Encouraging report regarding mother to child HIV transmission

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Encouraging report regarding mother to child HIV transmission

Saturday, May 18, 2019

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WASHINGTON, United States (CMC) — A new report by the Pan American Health Organization (PAHO) says 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 titled “New generations free 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, an estimated 30,800 children were born without HIV as a result of the interventions to prevent mother-to-child transmission.

“Significant progress has been made towards ensuring a generation free from AIDS and syphilis, and now efforts are also being made to stop children from being born with hepatitis B and Chagas,” said the Dominica-born, PAHO Director, Dr Carissa F Etienne.

“We must intensify and integrate the response and expand access to health services if we want to end transmission of these four diseases,” she said.

In 2017, PAHO said 20 countries reported data indicating the elimination of mother-to-child transmission of HIV, seven of which received validation from the World Health Organization (WHO).

However, it is estimated that each year, 3,500 children are either born with HIV, or contract HIV from their mothers in Latin America and the Caribbean.

PAHO said 73 per cent of pregnant women in the region underwent at least one HIV test, 73 per cent of those that tested positive went on to access treatment.

“This is an increase from 2010 but still lower than the 95 percent testing and treatment goal,” PAHO said.

According to the new report, in 2017, at least 15 countries also reported data indicating the elimination of congenital syphilis, seven of which received validation from WHO.

However, the report also states that cases of congenital syphilis are on the rise.

In 2017, there were 37 countries reporting more than 28,800 cases, 22 per cent more than in 2016, although 85 per cent of reported cases are concentrated in just one country in the region.

The report also shows other unequal results, stating that, while the screening of pregnant women for syphilis has decreased, the treatment of those who have had the test and are found to be positive has increased.

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

The estimated regional prevalence of hepatitis B in children aged five years is 0.1 per cent. Individually, it is estimated that several countries have also achieved this goal. However, it is estimated that 6,000 children contract the hepatitis B virus each year in the region.

PAHO said in order to prevent this, it recommends giving four doses of the vaccine to all children under the age of one, with the first dose during the first 24 hours of life, “which is a key time for preventing transmission.”

In 2017, PAHO said vaccination coverage with the third dose for children under the age of one was 87 per cent, with 25 countries introducing the vaccine dose during the first 24 hours after birth to all newborns.

“Efforts are needed to continue increasing hepatitis B vaccination coverage in children,” PAHO said, estimating that that around 9000 babies are born with Chagas disease in Latin America and the Caribbean, accounting for more than 20 per cent of all new cases in the region.

However, in 2017, PAHO said regional countries notified it of just 280 new cases, “which highlights the urgent need to improve detection and notification systems.”

PAHO said the screening of Chagas disease in pregnant women also varies significantly, from seven per cent to 55 per cent in the few countries that report data.

“Eliminating mother-to-child transmission of these four diseases presents a huge challenge”, said Dr Marcos Espinal, PAHO's Director of the Department of Communicable Diseases and Environmental Determinants of Health.

“However, implementing an integrated approach in addressing this issue is an opportunity to ensure that advances towards elimination are equitable.”

PAHO said the new report is the first to address the four diseases together, following the 2014 renewal of a commitment made in 2010 by Ministers of Health in the region to eliminate mother-to-child transmission of HIV and syphilis, which was then expanded to include the other two diseases.

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