{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T14:18:19Z","timestamp":1792592299399,"version":"4.5.0"},"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100031059","name":"Expertise France","doi-asserted-by":"crossref","award":["grant number 22-SB2712"],"award-info":[{"award-number":["grant number 22-SB2712"]}],"id":[{"id":"10.13039\/100031059","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100009253","name":"European Association for the Study of the Liver","doi-asserted-by":"publisher","award":["2022"],"award-info":[{"award-number":["2022"]}],"id":[{"id":"10.13039\/501100009253","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Introduction<\/jats:title>\n Mother-to-child transmission (MTCT) of HIV, syphilis, and hepatitis B virus (HBV) commonly observed in the WHO African region is associated with excess morbidity and mortality. Despite some progress, the coverage of interventions to prevent MTCT of these infections remains insufficient, particularly for syphilis and HBV. To fulfil these gaps and achieve the triple elimination of MTCT of these infections by 2030, the World Health Organization (WHO) advocates for integration of prevention of MTCT (PMTCT) activities for HBV with HIV and syphilis antenatal services. In partnership with the local governments, the TRI-MOM project, conducted in 2 phases, aims to evaluate a simplified (based on inexpensive rapid diagnostic tests), integrated (in maternal and child health services) and coordinated (between the various programs and health care workers) strategy for the triple elimination of HIV, syphilis and HBV MTCT in Burkina Faso and The Gambia.<\/jats:p>\n <\/jats:sec>\n \n Methods and analysis<\/jats:title>\n The strategy will be implemented in 5 rural and urban health facilities in each country and will include four activities: i) training sessions for healthcare workers working in maternal and child health services, ii) screening of pregnant women of the three infections using rapid diagnostic tests at the first antenatal visit, iii) clinical assessment and treatment of women tested positive for any of the 3 infections, and iv) raising awareness on HIV, Syphilis and HBV PMTCT among pregnant women and empowering those screened positive. 17,000 pregnant women are expected to be screened. The strategy will be evaluated through an interdisciplinary, mixed-methods approach comprising three studies: i) a quantitative and qualitative cross-sectional study conducted both before and after the implementation of the strategy to assess its impact on triple screening coverage in pregnant women; ii) a an intervention study with longitudinal follow-up of pregnant women positive for any of the three infections to assess the coverage of PMTCT measures; and iii) a cost and cost-effectiveness analysis of the project compared to the reference situation in each country, which will rely on a micro costing study to estimate the incremental cost of the strategy per mother\/child couple compared with the reference situation in each country, and compare it to the number of avoided infections.<\/jats:p>\n <\/jats:sec>\n \n Ethics and dissemination<\/jats:title>\n The study protocol has been approved by the competent authorities of the countries participating to the research (the LSHTM\/MRCUG Scientific Coordinating Committee, the Gambia Government\/MRC Joint Ethics Committee, the LSHTM ethics committee, the Burkinabe National Ethical Committee for Research in Health and the French Commission on Information Technology and Liberties). Results on the feasibility and acceptability of the triple elimination strategy will be disseminated using different media including policy briefs, posters and articles.<\/jats:p>\n <\/jats:sec>\n \n Trial registration number<\/jats:title>\n \n ClinicalTrials.gov\n NCT05951751<\/jats:ext-link>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0322670","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T18:22:06Z","timestamp":1770402126000},"page":"e0322670","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Towards triple elimination of HIV, syphilis and HBV mother-to-child transmission: Protocol of a simplified and integrated strategy in Burkina Faso and The Gambia: Protocol for the phase 1 of the TRI-MOM project"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8280-3426","authenticated-orcid":true,"given":"Erwan","family":"Vo-Quang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice N.","family":"Guingan\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"P\u00e9ri\u00e8res","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gibril","family":"Ndow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Some","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheriff","family":"Badjie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asta","family":"Jobe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clarisse","family":"Gouem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Shimakawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dramane","family":"Kania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maud","family":"Lemoine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvie","family":"Boyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the TRI-MOM study group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"pone.0322670.ref001","unstructured":"WHO. Global health sector strategies on, respectively, HIV, viral hepatitis and sexually transmitted infections for the period 2022-2030. 