Integrated prevention of mother-to-child transmission for human immunodeficiency virus, syphilis and hepatitis B virus in China

Abstract

ProblemChina continues to face challenges in eliminating mother-to-child transmission of human immunodeficiency virus (HIV), syphilis and hepatitis B virus (HBV).ApproachIn 2010, a programme that integrated and standardized prevention of mother-to-child transmission (PMTCT) efforts for HIV, syphilis and HBV was implemented in 1156 counties. At participating antenatal care clinics, pregnant women were offered all three tests concurrently and free of charge. Further interventions such as free treatment, prophylaxis and testing for mothers and their children were provided for HIV and syphilis.Local settingChina’s national PMTCT HIV programme started in 2003, at which time there were no national programmes for perinatal syphilis and HBV. In 2009, the rate of maternal-to-child transmission of HIV was 8.1% (57/702). Reported congenital syphilis was 60.8 per 100 000 live births. HBV infection was 7.2% of the overall population infected.Relevant changesBetween 2010 and 2013 the number of pregnant women attending antenatal care clinics with integrated PMTCT services increased from 5.5 million to 13.1 million. In 2013, 12.7 million pregnant women were tested for HIV, 12.6 million for syphilis and 12.7 million for HBV. Mother-to-child transmission of HIV fell to 6.7% in 2013. Data on syphilis transmission are not yet available.Lessons learntIntegrated PMTCT services proved to be feasible and effective, and they are now part of the routine maternal and child health services provided to infected women. The services are provided through a collaboration between maternal and child health clinics, the national and local Centers for Disease Control and Prevention, and general hospitals.

Effectiveness of treatment to improve pregnancy outcomes among women with syphilis in Zhejiang Province, China

“…As the prevalence of syphilis in China has risen since the 1990s, to prevent syphilis transmission from mother to child has become a priority 10 16. In this study, the overall prevalence of maternal syphilis was much higher than in other parts of the world, such as Europe (0.16%), the Mediterranean (0.06%) and slightly higher than the Chinese national average (0.24%) 1 9.…”

“…As the number of syphilis cases continues to soar in many regions, a national programme on integrated PMTCT of syphilis, HIV and hepatitis B was launched at the end of 2010; this included uptake of counselling and screening and strengthening of healthcare for infected mothers and their infants 10. The programme has achieved great success in reducing the incidence of CS in pilot areas such as Shenzhen, where the CS incidence decreased from 115/100 000 in 2002 to 10/100 000 (live births) in 2011 11.…”

High sero-prevalence of hepatitis B virus and human immunodeficiency virus infections among pregnant women attending antenatal clinic at Temeke municipal health facilities, Dar es Salaam, Tanzania: a cross sectional study

“…World Health Organization (WHO) has called for integrated and standardized prevention of mother-to-child transmission (PMTCT) for HIV, syphilis and HBV [15]. Despite the call Tanzania has not scaled up PMTCT services for HBV infection.…”

Residual mother-to-child transmission of HIV in Burkina Faso

“…These results are encouraging compared with previous sero-surveillance data in Burkina Faso, where the estimated percentage of children infected with HIV through vertical transmission from their HIV-positive mothers who have given birth in the last 12 months in2013, 2014, 2015 was 5.72%, 5.30% and 4.95%,respectively (10). In other countries such as China, the vertical transmission rate was reported as 6.7% in 2013 (11) and in Ukraine in 2010 it was reported as 4.1% (12), despite the implementation of PMTCT programs. In addition, similar vertical transmission rates have been reported in other countries, particularly South Africa, where surveys conducted in 2010 and 2011 revealed vertical transmission rates of 3.5% and 2.7%, respectively (13).…”