TITLE

Assessing the knowledge attitude and practices of mother to child transmission of

HIV/AIDs among HIV infected pregnant women attending antenatal clinic at the
Mifi District Hospital Bafoussam.

TABLE OF CONTENT

i
TITLE............................................................................................................................................. i
TABLE OF CONTENT....................................................................................................................... ii
LISTS OF ABREVIATION..................................................................................................................iv
LISTS OF FIGURES..................................................................................................................... v
List of table................................................................................................................................... vi
DEFINITION OF TERM................................................................................................................... vii
CHAPTER ONE............................................................................................................................1
INTRODUCTION..........................................................................................................................1
1.1. Background of study............................................................................................................1
1.2. Statement of problem.........................................................................................................2
1.3. Objectives of study..............................................................................................................3
1.3.1 Main objective............................................................................................................... 3
1.3.2 Specific objective.......................................................................................................... 3
1.4 Research questions............................................................................................................... 3
1.5 Significance of the study...................................................................................................... 3
CHAPTER TWO............................................................................................................................... 4
LITERATURE REVIEW...........................................................................................................4
2.1 DEFINITION...........................................................................................................................4
2.2 pathogenesis........................................................................................................................ 4
2.3 mode of transmission........................................................................................................... 5
2.4 Persons at risk of HIV infection...........................................................................................6
2.6 Diagnosis.............................................................................................................................. 7
2.7 Complications.......................................................................................................................8
2.8 Classification........................................................................................................................ 9
2.9 Treatment............................................................................................................................ 9
2.10 Nursing intervention........................................................................................................ 10
2.11 Prevention of HIV/AIDS....................................................................................................11
CHAPTER THREE...........................................................................................................................13
MATERIALS AND METHOD....................................................................................................... 13
3.1 Study design and period.....................................................................................................13
ii
 3.2 Research setting................................................................................................................. 13
3.2.1 Historical Back ground of the MIFI...............................................................................13
3.2.2 Geographical location of the MDH..............................................................................13
3.2.3 Infrastructure, Organization and functioning of the MDH..................................................15
3.3 Study participants.............................................................................................................. 16
3.4 Selection criteria................................................................................................................ 16
3.4.1 Inclusive criteria.......................................................................................................... 16
3.4.2 Exclusive criteria..........................................................................................................16
3.5 Sample size and sampling.................................................................................................. 16
3.6 Study procedure.................................................................................................................16
3.7 Data processing and analysis..............................................................................................16
3.8. Data storage and data quality and control........................................................................16
3.9. Ethical consideration.........................................................................................................17
TIME TABLE OF ACTIVITIES.......................................................................................................... 18
BUDJET......................................................................................................................................... 19
REFRENCES...................................................................................................................................20
QUESTIONNAIRE.......................................................................................................................... 23

LISTS OF ABREVIATION

iii
AIDS: Acquire Immunodeficiency Syndrome.

ANC: Antenatal Clinic.

ART: Antiretroviral Therapy.

CCR5: C-C Motif chemokine receptor.

CD4: Clusters of differentiation 4.

CXCRA4: C-X-C Motif chemokine receptor4.

DMH: District Mifi Hospital.

HIV: Human Immunodeficiency Virus.

ISSAB: Institute Superieur Sapientiae Bafoussam.

MTCT: Mother to child transmission.

T-Cells: Thymus cells.

WHO World: Health Organization.

iv
 LISTS OF FIGURES

Figure 1: geographical location of mifi District Hospital Bafoussam....................14

v
 List of table
Table 1: Table of activities......................................................................................18

Table 2: budget......................................................................................................19

vi
 DEFINITION OF TERM

 ANC: It refer to the regular medical and nursing recommended for a

pregnant woman throughout her pregnancy. The goal is to ensure the health
and well- being of both the mother and the developing fetus.
 Viral Load: The amount of HIV in a person’s body. A low viral load
generally indicates a slow disease progression.
 HIV: It is a virus that attacks the body immune system, specifically the CD4
T- cells, which are a type of white blood cells that plays a crucial role in the
immune response.
 AIDS: It is the last stage of HIV infection, characterized by a severely
weakened immune system and the development of various opportunistic
infections.
 ELISA: It is a blood test that check for the presence of antibodies to HIV as
well as a viral protein.

