Abstract #8  -  Outcome of PMTCT's implementation at the mothers and infant health centre (MIHC) of Guiglo (western Ivory Coast)
Authors:   Presenting Author:   Dr Bangaly doumbouya - aconda vs côte d'ivoire
Additional Authors:  Dr jean claude gauze, Mr hyacinthe Brou, Mme Thérèse Guiba, Dr Kouakoussui Konan,
Aim: In resource limited settings, HIV Counseling and Testing for pregnant women through the PMTCT is one of the first tools to limit the spread of HIV infection. the study aims to describe two years outcomes of PMTCT’s implementation at a small health centre in western Ivory Coast.
Method / Issue: In April 2005 the MIHC of Guiglo has been included in the PMTCT National Program. Pregnant women coming to Antenatal Service received a specific counselling by midwifes and HIV testing was offered. The test was performed using the Determine and Genie II kit according to the national guideline. The result was provided during the same visit. When positive for HIV, a single dose Nevirapine (NVP) prophylaxis was provided both for mother and child.
Results / Comments: From April 2005 to December 2007, serology screening was proposed to 4104 women and 3915 (95.4%) accepted. The mean age was 21.6 years (16-43y), 43.5% were living in Guiglo’s city and 56.5% came from the country side in the surroundings. Among the 189 patients who declined the test, 81 wanted to obtain the husband’s agreement, 35 had already been tested, 31 were worried about the possibility of a positive result, and 42 didn’t provide any reason. No difference was detected in the test acceptance’s rate, depending of the area patients were coming from (1785 from the rural areas vs 2319 from an urban setting). Two-hundred-thirty-seven positive women (6.04%) have been detected, 234 HIV-1 and 3 HIV-2. The prevalence was 7.01% among women living in an urban area and 3.52% in women coming from the rural areas. All the patients with HIV-1 accepted to receive the prophylaxis with NVP. Most of these women delivered in Guiglo District Hospital and have been followed up there.
Discussion: The response to HIV testing among women coming to the MIHC’s Antenatal Service of Guiglo has been positive, with a high percentage of patients accepting to be screened. Additional options should be considered for HIV-2 positive women and to limit the incidence of NVP resistant strains among women who received the prophylaxis.
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