| Autor: |
Aude Christelle Ka’e, Alex Durand Nka, Bouba Yagai, Irénée Domkam Kammogne, Ezechiel Ngoufack Jagni Semengue, Aubin Joseph Nanfack, Celine Nkenfou, Michel Carlos Tommo Tchouaket, Desire Takou, Samuel Martin Sosso, Nadine Fainguem, Aissatou Abba, Willy Pabo, Nelly Kamgaing, Edith Temgoua, Boris Tchounga, Patrice Tchendjou, Suzie Tetang, Anne Esther Njom Nlend, Francesca Ceccherini-Silberstein, Maria Mercedes Santoro, Joseph Fokam |
| Jazyk: |
angličtina |
| Rok vydání: |
2023 |
| Předmět: |
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| Popis: |
Background The mother-to-child transmission of HIV-1 (MTCT) remains on the major route of HIV-transmission among pediatric populations in Africa. Though a prevention of MTCT (PMTCT) high-priority country, data on the MTCT burdens in Cameroon remains fragmented. Objective We sought to assess the pooled MTCT rate, its risk-factors, and to characterize viral reservoirs of infected-children in Cameroon. Methods All relevant observational cohort and cross-sectional studies conducted in Cameroon were searched from PubMed, African Journals Online, Google scholar, ScienceDirect and academic medical education databases. Heterogeneity and publication bias were respectively assessed by the I2 statistic and the Egger/funnel plot test. Meta-analysis was performed using the random effects model. MTCT rate >5% was considered as “high”. This review was registered in the Prospero database, CRD42021224497. Results We included a total of 29 studies and analyzed 46 684 children born from HIV-positive mothers. The overall rate of MTCT was 7.00% (95% CI = 6.07–8.51). According to regions, the highest burden was in Adamaoua-region (17.51% [95% CI:14.21–21.07]) with only one study found. PMTCT option-B+ resulted in about 25% reduction of MTCT (8.97% [95% CI: 8.71–9.24] without option-B+ versus 2.88% [95% CI: 5.03–9.34] with option-B+). Regarding risk-factors, MTCT was significantly associated with the absence of PMTCT-interventions both in children (OR:5.40 [95% CI: 2.58–11.27]) and mothers (OR: 3.59 [95% CI: 2.15–5.99]). Regarding viral reservoirs, a pro-viral DNA mean of 3.34±1.05 log10/mL was observed among 5/57 children and archived HIV drug resistance mutations were identified in pro-viral DNA marker among 21/79 infected-children. Conclusion In spite of the dropdown in MTCT following option-B+ implementation, MTCT remains high in Cameroon, with substantial disparities across regions. Thus, in this era of option-B+, achieving MTCT elimination requires interventions in northern-Cameroon. The variation in pro-viral load in infected-children underlines the relevance of characterizing viral reservoirs for possible infection control in tropical settings. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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