vii
 CHAPTER ONE

INTRODUCTION

1.1. Background of study

Mother-to-child transmission (MTCT) of HIV remain a significant public health concern
globally, particularly in sub-Saharan Africa, where the burden of HIV is disproportionately high
[1]. In Cameroon, HIV prevalence among pregnant women is estimated to be substantial, posing
serious risks to maternal and child health [2]. Mother-to-child transmission, occur during
pregnancy, labor, delivery and breastfeeding. Without effective interventions, the risk of
transmission ranges from 15% to 45%, but with appropriate measures, such as Antiretroviral
therapy (ART), this risk can be reduce to less than 5% in breastfeeding populations and below
2% in non-breastfeeding settings [3]. The prevention of Mother to child transmission (MTCT) is
a cornerstone of Cameroon HIV/AIDS response [4]. Despite considerable progress in increasing
access to prevention of mother to child transmission (PMTCT) services, gaps in knowledge,
attitudes, and practices among HIV/AIDS infected pregnant women remain a barrier to achieving
elimination targets [5]. Awareness of mother to child transmission modes and prevention
strategies is critical for the success of prevention of mother to child transmission programs [6].
Furthermore, cultural beliefs, stigma and inadequate healthcare infrastructure can hinder the
implementation of these services [7]. Understanding the knowledge levels, attitudes, and
practices of HIV infected pregnant women is essential to address these barriers and tailor
interventions effectively [8]. Cameroon has made a significant progress in reducing the
prevalence of HIV/AIDS in 2024. The current HIV prevalence rate in the country is reported to
be 2.7%, a notable decrease from the 3.7% recorded in 2023.This decline reflects ongoing efforts
in public health initiatives aimed at combating the epidemic and improving access to treatment
and prevention services [9]. This to assess the knowledge, attitude and practices regarding
MTCT of HIV among HIV infected pregnant women in Cameroon providing insights that can
inform policy and program development to improve maternal and child health outcomes [10].
Therefore the aim of this study will be to assess the knowledge, attitude and practices of mother
to child transmission of HIV/AIDS among HIV infected pregnant women attending ANC at the
Mifi District Hospital Bafoussam.

viii
1.2. Statement of problem
Mother –to-child transmission (MTCT) of HIV remains a significant public health challenge in
Cameroon, despite advancements in the prevention of mother to child transmission (PMTCT)
programs [11]. Cameroon is among the countries with high HIV prevalence, where pregnant
women and children remain particularly vulnerable [12]. The national prevalence of HIV among
women of reproductive age is approximately3.4%, contributing significantly to the burden of
pediatric HIV infections if timely interventions are not implemented to mother to child
transmission can be drastically reduced to less than 5% through the use of antiretroviral therapy
(ART), appropriate obstetric interventions, and safe infant feeding practices [13]. However, gaps
in knowledge, attitude and practices related to MTCT persist among HIV-positive pregnant
women in Cameroon, exacerbated by socio-cultural factors, stigma, and limited access to
healthcare services [14]. Study and awareness regarding PMTCT strategies, misconceptions
about HIV transmission, and inadequate adherence to ART significantly increase the risk of
vertical transmission [15]. Additionally, structural challenge healthcare infrastructure,
insufficient trained personnel, and economic barriers further hinder the success of PMTCT
programs [16]. Understanding the level of knowledge and practice pregnant women is essential
for addressing these challenges [17]. Without targeted interventions to enhance awareness,
promote positive attitudes and improve adherence to prevention protocols, the goal of
eliminating pediatric HIV in Cameroon by 2030 will remain unattainable [18].Therefore the aim
of this study will be to assess the knowledge, attitude and practices of mother to child
transmission of HIV/AIDS among HIV infected pregnant women attending ANC at the Mifi
District Hospital Bafoussam.

ix
1.3. Objectives of study

1.3.1 Main objective

 To assess the knowledge, attitude, practices of mother to child transmission of HIV/AIDS
among HIV infected pregnant women attending antenatal care at the mifi Diistrict
Hospital Bafoussam.

1.3.2 Specific objective

 To determine the knowledge of prevention of mother to child transmission of HIV/AIDS
among HIV infected pregnant women attending ANC at the mifi District Hospital
Bafoussam.
 To examine the attitude toward voluntary counseling and testing and prevention of
mother to child transmission of HIV/AIDS among HIV infected pregnant women
attending ANC at the mifi District Hospital Bafoussam.
 To assess the practice of prevention of mother to child transmission of HIV/AIDS among
HIV infected pregnant women attending ANC at the mifi District Hospital Bafoussam.

1.4 Research questions

 What are the knowledge among HIV infected pregnant women regarding HIV/AIDS
prevention?
 What are the attitude of HIV infected pregnant women toward HIV/AIDS prevention?
 What are the practices of HIV infected pregnant women in relation to HIV/AIDS
prevention?

1.5 Significance of the study

This study on assessing the knowledge, attitude and practice towards HIV/AIDS among
infected pregnant women is aim at creating awareness on public health and a great change on
behavioral interventions by the state. Public health impact will be seen in that it will provide
available insights into current understanding of HIV/AIDS among infected pregnant women and
help in designing targeted education and awareness programs. By addressing knowledge gaps
and attitudinal challenges, this study contributes to a broader effort to improve preventive
healthcare and empower women to take charge their health.

x
 CHAPTER TWO

LITERATURE REVIEW

2.1 DEFINITION
HIV (Human immunodeficiency virus) is a virus that attack the immune system, specifically
targeting CD4 cells which are crucial for the body’s ability to fight off infection.

