Prevention of mother-to-child transmission of HIV at the second immunization visit: a cross-sectional study, Burkina Faso

Abstract

Objective To evaluate the performance of the cascade of activities for prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) at the second immunization visit in Burkina Faso. Methods In a cross-sectional study, we recruited mothers attending the second immunization visit for their infant in 20 health centres of Bobo-Dioulasso city, Burkina Faso over 12 months (2019–2020). We administered a short questionnaire to 14 176 mothers and performed HIV serological tests on mothers who had not been tested in the last 3 months. All mothers were asked about their attendance for antenatal care and HIV rapid testing. HIV-infected mothers were also asked about the timing of their HIV diagnosis, antiretroviral therapy, pre-exposure prophylaxis initiation at birth and infant diagnosis of HIV. Findings Of 14 136 respondents, 13 738 (97.2%) had at least one HIV serological test in their lifetime. Of 13 078 mothers who were never tested or were HIV-negative, 12 454 (95.2%) were tested during or after their last pregnancy. Among HIV-infected mothers already aware of their status, 110/111 (99.1%) women were on antiretroviral therapy. Among HIV-exposed infants, 84/101 (83.2%) babies received 6 weeks of antiretroviral prophylaxis at birth and 58/110 (52.7%) had a blood sample collected for early infant diagnosis. Only two mothers received their child’s test results at the time of the second immunization visit. Four mothers were newly diagnosed as HIV-positive during the study. Conclusion Collecting data at the second immunization visit, a visit rarely missed by mothers, could be useful for identifying gaps in the PMTCT cascade in settings where mothers are difficult to reach, such as in low-income countries with intermediate or low HIV prevalence.

Evaluation of the prevention of mother-to-child transmission of HIV programs at the second immunization visit in Burkina Faso and Zambia

“…In particular, it also complements the population-level evaluation of EID [ 21 ]. Although our findings are in full agreement with the proportions of pregnant women on ART in Burkina Faso [100% (100–100%)] and Zambia [97% (81–100)] estimated by UNAIDS [ 22 ], the actual EID coverage in our study was much lower confirming previous findings from Bobo-Dioulasso (Burkina Faso), where the EID coverage was as low as 1.8% at EPI-2 visit [ 16 ]. Although our evaluation took place, too early after sampling to report the coverage in terms of EID test results.…”

“…This provided a unique opportunity to retrospectively assess the PMTCT interventions that they had received up to that visit. This population-level assessment strategy has proven effective in Bobo-Dioulasso, a medium-sized urban city of Burkina Faso [ 16 ]. The present study aimed to validate this strategy in Burkina Faso and Zambia, two sub-Saharan African countries with different HIV epidemic patterns and different ANC/PMTCT health service organization.…”