Elimination of Vertical Transmission (Mother-to-Child) of HIV/AIDS and Congenital Syphilis in Jamaica
This project was started in October 2012.The aim of this project is to stop the spread of HIV and syphilis from mothers to their children in Jamaica by the year 2015. In a global context, Elimination of Mother to Child Transmission (EMTCT) of HIV and Syphilis is not a new concept. It has been achieved in several first world countries and several middle developing countries are working on their health systems to achieve the defined targets.
The goals of this project have been endorsed nationally and regionally by the Pan American Health Organization (PAHO), Chief Medical Officers of Health for the Caribbean, PANCAP/ CARICOM, Caribbean Coalition of National AIDS Programmes (CCNAPC), Caribbean Caucus of Health Ministers, National AIDS Committees, among other organizations.
This site was developed to provide health information for men and women of childbearing age, pregnant women, infants, children, and preteens (with and without HIV/AIDS) and provide educational resources for the health care team.
In specific terms, the following targets must be achieved by 2015 and sustained for the following two years:
- The rate of mother to child transmission (MTCT) for HIV is equal to, or below 2%, and the incidence is 0.3 cases per 1,000 live births
- The incidence rates of congenital syphilis are equal to, or below 0.5 cases per 1000 live births in Jamaica.
A review of the health care systems was conducted to determine existing gaps and guide interventions. Interventions were undertaken to:
- To strengthen the quality and expand the coverage of maternal and child health services to sustain prevention of mother to child transmission (pMTCT) services, including reproductive health services, antenatal, intra-partum and postnatal care, care of the newborn
- Improving critical health systems’ supports relating to laboratory capacity, procurement and maintenance services
- Scaling-up of primary prevention through integration of HIV/STI prevention and screening Sexual and Reproductive Health (SRH) and Maternal and Child Health (MCH) service delivery
- Strengthening case-based HIV and STI surveillance in MCH services
- Strengthening the capacity to implement comprehensive action and monitor progress towards elimination of MTCT HIV, syphilis and other STIs.
EMTCT Takes Teamwork!
A Multidisciplinary committee comprised of Doctors, Nurses, Community Service Groups, Funding Partners as well as the University of the West Indies and Ministry of Health personnel and officials from PAHO and UNICEF worked towards determining the necessary steps to achieve EMTCT of HIV and Syphilis.
Collaborators and Funding
This core group subsequently extended this initiative to include a number of collaborators, including the UWI Faculty of Medical Sciences, UNICEF, PAHO/WHO, UNAIDS, National Public Health Laboratory, National Family Planning Board, Clinton Health Access Initiative, the four Regional Health Authorities, 12 paediatric sites, 10 maternal sites, all labour wards and six private hospitals that deliver babies in the country.
Paediatricians, obstetricians, family practitioners, registered nurses, nurse midwives, family planning and public health nurses, social workers, contact investigators, laboratory staff, nutritionists, adherence counselors, psychologists, information technology personnel and administrators are among the professionals involved in the project.
Core funding for this program has been provided by Jamaica's National Health Fund to Jamaica's Pediatric, Perinatal and Adolescent HIV/AIDS (JaPPAAIDS) Program, which is an active collaboration between the University of the West Indies and Jamaica's Ministry of Health, who are working assiduously with the entire health care team in Jamaica to ensure that these goals are achieved and maintained.'
Results and Impact
This island-wide, multidisciplinary collaboration between The UWI and the Ministry of Health heading the entire health care team in Jamaica has in the past developed and implemented national policy throughout Jamaica. Their mission being, “ Elimination of mother to child transmission of HIV/AIDS while reducing HIV-attributable morbidity and mortality and improving quality of life for mothers, infants, children and adolescents, infected and affected by HIV/AIDS ”.
Under this project, the team is performing operational outcomes-based research and has already achieved some of the stated goals for 2012 (one year in advance of the target).
- 33,378 (99%) of pregnant women were tested for HIV
- 445 HIV infected women delivered
- 88% of HIV infected women received ARVs to prevent mother to child transmission of HIV/AIDS.
- 432 HIV-exposed infants were born to these women
- 98% (422) of HIV exposed infants received ARVs
- 10 HIV-infected babies were identified
- This translates to a mother-to child transmission rate of HIV of 2.4% and incidence of HIV of 0.25 per 1000 live births, less than the 0.3/1000 live birth target.
- The incidence of Congenital Syphilis was 0.33 per 1000 live births, less than the target of 0.5/ 1000 live births.
Research Publications (Selected):
Over 70 research publications have originated from this work, two of the most important include two compendia of research manuscripts in the West Indian Medical Journal, as follows.
- Pediatric and Perinatal HIV/AIDS in Jamaica. West Indian Medical Journal 2004;53(5);217-365.(15 papers)
- Pediatric, Perinatal and Adolescent HIV/AIDS in Jamaica. West Indian Medical Journal 2008;57(3);187-320. (20 papers)
- Christie CDC, Pierre RB. Eliminating Vertically-transmitted HIV/AIDS while Improving Access to Treatment and Care for Women, Children and Adolescents in Jamaica. West Indian Med J 2012; 6l;4:395–403.