Title : Towards elimination of HIV, syphilis and HBV mother-to-child transmission in the Gambia and Burkina Faso: The Triple Elimination Initiative of Mother-to-Child Transmission (TRI-MOM) program

Abstract:

Background:
West Africa faces significant challenges with mother-to-child transmission (MTCT) of HIV, syphilis, and hepatitis B virus (HBV) infections. Despite this burden, MTCT of these infections can be effectively prevented with straightforward interventions. The World Health Organization (WHO) has advocated for a "triple elimination" model, integrating the prevention of these infections into maternal care services to accelerate their control and elimination. The TRI-MOM project aims to evaluate the feasibility of integrating the triple elimination model in two West African countries.

Methods:
In The Gambia, the triple elimination strategy was deployed across four healthcare sites representing different levels of care. First, we conducted training for healthcare workers (HCWs) on the three infections to enhance awareness and capacity. Then we offered free routine antenatal screening for the three infections using rapid diagnostic tests. Pregnant women testing positive for any of the 3 infections received appropriate treatment or prophylaxis to prevent MTCT. Data on MTCT outcomes and cost-effectiveness were collected and analyzed to assess the strategy’s impact.

Results:
Between January-March 2024, HCWs in government facilities were trained. Simplified screening and treatment/prophylaxis SOPs were developed and adapted per health facility. Between 18 March and 23 December 2024, 6,301 pregnant women were screened for the 3 infections. Overall, 99% of all pregnant women accepted screening. Among these, 267 women (4.23%) tested positive for at least one infection: 75 had HIV mono-infection, 173 had HBV mono-infections, 14 had syphilis mono-infection, 4 had HIV/HBV co-infection and 1 had HIV/syphilis co-infection. All HIV-positive women were started on antiretroviral therapy (ART) following the "test-and-treat" approach. All syphilis-positive women accepted treatment with benzathine penicillin, with no adverse reactions reported. Of 173 HBV mono-infected women, 45 received TDF prophylaxis either based on high viral load (>200,000IU/mL) or based on a test-and-prophylax protocol.

Conclusions:
The TRI-MOM project demonstrates that integrating triple screening for HIV, syphilis, and HBV into maternal care is both feasible and acceptable. Training of government HCWs, counselling of women and availability of rapid diagnostic tools have enabled seamless implementation. This approach can improve maternal and neonatal health outcomes and promote elimination of MTCT of these infections.

Biography:

Abdoulie E Jallow is a public health professional with over a decade’s experience in Clinical research. and am currently pursuing a master’s degree in clinical research. Additionally, he have completed several professional training programs in clinical research, including vaccinology courses. His training includes the VACFA program at the University of Cape Town in South Africa, the Afro-ADVAC program at the University of Witwatersrand in South Africa, a Higher National Diploma in Public Health from The Gambia College, and a Diploma in Epidemiology and Public Health (Vaccinology) from the Institute Pasteur in Paris, France. He is currently involved in the TRI-MOM project with the Hepatitis Group, which focuses on strengthening the prevention of Mother-to-Child Transmission (MTCT) of HIV, syphilis, and Hepatitis B among pregnant women in The Gambia and Burkina Faso. This project employs an integrated, coordinated strategy to achieve the triple elimination of MTCT, highlighting my leadership role in global health initiatives.