Evaluation Of Comprehensive Intervention For Preventing Mother To Child Transmission Of AIDS And Syphilis In Wuhu In 2013-2017

Objective To identify the intervention and infection status of HIV and syphilis infected maternal women and their infants,to evaluate the effect of PMTCT project in Wuhu city,Anhui,China,in order to provide evidence for better prevention of mother-to-child transmission of AIDS and syphilis in the future.Methods The target population were all pregnant accepted pregnant and puerperal peri od health care services in Wuhu city between January 2013 and December 2017.The co mprehensive interventions were performed among HIV/syphilis positive pregnant wom en and their babies according to the National state's Implementation Programme for Pre vention of Mother-to-child Transmission of AIDS,Syphilis and Hepatitis B(PMTCT).The data were extracted from the National PMTCT Information System of AIDS,syphil is and hepatitis B,and the HIV testing rate of pregnant women,the proportion of wome n who was detected for HIV during pregnancy,the intervention proportion of infants bor n to HIV infected pregnant women,the HIV mother-to-child transmission rate,syphilis t esting detection rate of pregnant women,the proportion of women received syphilis det ection during pregnancy,the intervention proportion of infants born to syphilis infected pregnant women,the mother-to-child transmission rate of syphilis,and congenital syphi lis infection rate were calculated.All analyses were performed by SPSS 16 software.Results1?From 2013 to 2017,168,725 deliveries were hospitalized in Wuhu city,154408 were tested for HIV antibody during pregnancy,with an average pregnancy test rate of 91.51%over five years.Only 14005 people were tested for HIV antibody at birth,with an average of 8.30%at birth for 5 years.From 2013 to 2017,the proportion of pregnant women in hospital delivery showed an increasing trend year by year(?2trend=2187.12,p<0.001).A total of 167874 pregnant women received syphilis serological tests,including 154073 pregnant women,with a pregnancy test rate of91.32%.The trend chi-square test showed that the syphilis detection rate in Wuhu city during pregnancy increased year by year from 2013 to 2017(?~2trend=1751.54,p<0.001).2.From 2013 to 2017,18 HIV-positive pregnant women were reported in Wuhu city,and the total number of HIV-positive pregnant women in hospital delivery was 13,with a positive rate of 0.08‰;The total number of syphilis positive mothers in hospital delivery in Wuhu city was 467,with a positive rate of 0.28%.A total of 499 syphilis-positive pregnant and lying-in women were given birth information,180 of whom received regular plum-expelling treatment.The standardized treatment rate was12.86%in 2013 and 56.58%in 2017,showing an increasing trend year by year(?~2trend=47.224,p<0.001).3.All 13 babies born to HIV-positive pregnant women used antiviral drugs after birth,11 of them(84.62%)had HIV antibody screening tests at the end of 12 months,and the results were negative.Excluding HIV infection and bringing it into the management of normal children;One case(7.69%)was under 12 months old and was being followed up.One case(7.69%)was missed.Of the 509 infants born to 499 pregnant women infected with syphilis,2 died within 7 days.Seven cases of congenital syphilis were diagnosed at birth and three cases of congenital syphilis were diagnosed at follow-up.The incidence of congenital syphilis was 5.88/100,000.ConclusionThe HIV/syphilis detection rate and pregnancy detection rate in Wuhu city have increased year by year,with a good intervention in HIV-positive pregnant women and their babies.The intervention rate of syphilis positive pregnant women and their babies is also increasing year by year.Some progress has been made in the prevention of mother-to-child transmission of AIDS and syphilis.However,the standardized treatment rate of syphilis-positive pregnant women is low,and the intervention rate of their babies still needs to be improved.The next step is to further improve the standardized treatment rate of syphilis-positive pregnant women and reduce the incidence of adverse pregnancy outcomes.Increase the intervention rate of syphilis positive infants and reduce the incidence of congenital syphilis.