Authors:
Sandrine Talla, Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroon
Elvis Moma, Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroon
Eninwi Muna, Division of Global HIV and TB, U.S. Centers for Disease Control and Prevention, Yaoundé, Cameroon
Carmen Babodo, Central Technical Group, National AIDS Control Committee, Ministry of Public Health, Yaoundé, Cameroon
Alice Ketchadji, Division of Disease, Epidemic and Pandemic control, Ministry of Public Health, Cameroon
Boris Tchakounte Youngui, Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroon
Suzanne Essamba, Central Technical Group, National AIDS Control Committee, Ministry of Public Health, Yaoundé, Cameroon
Yasmine Moussa Fadil, Division of Global HIV and TB, U.S. Centers for Disease Control and Prevention, Yaoundé, Cameroon
Simplice Lekeumo, Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroon
Florence Minjiwa, Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroon
Ashu Ebot Takor, Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroon
Diego Tchouakam, Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroon
Eugenie Mayap, Department of Family Health, Ministry of Public Health, Yaoundé, Cameroon
Francis Bogni, Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroon
Ebako Takem, Division of Global HIV and TB, U.S. Centers for Disease Control and Prevention, Yaoundé, Cameroon
Joseph Fokam, Central Technical Group, National AIDS Control Committee, Ministry of Public Health, Yaoundé, Cameroon
Leonie Simo, Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroon
Grace Nyemb, Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroon
Martha Mukaminega, Elizabeth Glaser Pediatric AIDS Foundation, Washington, DC, United States
Serge Clotaire Billong, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
Anne-Cecile Zoung-kanyi Bissek, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
Zacharie Bissemou, Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroon
Gilles Ndayisaba, Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroon
Boris K. Tchounga, Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroon
Patrice Tchendjou, Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroon
Background: Early infant diagnosis (EID) is critical for timely identification and treatment of children living with HIV. However, in 2024, EID cascade indicators were suboptimal with only 27% and 22% of HIV-Exposed Infants (HEI) receiving their first and second virologic test within two and 12 months respectively, in Cameroon’s Littoral and South regions. We share the experience of a program optimization approach (POA) implemented to improve EID coverage in these regions.
Description: We analyzed cross-sectional routine program data from December 2024 to March 2025, during implementation of the POA in 75 facilities. The POA started with brainstorming sessions involving multidisciplinary teams to conduct root cause analysis of suboptimal EID coverage and identify areas of improvement and select appropriate interventions. The intervention package included line listing of HEI born between October 2022 and September 2024 from the national HIV program database, verification against facility cohort monitoring registers and patient files, active tracking of those eligible through phone calls and home visits, close monitoring of the coverage catch-up (real-time dashboard and regular supervision). Changes in EID cascade indicators were measured throughout the POA implementation.
Lessons Learned: A total of 3,491 HEI were identified at participating facilities; 2,845 (82%) were eligible for tracking and 1,975/2,845 (69%) were successfully tracked by March 2025. Completion of age-appropriate HIV virologic and serologic testing increased from 31%(1,079/3,491) to 69% (2,402/3,491) post implementation. Antiretroviral therapy initiation among infants with a positive virologic or serologic result improved from 68% (28/41) to 78% (32/41). The proportion of HEI eligible for a serologic test with a documented final HIV outcome increased from 17% (314/1,828) to 84% (1,534/1,828).
Next Steps: EID cascade indicators were higher following the completion of the POA intervention package activities, but substantial gaps remain. This underlines the importance of continuous monitoring to strengthen implementation process and outcomes.
