ABSTRACT
BACKGROUND: Early infant diagnosis of HIV is the key step for the early initiation of HAART among HIV-exposed children. The aim of this study was to estimate the proportion of children born to mothers infected with HIV who completed the early infant HIV diagnosis process and the factors associated with this complete process. METHODS: We conducted a retrospective cohort study at Tokoin University Hospital in the pediatrics ward. This study included all HIV-exposed children born between July 2009 and June 2011. The association between the mother's, spouse's, and child's characteristics as well as access to early HIV diagnosis by PCR (blood collection and reporting of results before the 6months of age) was studied using logistic regression analysis. RESULTS: A total of 455 HIV-exposed children were included: for 52.7%, the first test was PCR, 99 of them received their results, 59 of whom received their results before the 6th month of life (undergoing the complete process). In multivariate analysis, the only factor associated with the complete process of early HIV diagnosis was the maternal age≥28years (adjusted odds ratio, 1.75, 95% CI [1.18-2.76]). CONCLUSION: The availability of early infant PCR diagnosis remains a challenge and innovative strategies must be implemented.
Subject(s)
HIV Infections/diagnosis , HIV Infections/transmission , Health Services Accessibility , Infectious Disease Transmission, Vertical , Adult , Cohort Studies , Early Diagnosis , Female , HIV/genetics , HIV Infections/blood , Humans , Infant , Infant, Newborn , Male , Maternal Age , Multivariate Analysis , Polymerase Chain Reaction , Retrospective Studies , TogoABSTRACT
INTRODUCTION: The Benin Government introduced free caesarean section in public hospitals in 2009 and a national agency was created to manage free caesarean section. METHODS: Three years after introduction of free caesarean section, we evaluated this measure in the Ouidah hospital area (HZO) by analysing the hospital structure, the implementation process and the results. RESULTS: This study showed the efficacy of free caesarean section, which has helped to increase the caesarean rate from 2.38% in 2009 to 3.48% in 2012, a caesarean section mortality rate of 0.99%, insufficient information for beneficiaries, some drugs are not covered by this measure, and additional costs must be paid by beneficiaries. DISCUSSION: These results indicate the need for a detailed cost analysis to adjust the unit cost for caesarean section. This type of evaluation should be performed in all public hospitals in the country to more clearly identify malfunctions.
Subject(s)
Cesarean Section/economics , Cesarean Section/statistics & numerical data , Adolescent , Adult , Benin , Cesarean Section/mortality , Cross-Sectional Studies , Female , Hospitals, Public , Humans , Middle Aged , Pregnancy , Young AdultABSTRACT
L'examen de 302 tumeurs de l'ovaire a revele; 92 pour cent de tumeurs benignes; principalement des kystes. Les 8 pour cent de tumeurs malignes sont essentiellement des cystadenocarcinomes sereux et des lymphomes
