时取得了值得称赞的结果，即使在母乳喂养的儿童中也是如此，因此应使其可持续。
