Introduction: In spite of significant progress towards eliminating mother-to-child transmission (MCT) of HIV by 2025, trends in vertical mother-to-child transmission are still worrying in sub-Saharan African countries...Introduction: In spite of significant progress towards eliminating mother-to-child transmission (MCT) of HIV by 2025, trends in vertical mother-to-child transmission are still worrying in sub-Saharan African countries. This study aims to take stock of the factors associated with HIV MCT at the level of peripheral health training. Patients and Methods: This was a descriptive and analytical retrospective study, over a five-year period from January 1<sup>st</sup>, 2017 to December 31<sup>st</sup>, 2021. The study population was represented by HIV-positive women and their cared infants in the Parent-Child Transmission Prevention Unit (PCTP) of the Castors Urban Health Center (CUHC). Results: 288 medical records were selected out of a total of 347 HIV-positive mothers followed. HIV seroprevalence in the population of women who received PreNatal Consultation (PNC) during the study period was 8.2%. The HIV MCT rate was 3.7%. HIV+ mothers followed were mostly young (average age of 28), not living in a couple (96.9%), poorly educated (58.7%) and not engaged in income-generating activity (58.4%). They had all received triple therapy and the period of initiation of antiretroviral (ARV) therapy was in the majority of cases during the first trimester. Factors associated with MCT were: primiparity (OR = 18.4 [5.55 - 61.05];Khi<sup>2</sup> = 32.61;p < 0.001), late discovery of infection during large or after childbirth (OR = 0.03 [0.007 - 0.10];Khi<sup>2</sup> = 55.22;p < 0.001), WHO Clinical Stage 2 and 3 (OR = 0.007 [0.001 - 0.03];Khi<sup>2</sup> = 108.73;p < 0.001), CD4 count 200/mm<sup>3</sup> (OR = 14.12 [4.03 - 57.20];Khi<sup>2</sup> = 21.68;p < 0.001), viral load > 1000 copies/mm<sup>3</sup> (OR = 8.85 [2.33 - 43.20];Khi<sup>2</sup> = 10.46;p = 0.001), prolonged labor (OR = 12.33 [3.45 - 57.25];Khi<sup>2</sup> = 18.47;p < 0.001), premature rupture of membranes (OR = 24.03 [6.97 - 96.01];Khi<sup>2</sup> = 40.60;p <sup>2</sup> = 5.96;p = 0.014), and artificial or mixed breastfeeding (OR = 0.01 [0.002 - 0.043];Khi<sup>2</sup> = 97.65;p Conclusion: Taking into account the risk factors for PCTP is essential if we want to achieve the goal of “Zero New Infections in Children by the year 2025”.展开更多
Introduction: Pregnancy is a physiological condition that can sometimes end in death. The death of a woman is a constant concern for the obstetrician and is considered a major public health problem in our developing c...Introduction: Pregnancy is a physiological condition that can sometimes end in death. The death of a woman is a constant concern for the obstetrician and is considered a major public health problem in our developing countries. Objective: To identify the determinants that contribute to maternal morbidity and mortality in the Gynaecology and Obstetrics Department of the University Community Hospital. Methodology: We conducted a retrospective study from 1 January 2015 to 31 December 2019 (5 years) in the obstetrics and gynaecology department of the Centre Hospitalier Universitaire Communautaire (CHUC). It focused on the determinants of maternal mortality. Our study population consisted of all women who died during the period and met the World Health Organization (WHO) definition of maternal mortality (MOMA). We used non-probability sampling with the exhaustive choice technique. Results: The study revealed that the number of deaths recorded was 98, while 17,172 live births were registered during the same period. The maternal mortality ratio was 570 per 100,000 live births. The most common age group was 20 to 24, with an average age of 26. The frequency of death among primiparous women was 37.74%, pauciparous women 28.30% and multiparous women 26.42%. Direct causes were dominated by abortion complications (22.41%), followed by infections (9.30%) and haemorrhage (8.19%). Indirect causes were dominated by anaemia with a proportion of 45.16%. The majority of maternal deaths occurred in the post-partum period (34.71%). Most maternal deaths occurred after vaginal delivery, 19 cases (63.33%), while 11 deaths (36.66%) occurred after caesarean section. The occurrence of direct causes was associated with age less than or equal to 25 years, abortion complications and primiparity, with a statistically significant difference. Conclusion: At the end of this study, complications of unsafe abortion and poverty are all factors contributing to the rise in the maternal mortality rate. Emphasis should be placed on promoting family planning, as this would make a major contribution to reducing maternal mortality.展开更多
