3250.0: Monday, October 22, 2001 - 9:06 PM

Abstract #27834

Prenatal HIV screening and prevention of mother to child transmission of HIV in rural Cameroon, West Africa

Thomas K. Welty, MD, MPH1, Edith R. Welty, MD1, Tih Pius Muffih, MPH, PhD2, Marc Bulterys, MD, PhD3, Ndikintum George2, Nkuoh Godlove2, and Andrea S. Cedfeldt, MD2. (1) 10381 Pheasant Lane, Nampa, ID 83686-9171, 208-465-3612, tewelty@qwest.net, (2) AIDS Education and Prevention Program, Cameroon Baptist Convention Health Board, PO Box 9, Nso, Northwest Province, Kumbo, Cameroon, (3) Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Mailstop E-45, 1600 Clifton Road, Atlanta, GA 30333

Cameroon has experienced rapid increases in HIV/AIDS including increasing rates among prenatal patients. The antiretroviral drug nevirapine, given as a single dose to the mother during labor and a single dose to the neonate within the first three days of life, has been shown to reduce mother to child transmission (MTCT) of HIV by 47 % in Uganda. From Feb 2000-Apr 2001, 2509 prenatal patients at 2 large hospitals and three health centers run by the Cameroon Baptist Convention (CBC) Health Board in rural Northwest Province were counseled and offered screening with two rapid HIV tests, as part of their routine prenatal care. Through a grant from the Elizabeth Glaser Pediatric AIDS Foundation, the counseling and testing were offered free of charge, and 94.8 % were tested after signing consent. Fifteen HIV counselors have been trained and have provided extensive community HIV/AIDS education. Reasons for refusal (5.1%) included desire to first discuss with their spouse and fear of testing. Of those tested, 254 (10.7%) were HIV positive by rapid test, and 97.7%, returned for post-test counseling. Confirmatory testing is in process at CDC. As of April 2001, 94 HIV positive mothers and 96 of their infants were treated with nevirapine perinatally to prevent MTCT of HIV. Follow up PCR testing of these infants is in progress to determine efficacy of the intervention and the prevalence of drug resistance. This program is rapidly expanding to 18 more rural CBC integrated health centers and to government health facilities.

Learning Objectives: At the conclusion of the session, the participant will be able to: 1) Describe the protocol for use of nevirapine to prevent maternal to child transmission in developing countries. 2) Recognize the importance of integrating prenatal HIV screening into comprehensive prenatal care. 3) Describe some of the challenges of implementing HIV/AIDS prevention programs in rural areas of developing countries.

Keywords: HIV/AIDS, Maternal and Child Health

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Cameroon Baptist Convention Health Board
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA