3rd International AIDS Society Conference on HIV Pathogenesis and Treatment Rio de Janeiro - July 24 - 27, 2005

CAN WE SCALE UP NATIONAL PREVENTION OF MOTHER-TO-CHILD TRANSMISSION (PMTCT) PROGRAM IN LOW RESOURCES SETTINGS ?: LESSONS LEARNED AND CHALLENGES FROM CAMEROON'S EXPERIENCE

IAS Conf HIV Pathog Treat 2005 Jul 24-27;3rd: Abstract No. TuOa0302

Tsague L.¹, Njom Nlend A.², Zoung-Kanyi Bissek A.¹, Tchendjou P.³, Tejiokem M.³, Tih P.⁴, Tene G.⁵, Eteki N.⁶, Tonye R.⁶, Same Ekobo C.⁷, Engozo'o A.¹, Nokouni M.¹, Koulla S.⁸, Penda I.⁹, Tchendje T.¹⁰, Bella A.^1
1 Directorate for Disease Control, Ministry of Public Health, Yaoundé, Cameroon, ² Central Technical Group of National Aids Control Committee, Yaoundé, Cameroon, ³ Centre Pasteur du Cameroun, Yaoundé, Cameroon, ⁴ Cameroon Baptist Convention Health Board, Bamenda, Cameroon, ⁵ Chantal Biya Foundation, Yaoundé, Cameroon, ⁶ Yaounde Central Hospital, Yaoundé, Cameroon, ⁷ Essos Medical Center, Yaoundé, Cameroon, ⁸ Central Hospital of Yaounde, Yaoundé, Cameroon, ⁹ Laquinitinie Hospital Douala, Douala, Cameroon, ¹⁰ Affixe, thendjetchendje@yahoo.fr, Yaoundé, Cameroon

INTRODUCTION: Successful results of the pilot PMTCT project in 2000-2001 justified the extension of the program to all the country to reduce by 50% the incidence of HIV infection in children by offering PMTCT package in at least 80% of health districts by 2005.

METHODS: A combination of "top-bottom" and "bottom-up" strategies in the framework of a scaling up plan were used to ensure a proper coverage of the health services. Partnership with the private sector was encouraged through agreement with the MOH. A focal PMTCT officer was defined for the management of the program at the provincial. An integrated procurement and supply system for ARV and HIV tests was designed. Training of senior counsellor trainers was organised for all the ten provinces. A "district approach" was developed to improve the coverage and the integration of PMTCT services at the district level.

RESULTS: The program moved from less than 5% coverage of health district in 2001 to 60% by the end of 2004 with a variability of number of PMTCT sites by provinces (average per province : 27 sites, range : 4-61). From 2001 to 2004, 2,500 health providers were trained, and 200,000 pregnant women counselled for HIV in ANC. The average acceptance rate nationwide is 70% (range : 16-95%). In 2003, 70% (57,000/82,000) of pregnant women accepted to be tested for HIV in ANC and 7.5% were found positive. Among them, 63% was effectively treated with Nevirapine at delivery, and 70% of expected babies. An impact evaluation in babies at 18 months described a residual 10.6% risk of transmission.

CONCLUSIONS: The PMTCT program has effectively embarked into the scaling up phase, but some challenges remain: consolidate the existing activities and scaling up the interventions at the district level using the "district approach", Improve into the community awareness and commitment for PMTCT.

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Prevention | TuOa0302 | L. Tsague
MTCT-Plus

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