AIDS is the final stage of HIV infection, characterized by severe immune system damage
and increase susceptibility to opportunistic infection .The scale of the HIV/AIDS pandemic has
exceeded all expectation since its identification 20 years ago. Globally, an estimated 36 million
people are currently living with HIV and some 20 million people have already died, with the
worst of the pandemic centered on the sub –Saharan Africa [19]. The HIV/AIDS pandemic has
become a public health crises. Which researchers has deepened out understanding of how the
virus replicates, manipulation and hides in an infected person. Antiretroviral treatment has
transformed AIDS from an inevitably fatal condition to a chronic manageable disease in some
setting [20].

2.2 pathogenesis
When HIV enter a new host, the virus targets CCR5+ CD4+ effector memory T cells,
resulting in acute, massive damage of these cells from mucosal effector sites. This depletion does
not initially compromise the regenerative capacity of the immune system because the most
central memory T cells are spread. Here, we will talk on evidence suggesting that frequent
activation of these spread cells during chronic phase of HIV infection supplies mucosal tissues
with short lived CCRT+ CD4+ effector cells that prevent life threatening infections. This
immune activation may lead to infection and killing of target T cells by HIV. There are
selective and the impact on effector cells life span is limited. We propose however that,
persistent activation progressively destroys the functional organization of immune system
reducing its regenerative capacity and facilitating viral evolution that leads to loss of the
exquisite target cell. Sparing selectivity of viral replication, ultimately resulting in AIDS [21].
Infection with HIV begins without any symptoms and is accompanied by slight changes in the
immune system. This stage might take up to three months after infection until seroconversion,
where HIV specific antibodies can be detected in individuals following recent exposure. The

xi
outcome of infection and duration for a disease progression with clinical symptoms may vary
greatly between individuals, but often it progresses fairly slowly [22]. It take several years from
primary infection to the development of symptoms of advance HIV disease and
immunosuppression.

During primary infection, individuals may look healthy, but the virus is actively replicating
in the lymph nodes and blood stream of those who are infected. AS a result, the immune system
may get slowly damaged because of the burst in the viral load in the bodies [23].

Symptomatic stage of disease shows the late phase of HIV disease (AIDS) where
individuals may be open to other opportunistic infections such as mycobacterium avium,
mycobacterium tuberculosis, pneumocystis carina, toxoplasmosis and candidiasis. It has been
discovered that infected individuals develop an AIDS status when their plasma HIV load is high
and the CD4+T count is less than 200mm. The availability of the highly active antiretroviral
therapy may question the dilemma as to whether everyone who seroconverts HIV will develop
AIDS [24].

This led to the discovery of the chemokine receptor as essential coreceptors for HIV -1.
There are different types of these coreceptors for different cell types that HIV variants can use
for infection of cells. Two main chemokine receptors have been identified to play a major role in
HIV entry, CCR5 and CXCR4 (or fusing) [25]. HIV -1 is one of the most polymorphic viruses
known and exists as a swarm of genetically related variants. The polymorphic viruses nature of
HIV-1 can be directly attributed to its error prone reverse transcriptase and complexity of its
cDNA formation. Together with other factors, the evolution of the viral genome underlies all of
the changes in the biological characteristics of HIV-1 including cytopathic ability, immune
evasion, coreceptors usage and tropism.

2.3 mode of transmission

HIV (Human Immunodeficiency Virus) is primarily transmitted through specific bodily fluids,
including blood, semen, vaginal fluids, and breast milk. The most common mode of transmission
are;

xii
  From mother to child during childbirth: This is the most common way for HIV to
be transmitted from mother to child during pregnancy, labor and delivery or
breastfeeding. Without any interventions, the risk of vertical transmission is 15% -45%.
However, this risk can be reduce to below 5% with the used of antiretroviral therapy,
safe infant feeding methods [26].
 Blood transfusion and organ transplants: Although rare in countries with strict
screening procedures, HIV can be transmitted through contaminated blood transfusions
or organ transplants [27].
 Unprotected sexual contact: HIV is spread commonly through unprotected vaginal,
anal, or oral sex with an infected partner. The risk of transmission is higher if there are
open sores or cuts in the genital area and especially those with limited access to HIV
testing and preventions services.
 Sharing of needles or syringes: HIV can be spread through sharing needles or
syringes contaminated with infected blood, such as in the case of intravenous drug use.
 Unsterilized medical equipment: Reuse of unsterilized medical equipment in
healthcare settings can lead to the transmission of HIV between patients.

2.4 Persons at risk of HIV infection.

 People who inject drugs : Individuals who use injected drugs are at an increased risk
of HIV transmission due to the sharing of needles and syringes , which can lead to blood
to blood contact and the spread of the virus[28]
 Individuals with multiple sexual partner: People who have multiple sexual
partners or engage in high- risk behaviors, such as unprotected sex or sex with partners
who are HIV- positive, are at an increased risk of HIV transmission.

 People living in areas with high HIV prevalence: Individuals living in

communities or regions with a high prevalence of HIV are at an increased risk of
infection due to the higher like hood of coming into contact with the virus.
 Individuals with limited access to healthcare and prevention services:
People who face barriers to accessing HIV testing, treatment and

xiii
 prevention services, such as poverty, lack of education, geographic
isolation, maybe at a higher risk of infection [29].