2022."},{"issue":"9","key":"pone.0322670.ref002","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1001\/jama.283.9.1175","article-title":"Prevention of mother-to-child HIV transmission in resource-poor countries: translating research into policy and practice","volume":"283","author":"KM De Cock","year":"2000","journal-title":"JAMA"},{"key":"pone.0322670.ref003","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.ijid.2021.06.036","article-title":"Mother-to-child transmission of HIV-1 and infant mortality in the first six months of life, in the era of Option B Plus combination antiretroviral therapy","volume":"109","author":"LS Zijenah","year":"2021","journal-title":"Int J Infect Dis"},{"issue":"9939","key":"pone.0322670.ref004","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/S0140-6736(14)60164-1","article-title":"HIV infection: epidemiology, pathogenesis, treatment, and prevention","volume":"384","author":"G Maartens","year":"2014","journal-title":"Lancet"},{"key":"pone.0322670.ref005","volume-title":"Guidelines for the prevention, diagnosis, care and treatment for people with chronic hepatitis B infection [Internet]","author":"WHO","year":"2024"},{"issue":"5","key":"pone.0322670.ref006","doi-asserted-by":"crossref","first-page":"1140","DOI":"10.3390\/microorganisms11051140","article-title":"Vertical Transmission of Hepatitis B Virus-An Update","volume":"11","author":"D di Filippo Villa","year":"2023","journal-title":"Microorganisms"},{"key":"pone.0322670.ref007","unstructured":"Guidelines for the prevention, diagnosis, care and treatment for people with chronic hepatitis B infection [Internet]. [cit\u00e9 14 mai 2024]. Disponible sur: https:\/\/www.who.int\/publications-detail-redirect\/9789240090903"},{"issue":"3","key":"pone.0322670.ref008","doi-asserted-by":"crossref","first-page":"217","DOI":"10.2471\/BLT.12.107623","article-title":"Untreated maternal syphilis and adverse outcomes of pregnancy: a systematic review and meta-analysis","volume":"91","author":"GB Gomez","year":"2013","journal-title":"Bull World Health Organ"},{"issue":"2","key":"pone.0322670.ref009","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0211720","article-title":"Global burden of maternal and congenital syphilis and associated adverse birth outcomes-Estimates for 2016 and progress since 2012","volume":"14","author":"EL Korenromp","year":"2019","journal-title":"PLoS One"},{"key":"pone.0322670.ref010","first-page":"485","article-title":"Epidemiology and Challenges of HBV\/HIV Co-Infection Amongst HIV-Infected Patients in Endemic Areas: Review","volume":"13","author":"L Weldemhret","year":"2021","journal-title":"HIV AIDS (Auckl)"},{"key":"pone.0322670.ref011","article-title":"Contribution of syphilis to adverse pregnancy outcomes in people living with and without HIV in south Brazil: 2008-2018","author":"LZ Yang","year":"2024","journal-title":"Sex Transm Dis"},{"key":"pone.0322670.ref012","first-page":"102","volume-title":"Global guidance on criteria and processes for validation- elimination of mother-to-child transmission of HIV, syphilis and hepatitis B virus [Internet]","author":"WHO","year":"2022"},{"key":"pone.0322670.ref013","unstructured":"Minist\u00e8re de la Sant\u00e9, Comit\u00e9 minist\u00e9riel de lutte contre le VIH\/SIDA. Normes et protocoles de prise en charge m\u00e9dicale des personnes vivant avec le VIH au Burkina Faso. 5ieme \u00e9dition. f\u00e9vr 2018."},{"key":"pone.0322670.ref014","unstructured":"https:\/\/www.unaids.org\/sites\/default\/files\/country\/documents\/GMB_2020_countryreport.pdf"},{"issue":"1","key":"pone.0322670.ref015","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1136\/sti.2010.042465","article-title":"Low seroprevalence of syphilis in Burkina Faso","volume":"87","author":"F Kirakoya-Samadoulougou","year":"2011","journal-title":"Sex Transm Infect"},{"issue":"2","key":"pone.0322670.ref016","doi-asserted-by":"crossref","first-page":"585","DOI":"10.4314\/ahs.v21i2.13","article-title":"Prevalence of sexually transmitted infections among pregnant women attending antenatal clinics in West Coast Region of The Gambia","volume":"21","author":"A Isara","year":"2021","journal-title":"Afr Health Sci"},{"issue":"11","key":"pone.0322670.ref017","doi-asserted-by":"crossref","first-page":"750","DOI":"10.2471\/BLT.18.208603","article-title":"Hepatitis