RESUMO
BACKGROUND: French Guiana is the French department most affected by HIV. The situation in Western French Guiana is complicated by the transborder context and isolation of many patients. This study aims to describe the epidemiological characteristics of children born to mothers living with HIV followed in Western French Guiana. METHODS: This was a retrospective and descriptive study. All children born to HIV-infected mothers between 2014 and 2018 were included. Data were collected using a survey sheet to generate an Excel database. RESULTS: We recorded 177 newborns exposed to maternal HIV, four of whom (2.26 %) were infected. The majority of women (87 %) were of foreign origin, and only 7 % had conventional health insurance coverage. The infection was discovered during pregnancy in 20 % of women. Overall 21.71 % of newborns were preterm and 22.5 % hypotrophic. All neonates had received antiretroviral prophylaxis for four weeks, either as monotherapy (AZT) (67.43 %) or triple therapy (AZT/3TC/NVP) (25.71 %). Twenty-two neonates had at least one neonatal illness: transient respiratory distress (9 cases), asphyxia (3 cases), hyaline membrane disease (8 cases), and there were two cases with birth defects: clubfoot (1 case) and heart disease (1 case). The follow-up rate at 24 months was 65 % and 35 % of cases were lost to follow-up. The most common biological anomalies were anemia (69.14 %), hyperlacticaemia (23 %), and neutropenia (9.14 %). CONCLUSION: The prevalence of mother-to child transmission of HIV was high; a quarter of maternal infections were discovered during pregnancy. The mother's socio-economic situation was often precarious and follow-up interruptions common.
Assuntos
Infecções por HIV , Complicações Infecciosas na Gravidez , Gravidez , Humanos , Criança , Feminino , Recém-Nascido , Mães , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Infecções por HIV/tratamento farmacológico , Complicações Infecciosas na Gravidez/epidemiologia , Estudos Retrospectivos , Guiana Francesa/epidemiologia , Transmissão Vertical de Doenças Infecciosas/prevenção & controleRESUMO
INTRODUCTION: French Guiana is a French overseas territory in South America, marked by poverty and inequalities. Access to different services, including healthcare, is unequal depending on where people live. Several studies showed that among adults, the most precarious individuals had greater incidences of chronic and infectious diseases. Although the median age of the population living in this territory is 25, there is no specific focus on the pediatric population although it is documented that socioeconomic inequalities have an impact on child health. The objective of this scoping review is to shed light on health challenges concerning children living in French Guiana. METHODS: A literature search was performed on PubMed to identify relevant articles, and additional references were added if within the scope of this review. RESULTS: A total of 106 publications were reviewed. Perinatal health issues were linked to a high rate of teenage pregnancies with poor medical follow-up leading to complications such as preterm deliveries and congenital malformations and abnormalities. Infectious diseases were a significant burden with worrisome vaccination coverage figures for some bacterial infections, partly explaining a high mortality rate attributable to infectious diseases. Herbicide poisoning with paraquat was reported in children, and environment-related concerns such as wild animal attacks as well as lead and mercury exposure were reported. Some children living in remote Amerindian communities had a higher suicide rate than in mainland France, and chronic diseases such as sickle cell disease were reported to have more transfusion-related complications. CONCLUSION: Children living in French Guiana have worse pediatric health indicators in comparison with children from mainland France.