The symptoms of HIV and AIDS vary, depending on the phase of infection some people
infected by HIV develop a flu-like illness within 2 to 4 weeks after the virus enters the body
[30]. This illness is known as primary HIV infection may last for few week’s possible sign and
symptoms include:

 Fever
 Headache
 Muscle aches and joint pain
 Rash sore throat and painful mouth sore swollen lymph nodes, mainly on the neck.
 Diarrhea
 Weight loss, cough
 Night sweats.
The next stage is the clinical latent infection (chronic HIV). In this stage of infection
many people may not have any symptoms. This stage can last for many years. When it
reaches AIDS, the various symptoms can be seen [31].
 Sweats
 Chills
 Recurring fever
 Chronic diarrhea
 Persistent white sports or unusual lesions on your tongue or mouth. Persistent,
unexplained fatigue, skin rashes.

2.6 Diagnosis
Diagnosis tests for HIV infection have undergone considerable evolution since the first enzyme
immunoassay (EIA) and western blot were introduced 2 decades ago. Newer methods detect
infection sooner and yield the results much faster. Rapid test represent a major advance for HIV
screening. 6 rapid tests have been approved by the food and drug administration (FDA) since
November 2002. Four of these tests can be done in point of care and non- clinical settings
because they use whole blood or oral fluid and are simple to perform. An assay for detection of

xiv
HIV-1 RNA has been approved by the FDA to detect HIV infection before seroconversion has
occurred [32].

2.7 Complications
Patients with HIV infection often develop multiple complications and comorbidities.
Opportunistic infections should always be considered in the evaluation of symptomatic patients
with advanced HIV and AIDS, although, the overall incidence of these infections has decreased.
Complications of HIV infection can vary widely and can affect different parts of the body. Some
common complications include;

 Opportunistic infections: HIV weakens the immune system, making individuals

more susceptible to opportunistic infections such as tuberculosis, pneumonia, and certain
types of cancer. These infections can be severe and even lead to life- threatening in
people with advanced HIV disease.
 Neurological complications: HIV can cause neurological complications such as HIV
associated neurocognitive disorders (HAND), which can result in cognitive impairment,
motor dysfunction, and behavioral changes. HIV can also lead to conditions like HIV
associated dementia and peripheral neuropathy.
 Cardiovascular disease: People with HIV have an increased risk of developing
cardiovascular disease, including heart attacks, stroke, and other heart- related conditions.
This may be due to chronic inflammation and the effects of antiretroviral medications.
 Kidney disease: HIV can directly affect the kidney, leading to conditions such as HIV
associated nephropathy, which can cause kidney failure. Additionally, certain
antiretroviral medications may also contribute to kidney damage.
 Liver disease: HIV can lead to liver damage and increase the risk of conditions such as
hepatitis B and C co- infection, which can further impact liver health. Some antiretroviral
medications can also affect liver function.
 Mental health issues: People living with HIV are at a higher risk of experiencing
mental health issues such as depression, anxiety and substance abuse. Stigma and
discrimination related to HIV can also contribute to psychological distress.

xv
  Metabolic complications: HIV and certain antiretroviral medications can lead to
metabolic complications such as insulin resistance, dyslipidemia, and lip dystrophy,
which can increase the risk of diabetes and cardiovascular disease.
 Bone disorders: HIV and certain antiretroviral medications can affect bone health,
leading to conditions such as osteoporosis and osteopenia, which can increase the risk of
fracture [33].

2.8 Classification
At present, three classification systems are in use. The first defines primary isolates as
macrophage (M)- tropic or T- cell- line(T)- tropic. However, this system disguises the fact that
all primary isolates replicate in activated, primary CD4+ T- lymphocytes. The second system
categorizes isolate as being either syncytium- inducing non-syncytium- inducing (NSI) on the
basis of whether they form syncytia in MT-2 cells, which express CXCR4 but not CCR5 [34].
However, NSI viruses can readily form syncytia with CCR5- positive cells. The third system
defines viruses as either slow/low (SL) or rapid/ high (RH) depending on their growth kinetics in
culture2. These classifications are often used interchangeably, but they are not synonymous.

Primary infection of HIV also known as the acute stage may last for few weeks with
possible symptoms of fever, headache, and muscle ache. These symptoms can be so mild that
you might not even notice the manifestations [35]. However, the amount of virus in your blood
stream (viral load) is quite high at this time. As a result, the infection spreads more easily during
primary infection than during the next stage [36]. Clinical latent infection (chronic HIV). In this
stage of infection, HIV is still present in the body and in white blood cells however, many people
may not have any symptoms or infection during this time [37]. This stage can last for many years
if you are not receiving antiretroviral therapy (ART). Some people develop more severe disease
much sooner. Symptomatic HIV infection as the virus continues to multiply and destroy your
immune cells. The cells in your body that help fight off germs you may develop mild infections
[38].

