HIV IN PREGNANCY
Geneva Foundation for Medical Education and Research GFMER Sudan 2012Forum No: ( 2 )
NAME OF PRESENTERName Position Institution
Dr. Amal Khalil Coordinator of Reproductive & Child Health Research Unit (RCRU).
UMST
Name Position Institution
Dr . Hani Mohammed Ibrahim
Medical Director Research Assistant at (RCRU).
Um Bakhita Maternity .HUMST
Dr . MAJDI SABAHELZAIN
Pharmacist/ MSc. Public and Tropical Health
UMST
Name of contributors
CONTENT OF THE PRESENTATION
MTCT PMTCT in Sudan PMTCT Centers Prevention of MTCT
MTCT
largest source of HIV infection in children below the age of 15 years (95%).
< 80% of MTCT occurs late in the third trimester, during labour and delivery.
vaginal delivery, duration of membranes rupture, chorioamnionitis, preterm delivery and breast feeding.
INCREASED RISK OF MTCT IN
well advanced maternal HIV disease. low antenatal CD4 T- lymphocyte
counts . high mean plasma viral.
TIMING AND RISK OF TRANSMISSIONTransmission Rate
5 – 10% During pregnancy
10 – 20% During labour & delivery
5 – 20% During breast feeding
15 – 30% Overall without breastfeeding
25 – 35% Overall with breast feeding till 6 months
30 – 45% Overall with breast feeding till 18 to 24 months
PMTCT IN SUDAN
A pilot project was implemented in four states to examine the applicability of such an intervention before starting a nationwide implementation.
result of this project was 6593 pregnant women counseled, 927 tested and 7 was found to be positive and the prevalence was 0.76%.
PMTCT CENTERS
2007: 7 centers in high prevalence areas of South Darfur, Khartoum, Kassala, North Kordofan and Red Sea.
7,848 pregnant women attending had access to PMTCT services by receiving routine counseling and testing.
HIV PREVALENCE AMONG WOMEN ATTENDING PMTCT SERVICES IN SUDAN FROM AUGUST 2007 TO JULY 2008
Prevalence %
Total positive
Total tested Site
2.28 12 525 Omdurman
0.086 1 1159 Saudi Hospital
0.34 4 1185 Turkey Hospital
1.8 4 219 Port Sudan
0.8 8 994 Kassala
0.8 4 497 Elobeid
0.27 2 727 Nyala
0.66 35 5306 Total
BENEFITS OF HIV TESTING FOR PREGNANT WOMEN?
A mother who knows early in her pregnancy that she is HIV infected has more time to make important decisions. She and her health care provider will have more time to decide on effective ways to protect her health and prevent mother-to child transmission of HIV She can also take steps to prevent passing HIV to her partner.
IN SUDAN…
Awareness about mother-to-child transmission of HIV is 26.4%.
Knowledge of ways of mother-to-child transmission of HIV (all three means of vertical transmission) is 54%.
SHHS 2006
Knowledge of ways of mother-to-child transmission of HIV (%)
Awareness about mother-to-child transmission of HIV(%)
State
35.7 82.1 Khartoum
40.8 75.7 River Nile
12.5 21.0 W. Darfur
19.8 37.6 S. Kordofan
PREVENTION OF MTCT
using antiretroviral therapy (ART)- two complementary goals: to prevent the transmission of HIV to the unborn child and to safeguard the health of the mother.
delivery by elective caesarean section. vaginal under certain precautions avoidance of breast feeding (risk highest in
first 3 months). Formula feeding is associated with reduction
of MTCT to around 14%.
INFANT FEEDING RECOMMENDATIONS FOR HIV-POSITIVE WOMEN
•When replacement feeding is acceptable, feasible, affordable, sustainable and safe, avoidance of all breastfeeding by HIV-infected mothers is recommended.
•Otherwise, exclusive breastfeeding is recommended during the first months of life.
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