Pregnant Mothers recommended for  multiple tests to avoid mother-to-child HIV transmission

Amos Tayebwa

Mbarara

Specialists in HIV Health Care have recommended pregnant Mothers to undertake multiple tests for HIV status as one way of reducing chances of mother-to-child HIV transmission among children.

During recent the Health Journalists Network Uganda (HEJNU) media café to equip journalists on how best to report health stories at holy Innocents children’s hospital, Fredrick Kamugisha-Health educator Mbarara district, said that the journey of eliminating mother to child transmission (EMCT) begins with the mothers going for antenatal care.

He said that it is during antenatal care that the mother is taken through
the importance of breastfeeding and challenges likely to be faced thus
appealing to pregnant women to always go for early antenatal care to
protect their babies from HIV transmission.

“When a pregnant mother is examined and found positive, she is
initiated immediately to reduce the viral load of that mother to stop the
mother-child transmission” Kamugisha said.

He added that “At 6 weeks we do what we call early infant diagnosis
(PCR test) to ascertain whether a child is positive or negative.
Kamugisha said that the World health organisation (WHO)
Recommendation of HIV mothers avoiding breastfeeding the babies to
prevent them from acquiring the virus has been challenged by
socioeconomic status in Africa which poses a risk to the newborns.

“This is practical if there are affordable and feasible alternatives that
can feed that child but basing on our setting like Africa, Uganda in
particular it may not be possible” adding that, if they are not available
then we recommend breastfeeding” he said.

Kamugisha added that if the mother is not taking the drugs properly,
the viral load will be high and the virus will exist in the milk thus
encouraging institutional deliveries where medics educate the mothers
on EMCT.
“They need to understand that taking drugs consistently reduces risks
of children from acquiring HIV/AIDS.” He said

Dr. Mike Kyewalyanga, a Pediatrician at Holy Innocent Hospital Mbarara has revealed that a pregnant mother is supposed to test for HIV status for 8 times to easily detect the virus enabling those that  are found positive to start taking the drugs (ARVS).

He said that there are also drugs specifically for infants that prevent them from HIV transmission . “In early infant diagnosis for those below 18 months, we always want to eliminate all  the chances of    mother-to-child HIV transmission, we identify the best drug that can prevent the baby from HIV transmission.

According to Dr. Kyewalyanga, 5 percent of HIV can be transmitted through breastfeeding thus appealing to positive mothers to breastfeed for just
a year.

“After one year, the benefits of breast milk have reduced so we rather
stop the breastfeeding and minimise the risk of transmission than
keeping the baby on the breast with minimal benefits” Kyewalyanga
emphasised.

He said that mother to child transmission currently stands at 466 per
000s of HIV cases meaning that 466 children are at a risk of HIV
transmission out 100,000 live buts (mothers with HIV)
“The target as per world health organisation and UNICEF should be 50
mothers out of 100,000 to take us to the vision 95-95-95 to eliminate
HIV/AIDS by 2030” he said

According to the Ministry of health (MOH) report , before introduction of EMCT, the mother to child transmission used to be between 25-40
percent but with the ushering in of the programme, the HIV rate in
breastfeeding mothers went as low as below 5 percent and with non-
breastfeeding mothers as low as below 2 percent.

The HIV prevalence rate in Mbarara district is 4.1 percent and the
incidence rate is at 3 per a 000, meaning that out of 1000 people in the
district, three can acquire HIV, with a total of 7000 people HIV positive.

Catherine Ankunda, a mother and an HIV victim in Mbarara,
appreciated the government efforts to curb mother to child HIV/AIDS
transmission.

“If you go to the hospital they test and sensitise you on how you should
live. It is up to you as a parent to practise whatever they tell you to
protect your child from HIV transmission or not” Ankunda said
She said that being HIV positive is not the end of life, thus encouraging
people infected with the virus to routinely take their medication to
suppress the viral load.

“People should know their status and they should know that living with
HIV is not a crime. It is not the end of life because you can live like any
other person if you follow the given counselling and medication”
Ankunda said.

She also encouraged other people who are sick to open up to their
partners. “ I know it is hard but I opened up and I got a man who is
negative we produced a healthy baby, we are living happily a
discordancy life and my husband is very supportive so I advise HIV
positive mothers to follow the medics’ prescription so that we can
always produce healthy children” Ankunda explained.

However she challenged researchers to get advanced HIV treatment for
babies in the form of an injection rather than tablets that are
complicated to administer the babies at birth preventing them from HIV
transmission.

“The biggest challenge is administering the drug to the child, if it was an
injection at least there it would be easy for the children but sometimes
you give it to her, she vomits and you find she has not swallowed the
prescribed dose, it is a challenge that I have so far encountered
protecting my child from transmission” Ankunda emphasised

AIDS is a leading cause of death among young people aged 10-24 in
Africa and the second leading cause globally according to the World
Health Organisation [WHO]. It is estimated that the number of 10-24-
year-old Africans is set to rise more than 750 million by 2060 if HIV/AIDS prevention mechanisms are not taken seriously.

In Uganda, the HIV prevalence rate stands at 5.4 percent with females
contributing a greater percentage compared to males at 3.9 percent.
The highly affected districts include; Kalangala, Fort Portal, Mbarara,
Bushenyi among others.

The major drivers of HIV prevalence include; transactional sex practised
by commercial sex workers, alcohol influence, cultural practices,
poverty, myths, unsterilized equipment among other existing modes of
transmission.