title: Mother-to-child transmission of HIV: findings from an early infant diagnosis program in Bertoua, Eastern Cameroon.
abstract: BACKGROUND
  Early diagnosis of HIV is crucial to ensure early antiretroviral (ARV) treatment which is associated with lower mortality in HIV-infected children. This study reports the prevalence of HIV infection and the factors associated to mother-to-child transmission (MTCT) in an Early Infant Diagnosis (EID) program in Bertoua, Cameroon.
  
  
  METHODS
  We reviewed the records of 112 HIV-exposed infants aged six weeks to 18 months who had an HIV-1 DNA PCR test done in 2010. Data included socio-demographic characteristics, clinical manifestations of HIV, ARV prophylaxis, feeding options and results of the PCR tests.
  
  
  RESULTS
  The median age at first HIV testing was 4 months (IQR, 2-7). Ninety-one point one percent of infants and 65.2% of mothers did not receive ARV prophylaxis. Fifty infants (44.6%) were exclusively breastfed, 37 (33%) received formula feeding and 25 (22.4%) received mixed feeding. The prevalence of HIV in the infants was 11.6%. MTCT of HIV was significantly associated with mixed feeding (adjusted odds ratio (aOR): 6.7, 95% CI 1.6-28.3; p=0.009) and an age at 1st PCR test greater than 6 months (aOR: 6.5, 95% CI 1.4-29.3; p=0.014). The mothers of 66.1% of the infants tested returned to collect the result.
  
  
  CONCLUSIONS
  There is a high rate of MTCT of HIV in this setting, due to a poor implementation of the PMTCT program. There is a critical need to increase the use of ARV prophylaxis, and to improve rapid first testing and completion of the EID. The infant feeding practices also have to be improved.
authors.affiliation: Internal Medicine Unit, Edéa Regional Hospital, Edéa, Cameroon.
authors.forename: Jean Jacques N
authors.initials: JJ
authors.lastname: Noubiap
authors.forename: Adamo
authors.initials: A
authors.lastname: Bongoe
authors.forename: Sylvie Agokeng
authors.initials: SA
authors.lastname: Demanou
mesh_terms: D000328:Adult; D001903:Bottle Feeding / Q000706:statistics & numerical data; D001942:Breast Feeding / Q000706:statistics & numerical data; D002163:Cameroon / Q000453:epidemiology; D042241:Early Diagnosis; D005260:Female; D006678:HIV / Q000235:genetics; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000635:transmission*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000706:statistics & numerical data*; D008297:Male; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D015995:Prevalence; D012189:Retrospective Studies
keywords: Cameroon; Mother-to-child transmission of HIV; early infant diagnosis; polymerase chain reaction