The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #56514

Thomas K. Welty, MD, MPH¹, Marc Bulterys, MD, PhD², Edith R. Welty, MD¹, Tih Pius Muffih, MPH, PhD³, George Ndikintum³, Godlove Nkuoh³, Joseph Nkfusai³, and Janet Kayita, MD, MPH⁴. (1) Cameroon Baptist Convention Health Board, 10381 Pheasant Lane, Nampa, ID 83686, 208-465-3612, twelty@earthlink.net, (2) Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Mailstop E-45, 1600 Clifton Road, Atlanta, GA 30333, (3) AIDS Education and Prevention Program, Cameroon Baptist Convention Health Board, PO Box 9, Nso, Northwest Province, Kumbo, Cameroon, (4) Institute for HIV/AIDS, Family Health International, 2101 Wilson Blvd. Suite 700, Arlington, VA 22201

Background: The Cameroon Baptist Convention Health Board (CBCHB) PMTCT Program, supported by the Elizabeth Glaser Pediatric AIDS Foundation, began in February 2000 at 2 rural hospitals and, by November 2002, had screened over 15,000 women in 58 facilities (including 8 government and 17 other NGO facilities) in 6 of the 10 provinces of Cameroon.

Methods: We counseled pregnant women, obtained risk factor data, and offered free HIV testing, as part of routine prenatal care. We treated HIV positive women and their newborns with single-dose nevirapine. We expanded to government and other NGO facilities by providing training, rapid test kits, nevirapine, and monitoring capability. We developed 2 videos, a training manual, and a monitoring/evaluation system. We hosted an international conference and contributed to the National PMTCT Plan.

Findings: After counseling, 93.7 % of antenatal patients accepted HIV testing. Of those tested, 99.1% were post-test counseled on the same day. Of the 15,733 women tested through November 2002, 9.6% were antibody positive. Risk factors for HIV-1 infection included young age at first sexual intercourse, age less than 30 years, multiple sex partners, syphilis, maternal education, and non-farming occupations.

Interpretation: CBCHB successfully implemented PMTCT in rural Cameroon. Integration of PMTCT into routine prenatal care is crucial, but nevirapine treatment alone can not achieve the WHO 2010 goal of reducing infant HIV infections in Africa by 50%. Our risk factor analysis shows that primary HIV prevention among young women (eg. delay in sexual debut, fewer sexual partners, and appropriate condom use) is also essential.

Learning Objectives:

At the conclusion of the session, the participants in this session will be able to:
• Describe the essential components of a successful PMTCT Program
• List risk factors associated with HIV in pregnant women in Cameroon
• Describe the 3 prong approach for prevention of HIV infections in infants and children

Keywords: International MCH,

Presenting author's disclosure statement:
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.