xvi
2.9 Treatment
The treatment of HIV/AIDS typically involves a combination of antiretroviral drugs (ARVs) that
target the virus at different stages of its life cycle. The treatment regimen may vary based on the
stage of the disease, the individual’s overall health, and any co- existing conditions. Here is a
general overview of the different stages of HIV/AIDS and the corresponding treatment drugs:

 Acute HIV infection: During the acute phase of HIV infection, the virus rapidly
replicates and spreads throughout the body. Treatment during this stage aims to reduce
viral replication and establish viral suppression. Commonly used ARVs during this stage
may include:
 Tenofovir disoproxil fumarate( TDF)
 Emtricitabine (FTC)
 Dolutegravir (DTG)
 Raltegravir (RAL)
 Chronic HIV infection (asymptomatic stage): In this stage, the virus remains
active but may not cause any symptoms for many years. Treatment aims to maintain viral
suppression, prevent disease progression, and preserve immune function. Commonly
used ARVs during this stage may include:
 Tenofovir alafenamide (TAF)
 Emtricitabine/ tenofovir alafenamide (FTC/TAF)
 Efavirenz (EFV)
 Atazanavir (ATV)
 Symptomatic HIV infection (AIDS): As the disease progresses to AIDS, the immune
system becomes severely compromised, leading to opportunistic infections and other
complications [39].Treatment during this stage focuses on managing complications,
preventing opportunistic infections, and maintaining quality of life. Commonly used
ARVs during this stage may include:
 Lopinavir/ ritonavir (LPV/r)
 Darunavir (DRV)
 Abacavir (ABC)
 Lamivudine (3TC).

xvii
2.10 Nursing intervention
Nursing interventions for patients with HIV/AIDS focus on promoting health, preventing
complications, managing symptoms, and supporting emotional well-being. Some possible
nursing interventions are;

 Education and counseling: Provide comprehensive education to the patient about

HIV/AIDS, its transmission, treatment options adherence to medications, and preventive
measures. offer counseling and emotional support to address fears, anxiety ,and stigma
associated with the disease .
 Medication management: ensure that the patient understands the
importance of adherence to antiretroviral therapy (ART) and assist in
developing a medication schedule. Monitor for side effects and drug
interactions [40].
 Infection control: Educate the patient on infection control measures to prevent the
spread of HIV to others. Emphasize safe sex practices, needle safety, and proper hygiene.
 Symptom management: Asses and manage symptoms such as fatigue, pain, nausea,
and opportunistic infections. Provide comfort measures and collaborate with the
healthcare team to address symptom control.
 Nutritional support: Asses the patient’s nutritional status and provide guidance on
maintaining a healthy diet to support immune function. Monitor weight changes and
address any nutritional deficiencies.
 Psychosocial support: Offer emotional support, counseling, and referrals to support
groups or mental health services to help the patient cope with the psychological impact of
living with HIV/AIDS [41].

2.11 Prevention of HIV/AIDS

Prevention of HIV is a crucial aspect of controlling the spread of the virus and reducing the
burden of the disease on individuals and communities. Here are several key strategies for
preventing HIV transmission:

xviii
 Education and awareness: Providing comprehensive education about HIV
transmission, prevention methods, and the importance of regular testing can help
individuals make informed decisions about their sexual health and reduce the risk of
transmission.
 Condom use: Consistent and correct use of condoms during sexual activity can greatly
reduce the risk of HIV transmission. Condoms are readily available and are an effective
barrier method for preventing the spread of the virus.
 Testing and counseling: Regular HIV testing is important for early detection and
treatment. Individuals who are aware of their HIV status can take steps to protect
themselves and their partners, seek appropriate medical care, and access support services
[42].
 Pre-exposure prophylaxis (PrEP): PrEP is a medication taken by HIV negative
individuals to reduce their risk of acquiring the virus through sexual activity or injection
drug use. When taken as prescribed, PrEP can be highly effective in preventing HIV
transmission.
 Needle exchange programs: Providing access to clean needle and syringes for
individuals who inject drugs can reduce the risk of HIV transmission through sharing of
contaminated equipment.
 Harm reduction programs: Implementing harm reduction strategies, such as opioid
substitution therapy and supervised injection facilities, can help reduce the risk of HIV
transmission among individuals who use drugs.
 Addressing stigma and discrimination: Stigma and discrimination related to HIV
can create barriers to prevention efforts and discourage individuals from seeking testing
and treatment. Promoting understanding, empathy, and acceptance can help create a
supportive environment for HIV prevention and care [43]

xix
 CHAPTER THREE

MATERIALS AND METHOD

3.1 Study design and period

A cross sectional study will be use and the study will be carry out from January 2025 to march
2025.

3.2 Research setting

3.2.1 Historical Back ground of the MIFI
The research will be carry out at the mifi District hospital Bafoussam. In july 1995, the Mifi
District Hospital (MDH) was created. At this time, it was called ambulatory health center and
later on passed from integrated health center in 1995 to a medical district center in 1996 and
today, have become the district hospital of mifi since August 23 2005 following the ministerial
decree number 2002/A/MSP/SG/DOTS/SDSSP/SVDS. This hospital was belt by the Bafoussam
urban council 36 years ago.

