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Press release
August 11, 2017 at 1:12 pm
Washington, D.C. (TDN)
It is estimated that each year in Latin America and the Caribbean, approximately 2,100 children are born with HIV or are infected from their mothers; 22,400 children are infected with syphilis; approximately 9,000 children are born with Chagas disease; and 6,000 children are infected with the hepatitis B virus.
If not detected and treated promptly, these infections can lead to miscarriage, congenital malformations, neurological and cardiac problems, cirrhosis, liver cancer and, in some cases, death. In order to eliminate mother-to-child transmission of these four diseases by 2020, the Pan American Health Organization (PAHO) has launched the Framework for the Elimination of Mother-to-Child Transmission of HIV, Syphilis, Hepatitis B and Chagas Disease (EMTCT-PLUS), a road map of strategies and interventions for women before and during pregnancy, as well as for new mothers and their babies. “The new framework is an opportunity to integrate and redouble efforts to diagnose and treat pregnant women during antenatal visits to prevent miscarriage, fetal malformations and deaths from syphilis, and to prevent children from contracting diseases such as HIV, hepatitis B or Chagas disease, which can have serious long-term health consequences,” said Suzanne Serruya, Director of the Latin American Perinatal Center (CLAP) at PAHO. Since 2010, Latin American and Caribbean countries have been working to eliminate mother-to-child transmission of HIV and syphilis as a public health problem through the Strategy and Action Plan for the Elimination of Mother-to-Child Transmission of HIV and Congenital Syphilis, coordinated by PAHO. Since then, these countries have successfully reduced new infections among children by 55 percent, from 4,700 in 2010 to 2,100, preventing an estimated 28,000 HIV infections in children. Building on the success of this initiative, PAHO created the EMTCT-PLUS framework to integrate efforts to eliminate mother-to-child transmission of Chagas disease and hepatitis B into a comprehensive platform.
Preventing the spread
To minimize mother-to-child transmission of these four diseases, the Pan American Health Organization has advocated for universal screening of all pregnant women, a policy that all countries in the region and around the world have adopted for the diagnosis of HIV and syphilis, but not yet for Chagas disease and hepatitis B. As of 2016, 51 countries and territories in the Americas have included hepatitis B in their official vaccination schedules, with doses given at 2, 4, and 6 months of age. In addition, 21 countries, whose populations account for 90% of the region’s live birth cohort, have included hepatitis B vaccination for newborns in their vaccination schedules. The region’s three-dose series coverage is estimated at 89%, with 75% coverage for newborns. The success of vaccination programs in the Americas suggests that it is feasible to eliminate perinatal and early childhood transmission of hepatitis B. However, vaccination coverage must be expanded to ensure that at least 95% of children are vaccinated, starting with a single dose for newborns within 24 hours of birth. To date, the fight against Chagas disease has focused on vector control, environmental cleanup, and blood transfusion screening. However, the next step to eliminating this public health problem is to focus on preventing mother-to-child transmission, which currently accounts for about one-third of new infections. An estimated 1.12 million women of childbearing age in the region are infected with Trypanosoma cruzi, the parasite that causes the disease. The EMTCT-PLUS framework urges screening of all pregnant women, testing and treatment of infants of pregnant women who test positive, and of mothers after birth.
“We want the next generation to be free from not only HIV and syphilis, but also Chagas disease and hepatitis B,” said Marcos Espinal, director of PAHO’s infectious diseases and health analysis unit. “We have cost-effective tools to prevent children from being infected by their mothers, but we need these measures to reach all who need them.”
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