A review of national guidelines on preventing mother-to-child transmission of HIV, syphilis, and hepatitis B in the African region: testing practices for triple elimination

World Health Organization (WHO) updated guidelines for maternal HIV, syphilis and hepatitis B virus (HBV) testing for pregnant women. We reviewed national testing guidelines to assess alignment with WHO guidance and triple elimination of mother-to-child transmission (MTCT) priorities. We reviewed national HIV-related guidelines from 46 African countries after 2010, including guidelines on prevention of MTCT, HIV testing/self-testing, and HIV pre-exposure prophylaxis. Data was extracted on recommendations for maternal testing HIV (frequency and timing), syphilis (any test and test type); and HBV. Testing policies on HIV, syphilis, or HBV during pregnancy and/or postpartum from 38 (83%) countries were identified; 18 (47%) had policies updated after 2019. All 38 countries with HIV testing guidelines addressed maternal HIV retesting, 68% had guidelines recommending syphilis testing, and 58% had HBV testing guidelines. Half of countries had guidelines to test for all three infections; policy evaluations to measure implementation and impact are needed.