3.2.2 Geographical location of the MDH

Geographically, the MDH is found at the center of the Famla junction precisely at the Njoya
arouna street and is limited to the north by the Golden hotel center, to the south by FOKU
enterprise, to the west by a telephonic network anterne, and to the East by the fruit market of
Bafoussam.

Also, the MDH is found in the west region of Cameroon, mifi Division and precisely in
Bafoussam town.

xx
Figure 1: geographical location of mifi District Hospital Bafoussam
http:www.localization of the Mifi District hospital Bafoussam

xxi
3.2.3 Infrastructure, Organization and functioning of the MDH
The MDH is structure surrounded by a barrier up of blocs, painted in yellow. It has 3 modest
buildings with many departments such as;

 The emergency ward; where new patients are booked and emergency cases are equally
handled here. It is an emergency ward that is in charge of sending patients to the précised
ward or unit of the hospital.
 The men ward; here, male patients of 15 years and above are handled here.
 The women ward; here, female patients of 5 years and above are been taken care of.
 The surgical ward; here surgical acts are being done by a surgeon with many assistants.
 The maternity; women in labor and sick pregnant women are being handle here.
 The ANC unit; pregnant women coming for ANC and family planning are received here.
 Physiotherapy; it takes care of patients with nerves problems and those with broken arm
or leg that need massage.
 The dentistry; it takes care of patients with tooth problems.
 The ultrasound room; here, ultrasound and x-ray examination are being carried out.
 The pharmacy; drugs are stored and sold here.
 The laboratory; various test are being carried out here.
The antenatal clinic in MDH is an active clinic that runs from Monday to Friday of every
week between 8am – 3:30pm. The ANC unit is located in the building that host the
podiatry and the women ward, the activities of the clinic includes; booking visits, for
new pregnant women and routine antenatal visit for booked clients.

xxii
3.3 Study participants
The participants of the study will be all infected HIV pregnant women attending ANC at the
MDH Bafoussam.

3.4 Selection criteria

3.4.1 Inclusive criteria

 Pregnant women attending ANC at the Mifi District Hospital Bafoussam.
 Pregnant who will be willing to sign the consent form?

3.4.2 Exclusive criteria

Pregnant women who will be mentally ill (vulnerable groups) will be excluded in the study.

3.5 Sample size and sampling

A convenient sampling technique will be used. This is a non- probability sampling method where
the sampling is gotten from a group of people easy to contact.

3.6 Study procedure

Self- introduction will be done and the study will explain to the sample participants for them to
understand fully. Those interested in participating in the study will be given an informed consent
for them to fill and sign.

A semi structured questionnaire containing closed ended questions will be used, which contain 4
sections that is Socio- demographic characteristics, Knowledge on HIV/AIDS prevention,
Assessing the attitude score toward the prevention of HIV/AIDS, explore the practices toward
HIV/AIDS, will be administered to study participants for them to fill and return them back.
Those who will be unable to fully understand the questions will be help by the researcher.

3.7 Data processing and analysis

The data collected will be analyzed using the Statistical Package Social Science (SPSS) Version
27 and descriptive analysis will be used to present results on tables and charts.

3.8. Data storage and data quality and control

Before data collection, the questionnaire will be pre-tested and every questionnaire will be
checked for completeness after collection.

xxiii
The data collected will be stored in computer, USB key, Hard, soft copy as back up before it will
be analyzed.

3.9. Ethical consideration

An ethical approval to carry out this research will be obtained from ISSAB University. This
approval letter will be used together with a copy of the research proposal to obtain an
authorization to carry out research from the Regional Delegation of Public Health for the West
Region. Moreover, an informed consent form will be attached to the questionnaires which will be
well explained for the better understanding of the participants. Confidentiality will be highly
respected since personal information of the participants will not be collected.

xxiv
 TIME TABLE OF ACTIVITIES

Table 1: Table of activities

November December January February March April
2024 2024 2025 2025 2025 2025
Drafting of
research
proposal
Presentation
of research
proposal
Testing of
questionnaire
Data
collection
Data analysis

Defense

xxv
 BUDJET
Table 2: budget
N/S Activities Amount Justification

1 Proposal writing 10,000 Internet key,

downloading. Typing
and Printing, editing.

2 Pilot test 15,000 Print, photocopy,,

feeding transport.

3 Correction 3,000 Printing and

Correction.

4 The actual research or 20,000 Feeding logistic

data collection
Transport.

5 Analysis 25,000 SPSS

6 Final write up 20,000 Printing, binding, power

point payment.

Total 93,000

xxvi
 REFRENCES

1. .UNAID.(2022).GLOBAL AIDS Updated2022.Geneva;UNAIDS.