文摘Introduction: In spite of significant progress towards eliminating mother-to-child transmission (MCT) of HIV by 2025, trends in vertical mother-to-child transmission are still worrying in sub-Saharan African countries. This study aims to take stock of the factors associated with HIV MCT at the level of peripheral health training. Patients and Methods: This was a descriptive and analytical retrospective study, over a five-year period from January 1<sup>st</sup>, 2017 to December 31<sup>st</sup>, 2021. The study population was represented by HIV-positive women and their cared infants in the Parent-Child Transmission Prevention Unit (PCTP) of the Castors Urban Health Center (CUHC). Results: 288 medical records were selected out of a total of 347 HIV-positive mothers followed. HIV seroprevalence in the population of women who received PreNatal Consultation (PNC) during the study period was 8.2%. The HIV MCT rate was 3.7%. HIV+ mothers followed were mostly young (average age of 28), not living in a couple (96.9%), poorly educated (58.7%) and not engaged in income-generating activity (58.4%). They had all received triple therapy and the period of initiation of antiretroviral (ARV) therapy was in the majority of cases during the first trimester. Factors associated with MCT were: primiparity (OR = 18.4 [5.55 - 61.05];Khi<sup>2</sup> = 32.61;p < 0.001), late discovery of infection during large or after childbirth (OR = 0.03 [0.007 - 0.10];Khi<sup>2</sup> = 55.22;p < 0.001), WHO Clinical Stage 2 and 3 (OR = 0.007 [0.001 - 0.03];Khi<sup>2</sup> = 108.73;p < 0.001), CD4 count 200/mm<sup>3</sup> (OR = 14.12 [4.03 - 57.20];Khi<sup>2</sup> = 21.68;p < 0.001), viral load > 1000 copies/mm<sup>3</sup> (OR = 8.85 [2.33 - 43.20];Khi<sup>2</sup> = 10.46;p = 0.001), prolonged labor (OR = 12.33 [3.45 - 57.25];Khi<sup>2</sup> = 18.47;p < 0.001), premature rupture of membranes (OR = 24.03 [6.97 - 96.01];Khi<sup>2</sup> = 40.60;p <sup>2</sup> = 5.96;p = 0.014), and artificial or mixed breastfeeding (OR = 0.01 [0.002 - 0.043];Khi<sup>2</sup> = 97.65;p Conclusion: Taking into account the risk factors for PCTP is essential if we want to achieve the goal of “Zero New Infections in Children by the year 2025”.
文摘Introduction: Pregnancy is a physiological condition that can sometimes end in death. The death of a woman is a constant concern for the obstetrician and is considered a major public health problem in our developing countries. Objective: To identify the determinants that contribute to maternal morbidity and mortality in the Gynaecology and Obstetrics Department of the University Community Hospital. Methodology: We conducted a retrospective study from 1 January 2015 to 31 December 2019 (5 years) in the obstetrics and gynaecology department of the Centre Hospitalier Universitaire Communautaire (CHUC). It focused on the determinants of maternal mortality. Our study population consisted of all women who died during the period and met the World Health Organization (WHO) definition of maternal mortality (MOMA). We used non-probability sampling with the exhaustive choice technique. Results: The study revealed that the number of deaths recorded was 98, while 17,172 live births were registered during the same period. The maternal mortality ratio was 570 per 100,000 live births. The most common age group was 20 to 24, with an average age of 26. The frequency of death among primiparous women was 37.74%, pauciparous women 28.30% and multiparous women 26.42%. Direct causes were dominated by abortion complications (22.41%), followed by infections (9.30%) and haemorrhage (8.19%). Indirect causes were dominated by anaemia with a proportion of 45.16%. The majority of maternal deaths occurred in the post-partum period (34.71%). Most maternal deaths occurred after vaginal delivery, 19 cases (63.33%), while 11 deaths (36.66%) occurred after caesarean section. The occurrence of direct causes was associated with age less than or equal to 25 years, abortion complications and primiparity, with a statistically significant difference. Conclusion: At the end of this study, complications of unsafe abortion and poverty are all factors contributing to the rise in the maternal mortality rate. Emphasis should be placed on promoting family planning, as this would make a major contribution to reducing maternal mortality.
