1. HIV IN PREGNANCY
Geneva Foundation for Medical Education
and Research
GFMER Sudan 2012
Forum No: ( 2 )

2. NAME OF PRESENTER
Name Position Institution
Dr. Amal Khalil Coordinator of UMST
Reproductive & Child
Health Research Unit
(RCRU).
Name of contributors
Name Position Institution
Dr . Hani Mohammed Medical Director Um Bakhita Maternity .H
Ibrahim Research Assistant at UMST
(RCRU).
Dr . MAJDI Pharmacist/ MSc. Public UMST
SABAHELZAIN and Tropical Health

3. CONTENT OF THE
PRESENTATION
 MTCT
 PMTCT in Sudan
 PMTCT Centers
 Prevention of MTCT

4. MTCT
 largest source of HIV infection in children
below the age of 15 years (95%).
 < 80% of MTCT occurs late in the third
trimester, during labour and delivery.
 vaginal delivery, duration of membranes
rupture, chorioamnionitis, preterm delivery
and breast feeding.

5. INCREASED RISK OF MTCT IN
 well advanced maternal HIV disease.
 low antenatal CD4 T- lymphocyte counts .
 high mean plasma viral.

6. TIMING AND RISK OF
TRANSMISSION
Transmission Rate
During pregnancy 5 – 10%
During labour & delivery 10 – 20%
During breast feeding 5 – 20%
Overall without breastfeeding 15 – 30%
Overall with breast feeding till 6 months 25 – 35%
Overall with breast feeding till 18 to 24 30 – 45%
months

7. PMTCT IN SUDAN
 A pilot project was implemented in four states
to examine the applicability of such an
intervention before starting a nationwide
implementation.
 result of this project was 6593 pregnant
women counseled, 927 tested and 7 was
found to be positive and the prevalence was
0.76%.

8. PMTCT CENTERS
 2007: 7 centers in high prevalence areas of
South Darfur, Khartoum, Kassala, North
Kordofan and Red Sea.
 7,848 pregnant women attending had access
to PMTCT services by receiving routine
counseling and testing.

9. HIV PREVALENCE AMONG WOMEN
ATTENDING PMTCT SERVICES IN SUDAN
FROM AUGUST 2007 TO JULY 2008
Site Total tested Total positive Prevalence %
Omdurman 525 12 2.28
Saudi Hospital 1159 1 0.086
Turkey Hospital 1185 4 0.34
Port Sudan 219 4 1.8
Kassala 994 8 0.8
Elobeid 497 4 0.8
Nyala 727 2 0.27
Total 5306 35 0.66

10. BENEFITS OF HIV TESTING FOR
PREGNANT WOMEN?
 A mother who knows early in her pregnancy
that she is HIV infected has more time to
make important decisions. She and her
health care provider will have more time to
decide on effective ways to protect her health
and prevent mother-to child transmission of
HIV She can also take steps to prevent
passing HIV to her partner.

11. IN SUDAN…
 Awareness about mother-to-child
transmission of HIV is 26.4%.
 Knowledge of ways of mother-to-child
transmission of HIV (all three means of
vertical transmission) is 54%.

12. SHHS 2006
State Awareness about Knowledge of ways of
mother-to-child mother-to-child
transmission of HIV transmission of HIV
(%) (%)
Khartoum 82.1 35.7
River Nile 75.7 40.8
W. Darfur 21.0 12.5
S. Kordofan 37.6 19.8

13. PREVENTION OF MTCT
 using antiretroviral therapy (ART)- two
complementary goals: to prevent the
transmission of HIV to the unborn child and to
safeguard the health of the mother.
 delivery by elective caesarean section.
 vaginal under certain precautions
 avoidance of breast feeding (risk highest in first
3 months).
 Formula feeding is associated with reduction of
MTCT to around 14%.

14. INFANT FEEDING
RECOMMENDATIONS
FOR HIV-POSITIVE WOMEN
•When replacement feeding is acceptable,
feasible, affordable, sustainable and safe,
avoidance of all breastfeeding by HIV-infected
mothers is recommended.
•Otherwise, exclusive breastfeeding is
recommended during the first months of life.