2. World Health Organisation .(2021).Mother –to –child transmission of HIV.Retrieved
from WHO webside
3. Ministory of public Health, Cameroon .(2020).National strategic plan for the fight against
HIV/AIDS 2021-2023
4. UNICEF.(2021).Eliminating mother –to-child transmission of HIV in
Africa.NewYork:UNICEF.
5. Mahy,M;et; et al.(2021).program towards ending vertical transmission of HIV.A
review .pediatric infections Disease journal ,40(3),S15-S21.
6. .Cohen,M.S;et al.(2020).Prevention of HIV-1 trasmission with early antiretroviral
therapy .New England journal of Medical ,375(11),830-839.
7. .Fon, P.N.,et al(2019).Barriers to PMTCT uptake in cameroon :perspectives from
women and healthcare providers .Africa journal of Reproductive Health ,23(4),82-95.
8. .Nkenfou,C.N;et al.(2018).knowledge and practices regarding PMTCT among HIV-
Positive pregnant women in Cameroon.BMC Public Health ,18,845.
9. Chersich ,M.F;et al .(2017).Adherence to ARTand MTCT prevention :Insights from Sub-
Saharan Africa. The Lancet HIV,4(2),e63-e71.
10. Mini Mefo info on LinkedIN;Cameroon Records Significant Decline in HIV
Prevalence .Governing puts HIV/AIDS Prevalence rate at 2.7% The Guardian 2024
11. UNAIDS.(2022).Global AIDS Update 2022.Ministry of public Health ,Cameroon
(2020).National strategic plan for the Fight Against HIV/AIDS 2021-2023.
12. .World Health Organization .(2021). Mother –to –child transmission of HIV.Retrieved
from WHO website.
13. UNICEF.(2021).Eliminating mother –to-child transmission of HIV in Africa .New York ;
UNICEF.
14. .Fon ,P.N;et al .(2019).Barriers to PMTCT uptake from women and healthcare
providers .Africa Journal of Reproductive Health ,23(4),82-95.
15. .Mahy,M;et al .(2021). Progressing towards ending vertical transmission of HIV:A
review .Pediatric infections Disease journal 40(3),S15-S21.

xxvii
16. Nkenfou ,C.N;et al (2018).knowledge PMTCT amongst HIV –Positive pregnant women
in cameroon .BMC public ,Health ,18,845.
17. Cherish ,M.F, et al (2017).Adherence to ART and MTCT Prevention ;Insights from sub-
saharan Africa.The lancet HIV,4(2).e63-e71.
18. Zash ,R;et al.(2022).Advances from high –burden setting .Journal of Acquired Immune
Deficiency Syndromes (JAIDS),90(2),123-130.
19. Viviana Simon et Al. HIV and AIDS epidemiology, the lancet, 368 (9534), 489-504,
2006.
20. MD. Et Al. Condoms and HIV prevention centers for disease control and prevention,
centers for disease. Control, vol 4 (1), 2014.
21. Cunningham Al, L IS, Tuarez j. The level of HIV infection of macrophages is determined
by interaction of viral and host cell genotype, leukoc Biol, 68:311-7, 2000.
22. Anna Maria, Rukundo et Al. Health sciences, health 8(10), 2016.
23. M Atrouni W, Berbari E, Temesgen Z. HIV associated with opportunistic infections,
bacterial infections, pub med 54:80-3, 2006.
24. Chun TW, Fauci AS. HIV reservoirs, AIDS, 26:1261-8, 2012.
25. Mofenson, L.M (2010) Advance in the prevention if vertical transmission of human
Immunodifiency virus 001.Seminars in pediatric infectious Disease, 21 (4). 293-300
https://doi.org/10.1053/j spid. 2010. 08. 001.
26. Suy, A., Martinez, E., Coll O., Lonca, M., palacio, M., de Lazzari, E., … and Gatell, J.M.
(2006). Increased risk of preterm delivery in HIV infected women treated with highly
active antiretroviral therapy.
27. WHO. (2010). Toward 100% voluntary Blood Donation: A Global framework for action
Retrieved from https://www.who.int/bloodsafety/voluntary-donation/en/.
28. United Nations office on Drug .(2021). World Drug Report. 2021. Retrrieved from
https://www.unodc.org/unodclen/data.analysis/wdr2021.html.
29. Strathdee, S.A., and stock man, j.k (2010). Epidemiology of HIV among injecting drug
users: current trends and implications for interventions .Current HIV/AIDS Report, 7
(2),99-106.
30. Fauci As. 25 years of of HIV, nature, p453:289-90, 2008.