B and C virus seroprevalence, Burkina Faso: a cross-sectional study","volume":"96","author":"N Meda","year":"2018","journal-title":"Bull World Health Organ"},{"key":"pone.0322670.ref018","doi-asserted-by":"crossref","first-page":"102401","DOI":"10.1016\/j.pmedr.2023.102401","article-title":"Prevalence of hepatitis B infection in the Gambian population: A narrative review of recent developments","volume":"36","author":"M Camara","year":"2023","journal-title":"Prev Med Rep"},{"key":"pone.0322670.ref019","article-title":"Residual Risk of Hepatitis B Virus Mother-to-Child Transmission and Gaps in Care Cascades Among Pregnant Women in the Gambia: The INFANT-B Study","author":"G Ndow","year":"2025","journal-title":"J Infect Dis"},{"key":"pone.0322670.ref020","unstructured":"Minist\u00e8re de la Sant\u00e9. Plan de la triple \u00e9limination de la transmission de la m\u00e8re \u00e0 l\u2019enfant du VIH, de la syphilis et de l\u2019h\u00e9patite B, 2021-2025. 2021."},{"key":"pone.0322670.ref021","first-page":"29","volume-title":"Regional Office for the Western Pacific. Regional framework for the triple elimination of mother-to-child transmission of HIV, hepatitis B and syphilis in Asia and the Pacific, 2018-2030 [Internet]","author":"World Health Organization","year":"2018"},{"key":"pone.0322670.ref022","unstructured":"Mitchell C, https:\/\/www.facebook.com\/pahowho. Pan American Health Organization\/ World Health Organization. 2017 [cit\u00e9 4 juill 2023]. PAHO\/WHO | PAHO Launches New Initiative to Eliminate Mother-to-Child Transmission of Four Diseases. Disponible sur: https:\/\/www3.paho.org\/hq\/index.php?option=com_content&view=article&id=13567:paho-launches-new-initiative-to-eliminate-mother-to-child-transmission-of-four-diseases&Itemid=0&lang=en#gsc.tab=0"},{"issue":"11","key":"pone.0322670.ref023","doi-asserted-by":"crossref","DOI":"10.1016\/S2214-109X(21)00304-1","article-title":"Arresting vertical transmission of hepatitis B virus (AVERT-HBV) in pregnant women and their neonates in the Democratic Republic of the Congo: a feasibility study","volume":"9","author":"P Thompson","year":"2021","journal-title":"Lancet Glob Health"},{"issue":"1","key":"pone.0322670.ref024","doi-asserted-by":"crossref","first-page":"60","DOI":"10.2471\/BLT.20.281311","article-title":"Prevention of mother-to-child transmission of hepatitis B virus in antenatal care and maternity services, Mozambique","volume":"100","author":"A Loarec","year":"2022","journal-title":"Bull World Health Organ"},{"issue":"1","key":"pone.0322670.ref025","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1186\/s12913-019-4416-3","article-title":"Prevention and care of hepatitis B in the rural region of Fatick in Senegal: a healthcare workers\u2019 perspective using a mixed methods approach","volume":"19","author":"T Djaogol","year":"2019","journal-title":"BMC Health Serv Res"},{"issue":"6","key":"pone.0322670.ref026","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1177\/17571774221127546","article-title":"Gender disparity and stigma experience of patients with chronic hepatitis B virus infection: A prospective cross-sectional study from a hospital in Nigeria","volume":"23","author":"O Adekanle","year":"2022","journal-title":"J Infect Prev"},{"key":"pone.0322670.ref027","doi-asserted-by":"crossref","first-page":"252","DOI":"10.11604\/pamj.2022.42.252.34577","article-title":"Knowledge and attitude of hepatitis B infection among patients with the infection in the main liver clinic in The Gambia","volume":"42","author":"L Jarju","year":"2022","journal-title":"Pan Afr Med J"},{"key":"pone.0322670.ref028","unstructured":"Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach [Internet]. [cit\u00e9 13 juin 2022]. Disponible sur: https:\/\/www.who.int\/publications\/i\/item\/9789240031593"},{"key":"pone.0322670.ref029"},{"key":"pone.0322670.ref030","unstructured":"The INFANT-B Study [Internet]. Prolifica. [cit\u00e9 14 sept 2022]. Disponible sur: https:\/\/www.prolifica.africa\/about-the-study\/hepatitis-b\/infant-b-study"},{"issue":"2","key":"pone.0322670.ref031","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1016\/j.jeconom.2007.02.002","article-title":"Inverse probability weighted estimation for general missing data problems","volume":"141","author":"JM Wooldridge","year":"2007","journal-title":"Journal of Econometrics"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0322670","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T18:22:12Z","timestamp":1770402132000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0322670"}},"subtitle":[],"editor":[{"given":"Angelica Espinosa","family":"Miranda","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,2,6]]},"references-count":31,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2,6]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0322670","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,6]]}}}