Résumé
BackgroundMonitoring indicators for prevention of mother-to-child transmission of HIV programs (PMTCT) is key to assessing the progress toward elimination of mother-to-child transmission (MTCT) of HIV. Using a patient-orientated innovative strategy based on the second visit in the expanded program on immunization (EPI-2) visit at 6–8 weeks, we assessed PMTCT indicators in Burkina Faso and Zambia.MethodsFrom December 2019 to September 2021, the PROMISE-EPI study (Clinical Trial: NCT03870438) assessed women attending EPI-2 at primary health care facilities in Burkina Faso and Zambia with their children about their exposure to PMTCT interventions. Women living with HIV viral load was measured using GeneXpert® HIV RNA, and their children were tested for HIV using GeneXpert® HIV Qual.ResultsOverall, 25093 were enrolled from Burkina Faso and 8961 women from Zambia. Almost, all women attended at least one antenatal care visit, the median number of visits was 4 (IQR: 3–5) in both countries. Among Women diagnosed with HIV at EPI-2, 4.5% and 1.7% were not aware of their HIV status, in Burkina Faso and Zambia, respectively. Among those aware of their HIV positive status, 95.8% and 99.2% were on ART in Burkina Faso and Zambia respectively. Among WLHIV on ART, 75% and 79.2% achieved a viral load suppression (Viral load < 1000 copies/mL) in Burkina Faso and Zambia respectively. Infant post-natal prophylaxis was administered from birth until EPI-2 to 60.9% and 89.7% of HIV exposed children in Burkina Faso and Zambia, respectively. In Burkina Faso, only 60/192 (31.3%) of HIV exposed children were sampled for early infant diagnosis and 3 (1.6%) received a result by EPI-2. In Zambia, these figures were 879/1465 (64.0%) and 9.9% (145/1465) respectively.ConclusionThis evaluation strategy could strengthen program monitoring and help identifying gaps to be addressed on the last mile towards elimination of MTCT of HIV.