PAHO Launches New Initiative to Eliminate Mother-to-Child Transmission of Four Diseases

To end mother-to-child transmission (EMTCT) of HIV, syphilis, Chagas disease, or hepatitis B in Latin America and the Caribbean by 2020, the Pan American Health Organisation (PAHO) has launched the framework EMTCT-PLUS, a roadmap with strategies and interventions that targeted women before and during pregnancy, and also new mothers and their babies.

In a release yesterday, PAHO has stated that every year, about 2,100 children in Latin America and the Caribbean were born with HIV or contracted it from their mothers; 22,400 were infected with syphilis; 9,000 were born with Chagas disease; and 6,000 contracted the hepatitis B virus.

If not detected and treated in time, these infections could cause miscarriages, congenital malformations, neurological and heart problems, cirrhosis, liver cancer, and in some cases, even death.

“The new framework is an opportunity to integrate and redouble efforts to diagnose and treat pregnant women during prenatal check-ups to prevent miscarriages, fetal malformations, and deaths from syphilis, and to keep children from being infected with diseases such as HIV, hepatitis B, or Chagas disease, with serious long-term health consequences,” said Suzanne Serruya, director of PAHO’s Latin American Center for Perinatology (CLAP).

Latin American and Caribbean countries have been working since 2010 to eliminate mother-to-child transmission of HIV and syphilis as public health problems through the Strategy and Plan of Action for EMTCT.

Since then, the countries have managed to reduce new infections in children by 55 per cent from 4,700 to 2,100 between 2010 and 2015, preventing some 28,000 children from being infected with HIV.

To reduce mother-to-child transmission of these four diseases to a minimum, the PAHO initiative proposed universal screening of all pregnant women, a policy that every country in the region and the world has adopted for the diagnosis of HIV and syphilis, though not yet for Chagas disease and hepatitis B.

As of 2016, the 51 countries and territories in the Americas had included hepatitis B in their official vaccination schedules, with a dose of the vaccine administered at two, four and six of age.

Regional vaccination coverage of the three-dose series was estimated at 89 per cent and coverage of the dose for newborns, at 75 per cent.

While the success of vaccination programmes in the Americas suggested the elimination of perinatal and early childhood transmission of hepatitis B was feasible, access must be expanded to ensure that the vaccine reached at least 95 per cent of children, beginning with a dose for newborns in first 24 hours of life.

PAHO stated the fight against Chagas disease has focused on vector control, environmental clean-up, and the screening of blood for transfusions. However, the next step toward eliminating this disease as a public health problem was to focus on preventing mother-to-child transmission, which accounted for about one-third of new infections.

About 1.12 million women of reproductive age in the region were infected with T. cruzi, the parasite that caused the disease.