Prévention de la Transmission de la Mère à l’Enfant du VIH : Connaissances et Attitudes des Personnels du District Sanitaire de Talangaï (Brazzaville)

RESUME Introduction.  La Prevention de la Transmission du VIH de la mere a l’enfant (PTME) demeure un defi majeur de sante publique au Congo, car les taux de depistage du VIH et de traitement antiretroviral chez la femme enceinte restent bas : 21% et 19%.  L’etude vise l’evaluation des connaissances, attitudes et pratiques des personnels de CPN et d’accouchement afin d’ameliorer le depistage du VIH chez les femmes enceintes dans le district sanitaire de Talangai. Methodes.  Enquete transversale multicentrique menee dans le district sanitaire de Talangai en mars 2016 ; 94 personnels interroges sur leur CAP sur la PTME. -La connaissance des personnels sur la transmission du VIH de la mere a l’enfant et les moyens de la PTME a ete categorisee en : niveau acceptable et non acceptable ; la proposition de test de depistage aux patientes en : « systematique a toute patiente » et « non systematique ». Le CHI2 ou de Fisher a servi a comparer les proportions avec p fixe a p<0,05. Resultats. 14,9% des personnel avaient un niveau de connaissance de la PTME acceptable, proportion significativement plus elevee chez les medecins (p=0,001). La participation a une formation sur la PTME n’a pas influence le niveau de connaissance. Soixante-deux virgule huit pourcent des personnels oubliaient de prescrire le test VIH, 26,6% affirmaient prescrire ce test a toute gestante.  La prescription du test etait liee au grade medecin (p= 0,001) et une anciennete de 6 ans ou plus (p=0,01). Conclusion. La majorite avait une connaissance non acceptable sur la PTME, la proposition du test de depistage du VIH aux gestantes non systematique. Les formations n’ont pas eu d’impact sur la connaissance en PTME. L’amelioration de connaissance et d’attitudes sur la PTME est necessaire. ABSTRACT Background.  In Congo transmission mother to child of IHV is a main public health issue. The rate of antenatal testing and antiretroviral treatment for pregnant women is 21 and 19 percent, lower than other countries like Zambia or Botswana. To arise up the scale of antenatal HIV testing of pregnant women the care health providers need good knowledge, attitudes, and practices. The study aimed to assess the level of knowledge, attitudes, and practices on preventing mother to child transmission of HIV, among maternal health care providers. Method. This was a transversal multicentric study performed in Talangai health district. Ninety- four antenatal care providers were interviewed about their knowledge, attitudes and practices about mother to child transmission of HIV and its preventiIon include HIV testing pregnant women. The level of knowledge was qualified as “acceptable” or “non-acceptable”. The evaluation of practice was based on HIV test prescription; the two answers were  “to each pregnant” or “sometimes”. Results. Only 14,5% of antenatal care providers had an “acceptable level” of knowledge on MCT of HIV, “acceptable” level of knowledge was most frequent among gynecologists than midwives (p=0,001). Attending to seminary or lecture focused on prevention of MCT of HIV was not assocated to a greater  knowledge score. Twenty-six-point nine percent systematically prescribe the HIV testing (vs 73,4%). Most of them were a gynecologist or had at least 6 years as professional duration. Conclusion. The most antenatal care providers had a poor level of knowledge of MCT of HIV. Prescription HIV testing was not systematically done for each pregnant. Knowledge level was not linked to attending to MCT of HIV formation. Increasing the antenatal HIV testing while antenatal care needs to implement the effective actions in Talangai health district as relevant seminaries, providing the HIV-test settings.