title: Early assessment of the implementation of a national programme for the prevention of mother-to-child transmission of HIV in Cameroon and the effects of staff training: a survey in 70 rural health care facilities.
abstract: OBJECTIVE
  To assess the availability of equipment and the staff's knowledge to prevent Mother-To-Child Transmission (PMTCT) in rural healthcare facilities recently covered by the national PMTCT programme in Cameroon.
  
  
  METHODS
  In eight districts inventories of antiviral drugs and HIV test kits were made on site, using a standardised check-list. Knowledge of HIV and PMTCT was evaluated with a multiple-choice (MC) questionnaire based on typical clinical PMTCT cases. Staff participated subsequently in a 2-day training on HIV/AIDS and the Cameroon PMTCT guidelines. Immediately after training and after 7 months, retention of knowledge was tested with the same questions but in different order and layout.
  
  
  RESULTS
  Sixty two peripheral nurse-led clinics and the eight district hospitals were assessed. Whereas all district hospitals presented complete equipment, only six of the peripheral clinics (10%) were equipped with both complete testing materials and a full set of drugs to provide PMTCT. Thirty six peripheral facilities (58%) possessed full equipment for HIV-testing and 8 (13%) stocked all PMTCT drugs. Of 137 nurses, 102 (74%) agreed to the two knowledge tests. Fewer than 66% knew that HIV-diagnosis requires positive results in two different types of rapid tests and only 19% chose the right recommendation on infant-feeding for HIV-positive mothers. Correct answers on drug regimens in different PMTCT settings varied from 25% to 56%. All percentages of correct answers improved greatly with training (P < 0.001) and retention remained high 7 months after training (P < 0.001).
  
  
  CONCLUSIONS
  Prevent Mother-To-Child Transmission programmes in settings such as rural Cameroon need to be adapted to the special needs of peripheral nurse-led clinics. Appropriate short training may considerably improve nurses' competence in PMTCT. Other important components are regular supervision and measures to guarantee supply of equipment in rural areas.
authors.affiliation: Office of the Surgeon General Basel-Stadt, Basel-Stadt, Switzerland. niklaus.labhardt@gmail.com
authors.forename: Niklaus Daniel
authors.initials: ND
authors.lastname: Labhardt
authors.forename: Engelbert
authors.initials: E
authors.lastname: Manga
authors.forename: Mama
authors.initials: M
authors.lastname: Ndam
authors.forename: Jean-Richard
authors.initials: JR
authors.lastname: Balo
authors.forename: Alexandre
authors.initials: A
authors.lastname: Bischoff
authors.forename: Beat
authors.initials: B
authors.lastname: Stoll
mesh_terms: D015492:AIDS Serodiagnosis / Q000295:instrumentation; D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000600:supply & distribution; D002163:Cameroon; D002983:Clinical Competence; D004509:Education, Nursing, Continuing / Q000379:methods; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000517:prevention & control* / Q000635:transmission*; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000458:organization & administration*; D015397:Program Evaluation; D012423:Rural Health / Q000706:statistics & numerical data; D014773:Virology / Q000193:education
chemical_list: D019380:Anti-HIV Agents