the HIV pandemic continues to cause a heavy burden in large populations such as those in the Mono Couffo departments in Benin. reducing the transmission of the virus continues to be at the heart of many actions at the national and international level. In Benin, the PMTCT Program, which aims to reduce vertical mother-to-child transmission, has been in place since 2004, but there are still cases of children born from seropositive mothers with HIV. This study therefore sought to identify the factors that influence this transmission in the departments of Mono and Couffo where the highest rates of HIV infection in Benin are recorded. Early detection of newborns by RT-PCR gave a positivity rate of 6.59%. This rate, although low, poses the problem of the full implementation of the national program for the prevention of mother-to-child transmission of HIV. it is far higher than the rate reported in developed countries such as the United Kingdoms (less than 2% from 200–2006) [10]. the same is true for many other developed countries [11]. African countries such as the Ivory Coast [12], Cameroon [13], Mali [14], Malawi [15], South Africa [16], Zambia [17] and Ethiopia [18], Schumann at al., [19] have also had to obtain very low rates of MTCT. some countries have even reported having completely eliminated mother-to-child transmission of the virus [20, 21].
Indeed, many studies have reported the existence of several factors that can lead to the absence of opportunities for the prevention of vertical transmission of HIV such as the lack of knowledge of the population on the prevention of mother-to-child transmission of HIV, the antenatal service system and the HIV testing capacity of institutions, the monitoring method all correlated with underdevelopment [22].
The vast majority (86%) of the newborns included in this study were between 0 and 6 months old. This rate, close to national statistics, which gives 79.9% of screening in the first half of 2015, shows commendable efforts by the government to reduce the incidence of mother-to-child transmission of HIV by providing CIPECs with equipment for this diagnosis and the review. the plan to eliminate mother-to-child transmission of HIV [23]. This report also highlighted the gaps in the diagnosis which is justified by cases of children screened between 6 and 24 months. According to some authors, the socio-economic level of mothers, the low level of education and the non-involvement of the co-progenitor can constitute real obstacles [16, 24, 25].
the study of factors related to mother-to-child transmission of HIV shows a statistical association of mother-to-child transmission of HIV-1 with factors such as mother's PMTCT protocol, method of breastfeeding newborns, and the last viral load of mothers in the departments of Mono-Couffo in 2019.
Since 2004, a program to prevent mother-to-child transmission of HIV has been implemented nationwide in Benin. This study explored the correlation between the viral load of mothers and HIV transmission to newborns in the Mono and Couffo departments where the highest rates of HIV infection in Benin are recorded. Early screening of newborns by PCR gave a positivity rate of 6.59%. This rate, although low, raises the problem of full implementation of the national program for the Prevention of Mother-Child Transmission of HIV. Indeed, many studies have reported the existence of several factors that may result in the absence of opportunities for the prevention of vertical transmission of HIV such as the lack of knowledge of the population on the prevention of mother-to-child transmission of HIV, the system of antenatal services and the HIV testing capacity of the institutions, the mode of follow-up [22].
the studies by Kassaw et al. [18], Mandelbrot et al. [26] have already shown the effectiveness of WHO option B, which recommends the administration of antiretroviral treatment to all HIV-positive pregnant and breastfeeding women, regardless of CD4 cell count or clinical stage. however, in some regions of the world, such as the rural areas considered in this study, the effectiveness of the prenatal consultations recommended by the WHO is still a problem. Women lacking in means are unable to make antenatal consultations with no knowledge of serological status. Numerous studies have also highlighted the role of breastfeeding in the mother-to-child transmission of HIV1[27, 28] and that of the role of neonatal and child prophylaxis [29]. Regarding the method of breastfeeding, social factors such as knowledge of the serological status by the husband or the in-laws play an enormous role in the choice of the method of breastfeeding despite medical advice, especially in rural areas [30]. It is also necessary to take into account the rural environment which, according to the WHO, influences compliance with PMTCT recommendations [4]. The studies by Saizonou et al. [31] showed, for example, a good score for compliance with PMTCT in Cotonou, the economic capital of Benin [32] (WHO, 2011).
It is therefore important to further strengthen current strategies in order to increase adherence of HIV-positive women to PMTCT guidelines. The study by Tudor et al. describes, for example, that integrated PMTCT services could effectively reduce mother-to-child transmission of HIV [33]. Ibeziako et al. have shown that holistic but cost-effective prevention interventions help reduce the rate of mother-to-child transmission of HIV, even in economically developing countries [34]. These measures will achieve a reduction or even eradication of mother-to-child transmission of HIV [35].