Azhali Buti A, Setiabudi Djatnika, Alam Anggraini
Department of Child Health, Faculty of Medicine, Universitas Islam Bandung, Bandung, Indonesia.
Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia.
Narra J. 2023 Dec;3(3):e405. doi: 10.52225/narra.v3i3.405. Epub 2023 Nov 17.
Indonesian government launched a triple elimination program to eliminate mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV), syphilis, and hepatitis B in 2018, aiming to increase screening uptake among pregnant women during antenatal visits and to reduce the rates of these infections in children less than 50 per 100,000 live births. Despite this initiative, a thorough assessment of its effectiveness, particularly in Bandung, the capital city of West Java, as one of the most densely populated cities in Indonesia with a high HIV incidence, has yet to be conducted. The aim of this study was to analyze the impact of this triple elimination program in Bandung by assessing the data between 2017 and 2020. Monthly data was obtained from the Health Office of Bandung for four years, including number of screenings done for HIV, syphilis, and hepatitis B, number of confirmed cases and number of pregnant women treated for those infections. Additionally, data on children under 24 months old afflicted by these infections were also collected. Our data indicated an increase in screening coverage for HIV, syphilis, and HBV among pregnant women; however, it remained below the national set benchmarks for screening coverage. Only 59.5% of HIV-positive pregnant women received anti-retroviral therapy in 2020, while merely 25% of syphilis-positive cases were administered benzathine penicillin G. Syphilis screening was correlated with an increase in positive cases among children, suggesting missed opportunities in managing syphilis-positive pregnant women. Furthermore, management of HIV- and syphilis-positive cases had suboptimal outcomes. Data on hepatitis B was not evaluated since it was not available. To achieve the triple elimination program goals, comprehensive coordination among all relevant stakeholders is required, as is continuous monitoring and evaluation.
2018年，印度尼西亚政府启动了一项三重消除计划，以消除人类免疫缺陷病毒（HIV）、梅毒和乙型肝炎的母婴传播，旨在提高孕妇产前检查时的筛查接受率，并将这些感染在儿童中的发病率降低至每10万活产少于50例。尽管有这一举措，但尚未对其有效性进行全面评估，尤其是在西爪哇省省会万隆，作为印度尼西亚人口最密集且HIV发病率高的城市之一。本研究的目的是通过评估2017年至2020年的数据，分析该三重消除计划在万隆的影响。从万隆卫生局获取了四年的月度数据，包括HIV、梅毒和乙型肝炎的筛查次数、确诊病例数以及接受这些感染治疗的孕妇人数。此外，还收集了受这些感染影响的24个月以下儿童的数据。我们的数据表明，孕妇中HIV、梅毒和乙肝的筛查覆盖率有所提高；然而，仍低于国家设定的筛查覆盖率基准。2020年，只有59.5%的HIV阳性孕妇接受了抗逆转录病毒治疗，而梅毒阳性病例中只有25%接受了苄星青霉素G治疗。梅毒筛查与儿童阳性病例增加相关，表明在管理梅毒阳性孕妇方面存在错失的机会。此外，HIV和梅毒阳性病例的管理效果欠佳。由于没有可用数据，未对乙肝数据进行评估。为实现三重消除计划目标，所有相关利益攸关方需要进行全面协调，持续监测和评估也是如此。
