RESUMO
To assess mother-to-child transmission (MTCT) of hepatitis C virus (HCV) in Cameroon, 5,008 pregnant women were screened for HCV antibodies. Eighty-nine (1.8%) were HCV-antibody (HCV-Ab) positive. Among these, 7 (7.9%) were HBsAg positive, 6 (6.7%) HIV-positive, and one (1.1%) was co-infected by both hepatitis B virus (HBV) and HIV. Sixty-eight (76%) out of 89 HCV-Ab positive pregnant women were HCV-RNA positive. The HCV genotype determination indicated the predominance of genotype 4 (45.3%), followed by the genotypes 1 (28.1%) and 2 (26.6%). The mean HCV-RNA levels of 41 women at the time of delivery was 4.8 (range 0.06-34.7) x 10(6) RNA copies/mL. Finally, 35 women delivered 36 live children. None of those screened at 6 weeks and 6 months of age were HCV-RNA positive. The failure to detect HCV vertical transmission suggests that the mother-to-child transmission (MTCT) is not a major route of HCV transmission in Cameroon.
Assuntos
Hepacivirus/imunologia , Anticorpos Anti-Hepatite C/sangue , Hepatite C/transmissão , Transmissão Vertical de Doenças Infecciosas , Camarões , Feminino , Infecções por HIV/complicações , Hepacivirus/classificação , Hepacivirus/genética , Hepatite B/complicações , Hepatite C/virologia , Humanos , Lactente , Gravidez , Complicações Infecciosas na Gravidez , RNA Viral/sangueRESUMO
A public health program to prevent mother-to-child transmission (MTCT) of human immunodeficiency virus type 1 (HIV-1) by treatment with nevirapine has been ongoing in Yaounde, Cameroon since January 2000. After 24 months, plasma samples from 119 children born to HIV-1-positive mothers were tested for HIV-1 RNA between six and eight weeks after birth. Thirteen (10.9%) tested positive (95% confidence interval = 5.2-16.7%). Risk factors associated with MTCT in this study were maternal viral load (P < 0.05), low birth weight (chi2 for trend = 8.78, P = 0.01), and birth during the second half of the year. A high correlation was repeatedly observed between rainfall in a given month and the risk of MTCT of HIV-1 in children born three months later (r = 0.634, P < 0.001). Although we cannot rule out other tropical infections related to the rainy season, the role of malaria is highly suspected since the interval of three months we observed between the peaks of rainfall and the rate of transmission is consistent with the Plasmodium life cycle.
Assuntos
Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Transmissão Vertical de Doenças Infecciosas/estatística & dados numéricos , Complicações Infecciosas na Gravidez/epidemiologia , RNA Viral/análise , Adulto , Peso ao Nascer , Camarões/epidemiologia , Feminino , Infecções por HIV/sangue , Infecções por HIV/etiologia , HIV-1/genética , HIV-1/isolamento & purificação , Humanos , Lactente , Masculino , Gravidez , Complicações Infecciosas na Gravidez/sangue , Complicações Infecciosas na Gravidez/etiologia , Chuva , Fatores de Risco , Estações do Ano , Carga ViralRESUMO
Risk factors for HIV transmission within a hospital setting were assessed using pre-structured questionnaires and observations. Of 409 respondents, 66.3% corresponded to the nursing staff, 14.4% doctors and 8.3% laboratory staff. The irregular use of gloves and other protective clothing for risky tasks, and recapping of needles after use were some of the risk factors identified, especially amongst nurses. Preventive measures were not always implemented by health personnel. More emphasis should be placed not only on diffusing universal precautions and recommendations for hospital staff safety, but accompanying measures for monitoring and evaluation of implementation of these standards are also indispensable.