Encouraging report on HIV transmission from mother to child

WASHINGTON, USA (CMC) – A new report from the Pan American Health Organization (PAHO) indicates that Caribbean countries are moving towards the elimination of mother-to-child transmission of HIV , syphilis, hepatitis B and Chagas.

But the report also notes that progress in the Americas has been uneven.

The report "New Generated Generations of HIV, Syphilis, Hepatitis B and Chagas Disease in the Americas 2018" includes data from 52 countries and territories in the Americas.

It notes that since 2010, approximately 30,800 children have been born without HIV as a result of interventions to prevent mother-to-child transmission.

"Significant progress has been made in ensuring a generation without AIDS and syphilis, and efforts are also being made to prevent children from being born with hepatitis B and Chagas," said Dr. Carissa F Etienne, director of the Ministry of Health. OPS, born in Dominica in Dominica.

"We need to step up and integrate the response and expand access to health services if we want to stop the transmission of these four diseases," she said.

In 2017, PAHO stated that 20 countries had reported data indicating the elimination of mother-to-child transmission of HIV, of which seven were validated by the World Health Organization (WHO) .

However, it is estimated that each year 3,500 children are born with HIV or become infected with their mother's HIV in Latin America and the Caribbean.

PAHO reported that 73% of pregnant women in the area had at least one HIV test and 73% of those who tested positive had access to treatment.

"This is an increase over 2010, but it remains below the 95% screening and treatment targets," said OPS.

According to the new report, in 2017, at least 15 countries also provided data indicating the elimination of congenital syphilis, of which seven were validated by the WHO.

However, the report also indicates that cases of congenital syphilis are increasing.

In 2017, 37 countries reported more than 28,800 cases, 22% more than in 2016, although 85% of reported cases are concentrated in only one country in the region.

The report also shows other unequal results, indicating that, although screening for syphilis in pregnant women has decreased, the treatment of those who have passed the test and found to be positive has increased.

PAHO has stated that for more than 20 years, countries in the Americas have vaccinated against hepatitis B, which has enabled the region to achieve the goal of eliminating mother-to-child transmission of the disease.

The estimated regional prevalence of hepatitis B in children aged five is 0.1%. Individually, it is estimated that several countries have also achieved this goal. However, an estimated 6,000 children are infected with the hepatitis B virus each year in the region.

In order to avoid this, the OPS recommended giving four doses of the vaccine to all children under one year of age, the first dose during the first 24 hours of life, "which is a key moment to prevent transmission ".

In 2017, PAHO reported that vaccination coverage with the third dose in children younger than one year was 87%, with 25 countries introducing the vaccine dose within 24 hours of birth for all newborns.

"Efforts are needed to continue to increase immunization coverage against hepatitis B in children," said OPS, estimating that about 9,000 babies are born with Chagas disease in Latin America and in the Caribbean, more than 20% of new cases in the region. .

However, in 2017, PAHO told countries in the region that it was reporting only 280 new cases, "underscoring the urgent need to improve detection and notification systems."

OPS said screening for Chagas disease in pregnant women also varied significantly, ranging from 7% to 55% in the few countries that reported data.

"The elimination of mother-to-child transmission of these four diseases is a huge challenge," said Dr. Marcos Espinal, director of the department of communicable diseases and environmental determinants of health of PAHO.

"However, implementing an integrated approach to solving this problem is an opportunity to ensure that progress in eliminating is equitable."

The OPS said the new report was the first to address all four diseases together, following the 2014 renewal of a pledge made in 2010 by health ministers of the region. eliminate mother-to-child transmission of HIV and syphilis. include the other two diseases.