How to implement the framework for the elimination of mother-to-child transmission of HIV, syphilis, hepatitis B and chagas (EMTCT plus) in a disperse rural population from the gran chaco region: A tailor-made program focused on pregnant women

CRUDO, FAVIO; PIORNO, PABLO; KRUPITZKI, HUGO; GUILERA, ANALIA; LÓPEZ-ALBIZU, CONSTANZA; DANESI, EMMARIA; SCOLLOID, KARERINA; LLOVERAS, SUSANA; MIR, SEBASTIÁN; ÁLVAREZ, MARISA; YUDIS, SILVIO; FERNÁNDEZ, MIGUEL ANGEL CAYO; CIPRI, DIEGO; KROLEWIECKI, ALEJANDRO; PEREIRO, ANA CRISTINA; PERIAGO, MARÍA VICTORIA; ABRIL, MARCELO CLAUDIO; FERNANDEZ, MARIANA

PLoS Neglected Tropical Diseases

Public Library of Science

Año: 2020 vol. 14 p. 1 - 10

1935-2727

The framework for the elimination of mother-to-child transmission (EMTCT Plus) was proposedby the Pan American Health Organization in 2017 to all member states in order towiden the already existing framework for HIV and syphilis to include elimination of the infectionwith hepatitis B virus (HBV) and Chagas disease (ChD), now called EMTCT Plus. Theobjective of this wider initiative is to achieve and maintain the elimination of mother-to-childtransmission (MTCT) of the infection with HIV, syphilis, ChD, and the perinatal infection byHBV as a public health problem, in line with the Strategy for Universal Access to Health andUniversal Health Coverage [1]. The EMTCT Plus framework represents an interesting challengefor member states, since it requires adequate implementation strategies to overcomehealth system diversities. Additionally, each country implements this framework in a differentmanner and according to their own national administrative structure, which can even varywithin each country in federal administrations. Moreover, available data from each countryconstitute global national figures that do not necessarily reflect regional variations. This is thecase of many intervention areas with dispersed rural populations like the Tri-Border Areabetween Argentina, Bolivia, and Paraguay located in the Gran Chaco region.