Abstract
Outcome Evaluation of Early Implementation of Option B+ in Cameroon
Tshimwanga Katayi Edouard*
Corresponding Author: Tshimwanga Katayi Edouard, Cameroon Baptist Convention Health Board, Cameroon
Published: August 10, 2019;
Citation: Edouard TK. (2019) Outcome Evaluation of Early Implementation of Option B+ in Cameroon. J Immunol Res Ther, 4(S1): 02.
Copyrights: ©2019 Edouard TK. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
 

Mother to child transmission (MTCT) of HIV constitutes a major source of new infections in Cameroon. The aim of this implementation research was to assess outcomes and effectiveness of providing life-long antiretroviral therapy (ART) for HIV-positive pregnant and breastfeeding women (Option B+). From October 2013 to July 2014, HIV-positive pregnant and breastfeeding women, not on antiretrovirals (ARVs), were recruited from 22 purposefully selected health facilities in the Northwest and South-west regions for a prospective, observational cohort evaluation. Option B+ was offered to participants and outcome indicators were measured. Out of 680 women eligible for this assessment, 669 (98%) were initiated on Option B+. Retention-in-care was 90% (95% CI, 87.85-92.61) and 79% (95% CI, 75.20-81.88) and loss to follow up (LTFU) was 7% (95% CI, 4.95-8.90) and 15% (95% CI, 12.06-17.56) at 6 and 12 months, respectively. Maternal mortality at 12 months after ART initiation was 2% (13). As of March 2015, 538 HIV exposed infants (HEIs) were enrolled and received postpartum Nevirapine prophylaxis within 72 h of birth and 84% (454) were on Cotrimoxazole at 6 to 8 weeks. By 8 weeks of age, 515 infants had HIV DNA PCR test with 486 (94.4%) negative, 12 (2.3%) positive and 17 (3.3%) had unknown results. In Cameroon, successful implementation of Option B+ increased retention-in-care to 79% at one year for pregnant and breastfeeding women and reduced MTCT rate below 5% for HEIs at 8 weeks of age. Long term retention, maternal and infant mortality and final MTCT rate after cessation of breastfeeding require further evaluation.

 

Keywords: Option B+, Implementation research, Prevention of mother to child HIV transmission, HIV exposed infants