xxviii
31. Hassan M Naif, L IS, Alali M, J virol. CCR5 expression correlates with susceptibility of
maturing monocytes to human immunodeficiency virus type, PMC Free articals 72:830-
6.
32. WHO. (2021) Consolidated guidelines on HIV testing services for a changing epidemic.
33. Fouchier R, Groenink M, Koostra N. Phenotype association sequence variation in the
third variable domain of the human immunodeficiency virus type, 66:33183-7.
34. E.A. Berger, RW Doms, RA Weiss, EM Fenya, BTM Korner, DR Littman, JP Moore, QJ
Sattentau. A new classification for HIV, nature,391,240, 1998.
35. Fenyo, EJ virol. A new classification for HIV, nature, 1998.
36. Moore, JP,TrKola, A and Dragic, T. Curr.A new classification for HIV, nature1997.
37. Rachel A. Royce,PHD, MPH, Arlene Sena, MD,Willard cartes, Jr,MD, and Myron’s S.
Cohen. Sexual transmission of HIV, the new England Journal of medicine, 1997.
38. World Health Organization (WHO) consolidate guideline on the use of antiretroviral
drugs for treating and preventing HIV infection 2016.
39. American nurses association HIV/AIDS nursing: scope and standards of practice 2018.
40. The body pro, psychosocial issues in HIV/AIDS care 2018.
41. Marco Florida, Marina Giuliano,Lucia Palmisane, Stefano vella.Gender differences in
the treatment of HIV infection, pharmacology research 58 (3-4), 173-182, 2008.
42. Carl W Dieffenbach, Anthony S faice. Thirty years of HIV and AIDS, Annals of internal
medicine,154 (11), 766-771, 2011.
43. Namaitijiang Maimaiti, Jalan Yaacob Latiff, Bandar Tun Razak, Cheras Knowledge,
Attitude and Practice Regarding HIV/AIDS October 2010 published by Canadian center
of science and Education.
44. National institute of health . US department of health and human services. Workshop
summary: scientific evidence on condom effectiveness for sexually transmitted diseases
prevention. 12-13 june 2000.

xxix
 QUESTIONNAIRE
Dear respondent,

I am TESHI NADESH KIMIH, a level 300 student of Sapientiae University

Institute Bafoussam (ISSAB). I am carrying out a research titled “ Assessing the
knowledge attitude and practices of mother to child transmission of HIV/AIDs
among HIV infected pregnant women attending antenatal clinic at the Mifi
District Hospital Bafoussam.” please my respondent, I will be counting on your
kind collaboration as you will give a little of your time to answer the following
questions. Your answers will be kept confidentially.

(Tick the letter corresponding to your answer)

SECTION A: SOCIO DEMOGRAPHIC DATA

1- Age:
A) 15-20 B) 21-25 C) 26-30 D) 31 and above
2- Educational level:
A) No formal B) Primary C) Secondary D) University
3- Occupation:
A) Student B) Worker C) Farmer
4- Marital status
A) Married B) Single C) Widow D) Divorce

5- Religion:
A) Catholic B) Presbyterian C) Baptist D) Others

SECTIONB: KNOWLEDGE OF PREGNANT WOMEN ON HIV/AIDS TRANSMISSION

6- Have you heard of mother –to-child transmission of HIV?

A) Yes B) No C) Not sure

xxx
 7- How is HIV transmitted from mother to child?

A) During childbirth B) Through breastfeeding C) During pregnancy D) None

of them above E) All of them above

8- Can HIV be prevented from being transmitted to the child?

A) Yes B) No C) Not

9-What are some ways to prevent MTCT of HIV?

A) Taking antiretroviral Therapy (ART) B) Safe delivery practices C) Avoiding

breast feeding D) All of them above E) None of them above

10-Are you aware of the importance of early testing for HIV during pregnancy?

A) Yes B) No C) Not sure.

SECTION C: ATTITUDES TOWARDS THE PREVENTION OF HIV/AIDS.

11-Is it important to educate people about HIV/AIDS.

A) Agree B) Strongly agree C) Neutral D) Disagree E) Strongly disagree.

12- Do you feel comfortable discussing HIV prevention with your friends?

A) Agree B) Strongly agree C) Neutral D) Disagree E) Strongly disagree.

13-The use of condoms during sexual activity is an effective way to prevent the spread of
HIV.

A) Strongly agree B) Disagree C) Agree D) Strongly disagree E) Neutral

14- Are you aware of the different ways in which HIV can be transmitted?

A) Agree B) Disagree C) strongly disagree D) Neutral E) strongly agree.

15- Do you support the initiatives that promote HIV testing and encourage people to know
their status?

xxxi
A) Agree B) Strongly agree C) Neutral D) Disagree E) Strongly disagree.

16- Do you believe that stigma and discrimination against people living with HIV should be
addressed to prevent further spread of the virus?

A) Agree B) Strongly agree C) Neutral D) Strongly disagree E) Disagree.

SECTION D: PRACTICES RELATED TO HIV/AIDS PREVENTION

17- Do you use condoms during sexual intercourse to prevent the transmission of
HIV/AIDS?

A) Always B) Sometimes C) Never.

18- Have you ever been tested for HIV/AIDS?

A) Yes B) No.

19- Do you avoid sharing needle or syringes with others to prevent the risk of HIV
transmission?

A) Always B) Sometime C) Never.

20- Do you think that regular HIV testing is important for preventing the spread of
HIV/AIDS?

A) Agree B) Strongly agree C) Neutral D) Disagree E) Strongly disagree.

21-Do you think that education and awareness programs about HIV prevention are
effective in reducing the risk of HIV transmission?

A) Agree B) Strongly agree C) Neutral D) Strongly disagree

xxxii
xxxiii