Page 255 - Learnwell EVS
P. 255
8. Viral diseases
– Nosocomial transmission
P reven tion of n osocom ial H IV in fection is based on the ration al use of in jection s
an d
strict resp ect for hygien e an d sterilisation an d d isin fection p roced ures for m ed ical
m aterial.
– Mother-to-child transmission (MTCT)
T h e global rate of vertical tran sm ission varies from 2 0 % to 4 0 % . T h e risk of
tran sm ission through breastfeed in g is evaluated at ap p roxim ately 1 2 % an d p ersists
for the d uration of breastfeed in g.
In pregnant women: H IV tran sm ission from m other-to- child m ay be red uced by the
ad m in istration of A R V s. M an y d ifferen t p rotocols exist of varyin g com p lexity,
d uration an d effectiven ess. T he m ost com m on ly used A R V are A ZT , 3 T C an d
N V P.
A R V are ad m in istered to the m other d urin g p regn an cy, labour, p ost-p artum p eriod
an d to the n ew born . C heck n ation al recom m en d ation s.
P rogram m es targetin g p regn an t w om en also in clud e other p reven tive m easures: n o
system atic ep isiotom y; avoid artificial rup ture of th e m em bran es. I n certain
situation s, w h ere th e con text allow s, an elective caesarean section ( p rior to
com m en cem en t of labour or rup ture of m em bran es), un d er an tiretroviral cover, m ay
red uce m other-to-child tran sm ission . I t is absolutely im p erative to con sid er the risk
of a caesarean section again st the ben efit of this in terven tion .
In breastfeeding women: artificial m ilk if th e sup p ly of m ilk an d safe w ater is
guaran teed . I f n ot, exclusive m atern al breastfeed in g un til th e age of six m on th s
follow ed by w ean in g over 1 m on th p eriod . M ixed feed in g (m atern al + artificial m ilk )
is con tra-in d icated .
Prevention of opportunistic infections 8
In the absen ce of A R V treatm en t, all H I V in fection s becom e sym p tom atic an d
evolve
tow ard s A I D S . H ow ever, som e op p ortun istic in fection s can be p reven ted .
Primary prophylaxis
F or H I V in fected p atien ts w h o h ave n ot p reviously con tracted an op p ortun istic
in fection , in ord er to p reven t the d evelop m en t of som e op p ortun istic in fection s.
C IIa5fnrniC0tetdh0rDieaWcafe4obllrssHcp/eonrmuiOmncmectaloiirsnyf, fCdipecaearoDspl pisbeth4lnaeyg:dlcaeWoixsnuis1ng:Htoa:nnOWdnclHia2ntiioOwcnacilatlhsilntraCeigcceaoDslms34tamagcneeosnudn2d4,at 3t– the C coun t
–
3
3
Infections Primary prophylaxis
P n eum ocystosis cotrimoxazole P O:
C erebral toxop lasm osis C hild ren : 5 0 m g S M X + 1 0 m g T M P / k g on ce
d aily
Isosp oriasis A d ults: 8 0 0 m g S M X + 1 6 0 m g T M P on ce d aily
V arious bacterial in fection s
M alaria
– Nosocomial transmission
P reven tion of n osocom ial H IV in fection is based on the ration al use of in jection s
an d
strict resp ect for hygien e an d sterilisation an d d isin fection p roced ures for m ed ical
m aterial.
– Mother-to-child transmission (MTCT)
T h e global rate of vertical tran sm ission varies from 2 0 % to 4 0 % . T h e risk of
tran sm ission through breastfeed in g is evaluated at ap p roxim ately 1 2 % an d p ersists
for the d uration of breastfeed in g.
In pregnant women: H IV tran sm ission from m other-to- child m ay be red uced by the
ad m in istration of A R V s. M an y d ifferen t p rotocols exist of varyin g com p lexity,
d uration an d effectiven ess. T he m ost com m on ly used A R V are A ZT , 3 T C an d
N V P.
A R V are ad m in istered to the m other d urin g p regn an cy, labour, p ost-p artum p eriod
an d to the n ew born . C heck n ation al recom m en d ation s.
P rogram m es targetin g p regn an t w om en also in clud e other p reven tive m easures: n o
system atic ep isiotom y; avoid artificial rup ture of th e m em bran es. I n certain
situation s, w h ere th e con text allow s, an elective caesarean section ( p rior to
com m en cem en t of labour or rup ture of m em bran es), un d er an tiretroviral cover, m ay
red uce m other-to-child tran sm ission . I t is absolutely im p erative to con sid er the risk
of a caesarean section again st the ben efit of this in terven tion .
In breastfeeding women: artificial m ilk if th e sup p ly of m ilk an d safe w ater is
guaran teed . I f n ot, exclusive m atern al breastfeed in g un til th e age of six m on th s
follow ed by w ean in g over 1 m on th p eriod . M ixed feed in g (m atern al + artificial m ilk )
is con tra-in d icated .
Prevention of opportunistic infections 8
In the absen ce of A R V treatm en t, all H I V in fection s becom e sym p tom atic an d
evolve
tow ard s A I D S . H ow ever, som e op p ortun istic in fection s can be p reven ted .
Primary prophylaxis
F or H I V in fected p atien ts w h o h ave n ot p reviously con tracted an op p ortun istic
in fection , in ord er to p reven t the d evelop m en t of som e op p ortun istic in fection s.
C IIa5fnrniC0tetdh0rDieaWcafe4obllrssHcp/eonrmuiOmncmectaloiirsnyf, fCdipecaearoDspl pisbeth4lnaeyg:dlcaeWoixsnuis1ng:Htoa:nnOWdnclHia2ntiioOwcnacilatlhsilntraCeigcceaoDslms34tamagcneeosnudn2d4,at 3t
–
3
3
Infections Primary prophylaxis
P n eum ocystosis cotrimoxazole P O:
C erebral toxop lasm osis C hild ren : 5 0 m g S M X + 1 0 m g T M P / k g on ce
d aily
Isosp oriasis A d ults: 8 0 0 m g S M X + 1 6 0 m g T M P on ce d aily
V arious bacterial in fection s
M alaria
