Feasibility and acceptability of rapid HIV screening in a labour ward in Togo.
BACKGROUND
HIV screening in a labour ward is the last opportunity to initiate an antiretroviral prophylaxis among pregnant women living with HIV to prevent mother-to-child HIV transmission. Little is known about the feasibility and acceptability of HIV screening during labour in West Africa.


RESULTS
A cross-sectional survey was conducted in the labour ward at the Tokoin Teaching Hospital in Lomé (Togo) between May and August 2010. Pregnant women admitted for labour were randomly selected to enter the study and were interviewed on the knowledge of their HIV status. Clinical and biological data were collected from the individual maternal health chart. HIV testing or re-testing was systematically proposed to all pregnant women. Among 1530 pregnant women admitted for labour, 508 (32.2%)were included in the study. Information on HIV screening was available in the charts of 359 women (71%). Overall, 467 women accepted HIV testing in the labour ward (92%). The HIV prevalence was 8.8% (95% confidence interval: 6.4 to 11.7%). Among the 41 women diagnosed as living with HIV during labour, 34% had not been tested for HIV during pregnancy and were missed opportunities. Antiretroviral prophylaxis had been initiated antenatally for 24 women living with HIV and 17 in the labour room.


CONCLUSIONS
This study is the first to show in West Africa that HIV testing in a labour room is feasible and well accepted by pregnant women. HIV screening in labour rooms needs to be routinely implemented to reduce missed opportunities for intervention aimed at HIV care and prevention, especially PMTCT.
Département des Sciences Biologiques et Santé Publique, Faculté Mixte de Médecine et de Pharmacie, Lomé, Togo. didier.ekouevi@gmail.com
Didier K
DK
Ekouevi
Benjamin G
BG
Kariyiare
Patrick A
PA
Coffie
Marthe-Aline
MA
Jutand
Koffi
K
Akpadza
Annette
A
Lawson-Evi
Albert
A
Tatagan
François
F
Dabis
Mathieu
M
Sibe
Vincent P
VP
Pitche
Renaud
R
Becquet
Mireille
M
David
D000328:Adult; D044966:Anti-Retroviral Agents / Q000008:administration & dosage; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D007407:Interviews as Topic; D008403:Mass Screening / Q000379:methods*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*; D014037:Togo
D044966:Anti-Retroviral Agents